BACKGROUND Functional neurological disorder(FND)in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology.Despite its prevalence,FND in pe...BACKGROUND Functional neurological disorder(FND)in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology.Despite its prevalence,FND in pediatric populations remains under-researched,with challenges in diagnosis and management AIM To synthesize the current literature on FND in children,focusing on clinical presentation,diagnostic approaches,treatment strategies,and outcomes.METHODS A comprehensive literature search was conducted across multiple databases,including PubMed,Scopus,and Web of Science,for articles published up to August 2024.Studies were included if they addressed FND in pediatric populations,specifically focusing on review articles,research articles,systematic reviews,meta-analyses,case reports,guidelines,expert opinions,and editorials.Data extraction and quality assessment were performed according to PRISMA guidelines.A total of 308 articles were included in the final analysis.RESULTS The analysis included 189 review articles,57 research articles,3 systematic reviews and meta-analyses,5 case reports,2 guidelines,5 expert opinions,and 2 editorials.Key findings revealed a broad spectrum of symptoms,including motor and sensory disturbances and psychological factors contributing to the onset and persistence of FND.Diagnostic challenges were frequently highlighted,emphasizing the need for interdisciplinary approaches.Treatment strategies varied,with cognitive-behavioral therapy(CBT)and multidisciplinary care emerging as the most effective approaches.The outcomes varied,with early intervention being critical for a better prognosis.CONCLUSION Early diagnosis and multidisciplinary care,including CBT,are critical for improving outcomes in pediatric FND.Standardized diagnostic criteria and treatment protocols are needed to enhance clinical management.展开更多
Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment ...Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment response remains underexplored.Our review seeks to mainly delve into the effect of gender identity on ADHD,exploring the unique needs of individuals with various gender identities in the context of ADHD symptoms,diagnostic assessment,and treatment,with the goal of supplying theoretical support and practical recommendations for future research and clinical practice.The primary content includes,specifically:(1)Symptom expression differences:Gender identity significantly affects ADHD symptoms;male-identified individuals commonly perform worse in task orientation and attention stability,while female-identified individuals may demonstrate more variability in attention control and executive functions;(2)Diagnosis and treatment:Clinical practice generally neglects the impact of gender identity on ADHD management,with personalized needs of gender-identified individuals frequently not adequately addressed,potentially,affecting treatment outcomes;and(3)Future research directions:Future studies should further assess how gender identity affects the specific mechanisms of ADHD,conduct researches in multicultural contexts,and engage in long-term follow-up studies to evaluate the long-term impact of gender identity on ADHD progression.Besides,enhanced funding and public education on the relationship between gender identity and ADHD are needed to advance the field.展开更多
To the editor:A wide range of affective disorders affects people of all ages globally and contributes significantly to the global disease burden.1 In China,a nationwide survey found a 3.21% prevalence of affective dis...To the editor:A wide range of affective disorders affects people of all ages globally and contributes significantly to the global disease burden.1 In China,a nationwide survey found a 3.21% prevalence of affective disorders in children and adolescents,with major depressive disorder(MDD)at 2.00%and bipolar disorder at 0.86%.展开更多
Chat Generative Pre-trained Transformer(ChatGPT)is a conversational service that uses artificial intelligence and is also known as a chatbot.ChatGPT and similar applications have the potential to be a tool that can be...Chat Generative Pre-trained Transformer(ChatGPT)is a conversational service that uses artificial intelligence and is also known as a chatbot.ChatGPT and similar applications have the potential to be a tool that can be used in the field of psychiatry.Eating disorders affect a large number of individuals worldwide.Tools that encourage and support people with eating disorders to seek mental health services may be critical to helping them get the care they need.However,body image,defined as the totality of a person's thoughts and perceptions about their physical appearance,has been linked to a variety of health problems,particularly among young adults,about eating disorders.There is limited literature on how chatbots respond to or provide information about body image.Preventing eating disorders before they occur is also of great importance.However,young adults who struggle with body image perception may be misled by the information produced by ChatGPT.Studies have yet to clarify whether a chatbot can improve eating disorder-related factors,eating disorder psychopathology,depression,and anxiety or detect eating disorders in advance.This study focuses on the accuracy of ChatGPT in providing information regarding eating disorders and its potential effects on body image perception.展开更多
Background Mental disorders rank among the leading contributors to the global disease burden, with depressive disorders being among the most prevalent.Aims The objective of this study is to examine the prevalence, inc...Background Mental disorders rank among the leading contributors to the global disease burden, with depressive disorders being among the most prevalent.Aims The objective of this study is to examine the prevalence, incidence and years lived with disability (YLDs) associated with depressive disorders, particularly major depressive disorder and dysthymia, in Iran from 1990 to 2021. To achieve this, the research focused on analysing these metrics across various dimensions, including temporal trends, sex differences, age categories and subnational regions.Methods The data used in this study are sourced directly from the Institute for Health Metrics and Evaluation, ensuring that the information is both authoritative and reliable. All-age count estimates and age-standardised rates (per 100 000) were calculated for prevalence, incidence and YLDs. The disease burden indicators were analysed for the period spanning from 1990 to 2021, stratified by sex, age and location. The percentage change between 1990 and 2021 was also documented. The 95% uncertainty interval (UI) was reported for each of the reported estimates.Results The prevalence of depressive disorders in Iran demonstrated a notable upward trend from 1990 to 2021, with the rate of growth being particularly pronounced within the country. The age-standardised prevalence rate per 100 000 individuals for depressive disorders in Iran was 5609 (95% UI 4810 to 6488). By 2021, the number of depression cases in Iran reached 5.2 million, which is approximately 2.37 times the figure reported in 1990. The prevalence of depressive disorders was notably higher among females compared with males. The age-standardised prevalence rate per 100 000 individuals for males was 4184 (95% UI 3545 to 4929). For females, this figure was significantly greater, reaching 7077 (95% UI 6115 to 8172). Out of the total reported cases of depressive disorders in Iran, 3.2 million were observed in females, while males accounted for 2 million cases.Conclusions The findings highlighted the considerable impact of depressive disorders in Iran, both nationally and regionally, while also revealing variations across sex and age groups. Given the shifts in the demographic structure and the growing burden of these disorders, it is essential to prioritise screening initiatives, education programmes and strategies aimed at enhancing mental health awareness and ensuring improved access to mental health services in health policy planning.展开更多
Mental health disorders have emerged as a critical global health challenge,profoundly impacting individuals,communities,and societies worldwide.The prevalence of mental health problems has been steadily increasing,wit...Mental health disorders have emerged as a critical global health challenge,profoundly impacting individuals,communities,and societies worldwide.The prevalence of mental health problems has been steadily increasing,with~1 in 8 people,equivalent to 970 million individuals suffering from a mental disorder in 2019(https://vizhub.healthdata.org/gbd-results).Anxiety and depressive disorders are predominant,contributing significantly to the burden of mental health issues,according to the World Health Organization.The COVID-19 pandemic has further exacerbated this situation.It led to a notable upsurge in anxiety and major depressive disorders in 2020.Estimates indicate a 26%rise in anxiety and a 28%increase in depression within that year(https://www.who.int/publications/i/item/WHO-2019-nCoVSci_Brief-Mental_health-2022.1)[1].展开更多
BACKGROUND Speech and language therapy(ST)might moderate the prognosis in children with attention deficit and hyperactivity disorder(ADHD)comorbid with speech delay.This study investigated whether ST in children with ...BACKGROUND Speech and language therapy(ST)might moderate the prognosis in children with attention deficit and hyperactivity disorder(ADHD)comorbid with speech delay.This study investigated whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.AIM To investigate whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.METHODS The population-based National Health Insurance Research Database in Taiwan was used.Hazards of subsequent psychiatric disorders were compared between those who received ST and a propensity-score matched comparison group by Cox regression analyses.RESULTS Of 11987 children with ADHD identified from the dataset,2911(24%)had received ST.The adjusted hazard ratio for any subsequent recorded psychiatric disorder was 0.72(95%confidence interval:0.63-0.82)in children who received ST compared to the matched counterparts.This protective association was only statistically significant in the subgroup that received both medication and behavioral interventions.CONCLUSION ST can moderate the effects of integrated early interventions in ADHD children with speech delay.展开更多
Fear memory is crucial for survival and adaptation in complex and dynamically changing environments that enables individuals to avoid or escape from potentially dangerous situations.However,excessive fear memories can...Fear memory is crucial for survival and adaptation in complex and dynamically changing environments that enables individuals to avoid or escape from potentially dangerous situations.However,excessive fear memories can significantly contribute to emotional disabilities and mental disorders,including panic disorder,phobias,social anxiety disorder,and post-traumatic stress disorder(PTSD).展开更多
Tropomyosin receptor kinase B(TrkB)signaling plays a pivotal role in dendritic growth and dendritic spine formation to promote learning and memory.The activity-dependent release of brain-derived neurotrophic factor at...Tropomyosin receptor kinase B(TrkB)signaling plays a pivotal role in dendritic growth and dendritic spine formation to promote learning and memory.The activity-dependent release of brain-derived neurotrophic factor at synapses binds to pre-or postsynaptic TrkB resulting in the strengthening of synapses,reflected by long-term potentiation.Postsynaptically,the association of postsynaptic density protein-95 with TrkB enhances phospholipase Cγ-Ca^(2+)/calmodulin-dependent protein kinaseⅡand phosphatidylinositol 3-kinase-mechanistic target of rapamycin signaling required for long-term potentiation.In this review,we discuss TrkB-postsynaptic density protein-95 coupling as a promising strategy to magnify brain-derived neurotrophic factor signaling towards the development of novel therapeutics for specific neurological disorders.A reduction of TrkB signaling has been observed in neurodegenerative disorders,such as Alzheimer's disease and Huntington's disease,and enhancement of postsynaptic density protein-95 association with TrkB signaling could mitigate the observed deficiency of neuronal connectivity in schizophrenia and depression.Treatment with brain-derived neurotrophic factor is problematic,due to poor pharmacokinetics,low brain penetration,and side effects resulting from activation of the p75 neurotrophin receptor or the truncated TrkB.T1 isoform.Although TrkB agonists and antibodies that activate TrkB are being intensively investigated,they cannot distinguish the multiple human TrkB splicing isoforms or cell type-specific functions.Targeting TrkB–postsynaptic density protein-95 coupling provides an alternative approach to specifically boost TrkB signaling at localized synaptic sites versus global stimulation that risks many adverse side effects.展开更多
BACKGROUND Bipolar disorder(BD)is a severe mental illness characterized by significant mood swings.Effective drug treatment modalities are crucial for managing BD.AIM To analyze the current status and future trends of...BACKGROUND Bipolar disorder(BD)is a severe mental illness characterized by significant mood swings.Effective drug treatment modalities are crucial for managing BD.AIM To analyze the current status and future trends of global research on BD drug treatment over the last decade.METHODS The Web of Science Core Collection database spanning from 2015 to 2024 was utilized to retrieve literature related to BD drug treatment.A total of 2624 articles were extracted.Data visualization and analysis were conducted using CiteSpace,VOSviewer,Pajek,Scimago Graphica,and R-studio bibliometrix to identify RESULTS The United States,China,and the United Kingdom have made the most significant contributions to research on BD drug treatment and formed notable research collaboration networks.The University of Pittsburgh,Massachusetts General Hospital,and the University of Michigan have been identified as the major research institutions in this field.The Journal of Affective Disorders is the most influential journal.A keyword analysis revealed research hotspots related to clinical symptoms,drug efficacy,and genetic mechanisms.A citation analysis identified the management guidelines published by Yatham et al in 2018 as the most cited paper.CONCLUSION This study provides a detailed overview of the field of BD drug treatment,highlighting key contributors,research hotspots,and future directions.The study findings can be employed as a reference for future research and policymaking,which may enable further development and optimization of BD pharmacotherapy.展开更多
BACKGROUND Disorders of gut-brain interaction(DGBI)are common,but knowledge about their physiopathology is still poor,nor valid tools have been used to evaluate them in childhood.AIM To develop a psycho-gastroenterolo...BACKGROUND Disorders of gut-brain interaction(DGBI)are common,but knowledge about their physiopathology is still poor,nor valid tools have been used to evaluate them in childhood.AIM To develop a psycho-gastroenterological questionnaire(PGQ)to assess the psycho-gastroenterological profile and social characteristics of a pediatric population with and without DGBI.METHODS One hundred and nineteen Italian children(age 11-18)were included:28 outpatient patients with DGBI(Rome IV criteria)and 91 healthy controls.They filled the PGQ,faces pain scale revised(FPS-R),Bristol stool chart,ga-strointestinal symptoms rating scale,state-trait anxiety inventory,Toronto alexithymia scale 20,perceived self-efficacy in the management of negative emotions and expression of positive emotions(APEN-G,APEP-G),irritable bowel syndrome-quality of life questionnaire,school performances,tobacco use,early life events,degree of digital-ization.RESULTS Compared to controls,patients had more medical examinations(35%of them went to the doctor more than five times),a higher school performance(23%vs 13%,P<0.05),didn’t use tobacco(never vs 16%,P<0.05),had early life events(28%vs 1%P<0.05)and a higher percentage of pain classified as 4 in the FPS-R during the examination(14%vs 7%,P<0.05).CONCLUSION Pediatric outpatients with DGBI had a higher prevalence of early life events,a lower quality of life,more medical examinations rising health care costs,lower anxiety levels.展开更多
Major depressive disorder(MDD),a psychiatric disorder characterized by functional brain deficits,poses considerable diagnostic and treatment challenges,especially in adolescents owing to varying clinical presentations...Major depressive disorder(MDD),a psychiatric disorder characterized by functional brain deficits,poses considerable diagnostic and treatment challenges,especially in adolescents owing to varying clinical presentations.Biomarkers hold substantial clinical potential in the field of mental health,enabling objective assessments of physiological and pathological states,facilitating early diagnosis,and enhancing clinical decision-making and patient outcomes.Recent breakthroughs combine neuroimaging with machine learning(ML)to distinguish brain activity patterns between MDD patients and healthy controls,paving the way for diagnostic support and personalized treatment.However,the accuracy of the results depends on the selection of neuroimaging features and algorithms.Ensuring privacy protection,ML model accuracy,and fostering trust are essential steps prior to clinical implementation.Future research should prioritize the establishment of comprehensive legal frameworks and regulatory mechanisms for using ML in MDD diagnosis while safeguarding patient privacy and rights.By doing so,we can advance accuracy and personalized care for MDD.展开更多
Background Numerous studies have consistently demonstrated that a considerable proportion of patients with major depressive disorder (MDD) frequently exhibit pronounced dyslipidaemia. However, the causal dynamics betw...Background Numerous studies have consistently demonstrated that a considerable proportion of patients with major depressive disorder (MDD) frequently exhibit pronounced dyslipidaemia. However, the causal dynamics between MDD and dyslipidaemia remain elusive.Aims To comprehensively disentangle the genetic causality between MDD and various phenotypes of blood lipids, thereby facilitating the advancement of management strategies for these conditions.Methods We conducted a two-sample univariable Mendelian randomisation (MR) analysis using different models, including the inverse variance weighted (IVW) method and causal analysis using the summary effect (CAUSE) estimates, as well as a multivariable MR analysis. This analysis used summary statistics from genome-wide association studies (GWAS) of MDD and five lipid traits: low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, total cholesterol and triglycerides (TG), encompassing 5 237 893 individuals of European and East Asian ancestries. For MDD, a total of 598 701 individuals were included, with 500 199 individuals of European ancestry (Ncase=170 756, Ncontrol=329 443) and 98 502 of East Asian ancestry (Ncase=12 588, Ncontrol=85 914). Lipid data were collected from 4 639 192 individuals through the Global Lipids Genetics Consortium (European, N=4 096 085;East Asian, N=543 107). Next, we used the two-step MR to explore the mediating factors between MDD and TG, and the risk factors affecting TG through MDD. Finally, we conducted a GWAS meta-analysis and enrichment analysis.Results In univariable MR, we observed a negative causal effect of low-density lipoprotein on MDD in both European populations (IVW: odds ratio (OR): 0.972, 95% confidence interval (CI) 0.947 to 0.998, p=0.037) and East Asian populations (IVW: OR: 0.928, 95% CI 0.864 to 0.997, p=0.042). Additionally, we identified a bidirectional causal relationship between TG and MDD, with TG having a causal effect on MDD (IVW: OR: 1.052, 95% CI 1.020 to 1.085, p=0.001) and MDD having a causal effect on TG (IVW: OR: 1.075, 95% CI 1.047 to 1.104, p<0.001). Multivariable MR analysis further supported the role of TG in MDD (OR: 1.205, 95% CI 1.034 to 1.405, p=0.017). CAUSE estimates indicated that the causal model of MDD on TG provided a better fit than the sharing model (p=0.003), while the association of TG on MDD was more likely due to horizontal correlated pleiotropy than causality. Mediation analyses revealed that waist-hip ratio (WHR) mediated 69% of the total causal effect of MDD on TG, while other identified risk factors exhibited lower mediating proportions either mediated through MDD (≤17%) or originating from MDD (≤29%). The GWAS meta-analysis highlighted potential pathways related to lipid processes and nucleosome assembling, with significant cell types identified in brain regions and liver tissues.Conclusions The findings indicate that genetic proxies of MDD are associated with elevated levels of TG, with WHR serving as a clinical indicator of the association. This suggests that interventions targeting WHR may be effective in reducing TG levels in patients with MDD.展开更多
Bipolar disorder(BD)is a severe mood disorder characterized by recurrent episodes of mania and depression,and it is prone to delayed diagnosis,which can lead to worsened outcomes,including more frequent mood episodes,...Bipolar disorder(BD)is a severe mood disorder characterized by recurrent episodes of mania and depression,and it is prone to delayed diagnosis,which can lead to worsened outcomes,including more frequent mood episodes,greater functional impairment,and comorbidities.Early diagnosis of BD remains a significant challenge,although recent advances offer promising insights,such as research in molecular biomarkers,neuroimaging,exosomes,genetics,and epigenetics.This mini-review highlights their potential for providing earlier,more accurate identification of BD and discusses the underlying reasons why current research has not yet succeeded.For instance,the high heterogeneity of symptomatic presentations leads to low consistency in study participants;delayed BD diagnosis results in the inclusion of potential BD patients in the depression group;low specificity of biomarkers stems from limited understanding of BD pathophysiology;and there is a possibility that BD is not innate but develops over the course of the disease.Deepening our understanding of BD pathology,identifying more specific biomarkers,and integrating multiomics approaches for validation studies in well-defined homogeneous cohorts hold promise for significant breakthroughs.展开更多
Background The patient-reported Dimensional Anhedonia Rating Scale(DARS)has been adapted into Chinese,so there is a need to evaluate its measurement properties in a Chinese population.Aims To evaluate the reliability ...Background The patient-reported Dimensional Anhedonia Rating Scale(DARS)has been adapted into Chinese,so there is a need to evaluate its measurement properties in a Chinese population.Aims To evaluate the reliability and validity of the DARS among Chinese individuals with major depressive disorder(MDD)and its treatment sensitivity in a prospective clinical study.Methods Data were from a multicentre,prospective clinical study(NCT03294525),which recruited both patients with MDD,who were followed for 8 weeks,and healthy controls(HCs),assessed at baseline only.The analysis included confirmatory factor analysis,validity and sensitivity to change.Results Patients’mean(standard deviation(SD))age was 34.8(11.0)years,with 68.7%being female.75.2%of patients with MDD had melancholic features,followed by 63.8%with anxious distress.Patients had experienced MDD for a mean(SD)of 9.2(18)months.DARS scores covered the full range of severity with no major floor or ceiling effects.Confirmatory factor analysis showed adequate fit statistics(comparative fit index 0.976,goodness-of-fit index 0.935 and root mean square error of approximation 0.055).Convergent validity with anhedonia-related measures was confirmed.While the correlation between the DARS and the Hamilton Depression Rating Scale was not strong(r=0.31,baseline),the DARS was found to differentiate between levels of depression.Greater improvements in DARS scores were seen with the Hamilton Rating Scale for Depression responder group(effect size 1.16)compared with the non-responder group(effect size 0.46).Conclusions This study comprehensively evaluated the measurement properties of the DARS using a Chinese population with MDD.Overall,the Chinese version of DARS demonstrates good psychometric properties and has been found to be responsive to change during antidepressant treatment.The DARS is a suitable scale for assessing patient-reported anhedonia in future clinical trials.展开更多
In this article,we comment on the article by Zhang et al,which explores the familiarity,awareness,and usage of smart medical care and its correlation with mental health and personality traits.The use of intelligent he...In this article,we comment on the article by Zhang et al,which explores the familiarity,awareness,and usage of smart medical care and its correlation with mental health and personality traits.The use of intelligent healthcare technologies in treating mental disorders and substance use disorders shows significant promise,but involves certain challenges,such as limited access,low technological literacy,and privacy concerns.These barriers disproportionately affect deprived populations and individuals with severe mental health conditions.We highlight the positive impact of smart healthcare solutions,such as telemedicine and wearable technologies,on patient engagement,remote monitoring,and treatment adherence.To overcome these challenges,we propose strategies,such as improving user-friendliness,ensuring equitable access to digital interventions,enhancing cybersecurity,and integrating smart healthcare into clinical workflows.Training healthcare providers and developing policies to ensure the ethical use of patient data are essential.When implemented thoughtfully,smart healthcare technologies can revolutionize mental health and substance use disorder treatment,improve patient outcomes,and reduce healthcare inequities.展开更多
BACKGROUND Bipolar disorder(BD),marked by recurring manic and depressive episodes,often coexists with anxiety disorder(AD),which increases treatment complexity and morbidity.Although quetiapine,an atypical antipsychot...BACKGROUND Bipolar disorder(BD),marked by recurring manic and depressive episodes,often coexists with anxiety disorder(AD),which increases treatment complexity and morbidity.Although quetiapine,an atypical antipsychotic,has demonstrated efficacy in treating BD and AD,further investigation is needed regarding its effectiveness and safety in patients with AD at high-risk factors for BD.AIM To explore the application and efficacy of quetiapine in combination therapy for patients with AD at high-risk factors for BD.METHODS This study included 67 patients,with two excluded,leaving 65 divided into Group A(sertraline treatment)and Group B(combination treatment).All patients received sertraline,with Group B additionally receiving quetiapine.Efficacy was assessed using the Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),and Bech-Rafaelsen Mania sale(BRMS)throughout the treatment period.Side effects and physiological indicators were also monitored.RESULTS No significant baseline differences existed between the two groups at treatment onset.Over the treatment course,Group B exhibited significantly lower HAMA scores than Group A at the end of weeks 1 and 24.HAMD scores gradually decreased over time,with Group B consistently showing lower scores than Group A.BRMS scores decreased significantly from baseline by week 8.In Group A,27.27%of patients received zolpidem treatment compared to 10.53%in Group B,which was a significant difference.Incidence of adverse reactions did not differ significantly between groups at treatment onset,but most patients experienced relief from adverse reactions within 4 weeks.CONCLUSION Combination of quetiapine and sertraline can more rapidly alleviate anxiety and depressive symptoms in patients with AD at high-risk factors for BD,improving treatment outcomes.展开更多
Background Raising a child with attention deficit hyperactivity disorder(ADHD)is a key challenge for the primary caregiver.This systematic review aims to identify major burdens facing the primary caregiver of a child ...Background Raising a child with attention deficit hyperactivity disorder(ADHD)is a key challenge for the primary caregiver.This systematic review aims to identify major burdens facing the primary caregiver of a child with ADHD.Methods The electronic databases CINAHL,PubMed,and Google Scholar were searched for studies published in English from 2017 to 2022 assessing the challenges facing caregivers of a child with ADHD.The Johns Hopkins Nursing Evidence-Based Practice Model was used to assess quality and risk of bias of studies identified for inclusion.Articles were synthesized by evaluating principal themes of burden to caregivers,stress of caregivers,and effectiveness of intervention programs.Results Eleven articles were included in this review and included a total of 2426 participants.Findings revealed that caregivers of children with ADHD have a poor quality of life and high stress levels.Supportive parenting programs can be effective for improved coping and adaptation mechanisms with children with ADHD.However,few interventional studies were identified,increasing potential for bias.No meta-analysis was conducted.Conclusion Caregivers of children with ADHD can benefit from strategies to improve their quality of life and reduce their stress levels.Targeted parenting programs can make a positive difference in the well-being of caregivers and children with ADHD.Additional research is needed to address the evidence-based effectiveness of parenting support programs.展开更多
Premenstrual and menstrual exacerbation of psychiatric disorders is a significant area of concern in female mental health.Many females experience a worsening of psychiatric symptoms in the premenstrual and menstrual p...Premenstrual and menstrual exacerbation of psychiatric disorders is a significant area of concern in female mental health.Many females experience a worsening of psychiatric symptoms in the premenstrual and menstrual phases of their menstrual cycle,including heightened anxiety,depression,irritability,and mood swings.These exacerbations are most commonly associated with premenstrual syndrome and premenstrual dysphoric disorder that are characterized by severe emotional and physical symptoms that interfere with daily functioning.The hormonal fluctuations during the menstrual cycle,particularly changes in estrogen and progesterone levels,are believed to play a pivotal role in these exacerbations.Psychiatric disorders such as depression,anxiety,bipolar disorder,and schizophrenia may be influenced by these hormonal changes,with many females reporting an increase in symptom severity during specific phases of the cycle.The mechanisms behind this phenomenon remain complex,with both biological and psychosocial factors contributing to the heightened vulnerability.Clinical management includes careful monitoring of symptom patterns in relation to the menstrual cycle,with treatment options ranging from lifestyle modifications and psychotherapy to pharmacological interventions such as antidepressants and hormonal therapies.Understanding the link between menstruation and psychiatric disorders is essential for improving diagnosis and tailoring effective treatment strategies for affected individuals.展开更多
BACKGROUND Non-operative spinal infections(NOSI)are caused by tuberculosis,brucella,and other specific bacteria.The etiology of the disease is insidious,the onset is slow and the diagnosis and treatment are difficult....BACKGROUND Non-operative spinal infections(NOSI)are caused by tuberculosis,brucella,and other specific bacteria.The etiology of the disease is insidious,the onset is slow and the diagnosis and treatment are difficult.Identifying the factors associated with spinal infection and early intervention can reduce the occurrence of the disease.At present,the research mainly focuses on the accurate diagnosis and treatment of spinal infection,and there are few studies on the prevention of spinal infection.The concept of"preventive treatment of diseases"in traditional Chinese medicine may help identify the causes and reduce the occurrence of NOSI.AIM To determine the association of age,bowel movements,and sleep patterns with NOSI.METHODS Data of 69 NOSI patients and 84 healthy controls in a tertiary hospital from January 2019 to June 2024 were collected.Patients with NOSI had imaging evidence(magnetic resonance imaging)of spinal infections(including infections caused by tuberculosis,brucopathy,and other pathogens)and had no history of spinal surgery in the last 1 year were included in the analysis.Patients with spinalinfection due to spinal surgery are excluded in the study.Data including age,sex,place of residence,sleeping status,and bowel movements were collected.SPSS22.0 was used for correlation analysis of all data.RESULTS The mean age of the NOSI group and the control group was 63.55±14.635 years and 59.18±17.111 years,respectively,without statistical difference(P=0.096).There was also no statistically significant difference in gender between the two groups.In the NOSI group,45(65.22%)were over 60 years old,and 44(63.77%)were rural residents.Compared with the control group,the NOSI group had more patients with sleep disorder and defecation disorder,accounting for 69.57%and 68.12%,respectively,with significant statistical difference(both P<0.001).Regression analysis showed that defecation and sleep disorders were closely related to NOSI(both P<0.001).CONCLUSION Most patients with NOSI are older and have sleep disorders and abnormal defecation.展开更多
文摘BACKGROUND Functional neurological disorder(FND)in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology.Despite its prevalence,FND in pediatric populations remains under-researched,with challenges in diagnosis and management AIM To synthesize the current literature on FND in children,focusing on clinical presentation,diagnostic approaches,treatment strategies,and outcomes.METHODS A comprehensive literature search was conducted across multiple databases,including PubMed,Scopus,and Web of Science,for articles published up to August 2024.Studies were included if they addressed FND in pediatric populations,specifically focusing on review articles,research articles,systematic reviews,meta-analyses,case reports,guidelines,expert opinions,and editorials.Data extraction and quality assessment were performed according to PRISMA guidelines.A total of 308 articles were included in the final analysis.RESULTS The analysis included 189 review articles,57 research articles,3 systematic reviews and meta-analyses,5 case reports,2 guidelines,5 expert opinions,and 2 editorials.Key findings revealed a broad spectrum of symptoms,including motor and sensory disturbances and psychological factors contributing to the onset and persistence of FND.Diagnostic challenges were frequently highlighted,emphasizing the need for interdisciplinary approaches.Treatment strategies varied,with cognitive-behavioral therapy(CBT)and multidisciplinary care emerging as the most effective approaches.The outcomes varied,with early intervention being critical for a better prognosis.CONCLUSION Early diagnosis and multidisciplinary care,including CBT,are critical for improving outcomes in pediatric FND.Standardized diagnostic criteria and treatment protocols are needed to enhance clinical management.
基金Supported by the Central Guiding Local Science and Technology Development Fund Project,No.YDZX2022091。
文摘Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment response remains underexplored.Our review seeks to mainly delve into the effect of gender identity on ADHD,exploring the unique needs of individuals with various gender identities in the context of ADHD symptoms,diagnostic assessment,and treatment,with the goal of supplying theoretical support and practical recommendations for future research and clinical practice.The primary content includes,specifically:(1)Symptom expression differences:Gender identity significantly affects ADHD symptoms;male-identified individuals commonly perform worse in task orientation and attention stability,while female-identified individuals may demonstrate more variability in attention control and executive functions;(2)Diagnosis and treatment:Clinical practice generally neglects the impact of gender identity on ADHD management,with personalized needs of gender-identified individuals frequently not adequately addressed,potentially,affecting treatment outcomes;and(3)Future research directions:Future studies should further assess how gender identity affects the specific mechanisms of ADHD,conduct researches in multicultural contexts,and engage in long-term follow-up studies to evaluate the long-term impact of gender identity on ADHD progression.Besides,enhanced funding and public education on the relationship between gender identity and ADHD are needed to advance the field.
基金the Tianjin Health Research Project(Grant No.TJWJ2023MS038)Tianjin Education Commission Research Project(Grant No.2023KJ044)S&T Program of Hebei(SG2021189)。
文摘To the editor:A wide range of affective disorders affects people of all ages globally and contributes significantly to the global disease burden.1 In China,a nationwide survey found a 3.21% prevalence of affective disorders in children and adolescents,with major depressive disorder(MDD)at 2.00%and bipolar disorder at 0.86%.
文摘Chat Generative Pre-trained Transformer(ChatGPT)is a conversational service that uses artificial intelligence and is also known as a chatbot.ChatGPT and similar applications have the potential to be a tool that can be used in the field of psychiatry.Eating disorders affect a large number of individuals worldwide.Tools that encourage and support people with eating disorders to seek mental health services may be critical to helping them get the care they need.However,body image,defined as the totality of a person's thoughts and perceptions about their physical appearance,has been linked to a variety of health problems,particularly among young adults,about eating disorders.There is limited literature on how chatbots respond to or provide information about body image.Preventing eating disorders before they occur is also of great importance.However,young adults who struggle with body image perception may be misled by the information produced by ChatGPT.Studies have yet to clarify whether a chatbot can improve eating disorder-related factors,eating disorder psychopathology,depression,and anxiety or detect eating disorders in advance.This study focuses on the accuracy of ChatGPT in providing information regarding eating disorders and its potential effects on body image perception.
文摘Background Mental disorders rank among the leading contributors to the global disease burden, with depressive disorders being among the most prevalent.Aims The objective of this study is to examine the prevalence, incidence and years lived with disability (YLDs) associated with depressive disorders, particularly major depressive disorder and dysthymia, in Iran from 1990 to 2021. To achieve this, the research focused on analysing these metrics across various dimensions, including temporal trends, sex differences, age categories and subnational regions.Methods The data used in this study are sourced directly from the Institute for Health Metrics and Evaluation, ensuring that the information is both authoritative and reliable. All-age count estimates and age-standardised rates (per 100 000) were calculated for prevalence, incidence and YLDs. The disease burden indicators were analysed for the period spanning from 1990 to 2021, stratified by sex, age and location. The percentage change between 1990 and 2021 was also documented. The 95% uncertainty interval (UI) was reported for each of the reported estimates.Results The prevalence of depressive disorders in Iran demonstrated a notable upward trend from 1990 to 2021, with the rate of growth being particularly pronounced within the country. The age-standardised prevalence rate per 100 000 individuals for depressive disorders in Iran was 5609 (95% UI 4810 to 6488). By 2021, the number of depression cases in Iran reached 5.2 million, which is approximately 2.37 times the figure reported in 1990. The prevalence of depressive disorders was notably higher among females compared with males. The age-standardised prevalence rate per 100 000 individuals for males was 4184 (95% UI 3545 to 4929). For females, this figure was significantly greater, reaching 7077 (95% UI 6115 to 8172). Out of the total reported cases of depressive disorders in Iran, 3.2 million were observed in females, while males accounted for 2 million cases.Conclusions The findings highlighted the considerable impact of depressive disorders in Iran, both nationally and regionally, while also revealing variations across sex and age groups. Given the shifts in the demographic structure and the growing burden of these disorders, it is essential to prioritise screening initiatives, education programmes and strategies aimed at enhancing mental health awareness and ensuring improved access to mental health services in health policy planning.
基金supported by the National Natural Science Foundation of China(T2241028)STI2030-Major Projects[2021ZD0203000(2021ZD0203003)].
文摘Mental health disorders have emerged as a critical global health challenge,profoundly impacting individuals,communities,and societies worldwide.The prevalence of mental health problems has been steadily increasing,with~1 in 8 people,equivalent to 970 million individuals suffering from a mental disorder in 2019(https://vizhub.healthdata.org/gbd-results).Anxiety and depressive disorders are predominant,contributing significantly to the burden of mental health issues,according to the World Health Organization.The COVID-19 pandemic has further exacerbated this situation.It led to a notable upsurge in anxiety and major depressive disorders in 2020.Estimates indicate a 26%rise in anxiety and a 28%increase in depression within that year(https://www.who.int/publications/i/item/WHO-2019-nCoVSci_Brief-Mental_health-2022.1)[1].
文摘BACKGROUND Speech and language therapy(ST)might moderate the prognosis in children with attention deficit and hyperactivity disorder(ADHD)comorbid with speech delay.This study investigated whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.AIM To investigate whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.METHODS The population-based National Health Insurance Research Database in Taiwan was used.Hazards of subsequent psychiatric disorders were compared between those who received ST and a propensity-score matched comparison group by Cox regression analyses.RESULTS Of 11987 children with ADHD identified from the dataset,2911(24%)had received ST.The adjusted hazard ratio for any subsequent recorded psychiatric disorder was 0.72(95%confidence interval:0.63-0.82)in children who received ST compared to the matched counterparts.This protective association was only statistically significant in the subgroup that received both medication and behavioral interventions.CONCLUSION ST can moderate the effects of integrated early interventions in ADHD children with speech delay.
文摘Fear memory is crucial for survival and adaptation in complex and dynamically changing environments that enables individuals to avoid or escape from potentially dangerous situations.However,excessive fear memories can significantly contribute to emotional disabilities and mental disorders,including panic disorder,phobias,social anxiety disorder,and post-traumatic stress disorder(PTSD).
基金supported by Postdoc Fellowship from the Foundation for Angelman Syndrome Therapeutics(FT2022-005 to JM,PD2023-001 to XY,and FT2024-001 to YAH)STTR R41 MH118747(to JM)。
文摘Tropomyosin receptor kinase B(TrkB)signaling plays a pivotal role in dendritic growth and dendritic spine formation to promote learning and memory.The activity-dependent release of brain-derived neurotrophic factor at synapses binds to pre-or postsynaptic TrkB resulting in the strengthening of synapses,reflected by long-term potentiation.Postsynaptically,the association of postsynaptic density protein-95 with TrkB enhances phospholipase Cγ-Ca^(2+)/calmodulin-dependent protein kinaseⅡand phosphatidylinositol 3-kinase-mechanistic target of rapamycin signaling required for long-term potentiation.In this review,we discuss TrkB-postsynaptic density protein-95 coupling as a promising strategy to magnify brain-derived neurotrophic factor signaling towards the development of novel therapeutics for specific neurological disorders.A reduction of TrkB signaling has been observed in neurodegenerative disorders,such as Alzheimer's disease and Huntington's disease,and enhancement of postsynaptic density protein-95 association with TrkB signaling could mitigate the observed deficiency of neuronal connectivity in schizophrenia and depression.Treatment with brain-derived neurotrophic factor is problematic,due to poor pharmacokinetics,low brain penetration,and side effects resulting from activation of the p75 neurotrophin receptor or the truncated TrkB.T1 isoform.Although TrkB agonists and antibodies that activate TrkB are being intensively investigated,they cannot distinguish the multiple human TrkB splicing isoforms or cell type-specific functions.Targeting TrkB–postsynaptic density protein-95 coupling provides an alternative approach to specifically boost TrkB signaling at localized synaptic sites versus global stimulation that risks many adverse side effects.
基金Supported by the National College Students’Innovative Entrepreneurial Training Plan Program,No.202410403067the Innovation and Entrepreneurship Training Program for College Students in Jiangxi Province,No.S202410403035.
文摘BACKGROUND Bipolar disorder(BD)is a severe mental illness characterized by significant mood swings.Effective drug treatment modalities are crucial for managing BD.AIM To analyze the current status and future trends of global research on BD drug treatment over the last decade.METHODS The Web of Science Core Collection database spanning from 2015 to 2024 was utilized to retrieve literature related to BD drug treatment.A total of 2624 articles were extracted.Data visualization and analysis were conducted using CiteSpace,VOSviewer,Pajek,Scimago Graphica,and R-studio bibliometrix to identify RESULTS The United States,China,and the United Kingdom have made the most significant contributions to research on BD drug treatment and formed notable research collaboration networks.The University of Pittsburgh,Massachusetts General Hospital,and the University of Michigan have been identified as the major research institutions in this field.The Journal of Affective Disorders is the most influential journal.A keyword analysis revealed research hotspots related to clinical symptoms,drug efficacy,and genetic mechanisms.A citation analysis identified the management guidelines published by Yatham et al in 2018 as the most cited paper.CONCLUSION This study provides a detailed overview of the field of BD drug treatment,highlighting key contributors,research hotspots,and future directions.The study findings can be employed as a reference for future research and policymaking,which may enable further development and optimization of BD pharmacotherapy.
文摘BACKGROUND Disorders of gut-brain interaction(DGBI)are common,but knowledge about their physiopathology is still poor,nor valid tools have been used to evaluate them in childhood.AIM To develop a psycho-gastroenterological questionnaire(PGQ)to assess the psycho-gastroenterological profile and social characteristics of a pediatric population with and without DGBI.METHODS One hundred and nineteen Italian children(age 11-18)were included:28 outpatient patients with DGBI(Rome IV criteria)and 91 healthy controls.They filled the PGQ,faces pain scale revised(FPS-R),Bristol stool chart,ga-strointestinal symptoms rating scale,state-trait anxiety inventory,Toronto alexithymia scale 20,perceived self-efficacy in the management of negative emotions and expression of positive emotions(APEN-G,APEP-G),irritable bowel syndrome-quality of life questionnaire,school performances,tobacco use,early life events,degree of digital-ization.RESULTS Compared to controls,patients had more medical examinations(35%of them went to the doctor more than five times),a higher school performance(23%vs 13%,P<0.05),didn’t use tobacco(never vs 16%,P<0.05),had early life events(28%vs 1%P<0.05)and a higher percentage of pain classified as 4 in the FPS-R during the examination(14%vs 7%,P<0.05).CONCLUSION Pediatric outpatients with DGBI had a higher prevalence of early life events,a lower quality of life,more medical examinations rising health care costs,lower anxiety levels.
文摘Major depressive disorder(MDD),a psychiatric disorder characterized by functional brain deficits,poses considerable diagnostic and treatment challenges,especially in adolescents owing to varying clinical presentations.Biomarkers hold substantial clinical potential in the field of mental health,enabling objective assessments of physiological and pathological states,facilitating early diagnosis,and enhancing clinical decision-making and patient outcomes.Recent breakthroughs combine neuroimaging with machine learning(ML)to distinguish brain activity patterns between MDD patients and healthy controls,paving the way for diagnostic support and personalized treatment.However,the accuracy of the results depends on the selection of neuroimaging features and algorithms.Ensuring privacy protection,ML model accuracy,and fostering trust are essential steps prior to clinical implementation.Future research should prioritize the establishment of comprehensive legal frameworks and regulatory mechanisms for using ML in MDD diagnosis while safeguarding patient privacy and rights.By doing so,we can advance accuracy and personalized care for MDD.
基金supported by the National Natural Science Foundation of China(82071500,82271540,32370724,82401759,81871055,32070679)Shanghai Clinical Research Center for Mental Health(19MC1911100)+11 种基金Shanghai Key Laboratory of Psychotic Disorders(13dz2260500)Shanghai Municipal Administrator of Traditional Chinese Medicine(ZY-(2021-2023)-0207-01)Shanghai Municipal Health Commission Collaborative Innovation Group(2024CXJQ03)Shanghai Science and Technology Innovation Action Program(24JS2840400,24ZR1439900,21Y11921100)Shanghai Municipal Science and Technology Major Project,the National Key R&D Program of China(2023YFA0913804,2024YFA0916603,2022FYC2503300)the Program of Shanghai Academic/Technology Research Leader(21XD1423300)Shanghai Pujiang Program(21PJD063)Shanghai Municipal Science and Technology Major Project(2017SHZDZX01)Shanghai Municipal Commission of Education(2024AIZD016)the National Key R&D Program of China(2019YFA0905400,2017YFC0908105,2021YFC2702100)National Program for Support of Top-Notch Young Professionals,Taishan Scholar Program of Shandong Province(tstp20240526)the Natural Science Foundation of Shandong Province(ZR2019YQ14,YDZX2021009,2021ZDSYS06).
文摘Background Numerous studies have consistently demonstrated that a considerable proportion of patients with major depressive disorder (MDD) frequently exhibit pronounced dyslipidaemia. However, the causal dynamics between MDD and dyslipidaemia remain elusive.Aims To comprehensively disentangle the genetic causality between MDD and various phenotypes of blood lipids, thereby facilitating the advancement of management strategies for these conditions.Methods We conducted a two-sample univariable Mendelian randomisation (MR) analysis using different models, including the inverse variance weighted (IVW) method and causal analysis using the summary effect (CAUSE) estimates, as well as a multivariable MR analysis. This analysis used summary statistics from genome-wide association studies (GWAS) of MDD and five lipid traits: low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, total cholesterol and triglycerides (TG), encompassing 5 237 893 individuals of European and East Asian ancestries. For MDD, a total of 598 701 individuals were included, with 500 199 individuals of European ancestry (Ncase=170 756, Ncontrol=329 443) and 98 502 of East Asian ancestry (Ncase=12 588, Ncontrol=85 914). Lipid data were collected from 4 639 192 individuals through the Global Lipids Genetics Consortium (European, N=4 096 085;East Asian, N=543 107). Next, we used the two-step MR to explore the mediating factors between MDD and TG, and the risk factors affecting TG through MDD. Finally, we conducted a GWAS meta-analysis and enrichment analysis.Results In univariable MR, we observed a negative causal effect of low-density lipoprotein on MDD in both European populations (IVW: odds ratio (OR): 0.972, 95% confidence interval (CI) 0.947 to 0.998, p=0.037) and East Asian populations (IVW: OR: 0.928, 95% CI 0.864 to 0.997, p=0.042). Additionally, we identified a bidirectional causal relationship between TG and MDD, with TG having a causal effect on MDD (IVW: OR: 1.052, 95% CI 1.020 to 1.085, p=0.001) and MDD having a causal effect on TG (IVW: OR: 1.075, 95% CI 1.047 to 1.104, p<0.001). Multivariable MR analysis further supported the role of TG in MDD (OR: 1.205, 95% CI 1.034 to 1.405, p=0.017). CAUSE estimates indicated that the causal model of MDD on TG provided a better fit than the sharing model (p=0.003), while the association of TG on MDD was more likely due to horizontal correlated pleiotropy than causality. Mediation analyses revealed that waist-hip ratio (WHR) mediated 69% of the total causal effect of MDD on TG, while other identified risk factors exhibited lower mediating proportions either mediated through MDD (≤17%) or originating from MDD (≤29%). The GWAS meta-analysis highlighted potential pathways related to lipid processes and nucleosome assembling, with significant cell types identified in brain regions and liver tissues.Conclusions The findings indicate that genetic proxies of MDD are associated with elevated levels of TG, with WHR serving as a clinical indicator of the association. This suggests that interventions targeting WHR may be effective in reducing TG levels in patients with MDD.
基金Supported by Research Plan Project of Tianjin Municipal Education Commission,No.2022KJ264.
文摘Bipolar disorder(BD)is a severe mood disorder characterized by recurrent episodes of mania and depression,and it is prone to delayed diagnosis,which can lead to worsened outcomes,including more frequent mood episodes,greater functional impairment,and comorbidities.Early diagnosis of BD remains a significant challenge,although recent advances offer promising insights,such as research in molecular biomarkers,neuroimaging,exosomes,genetics,and epigenetics.This mini-review highlights their potential for providing earlier,more accurate identification of BD and discusses the underlying reasons why current research has not yet succeeded.For instance,the high heterogeneity of symptomatic presentations leads to low consistency in study participants;delayed BD diagnosis results in the inclusion of potential BD patients in the depression group;low specificity of biomarkers stems from limited understanding of BD pathophysiology;and there is a possibility that BD is not innate but develops over the course of the disease.Deepening our understanding of BD pathology,identifying more specific biomarkers,and integrating multiomics approaches for validation studies in well-defined homogeneous cohorts hold promise for significant breakthroughs.
基金supported by the National Natural Science Foundation of China(No.82371530,82171529)the Capital Health Development Special Research Project(2022-1-4111)the National Key Technology R and D Program(No.2015BAI13B01).
文摘Background The patient-reported Dimensional Anhedonia Rating Scale(DARS)has been adapted into Chinese,so there is a need to evaluate its measurement properties in a Chinese population.Aims To evaluate the reliability and validity of the DARS among Chinese individuals with major depressive disorder(MDD)and its treatment sensitivity in a prospective clinical study.Methods Data were from a multicentre,prospective clinical study(NCT03294525),which recruited both patients with MDD,who were followed for 8 weeks,and healthy controls(HCs),assessed at baseline only.The analysis included confirmatory factor analysis,validity and sensitivity to change.Results Patients’mean(standard deviation(SD))age was 34.8(11.0)years,with 68.7%being female.75.2%of patients with MDD had melancholic features,followed by 63.8%with anxious distress.Patients had experienced MDD for a mean(SD)of 9.2(18)months.DARS scores covered the full range of severity with no major floor or ceiling effects.Confirmatory factor analysis showed adequate fit statistics(comparative fit index 0.976,goodness-of-fit index 0.935 and root mean square error of approximation 0.055).Convergent validity with anhedonia-related measures was confirmed.While the correlation between the DARS and the Hamilton Depression Rating Scale was not strong(r=0.31,baseline),the DARS was found to differentiate between levels of depression.Greater improvements in DARS scores were seen with the Hamilton Rating Scale for Depression responder group(effect size 1.16)compared with the non-responder group(effect size 0.46).Conclusions This study comprehensively evaluated the measurement properties of the DARS using a Chinese population with MDD.Overall,the Chinese version of DARS demonstrates good psychometric properties and has been found to be responsive to change during antidepressant treatment.The DARS is a suitable scale for assessing patient-reported anhedonia in future clinical trials.
文摘In this article,we comment on the article by Zhang et al,which explores the familiarity,awareness,and usage of smart medical care and its correlation with mental health and personality traits.The use of intelligent healthcare technologies in treating mental disorders and substance use disorders shows significant promise,but involves certain challenges,such as limited access,low technological literacy,and privacy concerns.These barriers disproportionately affect deprived populations and individuals with severe mental health conditions.We highlight the positive impact of smart healthcare solutions,such as telemedicine and wearable technologies,on patient engagement,remote monitoring,and treatment adherence.To overcome these challenges,we propose strategies,such as improving user-friendliness,ensuring equitable access to digital interventions,enhancing cybersecurity,and integrating smart healthcare into clinical workflows.Training healthcare providers and developing policies to ensure the ethical use of patient data are essential.When implemented thoughtfully,smart healthcare technologies can revolutionize mental health and substance use disorder treatment,improve patient outcomes,and reduce healthcare inequities.
基金Supported by Huzhou City Science and Technology Plan Public Welfare Technology Application Research Project[Key Project],No.2020GZ42.
文摘BACKGROUND Bipolar disorder(BD),marked by recurring manic and depressive episodes,often coexists with anxiety disorder(AD),which increases treatment complexity and morbidity.Although quetiapine,an atypical antipsychotic,has demonstrated efficacy in treating BD and AD,further investigation is needed regarding its effectiveness and safety in patients with AD at high-risk factors for BD.AIM To explore the application and efficacy of quetiapine in combination therapy for patients with AD at high-risk factors for BD.METHODS This study included 67 patients,with two excluded,leaving 65 divided into Group A(sertraline treatment)and Group B(combination treatment).All patients received sertraline,with Group B additionally receiving quetiapine.Efficacy was assessed using the Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),and Bech-Rafaelsen Mania sale(BRMS)throughout the treatment period.Side effects and physiological indicators were also monitored.RESULTS No significant baseline differences existed between the two groups at treatment onset.Over the treatment course,Group B exhibited significantly lower HAMA scores than Group A at the end of weeks 1 and 24.HAMD scores gradually decreased over time,with Group B consistently showing lower scores than Group A.BRMS scores decreased significantly from baseline by week 8.In Group A,27.27%of patients received zolpidem treatment compared to 10.53%in Group B,which was a significant difference.Incidence of adverse reactions did not differ significantly between groups at treatment onset,but most patients experienced relief from adverse reactions within 4 weeks.CONCLUSION Combination of quetiapine and sertraline can more rapidly alleviate anxiety and depressive symptoms in patients with AD at high-risk factors for BD,improving treatment outcomes.
文摘Background Raising a child with attention deficit hyperactivity disorder(ADHD)is a key challenge for the primary caregiver.This systematic review aims to identify major burdens facing the primary caregiver of a child with ADHD.Methods The electronic databases CINAHL,PubMed,and Google Scholar were searched for studies published in English from 2017 to 2022 assessing the challenges facing caregivers of a child with ADHD.The Johns Hopkins Nursing Evidence-Based Practice Model was used to assess quality and risk of bias of studies identified for inclusion.Articles were synthesized by evaluating principal themes of burden to caregivers,stress of caregivers,and effectiveness of intervention programs.Results Eleven articles were included in this review and included a total of 2426 participants.Findings revealed that caregivers of children with ADHD have a poor quality of life and high stress levels.Supportive parenting programs can be effective for improved coping and adaptation mechanisms with children with ADHD.However,few interventional studies were identified,increasing potential for bias.No meta-analysis was conducted.Conclusion Caregivers of children with ADHD can benefit from strategies to improve their quality of life and reduce their stress levels.Targeted parenting programs can make a positive difference in the well-being of caregivers and children with ADHD.Additional research is needed to address the evidence-based effectiveness of parenting support programs.
文摘Premenstrual and menstrual exacerbation of psychiatric disorders is a significant area of concern in female mental health.Many females experience a worsening of psychiatric symptoms in the premenstrual and menstrual phases of their menstrual cycle,including heightened anxiety,depression,irritability,and mood swings.These exacerbations are most commonly associated with premenstrual syndrome and premenstrual dysphoric disorder that are characterized by severe emotional and physical symptoms that interfere with daily functioning.The hormonal fluctuations during the menstrual cycle,particularly changes in estrogen and progesterone levels,are believed to play a pivotal role in these exacerbations.Psychiatric disorders such as depression,anxiety,bipolar disorder,and schizophrenia may be influenced by these hormonal changes,with many females reporting an increase in symptom severity during specific phases of the cycle.The mechanisms behind this phenomenon remain complex,with both biological and psychosocial factors contributing to the heightened vulnerability.Clinical management includes careful monitoring of symptom patterns in relation to the menstrual cycle,with treatment options ranging from lifestyle modifications and psychotherapy to pharmacological interventions such as antidepressants and hormonal therapies.Understanding the link between menstruation and psychiatric disorders is essential for improving diagnosis and tailoring effective treatment strategies for affected individuals.
文摘BACKGROUND Non-operative spinal infections(NOSI)are caused by tuberculosis,brucella,and other specific bacteria.The etiology of the disease is insidious,the onset is slow and the diagnosis and treatment are difficult.Identifying the factors associated with spinal infection and early intervention can reduce the occurrence of the disease.At present,the research mainly focuses on the accurate diagnosis and treatment of spinal infection,and there are few studies on the prevention of spinal infection.The concept of"preventive treatment of diseases"in traditional Chinese medicine may help identify the causes and reduce the occurrence of NOSI.AIM To determine the association of age,bowel movements,and sleep patterns with NOSI.METHODS Data of 69 NOSI patients and 84 healthy controls in a tertiary hospital from January 2019 to June 2024 were collected.Patients with NOSI had imaging evidence(magnetic resonance imaging)of spinal infections(including infections caused by tuberculosis,brucopathy,and other pathogens)and had no history of spinal surgery in the last 1 year were included in the analysis.Patients with spinalinfection due to spinal surgery are excluded in the study.Data including age,sex,place of residence,sleeping status,and bowel movements were collected.SPSS22.0 was used for correlation analysis of all data.RESULTS The mean age of the NOSI group and the control group was 63.55±14.635 years and 59.18±17.111 years,respectively,without statistical difference(P=0.096).There was also no statistically significant difference in gender between the two groups.In the NOSI group,45(65.22%)were over 60 years old,and 44(63.77%)were rural residents.Compared with the control group,the NOSI group had more patients with sleep disorder and defecation disorder,accounting for 69.57%and 68.12%,respectively,with significant statistical difference(both P<0.001).Regression analysis showed that defecation and sleep disorders were closely related to NOSI(both P<0.001).CONCLUSION Most patients with NOSI are older and have sleep disorders and abnormal defecation.
