BMC Psychiatry最新文献

Background: Smartphone use has rapidly increased worldwide. It was estimated that worldwide use of smartphones surpassed 4.3 billion in 2023, which means 54% of the world's population now uses smartphones. However, research shows that excessive smartphone use poses health risks and decreases sleep quality, which can be detrimental for students. This study investigates the impact of problematic smartphone usage on health status, mental health, and sleep quality among medical students enrolled in Sudanese universities.

Methods: A cross-sectional study was conducted from January to March 2024, targeting medical students and recent graduates from Sudanese universities through an online survey. Data were collected using validated scales for smartphone addiction, sleep quality, suboptimal health status, and mental health. Descriptive and correlation analyses were performed using SPSS software v28.0.0.

Results: Out of 231 respondents (69% female, mean age 22.7), 67.6% exhibited high levels of smartphone addiction. Significant correlations were found between smartphone addiction and poor sleep quality (r = 0.462, p < 0.001), suboptimal health (r = 0.527, p < 0.001), and mental health issues (r = 0.365, p < 0.001). Single students had higher addiction and stress scores, while those living in Sudan showed higher suboptimal health scores.

Conclusions: Problematic smartphone use (PSU) is prevalent among Sudanese medical students, negatively affecting mental health and sleep.

Background: Anxiety during pregnancy is linked to adverse maternal and neonatal outcomes, as well as dissatisfaction with childbirth, and may contribute to the development of postpartum depression. This study aimed to evaluate the effect of mindfulness-based counselling on the anxiety levels and childbirth satisfaction among primiparous pregnant women.

Methods: This two-group, parallel, randomized controlled trial involved 60 eligible primiparous pregnant women who were referred to health centers in Kermanshah province (western Iran). Participants were selected based on inclusion/exclusion criteria and randomly assigned to either the experimental or control group using a simple randomization method. The control group (n = 30) received routine prenatal care, while the experimental group (n = 25) participated in eight group mindfulness-based counseling sessions (60-90 min each), held twice a week, in addition to routine prenatal care. The intervention was based on the Mindfulness-Based Childbirth and Parenting Program (MBCP), which aims to promote the health and well-being of families by integrating mindfulness practices throughout pregnancy, childbirth, and early parenthood. Both groups completed the Pregnancy-Related Anxiety Questionnaire (PRAQ) before, immediately after, and one month after the intervention. Additionally, 24 h post-delivery, both groups completed the Scales for Measuring Maternal Satisfaction in Normal and Caesarean Births (SMMS-normal and SMMS-caesarean). The scores were then compared. Recruitment took place between June and December 2019, and 55 participants completed the study. Data were analyzed using the Mann-Whitney U test, Independent t-test, and Friedman test with SPSS (25), and significance was set at p < 0.05.

Results: There was no significant difference between the control and experimental groups in terms of anxiety scores before the intervention. However, a significant difference was observed between the two groups immediately after the intervention (p = 0.001) and one month after (p = 0.001). In terms of childbirth satisfaction, the experimental group reported significantly higher satisfaction 24 h after delivery compared to the control group (p ≤ 0.001). No significant adverse events or side effects were reported.

Conclusion: The findings of this study suggest that mindfulness training for pregnant women can effectively reduce anxiety and enhance childbirth satisfaction. The 4-week Mindfulness-Based Childbirth and Parenting program for expectant mothers appears to be a well-received and effective intervention for improving maternal mental health.

Trial registration clinical trials: Iranian Registery of clinical trials-Beta version, https://en.irct.ir/trial/35390 (IRCT20170305032900N3), registered (2019-02-24).

Objective: The objective of this study was to identify serum complement factor-based biomarkers indicative of clinical efficacy in patients with first-episode schizophrenia (SCZ) following treatment with aripiprazole.

Methods: The retrospective study cohort comprised 40 patients diagnosed with first-episode SCZ (SCZ group) and 40 healthy individuals (control group). Quantitative analyses were conducted on five complement factors, namely complement component 1 (C1), C2, C3, C4, and the 50% hemolytic complement (CH50). Baseline serum complement factor levels were compared between the SCZ and control groups. Patients diagnosed with SCZ underwent a 4-week treatment regimen with aripiprazole. The severity of psychiatric symptoms in these patients was assessed using the Positive and Negative Symptom Scale (PANSS) and the Brief Psychiatric Rating Scale-18 Item Version (BPRS). Comparative analyses were conducted on PANSS and BPRS scores, as well as serum complement factor levels, both prior to (pre-treatment group) and following aripiprazole administration (post-treatment group). Pearson's correlation test was employed to evaluate the relationships between changes in serum complement factor levels and the reduction rates of PANSS/BPRS scores.

Results: At baseline, patients with SCZ exhibited significantly elevated levels of C1, C2, C3, C4, and CH50 compared to the control group (P < 0.05). Moreover, following treatment, there was a significant reduction in the PANSS total score, positive symptom score, negative symptom score, and BPRS score in the post-treatment group compared to the pre-treatment group (P < 0.05). Furthermore, patients in the post-treatment group exhibited a significant reduction in serum levels of C2, C3, and C4, alongside a significant increase in the serum level of CH50 compared to those in the pre-treatment group (P < 0.05). Additionally, the baseline serum C2 levels and the variations in serum C2 levels pre- and post-treatment exhibited a negative correlation with the reduction rate of PANSS/BPRS scores (P < 0.05). Similarly, both the baseline serum C3 levels and the changes in serum C3 levels pre- and post-treatment were negatively correlated with the reduction rate of PANSS/BPRS scores (P < 0.05).

Conclusion: Baseline serum levels of C2 and C3, as well as their variations pre- and post-treatment, may serve as biomarkers for predicting clinical efficacy in patients with first-episode SCZ undergoing treatment with aripiprazole.

Background: Problematic Internet use (PIU) is a growing concern in modern society. There is a limitation of epidemiologic data related to PIU. This is due to a lack of consensus on the definition and variability of assessment tools of PIU. PIU has been linked to a range of negative outcomes including depression, anxiety, social isolation, and poor academic or work performance. Resident physicians are at risk of exhibiting problematic internet use due to the high stress of academic demands, social isolation, long working hours, busy schedules, and internet access. There is limited research on this topic and targeting resident physicians in Ethiopia. This study aimed to determine the PIU prevalence and associated factors among resident physicians in SPHMMC, Ethiopia.

Methods: An institutional-based cross-sectional study was conducted from September 1, 2023, to November 25, 2023, at St. Paul's Hospital Millennium Medical College (SPHMMC). This study included 417 physician residents who were selected using multistage sampling techniques, and Young's Internet addiction test was used to assess PIU. To look for associations, logistic regression analysis, both binary and multivariable, was performed, and a p-value of < 0.05 was used to determine statistical significance.

Results: 414 participants were included in this study, with a response rate of 99.3%. The prevalence of PIU was 46.6%, with a 95% CI of 41.7-51.6%. The multivariable logistic regression model revealed that using the Internet for five or more hours per day (AOR: 1.84, 95% CI = 1.14, 2.99), having less than 7 h of actual sleep per night (AOR: 2.16, 95% CI = 1.03, 4.53), and having depression (AOR: 7.98, 95% CI = 2.47, 25.78) were significantly positively associated with PIU. In addition, factors such as being married (AOR: 0.42, 95% CI = 0.19, 0.91) and residents of the obstetrics and gynecology department (AOR: 0.32, 95% CI = 0.13, 0.81) were negatively associated with PIU.

Conclusion: This study revealed high PIU use among resident physicians at SPHMMC. Factors such as using the Internet for five or more hours per day, having less than seven hours of actual sleep per night, and having depression were found to be risk factors for PIU. On the other hand, being married and residents of the obstetrics and gynecology department were protective factors. Thus, creating awareness among medical residents about healthy tech habits and involving policymakers to develop guidelines for healthy internet use and awareness campaigns to reduce the impact of PIU is recommended.

Background: Major depressive disorder (MDD) is a highly prevalent mental disorder with devastating consequences that often first manifest during adolescence. Anhedonia has emerged as one of the most promising symptoms of adolescent MDD, which means a longer time to remission， fewer depression-free days, and also increased risk of suicide ideas or actions. Research has shown that at least two-thirds of depressed adolescents have significant sleep-onset or sleep-maintenance problems. However, the association between sleep disorder and anhedonia, and the potential mediators are less understood.

Methods: This is a cross-sectional study that includes 200 adolescents suffered from MDD between the ages of 12-17. We use Spearman's test to explore the relationship among main variables. To evaluate the mediating effects of stress, we applied regression models and used bootstrap method to validate the significance of effects.

Results: Significant correlation exists among sleep disorder, stress, and anhedonia (P<0.05).The direct effect of sleep disorder on anhedonia was 0.214 (95% CI: 1.5235, 6.2073), while the total effect was 0.295 (95% CI: 2.9683, 7.6924). The indirect effect of sleep disorder on anhedonia mediated by stress was 0.081 (95% CI: 0.5842, 2.5268). Robustness of the regression analysis results has been verified by bootstrap test.

Conclusions: Our finding suggested a positive correlation between sleep disturbance and anhedonia in adMDD. Stress partially mediated the relationship between sleep disorder and anhedonia. Due to the deleterious effects of anhedonia on depressed adolescents, these findings provide impetus to investigate further the causal relationship between sleep problems and anhedonia.

Trial registration: ChiCTR2200060176(Registration Date: 21/05/2022).

Background: This study investigates the effectiveness and safety of aripiprazole oral solution in Chinese patients with schizophrenia.

Methods: This was a multicenter, single-arm phase IV study involving 134 patients in China in the acute stage of schizophrenia from May 2021 to July 2022. The patients received aripiprazole oral solution 10 - 30 mg/d for 12 weeks. The effectiveness endpoints included the Positive and Negative Symptom Scale (PANSS) and the Clinical Global Impression (CGI) scale score. The safety endpoints included adverse events, laboratory inspection indicators (including the serum prolactin level [PRL]), and waist circumferences (WC).

Results: Ultimately, 86 patients (64.18%) completed the trial, and 21 patients (15.67%) dropped out due to poor effectiveness. From baseline to week eight, 43.28% of patients had a PANSS reduction of ≥ 50%, 82.84% of patients improved in the CGI-Improvement (CGI-I scale score of 1 - 3), and the percentage of patients with abnormal PRL and waist circumferences decreased significantly. In total, 45 patients (33.58%) experienced mild adverse drug reactions predominately manifested as extrapyramidal symptoms (EPSs; 9.70%), constipation (8.96%), and palpitations (7.46%). Upon further subgroup analysis, aripiprazole oral solution demonstrated significantly improved effectiveness in first-episode schizophrenia patients and those with symptoms of agitation.

Conclusions: Aripiprazole oral solution displayed positive clinical effectiveness and favorable tolerability in Chinese patients in the acute stage of schizophrenia.

Clinical trial registration: Clinical trial registration number: ChiCTR2100044653. Name of trial registration: A real-world study of Aripiprazole Oral Solution in the treatment of schizophrenia (Registration date: 25/03/2021). The full trial protocol can be accessed at the Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ).

Background: Healthcare professionals play an important role in successfully implementing digital interventions in routine mental healthcare settings. While a larger body of research has focused on the experiences of mental healthcare professionals with the combination of digital interventions and face-to-face outpatient treatment, comparatively little is known about their experiences with digital interventions combined with inpatient treatment. This is especially true for acute psychiatric inpatient care, where studies on the implementation of digital interventions are more rare. The current study aimed to investigate healthcare professionals' experiences with an internet-based emotion regulation intervention added to acute psychiatric inpatient treatment.

Methods: Physicians, nurses, psychologists, social workers, and occupational therapists from three acute inpatient wards (n = 20) were interviewed regarding their experiences. A thematic analysis approach was used to analyze the interview data.

Results: The following themes and corresponding subthemes were identified: lack of experience (few or no previous experiences, no expectations, few points of contact), the intervention as a contemporary complement (positive expectations, necessary and contemporary, positive effects on therapeutic work and patients, characteristics of the internet-based program), concerns about fit for acute psychiatric inpatient care (fit for acute psychiatric inpatients, doubts about implementation), the human factor as essential for implementation (the team makes or breaks it, guidance is key, patient characteristics), and requirements for implementation beyond the human factor (integration into existing treatment structure, resources, changes to the internet-based program, timing).

Conclusions: While healthcare professionals reported few points of contact with the intervention, they saw it as a contemporary complement to acute psychiatric inpatient care with benefits for therapeutic work and patients. The findings further suggest that specific concerns regarding the fit for acute psychiatric inpatient care remain and that human factors such as support from the ward team, human guidance during the intervention and being mindful of specific patient characteristics are considered important for implementation. Moreover, factors such as integration of the intervention into the ward program, resource availability and the timing of the intervention during a patient's individual stay should be considered for successful implementation.

Trial registration: Clinicaltrials.gov, NCT04990674, 04/08/2021.

Background: There is robust evidence that posttraumatic stress disorder (PTSD) is associated with neurocognitive deficits, such as executive dysfunction or memory dysfunction. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment for PTSD, in which eye movements (EMs) are performed during traumatic memory retrieval. We examined whether Eye Movement Desensitization (EMD) improves neurocognitive functioning in PTSD patients, in comparison with a retrieval-only control condition without EMs.

Methods: Adult patients with PTSD (N = 91) were randomized into EMD (N = 47) or retrieval-only (N = 44). Data were collected at baseline (T0), one-week post-treatment (T1), one-month follow-up (T2), and at three-month follow-up (T3). Outcome measures were the California Verbal Learning Test (CVLT), the Trail Making Test (TMT), and the Digit Span Subtest of the Wechsler Adult Intelligence Scale fourth edition (WAIS-IV). We conducted linear mixed model to analyse the main outcomes.

Results: There was a main effect of time, indicating improvements for both the EMD and retrieval-only groups in CVLT scores, TMT A, TMT B and Digit Span score of WAIS-IV (Bonferroni-adjusted p's < 0.001) from T0 to T3. There were no effects of group (p = .64) or group by time on CVLT total trial A (T3; p = .34), delay A (T3; p = .76), TMT A (T3; p = .61), TMT B (T3: p = .58), and Digit Span scores (T3; p = .78) of the WAIS-IV, indicating no significant differences between groups on any of the outcomes.

Conclusion: Comparing EMD and retrieval-only did not show evidence for additive effects of EMs on the treatment of PTSD in terms of improvements in neurocognitive functioning. Thus, treatments based on retrieval of traumatic memories may be used to improve neurocognitive functioning in patients with PTSD.

Clinical trial registration: The trial was registered 19/12/2017 at ClinicalTrials.gov, identifier [ISRCTN55239132].