BMC Psychiatry最新文献

Objective: This study investigated the association between the Oxidative Balance Score (OBS) and the odds of depressive symptoms in adults with metabolic syndrome (MetS) using National Health and Nutrition Examination Survey data (2007-2018), and employed machine learning to enhance predictive insights.

Methods: We analyzed 6,244 U.S. adults with MetS. Multivariable logistic regression assessed the relationship between the OBS and the odds of depressive symptoms in U.S. adults with MetS, with subgroup and Restricted cubic spline (RCS) regression analyses. Four machine learning models (Decision Tree, k-Nearest Neighbors (KNN), Random Forest, and Extreme Gradient Boosting (XGBoost)) were developed and interpreted using Shapley Additive Explanations (SHAP).

Results: Among the participants, 1,087 individuals (16.87%) were identified as having depressive symptoms. Significant differences were observed between participants with MetS plus depressive symptoms and those with MetS alone in terms of age, gender, race, poverty-to-income ratio (PIR), smoking status, educational level, marital status, hypertension, diabetes, and OBS. No significant difference was found in abdominal obesity. In the unadjusted model, partially adjusted models, and the fully adjusted model, higher OBS were consistently associated with reduced odds of depressive symptoms with MetS. Subgroup analyses revealed no significant differences in the association between OBS and depressive symptoms across the examined strata among adults with MetS. RCS indicated a linear negative correlation. Machine learning models demonstrated strong performance, with Random Forest achieving the highest AUC (0.914). SHAP analysis identified educational level, marital status, and gender as the top predictors.

Conclusion: A higher OBS is associated with reduced the odds of depressive symptoms in U.S. adults with MetS, highlighting the significant role of socioeconomic factors. These findings align with existing evidence and warrant prospective validation.

Background: Transcription factor 21 (TCF21) encodes a basic-helix-loop-helix transcription factor that is thought to play a vital role in epicardial progenitor cell development, with these cells differentiating into coronary artery smooth muscle cells and cardiac fibroblasts. Reduced TCF21 expression has been linked to coronary artery disease severity; however, its relationship with coronary artery calcium (CAC) and genetic determinants of circulating TCF21 levels has not been examined. This study investigated the associations between plasma TCF21 levels, CAC burden, and TCF21 gene polymorphisms in patients with chronic schizophrenia, a population at increased cardiometabolic risk.

Methods: A total of 185 consecutive patients with chronic schizophrenia were enrolled. Plasma TCF21 concentrations were measured using enzyme-linked immunosorbent assay. CAC was quantified using cardiac multislice computed tomography, with independent assessment by two blinded radiologists. The rs12190287 (G/C) polymorphism of the TCF21 gene was genotyped. Simple linear regression analyses were performed to explore associations between TCF21 levels and clinical variables, followed by multiple linear regression adjusted for age and sex. Multiple testing was addressed using false discovery rate (FDR) correction as a sensitivity analysis. Multivariable logistic regression analyses were conducted to assess the independent association between TCF21 levels and severe CAC after adjustment for established cardiovascular risk factors.

Results: After adjustment for age and sex, plasma TCF21 levels were positively associated with triglyceride levels and circulating inflammatory cell counts, including white blood cell, neutrophil, and monocyte counts, and inversely associated with both calcium score-Agatston and calcium score-volume. Following FDR correction, the associations with CAC measures, triglycerides, and inflammatory cell counts remained statistically significant. Lower plasma TCF21 levels were independently associated with severe CAC defined by both Agatston and calcium volume thresholds after adjustment for established cardiovascular risk factors. In genotype-based analyses, patients carrying the CC genotype exhibited significantly lower plasma TCF21 levels and higher CAC burden compared with GG and GC genotypes, and these differences remained significant after FDR correction.

Conclusions: Lower plasma TCF21 levels are robustly associated with greater CAC burden in patients with chronic schizophrenia, independent of major cardiovascular risk factors. Genetic variation in TCF21 is associated with reduced circulating TCF21 levels and higher coronary calcification. These findings suggest that TCF21 may represent a potential biomarker related to cardiovascular risk in this vulnerable population.

Clinical trial number: Not applicable.

Background: Domestic workers comprise a substantial workforce segment, especially in Sub-Saharan Africa, fulfilling crucial functions in sustaining households and economies. Nevertheless, they frequently encounter a multitude of obstacles and hazards within their work environment, including violence at the workplace. Despite pervasiveness, repercussions, and potential mental health consequences, studies with a focus on the mental health of domestic workers who experience workplace violence are still scarce. The purpose of this research was to examine the association between workplace violence and mental health conditions (depression, suicidal ideation, anxiety, and post-traumatic stress disorder) among domestic workers in Rwanda.

Method: A cross-sectional design was used. Data were collected in 2023, and a total of 862 Domestic Workers (DWs) participated in the study. The mental health conditions were assessed using the Patient Health Questionnaire-9 (depression), four questions to evaluate suicidal ideations from the General Health Questionnaire-28, Generalised Anxiety Disorder Assessment-7 (anxiety), and the PTSD Checklist for DSM-5. The association between workplace violence and mental health conditions was assessed using the propensity score matching analysis.

Results: A significant positive association was found between experiencing workplace violence and the severity of mental health conditions.

Conclusion: The research emphasizes the concealed anguish endured by domestic workers and stresses the criticality of safeguarding their rights and welfare in order to establish an environment of dignity and esteem at work. This highlights the critical need for advocacy and intervention to prevent and mitigate workplace violence and mental health conditions among domestic workers in Rwanda.

Background: Body Dysmorphic Disorder (BDD) is a psychiatric condition characterized by obsessive preoccupation with perceived physical flaws, often accompanied by emotional dysregulation and attentional biases. Despite increasing clinical recognition, the neurophysiological and attentional mechanisms underlying BDD remain poorly understood.

Methods: This study employed a multimodal experimental design to compare individuals with BDD (n = 27) and healthy controls (n = 27). Participants completed standardized psychometric assessments and were exposed to emotionally valenced facial and body-related images while undergoing electroencephalography (EEG), galvanic skin response (GSR), and eye-tracking. Group-by-valence interactions were analyzed using mixed-model ANOVAs.

Results: The BDD group showed significantly higher depression, anxiety, body image disturbance, and suppression scores, alongside reduced cognitive reappraisal and self-efficacy. EEG analyses revealed increased N170 amplitudes, attenuated P300 amplitudes, and greater right-sided frontal alpha asymmetry, suggesting early hypervigilance, reduced evaluative processing, and affective withdrawal. GSR data indicated heightened sympathetic arousal and delayed physiological recovery. Eye-tracking data descriptively indicated gender-specific attentional patterns within the BDD group, with females allocating greater visual attention to facial and lower-body regions and males showing increased fixation on muscular upper-body features; such patterns were not observed in the control group.

Conclusion: BDD is associated with dysregulated multisystem responses to appearance-related stimuli, characterized by neural hyperreactivity, impaired cognitive-emotional regulation, and gender-related patterns of visual attention. These findings support the utility of integrating psychophysiological and attentional markers into individualized assessment and intervention strategies for BDD.

Clinical trial number: Not applicable.

Background: The behavioral profile of autism spectrum disorder (ASD) is highly heterogeneous. Analyses relying on total scores often fail to capture the associative patterns among individual behavioral items. This study applied network analysis to parent-reported Autism Spectrum Screening Questionnaire (ASSQ) data to explore the internal associative structure among core ASD behavioral domains and to identify key items within the network.

Methods: This retrospective study included 995 children and adolescents aged 7-16 years diagnosed with ASD according to ICD-10 criteria at Xiamen Xianyue Hospital between 2019 and 2025, whose parents completed the ASSQ. Given the 3-point Likert scale of the ASSQ, two parallel network modeling strategies were employed to enhance robustness: a dichotomized (Ising model) and an ordinal (Gaussian Graphical Model, GGM) approach to explore associations among ASSQ items. Comorbidities and psychiatric medication history were included as covariates. Central and bridge nodes were identified using expected influence and bridge expected influence, respectively, and the optimal model was selected. Network Comparison Tests were conducted to examine differences in global strength and structure between sex (male/female) and age groups (7-11/12-16 years).

Results: (1) The ordinal network model (ASSQ-GGM network) demonstrated better centrality stability and was therefore selected for reporting. (2) The ASSQ-GGM network identified the following central nodes: Q11 (inability to adjust, EI = 1.238), Q27 (unusual posture, EI = 1.154), and Q15 (fails to make relationships with peers, EI =  1.047). Bridge nodes were: Q26 (unusual facial expression, bEI = 0.806), Q11 (inability to adjust, bEI = 0.719) and Q12 (lacks empathy, bEI=0.710). (3) Network Comparison Tests found no significant differences in network structure by sex or age, which may be due to insufficient or imbalanced subsample sizes. The possibility of sex- or age-specific network patterns cannot be ruled out.

Conclusions: This study presents a network of interrelated parent-reported ASD-related behavioral features based on ASSQ items. No significant sex or age differences in network structure were found. These findings provide insights into the associative patterns among ASSQ items. As this study is based on cross-sectional, guardian-reported data, the findings are hypothesis-generating and do not support causal inferences. Any implications for intervention require validation through longitudinal or experimental studies.

Clinical trial number: Not applicable.