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Whispers and whirlwinds - Reflection. 低语与旋风--反思。
IF 8.7 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-11-12 DOI: 10.1192/bjp.2024.102
Antonio Yaghy
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引用次数: 0
Air pollutants, genetic susceptibility and the risk of schizophrenia: large prospective study. 空气污染物、遗传易感性和精神分裂症风险:大型前瞻性研究。
IF 8.7 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-01 DOI: 10.1192/bjp.2024.118
Run Liu, Dankang Li, Yudiyang Ma, Lingxi Tang, Ruiqi Chen, Yaohua Tian

Background: Evidence linking air pollutants and the risk of schizophrenia remains limited and inconsistent, and no studies have investigated the joint effect of air pollutant exposure and genetic factors on schizophrenia risk.

Aims: To investigate how exposure to air pollution affects schizophrenia risk and the potential effect modification of genetic susceptibility.

Method: Our study was conducted using data on 485 288 participants from the UK Biobank. Cox proportional hazards models were used to estimate the schizophrenia risk as a function of long-term air pollution exposure presented as a time-varying variable. We also derived the schizophrenia polygenic risk score (PRS) utilising data provided by the UK Biobank, and investigated the modification effect of genetic susceptibility.

Results: During a median follow-up period of 11.9 years, 417 individuals developed schizophrenia (mean age 55.57 years, s.d. = 8.68; 45.6% female). Significant correlations were observed between long-term exposure to four air pollutants (PM2.5; PM10; nitrogen oxides, NOx; nitrogen dioxide, NO2) and the schizophrenia risk in each genetic risk group. Interactions between genetic factors and the pollutants NO2 and NOx had an effect on schizophrenia events. Compared with those with low PRS and low air pollution, participants with high PRS and high air pollution had the highest risk of incident schizophrenia (PM2.5: hazard ratio = 6.25 (95% CI 5.03-7.76); PM10: hazard ratio = 7.38 (95% CI 5.86-9.29); NO2: hazard ratio = 6.31 (95% CI 5.02-7.93); NOx: hazard ratio = 6.62 (95% CI 5.24-8.37)).

Conclusions: Long-term exposure to air pollutants was positively related to the schizophrenia risk. Furthermore, high genetic susceptibility could increase the effect of NO2 and NOx on schizophrenia risk.

背景:目的:调查空气污染暴露如何影响精神分裂症风险以及遗传易感性的潜在影响:我们的研究使用了英国生物库中485 288名参与者的数据。我们使用 Cox 比例危险模型来估算作为时变变量的长期空气污染暴露对精神分裂症风险的影响。我们还利用英国生物库提供的数据得出了精神分裂症多基因风险评分(PRS),并研究了遗传易感性的修饰效应:中位随访期为 11.9 年,共有 417 人患上精神分裂症(平均年龄 55.57 岁,标准差 = 8.68;45.6% 为女性)。研究发现,长期暴露于四种空气污染物(PM2.5、PM10、氮氧化物(NOx)、二氧化氮(NO2))与各遗传风险组的精神分裂症风险之间存在显著相关性。遗传因素与污染物二氧化氮和氮氧化物之间的相互作用对精神分裂症事件有影响。与低PRS和低空气污染的参与者相比,高PRS和高空气污染的参与者患精神分裂症的风险最高(PM2.5:危险比=6.25(95% CI 5.03-7.76);PM10:危险比=7.38(95% CI 5.86-9.29);二氧化氮:危险比=6.31(95% CI 5.02-7.93);氮氧化物:危险比=6.62(95% CI 5.24-8.37)):结论:长期暴露于空气污染物与精神分裂症风险呈正相关。此外,高遗传易感性会增加二氧化氮和氮氧化物对精神分裂症风险的影响。
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引用次数: 0
Bark of the giant Sequoia tree - Reflection. 巨型红杉树的树皮 - 反射。
IF 8.7 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-11-12 DOI: 10.1192/bjp.2024.93
Chinenye Omesili
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引用次数: 0
Franco Basaglia (1924-1980): the reformer of the Italian psychiatric system - Psychiatry in history. 弗朗科-巴萨利亚(1924-1980 年):意大利精神病学体系的改革者 - 历史上的精神病学。
IF 8.7 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-11-12 DOI: 10.1192/bjp.2024.86
Maximilian Schochow, Alexander Ernst, Florian Steger
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引用次数: 0
Investing in mental health: a path to economic growth through psychological therapies. 投资心理健康:通过心理疗法实现经济增长之路。
IF 8.7 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-11-12 DOI: 10.1192/bjp.2024.70
Roger Muñoz-Navarro, Rob Saunders, Joshua E J Buckman, Paloma Ruiz-Rodríguez, César González-Blanch, Leonardo A Medrano, Juan Antonio Moriana, Antonio Cano-Vindel
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引用次数: 0
Childhood trauma and differential response to long-term psychoanalytic versus cognitive-behavioural therapy for chronic depression in adults. 童年创伤与成人对长期精神分析疗法和认知行为疗法治疗慢性抑郁症的不同反应。
IF 8.7 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-01 DOI: 10.1192/bjp.2024.112
Lina Krakau, Mareike Ernst, Martin Hautzinger, Manfred E Beutel, Marianne Leuzinger-Bohleber

Background: Childhood trauma is a major risk factor for chronic depression. It has been suggested that adults with chronic depression who have experienced childhood trauma may require long-term treatment owing to a breakdown of basic trust and related difficulties in developing a productive therapeutic relationship.

Aims: As empirical studies have been preliminary and scarce, we studied the effects of psychoanalytic therapy (PAT) versus cognitive-behavioural therapy (CBT) for chronic depression in adults with a history of childhood trauma. In this subgroup, we expected a greater symptom reduction in PAT compared with CBT.

Method: In a large trial of long-term psychotherapies for chronic depression (LAC-Study; Clinical Trial Register ISRCTN91956346), 210 adults received open-ended CBT or PAT in an out-patient setting and were examined yearly over 5 years on the Beck Depression Inventory - II (BDI-II). Based on a linear mixed model approach, we tested participant-reported childhood trauma based on the Childhood Trauma Questionnaire (CTQ) as a predictor and moderator of treatment outcome. CTQ subscales were examined exploratively.

Results: Depressive symptoms decreased over time (b = -4.55, s.e. = 0.90, 95% CI -6.32 to -2.81, T = -5.08; P < 0.001). A significant three-way interaction between childhood trauma, time and therapy group (b = -0.05, s.e. = 0.02, 95% CI -0.09 to -0.01, T = -2.42; P = 0.016) indicated that participants with childhood trauma profited especially well from PATs.

Conclusions: Our results indicate differential benefits from PAT compared with CBT among adults with chronic depression and a history of childhood trauma. The results have important implications for differential indication and policy.

背景:童年创伤是慢性抑郁症的主要风险因素。目的:由于实证研究尚属初步且稀缺,我们研究了精神分析疗法(PAT)与认知行为疗法(CBT)对有童年创伤史的成人慢性抑郁症的治疗效果。在这个亚组中,我们预计精神分析疗法与认知行为疗法相比,症状减轻的程度更大:在一项大型慢性抑郁症长期心理疗法试验(LAC-Study;临床试验注册号 ISRCTN91956346)中,210 名成人在门诊环境中接受了开放式 CBT 或 PAT 治疗,并在 5 年内每年接受一次贝克抑郁量表 - II (BDI-II) 测试。基于线性混合模型方法,我们测试了参与者根据童年创伤问卷(CTQ)报告的童年创伤对治疗结果的预测和调节作用。我们还对 CTQ 的子量表进行了探索性研究:随着时间的推移,抑郁症状有所减轻(b = -4.55, s.e. = 0.90, 95% CI -6.32 to -2.81, T = -5.08; P < 0.001)。童年创伤、时间和治疗组(b = -0.05,s.e. = 0.02,95% CI -0.09至-0.01,T = -2.42;P = 0.016)三者之间存在明显的交互作用,表明有童年创伤的参与者从PATs中获益特别多:结论:我们的研究结果表明,在患有慢性抑郁症并有童年创伤史的成年人中,与 CBT 相比,PAT 能带来不同程度的益处。这些结果对于区别对待和政策制定具有重要意义。
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引用次数: 0
Winifred Holtby (1898-1935): a mental hospital visit, early 1930s - Psychiatry in literature. 威妮弗蕾德-霍尔特比(1898-1935 年):20 世纪 30 年代初的一次精神病院探访 - 文学作品中的精神病学。
IF 8.7 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-01 Epub Date: 2024-11-04 DOI: 10.1192/bjp.2024.44
Andrew J Larner
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引用次数: 0
Randomised controlled trial of the short-term effects of osmotic-release oral system methylphenidate on symptoms and behavioural outcomes in young male prisoners with attention deficit hyperactivity disorder (ADHD): CIAO-II study: commentary, Asherson et al. 渗透释放口服系统哌醋甲酯对患有注意缺陷多动障碍 (ADHD) 的年轻男性囚犯的症状和行为结果的短期影响的随机对照试验:CIAO-II研究:评论》,Asherson等人,2007年。
IF 8.7 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-01 Epub Date: 2024-11-04 DOI: 10.1192/bjp.2024.60
Philip Asherson, Andrew Forrester, Lena Johansson, Lindsay Thomson
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引用次数: 0
LSD-assisted therapy in patients with anxiety: open-label prospective 12-month follow-up. 焦虑症患者的 LSD 辅助疗法:开放标签前瞻性 12 个月随访。
IF 8.7 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-01 DOI: 10.1192/bjp.2024.99
Friederike Holze, Peter Gasser, Felix Müller, Manuel Strebel, Matthias E Liechti

Background: Anxiety disorders are a major public health burden with limited treatment options.

Aims: We investigated the long-term safety and efficacy of lysergic acid diethylamide (LSD)-assisted therapy in patients with anxiety with or without life-threatening illness.

Method: This study was an a priori-planned long-term follow-up of an investigator-initiated, two-centre trial that used a double-blind, placebo-controlled, two-period, random-order, crossover design with two sessions with either oral LSD (200 μg) or placebo per period. Participants (n = 39) were followed up 1 year after the end-of-study visit to assess symptoms of anxiety, depression and long-term effects of psychedelics using Spielberger's State-Trait Anxiety Inventory-Global (STAI-G), the Beck Depression Inventory (BDI), the Persisting Effects Questionnaire and measures of personality traits using the NEO-Five-Factor Inventory.

Results: Participants reported a sustained reduction of STAI-G scores compared with baseline (least square means (95% CI) = -21.6 (-32.7, -10.4), d = 1.04, P < 0.001, for those who received LSD in the first period (94 weeks after the last LSD treatment) and -16.5 (-26.2, -6.8), d = 1.02, P < 0.05, for those who received LSD in the second period (68 weeks after the last LSD treatment)). Similar effects were observed for comorbid depression with change from baseline BDI scores of -8.1 (-13.2, -3.1), d = 0.71, P < 0.01, and -8.9 (-12.9, -4.9), d = 1.21, P < 0.01, for the LSD-first and placebo-first groups, respectively. Personality trait neuroticism decreased (P < 0.0001) and trait extraversion increased (P < 0.01) compared with study inclusion. Individuals attributed positive long-term effects to the psychedelic experience.

Conclusions: Patients reported sustained long-term effects of LSD-assisted therapy for anxiety.

背景:目的:我们研究了麦角酰二乙胺(LSD)辅助疗法对患有或不患有危及生命疾病的焦虑症患者的长期安全性和有效性:该试验采用双盲、安慰剂对照、两期、随机顺序、交叉设计,每期口服 LSD(200 μg)或安慰剂两次。研究结束一年后,对参与者(39 人)进行随访,使用斯皮尔伯格状态-特质焦虑量表-全球(STAI-G)、贝克抑郁量表(BDI)、持续效应问卷和 NEO 五因子量表测量人格特质,评估焦虑、抑郁症状和迷幻药的长期影响:与基线相比,参与者的 STAI-G 分数持续降低(最小平方均值 (95% CI) = -21.6 (-32.7, -10.4),d = 1.04,P < 0.001,适用于在第一阶段(最后一次 LSD 治疗后 94 周)接受 LSD 治疗的患者;d = 1.02,P < 0.05,适用于在第二阶段(最后一次 LSD 治疗后 68 周)接受 LSD 治疗的患者)。在合并抑郁症方面也观察到类似的效果,先接受 LSD 治疗组和先接受安慰剂治疗组的 BDI 评分与基线相比的变化分别为 -8.1 (-13.2, -3.1), d = 0.71, P < 0.01 和 -8.9 (-12.9, -4.9), d = 1.21, P < 0.01。与纳入研究相比,人格特质神经质减少(P < 0.0001),特质外向性增加(P < 0.01)。患者认为迷幻体验产生了积极的长期效果:患者报告称,迷幻剂辅助治疗焦虑症具有持续的长期效果。
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引用次数: 0
Towards a unified theory of the aetiology of schizophrenia: commentary, Shergill et al. 走向精神分裂症病因学的统一理论:Shergill 等人的评论。
IF 8.7 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-01 DOI: 10.1192/bjp.2024.107
Sukhwinder S Shergill, Kyrillos M Meshreky
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引用次数: 0
期刊
British Journal of Psychiatry
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