BMC Psychiatry最新文献

Background: Breast cancer (BC) survivorship presents significant health disparities, particularly affecting Black women, who experience a 40% higher BC death rate compared to White women. These disparities are exacerbated by comorbidities, which contribute to poorer overall health outcomes. Additionally, Black BC survivors often face psychosocial challenges, including increased stress and lower well-being, which can lead to adverse physical health effects. This pilot study aims to assess the feasibility and efficacy of a culturally sensitive gratitude journaling intervention designed to enhance spiritual well-being, exercise self-efficacy, and reduce inflammation among Black BC survivors.

Methods: This pilot study employed a two-group, parallel random-assignment experimental design to compare a gratitude journaling intervention with a general memory journaling control group. Twenty-six Black women aged 40 to 70 years with a history of BC were randomly assigned to either the gratitude journaling intervention group (n = 13) or the control group (n = 13). The gratitude intervention group engaged in gratitude journaling twice weekly for eight weeks, while the control group documented daily memories. Outcomes measured included Gratitude Questionnaire-6, FACIT-Spiritual Well-Being 12 Item Scale, Perceived Stress Scale, Giscombe Superwoman Schema Questionnaire, and the Stage of Motivational Readiness for Physical Activity questionnaire and inflammatory biomarkers. Statistical analyses included the Wilcoxon rank sum test and Fisher's exact test.

Results: Twenty-six participants were enrolled, with 73% completing baseline and post-intervention assessments. The intervention group showed a significant improvement in spiritual well-being (p = 0.014) with a large effect size (ES = 0.57). Marginal improvements in exercise self-efficacy were also observed (ES = 0.39). Although there were no significant differences in dispositional gratitude and perceived stress between groups, the intervention group exhibited trends toward increased gratitude and reduced stress. Inflammatory biomarker analysis indicated non-significant changes, though IL-6 levels increased in the intervention group.

Conclusion: This study demonstrates the feasibility and acceptability of a gratitude journaling intervention among Black BC survivors. The intervention significantly enhanced spiritual well-being and showed promise in improving exercise self-efficacy, suggesting its potential for promoting holistic wellness in this population. These findings provide a foundation for future larger-scale randomized controlled trials to further evaluate the efficacy of gratitude-based interventions for Black BC survivors.

Trial registration: This study was registered prospectively at ClinicalTrials.gov (NCT05473026) on 07-13-2022.

Background: Migrant elderly following children (MEFC) is an emerging special elderly mobile migrant population in China. MEFC face multiple dilemmas of distress, which makes their depressive symptoms more prominent. To explore ways to alleviate depressive symptoms, this study aimed to investigate the chain mediating effects of resilience and loneliness on the relationship between social support and depressive symptoms among MEFC.

Methods: A cross-sectional study was conducted using purposive sampling from Changsha, Hunan Province, China, and 298 MEFC were included. The 15-item Geriatric Depression Scale, Social Support Rating Scale, University of California Los Angeles Loneliness Scale, and Connor-Davidson Resilience Scale were used to measure depressive symptoms, social support, loneliness, and resilience, respectively. Pearson's correlation analysis was conducted to clarify the association between the variables. The PROCESS macro model 6 was applied to analyze the multiple mediating effects.

Results: The prevalence of depressive symptoms among MEFC was 29.86%. Social support (r = -0.354, P < 0.001), resilience (r = -0.373, P < 0.001), and loneliness (r = 0.483, P < 0.001) were significantly associated with depressive symptoms. Social support not only had a direct negative effect (Effect= -0.086, 95% CI: -0.149 to -0.023) on depressive symptoms, but also had an indirect effect on depressive symptoms through resilience (Effect= -0.045, 95% CI: -0.076 to -0.015), loneliness (Effect= -0.053, 95% CI: -0.091 to -0.020), and the chain mediating effects of resilience and loneliness (Effect= -0.019, 95% CI: -0.037 to -0.007), respectively.

Conclusions: The prevalence of depressive symptoms was relatively high. Resilience and loneliness partially mediated the association between social support and depressive symptoms. In the future, interventions could focus on increasing social support to enhance resilience and reduce loneliness, thereby reducing depressive symptoms in MEFC.

Background: Information sharing and information privacy are important issues in mental health services. Yet the perspectives of Australians who access mental health services about these issues are poorly understood. This article addresses the research question: What are the concerns of people who use mental health services about the collection and use of their health information in mental health and related systems in Australia?

Methods: Participants were 16 people who had accessed mental health services and were involved in a series of co-design workshops as part of a larger study. Focused group activities were conducted in which participants were asked to discuss and create a visual map to describe their collective experiences of sharing information relating to mental health and recovery. The data were analysed using qualitative content analysis and the coding techniques of constant comparative analysis.

Results: Participants expressed a sense of unknowability about the information held and accessed by various organisations. They described providing information to a wide variety of entities, though not always in a free or informed way. They believed other information held about them had been generated and/or shared by people other than themselves, often without their knowledge or consent. Participants reported that both the collection and storage of this information involved risks for them, and they sometimes restricted the information they provided. To improve their comfort with the use of their information, participants recommended customised and transparent information collection; individuals' access and input to their own information; and use of information only for their benefit.

Conclusions: Trust is key to positive experiences of information provision and information sharing. Central to establishing trust are transparent practices that facilitate greater choice and control.

Background: Sustained attention deficits were reported more significant in patients with major depressive disorder (MDD) than in healthy controls (HCs), and are pivotal in both the development and aggravation of depression. Childhood trauma is also common in MDD and the exposure to childhood trauma may impede sustained attention and increase the treatment resistance in MDD. However, the underlying neuro-mechanisms link the childhood trauma to sustained attention deficits in MDD remain unclear.

Methods: We collected resting-state functional magnetic resonance imaging data, and measured childhood trauma severity using the Childhood Trauma Questionnaire and sustained attention using the Continuous Performance Test, Identical Pairs version. After excluding subjects with significant head movement, 45 MDDs and 54 HCs were included in the analysis. We compared fractional amplitude of low-frequency fluctuation (fALFF) between the groups, conducted whole-brain correlation analysis between the fALFF and sustained attention in the MDD group, and defined significant regions as the regions of interest for the seed-to-whole brain functional connectivity (FC) analysis. We further performed mediation analyses to investigate the relationships among the childhood trauma, fALFF and FC values, and the level of sustained attention in the MDD group.

Results: Compared with HCs, MDDs exhibited higher fALFF in the right middle frontal gyrus and left inferior frontal gyrus, and lower fALFF in the bilateral insular cortex, left medial orbital superior frontal gyrus and left angular gyrus (ANG.L). Whole-brain correlation analysis showed that impaired sustained attention was associated with increased fALFF in the left postcentral gyrus (PoCG.L), and FC of PoCG.L-left precentral gyrus (PreCG.L) and ANG.L-right superior temporal gyrus (STG.R) in the MDD group. Furthermore, mediation analyses showed that the fALFF in PoCG.L, and FC of PoCG.L-PreCG.L and ANG.L-STG.R mediated the relationship between the childhood trauma and sustained attention in the MDD group.

Conclusion: The fALFF in PoCG.L, and FC of PoCG.L-PreCG.L and ANG.L-STG.R might be potential neural substrate in the association between the childhood trauma and poor sustained attention in the MDDs, and might serve as potential intervention targets for the treatment of sustained attention deficits in MDDs with childhood trauma history.

Background: The behavioral disorder is characterized by a profound abnormality in an individual's cognition, emotion or behavior that reflects in psychological, biological or developmental dysfunction. Rheumatic heart disease (RHD) is a long-term sequel of single or recurrent acute rheumatic fever. Children with RHD are thought to be at increased risk for behavioral problems due to autoimmunity seen in pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). Behavior disorder is not well studied among children with RHD. Hence, this study aimed to assess the pattern and predictors of behavioral problems among children with RHD enrolled in chronic care at a national cardiac referral Hospital.

Methods: This cross-sectional study used a validated parental-reported Amharic Strengths and Difficulties Questionnaire (SDQ) to assess behavior problems. Children with RHD aged 6-17 years on chronic outpatient cardiac care at Tikur Anbessa Specialized Hospital, Ethiopia between February and May 2023 were included. Factors associated with behavior problems were assessed using logistic regression models.

Results: The study included 166 children with a median age of 15 years [Interquartile range (IQR):13-17 years]. One-fourth of children, 24.7% (95% CI: 18.34-31.98), had behavioral problems. Of these, 46.4% (77) emotional, 35.5% (59) peer, 18.1% (30) conduct and 6.6% (11) hyperactivity problems were documented. Children who had good medication adherence, adjusted odds ratio AOR 0.29(95% CI: 0.09-0.94, P 0.040) and on New York Health Association (NYHA) class I, AOR 0.28(95% CI: 0.11-0.79, P 0.016) had lower odds for behavioral problems.

Conclusion: One-fourth of children with RHD had behavioral abnormalities. Medication adherence and NYHA predicted behavioral abnormality. Better physical symptom control was associated with fewer behavioral problems. Behavioral abnormalities should be considered and assessed among children with RHD. Further multi-center mixed studies are recommended to uncover the unseen behavioral problem and guide health policy action on modalities of integration of behavioral problems assessment tools in clinical care.

Background: Borderline Personality Disorder (BPD) is one of the most frequent, severe, mental conditions and is associated with a serious burden of disease. Treatment for patients with BPD involves structured psychotherapy. In addition and in order to improve access to care, psychiatric treatments are available. So far, it remains unclear if brief psychiatric intervention according to Good Psychiatric Management (GPM) produces a reliable effect on a variety of clinical outcomes. The assessment of mechanisms of change contributes to focus the treatment on the essential ingredients of change. The current study aims to demonstrate the emotional processing as a mechanism of change, assessed in an ecologically valid experimental context, of brief GPM.

Methods: The present two-arm randomized controlled study aims at testing the effects (i.e., reduction in borderline symptoms) and emotional processing as mechanism of change of a brief psychiatric treatment (10 sessions over 4 months), compared with treatment as usual. Participants are N = 76 patients with BPD who are either randomized to a 4 month GPM or a 4 month TAU without any BPD-specific content. All patients undergo assessments of borderline symptoms using ZAN-BPD and experiential enactment for assessment of emotional processing, at intake, 2 months and 4 months (discharge).

Results: The effect of a brief version of GPM is not different from the effect of TAU on the total score of the ZAN-BPD at 4 month (d = 0.04). At the level of the secondary effects, GPM is more effective in reducing relationship problems on the ZAN-BPD sub-scale (F(1, 61) = 5.53; p = .022, d = 0.52), and in reducing impulsivity and social problems, and it increases treatment retention. Change in emotional processing between intake and month 2 mediates the reduction on the ZAN-BPD subscale relationship problems assessed between months 2 and 4, in an ecologically valid experimental context.

Conclusions: Overall, brief GPM is not different from TAU in terms of reduction in borderline symptoms, but it may produce reduction in relationship problems between months 2 and 4 into the brief intervention. Change in emotional processing in an experimental context may function as mechanism of change of brief GPM. This study is in line with the top priority of establishing efficacy of brief interventions for BPD and proposes an evidence-based explanation for efficacy. These results should help disseminate brief psychiatric treatments for BPD, which contribute to reduce the societal burden related with BPD.

Trial registration: Clinical Trials NCT03717818 (date of registration of Abstract October 24th, 2018). Protocol number 2 from February 9th, 2018.

Introduction: Co-production involves researchers, practitioners and people with lived experience working in a collaborative manner, with shared power. The potential benefits of co-production are well documented. However, there is little research describing the experience of having been involved in co-production from the perspective of Experts By Lived Experience (EBLE). The aim of the present study is to explore the experiences of EBLE of obsessive-compulsive disorder (OCD) on their involvement in co-producing a blended intervention to prevent relapse for OCD.

Methods: Five EBLE took part in semi-structured interviews enquiring about their experiences of co-producing a relapse prevention intervention. Reflexive thematic analysis was used to analyse the data.

Results: Four themes were developed: (1) Welcome but unexpected therapeutic benefits; (2) The parameters of a safe space; (3) Genuine co-production brings meaningful change; and (4) Navigating the challenging terrain of co-production.

Conclusions: Overall, EBLE reported their involvement in the co-production process to have had positive impacts on both the development of the intervention and their own personal recovery journey. EBLE valued the safety created within the group, and the importance this had for allowing them to speak open and honestly about their experiences and the difficulties that can arise with the nature of the work.

Background: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with different subtypes of pathogenesis. Insufficient research on the subtypes of ADHD has limited the effectiveness of therapeutic methods.

Methods: This study used resting-state functional near-infrared spectroscopy (fNIRS) to record hemodynamic signals in 34 children with ADHD-combined subtype (ADHD-C), 52 children with ADHD-inattentive subtype (ADHD-I), and 24 healthy controls (HCs). The amplitude of low-frequency fluctuation (ALFF) and the functional connectivity (FC) analysis were conducted for all subjects.

Results: Compared with HCs, the ADHD group exhibited significantly increased ALFF and decreased FC. The ADHD-C group showed significantly higher ALFF in partial brain regions and significantly lower FC between multiple brain regions than participants with ADHD-I. The male group displayed a significant increase in ALFF in some brain regions, while no significant difference was found in FC when compared to the female group.

Conclusions: This study provides evidence to support the subtype classification of ADHD-I and ADHD-C, and the combined analysis of ALFF and FC has the potential to be a promising biomarker for the diagnosis of ADHD.

Background: Recurrent observations have indicated the presence of deficits in mismatch negativity (MMN) among schizophrenia. There is evidence suggesting a correlation between increased dopaminergic activity and reduced MMN amplitude, but there is no consensus on whether antipsychotic medications can improve MMN deficit in schizophrenia.

Methods: We conducted clinical assessments, cognitive function tests, and EEG data collection and analysis on 31 drug-naïve patients with schizophrenia. Comprehensive evaluation tools such as PANSS and MCCB. MMN amplitude was analyzed by event-related potential (ERP) approaches, evoked theta power was analyzed by event-related spectral perturbation (ERSP) approaches.

Results: Our findings indicate that antipsychotic treatment significantly improved clinical symptoms, as evidenced by reductions in PANSS positive, negative, general symptoms, and total scores (all p < 0.001). Cognitive function improvements were observed in language learning, working memory, and overall MCCB scores (p < 0.05), although other cognitive domains showed no significant changes. However, no significant improvements were noted in MMN amplitude and evoke theta power after four weeks of antipsychotic treatment (p > 0.05).

Conclusion: These results suggest that while antipsychotic medications effectively alleviate clinical symptoms, their impact on MMN amplitude and evoke theta power deficit is limited in the short term. Moreover, the amelioration of cognitive impairment in individuals with schizophrenia is not readily discernible, and it cannot be discounted that the enhancement observed in language acquisition and working memory may be attributed to a learning effect. These findings underscore the complexity of the neurobiological mechanisms involved and highlight the need for further research to optimize individualized treatment strategies for schizophrenia.

Trial registration: ChiCTR2000038961, October 10, 2020.