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 Functional gastrointestinal disorders(FGIDs)in children present with chronic symptoms like abdominal pain,diarrhea,and constipation without identifiable structural abnormalities.These disorders are closely ...BACKGROUND Functional gastrointestinal disorders(FGIDs)in children present with chronic symptoms like abdominal pain,diarrhea,and constipation without identifiable structural abnormalities.These disorders are closely linked to gut-brain axis dysfunction,altered gut microbiota,and psychosocial stress,leading to psychia-tric comorbidities such as anxiety,depression,and behavioral issues.Under-standing this bidirectional relationship is crucial for developing effective,holistic management strategies that address physical and mental health.AIM To examine the psychiatric impacts of FGIDs in children,focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood,such as attention-deficit/hyperactivity disorder,emphasizing the role of the gut-brain axis,emotional dysregulation,and psychosocial stress.Key mechanisms explored include neurotransmitter dysregulation,microbiota imbalance,central sensitization,heightening stress reactivity,emotional dysregulation,and symptom perception.The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.METHODS A narrative review was conducted using 328 studies sourced from PubMed,Scopus,and Google Scholar,covering research published over the past 20 years.Inclusion criteria focused on studies examining FGID diagnosis,gut-brain mechanisms,psychiatric comorbidities,and psychosocial factors in pediatric populations.FGIDs commonly affecting children,including functional constipation,abdominal pain,irritable bowel syndrome,gastroesophageal reflux,and cyclic vomiting syndrome,were analyzed concerning their psychological impacts.RESULTS The review highlights a strong connection between FGIDs and psychiatric symptoms,mediated by gut-brain axis dysfunction,dysregulated microbiota,and central sensitization.These physiological disruptions increase children’s vulnerability to anxiety and depression,while psychosocial factors-such as chronic stress,early-life trauma,maladaptive family dynamics,and ineffective coping strategies-intensify the cycle of gastrointestinal and emotional distress.CONCLUSION Effective management of FGIDs requires a biopsychosocial approach integrating medical,psychological,and dietary interventions.Parental education,early intervention,and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.展开更多
Historically,psychiatric diagnoses have been made based on patient’s reported symptoms applying the criteria from diagnostic and statistical manual of mental disorders.The utilization of neuroimaging or biomarkers to...Historically,psychiatric diagnoses have been made based on patient’s reported symptoms applying the criteria from diagnostic and statistical manual of mental disorders.The utilization of neuroimaging or biomarkers to make the diagnosis and manage psychiatric disorders remains a distant goal.There have been several studies that examine brain imaging in psychiatric disorders,but more work is needed to elucidate the complexities of the human brain.In this editorial,we examine two articles by Xu et al and Stoyanov et al,that show developments in the direction of using neuroimaging to examine the brains of people with schizo-phrenia and depression.Xu et al used magnetic resonance imaging to examine the brain structure of patients with schizophrenia,in addition to examining neurotransmitter levels as biomarkers.Stoyanov et al used functional magnetic resonance imaging to look at modulation of different neural circuits by diagnostic-specific scales in patients with schizophrenia and depression.These two studies provide crucial evidence in advancing our understanding of the brain in prevalent psychiatric disorders.展开更多
The term disorders of gut-brain interaction(DGBIs)encompasses gastrointestinal disorders that globally affect more than one third of all people.The Rome IV criteria replaced the former term“functional gastrointestina...The term disorders of gut-brain interaction(DGBIs)encompasses gastrointestinal disorders that globally affect more than one third of all people.The Rome IV criteria replaced the former term“functional gastrointestinal disorders.”DGBIs can seriously challenge health and quality of life(QoL).A traditional but outdated approach differentiated“organic”vs“functional”disorders,seen by some as real vs psychiatric or undefined ones.This traditional distinction did not help patients whose health and QoL are seriously affected.DGBIs include motility disturbance;visceral hypersensitivity;altered mucosal and immune function;altered central nervous system processing,and more.Several DGBIs affect both children and adolescents.DGBIs are characterized by clusters of symptoms.Their pathophysiology relates to combinations of altered motility,visceral sensitivity,mucosal immune function,and more.Routine investigations find no structural abnormality that would easily explain the symptoms.Symptom-based criteria were developed to better understand patients where no mechanistic explanation was available for clinical practice and inclusion into clinical trials.To understand DGBIs and to find ways to treat them,these rigid mechanistic views fall short.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
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
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
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 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 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
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 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
Suicide is defined as the act of a person attempting to take their own life by causing death.Suicide is a complex phenomenon that is influenced by a multitude of factors,including psychosocial,cultural,and religious a...Suicide is defined as the act of a person attempting to take their own life by causing death.Suicide is a complex phenomenon that is influenced by a multitude of factors,including psychosocial,cultural,and religious aspects,as well as genetic,biochemical,and environmental factors.From a biochemical perspective,it is crucial to consider the communication between the endocrine,immune,and nervous systems when studying the etiology of suicide.Several pathologies involve the bidirectional communication between the peripheral activity and the central nervous system by the action of molecules such as cytokines,hormones,and neurotransmitters.These humoral signals,when present in optimal quantities,are responsible for maintaining physiological homeostasis,including mood states.Stress elevates the cortisol and proinflammatory cytokines levels and alter neurotransmitters balance,thereby increasing the risk of developing a psychiatric disorder and subsequently the risk of suicidal behavior.This review provides an integrative perspective about the neurochemical,immunological,and endocrinological disturbances associated with suicidal behavior,with a particular focus on those alterations that may serve as potential risk markers and/or indicators of the state preceding such a tragic act.展开更多
Physician mental health(MH)is in crisis,particularly in high-stress areas of medicine such as the emergency roomand the intensive care unit.The high prevalence of burnout and psychiatric illness among critical care ph...Physician mental health(MH)is in crisis,particularly in high-stress areas of medicine such as the emergency roomand the intensive care unit.The high prevalence of burnout and psychiatric illness among critical care physicians,along with delays in seeking psychiatric care,can lead to suicide,ruined careers,damaged relationships,and medical errors.Psychoeducation programs can reduce MH sick leave days,increase empathy,and enhance helpseeking attitudes.The purpose of this brief communication is to demonstrate that physician psychoeducation programs can improve patient care,improve outcomes in physicians with psychiatric illness,and improve burnout rates,and we describe the essential aspects of such a program.展开更多
This letter discusses the study by Liu et al recently published in World Journal of Psychiatry,which examines the benefits of combining epirubicin(EPI)with mindfulness interventions for patients with urinary system tu...This letter discusses the study by Liu et al recently published in World Journal of Psychiatry,which examines the benefits of combining epirubicin(EPI)with mindfulness interventions for patients with urinary system tumors and depre-ssion.The study included 110 patients and compared an experimental group receiving EPI and a mindfulness intervention strategy with a control group treated with mitomycin and standard care.Results showed that the experimental group had significant improvements in immune function,tumor markers,depression severity,quality of life,cancer-related fatigue,and nursing satisfac-tion.Despite acknowledging the study limitations such as a relatively small sample size and a short duration,the study highlights the efficacy of integrating mindfulness interventions into cancer treatment strategies to enhance patient outcomes and address psychological distress.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
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
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
The alteration of gene expression is not restricted to transcriptional regulation but includes a variety of posttranscriptional mechanisms;however,the role of the latter in many diseases remains relatively unknown.By ...The alteration of gene expression is not restricted to transcriptional regulation but includes a variety of posttranscriptional mechanisms;however,the role of the latter in many diseases remains relatively unknown.By using an RNA-Seq dataset of 1510 brain samples from individuals with autism spectrum disorder(ASD),bipolar disorder(BD),schizophrenia(SCZ),and controls,we assessed the contribution of post-transcriptional dysregulation and identified top perturbators accountable for transcriptomic alterations in neuropsychiatric disorders.Approximately 30%of the expression variability was attributed to post-transcriptional dysregulation.Interestingly,mature mRNA levels tended to be post-transcriptionally downregulated in SCZ and BD,leading to the inhibition of neurogenesis and neural differentiation,while they were upregulated in ASD,resulting in enhanced activity of apoptosis.These findings imply contrasting pathologies involving RNA metabolism across neuropsychiatric disorders.An RNA-binding protein,ELAVL3,was predicted to be significantly involved in the disruption of post-transcriptional regulation in all three disorders.To validate this,we knocked down its expression in cerebral organoids.Not only did the differentially expressed genes in ELAVL3 knockdown cover a considerable proportion of predicted targets in the three disorders,but we also found that neurogenesis was significantly affected,given the diminished proliferation and consequently reduced size of the organoids.The present study extends the current understanding of the link between post-transcriptional regulation and neuropsychiatric disorders and provides new potential therapeutic targets for early intervention.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.
文摘BACKGROUND Functional gastrointestinal disorders(FGIDs)in children present with chronic symptoms like abdominal pain,diarrhea,and constipation without identifiable structural abnormalities.These disorders are closely linked to gut-brain axis dysfunction,altered gut microbiota,and psychosocial stress,leading to psychia-tric comorbidities such as anxiety,depression,and behavioral issues.Under-standing this bidirectional relationship is crucial for developing effective,holistic management strategies that address physical and mental health.AIM To examine the psychiatric impacts of FGIDs in children,focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood,such as attention-deficit/hyperactivity disorder,emphasizing the role of the gut-brain axis,emotional dysregulation,and psychosocial stress.Key mechanisms explored include neurotransmitter dysregulation,microbiota imbalance,central sensitization,heightening stress reactivity,emotional dysregulation,and symptom perception.The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.METHODS A narrative review was conducted using 328 studies sourced from PubMed,Scopus,and Google Scholar,covering research published over the past 20 years.Inclusion criteria focused on studies examining FGID diagnosis,gut-brain mechanisms,psychiatric comorbidities,and psychosocial factors in pediatric populations.FGIDs commonly affecting children,including functional constipation,abdominal pain,irritable bowel syndrome,gastroesophageal reflux,and cyclic vomiting syndrome,were analyzed concerning their psychological impacts.RESULTS The review highlights a strong connection between FGIDs and psychiatric symptoms,mediated by gut-brain axis dysfunction,dysregulated microbiota,and central sensitization.These physiological disruptions increase children’s vulnerability to anxiety and depression,while psychosocial factors-such as chronic stress,early-life trauma,maladaptive family dynamics,and ineffective coping strategies-intensify the cycle of gastrointestinal and emotional distress.CONCLUSION Effective management of FGIDs requires a biopsychosocial approach integrating medical,psychological,and dietary interventions.Parental education,early intervention,and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.
文摘Historically,psychiatric diagnoses have been made based on patient’s reported symptoms applying the criteria from diagnostic and statistical manual of mental disorders.The utilization of neuroimaging or biomarkers to make the diagnosis and manage psychiatric disorders remains a distant goal.There have been several studies that examine brain imaging in psychiatric disorders,but more work is needed to elucidate the complexities of the human brain.In this editorial,we examine two articles by Xu et al and Stoyanov et al,that show developments in the direction of using neuroimaging to examine the brains of people with schizo-phrenia and depression.Xu et al used magnetic resonance imaging to examine the brain structure of patients with schizophrenia,in addition to examining neurotransmitter levels as biomarkers.Stoyanov et al used functional magnetic resonance imaging to look at modulation of different neural circuits by diagnostic-specific scales in patients with schizophrenia and depression.These two studies provide crucial evidence in advancing our understanding of the brain in prevalent psychiatric disorders.
文摘The term disorders of gut-brain interaction(DGBIs)encompasses gastrointestinal disorders that globally affect more than one third of all people.The Rome IV criteria replaced the former term“functional gastrointestinal disorders.”DGBIs can seriously challenge health and quality of life(QoL).A traditional but outdated approach differentiated“organic”vs“functional”disorders,seen by some as real vs psychiatric or undefined ones.This traditional distinction did not help patients whose health and QoL are seriously affected.DGBIs include motility disturbance;visceral hypersensitivity;altered mucosal and immune function;altered central nervous system processing,and more.Several DGBIs affect both children and adolescents.DGBIs are characterized by clusters of symptoms.Their pathophysiology relates to combinations of altered motility,visceral sensitivity,mucosal immune function,and more.Routine investigations find no structural abnormality that would easily explain the symptoms.Symptom-based criteria were developed to better understand patients where no mechanistic explanation was available for clinical practice and inclusion into clinical trials.To understand DGBIs and to find ways to treat them,these rigid mechanistic views fall short.
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.
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.
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.
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 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.
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.
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.
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Supported by CONAHCYT Project,No.CF-2023-I-2663Instituto Nacional de Psiquiatría Project,No.NC24208.0(to Pérez-Sánchez G,Pavón L,Sánchez-Huerta K,Maldonado-García JL,Chin-Chan JM,Ponce-Regalado MD,Arreola R,Contis-Montes de Oca A,and Moreno-Lafont MC).
文摘Suicide is defined as the act of a person attempting to take their own life by causing death.Suicide is a complex phenomenon that is influenced by a multitude of factors,including psychosocial,cultural,and religious aspects,as well as genetic,biochemical,and environmental factors.From a biochemical perspective,it is crucial to consider the communication between the endocrine,immune,and nervous systems when studying the etiology of suicide.Several pathologies involve the bidirectional communication between the peripheral activity and the central nervous system by the action of molecules such as cytokines,hormones,and neurotransmitters.These humoral signals,when present in optimal quantities,are responsible for maintaining physiological homeostasis,including mood states.Stress elevates the cortisol and proinflammatory cytokines levels and alter neurotransmitters balance,thereby increasing the risk of developing a psychiatric disorder and subsequently the risk of suicidal behavior.This review provides an integrative perspective about the neurochemical,immunological,and endocrinological disturbances associated with suicidal behavior,with a particular focus on those alterations that may serve as potential risk markers and/or indicators of the state preceding such a tragic act.
文摘Physician mental health(MH)is in crisis,particularly in high-stress areas of medicine such as the emergency roomand the intensive care unit.The high prevalence of burnout and psychiatric illness among critical care physicians,along with delays in seeking psychiatric care,can lead to suicide,ruined careers,damaged relationships,and medical errors.Psychoeducation programs can reduce MH sick leave days,increase empathy,and enhance helpseeking attitudes.The purpose of this brief communication is to demonstrate that physician psychoeducation programs can improve patient care,improve outcomes in physicians with psychiatric illness,and improve burnout rates,and we describe the essential aspects of such a program.
文摘This letter discusses the study by Liu et al recently published in World Journal of Psychiatry,which examines the benefits of combining epirubicin(EPI)with mindfulness interventions for patients with urinary system tumors and depre-ssion.The study included 110 patients and compared an experimental group receiving EPI and a mindfulness intervention strategy with a control group treated with mitomycin and standard care.Results showed that the experimental group had significant improvements in immune function,tumor markers,depression severity,quality of life,cancer-related fatigue,and nursing satisfac-tion.Despite acknowledging the study limitations such as a relatively small sample size and a short duration,the study highlights the efficacy of integrating mindfulness interventions into cancer treatment strategies to enhance patient outcomes and address psychological distress.
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 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The alteration of gene expression is not restricted to transcriptional regulation but includes a variety of posttranscriptional mechanisms;however,the role of the latter in many diseases remains relatively unknown.By using an RNA-Seq dataset of 1510 brain samples from individuals with autism spectrum disorder(ASD),bipolar disorder(BD),schizophrenia(SCZ),and controls,we assessed the contribution of post-transcriptional dysregulation and identified top perturbators accountable for transcriptomic alterations in neuropsychiatric disorders.Approximately 30%of the expression variability was attributed to post-transcriptional dysregulation.Interestingly,mature mRNA levels tended to be post-transcriptionally downregulated in SCZ and BD,leading to the inhibition of neurogenesis and neural differentiation,while they were upregulated in ASD,resulting in enhanced activity of apoptosis.These findings imply contrasting pathologies involving RNA metabolism across neuropsychiatric disorders.An RNA-binding protein,ELAVL3,was predicted to be significantly involved in the disruption of post-transcriptional regulation in all three disorders.To validate this,we knocked down its expression in cerebral organoids.Not only did the differentially expressed genes in ELAVL3 knockdown cover a considerable proportion of predicted targets in the three disorders,but we also found that neurogenesis was significantly affected,given the diminished proliferation and consequently reduced size of the organoids.The present study extends the current understanding of the link between post-transcriptional regulation and neuropsychiatric disorders and provides new potential therapeutic targets for early intervention.
