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 Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term...BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term cystitis suggests an inflammatory or infectious origin,no definite cause has been identified.It occurs in both sexes,but women are twice as much affected.AIM To systematically review evidence of psychiatric/psychological changes in persons with IC/BPS.METHODS Hypothesizing that particular psychological characteristics could underpin IC/BPS,we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy:("interstitial cystitis"OR"bladder pain syndrome")AND("mood disorder"OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cyclasterisk OR dysthymiasterisk OR dysphoriasterisk).RESULTS On September 27,2023,the PubMed search produced 223 articles,CINAHL 62,and the combined PsycLIT/PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search 36.Search on ClinicalTrials.gov produced 14 studies,of which none had available data.Eligible were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS,i.e.63 articles spanning from 2000 to October 2023.These studies identified depression and anxiety problems in the IC/BPS population,along with sleep problems and the tendency to catastrophizing.CONCLUSION Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/BPS.Such concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.展开更多
What is already known about this topic?Suicide behaviors are prevalent among inpatients with schizophrenia.However,the relationships between psychiatric symptoms,sleep disturbances,and suicide risk remain poorly under...What is already known about this topic?Suicide behaviors are prevalent among inpatients with schizophrenia.However,the relationships between psychiatric symptoms,sleep disturbances,and suicide risk remain poorly understood in these high-risk populations.What is added by this report?In a study of 672 schizophrenia inpatients across 9 hospitals in 4 Chinese provinces,the prevalence of suicide risk was 22.3%[95%confidence interval(CI):19.3%,25.6%].The study identified significant associations between suicide risk and multiple clinical factors,including poor sleep quality,depressive symptoms,anxiety symptoms,and other psychiatric manifestations such as thinking disorder and activation.What are the implications for public health practice?Understanding the common sleep-related and psychiatric factors associated with suicide risk in hospitalized schizophrenia patients will enable clinicians and policymakers to better identify clinical risk indicators and enhance the quality of suicide prevention and treatment programs.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
BACKGROUND Traditional Chinese medicine(TCM)body constitution is a key factor in determining and influencing the occurrence,development,and variation of diseases.As the mind interact with the body,TCM body constitutio...BACKGROUND Traditional Chinese medicine(TCM)body constitution is a key factor in determining and influencing the occurrence,development,and variation of diseases.As the mind interact with the body,TCM body constitution is useful in preventing and treating psychiatric disorders and insomnia.AIM To investigate the interrelationship between TCM body constitution,psychiatric disorders and sleep quality.METHODS A total of 2441 participants were enrolled in our study.TCM body constitution was measured using the Constitution in Chinese Medicine Questionnaire,sleep quality was assessed using the Chinese version of the Pittsburgh Sleep Quality Index,and psychopathological symptoms were evaluated using Symptom Checklist-90.Logistic regression was used to estimate the interrelationship between TCM body constitution,psychiatric disorders and sleep quality.RESULTS The Pittsburgh Sleep Quality Index score and the proportions of participants with Qi-deficiency constitution,Qi-stagnation constitution,and blood-stasis constitution were significantly higher in the psychiatric symptoms group.Additionally,psychiatric symptoms were considerably associated with sleep quality,Qi-deficiency constitution,and Qi-stagnation constitution,but were inversely associated with male sex.Obsessive–compulsive symptoms were considerably associated with sleep quality,Qi-deficiency constitution and Qi-stagnation constitution.Depression was considerably associated with sleep quality,hyperuricemia,and Qi-stagnation constitution.Anxiety was considerably associated with sleep quality,diabetes,and Qi-stagnation constitution.Finally,poor sleep quality was considerably associated with Qi-deficiency constitution,Qi-stagnation constitution,dampness-heat constitution,phlegm-dampness constitution,and blood-stasis constitution but was inversely associated with male sex and body mass index>23.9.CONCLUSION TCM body constitutions are strongly associated with psychiatric symptoms and sleep quality.Further research is needed to verify whether TCM body constitution can be used to treat and prevent psychiatric conditions as well as enhance sleep quality.展开更多
Mercury is usually added to skin-lightening products due to its whitening effect.The Food and Drug Administration （FDA） limits the amount of mercury in cosmetics to trace amounts under 1 ppm.Nevertheless,many cosmet...Mercury is usually added to skin-lightening products due to its whitening effect.The Food and Drug Administration （FDA） limits the amount of mercury in cosmetics to trace amounts under 1 ppm.Nevertheless,many cosmetics contain mercury above 1000 ppm to increase the whitening effect.In a group of special patients in the study,pain,renal damage,and neuropsychiatric symptoms were the cardinal symptoms observed.展开更多
Anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis has been increasingly recognized in recent years.This condition may be the most common cause of antibody-mediated encephalitis worldwide.The majority of patients a...Anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis has been increasingly recognized in recent years.This condition may be the most common cause of antibody-mediated encephalitis worldwide.The majority of patients are young at the time of onset,female,and present with an acute-to-subacute onset of behavioral changes followed by seizure,abnormal movement,autonomic dysfunction,and finally hypoventilation with coma if left untreated.The immunopathogenesis of this disease may be due to antibody-mediated internalization of NMDARs from synapses,which results in the dysfunction of particular brain regions(especially the hippocampus and frontostriatal area).Compared to serum,the cerebrospinal fluid permits the more sensitive detection of anti-NMDAR antibody.Ovarian teratoma may be present in up to 40%of patients but is less frequent in children or late-onset disease(>45 years old).The severity at the time of disease onset and time to appropriate immunotherapy(high-dose steroid plus plasmapheresis or intravenous immunoglobulin)are independent factors that are associated with good outcomes.展开更多
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 Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term cystitis suggests an inflammatory or infectious origin,no definite cause has been identified.It occurs in both sexes,but women are twice as much affected.AIM To systematically review evidence of psychiatric/psychological changes in persons with IC/BPS.METHODS Hypothesizing that particular psychological characteristics could underpin IC/BPS,we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy:("interstitial cystitis"OR"bladder pain syndrome")AND("mood disorder"OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cyclasterisk OR dysthymiasterisk OR dysphoriasterisk).RESULTS On September 27,2023,the PubMed search produced 223 articles,CINAHL 62,and the combined PsycLIT/PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search 36.Search on ClinicalTrials.gov produced 14 studies,of which none had available data.Eligible were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS,i.e.63 articles spanning from 2000 to October 2023.These studies identified depression and anxiety problems in the IC/BPS population,along with sleep problems and the tendency to catastrophizing.CONCLUSION Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/BPS.Such concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.
基金Supported by the Ministry of Science and Technology of the People’s Republic of China(STI2030-Major Projects2021ZD0201900)the National Natural Science Foundation of China(81971235).
文摘What is already known about this topic?Suicide behaviors are prevalent among inpatients with schizophrenia.However,the relationships between psychiatric symptoms,sleep disturbances,and suicide risk remain poorly understood in these high-risk populations.What is added by this report?In a study of 672 schizophrenia inpatients across 9 hospitals in 4 Chinese provinces,the prevalence of suicide risk was 22.3%[95%confidence interval(CI):19.3%,25.6%].The study identified significant associations between suicide risk and multiple clinical factors,including poor sleep quality,depressive symptoms,anxiety symptoms,and other psychiatric manifestations such as thinking disorder and activation.What are the implications for public health practice?Understanding the common sleep-related and psychiatric factors associated with suicide risk in hospitalized schizophrenia patients will enable clinicians and policymakers to better identify clinical risk indicators and enhance the quality of suicide prevention and treatment programs.
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,No.82103022the Science Foundation of the Second Affiliated Hospital of Xi’an Jiaotong University,No.RC(XM)202012.
文摘BACKGROUND Traditional Chinese medicine(TCM)body constitution is a key factor in determining and influencing the occurrence,development,and variation of diseases.As the mind interact with the body,TCM body constitution is useful in preventing and treating psychiatric disorders and insomnia.AIM To investigate the interrelationship between TCM body constitution,psychiatric disorders and sleep quality.METHODS A total of 2441 participants were enrolled in our study.TCM body constitution was measured using the Constitution in Chinese Medicine Questionnaire,sleep quality was assessed using the Chinese version of the Pittsburgh Sleep Quality Index,and psychopathological symptoms were evaluated using Symptom Checklist-90.Logistic regression was used to estimate the interrelationship between TCM body constitution,psychiatric disorders and sleep quality.RESULTS The Pittsburgh Sleep Quality Index score and the proportions of participants with Qi-deficiency constitution,Qi-stagnation constitution,and blood-stasis constitution were significantly higher in the psychiatric symptoms group.Additionally,psychiatric symptoms were considerably associated with sleep quality,Qi-deficiency constitution,and Qi-stagnation constitution,but were inversely associated with male sex.Obsessive–compulsive symptoms were considerably associated with sleep quality,Qi-deficiency constitution and Qi-stagnation constitution.Depression was considerably associated with sleep quality,hyperuricemia,and Qi-stagnation constitution.Anxiety was considerably associated with sleep quality,diabetes,and Qi-stagnation constitution.Finally,poor sleep quality was considerably associated with Qi-deficiency constitution,Qi-stagnation constitution,dampness-heat constitution,phlegm-dampness constitution,and blood-stasis constitution but was inversely associated with male sex and body mass index>23.9.CONCLUSION TCM body constitutions are strongly associated with psychiatric symptoms and sleep quality.Further research is needed to verify whether TCM body constitution can be used to treat and prevent psychiatric conditions as well as enhance sleep quality.
基金This study was supported by grants from the National Natural Science Foundation of China （No. 81501111）, and the Henan Provincial Major Scientific College Project （No. 18A320065）.
文摘Mercury is usually added to skin-lightening products due to its whitening effect.The Food and Drug Administration （FDA） limits the amount of mercury in cosmetics to trace amounts under 1 ppm.Nevertheless,many cosmetics contain mercury above 1000 ppm to increase the whitening effect.In a group of special patients in the study,pain,renal damage,and neuropsychiatric symptoms were the cardinal symptoms observed.
文摘Anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis has been increasingly recognized in recent years.This condition may be the most common cause of antibody-mediated encephalitis worldwide.The majority of patients are young at the time of onset,female,and present with an acute-to-subacute onset of behavioral changes followed by seizure,abnormal movement,autonomic dysfunction,and finally hypoventilation with coma if left untreated.The immunopathogenesis of this disease may be due to antibody-mediated internalization of NMDARs from synapses,which results in the dysfunction of particular brain regions(especially the hippocampus and frontostriatal area).Compared to serum,the cerebrospinal fluid permits the more sensitive detection of anti-NMDAR antibody.Ovarian teratoma may be present in up to 40%of patients but is less frequent in children or late-onset disease(>45 years old).The severity at the time of disease onset and time to appropriate immunotherapy(high-dose steroid plus plasmapheresis or intravenous immunoglobulin)are independent factors that are associated with good outcomes.
