BMC Psychiatry最新文献

Background: Understanding the differences between various instruments for assessing depression will help researchers and health practitioners to choose a more appropriate tool and develop a framework to enhance resilience to mental health problems in the older population. The current study aimed to compare the 10-item Center for Epidemiological Studies-Depression (CES-D) scale with the Composite International Diagnostic Interview-Short Form (CIDI-SF) for measuring depressive symptoms in older Indians.

Methods: Data came from the first wave of the Longitudinal Aging Study in India (LASI) which was conducted during 2017-19. The final sample included 30,368 older individuals aged 60 years and above (15,824 women and 14,544 men). The level of agreement between the CES-D and CIIDI-SF instruments for depression classification was assessed using Kappa coefficients at various cut-off values. Multivariable logistic regression models were used to examine the associations between background characteristics and depressive symptoms assessed by both instruments.

Results: The prevalence of depressive symptoms based on the CES-D instrument was higher than that of CIDI-SF (30.2% vs. 8.3%). The level of agreement between the CES-D and CIDI-SF for depression classification was 'none' to 'minimal' (κ = 0.04-0.24). Assuming the CIDI-SF scale as the "gold standard", with rising threshold values, sensitivity of the CES-D scale decreased while specificity increased. The CES-D scale yielded a sensitivity of 29-82% and specificity of 39-92% across cut-off values of 3 to 6. The Pearson correlation between the CIDI-SF and CES-D total scores was significant but weak (r =.20). Multivariable analysis showed that depressive symptoms were more prevalent among women, those with higher education, individuals living alone, those with diagnosed psychiatric disorders, and individuals with two or more chronic conditions, compared to men, those who were uneducated, those not living alone and healthier peers, when assessed using both CES-D and CIDI-SF scales. The associations of marital status, religion and wealth quintiles were significant only for depressive symptoms assessed using the CES-D scale.

Conclusions: Depression cases identified by the CES-D showed poor agreement with those identified by the CIDI-SF. Therefore, the prevalence of depressive symptoms measured by the CESD is not interchangeable with that measured by the CIDI-SF. These findings suggest the importance of using both the CES-D and CIDI-SF in large population-based cohorts and surveillance surveys to obtain more accurate and nuanced understanding of depressive disorders across various subgroups of the older population.

Background: The pathophysiological mechanisms of schizophrenia are complex and not fully elucidated. This study aimed to investigate changes to total glutathione (T-GSH), glutathione disulfide (GSSG), reduced glutathione (GSH), and the GSH/GSSG ratio before and after electroconvulsive therapy (ECT) for patients with acute relapse of schizophrenia and associations with clinical symptoms.

Methods: The study cohort included 110 patients with acute relapse of schizophrenia and 55 healthy controls. All patients received 8-10 sessions of ECT. Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS).

Results: As compared to the healthy controls, schizophrenia patients had decreased baseline GSSG levels (t = -2.115, p = 0.036) and elevated GSH/GSSG ratios (t = 2.141, p = 0.034). Baseline GSSG levels were negatively correlated with both PANSS total scores (beta = -0.369, t = -4.108, p < 0.001) and positive symptom scores (beta = -0.332, t = -3.730, p < 0.001), while changes to GSSG levels were positively correlated with improvements in PANSS total scores (r = 0.392, p < 0.001) and positive symptom scores (r = 0.293, p = 0.005) after ECT treatment. In treatment responders, GSSG levels were significantly increased (t = -2.817, p = 0.006) and GSH/GSSG ratios were decreased (t = 4.474, p < 0.001), as compared to before ECT, with baseline T-GSH (B = 0.734, OR = 2.083, 95%CI:1.287-3.372, p = 0.003), GSSG (B = -2.720, OR = 0.066, 95%CI:0.011-0.390, p = 0.003), and GSH/GSSG ratio (B = -1.013, OR = 0.363, 95%CI:0.142-0.930, p = 0.035) predictive of clinical improvement.

Conclusion: Patients with schizophrenia exhibit significant redox imbalance, and GSSG levels may serve as a potential biomarker to evaluate and predict ECT outcomes.

Background: Schizophrenia, a severe mental disorder with complex pathophysiology, involves neurotrophic factors, which play crucial roles in neurodevelopment and neuroplasticity. This study investigated NGF-β and BDNF levels in chronic schizophrenia and their association with clinical symptoms, cognitive function, and 1,25(OH)₂D levels.

Methods: In this cross-sectional study, 72 male patients with chronic schizophrenia and 70 matched healthy controls were enrolled. Psychopathological symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), and cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The serum levels of NGF-β, BDNF, and 1,25(OH)₂D were measured.

Results: Serum levels of NGF-β (F = 35.239, P < 0.001) and BDNF (F = 12.669, P < 0.001) were significantly decreased in patients with chronic schizophrenia compared to healthy controls. NGF-β levels were negatively correlated with PANSS negative symptoms (beta = -0.205, t = -2.098, P = 0.040) and positively correlated with 1,25(OH)₂D levels (r = 0.324, P = 0.006). Decreased serum BDNF concentrations were negatively correlated with language deficits (beta = -0.301, t = -2.762, P = 0.007). Significant associations were observed between chronic schizophrenia and reduced levels of NGF-β (B = 1.040, P < 0.001, RR = 2.829, 95% CI: 2.101-3.811) and BDNF (B = 0.526, P = 0.001, RR = 1.692, 95% CI: 1.241-2.306).

Conclusions: Our findings indicated that NGF-β and BDNF levels were altered in chronic schizophrenia and were associated with clinical symptoms and vitamin D metabolism. These results provided new insight into the etiology of schizophrenia.

Introduction: Medication nonadherence is a prevalent issue among patients with bipolar disorder, leading to substantial negative consequences. Despite documented cognitive deficits in this population, the relationship between executive dysfunction and medication nonadherence remains unclear. This study aims to investigate the association between executive functions and medication adherence in euthymic patients with bipolar I disorder.

Method: In this cross-sectional, comparative study, we recruited 200 euthymic bipolar I disorder patients aged 18 to 55 years from the outpatient clinic of Iran Psychiatric Hospital in Tehran in 2024, using a convenience sampling method. The euthymic phase was confirmed using the Persian versions of the Young Mania Rating Scale and the Hamilton Rating Scale for Depression. Patients completed the Medication Adherence Rating Scale, along with a series of executive function tests including Go/No-Go, Wisconsin Card Sorting Test, and Iowa Gambling Task. Multivariate analysis of covariance was employed to analyze the results, controlling for demographic and clinical variables as covariates.

Results: Of the participants, 54.5% had low medication adherence. Low adherent patients exhibited significantly poorer performance in Go/No-Go as indicated by higher commission errors (F [1] = 7.63, p = 0.006) as well as the Wisconsin Card Sorting Test, evidenced by a higher number of perseveration errors (F [1] = 8.61, p = 0.004) and fewer completed categories (F [1] = 6.67, p = 0.011), compared to high adherent patients. Notably, although differences in decision-making were observed between the two groups, these did not reach statistical significance (p = 0.139).

Conclusions: This study establishes a correlation between low medication adherence and deficits in executive functions-specifically response inhibition and cognitive flexibility-in patients with bipolar I disorder. Furthermore, even after controlling for covariates, the differences in executive functions between medication adherence groups remained significant.

Background: Nearly 20% of women will be confronted with anxiety or depressive disorders during the perinatal period and this may lead to adverse outcomes for both mother and child. Cognitive behavioural therapy (CBT) is the psychological intervention with the most empirical support for the clinical management of anxiety and depressive disorders. Anxiety and depression frequently occur in women during the perinatal period, and there is growing evidence that internet-delivered CBT (iCBT) could be an acceptable and effective intervention. THIS WAY UP, an Australian digital mental health service, has developed a program for postnatal anxiety and depression. This study protocol aims to examine the acceptability and efficacy of a French-Canadian adaptation of the program.

Methods/design: The research team propose to conduct a mixed hybrid type 1 pragmatic randomized clinical trial and implementation study to replicate the findings of the trial conducted in Australia by Loughnan et al. (2019), as well as explore barriers and facilitators to potential large-scale implementation. TREATMENT AND CONTROL CONDITIONS: a) postnatal anxiety and depression iCBT program with three lessons to complete in a six-week period, added to treatment-as-usual (TAU); b) TAU. Participants will include French-speaking women with probable postnatal depression or anxiety as per the Generalized Anxiety Disorder-7 (GAD-7) or the Edinburgh Postnatal Depression Scale (EPDS). The primary outcome measures will be the GAD-7 and the EPDS. Secondary outcome measures will comprise self-reported instruments to evaluate psychological distress, quality of life, mother-child experience, and treatment experience. Qualitative interviews with participants and health professionals will provide insights on acceptability and delivery of the iCBT program.

Statistical analysis: Statistical analysis will follow intent-to-treat principles. A mixed model regression approach will be used to account for between- and within-subject variations in the analysis of the effects of iCBT compared to TAU only intervention.

Discussion: The study will generate important data of efficacy and acceptability to patients, clinicians, and decision-makers to inform the scaling-up of the postnatal iCBT intervention in Canada.

Trial registration: ClinicalTrials.gov: NCT06778096, prospectively registered on 2025/01/16.

Background: Dysthymia, a chronic depressive disorder, poses a significant public health challenge due to its prolonged course and substantial impact on quality of life, particularly among high-risk populations such as young adults. This study aims to investigate trends in dysthymia incidence and prevalence among young adults in China from 1990 to 2021 and to project future patterns through 2026.

Methods: Using data from the Global Burden of Disease (GBD) 2021 Study, we conducted an Age-Period-Cohort (APC) analysis to assess the relative risks (RRs) of dysthymia incidence and prevalence among Chinese young adults aged 20-44 years from 1990 to 2021. Bayesian and Nordpred APC models were applied to forecast age-standardized incidence rates (ASIR) and prevalence rates (ASPR) for the next 25 years (2022-2046).

Results: Between 1990 and 2019, both ASIR and ASPR of dysthymia exhibited a declining trend. Among females, ASIR decreased from 363.099 (95% uncertainty interval [UI]: 339.146, 387.051) per 100,000 population to 318.100 (95% UI: 296.812, 339.388), while among males, it declined from 232.757 (95% UI: 216.022, 249.492) to 208.467 (95% UI: 193.617, 223.317). Similarly, ASPR decreased from 2,072.562 (95% UI: 1,813.254, 2,331.870) to 1,795.234 (95% UI: 1,582.628, 2,007.841) for females and from 1,278.432 (95% UI: 1,116.869, 1,439.994) to 1,131.620 (95% UI: 994.059, 1,269.180) for males. However, a marked increase was observed from 2020, with 2021 rates approaching 1990 levels for both sexes. APC analysis showed that RRs for dysthymia incidence and prevalence increased with age, particularly beyond 35-39 years. More recent cohorts demonstrated lower RRs compared to earlier cohorts, whereas period effects remained relatively stable. Projections indicate a continuous rise in ASIR and ASPR from 2022 to 2046 for both sexes. Throughout the study period, dysthymia prevalence rates consistently exceeded incidence rates, with females exhibiting higher rates than males.

Conclusion: Enhancing early diagnostic capabilities in primary care, advancing standardized treatment strategies, improving mental health literacy through health education and social media, and implementing targeted interventions for high-risk groups-particularly young women and individuals in early adulthood-are essential for alleviating the burden of dysthymia in China and other countries with similar demographic and epidemiological characteristics.

Background: Russia's full-scale military invasion of Ukraine on February 24, 2022 led to an increase of anxiety and depressive states, psychosomatic manifestations, and a tendency to abuse alcohol and psychoactive substances in the population. The aim of this paper is to examine the mental health burden among university students twenty months after war and to identify risk and protective factors for mental health problems.

Methods: A cross-sectional study was conducted among Ukrainian students in October 2023 (n = 1398). The online survey included sociodemographic data collection, evaluation of psychological well-being and measured depression, anxiety, PTSD symptoms and insomnia. Normality of included variables was verified by Kolmogorov-Smirnov test. An independent-samples t-test, Mann-Whitney U-test, χ2 test and analysis of variance were used to compare the data. Differences in PHQ-9 and GAD-7 levels based on sociodemographic characteristics were analyzed using ANOVA. Correlation between variables was calculated with Pearson correlation, adjusted with Benjamini-Hochberg procedure. To develop the predictive model the XGBoost algorithm was employed, additionally, the SHAP algorithm was utilized.

Results: Symptoms of PTSD, as well as moderate and severe symptoms of anxiety, depression, and insomnia, were reported by 48.1%, 34.1%, 33.6%, and 19.3% of students, respectively. The severity of these symptoms varied based on factors such as sex, age, prior trauma experiences, and living conditions. Additionally, the type of relocation (within Ukraine or abroad) significantly influenced mental health outcomes. A majority of participants (68.5%) reported the experience of war-related traumatic events. Factors linked to higher depression symptom scores included lower initial well-being, greater social media use, female gender, exposure to multiple traumatic events, experiences of assault or sexual violence, the loss of a loved one, pre-existing and ongoing mental health treatment during the war, and the use of psychotropic medications.

Conclusions: Ukrainian university students face a significant mental health burden due to the ongoing war, with high rates of reported PTSD, anxiety, depression, and insomnia symptoms. These findings highlight the importance of tailored mental health interventions through different stakeholders that take into account individual needs, past experiences, burdens and social media usage.

Background: Most research in children with ADHD has focused on risk factors and their outcomes, such as symptom severity as a risk factor for functional impairment. Yet, a small group of studies show that some children function well despite their symptom severity. Preliminary evidence suggests that social protective factors may protect children with ADHD against its negative impact across different domains. The purpose of this study was to evaluate whether prosocial behavior, as a protective factor, buffers the effects of symptoms on impairment in children and adolescents with ADHD symptoms.

Methods: In this cross-sectional study, we used routinely collected data from the Development and Well-Being Assessment (DAWBA). Reports were included from 822 mothers, 581 fathers, and 1109 teachers, who provided information on the children's symptoms, impairment and prosocial behavior (aged 5-18). To examine the effects of prosocial behavior on the relationship between symptoms and functional impairment, multiple regression analyses were conducted using data from these three perspectives.

Results: Although we did not find buffering effects, regression analyses revealed that parent- and teacher-reported prosocial behavior demonstrated promotive effects on functional impairment, indicating that prosocial behavior may be beneficial in reducing impairment on daily life of children with ADHD. These results were consistent across raters and age-groups, except the mother-rated model for adolescents. Additionally, when investigating these effects by gender, we found that higher prosocial behavior, as observed by fathers, was related to lower impairment for girls.

Conclusion: Our results suggest that prosocial behavior should be considered in clinical practice when evaluating impairment scores for ADHD. Finally, our findings plead for more in-depth measures of social protective factors and across different levels, including individual, family, and community levels. This approach will help identify factors that, independently of risks, may positively impact the functioning of these children.

Background: Individuals with obsessive-compulsive disorder (OCD) face both personal and system-based barriers in receiving first-line treatment, i.e. cognitive behavioral therapy (CBT) with exposure and response prevention (ERP). The present study comprehensively investigated help-seeking behavior, treatment barriers and facilitators, attitudes and access to gold-standard treatment in adults with OCD in Germany. We aimed to characterize the care situation and examine the influence of clinical and sociodemographic variables on help-seeking behavior and receiving treatment.

Methods: An anonymous online survey was performed in individuals with OCD who were recruited in- and outside the psychiatric healthcare system. The survey included a wide range of questions regarding help-seeking behavior, treatment barriers and facilitators, attitudes towards different treatment options and access to treatment. Sociodemographic and clinical characteristics were also collected. The final sample comprised 276 individuals with OCD.

Results: The mean delay to seeking psychotherapeutic treatment was M = 5.15 years (SD = 6.88) and the mean delay to recognition of OCD was M = 5.58 years (SD = 7.16). Of those 211 who had ever received CBT, 49.5% reported that therapist-guided ERP had been performed at some point during treatment. Indicators of poor healthcare, such as longer delay to recognition or a larger number of treatments before receiving ERP were significantly associated with increased symptom severity. Moreover, a younger age was associated with a shorter delay to recognition of OCD. Taboo thoughts (60.9%) and checking (52.9%) were the most commonly reported symptom dimensions, and individuals with current taboo thoughts were significantly more likely to be treated with CBT. Educational websites were identified as the most important facilitators in recognizing OCD and providing information on effective treatment options. Lack of knowledge about treatment options was reported as the most common barrier to seeking/receiving ERP-based treatment.

Conclusions: Delays to the recognition of OCD and to seeking help still exceed 5 years on average, but were reduced in younger individuals, potentially reflecting increased mental health literacy. Although our sample may not be fully representative, our results fill the gap between epidemiological surveys and previous studies in outpatients. Options for improving the care situation are discussed.

In a study involving 831 women and 309 men aged 18 to 64, we sought to explore the key determinants influencing various components of well-being, including happiness, life satisfaction, and vigor/vitality. The determinants examined encompassed sociodemographic variables, health indicators, sedentary behaviors, physical activity, body mass index (BMI), sleep patterns, eating habits, alcohol consumption, smoking, mood indicators, personality traits, emotional intelligence, logical thinking, non-utilitarian decision-making, and adverse childhood experiences. Our findings indicate that happiness, life satisfaction, and vigor are most significantly affected by mood indicators-especially depression-emotional intelligence (particularly the ability to manage emotions), and overall subjective health. Additionally, specific personality traits, such as extraversion in women and neuroticism in men, played a significant role in influencing well-being. Conversely, determinants such as BMI, sleep habits, regular physical activity, sedentary behavior, dietary habits, avoiding smoking and excessive alcohol consumption, as well as logical thinking, non-utilitarian decision-making, and adverse childhood experiences, showed limited or no significant impact on well-being components like happiness, life satisfaction, and vigor. These findings provide valuable insights into the complex dynamics of human well-being, highlighting the distinct determinants of happiness, life satisfaction, and vigor/vitality for men and women.