BMC Psychiatry最新文献

Background: Childhood trauma exacerbates bipolar disorder in adolescents, particularly intensifying depressive symptoms. While the potential mechanisms are unclear, sleep disturbances might mediate the link between childhood trauma and depression. This study investigated if sleep problems mediate the relationship between childhood trauma and depression severity in adolescents with bipolar disorder.

Methods: 426 adolescents with bipolar I or II disorder were recruited from Renmin Hospital of Wuhan University in 2024. They completed questionnaires on the Childhood Trauma Questionnaire, the Pittsburgh Sleep Quality Index, and the Patient Health Questionnaire-9. Data analysis included Pearson correlations and a mediation analysis using the PROCESS macro to examine the proposed indirect effect.

Results: Correlation analyses revealed significant positive associations between childhood trauma, sleep disturbance, and depressive symptoms (all p < 0.001). Controlled the variables of age, gender, and diagnosis classification, the mediation analysis confirmed that sleep disturbance served as a significant partial mediator in the relationship between childhood trauma and depressive symptoms. The indirect effect was significant (B = 0.071, 95% CI =[0.0495, 0.0944]), accounting for 38.59% of the total effect.

Conclusion: Our findings demonstrate that sleep disturbance represented a critical mediating mechanism in the association between childhood trauma and depressive symptoms among adolescents with bipolar disorder. These results underscore the importance of systematically assessing and addressing sleep disturbances in both clinical care and therapeutic management, particularly for at-risk individuals with a history of early-life adversity.

Clinical trial number: Not applicable.

Background: Non-suicidal self-injury (NSSI) has high prevalence among adolescents with mood disorders and is accompanied by cognitive impairments. Most existing studies have examined their impairments on single cognitive domains. It remains unclear which cognitive deficits are associated with adolescent NSSI and its functions and addictive features, from a multidimensional perspective.

Methods: A total of 161 adolescents diagnosed with first-episode major depressive disorder (MDD) and 137 healthy controls were recruited between June 2020 and December 2024. Participants were divided into three groups: adolescents with MDD and NSSI (MDD + NSSI, n = 84, age = 15.47 ± 1.59), those with MDD and without NSSI (MDD-NSSI, n = 77, age = 16.11 ± 2.16), and healthy controls (HCs, n = 137, age = 15.92 ± 3.13). NSSI behavior and its four common functions (internal emotion regulation, external emotion regulation, social influence, and sensation seeking) as well as the addiction feature, were assessed using the Ottawa Self-injury Inventory. Cognitive domains such as emotion recognition, cognitive control, working memory, and reward processing were assessed using an in-house Cognitive Assessment Battery. Data were analyzed via ANOVA, logistic regression, and multiple linear regression.

Results: Both the MDD + NSSI and MDD-NSSI groups showed significantly greater cognitive dysfunctions compared to the HCs. Logistic regression models indicated that cognitive domains such as memory, cognitive control, reward processing, delay discounting, and time perception were significantly associated with the presence of NSSI among adolescents with MDD. Multiple linear regression analyses further revealed that emotion recognition, working memory, cognitive control, and reward processing were significantly related to NSSI functions and the addictive features.

Conclusions: Our results showed that NSSI behaviors, its functions, and addictive features are all associated with multidimensional cognitive dysfunctions. These findings highlight the clinical relevance of implementing thorough, multidomain cognitive evaluations in adolescents with NSSI.

Clinical trial number: Not applicable.

Background: Second-generation antipsychotics (SGAs), specifically aripiprazole and risperidone, and selective serotonin reuptake inhibitors (SSRIs), are psychotropic medications commonly prescribed to individuals with autism spectrum disorder (ASD). However, it is unclear how often individuals with ASD initiate with SGAs, how frequently they switch medications, and how utilization has changed over time. This study investigates trends in psychotropic medication use among individuals with ASD in the USA from 2012 to 2021.

Methods: We analyzed a national cohort of commercially insured individuals with ASD aged 2 to 26 years using data from the IQVIA PharMetrics Plus for Academics database. Individuals were classified as newly prescribed if they had not previously received a prescription for the medication before the study period, and no prescription in the period immediately preceding it. We examined trends in psychotropic medication utilization yearly and conducted a detailed month-by-month analysis for 2019. A Mann-Whitney U test was used to compare medication switching rates between SSRIs and SGAs.

Results: Among 24,730 individuals, 64.6% were prescribed SGAs or SSRIs. Medication switching was more frequent among those initially prescribed aripiprazole or risperidone (6.13% annually) compared to those starting with SSRIs (3.41%). The Mann-Whitney U test (W = 67, p < 0.05) confirmed a significant difference in switching rates between the two groups. Switching from risperidone decreased from 2012 to 2021 (Spearman's ρ = -0.32), whereas switching from aripiprazole increased (Spearman's ρ = 0.50).

Conclusions: Individuals with ASD newly prescribed SGAs switched to other drug classes nearly twice as often as those prescribed SSRIs. The higher switching rate may be influenced by adverse effects or insufficient symptom improvement. Future studies should explore long-term outcomes and the clinical decision-making processes underlying medication changes.

Clinical trial number: Not applicable.

Background: Internet gaming disorder (IGD) and anxiety frequently co-occur among young adults and represent an increasing mental health concern in China. Nevertheless, the psychological network underlying this comorbidity and the identification of potential intervention targets remain poorly understood.

Methods: We conducted a cross-sectional study of 605 Chinese university freshmen to investigate the association between internet gaming disorder (IGD), anxiety. And the behavioral inhibition system (BIS)/ behavioral activation system (BAS) was examined as potential mediators of this relationship.

Results: Anxiety was positively associated with Internet gaming disorder (IGD), with the behavioral inhibition system (BIS) functioning as a complementary partial mediation. Complementary configurational and network analyses further identified heightened punishment/ reward sensitivity and loss of control over mind and behavior as key psychological symptoms linking IGD to anxiety.

Conclusions: These findings highlight anxiety's central role in IGD, with an imbalance in reward and punishment sensitivity closely associated with the comorbidity. Intense gaming rewards reinforce the drive to continue playing, while cessation triggers negative emotions like anxiety. These results emphasize the need for interventions that promote healthier emotional regulation in individuals with IGD and comorbid anxiety.

Background: Social functioning, symptoms, cognition and well-being are all considered important recovery domains for patients with schizophrenia spectrum disorders (SSD). In the current study, we investigated to what extent longitudinal changes in one recovery domain moderated changes in another recovery domain, and which personal, clinical or social patient characteristics influence changes in recovery domains for patients with SSD.

Methods: We investigated data from GROUP, a prospective, longitudinal six-year study of patients with SSD. We analyzed longitudinal changes in 15 outcomes (i.e., subdomains of symptoms, social functioning, cognition, quality of life or well-being), through a linear mixed-effects model analysis. Changes in other outcomes, patients' duration of illness (DOI), and personal, clinical, or social patient characteristics at baseline were treated as covariates in the analyses.

Results: We observed long-term improvement in all outcomes, except for depressive symptoms and subjective well-being. Larger improvements in positive symptoms, social functioning and executive functioning were indicated for patients with a short DOI. We found multiple, moderating effects, mainly for patients with a short DOI, between changes in cognition, social functioning, symptoms and quality of life. Limited moderating effects were indicated between these recovery domains and well-being. Baseline levels of outcomes, schizophrenia diagnosis, education level, ethnicity, living situation, employment status and marital status were all moderators for changes in most outcomes.

Conclusions: Symptoms, social functioning, cognition and quality of life often concurrently improved over the course of SSD. These longitudinal changes were mostly driven by social patient characteristics, such as education level, ethnicity, living situation, employment status and marital status.

Clinical trial number: Not applicable.

Background: Abnormal thyroid function is common in patients with major depressive disorder (MDD), which may be closely associated with metabolic disturbances, especially overweight and obesity. This study aimed to examine the prevalence of overweight and obesity and their related factors in MDD patients with elevated thyroid stimulating hormone (TSH) levels.

Methods: A total of 1718 patients with MDD were recruited in this study. Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), and Positive and Negative Syndrome Scale (PANSS) positive subscale were used to assess clinical symptoms. In addition, free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), anti-thyroglobulin (A-TG), body weight, height, and blood pressure were measured.

Results: MDD patients with elevated TSH levels had a higher rate of obesity and overweight compared to those without abnormal TSH levels. Among patients with elevated TSH levels, those who were overweight and obese had an older actual age and age of onset, lower A-TG levels, and higher systolic blood pressure than those who were not overweight and obese. Further logistic regression analysis showed that being married (OR: 1.582, 95% CI: 1.191-2.102) and having no suicidal behavior (OR: 1.444, 95% CI: 1.079-1.934) were independently associated with overweight and obesity in patients with elevated TSH level (p < 0.05).

Conclusion: Patients with MDD who have elevated TSH levels are more likely to be obese and overweight. Actual age, age of onset, systolic blood pressure, A-TG levels, marital statusand and suicidal behavior were associated with obesity and overweight in MDD patients with elevated TSH levels.