BMC Psychiatry最新文献

Background: Major depressive disorder (MDD) and schizophrenia (SCH) are common and severe mental disorders that are mainly diagnosed depending on the subjective identification by psychiatrists. Finding potential objective biomarkers that can distinguish these two diseases is still meaningful.

Methods: In the present study, we investigate the differences in plasma inflammatory cytokines and short-chain fatty acids (SCFAs) among patients with MDD (n = 24) and SCH (n = 24), and gender- and age-matched healthy controls (HC, n = 27) and identify potential plasma biomarkers.

Results: We found that the concentrations of pro-inflammatory cytokines were increased, whereas the anti-inflammatory cytokines were decreased in both MDD and SCH. Meanwhile, except for an increase in 4-Methylvaleric acid, other SCFAs with statistical differences were reduced in both MDD and SCH. Moreover, potential biomarker panels were developed that can effectively discriminate MDD from HC (AUC = 0.997), SCH from HC (AUC = 0.999), and from each other (MDD from SCH, AUC = 0.983).

Conclusions: These data suggest that alterations in plasma cytokines and SCFAs might be one of the potential features for distinguishing MDD and SCH.

Trial registration: Chinese Clinical Trial Registry: ChiCTR2100051243, registration date: 2021/09/16.

Background: Depression is a major contributor to the global burden of diseases, and alcohol intake is often considered to be associated with depression. However, the relationship between alcohol drinking frequency and depression remains unclear. This study aims to explore the association between alcohol drinking frequency and depression.

Methods: This study collected NHANES data from 2009 to 2016, involving 17,466 participants. Depression was diagnosed based on the Patient Health Questionnaire-9 (PHQ-9), and alcohol drinking frequency was collected through questionnaire surveys. Multifactorial logistic regression models, subgroup analysis, smooth curve fitting, and threshold effect analysis were used to investigate the relationship between alcohol drinking frequency and depression.

Results: We divided the alcohol drinking frequency into five groups on average. After adjusting for all covariates, the Q3 group had the lowest odds of depression (OR = 0.68; 95% CI: 0.56 ~ 0.82; p < 0.05). Through smooth curve fitting, we found an "M-shaped" relationship between alcohol drinking frequency and depression. Further threshold effect analysis revealed that the most significant inflection points were 80 and 150.

Conclusion: In this cross-sectional study of American adults, we found an "M-shaped" relationship between alcohol drinking frequency and depression, which may partially explain the different effects of moderate alcohol consumption on depression.

Background and objectives: The adverse impacts of climate change on mental health is a burgeoning area, although findings are inconsistent. The emerging concept of eco-anxiety represents distress in relation to climate change and may be related to mental health. The aim of this study was to explore the relationship between eco-anxiety with validated mental health outcomes, specifically psychological distress and symptoms of major affective disorders.

Design: Systematic review.

Methods: EBSCO, ProQuest, and Web of Science databases were searched to February 2024 for studies of adult samples quantifying eco-anxiety (exposure, i.e. fear, worry or anxiety in relation to climate change) and symptoms of psychological distress and major affective disorders (outcomes), as assessed by validated measures.

Results: Full text review of 83 studies was performed, and k = 35 studies were included in the review (N = 45 667, 61% female, M_age 31.2 years). Consistently, eco-anxiety showed small to large positive correlations with mental health outcomes of psychological distress, depression symptoms, anxiety symptoms, and stress symptoms. However, results regarding post-traumatic stress disorder symptoms and pathological worry were mixed. Stronger associations were observed where eco-anxiety was operationalised as 'anxiety' rather than 'worry'.

Conclusions: Findings underscore that eco-anxiety is related to psychological burden. Greater consideration of eco-anxiety in assessment and treatment is needed in clinical practice and further policy development is warranted at the intersection of climate and health to address the mental health challenges posed by climate change.

Background: How cognition is influenced by electroconvulsive treatment (ECT) and major depressive disorder (MDD) is still debated. The development and etiology of neurocognitive impairment in MDD were examined by investigating the cognitive profile following ECT related to the state, scar, and trait perspectives, with the former predicting improvements parallel with depressive symptoms, while the two latter expected persisting impairments. Executive functions (EF) and attention are central to cognition and alterations in these functions could influence other domains like memory. The main aims of the present study were to examine the short and long-term effects of ECT on EF and attention in patients with major depressive disorder by exploiting the rapid antidepressant effect of this treatment.

Methods: A case-control longitudinal follow-up design was used to investigate the effects of unilateral brief-pulse ECT on EF and attention in patients with depression (n = 36) compared to untreated healthy controls (n = 16). EF and attention were measured pre-treatment, approximately two weeks, and six months post-treatment.

Results: The patient group showed significantly worse performance on most tests compared to healthy controls pre-treatment, and no short- or long-term worsening of EF and attention following ECT was found. Significant improvement was identified in patients' attention, processing speed and inhibition after ECT.

Conclusions: The present study showed that there was no cognitive worsening after ECT treatment. An improvement in several of the tests measuring inhibition, attention, and processing speed was parallel to symptom reduction, with the former showing associations to symptom change, suggesting state-related effects from improved mood. Still, the patient group performed significantly worse on most measures both pre-treatment and at the short and long-term follow-ups, indicating prevailing trait or scar effects on cognitive functions and potential lack of practice effects.

Clinical trial number: NCT04348825 (14.04.20).

Background: The relationship between public health emergencies and psychological distress had been well known, yet none research had been conducted on the trend in psychological resilience and its longitudinal determinants during the pandemic. This study aimed to explore the changes of psychological resilience of university students during COVID-19 pandemic, and further clarify the longitudinal relationship between family factors, mental health, social mentality and psychological resilience.

Methods: Questionnaires were distributed to students from five universities in Shandong Province, China during the COVID-19. A total of 1635 students were finally included in this three-wave follow-up study using stratified random sampling method. Mental health was assessed by Depression Anxiety Stress Scale, social mentality was measured by the Bi-Dimensional Structure Questionnaire of Social Mentality, psychological resilience was evaluated by the Chinese version of the Psychological Resilience Scale. Repeated-measures analysis of variance was used to analyze the longitudinal changes of psychological resilience, generalized estimating equation (GEE) was conducted to estimate the determinants of psychological resilience.

Results: Psychological resilience changed from 28.37 in Wave 1, 29.10 in Wave 2, and 29.15 in Wave 3 among the university students. The students who majored in Art (β = 0.872, P = 0.032), parents (mother β = 0.546, P = 0.035; father β = 0.718, P = 0.012) had a greater influence on children's personality, and positive social mentality (β = 5.725, P < 0.001) were more likely to report a higher psychological resilience. Being female (β=-0.932, P < 0.001), not being a student leader (β=-0.911, P < 0.001), being anxious (β=-1.845, P < 0.001) and depressed (β=-1.846, P < 0.001), and negative social mentality (β=-0.803, P < 0.001) were less likely to report a higher psychological resilience.

Conclusions: The psychological resilience of the university students in Shandong Province, China increased significantly from Wave 1 to Wave 3 during the COVID-19 pandemic. Majoring in Art, parents having a greater influence on children's personality, better mental health, positive social mentality were more likely to report a higher psychological resilience, while female, not student leader, worse mental health, and negative social mentality were less likely to report a higher the psychological resilience.

Background: Technology-enabled services (TES; clinical services that include both technology-driven [e.g., personal sensing technologies] and person-powered support elements) may address gaps in depression and anxiety treatments in healthcare settings. The current study: (1) developed a TES tailored for Primary Care patients with depression and/or anxiety, and (2) conducted a pilot randomized controlled trial to assess the efficacy of the TES compared to a digital psychoeducation control app.

Methods: Participants were randomized to either: (1) TES: the "Vira" smartphone app (Ksana Health Inc.), informed by behavioral activation and using passive sensing technology to provide behavioral "insights" and target behaviors associated with mental health symptoms, alongside lay-provider coaching, or (2) Control: the Mood Education mobile app (ME), containing static psychoeducational resources designed to target mental health symptoms. Both apps collected usage data. Participants completed assessments on depression (PHQ-9), anxiety (GAD-7), health-related quality of life (PedsQL), and engagement (TWEETs) at baseline, mid-treatment (week 4), end-of-treatment (week 8), and post-treatment (week 12).

Results: Participants (N = 130) were randomized to receive either the TES (Vira; M_age= 30) or ME (M_age= 33). Linear mixed-effects models determined significant improvements in PHQ-9 and GAD-7 scores for participants across both conditions (ps < 0.001). There was no interactive effect of intervention and time for the PHQ-9 (p = .90) nor the GAD-7 (p = .49). Adjusting for baseline differences and randomization strata, TES participants reported a greater change in a quality of life rating of Physical Functioning (PedsQL) across time (p = .018). TES participants also reported higher levels of engagement and demonstrated higher app usage. However, adjusting for baseline symptom severity, neither app usage nor coach interaction frequency moderated outcomes (ps ≥ 0.2).

Conclusions: While the TES demonstrated superior engagement, improvements in depressive and anxious symptoms for both conditions speak to the potential benefit of both TES and low-intensity psychoeducation treatments in care settings. Future research is needed to better understand which patients might differentially benefit from TESs and broader personal sensing technologies over low-intensity treatments.

Trial registration: ClinicalTrials.gov NCT05406791.

Background: Consensus on what outcomes should be included in trials of psychological therapies on acute psychiatric inpatient wards is currently lacking. Inclusion of different viewpoints, including service user perspectives, is crucial in ensuring that future trials measure outcomes which are meaningful and important. Development of a Core Outcome Set (COS), a minimum standardised set of outcomes to be measured and reported, would help improve synthesis and interpretation of clinical trial data in this area.

Methods: Stage 1 of the COS development involved compiling a comprehensive long-list of outcomes from key sources including i) a systematic review of outcomes from published trials, ii) online survey of key stakeholders (service users, carers, healthcare professionals, researchers, and end users of research), iii) qualitative interviews with service users and carers. Stage 2 involved stakeholder groups short-listing the outcomes using consensus methods (e-Delphi survey). The final outcome set was derived from the short-list at a consensus meeting of stakeholders, facilitated by an Independent Chair.

Results: A long-list of 68 outcomes was compiled from the systematic review (n = 30 trials), online stakeholder survey (n = 100 participants) and qualitative interviews (n = 15 participants). Fifty stakeholders took part in the e-Delphi study, where the long-list was cut down to a short-list of 12 outcomes over 2 rounds. Nine stakeholders took part in the final consensus meeting, and after some outcomes were removed and/or amalgamated, a final set of 6 outcomes was recommended for inclusion in the COS. These were Ability to Cope, Hopefulness, Quality of Life, Psychosis Symptoms, Mood, and Self-Harm Behaviours.

Conclusions: Widespread future adoption of the COS will reduce research waste by ensuring that outcomes are more easily comparable across trials, and that the full range of stakeholder priorities are represented in trial outcomes. This makes it more likely that effective therapies will be identified in a timely fashion and successfully implemented in routine clinical practice. The final 6-outcome COS should be feasible to implement given the need keep participant burden to a minimum in inpatient trials. Further work is needed to make recommendations for the best outcome measurement instruments to use, including the use of patient-reported outcomes alongside clinician-rated measures.

Trial registration: Not applicable.

Background: Collaborative care relationships form a key component of recovery-oriented mental healthcare, but can be disrupted if service users feel judged by professionals. Professionals can express stigmatizing attitudes through microaggressions, i.e. subtle forms of discrimination that have a negative cumulative effect. People with psychosis have been found to regularly experience overt and subtle forms of stigma in mental healthcare. This study aims to expand our understanding of the various forms and consequences of microaggression from a service user perspective.

Methods: In this qualitative study, we analysed narratives of people with psychosis purposefully selected from two collections of Dutch patient-authored stories ('Verhalenbank psychiatrie' and 'Patientervaringsverhalen'), including two books and nine transcripts of low-structured interviews. We performed thematic analysis to identify different forms of microaggression and additionally used narrative analysis to gain insight into the experienced consequences for recovery.

Results: We identified three main forms of microaggression: microaggressions that dehumanize; microaggressions that disregard service users' perspectives; and microaggressions that convey hopelessness. Experienced consequences of microaggression included feelings of loneliness, powerlessness and uselessness, acts of despair, resistance or withdrawal, and disengagement from services. Microaggressions were found to create additional recovery needs that were often addressed outside mental healthcare.

Conclusion: Our findings illustrate the gap between ideals concerning collaborative care relationships and the everyday experiences of service users. Service users often experienced an absence of relationship-building in mental healthcare, with negative consequences for their recovery process. Our identification of different forms of microaggression can raise awareness and effectuate behavioural change in professionals and contribute to the emancipation of people with psychosis.

Background: Global mental health has been threatened by the COVID-19 pandemic, both directly through long-lasting neuropsychiatric disorders that occur during primary infection in affected individuals and indirectly through stressful and disruptive societal changes. Thus, this study determined the pooled prevalence of common mental disorders and associated factors among adults after COVID-19 pandemic in Ethiopia.

Methods: This systematic review and meta-analysis were conducted using primary published and unpublished studies that were retrieved from various databases. Studies conducted on adults, published in English, and conducted in Ethiopia were included in this review. A standardized data extraction format developed from Excel was used to collect the data. A random effect meta-analysis model was used to estimate the pooled effect size of all included studies at a 95% confidence interval. The heterogeneity was evaluated by Cochran Q test and the I-squared. Funnel plot and egger tests were used to determine publication bias.

Results: A total of 20 studies were eligible for this systematic review. The pooled prevalence of common mental disorders among adults was 40.44% (95%CI: 31.86-49.02%). Female gender (AOR = 1.88, 95% CI: 1.33-2.44), unemployed (AOR = 2.05, 95% CI: 1.12-2.98), poor social support (AOR = 3.12, 95% CI: 2.08-4.17), substance use (AOR = 2.5, 95% CI: 1.58-3.41), history of mental illness (AOR = 1.73, 95% CI: 1.01-2.44), family history of mental illness (AOR = 2.47, 95% CI: 1.54-3.41), and chronic medical illness (AOR = 1.6, 95%CI:1.02-2.17) were risk factors for common mental disorders.

Conclusion: In this study, more than one-third of adults were affected by common mental disorders after the onset of the COVID-19 pandemic. This indicated that, in order to reduce the prevalence of common mental disorders, enhancing the provision of mental health services should be improved after the COVID-19 pandemic. Screening for common mental disorders should be given, especially to females, unemployed people, substance users, chronic medically ill people, those with a history of mental illnesses, and those with a family history of mental illness. Strengthening social support during the COVID-19 pandemic is also important.

Prospero protocol registration: The registration ID for this systematic review is CRD42024496826.

Background: Ethiopian migrants to the Middle East and South Africa are exposed to dangerous traveling and working conditions and their experiences are mostly tragic. They are unwelcomed not only by the situation in the destination but also by the community at home which is an important indicator of stigma and discrimination. However, there is lack of evidence on how psychological distress is associated with migration experiences, stigma and coping strategies. Therefore, it was aimed to determine the mediating effect of psychological distress in the association between migration experiences and stigma and discrimination and coping strategies.

Methods: A total of 739 Ethiopian migrant returnees from the Middle East and South Africa were included in the study. A cross-sectional study was conducted in five migration hotspot areas in Ethiopia, namely Addis Ababa, Dessie, Shashemene, Hossana, and Gondar. Data related to socio-demographic, economic, migration experiences, psychological distress, coping strategies, and stigma and discrimination were collected. Psychological distress was measured using the 21- item version of the Depression, Anxiety and Stress Scale and coping strategies were measured with the Brief-COPE. Structural equation modeling was employed to estimate the relationship among variables.

Results: About 395 (57.33%) of the participants reported symptoms of depression, 428 (59.86%) anxiety symptoms, and 313 (45.21%) stress symptoms. The mediated association between physical violence and coping strategy through psychological distress was 0.29 (adjusted β = 0.29, 95%CI: 0.15, 0.44). Denial of salary had positive direct (adjusted β = 1.00, 95%CI: 0.50, 1.50) and mediated (adjusted β = 1.20, 95%CI: 0.71, 1.68) associations with stigma and discrimination through psychological distress. Restricted freedom had positive mediated (adjusted β = 0.39, 95%CI: 0.13, 0.65) and total (adjusted β = 0.94, 95%CI: 0.59, 1.29) associations with stigma and discrimination through psychological distress.

Conclusion: Depression, anxiety, and stress symptoms are common among migrant returnees. Religious practice is the most commonly used coping mechanism. Psychological distress has positive mediating association with the relationships between denial of salary by employers and stigma and discrimination, physical violence and coping strategy, and restricted freedom and stigma and discrimination. Psychological interventions to deal with the psychological distress and stigma and discrimination of migrant returnees and to encourage the practice of positive coping strategies are warranted.