The open psychiatry journal最新文献

英文中文

Adolescents in Primary Care with Sub-Threshold Depressed Mood Screened for Participation in a Depression Prevention Study: Co-Morbidity and Factors Associated with Depressive Symptoms~!2010-02-08~!2010-04-05~!2010-04-23~! 在初级保健机构接受亚阈值抑郁情绪筛查的青少年参与抑郁症预防研究:抑郁症状的共发病及相关因素2010-02-08 2010-04-05 2010-04-23

The open psychiatry journal

Pub Date : 2010-05-04 DOI: 10.2174/1874354401004010010

Benjamin W. Voorhees, S. Melkonian, Monika Marko, J. Humensky, J. Fogel

引用次数: 0

Anhedonia in Unipolar Major Depressive Disorder: A Review~!2009-10-26~!2010-02-18~!2010-04-08~! 单极重性抑郁障碍的快感缺乏研究进展2009-10-26 2010-02-18 2010-04-08

The open psychiatry journal

Pub Date : 2010-04-08 DOI: 10.2174/1874354401004010001

G. Dichter

Anhedonia, the decreased capacity to experience pleasure, is a defining symptom of unipolar major depressive disorder (MDD). This review summarizes definitions and measurement issues related to the assessment of hedonic capacity in MDD, epidemiological research addressing linkages between anhedonia and MDD, as well as biomedical research investigating the neurobiology of anhedonia in both pre-clinical and clinical contexts. A synthesis of available data is presented that suggests that anhedonia is a core symptom of MDD, the elucidation of which is critical for improved understanding, detection, and treatment of MDD.

快感缺乏，即体验快乐的能力下降，是单极重性抑郁症(MDD)的典型症状。本文综述了与重度抑郁症中享乐能力评估相关的定义和测量问题，研究享乐缺乏和重度抑郁症之间联系的流行病学研究，以及在临床前和临床背景下调查享乐缺乏神经生物学的生物医学研究。综合现有数据提出，快感缺乏是重度抑郁症的核心症状，阐明这一点对于提高对重度抑郁症的理解、检测和治疗至关重要。

引用次数: 58

Adolescents in Primary Care with Sub-Threshold Depressed Mood Screened for Participation in a Depression Prevention Study: Co-Morbidity and Factors Associated with Depressive Symptoms. 在初级保健中接受亚阈值抑郁情绪筛查的青少年参与抑郁症预防研究:与抑郁症状相关的共发病和因素

The open psychiatry journal

Pub Date : 2010-01-01 DOI: 10.2174/1874300501004010010

B. V. Van Voorhees, S. Melkonian, Monika Marko, J. Humensky, J. Fogel

PURPOSE Adolescents in primary care with sub-threshold depression symptoms may be candidates for early intervention to prevent onset of full major depressive disorder. Little is known about this population. METHOD We screened consecutive adolescents (ages 14-21) in 13 primary care sites for presence of depression symptoms for "at least a few days" or "nearly every day" in the last two weeks for possible enrollment in a primary care/Internet-based depression prevention intervention (CATCH-IT). We report illness severity, prevalence of self-harm ideation, prevalence correlates (automatic negative thoughts, generalized self-efficacy, perceived social support from family and friends) and co-occurring symptoms of other mental disorders with depressed mood. RESULTS Twenty-one percent (N=293) of those screened reported a core symptom of depressive disorder of which 83 enrolled in the study and were analyzed. The sample was 40% ethnic minority with a mean zip code household income of $40,249 (SD=$14,500). Reporting at least one symptom of another mental disorder was common for anxiety (48%, N=40), substance abuse (31%, N=15), conduct disorder (71%, N=53), as were self-harm ideation (16%, N=12) and reporting school impairment (100%, N=83). Prevalence correlates for current depressive symptoms included low self-efficacy, automatic negative thoughts, perceived low peer acceptance, and school impairment. CONCLUSIONS Adolescents with sub-threshold depressed mood have frequent co-morbid symptoms that may need to be considered in developing prevention interventions. Early intervention targets to reduce depressed mood include pessimistic thinking, low self-efficacy, low peer acceptance, and school impairment.

目的:在初级保健中有阈下抑郁症状的青少年可能是早期干预预防完全性重度抑郁障碍发病的候选者。人们对这个群体知之甚少。方法:我们在13个初级保健站点连续筛选14-21岁的青少年(14-21岁)，在过去两周内“至少几天”或“几乎每天”出现抑郁症状，以便可能纳入初级保健/基于互联网的抑郁预防干预(CATCH-IT)。我们报告了疾病的严重程度、自残想法的流行程度、相关因素的流行程度(自动消极思想、广义自我效能感、来自家人和朋友的感知社会支持)以及其他精神障碍与抑郁情绪的共存症状。结果被筛选者中有21% (N=293)报告了抑郁症的核心症状，其中83人入选研究并进行了分析。样本中40%是少数民族，邮政编码家庭平均收入为40,249美元(标准差= 14,500美元)。焦虑(48%，N=40)、药物滥用(31%，N=15)、行为障碍(71%，N=53)、自残意念(16%，N=12)和报告学业障碍(100%，N=83)中至少报告一种其他精神障碍的症状是常见的。与当前抑郁症状相关的患病率包括低自我效能感、自动消极思想、感知低同伴接受度和学业障碍。结论阈下抑郁情绪青少年有常见的合并症，需要在制定预防干预措施时加以考虑。减少抑郁情绪的早期干预目标包括悲观思维、低自我效能、低同伴接纳和学业障碍。

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引用次数: 13

Adolescents in Primary Care with Sub-Threshold Depressed Mood Screened for Participation in a Depression Prevention Study: Co-Morbidity and Factors Associated with Depressive Symptoms. 在初级保健中接受亚阈值抑郁情绪筛查的青少年参与抑郁症预防研究:与抑郁症状相关的共发病和因素

The open psychiatry journal

Pub Date : 2010-01-01

Benjamin W Van Voorhees, Stephanie Melkonian, Monika Marko, Jennifer Humensky, Joshua Fogel

Purpose: Adolescents in primary care with sub-threshold depression symptoms may be candidates for early intervention to prevent onset of full major depressive disorder. Little is known about this population.

Method: We screened consecutive adolescents (ages 14-21) in 13 primary care sites for presence of depression symptoms for "at least a few days" or "nearly every day" in the last two weeks for possible enrollment in a primary care/Internet-based depression prevention intervention (CATCH-IT). We report illness severity, prevalence of self-harm ideation, prevalence correlates (automatic negative thoughts, generalized self-efficacy, perceived social support from family and friends) and co-occurring symptoms of other mental disorders with depressed mood.

Results: Twenty-one percent (N=293) of those screened reported a core symptom of depressive disorder of which 83 enrolled in the study and were analyzed. The sample was 40% ethnic minority with a mean zip code household income of $40,249 (SD=$14,500). Reporting at least one symptom of another mental disorder was common for anxiety (48%, N=40), substance abuse (31%, N=15), conduct disorder (71%, N=53), as were self-harm ideation (16%, N=12) and reporting school impairment (100%, N=83). Prevalence correlates for current depressive symptoms included low self-efficacy, automatic negative thoughts, perceived low peer acceptance, and school impairment.

Conclusions: Adolescents with sub-threshold depressed mood have frequent co-morbid symptoms that may need to be considered in developing prevention interventions. Early intervention targets to reduce depressed mood include pessimistic thinking, low self-efficacy, low peer acceptance, and school impairment.

目的:初级保健中有阈下抑郁症状的青少年可能是早期干预以预防完全性重度抑郁症发作的候选者。人们对这个群体知之甚少。方法:我们在13个初级保健站点连续筛选青少年(14-21岁)，在过去两周内“至少几天”或“几乎每天”出现抑郁症状，以便可能参加初级保健/基于互联网的抑郁预防干预(CATCH-IT)。我们报告了疾病的严重程度、自残想法的流行程度、相关因素的流行程度(自动消极思想、广义自我效能感、来自家人和朋友的感知社会支持)以及其他精神障碍与抑郁情绪的共存症状。结果:21% (N=293)的筛选者报告了抑郁症的核心症状，其中83人参加了研究并进行了分析。样本中40%是少数民族，邮政编码家庭平均收入为40,249美元(标准差= 14,500美元)。焦虑(48%，N=40)、药物滥用(31%，N=15)、行为障碍(71%，N=53)、自残意念(16%，N=12)和报告学业障碍(100%，N=83)中至少报告一种其他精神障碍的症状是常见的。与当前抑郁症状相关的患病率包括低自我效能感、自动消极思想、感知低同伴接受度和学业障碍。结论:阈下抑郁情绪的青少年有常见的共病症状，可能需要在制定预防干预措施时加以考虑。减少抑郁情绪的早期干预目标包括悲观思维、低自我效能、低同伴接纳和学业障碍。

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引用次数: 0

Predictors of Patient Satisfaction with the Feedback After aNeuropsychological Assessment 神经心理评估后患者满意度反馈的预测因素

The open psychiatry journal

Pub Date : 2009-08-20 DOI: 10.2174/1874354400903010050

Ylva Holst, H. Nyman, J. Larsson

An increasing number of adults in general psychiatry are referred for assessment regarding Attention- Deficit/Hyperactivity Disorders (ADHD) and Autism Spectrum Disorders (ASD). The aim of this study was to investigate patients' recollections of satisfaction with the feedback after a neuropsychological assessment, measured by the Assessment Questionnaire (AQ). The results showed that the patients generally had a low level of satisfaction with this feedback, and a low level of satisfaction was especially related to low self-esteem. The results indicate a need for more empirical studies of how assessments should be designed in order to increase satisfaction.

越来越多的成年人在普通精神科接受关于注意力缺陷/多动障碍(ADHD)和自闭症谱系障碍(ASD)的评估。本研究的目的是调查患者在神经心理评估后对反馈满意度的回忆，评估问卷(AQ)测量。结果表明，患者对这种反馈的满意度普遍较低，且满意度低与低自尊的关系尤为密切。结果表明，需要更多的实证研究，评估应如何设计，以提高满意度。

引用次数: 8

Premenstrual Syndrome and Premenstrual Dysphoric Disorder: Symptoms and Cluster Influences 经前综合征和经前烦躁障碍:症状和群集影响

The open psychiatry journal

Pub Date : 2009-08-04 DOI: 10.2174/1874354400903010039

F. Pérez-López, P. Chedraui, G. Pérez-Roncero, M. T. López-Baena, J. L. Cuadros-López

Many women in their reproductive years experience some mood, behavioral, or physical symptoms in the week prior to menses. Women experiencing mild symptoms may have a wide variability in the level of symptom burden, whereas a minority suffers severe and debilitating symptoms. Severe premenstrual syndrome (PMS) affects 3% to 5% of women of reproductive age and has been classified under the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) as premenstrual dysphoric disorder (PMDD). Both disorders are characterized mainly by symptoms confined to the premenstrual period, which reduce not only patients' quality of life, but also their working activities. Women suffering PMDD experience severe dysphoric mood, and a greater desire and actual intake of certain foods, demonstrating impaired cognitive performance during the luteal phase. Several theories have been proposed to explain the underlying mechanisms of PMS and PMDD with complex bio-psycho-social factors involved. Although precise causes are unknown, the late luteal phase could be associated with diverse psychosomatic and behavioral symptoms appearing premenstrually which should be appropriately treated. Notwithstanding this high prevalence, no specific symptoms or signs appear, nor have any recognizable anatomical factors been identified in women suffering PMS or PMDD, and hence, no universal treatment yet exists. Despite this, therapeutic progress has been reached, although the ideal treatment has not yet been obtained due to the many clusters involved.

许多处于生育年龄的女性在月经前一周会经历一些情绪、行为或身体上的症状。出现轻微症状的妇女在症状负担水平上可能有很大差异，而少数妇女则出现严重和使人衰弱的症状。严重经前综合症(PMS)影响3%至5%的育龄妇女，根据《精神疾病诊断和统计手册》(DSM IV)，它被归类为经前焦虑症(PMDD)。这两种疾病的主要特征是症状局限于经前期，这不仅降低了患者的生活质量，而且降低了他们的工作活动。患有经前不悦症的女性会经历严重的烦躁情绪，对某些食物的欲望和实际摄入量更大，在黄体期表现出认知能力受损。人们提出了几种理论来解释经前症候群和经前不悦症的潜在机制，其中涉及复杂的生物、心理和社会因素。虽然确切的原因尚不清楚，但黄体期晚期可能与经前出现的各种心身和行为症状有关，应适当治疗。尽管发病率很高，但在患有经前症候群或经前不悦症的妇女身上没有出现具体的症状或体征，也没有发现任何可识别的解剖学因素，因此，目前还没有普遍的治疗方法。尽管如此，治疗已经取得了进展，尽管由于涉及许多簇，尚未获得理想的治疗方法。

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引用次数: 26

Depression Across the Species 物种间的抑郁症

The open psychiatry journal

Pub Date : 2009-06-18 DOI: 10.2174/1874354400903010033

Á. Dias, Ana Karina Santos, Margareth Yuri Takeuchi, C. H. Adania

Backgrounds: this article has two close related goals. First it reviews the current literature on animal models of depression, using data mining techniques. Second it discusses whether it is feasible or not to extend the concept of depression to non-humans. Results: the use of animal models of depression increased dramatically over the last years, in association with the development of new drugs and genetic studies. On the other hand, the possibility to assume a strong correlation between human depression and low mood in other mammals remains unfeasible. Human depression represents a 'reaching-point', both at the organic and the phenomenological levels; nosographically, it can be asserted only within the horizon of possibilities represented by alternative disorders with which it shares common features.

背景:本文有两个密切相关的目标。首先，它回顾了目前使用数据挖掘技术的抑郁症动物模型的文献。其次，它讨论了将抑郁症的概念扩展到非人类是否可行。结果:在过去几年中，随着新药和基因研究的发展，抑郁症动物模型的使用急剧增加。另一方面，假设人类抑郁和其他哺乳动物情绪低落之间存在强烈关联的可能性仍然是不可行的。人类抑郁代表了一个“到达点”，无论是在有机层面还是在现象学层面;从病源学上讲，它只能在具有共同特征的其他疾病所代表的可能性范围内断言。

引用次数: 3

Bayesian Monitoring and Bootstrap Trial Simulation: A New Paradigm to Implement Adaptive Trial Design for Testing Antidepressant Drugs 贝叶斯监测和自举试验模拟:抗抑郁药物自适应试验设计的新范式

The open psychiatry journal

Pub Date : 2009-06-02 DOI: 10.2174/1874354400903000020

E. Merlo-Pich, P. Bettica, R. Gomeni

A novel methodology is proposed for continuous monitoring of efficacy data in ongoing antidepressant clinical trials and for decision making to support progression or discontinuation of the trial or one of the treatment arms. The Posterior Probability of Superiority (PPS) resulting from the application of Monte Carlo Markov Chain approach to a longitudinal model describing the time course of placebo and antidepressant drugs was used to estimate criteria to discontinue a treatment arm or the trial for futility, and to predict the treatment effect at study-end while the trial was still ongoing. The decision to stop the study was based on PPS, Predictive Power and on risk analysis based on a non-parametric bootstrap trial simulation. The performance of the Bayesian monitoring was evaluated by the retrospective analysis of 3 clinical trials. The Bootstrap-based methodology was compared to the Conditional Power and the Predictive Probability approaches. The application of the proposed methodology showed the possibility to stop a trial for futility when about 50% of total information was available and to detect signal of a treatment effect when limited information (<40%) was available. The comparisons with the Condition Power and the Predictive Probability approaches indicated that the Bayesian Bootstrap method, based on data-driven assumptions for priors, provided a better control for the risk of inappropriate decisions. The results suggest that the proposed methodology to monitor the accumulating information and to provide a scenario- based risk analysis could constitute a valuable approach to re-engineer the development process of novel drugs.

提出了一种新的方法，用于持续监测正在进行的抗抑郁药物临床试验的疗效数据，并用于支持试验进展或停止试验或其中一个治疗组的决策。通过蒙特卡洛马尔可夫链方法对描述安慰剂和抗抑郁药物时间过程的纵向模型的应用产生的后验优势概率(PPS)用于估计因无效而停止治疗组或试验的标准，并在试验仍在进行时预测研究结束时的治疗效果。停止研究的决定是基于PPS、Predictive Power和基于非参数自举试验模拟的风险分析。通过3项临床试验的回顾性分析，评价贝叶斯监测的效果。将基于bootstrap的方法与条件功率法和预测概率法进行了比较。所提出方法的应用表明，当总信息的50%可用时，有可能因无效而停止试验，当有限信息(<40%)可用时，有可能检测到治疗效果的信号。与条件功率和预测概率方法的比较表明，基于数据驱动的先验假设的贝叶斯Bootstrap方法可以更好地控制不适当决策的风险。结果表明，所提出的监测累积信息和提供基于情景的风险分析的方法可能构成一种有价值的方法来重新设计新药的开发过程。

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引用次数: 5

Does Assertive Community Treatment Work with Forensic Populations? Review and Recommendations 自信的社区治疗对法医群体有效吗?检讨及建议

The open psychiatry journal

Pub Date : 2009-05-05 DOI: 10.2174/1874354400903010013

J. Jennings

Several variations of the Assertive Community Treatment model have been tried with forensic and offender populations, including Forensic Assertive Community Treatment (FACT), Forensic Intensive Case Management (FICM) and Integrated Dual Diagnosis Treatment (IDDT). Based on a comprehensive review of multiple reviews and research studies, it appears that the field is converging on the conclusion that ACT may have a positive impact on mental health for forensic patients, but that it is probably ineffective or minimally effective in reducing criminal recidivism. The author argues that emerging research from the "forensic continuum of care model" and correctional re-entry treatment programs suggests that the community aftercare component is vital with offending populations and that aftercare programs like ACT can be enhanced by a "pre-treatment" residential treatment precursor. Specifically, the provision of enriched or extended residential treatment - in which forensic patients have adequate time to learn, practice and master life management skills - can maximize the effectiveness of follow-up ACT. Most FACT and FICM approaches have lacked this "continuum" feature.

在法医和罪犯群体中，已经尝试了几种自信社区治疗模式的变体，包括法医自信社区治疗(FACT)、法医强化病例管理(FICM)和综合双重诊断治疗(IDDT)。根据对多项审查和研究的综合审查，该领域似乎正在达成这样的结论，即ACT可能对法医病人的精神健康产生积极影响，但在减少犯罪累犯方面可能无效或收效甚微。作者认为，来自“法医连续护理模式”和惩教再入治疗项目的新兴研究表明，社区善后护理对犯罪人群至关重要，而像ACT这样的善后护理项目可以通过“治疗前”的住院治疗前兆来加强。具体而言，提供丰富或延长的住院治疗——让法医病人有足够的时间学习、实践和掌握生活管理技能——可以最大限度地提高后续ACT的有效性。大多数FACT和FICM方法都缺乏这种“连续”特性。

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引用次数: 15

Suicidal Behavior and the Serotonin Transporter Gene Polymorphism (5-HTTLPR) with Novel Subtypes, in Danish Schizophrenic Patients 丹麦精神分裂症患者自杀行为和5-羟色胺转运蛋白基因多态性(5-HTTLPR)的新亚型

The open psychiatry journal

Pub Date : 2009-04-20 DOI: 10.2174/1874354400903010009

August G. Wang, H. Rasmussen, H. Sørensen, Marianne Hvid, Claus Breddam, B. Hansen, V. Bille, O. Garsdal, A. Jacoby, K. Søeby, H. Dam, L. Krogsbøll, S. Timm, T. Werge

Background: Literature reports a genetic component for suicidal behavior, especially of determinant/violent type. One of the candidates has been the polymorphism 5-HTTLPR in the serotonin promoter. Employing a between group design, we wished to test the association between suicidal behavior and serotonin-related polymorphisms. Method: 350 Danish patients with average 14 years' duration of illness and with well researched history of suicidal behavior participated. Three groups were identified: 1. without suicidal behavior, 2. with suicidal behavior of non- determinant/non-violent methods, and 3. suicidal behavior with determinant/violent methods. We used the common alleles S and L as well as the new aspect with allelic subtypes SA, SG, LA.LG to constitute 3 functional genotypes: SS, SL and LL. We also included duration of illness, age at onset and sex in our study as potential covariates. Results: We tested suicidal behavior types 2 and 3 versus type 1 for distribution differences as well as for possible trend. We did not find any statistical significant relations. Conclusions: We could not find support for a relevant relation between the polymorphisms in the serotonin promoter and suicidal behavior in our schizophrenic patient sample.

背景:文献报道了自杀行为的遗传因素，尤其是决定性/暴力类型。其中一个候选是5-HTTLPR在5-羟色胺启动子中的多态性。采用组间设计，我们希望测试自杀行为和血清素相关多态性之间的关系。方法:对350例平均病程14年且有自杀行为史的丹麦患者进行研究。分为三组:1.;2.没有自杀行为;2 .用非决定性/非暴力的方法自杀行为;具有决定性/暴力方法的自杀行为。我们利用了常见的等位基因S和L，以及带有SA、SG、LA等位基因亚型的新性状。LG构成3个功能基因型:SS、SL和LL。我们还将病程、发病年龄和性别作为潜在的协变量纳入研究。结果:我们测试了自杀行为类型2和3与类型1的分布差异以及可能的趋势。我们没有发现任何有统计学意义的关系。结论:在我们的精神分裂症患者样本中，我们无法找到支持血清素启动子多态性与自杀行为之间相关关系的证据。

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引用次数: 3

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