BMC Psychiatry最新文献

Background: The ongoing conflict in Sudan leads to widespread displacement and increased mortality, significantly impacting the mental health of populations in conflict zones. This study aims to fill the gap and assess the level of stress, depression, and anxiety among Khartoum University undergraduate students in war-afflicted regions.

Methods: A cross-sectional study among 443 undergraduate students Was conducted using cluster and stratified sampling techniques. Data was collected using a valid questionnaire in a period of one month and analyzed using SPSS and a regression model to assess factors affecting distress.

Results: The study shows high levels of psychological distress, particularly among female students. Median anxiety and stress levels were 12.50 and 14.00, respectively, for women, significantly higher than those for men (p < 0.001). Faculty, physical health, time management, and support systems were also significantly correlated with distress levels. Students in the Faculty of Forests and Animal Breeding exhibited the highest levels of depression and anxiety. Poor physical health and seeking professional help were strongly associated with increased psychological distress. Regression analysis identified gender (p = 0.001) and time management (p = 0.022) as significant predictors of overall distress.

Conclusion: Undergraduate university students in war regions experience high levels of stress, anxiety, and depression due to conflict situations. These findings reflect the urgent need for interventions such as community-based programs and counselling. We recommended future studies to explore long-term impacts on students' mental health.

Background: Recent studies indicate that patients with first-episode drug-naïve (FEDN) and recurrent major depressive disorder (R-MDD) exhibit distinct atrophy patterns in the hippocampal subregions along the proximal-distal axis. However, it remains unclear whether such differences occur along the long axis and how they may relate to specific genes.

Methods: In the present study, we analyzed T1-weighted images from 421 patients (FEDN: n = 232; R-MDD: n = 189) and 544 normal controls (NC) as part of the REST-meta-MDD consortium. Additionally, transcriptome maps and structural Magnetic Resonance Imaging (MRI) data of six donated brains were obtained from the Allen Human Brain Atlas (AHBA). We first identified changes in gray matter volume (GMV) within the hippocampus of both FEDN and R-MDD patients and then integrated these findings with AHBA transcriptome data to investigate the genes associated with hippocampal GMV changes.

Results: Compared to NC, FEDN patients displayed reduced GMV in the left hippocampal tail, whereas R-MDD patients exhibited decreased GMV in the bilateral hippocampal body and increased GMV in the bilateral hippocampal tail. Further analysis revealed that expression levels of SYTL2 positively correlated with GMV changes in the hippocampus of FEDN patients, while SORCS3 and SLIT2 positively correlated with those in R-MDD.

Conclusions: Our results suggest that GMV alterations in hippocampal subfields along the long axis differ between FEDN and R-MDD, reflecting progressive hippocampal deterioration with prolonged depression, potentially supported by the expression of specific genes. These findings offer valuable insights into the distinct neural and genetic mechanisms underlying FEDN and R-MDD, which may aid in the development of more targeted and effective treatment strategies for MDD subtypes.

Background: Individuals experiencing serious mental illness (SMI) have higher rates of comorbid physical health conditions, poorer associated health outcomes, and die on average 10-20 years earlier than the general population. They encounter multiple barriers to accessing appropriate physical health care in many countries, including Canada, where policies and practices to promote integrated care delivery to this population remain scant. This qualitative study aimed to explore health provider perspectives and experiences with integrated physical and mental health care within mental health settings in Canada, in efforts to address the health needs of this population.

Methods: This qualitative descriptive study involved conducting individual semi-structured interviews with 13 health administrators and four focus groups with 15 clinicians between July 2023 and April 2024. The data analysis team, inclusive of individuals with SMI, used thematic analysis to identify overarching themes that capture participants' perspectives on and experiences with delivering integrated physical and mental health care within mental health settings in Canada, including their clinical practices and organizational contexts.

Results: We identified four themes in participant narratives: (1) the need for integrated care delivery within mental health settings; (2) organizational readiness for integrated care; (3) moving integration forward: addressing challenges; and (4) leveraging opportunities to advance integrated care. Both participant groups highlighted challenges with fragmented healthcare services, emphasized the urgent need for policies, practices and guidelines that support person-centered, comprehensive care within mental health settings, and called for engaging people with living/lived experience and family members in service redesign.

Conclusion: Findings underscore the importance of accelerating efforts to promote integrated health care delivery for adults with SMI within mental health settings, and of implementing policies that address health disparities for this population in the Canadian context.

Clinical trial number: Not Applicable.

Introduction: The integration of artificial intelligence in mental health care represents a transformative shift in the identification, treatment, and management of mental disorders. This systematic review explores the diverse applications of artificial intelligence, emphasizing both its benefits and associated challenges.

Methods: A comprehensive literature search was conducted across multiple databases based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, including ProQuest, PubMed, Scopus, and Persian databases, resulting in 2,638 initial records. After removing duplicates and applying strict selection criteria, 15 articles were included for analysis.

Results: The findings indicate that AI enhances early detection and intervention for mental health conditions. Various studies highlighted the effectiveness of AI-driven tools, such as chatbots and predictive modeling, in improving patient engagement and tailoring interventions. Notably, tools like the Wysa app demonstrated significant improvements in user-reported mental health symptoms. However, ethical considerations regarding data privacy and algorithm transparency emerged as critical challenges.

Discussion: While the reviewed studies indicate a generally positive trend in AI applications, some methodologies exhibited moderate quality, suggesting room for improvement. Involving stakeholders in the creation of AI technologies is essential for building trust and tackling ethical issues. Future studies should aim to enhance AI methods and investigate their applicability across various populations.

Conclusion: This review underscores the potential of AI to revolutionize mental health care through enhanced accessibility and personalized interventions. However, careful consideration of ethical implications and methodological rigor is essential to ensure the responsible deployment of AI technologies in this sensitive field.

The Gaza War has significantly escalated conflict and humanitarian crises in the Gaza Strip, causing profound human suffering and psychological impact. This study investigates the mental health of residents of Jordan, examining anxiety and depression levels, sociodemographic factors, and resilience mechanisms to understand the psychological resilience of communities facing conflict-related stressors. This cross-sectional study used a convenience sampling method to collect data from Jordanian residents over 18 years of age. An online questionnaire shared on social media platforms was used, the Patient Health Questionnaire-4 (PHQ-4) was used to measure anxiety and depression, the Perceived Stress Scale (PSS) 4-item questionnaire was used to measure perceived stress, and the Brief Resilience Scale was used to measure population resilience. A total of 1,664 participants were included in the study. The mean stress score was reported as 8.72 (SD +/-2.342). Stress, anxiety, and depression were significantly associated with age and sex, with younger populations and female participants reporting higher stress scores. Among the sample, 65.0% of individuals displayed both anxiety and depression indicators, with 25.9% exhibiting severe, 66.4% exhibiting moderate and 33.6% exhibiting mild level. A comprehensive, multi-institutional approach is needed to increase awareness and screening of mental health conditions.

Background: Internalizing problems, such as worrying, anxiety and low mood, are increasingly common in youth and may constitute an early stage of mental illness development. There is thus an urgent need for effective measures to address mental health complaints as they develop and to prevent progression into more serious mental illness. Enhanced understanding of early-stage mental illness development, associated cognitive and brain processes, and their amenability to early intervention is crucial to this effort. Mindfulness-based interventions offer an accessible intervention option with demonstrated positive effects on internalizing disorders such as depression. Furthermore, mindfulness-based interventions may modulate cognitive processes and brain activity patterns associated with internalizing disorders. This study aims to determine how early-stage mindfulness-based intervention impacts internalizing symptom development, associated cognitive and brain processes, and mental illness progression in help-seeking youth.

Methods: This longitudinal two-arm randomized controlled trial will be conducted in 155 help-seeking youth between 16 and 25 years of age. The investigational treatment, the Learning to Offset Stress program, is an adaptation of existing mindfulness-based programs. Developed for youth with internalizing problems, the training combines mindfulness exercises with mindful physical activity and yoga in 8 weekly 2-hour sessions. Participants are randomized to either Learning to Offset Stress program as an add on to care-as-usual, or care-as-usual-only. Assessments take place at baseline, end of treatment, and 2 months and 6 months after completion of treatment. The primary outcome is the level of internalizing problems measured with the internalizing subscale of the Adult Self Report questionnaire at end of treatment. Secondary outcomes include measures of self-compassion, rumination, experiential avoidance, and well-being. In addition, (functional) magnetic resonance imaging and computerized cognitive tasks are conducted at baseline and at end of treatment.

Discussion: The current randomized controlled trial aims to enhance our understanding of the trajectory of emerging mental illness, associated cognitive and brain processes, and their modulation by early-stage mindfulness-based intervention.

Trial registration: ClinicalTrials.gov NCT05916651. Registered on 23 June 2023.

Background: Children with mental health difficulties are at increased risk of many adverse psychological, academic, and social outcomes. Emotion regulation is a key transdiagnostic factor in the development and maintenance of mental health challenges. Parents and the family system (e.g., parental functioning, parenting, parent-child relationship) play a central role in children's development of emotion regulation and, in turn, their mental health. Therefore, continued efforts are needed to understand the effectiveness of emotion-focused treatments for child mental health difficulties, particularly those that include a family-based approach. Emotion Focused Family Therapy (EFFT) is an intervention for parents of children with mental health difficulties that teaches parents advanced skills to support their child's emotional development, potentially leading to improvements in the psychological functioning of the affected child as well as the family. Despite this, EFFT's efficacy has yet to be tested empirically via a randomized controlled trial.

Methods: A six-week group modality of EFFT was developed based on the standard manualized version of a two-day group modality of EFFT. Efficacy of the six-week group modality of EFFT will be tested in a randomized controlled trial among parents of children aged 7 to 15 with anxiety, depression, or behavioral challenges. Parents will be randomized to the intervention condition or waitlist control condition. Online questionnaires and in-lab assessments will be conducted at pre-treatment, post-treatment, 4-month follow-up and 1-year follow-up. Intervention effects on primary (parent psychological symptoms, child psychological symptoms, parent emotion regulation, child emotion regulation, parent-child co-regulation) and secondary (parental emotion socialization, parent emotion blocks, parental self-efficacy, perceived parental stress, treatment satisfaction, treatment fidelity) outcomes will be analyzed by linear mixed models.

Discussion: The study protocol describes the randomized controlled trial of EFFT, a parent group intervention for parents of children with anxiety, depression, and behavioral challenges. Findings contribute to the understanding of the efficacy of EFFT as a time-limited, transdiagnostic intervention for the treatment of child mental health challenges with potential positive impacts on parent and family functioning. TRIAL REGISTRATION [2A]: ClinicalTrials.gov: NCT05603000. Prospectively registered October 13, 2022. PROTOCOL VERSION [3]: Version 1.1 November 2023.

Objective: Previous research has indicated that patients with Anorexia Nervosa (AN) exhibit specific eye movement changes, identified through eye tracking sensor technology. These changes have been proposed as potential digital biomarkers and endophenotypes for early diagnosis and preventive clinical interventions. This study aims to explore whether these eye movement changes are also present in individuals with subclinical eating disorder (ED) symptomatology compared to control participants.

Method: The study recruited participants using convenience sampling and employed the Eating Disorder Examination Questionnaire for initial screening. The sample was subsequently divided into two groups: individuals exhibiting subclinical ED symptomatology and control participants. Both groups performed various tasks, including a fixation task, prosaccade/antisaccade task, and memory-guided task. Alongside these tasks, anxiety and premorbid intelligence were measured as potential confounding variables. The data were analyzed through means comparison and exploratory Pearson's correlations.

Results: No significant differences were found between the two groups in the three eye tracking tasks.

Discussion: The findings suggest that the observed changes in previous research might be more related to the clinical state of the illness rather than a putative trait. Implications for the applicability of eye movement changes as early biomarkers and endophenotypes for EDs in subclinical populations are discussed. Further research is needed to validate these findings and understand their implications for preventive diagnostics.

Registration: https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-022-00573-2.

Background: Given the accelerated aging population in China, the number of disabled elderly individuals is increasing, and depression is a common mental disorder among older adults. This study aims to establish an effective model for predicting depression risks among disabled elderly individuals.

Methods: The data for this study was obtained from the 2018 China Health and Retirement Longitudinal Study (CHARLS). In this study, disability was defined as a functional impairment in at least one activity of daily living (ADL) or instrumental activity of daily living (IADL). Depressive symptoms were assessed by using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D10). We employed SPSS 27.0 to select independent risk factor variables associated with depression among disabled elderly individuals. Subsequently, a predictive model for depression in this population was constructed using R 4.3.0. The model's discrimination, calibration, and clinical net benefits were assessed using receiver operating characteristic (ROC) curves, calibration plots, and decision curves.

Results: In this study, 3,107 elderly individuals aged 60 years and older with disabilities were included. Poor self-rated health, pain, absence of caregivers, cognitive impairment, and shorter sleep duration were identified as independent risk factors for depression in disabled elderly individuals. The XGBoost model demonstrated superior performance in the training set, while the logistic regression model outperformed it in the validation set, with AUCs of 0.76 and 0.73, respectively. The calibration curve and Brier score (Brier: 0.20) indicated a good model fit. Moreover, decision curve analysis confirmed the clinical utility of the model.

Conclusions: The predictive model exhibits outstanding predictive efficacy, greatly assisting healthcare professionals and family members in evaluating depression risks among disabled elderly individuals. Consequently, it enables the early identification of elderly individuals at high risk for depression.