Non-right-handedness(NRH),encompassing left-handedness and mixed-handedness,has been frequently reported at elevated rates in individuals with various psychiatric disorders.The consistency of this association across m...Non-right-handedness(NRH),encompassing left-handedness and mixed-handedness,has been frequently reported at elevated rates in individuals with various psychiatric disorders.The consistency of this association across multiple conditions and its underlying mechanisms is the subject of ongoing investigation.This review synthesized current evidence to explore the association between NRH and psychiatric disorders from epidemiological,genetic,and neurobiological perspectives.We systematically identified and appraised relevant literature investigating NRH prevalence in psychiatric populations and potential explanatory mechanisms.Epidemiological evidence indicates an elevated prevalence of NRH,particularly within neurodevelopmental disorders.Potential contributing mechanisms identified include early developmental disruptions,shared genetic predispositions,and atypical patterns of brain lateralization.While the association between NRH and psychiatric conditions,especially neurodevelopmental disorders,is evident,the causal pathways and relative contributions of identified mechanisms are complex and debated.This review highlighted key areas requiring further research to elucidate these relationships.展开更多
The inability to access brain tissue has greatly hindered our ability to study and care for individuals suffering from psychiatric and neurological conditions.Critics have questioned efforts to develop peripheral bloo...The inability to access brain tissue has greatly hindered our ability to study and care for individuals suffering from psychiatric and neurological conditions.Critics have questioned efforts to develop peripheral blood biomarkers in neurological and psychiatric disorders based on the assertion that disease pathology is limited to the brain.The discovery that all tissues,including the brain,release extracellular vesicles(Raposo and Stoorvogel,2013)and cell free DNAs(Chan et al.,2013)into various body fluids has provided a potential way to measure activity from inaccessible tissues like the central nervous system(CNS)and has given rise to the term“liquid biopsy.”The development of liquid biopsies that can diagnose and predict the course of psychiatric and neurological disorders would be transformative.The ability to predict episodic events such as mania,depression,and risk for suicide would be particularly useful for psychiatric care as it would enable the development of interventions that prevent mortality and improve outcomes.Additionally,biomarkers that are informative about drug response and aid in treatment decisions would be a significant advance in psychiatric care as it would prevent patients from having to endure multiple courses of ineffective treatments and side effects.展开更多
BACKGROUND Post-stroke psychiatric complications,particularly depression and anxiety,significantly impact rehabilitation outcomes and quality of life.Despite their prevalence and clinical significance,these conditions...BACKGROUND Post-stroke psychiatric complications,particularly depression and anxiety,significantly impact rehabilitation outcomes and quality of life.Despite their prevalence and clinical significance,these conditions often remain underrecognized in routine stroke care.Understanding their clinical features and temporal patterns is crucial for improving patient outcomes.AIM To investigate the prevalence,temporal evolution,and clinical correlates of depression and anxiety post-stroke and their impact on functional recovery.METHODS In this prospective observational study,127 patients first-ever ischemic stroke were enrolled between June 2022 and June 2024.Depression and anxiety were assessed using the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale at baseline and follow-up intervals(2 weeks,1 month,3 months,and 6 months).Stroke severity was evaluated using the National Institutes of Health Stroke Scale,and functional outcomes were measured using the modified Rankin Scale.RESULTS Among 120 patients who completed follow-up(94.5%completion rate),37.5%had depression(mild:18.3%,moderate:12.5%,severe:6.7%)and 41.7%had anxiety at baseline.Depression prevalence showed a biphasic pattern,peaking at 2 weeks(37.5%),declining at 3 months(28.3%),and slightly increasing at 6 months(30.8%).Stroke severity significantly correlated with both depression(odds ratio=1.18,95%CI:1.06-1.31,P=0.003)and anxiety(odds ratio=1.15,95%CI:1.04-1.27,P=0.008).Left hemisphere lesions had a stronger association with psychiatric symptoms than right hemisphere lesions(P=0.035).Patients with psychiatric complications demonstrated poorer functional outcomes at 6 months(median modified Rankin Scale 3 vs 2,P=0.015)and longer hospital stays(mean difference:3.2 days,P=0.002).CONCLUSION Identifying the clinical and neuroanatomical correlates of depression and anxiety will enable effective risk stratification and patient management.Integrating routine psychiatric screening and early intervention is essential in stroke care.展开更多
BACKGROUND Insomnia is a common sleep disorder that negatively impacts quality of life and is frequently comorbid with depression and anxiety.Chronic insomnia affects approximately 15%of the global population,with hig...BACKGROUND Insomnia is a common sleep disorder that negatively impacts quality of life and is frequently comorbid with depression and anxiety.Chronic insomnia affects approximately 15%of the global population,with higher prevalence among females and the elderly.While existing research suggests a bidirectional relationship between insomnia and emotional disorders,the specific impact of insomnia severity on depression,anxiety,and quality of life remains unclear.This study investigates the correlation between insomnia severity and these factors in psychiatric outpatients,hypothesizing that greater insomnia severity is associated with higher levels of depression and anxiety,as well as poorer quality of life.AIM To explore the correlation between insomnia severity and depression,anxiety,and quality of life in primary chronic insomnia patients.METHODS From June to December 2023,345 patients with primary insomnia in Chifeng city were recruited and divided into three groups based on Pittsburgh sleep quality index(PSQI)scores:Mild(n=137),moderate(n=162),and severe(n=46).Demographic data were collected via questionnaires.Self-rating depression scale(SDS),self-rating anxiety scale(SAS),PSQI,and short form 36(SF-36)scores were compared,and Pearson and partial correlation analyses were performed.RESULTS The greater the degree of insomnia,the greater the symptoms of depression and anxiety(P<0.001).The more severe the insomnia,the lower the SF-36 score(excluding body pain),and the difference between the three groups was statist ically significant(P<0.001).Pearson correlation analysis and partial correlation analysis depicted the SDS score and SAS score were apparently positively correlated with the severity of insomnia(P<0.001).Pearson correlation analysis and partial correlation analysis depicted the SF-36 scores were apparently positively correlated with the severity of insomnia(P<0.05).CONCLUSION Depression and anxiety are independent factors influencing insomnia severity in primary chronic insomnia patients.Higher depression/anxiety levels correlate with worse insomnia,impacting quality of life.展开更多
Hypophosphatasia(HPP)is a rare metabolic bone disorder often misdiagnosed as fibromyalgia due to overlapping symptoms such as chronic pain,fatigue,and muscle weakness.This diagnostic error disproportionately affects w...Hypophosphatasia(HPP)is a rare metabolic bone disorder often misdiagnosed as fibromyalgia due to overlapping symptoms such as chronic pain,fatigue,and muscle weakness.This diagnostic error disproportionately affects women and can result in significant psychological distress due to repeated dismissal of symptoms.Despite low serum alkaline phosphatase(ALP)being a key biochemical clue to HPP,it is frequently overlooked in standard diagnostic evaluations.Consequen-tly,many patients endure years of ineffective treatment,invalidation,and worse-ning psychiatric outcomes.This editorial emphasizes the need for greater clinical vigilance in distinguishing HPP from fibromyalgia,particularly when features such as chronic pain,premature tooth loss,and persistently low ALP are present.Gender biases in pain diagnosis further compound this problem,leading to gr-eater misdiagnosis rates among women and contributing to the erosion of trust in medical care.The psychiatric consequences of diagnostic delays are substantial,with affected individuals experiencing elevated rates of depression,anxiety,and emotional distress.Greater recognition of low ALP as a meaningful diagnostic clue may enhance diagnostic accuracy,improve patient outcomes,and reduce the psychological toll of misdiagnosis.展开更多
Dysfunction of the interoceptive system is recognized as an important component of clinical symptoms,including anxiety,depression,psychosis,and other mental disorders.Non-invasive neuromodulation is an emerging clinic...Dysfunction of the interoceptive system is recognized as an important component of clinical symptoms,including anxiety,depression,psychosis,and other mental disorders.Non-invasive neuromodulation is an emerging clinical intervention approach,and over the past decade,research on non-invasive neuromodulation aimed at regulating interoception has rapidly developed.This review first outlines the pathways of interoceptive signals and assessment methods,then summarizes the interoceptive abnormalities in psychiatric disorders and current studies for non-invasive neuromodulation targeting interoception,including intervention modes,target sites,interoceptive measures,and potential neurobiological mechanisms.Finally,we discuss significant research challenges and future directions.展开更多
This manuscript critically evaluates the randomized controlled trial(RCT)conducted by Phiri et al,which assessed the effectiveness of virtual reality(VR)training for psychiatric staff in reducing restrictive practices...This manuscript critically evaluates the randomized controlled trial(RCT)conducted by Phiri et al,which assessed the effectiveness of virtual reality(VR)training for psychiatric staff in reducing restrictive practices(RPs).Specifically,this RCT investigated the impact of VR on the handling of aggressive patients by psychiatric staff compared to traditional training methods.Despite significant reductions in perceived discrimination in the VR group,there were no major improvements in self-efficacy or anxiety levels.The system usability scale rated the VR platform highly,but it did not consistently outperform traditional training methods.Indeed,the study shows the potential for VR to reduce RPs,although fluctuations in RP rates suggest that external factors,such as staff turnover,influenced the outcomes.This manuscript evaluates the study’s methodology,results,and broader implications for mental health training.Additionally,it highlights the need for more comprehensive research to establish VR as a standard tool for psychiatric staff education,focusing on patient care outcomes and real-world applicability.Finally,this study explores future research di-rections,technological improvements,and the potential impact of policies that could enhance the integration of VR in clinical training.展开更多
BACKGROUND First-generation antipsychotics demonstrate certain therapeutic benefits in schizophrenia;however,they often fail to significantly address negative symptoms.Thus,continued exploration is essential to refine...BACKGROUND First-generation antipsychotics demonstrate certain therapeutic benefits in schizophrenia;however,they often fail to significantly address negative symptoms.Thus,continued exploration is essential to refine these treatments.AIM To examine lurasidone plus sulpiride influence on treatment efficacy,psychiatric symptoms,and quality of life in patients with schizophrenia.METHODS A total of 110 patients with schizophrenia,admitted between October 2021 and October 2024,were recruited for this study.The control group(n=50)received sulpiride alone.Conversely,the observation group(n=60)was treated with a combination of lurasidone and sulpiride.A series of assessments were conducted to compare the two groups.These included evaluating treatment efficacy;recording the incidence of adverse events such as fatigue,xerostomia,insomnia,anorexia,and headache;assessing psychiatric symptoms using the positive and negative syndrome scale(PANSS);evaluating cognitive and social functions using the repeatable battery for the assessment of neuropsychological status(RBANS),and the personal and social performance scale(PSP);measuring quality of life using the schizophrenia quality of life scale(SQLS);and analyzing serum markers including interleukin 6(IL-6),IL-17,and prolactin(PRL).RESULTS Overall treatment efficacy was significantly higher in the observation group than in the control group.The total incidence of adverse events was comparable between the two groups.After treatment,the scores for positive symptoms,negative symptoms,and general psychopathological symptoms on the PANSS in the observation group were significantly reduced compared to pretreatment levels,and were also lower than those in the control group.Additionally,RBANS and PSP scores in the observation group significantly increased post-treatment and were notably higher than in the control group.Regarding the quality of life,SQLS scores in the psychosocial,symptoms,and side effects and motivation and energy dimensions in the observation group were significantly lower after treatment than both baseline levels and those in the control group.Furthermore,post-treatment levels of IL-6 and IL-17 in the observation group were significantly reduced and lower than those in the control group,whereas the PRL level was significantly elevated.CONCLUSION The combination of lurasidone and sulpiride can effectively enhance treatment efficacy,alleviate psychiatric symptoms,and improve quality of life in patients with schizophrenia,supporting its broader clinical use.展开更多
The extensive spread of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)throughout China in late 2022 has underscored the correlation between this virus and severe psychiatric disorders.However,there remain...The extensive spread of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)throughout China in late 2022 has underscored the correlation between this virus and severe psychiatric disorders.However,there remains a lack of reported clinical and pathological features.Accordingly,we retrospectively reviewed the electronic medical records of psychiatric inpatients for seven days from early January 2023.Twenty-one inpatients who developed first-episode psychiatric disorders within two weeks after SARS-CoV-2 infection were recruited,while 24 uninfected first-episode psychiatric inpatients were selected as controls.Comparative analyses of clinical manifestations,routine laboratory tests,and imaging examinations were performed.Our investigation demonstrated a 330%increase in the incidence of first-episode psychiatric inpatients after SARS-CoV-2 infection in 2023,compared with the preceding year without SARS-CoV-2 infections.Most cases exhibited psychiatric symptoms within one week of SARS-CoV-2 infection,which resolved after approximately two weeks,with no residual symptoms after three months.One-way ANOVA demonstrated a significant difference in the highest fever temperature between inpatients with and without psychotic symptoms.Infected inpatients displayed elevated levels of interleukin-4,interleukin-8,and interferon-α,but decreased levels of eosinophils and basophils.These findings suggest that SARS-CoV-2 may contribute to the development of psychiatric disorders,likely mediated by the virus-induced inflammatory response and neuronal dysfunction in the context of psychological distress.展开更多
BACKGROUND Neurodevelopmental delays encompass a wide range of conditions that impair cognitive,motor,and social functioning,often increasing the risk of psychiatric comorbidities.Children with these delays frequently...BACKGROUND Neurodevelopmental delays encompass a wide range of conditions that impair cognitive,motor,and social functioning,often increasing the risk of psychiatric comorbidities.Children with these delays frequently present with disorders such as attention-deficit/hyperactivity disorder(ADHD),anxiety,and behavioral disturbances,which can significantly affect development and quality of life.While genetic predisposition has been linked to these comorbidities,growing evidence highlights the role of environmental factors,including prenatal and early-life stressors.However,the interaction between genetic susceptibility and environmental influences remains poorly understood.Identifying specific genetic variants,environmental risks,and their interactions is essential for early detection and targeted interventions.AIM To investigate the combined effects of genetic and environmental factors on psychiatric comorbidities in children with neurodevelopmental delays,elucidate underlying mechanisms,and inform clinical management strategies.METHODS This retrospective cohort study included 80 children with confirmed neurodevelopmental delays and 40 age-and sex-matched typically developing controls.Comprehensive clinical and psychiatric evaluations,genetic testing(chromosomal microarray analysis and targeted next-generation sequencing),and environmental exposure assessments were conducted.Statistical analyses explored associations between genetic variants and psychiatric comorbidities,environmental risk factors,and gene-environment interactions.RESULTS Children with neurodevelopmental delays exhibited significantly higher rates of psychiatric comorbidities(70.0%)compared to controls(15.0%),with ADHD(42.5%),anxiety disorders(28.8%),and behavioral disorders(23.8%)being the most common.Pathogenic genetic variants were identified in specific pathways associated with distinct psychiatric presentations:Glutamatergic signaling variants were linked to anxiety disorders(odds ratio=3.8),dopaminergic system variants to ADHD(odds ratio=4.2),and synaptic function variants to both behavioral and anxiety disorders.Environmental factors,particularly prenatal maternal stress,early childhood adversity,and family dysfunction were strong predictors of psychiatric outcomes(β=0.42).Significant gene-environment interactions were identified,indicating that environmental exposure can moderate the effects of genetic risks on psychiatric outcomes.CONCLUSION Psychiatric comorbidities in children with neurodevelopmental delays are significantly influenced by both genetic and environmental factors,with complex interactions between the two.These findings underscore the need for integrated assessments and targeted interventions addressing both biological and environmental contributors to improve outcomes in this vulnerable population.展开更多
BACKGROUND The neurological and psychiatric sequelae of coronavirus disease 2019(COVID-19)have been documented,yet further data are needed to thoroughly evaluate the impact of COVID-19 on brain health years after the ...BACKGROUND The neurological and psychiatric sequelae of coronavirus disease 2019(COVID-19)have been documented,yet further data are needed to thoroughly evaluate the impact of COVID-19 on brain health years after the infection.AIM To examine whether COVID-19 infection is associated with exacerbation,recurrence,or progression of pre-existing neurological or psychiatric disorders-a highrisk population that is underrepresented in COVID-19 outcome research in National Guard Health Affair patients in 4-years following a COVID-19 diagnosis.METHODS For this multicenter retrospective cohort study,we used data from the National Guard hospitals electronic health records network(BestCare)with over 10 million patients.Our cohort comprised patients who had a COVID-19 diagnosis;a matched control cohort included patient did not expose to COVID-19 in same period.Age and sex were matching factors.We estimated the incidence of 14 neurological and psychiatric outcomes in nearly 4 years after a confirmed diagnosis of COVID-19.Using a multiple logistic regression,we compared incidences with those in propensity score-matched cohorts of patients with no exposure to COVID-19.Ramadan M et al.Neurological and psychiatric risks post-COVID-19 RESULTS Our primary cohort comprised 4437 patients diagnosed with COVID-19,and our propensity-score 1:1 matched control cohort comprised 4437 individuals.Nearly two-third of the COVID-19 cohort(71%)were diagnosed in 2020,and 2021.The most prevalent diagnoses for both cohorts were epilepsy 30.68%,mood disorder 23.92%,and nerve plexus disorder 22.13%.Dementia was nearly 4 times higher among COVID-19 cohort(8.27%)compared to the control cohort(2.57%).Five neurological and psychiatric outcomes had odds ratios(OR)that were significantly higher than 1 for people who had COVID-19 compared to people who had never been infected.These outcomes were cognitive deficit OR=1.54,95%confidence interval(CI):1.23-1.91,P=0.0001;nerve plexus disorder OR=1.13,95%CI:1.01-1.25,P=0.02;substance use disorder OR=1.95,95%CI:1.12-3.38,P=0.01;mood disorder OR=1.16,95%CI:1.05-1.29,P=0.003;and anxiety disorder OR=1.39,95%CI:1.07-1.79,P=0.01.CONCLUSION The study highlights the persistent risk of neurological and psychiatric conditions in COVID-19 survivors up to four years post-infection.Although the incidence was lower than in previous large studies,long-term consequences remain significant,emphasizing the need for ongoing monitoring and support in mental health and neurological care.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 Paracetamol overdose(POD)is the most common cause of acute hepatic failure(AHF)in the United Kingdom.Without urgent orthotopic liver transplant(OLT),mortality is high.Psychiatric assessment for transplant i...BACKGROUND Paracetamol overdose(POD)is the most common cause of acute hepatic failure(AHF)in the United Kingdom.Without urgent orthotopic liver transplant(OLT),mortality is high.Psychiatric assessment for transplant is time-pressured and often undertaken by psychiatrists without transplant experience.Assessors may identify absolute psychiatric contraindications(APCIs)precluding transplant in otherwise medically suitable patients.It is unknown how often this occurs.The combination of high but unknown mortality,time pressure,and relative inexperience is likely to provoke anxiety in assessors.This study hypothesised that the proportion of POD patients assessed for OLT who die because psychiatric contraindications preclude transplant would be small but not negligible.AIM To determine the proportion of patients with paracetamol-induced AHF,for whom psychiatric contraindications preclude transplantation,and the consequent mortality.METHODS This is an 18-year single-centre retrospective cohort study based in a national liver transplant centre.524 participants were identified from a departmental database and included if they had AHF from suspected POD and received a psychiatric assessment for OLT.For those who died before discharge,records were reviewed for medical and psychiatric contraindications to transplant,alongside age,sex,and primary psychiatric diagnosis.We calculated the proportion of patients assessed for whom APCIs precluded transplant,resulting in death.RESULTS Among 524 patients undergoing psychiatric assessment for OLT,there were 102 in-episode deaths(19.5%).APCIs were identified in 46 patients who were otherwise medically suitable for transplant and went on to die.This statistic represents 8.8%of the number of persons evaluated and 45%of the number of deaths.Within this subgroup,27(59%)were female,with a mean age of 44.6 years(ranging from 19-72 years).The most common primary psychiatric diagnosis was alcohol dependence syndrome,which accounted for 67%(n=31).CONCLUSION 8.8%of medically suitable patients with AHF following POD died with APCIs to transplant.This indicates a need for ongoing assessor training and support,and(inter)national comparisons of practice.展开更多
A growing interest in the comprehensive pathogenic mechanisms of psychiatric disorders from the perspective of the microbiome has been witnessed in recent decades;the intrinsic link between microbiota and brain functi...A growing interest in the comprehensive pathogenic mechanisms of psychiatric disorders from the perspective of the microbiome has been witnessed in recent decades;the intrinsic link between microbiota and brain function through the microbiota-gut-brain axis or other pathways has gradually been realized.However,little research has focused on viruses–entities characterized by smaller dimensions,simpler structures,greater diversity,and more intricate interactions with their surrounding milieu compared to bacteria.To date,alterations in several populations of bacteriophages and viruses have been documented in both mouse models and patients with psychiatric disorders,including schizophrenia,major depressive disorder,autism spectrum disorder,and Alzheimer’s disease,accompanied by metabolic disruptions that may directly or indirectly impact brain function.In addition,eukaryotic virus infection-mediated brain dysfunction provides insights into the psychiatric pathology involving viruses.Efforts towards virus-based diagnostic and therapeutic approaches have primarily been documented.However,limitations due to the lack of large-scale cohort studies,reliability,clinical applicability,and the unclear role of viruses in microbiota interactions pose a challenge for future studies.Nevertheless,it is conceivable that investigations into viruses herald a new era in the field of precise psychiatry.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
BACKGROUND Brain-computer interface(BCI)technology is rapidly advancing in psychiatry.Informed consent competency(ICC)assessment among psychiatric patients is a pivotal concern in clinical research.AIM To analyze the ...BACKGROUND Brain-computer interface(BCI)technology is rapidly advancing in psychiatry.Informed consent competency(ICC)assessment among psychiatric patients is a pivotal concern in clinical research.AIM To analyze the assessment of ICC and form a framework with multi-dimensional elements involved in ICC of BCI clinical research among psychiatric disorders.METHODS A systematic review of studies regarding ICC assessments of BCI clinical research in patients with six kinds of psychiatric disorders was conducted.A systematic literature search was performed using PubMed,ScienceDirect,and Web of Science.Peer-reviewed articles and full-text studies were included in the analysis.There were no date restrictions,and all studies published up to February 27,2025,were included.RESULTS A total of 103 studies were selected for this review.Fifty-eight studies included ICC factors,and forty-five were classified in ICC related ethical issues of BCI research in six kinds of psychiatric disorders.Executive function impairment is widely recognized as the most significant factor impacting ICC,and processing speed deficits are observed in schizophrenia,mood disorders,and Alzheimer’s disease.Memory dysfunction,particularly episodic and working memory,contributes to compromised ICC.Five core ethical issues in BCI research should be addressed:BCI specificity,vulnerability,autonomy,dynamic ICC,comprehensiveness,and uncertainty.CONCLUSION A Five-Dimensional evaluative framework,including clinical,ethical,sociocultural,legal,and procedural dimensions,is constructed and proposed for future ICC research in BCI clinical research involving psychiatric disorders.展开更多
Psychiatric disorders significantly impact surgical outcomes,presenting unique challenges in perioperative care.The intricate relationship between preoperative psychiatric conditions and surgical complications involve...Psychiatric disorders significantly impact surgical outcomes,presenting unique challenges in perioperative care.The intricate relationship between preoperative psychiatric conditions and surgical complications involves complex mechanisms,including altered coagulation,cardiovascular function,and pain perception.Common psychiatric disorders in surgical patients,such as anxiety,depression,and substance use disorders,vary in prevalence and manifestation.Demographic factors,comorbidities,and psychotropic medications further modulate these effects on surgical outcomes.Effective screening and assessment strategies are crucial,yet they present both opportunities and limitations in the preoperative setting.Preoperative psychological interventions,including cognitive-behavioral therapy,supportive care,and mind-body techniques,show promise in mitigating psychological distress and improving surgical outcomes.Multidisciplinary approaches,involving collaborative efforts between psychiatric and surgical teams,are essential to provide comprehensive patient care.Emerging inter-ventions,technological innovations,and personalized medicine approaches offer exciting possibilities to advance preoperative psychiatric care.By understanding the complex interplay between psychiatric disorders and surgical outcomes,healthcare professionals can implement integrated,patient-centered approaches to optimize perioperative care and improve overall patient outcomes.展开更多
Atrial fibrillation(AF)is a very common tachyarrhythmia in clinical practice.Several risk factors,such as higher inflammatory marker levels,diabetes mellitus,hypertension,valvular disease,ischemic heart disease,heart ...Atrial fibrillation(AF)is a very common tachyarrhythmia in clinical practice.Several risk factors,such as higher inflammatory marker levels,diabetes mellitus,hypertension,valvular disease,ischemic heart disease,heart failure,and obesity have been proposed to enhance the risk of AF,contributing to higher healthcare system utilization rates and socioeconomic costs.Some interesting studies also investigated the link between AF and psychiatric diseases.This article debates this link between AF and psychiatric diseases from the perspective of Ca^(2+)/cAMP signaling.展开更多
Insulin plays a crucial role in the metabolic priming and proliferation of neural stem cells(NSCs).However,insulin resistance(IR)is associated with impaired NSC proliferation and cognitive dysfunction,which are the ha...Insulin plays a crucial role in the metabolic priming and proliferation of neural stem cells(NSCs).However,insulin resistance(IR)is associated with impaired NSC proliferation and cognitive dysfunction,which are the hallmarks of psychiatric disorders(PDs).In addition to insulin,de novo lipogenesis(DNL)also plays an essential role in NSC proliferation and function as it supplies fatty acids for membrane phospholipid synthesis and cell signaling.However,enhanced DNL is associated with lipid/fatty acid accumulation,IR,and impaired NSC proliferation.Intriguingly,data from lipidomic studies suggest that DNL could be enhanced before the onset of classical symptoms in patients with PDs.Further,evidence suggests that patients with PDs may develop IR during childhood or before adolescence;therefore,DNL could be enhanced preceding the development of IR.Regarding treatment,while most antidepressants and antipsychotic drugs have been shown to further deteriorate IR and stimulate DNL,various adjunctive drugs/therapies,including chemical,physical,and stem cell therapy,which have shown promising success in treating PDs,reduce DNL while enhancing insulin sensitivity,NSC proliferation,and cognitive function in laboratory animals.Preliminary clinical outcomes and future prospects of these adjunctive drugs/therapies,especially stem cell therapy in treating PDs including schizophrenia and depression,are discussed.展开更多
γ neuromodulation has emerged as a promising strategy for addressing neurological and psychiatric disorders,particularly in regulating executive and cognitive functions.This review explores the latest neuromodulation...γ neuromodulation has emerged as a promising strategy for addressing neurological and psychiatric disorders,particularly in regulating executive and cognitive functions.This review explores the latest neuromodulation techniques,focusing on the critical role of γ oscillations in various brain disorders.Direct γ neuromodulation induces γ -frequency oscillations to synchronize disrupted brain networks,while indirect methods influence γ oscillations by modulating cortical excitability.We investigate how monitoring dynamic features of γ oscillations allows for detailed evaluations of neuromodulation effectiveness.By targeting γ oscillatory patterns and restoring healthy cross-frequency coupling,interventions may alleviate cognitive and behavioral symptoms linked to disrupted communication.This review examines clinical applications of γ neuromodulations,including enhancing cognitive function through 40 Hz multisensory stimulation in Alzheimer’s disease,improving motor function in Parkinson’s disease,controlling seizures in epilepsy,and modulating emotional dysfunctions in depression.Additionally,these neuromodulation strategies aim to regulate excitatory-inhibitory imbalances and restore γ synchrony across neurological and psychiatric disorders.The review highlights the potential of γ oscillations as biomarkers to boost restorative results in clinical applications of neuromodulation.Future studies might focus on integrating multimodal personalized protocols,artificial intelligence(AI)driven frameworks for neural decoding,and global multicenter collaborations to standardize and scale precision treatments across diverse disorders.展开更多
文摘Non-right-handedness(NRH),encompassing left-handedness and mixed-handedness,has been frequently reported at elevated rates in individuals with various psychiatric disorders.The consistency of this association across multiple conditions and its underlying mechanisms is the subject of ongoing investigation.This review synthesized current evidence to explore the association between NRH and psychiatric disorders from epidemiological,genetic,and neurobiological perspectives.We systematically identified and appraised relevant literature investigating NRH prevalence in psychiatric populations and potential explanatory mechanisms.Epidemiological evidence indicates an elevated prevalence of NRH,particularly within neurodevelopmental disorders.Potential contributing mechanisms identified include early developmental disruptions,shared genetic predispositions,and atypical patterns of brain lateralization.While the association between NRH and psychiatric conditions,especially neurodevelopmental disorders,is evident,the causal pathways and relative contributions of identified mechanisms are complex and debated.This review highlighted key areas requiring further research to elucidate these relationships.
基金supported by Department of Defense grant HT9425-24-1-0030 a grant from the Stanley Medical Research Institute(to SS).
文摘The inability to access brain tissue has greatly hindered our ability to study and care for individuals suffering from psychiatric and neurological conditions.Critics have questioned efforts to develop peripheral blood biomarkers in neurological and psychiatric disorders based on the assertion that disease pathology is limited to the brain.The discovery that all tissues,including the brain,release extracellular vesicles(Raposo and Stoorvogel,2013)and cell free DNAs(Chan et al.,2013)into various body fluids has provided a potential way to measure activity from inaccessible tissues like the central nervous system(CNS)and has given rise to the term“liquid biopsy.”The development of liquid biopsies that can diagnose and predict the course of psychiatric and neurological disorders would be transformative.The ability to predict episodic events such as mania,depression,and risk for suicide would be particularly useful for psychiatric care as it would enable the development of interventions that prevent mortality and improve outcomes.Additionally,biomarkers that are informative about drug response and aid in treatment decisions would be a significant advance in psychiatric care as it would prevent patients from having to endure multiple courses of ineffective treatments and side effects.
基金the 2023 Fuyang Municipal Scientific Research Projects in Health and Wellness,No.FY2023-0.
文摘BACKGROUND Post-stroke psychiatric complications,particularly depression and anxiety,significantly impact rehabilitation outcomes and quality of life.Despite their prevalence and clinical significance,these conditions often remain underrecognized in routine stroke care.Understanding their clinical features and temporal patterns is crucial for improving patient outcomes.AIM To investigate the prevalence,temporal evolution,and clinical correlates of depression and anxiety post-stroke and their impact on functional recovery.METHODS In this prospective observational study,127 patients first-ever ischemic stroke were enrolled between June 2022 and June 2024.Depression and anxiety were assessed using the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale at baseline and follow-up intervals(2 weeks,1 month,3 months,and 6 months).Stroke severity was evaluated using the National Institutes of Health Stroke Scale,and functional outcomes were measured using the modified Rankin Scale.RESULTS Among 120 patients who completed follow-up(94.5%completion rate),37.5%had depression(mild:18.3%,moderate:12.5%,severe:6.7%)and 41.7%had anxiety at baseline.Depression prevalence showed a biphasic pattern,peaking at 2 weeks(37.5%),declining at 3 months(28.3%),and slightly increasing at 6 months(30.8%).Stroke severity significantly correlated with both depression(odds ratio=1.18,95%CI:1.06-1.31,P=0.003)and anxiety(odds ratio=1.15,95%CI:1.04-1.27,P=0.008).Left hemisphere lesions had a stronger association with psychiatric symptoms than right hemisphere lesions(P=0.035).Patients with psychiatric complications demonstrated poorer functional outcomes at 6 months(median modified Rankin Scale 3 vs 2,P=0.015)and longer hospital stays(mean difference:3.2 days,P=0.002).CONCLUSION Identifying the clinical and neuroanatomical correlates of depression and anxiety will enable effective risk stratification and patient management.Integrating routine psychiatric screening and early intervention is essential in stroke care.
文摘BACKGROUND Insomnia is a common sleep disorder that negatively impacts quality of life and is frequently comorbid with depression and anxiety.Chronic insomnia affects approximately 15%of the global population,with higher prevalence among females and the elderly.While existing research suggests a bidirectional relationship between insomnia and emotional disorders,the specific impact of insomnia severity on depression,anxiety,and quality of life remains unclear.This study investigates the correlation between insomnia severity and these factors in psychiatric outpatients,hypothesizing that greater insomnia severity is associated with higher levels of depression and anxiety,as well as poorer quality of life.AIM To explore the correlation between insomnia severity and depression,anxiety,and quality of life in primary chronic insomnia patients.METHODS From June to December 2023,345 patients with primary insomnia in Chifeng city were recruited and divided into three groups based on Pittsburgh sleep quality index(PSQI)scores:Mild(n=137),moderate(n=162),and severe(n=46).Demographic data were collected via questionnaires.Self-rating depression scale(SDS),self-rating anxiety scale(SAS),PSQI,and short form 36(SF-36)scores were compared,and Pearson and partial correlation analyses were performed.RESULTS The greater the degree of insomnia,the greater the symptoms of depression and anxiety(P<0.001).The more severe the insomnia,the lower the SF-36 score(excluding body pain),and the difference between the three groups was statist ically significant(P<0.001).Pearson correlation analysis and partial correlation analysis depicted the SDS score and SAS score were apparently positively correlated with the severity of insomnia(P<0.001).Pearson correlation analysis and partial correlation analysis depicted the SF-36 scores were apparently positively correlated with the severity of insomnia(P<0.05).CONCLUSION Depression and anxiety are independent factors influencing insomnia severity in primary chronic insomnia patients.Higher depression/anxiety levels correlate with worse insomnia,impacting quality of life.
文摘Hypophosphatasia(HPP)is a rare metabolic bone disorder often misdiagnosed as fibromyalgia due to overlapping symptoms such as chronic pain,fatigue,and muscle weakness.This diagnostic error disproportionately affects women and can result in significant psychological distress due to repeated dismissal of symptoms.Despite low serum alkaline phosphatase(ALP)being a key biochemical clue to HPP,it is frequently overlooked in standard diagnostic evaluations.Consequen-tly,many patients endure years of ineffective treatment,invalidation,and worse-ning psychiatric outcomes.This editorial emphasizes the need for greater clinical vigilance in distinguishing HPP from fibromyalgia,particularly when features such as chronic pain,premature tooth loss,and persistently low ALP are present.Gender biases in pain diagnosis further compound this problem,leading to gr-eater misdiagnosis rates among women and contributing to the erosion of trust in medical care.The psychiatric consequences of diagnostic delays are substantial,with affected individuals experiencing elevated rates of depression,anxiety,and emotional distress.Greater recognition of low ALP as a meaningful diagnostic clue may enhance diagnostic accuracy,improve patient outcomes,and reduce the psychological toll of misdiagnosis.
基金supported by grants from the National Natural Science Foundation of China(82101582)the Shanghai Science and Technology Committee(22Y11903600 and 23Y11906000)the Shanghai Municipal Health Commission(202240266).
文摘Dysfunction of the interoceptive system is recognized as an important component of clinical symptoms,including anxiety,depression,psychosis,and other mental disorders.Non-invasive neuromodulation is an emerging clinical intervention approach,and over the past decade,research on non-invasive neuromodulation aimed at regulating interoception has rapidly developed.This review first outlines the pathways of interoceptive signals and assessment methods,then summarizes the interoceptive abnormalities in psychiatric disorders and current studies for non-invasive neuromodulation targeting interoception,including intervention modes,target sites,interoceptive measures,and potential neurobiological mechanisms.Finally,we discuss significant research challenges and future directions.
基金Supported by Basic Science Research Program Through the National Research Foundation of Korea(NRF)Funded by the Ministry of Education,No.NRF-RS-2023-00237287 and No.NRF-2021S1A5A8062526Local Government-University Cooperation-Based Regional Innovation Projects,No.2021RIS-003.
文摘This manuscript critically evaluates the randomized controlled trial(RCT)conducted by Phiri et al,which assessed the effectiveness of virtual reality(VR)training for psychiatric staff in reducing restrictive practices(RPs).Specifically,this RCT investigated the impact of VR on the handling of aggressive patients by psychiatric staff compared to traditional training methods.Despite significant reductions in perceived discrimination in the VR group,there were no major improvements in self-efficacy or anxiety levels.The system usability scale rated the VR platform highly,but it did not consistently outperform traditional training methods.Indeed,the study shows the potential for VR to reduce RPs,although fluctuations in RP rates suggest that external factors,such as staff turnover,influenced the outcomes.This manuscript evaluates the study’s methodology,results,and broader implications for mental health training.Additionally,it highlights the need for more comprehensive research to establish VR as a standard tool for psychiatric staff education,focusing on patient care outcomes and real-world applicability.Finally,this study explores future research di-rections,technological improvements,and the potential impact of policies that could enhance the integration of VR in clinical training.
文摘BACKGROUND First-generation antipsychotics demonstrate certain therapeutic benefits in schizophrenia;however,they often fail to significantly address negative symptoms.Thus,continued exploration is essential to refine these treatments.AIM To examine lurasidone plus sulpiride influence on treatment efficacy,psychiatric symptoms,and quality of life in patients with schizophrenia.METHODS A total of 110 patients with schizophrenia,admitted between October 2021 and October 2024,were recruited for this study.The control group(n=50)received sulpiride alone.Conversely,the observation group(n=60)was treated with a combination of lurasidone and sulpiride.A series of assessments were conducted to compare the two groups.These included evaluating treatment efficacy;recording the incidence of adverse events such as fatigue,xerostomia,insomnia,anorexia,and headache;assessing psychiatric symptoms using the positive and negative syndrome scale(PANSS);evaluating cognitive and social functions using the repeatable battery for the assessment of neuropsychological status(RBANS),and the personal and social performance scale(PSP);measuring quality of life using the schizophrenia quality of life scale(SQLS);and analyzing serum markers including interleukin 6(IL-6),IL-17,and prolactin(PRL).RESULTS Overall treatment efficacy was significantly higher in the observation group than in the control group.The total incidence of adverse events was comparable between the two groups.After treatment,the scores for positive symptoms,negative symptoms,and general psychopathological symptoms on the PANSS in the observation group were significantly reduced compared to pretreatment levels,and were also lower than those in the control group.Additionally,RBANS and PSP scores in the observation group significantly increased post-treatment and were notably higher than in the control group.Regarding the quality of life,SQLS scores in the psychosocial,symptoms,and side effects and motivation and energy dimensions in the observation group were significantly lower after treatment than both baseline levels and those in the control group.Furthermore,post-treatment levels of IL-6 and IL-17 in the observation group were significantly reduced and lower than those in the control group,whereas the PRL level was significantly elevated.CONCLUSION The combination of lurasidone and sulpiride can effectively enhance treatment efficacy,alleviate psychiatric symptoms,and improve quality of life in patients with schizophrenia,supporting its broader clinical use.
基金supported by the National Natural Science Foundation of China(Grant Nos.81971289 and 81871344)。
文摘The extensive spread of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)throughout China in late 2022 has underscored the correlation between this virus and severe psychiatric disorders.However,there remains a lack of reported clinical and pathological features.Accordingly,we retrospectively reviewed the electronic medical records of psychiatric inpatients for seven days from early January 2023.Twenty-one inpatients who developed first-episode psychiatric disorders within two weeks after SARS-CoV-2 infection were recruited,while 24 uninfected first-episode psychiatric inpatients were selected as controls.Comparative analyses of clinical manifestations,routine laboratory tests,and imaging examinations were performed.Our investigation demonstrated a 330%increase in the incidence of first-episode psychiatric inpatients after SARS-CoV-2 infection in 2023,compared with the preceding year without SARS-CoV-2 infections.Most cases exhibited psychiatric symptoms within one week of SARS-CoV-2 infection,which resolved after approximately two weeks,with no residual symptoms after three months.One-way ANOVA demonstrated a significant difference in the highest fever temperature between inpatients with and without psychotic symptoms.Infected inpatients displayed elevated levels of interleukin-4,interleukin-8,and interferon-α,but decreased levels of eosinophils and basophils.These findings suggest that SARS-CoV-2 may contribute to the development of psychiatric disorders,likely mediated by the virus-induced inflammatory response and neuronal dysfunction in the context of psychological distress.
文摘BACKGROUND Neurodevelopmental delays encompass a wide range of conditions that impair cognitive,motor,and social functioning,often increasing the risk of psychiatric comorbidities.Children with these delays frequently present with disorders such as attention-deficit/hyperactivity disorder(ADHD),anxiety,and behavioral disturbances,which can significantly affect development and quality of life.While genetic predisposition has been linked to these comorbidities,growing evidence highlights the role of environmental factors,including prenatal and early-life stressors.However,the interaction between genetic susceptibility and environmental influences remains poorly understood.Identifying specific genetic variants,environmental risks,and their interactions is essential for early detection and targeted interventions.AIM To investigate the combined effects of genetic and environmental factors on psychiatric comorbidities in children with neurodevelopmental delays,elucidate underlying mechanisms,and inform clinical management strategies.METHODS This retrospective cohort study included 80 children with confirmed neurodevelopmental delays and 40 age-and sex-matched typically developing controls.Comprehensive clinical and psychiatric evaluations,genetic testing(chromosomal microarray analysis and targeted next-generation sequencing),and environmental exposure assessments were conducted.Statistical analyses explored associations between genetic variants and psychiatric comorbidities,environmental risk factors,and gene-environment interactions.RESULTS Children with neurodevelopmental delays exhibited significantly higher rates of psychiatric comorbidities(70.0%)compared to controls(15.0%),with ADHD(42.5%),anxiety disorders(28.8%),and behavioral disorders(23.8%)being the most common.Pathogenic genetic variants were identified in specific pathways associated with distinct psychiatric presentations:Glutamatergic signaling variants were linked to anxiety disorders(odds ratio=3.8),dopaminergic system variants to ADHD(odds ratio=4.2),and synaptic function variants to both behavioral and anxiety disorders.Environmental factors,particularly prenatal maternal stress,early childhood adversity,and family dysfunction were strong predictors of psychiatric outcomes(β=0.42).Significant gene-environment interactions were identified,indicating that environmental exposure can moderate the effects of genetic risks on psychiatric outcomes.CONCLUSION Psychiatric comorbidities in children with neurodevelopmental delays are significantly influenced by both genetic and environmental factors,with complex interactions between the two.These findings underscore the need for integrated assessments and targeted interventions addressing both biological and environmental contributors to improve outcomes in this vulnerable population.
文摘BACKGROUND The neurological and psychiatric sequelae of coronavirus disease 2019(COVID-19)have been documented,yet further data are needed to thoroughly evaluate the impact of COVID-19 on brain health years after the infection.AIM To examine whether COVID-19 infection is associated with exacerbation,recurrence,or progression of pre-existing neurological or psychiatric disorders-a highrisk population that is underrepresented in COVID-19 outcome research in National Guard Health Affair patients in 4-years following a COVID-19 diagnosis.METHODS For this multicenter retrospective cohort study,we used data from the National Guard hospitals electronic health records network(BestCare)with over 10 million patients.Our cohort comprised patients who had a COVID-19 diagnosis;a matched control cohort included patient did not expose to COVID-19 in same period.Age and sex were matching factors.We estimated the incidence of 14 neurological and psychiatric outcomes in nearly 4 years after a confirmed diagnosis of COVID-19.Using a multiple logistic regression,we compared incidences with those in propensity score-matched cohorts of patients with no exposure to COVID-19.Ramadan M et al.Neurological and psychiatric risks post-COVID-19 RESULTS Our primary cohort comprised 4437 patients diagnosed with COVID-19,and our propensity-score 1:1 matched control cohort comprised 4437 individuals.Nearly two-third of the COVID-19 cohort(71%)were diagnosed in 2020,and 2021.The most prevalent diagnoses for both cohorts were epilepsy 30.68%,mood disorder 23.92%,and nerve plexus disorder 22.13%.Dementia was nearly 4 times higher among COVID-19 cohort(8.27%)compared to the control cohort(2.57%).Five neurological and psychiatric outcomes had odds ratios(OR)that were significantly higher than 1 for people who had COVID-19 compared to people who had never been infected.These outcomes were cognitive deficit OR=1.54,95%confidence interval(CI):1.23-1.91,P=0.0001;nerve plexus disorder OR=1.13,95%CI:1.01-1.25,P=0.02;substance use disorder OR=1.95,95%CI:1.12-3.38,P=0.01;mood disorder OR=1.16,95%CI:1.05-1.29,P=0.003;and anxiety disorder OR=1.39,95%CI:1.07-1.79,P=0.01.CONCLUSION The study highlights the persistent risk of neurological and psychiatric conditions in COVID-19 survivors up to four years post-infection.Although the incidence was lower than in previous large studies,long-term consequences remain significant,emphasizing the need for ongoing monitoring and support in mental health and neurological care.
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 Paracetamol overdose(POD)is the most common cause of acute hepatic failure(AHF)in the United Kingdom.Without urgent orthotopic liver transplant(OLT),mortality is high.Psychiatric assessment for transplant is time-pressured and often undertaken by psychiatrists without transplant experience.Assessors may identify absolute psychiatric contraindications(APCIs)precluding transplant in otherwise medically suitable patients.It is unknown how often this occurs.The combination of high but unknown mortality,time pressure,and relative inexperience is likely to provoke anxiety in assessors.This study hypothesised that the proportion of POD patients assessed for OLT who die because psychiatric contraindications preclude transplant would be small but not negligible.AIM To determine the proportion of patients with paracetamol-induced AHF,for whom psychiatric contraindications preclude transplantation,and the consequent mortality.METHODS This is an 18-year single-centre retrospective cohort study based in a national liver transplant centre.524 participants were identified from a departmental database and included if they had AHF from suspected POD and received a psychiatric assessment for OLT.For those who died before discharge,records were reviewed for medical and psychiatric contraindications to transplant,alongside age,sex,and primary psychiatric diagnosis.We calculated the proportion of patients assessed for whom APCIs precluded transplant,resulting in death.RESULTS Among 524 patients undergoing psychiatric assessment for OLT,there were 102 in-episode deaths(19.5%).APCIs were identified in 46 patients who were otherwise medically suitable for transplant and went on to die.This statistic represents 8.8%of the number of persons evaluated and 45%of the number of deaths.Within this subgroup,27(59%)were female,with a mean age of 44.6 years(ranging from 19-72 years).The most common primary psychiatric diagnosis was alcohol dependence syndrome,which accounted for 67%(n=31).CONCLUSION 8.8%of medically suitable patients with AHF following POD died with APCIs to transplant.This indicates a need for ongoing assessor training and support,and(inter)national comparisons of practice.
基金supported by The Research Project of Jinan Microecological Biomedicine Shandong Laboratory(JNL-2023001B)The National Key Research and Development Program of China(2023YFC2506200)+2 种基金The Zhejiang Provincial Key Research and Development Program(2021C03107)The Leading Talent of Scientific and Technological Innovation-“Ten Thousand Talents Program”of Zhejiang Province(2021R52016)The Fundamental Research Funds for the Central Universities(226-2022-00193,226-2022-00002,2023ZFJH01-01,and 2024ZFJH01-01).
文摘A growing interest in the comprehensive pathogenic mechanisms of psychiatric disorders from the perspective of the microbiome has been witnessed in recent decades;the intrinsic link between microbiota and brain function through the microbiota-gut-brain axis or other pathways has gradually been realized.However,little research has focused on viruses–entities characterized by smaller dimensions,simpler structures,greater diversity,and more intricate interactions with their surrounding milieu compared to bacteria.To date,alterations in several populations of bacteriophages and viruses have been documented in both mouse models and patients with psychiatric disorders,including schizophrenia,major depressive disorder,autism spectrum disorder,and Alzheimer’s disease,accompanied by metabolic disruptions that may directly or indirectly impact brain function.In addition,eukaryotic virus infection-mediated brain dysfunction provides insights into the psychiatric pathology involving viruses.Efforts towards virus-based diagnostic and therapeutic approaches have primarily been documented.However,limitations due to the lack of large-scale cohort studies,reliability,clinical applicability,and the unclear role of viruses in microbiota interactions pose a challenge for future studies.Nevertheless,it is conceivable that investigations into viruses herald a new era in the field of precise psychiatry.
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.
基金Supported by the Ministry of Science and Technology of the People's Republic of China(2021ZD0201900)Project 5,No.2021ZD0201905Capital’s Funds for Health Improvement and Research,No.CFH 2022-2-4115.
文摘BACKGROUND Brain-computer interface(BCI)technology is rapidly advancing in psychiatry.Informed consent competency(ICC)assessment among psychiatric patients is a pivotal concern in clinical research.AIM To analyze the assessment of ICC and form a framework with multi-dimensional elements involved in ICC of BCI clinical research among psychiatric disorders.METHODS A systematic review of studies regarding ICC assessments of BCI clinical research in patients with six kinds of psychiatric disorders was conducted.A systematic literature search was performed using PubMed,ScienceDirect,and Web of Science.Peer-reviewed articles and full-text studies were included in the analysis.There were no date restrictions,and all studies published up to February 27,2025,were included.RESULTS A total of 103 studies were selected for this review.Fifty-eight studies included ICC factors,and forty-five were classified in ICC related ethical issues of BCI research in six kinds of psychiatric disorders.Executive function impairment is widely recognized as the most significant factor impacting ICC,and processing speed deficits are observed in schizophrenia,mood disorders,and Alzheimer’s disease.Memory dysfunction,particularly episodic and working memory,contributes to compromised ICC.Five core ethical issues in BCI research should be addressed:BCI specificity,vulnerability,autonomy,dynamic ICC,comprehensiveness,and uncertainty.CONCLUSION A Five-Dimensional evaluative framework,including clinical,ethical,sociocultural,legal,and procedural dimensions,is constructed and proposed for future ICC research in BCI clinical research involving psychiatric disorders.
文摘Psychiatric disorders significantly impact surgical outcomes,presenting unique challenges in perioperative care.The intricate relationship between preoperative psychiatric conditions and surgical complications involves complex mechanisms,including altered coagulation,cardiovascular function,and pain perception.Common psychiatric disorders in surgical patients,such as anxiety,depression,and substance use disorders,vary in prevalence and manifestation.Demographic factors,comorbidities,and psychotropic medications further modulate these effects on surgical outcomes.Effective screening and assessment strategies are crucial,yet they present both opportunities and limitations in the preoperative setting.Preoperative psychological interventions,including cognitive-behavioral therapy,supportive care,and mind-body techniques,show promise in mitigating psychological distress and improving surgical outcomes.Multidisciplinary approaches,involving collaborative efforts between psychiatric and surgical teams,are essential to provide comprehensive patient care.Emerging inter-ventions,technological innovations,and personalized medicine approaches offer exciting possibilities to advance preoperative psychiatric care.By understanding the complex interplay between psychiatric disorders and surgical outcomes,healthcare professionals can implement integrated,patient-centered approaches to optimize perioperative care and improve overall patient outcomes.
文摘Atrial fibrillation(AF)is a very common tachyarrhythmia in clinical practice.Several risk factors,such as higher inflammatory marker levels,diabetes mellitus,hypertension,valvular disease,ischemic heart disease,heart failure,and obesity have been proposed to enhance the risk of AF,contributing to higher healthcare system utilization rates and socioeconomic costs.Some interesting studies also investigated the link between AF and psychiatric diseases.This article debates this link between AF and psychiatric diseases from the perspective of Ca^(2+)/cAMP signaling.
文摘Insulin plays a crucial role in the metabolic priming and proliferation of neural stem cells(NSCs).However,insulin resistance(IR)is associated with impaired NSC proliferation and cognitive dysfunction,which are the hallmarks of psychiatric disorders(PDs).In addition to insulin,de novo lipogenesis(DNL)also plays an essential role in NSC proliferation and function as it supplies fatty acids for membrane phospholipid synthesis and cell signaling.However,enhanced DNL is associated with lipid/fatty acid accumulation,IR,and impaired NSC proliferation.Intriguingly,data from lipidomic studies suggest that DNL could be enhanced before the onset of classical symptoms in patients with PDs.Further,evidence suggests that patients with PDs may develop IR during childhood or before adolescence;therefore,DNL could be enhanced preceding the development of IR.Regarding treatment,while most antidepressants and antipsychotic drugs have been shown to further deteriorate IR and stimulate DNL,various adjunctive drugs/therapies,including chemical,physical,and stem cell therapy,which have shown promising success in treating PDs,reduce DNL while enhancing insulin sensitivity,NSC proliferation,and cognitive function in laboratory animals.Preliminary clinical outcomes and future prospects of these adjunctive drugs/therapies,especially stem cell therapy in treating PDs including schizophrenia and depression,are discussed.
基金supported by the National Natural Science Foundation of China(82401829)the Leading Innovative and Entrepreneur Team Introduction Program of Zhejiang(2023R01002).
文摘γ neuromodulation has emerged as a promising strategy for addressing neurological and psychiatric disorders,particularly in regulating executive and cognitive functions.This review explores the latest neuromodulation techniques,focusing on the critical role of γ oscillations in various brain disorders.Direct γ neuromodulation induces γ -frequency oscillations to synchronize disrupted brain networks,while indirect methods influence γ oscillations by modulating cortical excitability.We investigate how monitoring dynamic features of γ oscillations allows for detailed evaluations of neuromodulation effectiveness.By targeting γ oscillatory patterns and restoring healthy cross-frequency coupling,interventions may alleviate cognitive and behavioral symptoms linked to disrupted communication.This review examines clinical applications of γ neuromodulations,including enhancing cognitive function through 40 Hz multisensory stimulation in Alzheimer’s disease,improving motor function in Parkinson’s disease,controlling seizures in epilepsy,and modulating emotional dysfunctions in depression.Additionally,these neuromodulation strategies aim to regulate excitatory-inhibitory imbalances and restore γ synchrony across neurological and psychiatric disorders.The review highlights the potential of γ oscillations as biomarkers to boost restorative results in clinical applications of neuromodulation.Future studies might focus on integrating multimodal personalized protocols,artificial intelligence(AI)driven frameworks for neural decoding,and global multicenter collaborations to standardize and scale precision treatments across diverse disorders.
