Background Dynamic interpersonal therapy(DIT)is a short-term psychodynamic psychotherapy that has been shown to effectively reduce depressive symptoms in patients with major depressive disorder(MDD).In DIT,the depress...Background Dynamic interpersonal therapy(DIT)is a short-term psychodynamic psychotherapy that has been shown to effectively reduce depressive symptoms in patients with major depressive disorder(MDD).In DIT,the depressive symptoms are formulated as responses to impaired mentalisation.DIT aims to alleviate depressive symptoms by improving mentalising.Aims This study aimed to examine the effect of DIT on improving mentalising and the mediating effect of mentalising in changes in depressive symptoms.Methods Outpatients received either DIT combined with antidepressant medication treatment(DIT group)or antidepressant medication treatment alone(ADM group)for 16 weeks.The Hamilton Depression Rating Scale(HAMD),Patient Health Questionnaire(PHQ)and Reflective Functioning Questionnaire(RFQ)were used.The intention-to-treat principle,mixed linear models,multiple imputation,Pearson's correlation analysis and mediation analysis were conducted.The per-protocol principle was used as sensitivity analysis.Results The DIT group had significantly lower HAMD(least-squares(LS)mean difference=-3.756,p<0.001),PHQ(LS mean difference=-4.188,p<0.001),uncertainty about mental states in the RFQ(RFQ-U,LS mean difference=-2.116,p<0.001)and higher certainty about mental states in the RFQ(RFQ-C,LS mean difference=2.214,p=0.028)scores than the ADM group at post-treatment.The change in RFQ-C was marginally significantly correlated with the change in HAMD(r=-0.218,poretao=0.090),The change in RFQ-U was significantly correlated with the change in HAMD(r=-0.269,poroco-0.024)and the change in PHQ(r=-0.43,Peoretceo l<e0.001).When using RFQ-U as the mediating variable and PHQ as the dependent variable,a significant mediating effect was found(p=0.043,95% confidence interval 0.024 to 1.453).Conclusions The DIT group yielded better outcomes compared with the ADM group in reducing depressive symptoms and improving mentalising.Improvements in mentalising were associated with reductions in depressive symptoms.These findings support that mentalising may contribute to the therapeutic effects of DIT in MDD.展开更多
The predominance of pituitary adenoma in the etiology of sellar masses often leads to the diagnostic fallacy of“availability bias”so that pituitary adenoma is almost always considered the most likely diagnosis of al...The predominance of pituitary adenoma in the etiology of sellar masses often leads to the diagnostic fallacy of“availability bias”so that pituitary adenoma is almost always considered the most likely diagnosis of all sellar masses,even when clinical evidence suggests otherwise.Primary sellar atypical teratoid/rhabdoid tumor(AT/RT)is the most aggressive sellar tumor.Most patients with sellar AT/RT are initially misdiagnosed with pituitary macroadenoma.Early diagnosis of sellar AT/RT is of paramount importance to counsel patients and family on the grave prognosis and to avoid futile surgical procedures.Since there are no discerning imaging features to differentiate AT/RT from other sellar tumors,the acuity of sellar compression symptoms characteristic of AT/RT is the only evidence indicative of the AT/RT diagnosis.Based on the biological and anatomical properties of the sella turcica and its surrounding structures,the nature,order of manifestation,and acuity of the sellar compression symptoms in response to sellar content expansion are mostly predictable.It is concluded that rapidly progressive headache and subsequent similarly rapidly progressive visual symptoms in a female with a large sellar mass are pathognomonic of sellar AT/RT(the“Yu rule”).展开更多
Objectives To identify core symptoms and symptom clusters in patients with neuromyelitis optica spectrum disorder(NMOSD)by network analysis.Methods From October 10 to 30,2023,140 patients with NMOSD were selected to p...Objectives To identify core symptoms and symptom clusters in patients with neuromyelitis optica spectrum disorder(NMOSD)by network analysis.Methods From October 10 to 30,2023,140 patients with NMOSD were selected to participate in this online questionnaire survey.The survey tools included a general information questionnaire and a self-made NMOSD symptoms scale,which included the prevalence,severity,and distress of 29 symptoms.Cluster analysis was used to identify symptom clusters,and network analysis was used to analyze the symptom network and node characteristics and central indicators including strength centrality(r_(s)),closeness centrality(r_(c))and betweeness centrality(r_(b))were used to identify core symptoms and symptom clusters.Results The most common symptom was pain(65.7%),followed by paraesthesia(65.0%),fatigue(65.0%),easy awakening(63.6%).Regarding the burden level of symptoms,pain was the most burdensome symptom,followed by paraesthesia,easy awakening,fatigue,and difficulty falling asleep.Six clusters were identified:somatosensory,motor,visual,and memory symptom clusters,bladder and rectum symptom clusters,sleep symptoms clusters,and neuropsychological symptom clusters.Fatigue(r_(s)=12.39,r_(b)=68.00,r_(c)=0.02)was the most central and prominent bridge symptom,and motor symptom cluster(r_(s)=2.68,r_(c)=0.10)was the most central symptom cluster among the six clusters.Conclusions Our study demonstrated the necessity of symptom management targeting fatigue,pain,and motor symptom cluster in patients with NMOSD.展开更多
BACKGROUND Examining patterns of media consumption and their associations with mental health outcomes in the general population during the coronavirus disease 2019(COVID-19)pandemic has implications for public mental ...BACKGROUND Examining patterns of media consumption and their associations with mental health outcomes in the general population during the coronavirus disease 2019(COVID-19)pandemic has implications for public mental health in future pandemics.AIM To investigate patterns of media consumption and their associations with depressive and anxiety symptoms among adults affected by the COVID-19 pandemic.METHODS A total of 8473 adults were recruited through snowball sampling for an online cross-sectional survey.The participants were asked to report the three media sources from which they most frequently acquired knowledge about COVID-19 from a checklist of nine media sources.Depression and anxiety were assessed with the Patient Health Questionnaire and the Generalized Anxiety Disorder Scale,respectively.A two-step cluster analysis was performed to identify distinct clusters of consumption of media sources.RESULTS Seven clusters were identified.The lowest prevalence of depression and anxiety(29.1%and 22.8%,respectively)was observed in cluster one,which was labeled“television and news portals and clients,minimal social media”.The highest prevalence of depression(43.1%)was observed in cluster three,labeled“WeChat,MicroBlog,and news portals,minimal traditional media”.The greatest prevalence of anxiety(35.8%)was observed in cluster seven,which was labeled“news clients and WeChat,no newspaper,radio,or news portals”.Relative to cluster one,a significantly elevated risk of depression and anxiety was found in clusters three,six(labeled“news portals and clients,WeChat,no newspaper and radio”)and seven(adjusted odds ratio=1.28-1.46,P≤0.011).Multiple logistic regression analyses revealed that the risk of COVID-19 infection and knowledge about COVID-19 partially explained the variations in the prevalence of depression and anxiety across the seven clusters.CONCLUSION Communication policies should be designed to channel crucial pandemic-related information more effectively through traditional and digital media sources.Encouraging the use of these media and implementing regulatory policies to reduce misinformation and rumors on social media,may be effective in mitigating the risk of depression and anxiety among populations affected by the pandemic.展开更多
In the era of artificial intelligence(AI),healthcare and medical sciences are inseparable from different AI technologies[1].ChatGPT once shocked the medical field,but the latest AI model DeepSeek has recently taken th...In the era of artificial intelligence(AI),healthcare and medical sciences are inseparable from different AI technologies[1].ChatGPT once shocked the medical field,but the latest AI model DeepSeek has recently taken the lead[2].PubMed indexed publications on DeepSeek are evolving[3],but limited to editorials and news articles.In this Letter,we explore the use of DeepSeek in early symptoms recognition for stroke care.To the best of our knowledge,this is the first DeepSeek-related writing on stroke.展开更多
Parkinson’s disease patients,in addition to typical motor symptoms,often experience various psychological symptoms,including depression,anxiety,cognitive impairment,impulse control disorders,and psychotic symptoms.Th...Parkinson’s disease patients,in addition to typical motor symptoms,often experience various psychological symptoms,including depression,anxiety,cognitive impairment,impulse control disorders,and psychotic symptoms.These symptoms severely affect patients’quality of life and may even cause a greater disease burden than motor symptoms.This review focuses on the application progress of transcranial magnetic stimulation(TMS)as a non-invasive neuromodulation technique in the treatment of psychological symptoms in Parkinson’s disease.Studies have shown that repetitive TMS(rTMS)has significant improvement effects on Parkinson’s disease-related depressive symptoms,with mechanisms possibly related to the regulation of the prefrontal-striatal dopamine pathway and the promotion of neuroplasticity.For anxiety symptoms,continuous theta burst stimulation has shown potential in indirect regulation of the amygdala and hippocampal regions.For cognitive impairment,high-frequency rTMS applied to the dorsolateral prefrontal cortex can improve executive function deficits,while bilateral coordinated stimulation protocols help enhance attention and memory functions.For impulse control disorders in Parkinson’s disease patients,inhibitory stimulation applied to the orbitofrontal cortex can alleviate pathological gambling and compulsive behaviors.In terms of sleep disorders,TMS has also shown potential efficacy in regulating circadian rhythms and improving rapid eye movement sleep behavior disorder.However,current research still has limitations such as small sample sizes,non-standardized stimulation protocols,and insufficient evaluation of long-term efficacy.Future research directions should focus on optimizing stimulation parameters,exploring individualized treatment protocols,integrating multimodal imaging assessments,and conducting large-sample randomized controlled trials to clarify the clinical application value of TMS in the rehabilitation of psychological symptoms in Parkinson’s disease,providing new approaches for the comprehensive management of this common neurodegenerative disease.展开更多
BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affectin...BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affecting work and interpersonal communication,increasing the risk of recurrence,and adding to the burden on families.Studying the influencing factors of their social function is of great significance.AIM To explore the social function score and its influencing factors in patients with residual depressive symptoms.METHODS This observational study surveyed patients with residual depressive symptoms(case group)and healthy patients undergoing physical examinations(control group).Participants were admitted between January 2022 and December 2023.Social functioning was assessed using the Sheehan Disability Scale(SDS),and scores were compared between groups.Factors influencing SDS scores in patients with residual depressive symptoms were analyzed by applying multiple linear regression while using the receiver operating characteristic curve,and these RESULTS The SDS scores of the 158 patients with depressive symptoms were 11.48±3.26.Compared with the control group,the SDS scores and all items in the case group were higher.SDS scores were higher in patients with relapse,discon-tinuous medication,drug therapy alone,severe somatic symptoms,obvious residual symptoms,and anxiety scores≥8.Disease history,medication compliance,therapy method,and residual symptoms correlated positively with SDS scores(r=0.354,0.414,0.602,and 0.456,respectively).Independent influencing factors included disease history,medication compliance,therapy method,somatic symptoms,residual symptoms,and anxiety scores(P<0.05).The areas under the curve for predicting social functional impairment using these factors were 0.713,0.559,0.684,0.729,0.668,and 0.628,respectively,with sensitivities of 79.2%,61.8%,76.8%,81.7%,63.6%,and 65.5%and specificities of 83.3%,87.5%,82.6%,83.3%,86.7%,and 92.1%,respectively.CONCLUSION The social function scores of patients with residual symptoms of depression are high.They are affected by disease history,medication compliance,therapy method,degree of somatic symptoms,residual symptoms,and anxiety.展开更多
BACKGROUND The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia,especially thyroid hormones.AIM To study the relationship between triiodothyronine(T3),thyro...BACKGROUND The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia,especially thyroid hormones.AIM To study the relationship between triiodothyronine(T3),thyroxine(T4),free T3(FT3),free T4(FT4),thyroid stimulating hormone(TSH)and schizophrenia.METHODS In this study,100 schizophrenia patients were selected from our hospital between April 2022 and April 2024.Their clinical data were analyzed retrospectively.Based on the Positive and Negative Syndrome Scale(PANSS)score,patients were divided into mild(1-3 points,n=39),moderate(4 points,n=45),and severe groups(5-7 points,n=16).Additionally,55 healthy individuals served as a control group.Venous blood samples were collected to measure T3,T4,FT3,FT4,TSH,and cortisol concentrations,analyzing their relationship with PANSS scores.RESULTS The serum levels of T3,FT3,FT4,TSH and cortisol in the schizophrenia group were lower than those in the control group(P<0.05).With the increase of the severity of the disease,the concentrations of T3 and T4 decreased,while the con-centrations of TSH and cortisol increased(P<0.05).The concentrations of TSH and cortisol were positively correlated with the PANSS score,while T3 and T4 were negatively correlated with the PANSS score(P<0.05).The receiver ope-rating characteristic curve results showed that T3,T4,TSH,and cortisol had good efficacy in the diagnosis of schizophrenia.Logistic results showed that decreased T3 level,decreased T4 level,decreased TSH level and increased cortisol level may be independent risk factors for schizophrenia.CONCLUSION Thyroid hormone levels are associated with the severity of schizophrenia symptoms,which can provide new solutions for the diagnosis and treatment of schizophrenia.展开更多
BACKGROUND Sensitivity to stress is essential in the onset,clinical symptoms,course,and prognosis of major depressive disorder(MDD).Meanwhile,it was unclear how variously classified but connected stress-sensitivity va...BACKGROUND Sensitivity to stress is essential in the onset,clinical symptoms,course,and prognosis of major depressive disorder(MDD).Meanwhile,it was unclear how variously classified but connected stress-sensitivity variables affect MDD.We hypothesize that high-level trait-and state-related stress-sensitivity factors may have different cumulative effects on the clinical symptoms and follow-up outcomes of MDD.AIM To investigate how stress-sensitivity factors added up and affected MDD clinical symptoms and follow-up results.METHODS In this prospective study,281 MDD patients were enrolled from a tertiary care setting.High-level stress-sensitivity factors were classified as trait anxiety,state anxiety,perceived stress,and neuroticism,with a total score in the top quartile of the research cohort.The cumulative effects of stress-sensitivity factors on cognitive dysfunction,disability and functional impairment,suicide risk,and depressive and anxiety symptoms were examined using an analysis of variance with linear trend analysis.Correlations were investigated further using multiple regression analysis.RESULTS Regarding high-level stress-sensitivity factors,53.40%of patients had at least one at baseline,and 29.61%had two or more.Four high-level stress-sensitivity components had significant cumulative impacts on MDD symptoms at baseline(all P<0.001).Perceived stress predicted the greatest effect sizes of state-related factors on depressive symptoms(partialη^(2)=0.153;standardizedβ=0.195;P<0.05).The follow-up outcomes were significantly impacted only by the high-level trait-related components,mainly when it came to depressive symptoms and suicide risk,which were predicted by trait anxiety and neuroticism,respectively(partialη^(2)=0.204 and 0.156;standardizedβ=0.247 and 0.392;P<0.05).CONCLUSION To enhance outcomes of MDD and lower the suicide risk,screening for stress-sensitivity factors and considering multifaceted measures,mainly focusing on trait-related ones,should be addressed clinically.展开更多
BACKGROUND With the growing scholarly and clinical fascination with somatic symptom dis-order(SSD),a bibliometric analysis is lacking.AIM To conduct a bibliometric analysis to investigate the current status and fronti...BACKGROUND With the growing scholarly and clinical fascination with somatic symptom dis-order(SSD),a bibliometric analysis is lacking.AIM To conduct a bibliometric analysis to investigate the current status and frontiers of SSD.METHODS The documents related to SSD are obtained from the web of science core collection database(WoSCC),and VOSviewer 1.6.16 from January 1,2000 to December 31,2023,and the WoSCC’s literature analysis wire were used to conduct the biblio-metric analysis.RESULTS A total of 567 documents related to SSD were included,and 2325 authors across 947 institutions from 57 countries/regions have contributed to SSD research,published in 277 journals.The most productive author,institution,country and journal were Löwe B,University of Hamburg,Germany,and Journal of Psycho-somatic Research respectively.The first high-cited document was published in the Journal of Psychosomatic Research in 2013 by Dimsdale JE and colleagues,which explored the rationale behind the SSD diagnosis introduction in diagnostic and statistical manual of mental disorders.CONCLUSION In conclusion,the main research hotspots and frontiers in the field of SSD are validity and reliability of the SSD criteria,functional impairment of SSD,and the treatment for SSD.More high-quality studies are needed to assess the diagnosis and treatment of SSD.展开更多
BACKGROUND Revisiting the epidemiology of posttraumatic stress symptoms(PTSSs)among university students during the coronavirus disease 2019(COVID-19)pandemic as well as understanding the mental health help-seeking beh...BACKGROUND Revisiting the epidemiology of posttraumatic stress symptoms(PTSSs)among university students during the coronavirus disease 2019(COVID-19)pandemic as well as understanding the mental health help-seeking behavior of individuals with PTSSs has critical implications for public mental health strategies in future medical pandemics.AIM To investigate the prevalence and correlates of PTSSs among university students during the first wave of the COVID-19 pandemic in China and to examine mental health help-seeking behaviors among these students.METHODS A total of 2507 Chinese university students were recruited via snowball sampling.The students completed the Seven-item Screening Scale for Post-traumatic Stress Disorder during the first wave of the COVID-19 pandemic in China.Sociodemo-graphic characteristics,pandemic-related characteristics,and mental health help-seeking behaviors of students with PTSSs were also collected.RESULTS The prevalence of PTSSs among the participants was 28.0%.Seven significant correlates of PTSSs were identified(odds ratio=1.23-3.65,P≤0.024):Female sex,being 19 years old or older,living with others or alone,a low level of family economic status,fair or poor interpersonal relationships,severe or very severe local pandemic,and having family members diagnosed with COVID-19.However,only 3.28%of the students with PTSSs reported seeking help from mental health specialists.Among the 23 students who sought help from mental health specialists,13 opted for online or telephone-based psychological consultation.CONCLUSION Our data suggest that there was a high risk of PTSSs among university students and a high level of unmet mental health needs during the COVID-19 pandemic.The delivery of mental health services online or via telephone is a promising approach to address these unmet needs.展开更多
BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with an...BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with and without prominent nega-tive symptoms(PNS).AIM To evaluate the effectiveness and safety of blonanserin monotherapy for first-episode schizophrenia in real-world clinical settings and to explore the efficacy and safety of different doses of blonanserin for patients with PNS and without PNS.METHODS A 12-week,multicenter,prospective post-marketing surveillance was conducted.In this study,we included patients with first-episode schizophrenia who received blonanserin monotherapy.Patients were divided into those with PNS and without PNS,based on the Brief Psychiatric Rating Scale(BPRS)negative symptoms subscale scores.Additionally,patients were labeled as high-dose and low-dose was evaluated through the incidence of adverse drug reactions(ADRs).RESULTS A total of 653 patients were included in the analysis,with 613 completing the study.The BPRS total score decreased significantly from 47.94±16.31 at baseline to 26.88±9.47 at 12 weeks(P<0.001).A significant interaction of PNS×dose×time was observed for BPRS total scores(F=3.47,P=0.040)and negative symptom subscale scores(F=6.76,P=0.002).In the PNS group,the high-dose group showed greater reductions in BPRS total scores(P=0.001)and negative symptom subscale scores(P=0.003)than the low-dose group in week 12.In the without PNS group,no significant difference was observed between the high-dose and low-dose groups at any visit.Most adverse reactions were mild or moderate,with extrapyramidal symptoms(9.3%)being most common;1.5%of patients gained≥7%body weight at 12 weeks.CONCLUSION Blonanserin effectively alleviated the clinical symptoms of first-episode schizophrenia with an acceptable safety profile.High-dose blonanserin is particularly beneficial for patients with PNS in the acute phase of first-episode schizophrenia.However,due to the limitation of ADR reporting the real world,the ADR incidence observed in this study may be underestimated.展开更多
BACKGROUND Patients with schizophrenia may lack awareness of the importance of posttracheotomy care due to the impact of their condition,often showing resistance or misunderstanding of care measures.When coupled with ...BACKGROUND Patients with schizophrenia may lack awareness of the importance of posttracheotomy care due to the impact of their condition,often showing resistance or misunderstanding of care measures.When coupled with the impact of negative symptoms and the risk of complications after tracheotomy,patients may experience emotional fluctuations,restlessness,anxiety,and hostile behaviors,which pose significant challenges to nursing work.CASE SUMMARY We have reported the case of an 87-year-old male patient who was admitted to the hospital because of negative symptoms of schizophrenia and who underwent tracheotomy for severe pneumonia.In this study,we have summarized the nursing experience of a patient with negative symptoms of schizophrenia who underwent tracheotomy.The key nursing strategies included proper tracheotomy care,the management of psychiatric symptoms,a thorough assessment and implementation of enteral and parenteral nutrition,effective skincare,infection prevention,and comprehensive mental care.Individualized nursing skills helped stabilize the patient’s condition,followed by isolation and observation in a psychiatric hospital.CONCLUSION Effective postoperative tracheostomy care in patients with schizophrenia necessitates a tailored,multidisciplinary approach that addresses their psychiatric,physical,and emotional needs to achieve optimal clinical outcomes.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
Objective:To explore symptom experiences and self-coping patterns during the early and late stages of chemotherapy in these patients to provide a basis for developing targeted symptom management strategies.Methods:A t...Objective:To explore symptom experiences and self-coping patterns during the early and late stages of chemotherapy in these patients to provide a basis for developing targeted symptom management strategies.Methods:A total of 27 patients with pancreatic cancer undergoing chemotherapy at two medical institutions were recruited between November 2023 and August 2024.Semi-structured interviews were conducted in person or over the phone.Data were analyzed using traditional content and thematic analyses.Results:Three themes were identified:symptom experience,self-coping patterns,and existing obstacles.During the early stages of chemotherapy,patients reported a higher frequency of unpleasant symptoms and recognized these symptoms earlier in the treatment course.Patients in the early stages primarily relied on external support to cope with symptoms,while those in the later stages adopted self-care strategies.Several challenges related to unpleasant symptoms were observed,which appeared to correlate with the self-coping patterns employed.Conclusion:Patients with pancreatic cancer undergoing chemotherapy experience a complex and diverse range of symptoms,with varying coping patterns at different stages of treatment.Symptom management during chemotherapy presents significant challenges.Healthcare providers should improve the ongoing monitoring of symptoms post-chemotherapy.By linking patients’symptom experiences and self-coping patterns at different stages of chemotherapy to their specific challenges,personalized symptom management strategies can be developed to enhance care quality.展开更多
BACKGROUND Depression is a significant risk factor for diabetes,particularly type 2 diabetes.However,depressive symptoms differ from clinical depression.Previous research has not fully considered the relationship betw...BACKGROUND Depression is a significant risk factor for diabetes,particularly type 2 diabetes.However,depressive symptoms differ from clinical depression.Previous research has not fully considered the relationship between the trajectory of depressive symptoms and the risk of developing diabetes over time.AIM To investigate the association between depressive symptoms,their trajectories,and the risk of developing diabetes in two prospective cohort studies.METHODS In the first phase we analyzed the association between depressive symptoms and the risk of developing diabetes separately using the Health and Retirement Study(HRS).Depressive symptom trajectories were assessed by examining changes in depressive symptoms at baseline and again 8 years later.We then identified specific depressive symptom trajectories that increased the risk of diabetes in the second phase.Finally,we confirmed the association between depressive symptoms and their trajectories with diabetes risk using the English Longitudinal Study of Ageing(ELSA)as a validation study.Depressive symptom trajectories were categorized into five states based on changes in the modified 8-item Center for Epidemiological Studies-Depression scores:Persistently high;increasing;fluctuating;decreasing;and persistently low.Diabetes mellitus was defined as self-reported,physician-diagnosed diabetes.Cox proportional hazards models were used to assess hazard ratios(HR)and 95%confidence intervals(CI),adjusting for potential confounders.RESULTS In the first phase a total of 27658 participants were included(HRS:18633,ELSA:9025),among whom 6582 had depressive symptoms(HRS:4547,ELSA:2035),6407 had somatic depressive symptoms(HRS:4414,ELSA:1993),and 26415 had cognitive-affective depressive symptoms(HRS:17755,ELSA:8660).We found that overall depressive symptoms(HRS:HR=1.14,95%CI:1.07-1.22;ELSA:HR=1.18,95%CI:1.03-1.34)and somatic depressive symptoms(HRS:HR=1.14,95%CI:1.07-1.22;ELSA:HR=1.25,95%CI:1.10-1.42)increased the risk of diabetes,while cognitive depressive symptoms were not associated with diabetes risk.Over an 8-year follow-up we identified 19729 trajectories of overall,somatic,and cognitive-affective depressive symptoms(HRS:13918,ELSA:5811).In the second phase we found that persistently high(HRS:HR=1.22,95%CI:1.06-1.40,ELSA:HR=1.54,95%CI:1.16-2.05 in total and HRS:HR=1.24,95%CI:1.07-1.43,ELSA:HR=1.79,95%CI:1.36-2.35 in somatic)and fluctuating(HRS:HR=1.09,95%CI:1.01-1.17,ELSA:HR=1.33,95%CI:1.14-1.55 in total and HRS:HR=1.10,95%CI:1.02-1.18,ELSA:HR=1.31,95%CI:1.13-1.53 in somatic)trajectories of overall and somatic depressive symptoms increased the risk of diabetes,while increasing trajectories may also raise diabetes risk.However,decreasing trajectories were not associated with diabetes risk.Cognitive-affective depressive symptoms showed no association with diabetes risk regardless of trajectory changes.Sensitivity analyses confirmed the reliability of the findings.CONCLUSION Persistently high and fluctuating trajectories of overall and somatic depressive symptoms increased the risk of diabetes,while decreasing trajectories were not associated with diabetes risk.In contrast trajectories of cognitiveaffective depressive symptoms show no relationship with diabetes risk.Focusing on depressive symptom trajectories,particularly those of somatic depressive symptoms,represented a viable strategy for future diabetes prevention.展开更多
BACKGROUND Diabetes mellitus(DM)is a rapidly growing global health emergency of the 21st century.Comorbidities,such as DM and depression,are common,presenting challenges to the healthcare system.AIM To investigate the...BACKGROUND Diabetes mellitus(DM)is a rapidly growing global health emergency of the 21st century.Comorbidities,such as DM and depression,are common,presenting challenges to the healthcare system.AIM To investigate the prevalence of depression and its associated factors in patients with DM and to strengthen the management of depression in this patient group.METHODS Participants were selected from the 2018 China Health and Retirement Longitudinal Study.Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale,with a score of 10 or more indicating depression.Group differences were compared using analysis of variance andχ^(2)tests.Binary logistic regression was conducted to explore the odds ratios(ORs)of independent variables.Following Andersen’s behavioral model,predisposing,enabling,health need,and health behavior variables were introduced stepwise into the logistic model.RESULTS Of the 1673 patients with diabetes,41.4%had depressive symptoms.Regarding the predisposing characteristics,patients who were male(OR 0.426,P<0.05),married(OR 0.634,P<0.05),and received a high school education or higher(OR 0.432,P<0.05)reported fewer depressive symptoms.Healthcare needs,including better self-rated health(OR 0.458 for fair and OR 0.247 for good,P<0.05)and more sleep(OR 0.642,P<0.05),were associated with a lower likelihood of depressive symptoms.In contrast,pain(OR 1.440 for mild and OR 2.644 for severe,P<0.05)and impairment in the basic activities of daily living(OR 1.886,P<0.05)were inversely associated.Additionally,patients highly satisfied with healthcare services(OR 0.579,P<0.05)were less likely to have depressive symptoms.CONCLUSION Nearly half of the patients with DM reported depressive symptoms,which were strongly associated with predisposing characteristics and healthcare needs,particularly physical pain and impairment in basic activities of daily living.Our study emphasizes the significance of enhanced screening and intervention for depression in diabetes care along with improved management of functional impairments.展开更多
Breast cancer is the most common cancer in women worldwide.A high percentage of these patients may have depressive symptoms and an early detection is crucial as part of a comprehensive management of the disease.Mao et...Breast cancer is the most common cancer in women worldwide.A high percentage of these patients may have depressive symptoms and an early detection is crucial as part of a comprehensive management of the disease.Mao et al recently conducted a study constructing a depression risk predictive model in young and middle-aged breast cancer patients.Four questionnaires(a general one,Patient Health Questionnaire-9,Perceived Social Support From Family Scale and International Physical Activity Questionnaire)and the Visual Analogue Scale were used to examine the correlation between different variables and depressive symptoms.The constructed predictive model showed strong predictive capability with an area under the receiver operating characteristic curve of 0.852 and high sensitivity and specificity values.However,the screening depression tools and questionnaires to assess social support or physical activity are not originally designed for oncological patients and further investigation to corroborate their applicability in this context is relevant.The cross-sectional design of the study prevents establishing clear causal relationships between the identified risk factors and depression.Besides,the study includes only a sample of Chinese patients and the applicability in a different sociocultural context is uncertain.Further investigation is crucial to corroborate the results in larger samples and different contexts.展开更多
BACKGROUND Septic shock represents one of the most severe critical illness types,characterized by significant hemodynamic disorders and neuropsychiatric symptoms.This study aimed to investigate the association mechani...BACKGROUND Septic shock represents one of the most severe critical illness types,characterized by significant hemodynamic disorders and neuropsychiatric symptoms.This study aimed to investigate the association mechanism between hemodynamic indicators and neuropsychiatric symptoms in patients with septic shock,revealing potential pathophysiological connections.AIM To investigate the link between hemodynamic parameters and neuropsychiatric symptoms in septic shock.METHODS A retrospective case-control study involving 132 patients with septic shock.Multiple assessment tools were employed,including the Confusion Assessment Method,Hospital Anxiety and Depression Scale,Posttraumatic Stress Disorder Scale,and Mini-Mental State Examination,systematically evaluating patients’neuropsychiatric symptoms and hemodynamic indicators.RESULTS Patient mean age was 52.4±12.3 years,with 68.5%males.Multivariate analysis revealed significant correlations between neuropsychiatric symptom severity and mean arterial pressure<65 mmHg[odds ratio(OR)=2.7],lactate levels>4 mmol/L(OR=3.1),and elevated interleukin-6 inflammatory factors(OR=2.4).Neuropsychiatric symptom incidence rates were:Delirium 37.1%;anxiety 28.8%;depression 24.2%;and posttraumatic stress disorder 19.7%.CONCLUSION Hemodynamic disorders in patients with septic shock are closely associated with neuropsychiatric symptoms,influencing central nervous system function through complex inflammatory and neurotransmitter pathways.展开更多
Breast cancer ranks among the most prevalent cancers worldwide,particularly affecting young and middle-aged women,who face higher recurrence rates,lower survival rates,and substantial psychological health challenges.D...Breast cancer ranks among the most prevalent cancers worldwide,particularly affecting young and middle-aged women,who face higher recurrence rates,lower survival rates,and substantial psychological health challenges.Depressive symptoms,frequently observed in breast cancer patients,significantly influence treatment outcomes and quality of life.Recent years have seen a growing focus on these symptoms,emphasizing early identification and intervention.This editorial comments on the recent study by Mao et al on a risk prediction model for de-pression in young and middle-aged breast cancer patients.Research suggests that factors such as tumor grade,monthly income,pain perception,family support,and physical activity critically influence the onset of depressive symptoms.By developing personalized risk prediction models,it becomes possible to identify high-risk patients early,allowing healthcare professionals to implement pre-ventive strategies proactively.The editorial advocates for increased attention and resources dedicated to psychological health interventions for breast cancer pa-tients,aiming to foster comprehensive care strategies that mitigate the impacts of depression and enhance overall quality of life.展开更多
基金funded by Science and Technology Commission of Shanghai Municipality(No.21Y11905400)National Natural ScienceFoundationof China(General Program,No.82371555).
文摘Background Dynamic interpersonal therapy(DIT)is a short-term psychodynamic psychotherapy that has been shown to effectively reduce depressive symptoms in patients with major depressive disorder(MDD).In DIT,the depressive symptoms are formulated as responses to impaired mentalisation.DIT aims to alleviate depressive symptoms by improving mentalising.Aims This study aimed to examine the effect of DIT on improving mentalising and the mediating effect of mentalising in changes in depressive symptoms.Methods Outpatients received either DIT combined with antidepressant medication treatment(DIT group)or antidepressant medication treatment alone(ADM group)for 16 weeks.The Hamilton Depression Rating Scale(HAMD),Patient Health Questionnaire(PHQ)and Reflective Functioning Questionnaire(RFQ)were used.The intention-to-treat principle,mixed linear models,multiple imputation,Pearson's correlation analysis and mediation analysis were conducted.The per-protocol principle was used as sensitivity analysis.Results The DIT group had significantly lower HAMD(least-squares(LS)mean difference=-3.756,p<0.001),PHQ(LS mean difference=-4.188,p<0.001),uncertainty about mental states in the RFQ(RFQ-U,LS mean difference=-2.116,p<0.001)and higher certainty about mental states in the RFQ(RFQ-C,LS mean difference=2.214,p=0.028)scores than the ADM group at post-treatment.The change in RFQ-C was marginally significantly correlated with the change in HAMD(r=-0.218,poretao=0.090),The change in RFQ-U was significantly correlated with the change in HAMD(r=-0.269,poroco-0.024)and the change in PHQ(r=-0.43,Peoretceo l<e0.001).When using RFQ-U as the mediating variable and PHQ as the dependent variable,a significant mediating effect was found(p=0.043,95% confidence interval 0.024 to 1.453).Conclusions The DIT group yielded better outcomes compared with the ADM group in reducing depressive symptoms and improving mentalising.Improvements in mentalising were associated with reductions in depressive symptoms.These findings support that mentalising may contribute to the therapeutic effects of DIT in MDD.
文摘The predominance of pituitary adenoma in the etiology of sellar masses often leads to the diagnostic fallacy of“availability bias”so that pituitary adenoma is almost always considered the most likely diagnosis of all sellar masses,even when clinical evidence suggests otherwise.Primary sellar atypical teratoid/rhabdoid tumor(AT/RT)is the most aggressive sellar tumor.Most patients with sellar AT/RT are initially misdiagnosed with pituitary macroadenoma.Early diagnosis of sellar AT/RT is of paramount importance to counsel patients and family on the grave prognosis and to avoid futile surgical procedures.Since there are no discerning imaging features to differentiate AT/RT from other sellar tumors,the acuity of sellar compression symptoms characteristic of AT/RT is the only evidence indicative of the AT/RT diagnosis.Based on the biological and anatomical properties of the sella turcica and its surrounding structures,the nature,order of manifestation,and acuity of the sellar compression symptoms in response to sellar content expansion are mostly predictable.It is concluded that rapidly progressive headache and subsequent similarly rapidly progressive visual symptoms in a female with a large sellar mass are pathognomonic of sellar AT/RT(the“Yu rule”).
基金supported by the Specific Research Fund for Top-notch Talents of Guangdong Provincial Hospital of Chinese Medicine(No.2022KT1188).
文摘Objectives To identify core symptoms and symptom clusters in patients with neuromyelitis optica spectrum disorder(NMOSD)by network analysis.Methods From October 10 to 30,2023,140 patients with NMOSD were selected to participate in this online questionnaire survey.The survey tools included a general information questionnaire and a self-made NMOSD symptoms scale,which included the prevalence,severity,and distress of 29 symptoms.Cluster analysis was used to identify symptom clusters,and network analysis was used to analyze the symptom network and node characteristics and central indicators including strength centrality(r_(s)),closeness centrality(r_(c))and betweeness centrality(r_(b))were used to identify core symptoms and symptom clusters.Results The most common symptom was pain(65.7%),followed by paraesthesia(65.0%),fatigue(65.0%),easy awakening(63.6%).Regarding the burden level of symptoms,pain was the most burdensome symptom,followed by paraesthesia,easy awakening,fatigue,and difficulty falling asleep.Six clusters were identified:somatosensory,motor,visual,and memory symptom clusters,bladder and rectum symptom clusters,sleep symptoms clusters,and neuropsychological symptom clusters.Fatigue(r_(s)=12.39,r_(b)=68.00,r_(c)=0.02)was the most central and prominent bridge symptom,and motor symptom cluster(r_(s)=2.68,r_(c)=0.10)was the most central symptom cluster among the six clusters.Conclusions Our study demonstrated the necessity of symptom management targeting fatigue,pain,and motor symptom cluster in patients with NMOSD.
基金Supported by National Natural Science Foundation of China,No.71774060the Young Top Talent Program in Public Health from Health Commission of Hubei Province,No.EWEITONG[2021]74.
文摘BACKGROUND Examining patterns of media consumption and their associations with mental health outcomes in the general population during the coronavirus disease 2019(COVID-19)pandemic has implications for public mental health in future pandemics.AIM To investigate patterns of media consumption and their associations with depressive and anxiety symptoms among adults affected by the COVID-19 pandemic.METHODS A total of 8473 adults were recruited through snowball sampling for an online cross-sectional survey.The participants were asked to report the three media sources from which they most frequently acquired knowledge about COVID-19 from a checklist of nine media sources.Depression and anxiety were assessed with the Patient Health Questionnaire and the Generalized Anxiety Disorder Scale,respectively.A two-step cluster analysis was performed to identify distinct clusters of consumption of media sources.RESULTS Seven clusters were identified.The lowest prevalence of depression and anxiety(29.1%and 22.8%,respectively)was observed in cluster one,which was labeled“television and news portals and clients,minimal social media”.The highest prevalence of depression(43.1%)was observed in cluster three,labeled“WeChat,MicroBlog,and news portals,minimal traditional media”.The greatest prevalence of anxiety(35.8%)was observed in cluster seven,which was labeled“news clients and WeChat,no newspaper,radio,or news portals”.Relative to cluster one,a significantly elevated risk of depression and anxiety was found in clusters three,six(labeled“news portals and clients,WeChat,no newspaper and radio”)and seven(adjusted odds ratio=1.28-1.46,P≤0.011).Multiple logistic regression analyses revealed that the risk of COVID-19 infection and knowledge about COVID-19 partially explained the variations in the prevalence of depression and anxiety across the seven clusters.CONCLUSION Communication policies should be designed to channel crucial pandemic-related information more effectively through traditional and digital media sources.Encouraging the use of these media and implementing regulatory policies to reduce misinformation and rumors on social media,may be effective in mitigating the risk of depression and anxiety among populations affected by the pandemic.
文摘In the era of artificial intelligence(AI),healthcare and medical sciences are inseparable from different AI technologies[1].ChatGPT once shocked the medical field,but the latest AI model DeepSeek has recently taken the lead[2].PubMed indexed publications on DeepSeek are evolving[3],but limited to editorials and news articles.In this Letter,we explore the use of DeepSeek in early symptoms recognition for stroke care.To the best of our knowledge,this is the first DeepSeek-related writing on stroke.
文摘Parkinson’s disease patients,in addition to typical motor symptoms,often experience various psychological symptoms,including depression,anxiety,cognitive impairment,impulse control disorders,and psychotic symptoms.These symptoms severely affect patients’quality of life and may even cause a greater disease burden than motor symptoms.This review focuses on the application progress of transcranial magnetic stimulation(TMS)as a non-invasive neuromodulation technique in the treatment of psychological symptoms in Parkinson’s disease.Studies have shown that repetitive TMS(rTMS)has significant improvement effects on Parkinson’s disease-related depressive symptoms,with mechanisms possibly related to the regulation of the prefrontal-striatal dopamine pathway and the promotion of neuroplasticity.For anxiety symptoms,continuous theta burst stimulation has shown potential in indirect regulation of the amygdala and hippocampal regions.For cognitive impairment,high-frequency rTMS applied to the dorsolateral prefrontal cortex can improve executive function deficits,while bilateral coordinated stimulation protocols help enhance attention and memory functions.For impulse control disorders in Parkinson’s disease patients,inhibitory stimulation applied to the orbitofrontal cortex can alleviate pathological gambling and compulsive behaviors.In terms of sleep disorders,TMS has also shown potential efficacy in regulating circadian rhythms and improving rapid eye movement sleep behavior disorder.However,current research still has limitations such as small sample sizes,non-standardized stimulation protocols,and insufficient evaluation of long-term efficacy.Future research directions should focus on optimizing stimulation parameters,exploring individualized treatment protocols,integrating multimodal imaging assessments,and conducting large-sample randomized controlled trials to clarify the clinical application value of TMS in the rehabilitation of psychological symptoms in Parkinson’s disease,providing new approaches for the comprehensive management of this common neurodegenerative disease.
文摘BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affecting work and interpersonal communication,increasing the risk of recurrence,and adding to the burden on families.Studying the influencing factors of their social function is of great significance.AIM To explore the social function score and its influencing factors in patients with residual depressive symptoms.METHODS This observational study surveyed patients with residual depressive symptoms(case group)and healthy patients undergoing physical examinations(control group).Participants were admitted between January 2022 and December 2023.Social functioning was assessed using the Sheehan Disability Scale(SDS),and scores were compared between groups.Factors influencing SDS scores in patients with residual depressive symptoms were analyzed by applying multiple linear regression while using the receiver operating characteristic curve,and these RESULTS The SDS scores of the 158 patients with depressive symptoms were 11.48±3.26.Compared with the control group,the SDS scores and all items in the case group were higher.SDS scores were higher in patients with relapse,discon-tinuous medication,drug therapy alone,severe somatic symptoms,obvious residual symptoms,and anxiety scores≥8.Disease history,medication compliance,therapy method,and residual symptoms correlated positively with SDS scores(r=0.354,0.414,0.602,and 0.456,respectively).Independent influencing factors included disease history,medication compliance,therapy method,somatic symptoms,residual symptoms,and anxiety scores(P<0.05).The areas under the curve for predicting social functional impairment using these factors were 0.713,0.559,0.684,0.729,0.668,and 0.628,respectively,with sensitivities of 79.2%,61.8%,76.8%,81.7%,63.6%,and 65.5%and specificities of 83.3%,87.5%,82.6%,83.3%,86.7%,and 92.1%,respectively.CONCLUSION The social function scores of patients with residual symptoms of depression are high.They are affected by disease history,medication compliance,therapy method,degree of somatic symptoms,residual symptoms,and anxiety.
文摘BACKGROUND The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia,especially thyroid hormones.AIM To study the relationship between triiodothyronine(T3),thyroxine(T4),free T3(FT3),free T4(FT4),thyroid stimulating hormone(TSH)and schizophrenia.METHODS In this study,100 schizophrenia patients were selected from our hospital between April 2022 and April 2024.Their clinical data were analyzed retrospectively.Based on the Positive and Negative Syndrome Scale(PANSS)score,patients were divided into mild(1-3 points,n=39),moderate(4 points,n=45),and severe groups(5-7 points,n=16).Additionally,55 healthy individuals served as a control group.Venous blood samples were collected to measure T3,T4,FT3,FT4,TSH,and cortisol concentrations,analyzing their relationship with PANSS scores.RESULTS The serum levels of T3,FT3,FT4,TSH and cortisol in the schizophrenia group were lower than those in the control group(P<0.05).With the increase of the severity of the disease,the concentrations of T3 and T4 decreased,while the con-centrations of TSH and cortisol increased(P<0.05).The concentrations of TSH and cortisol were positively correlated with the PANSS score,while T3 and T4 were negatively correlated with the PANSS score(P<0.05).The receiver ope-rating characteristic curve results showed that T3,T4,TSH,and cortisol had good efficacy in the diagnosis of schizophrenia.Logistic results showed that decreased T3 level,decreased T4 level,decreased TSH level and increased cortisol level may be independent risk factors for schizophrenia.CONCLUSION Thyroid hormone levels are associated with the severity of schizophrenia symptoms,which can provide new solutions for the diagnosis and treatment of schizophrenia.
基金Supported by Science and Technology Innovation 2030-Major Projects,No.2021ZD0202000National Key Research and Development Program of China,No.2019YFA0706200+2 种基金National Natural Science Foundation of China,No.82371535Science and Technology Innovation Program of Hunan Province,No.2023RC3083Fundamental Research Funds for the Central Universities of Central South University,No.2023ZZTS0838.
文摘BACKGROUND Sensitivity to stress is essential in the onset,clinical symptoms,course,and prognosis of major depressive disorder(MDD).Meanwhile,it was unclear how variously classified but connected stress-sensitivity variables affect MDD.We hypothesize that high-level trait-and state-related stress-sensitivity factors may have different cumulative effects on the clinical symptoms and follow-up outcomes of MDD.AIM To investigate how stress-sensitivity factors added up and affected MDD clinical symptoms and follow-up results.METHODS In this prospective study,281 MDD patients were enrolled from a tertiary care setting.High-level stress-sensitivity factors were classified as trait anxiety,state anxiety,perceived stress,and neuroticism,with a total score in the top quartile of the research cohort.The cumulative effects of stress-sensitivity factors on cognitive dysfunction,disability and functional impairment,suicide risk,and depressive and anxiety symptoms were examined using an analysis of variance with linear trend analysis.Correlations were investigated further using multiple regression analysis.RESULTS Regarding high-level stress-sensitivity factors,53.40%of patients had at least one at baseline,and 29.61%had two or more.Four high-level stress-sensitivity components had significant cumulative impacts on MDD symptoms at baseline(all P<0.001).Perceived stress predicted the greatest effect sizes of state-related factors on depressive symptoms(partialη^(2)=0.153;standardizedβ=0.195;P<0.05).The follow-up outcomes were significantly impacted only by the high-level trait-related components,mainly when it came to depressive symptoms and suicide risk,which were predicted by trait anxiety and neuroticism,respectively(partialη^(2)=0.204 and 0.156;standardizedβ=0.247 and 0.392;P<0.05).CONCLUSION To enhance outcomes of MDD and lower the suicide risk,screening for stress-sensitivity factors and considering multifaceted measures,mainly focusing on trait-related ones,should be addressed clinically.
文摘BACKGROUND With the growing scholarly and clinical fascination with somatic symptom dis-order(SSD),a bibliometric analysis is lacking.AIM To conduct a bibliometric analysis to investigate the current status and frontiers of SSD.METHODS The documents related to SSD are obtained from the web of science core collection database(WoSCC),and VOSviewer 1.6.16 from January 1,2000 to December 31,2023,and the WoSCC’s literature analysis wire were used to conduct the biblio-metric analysis.RESULTS A total of 567 documents related to SSD were included,and 2325 authors across 947 institutions from 57 countries/regions have contributed to SSD research,published in 277 journals.The most productive author,institution,country and journal were Löwe B,University of Hamburg,Germany,and Journal of Psycho-somatic Research respectively.The first high-cited document was published in the Journal of Psychosomatic Research in 2013 by Dimsdale JE and colleagues,which explored the rationale behind the SSD diagnosis introduction in diagnostic and statistical manual of mental disorders.CONCLUSION In conclusion,the main research hotspots and frontiers in the field of SSD are validity and reliability of the SSD criteria,functional impairment of SSD,and the treatment for SSD.More high-quality studies are needed to assess the diagnosis and treatment of SSD.
文摘BACKGROUND Revisiting the epidemiology of posttraumatic stress symptoms(PTSSs)among university students during the coronavirus disease 2019(COVID-19)pandemic as well as understanding the mental health help-seeking behavior of individuals with PTSSs has critical implications for public mental health strategies in future medical pandemics.AIM To investigate the prevalence and correlates of PTSSs among university students during the first wave of the COVID-19 pandemic in China and to examine mental health help-seeking behaviors among these students.METHODS A total of 2507 Chinese university students were recruited via snowball sampling.The students completed the Seven-item Screening Scale for Post-traumatic Stress Disorder during the first wave of the COVID-19 pandemic in China.Sociodemo-graphic characteristics,pandemic-related characteristics,and mental health help-seeking behaviors of students with PTSSs were also collected.RESULTS The prevalence of PTSSs among the participants was 28.0%.Seven significant correlates of PTSSs were identified(odds ratio=1.23-3.65,P≤0.024):Female sex,being 19 years old or older,living with others or alone,a low level of family economic status,fair or poor interpersonal relationships,severe or very severe local pandemic,and having family members diagnosed with COVID-19.However,only 3.28%of the students with PTSSs reported seeking help from mental health specialists.Among the 23 students who sought help from mental health specialists,13 opted for online or telephone-based psychological consultation.CONCLUSION Our data suggest that there was a high risk of PTSSs among university students and a high level of unmet mental health needs during the COVID-19 pandemic.The delivery of mental health services online or via telephone is a promising approach to address these unmet needs.
文摘BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with and without prominent nega-tive symptoms(PNS).AIM To evaluate the effectiveness and safety of blonanserin monotherapy for first-episode schizophrenia in real-world clinical settings and to explore the efficacy and safety of different doses of blonanserin for patients with PNS and without PNS.METHODS A 12-week,multicenter,prospective post-marketing surveillance was conducted.In this study,we included patients with first-episode schizophrenia who received blonanserin monotherapy.Patients were divided into those with PNS and without PNS,based on the Brief Psychiatric Rating Scale(BPRS)negative symptoms subscale scores.Additionally,patients were labeled as high-dose and low-dose was evaluated through the incidence of adverse drug reactions(ADRs).RESULTS A total of 653 patients were included in the analysis,with 613 completing the study.The BPRS total score decreased significantly from 47.94±16.31 at baseline to 26.88±9.47 at 12 weeks(P<0.001).A significant interaction of PNS×dose×time was observed for BPRS total scores(F=3.47,P=0.040)and negative symptom subscale scores(F=6.76,P=0.002).In the PNS group,the high-dose group showed greater reductions in BPRS total scores(P=0.001)and negative symptom subscale scores(P=0.003)than the low-dose group in week 12.In the without PNS group,no significant difference was observed between the high-dose and low-dose groups at any visit.Most adverse reactions were mild or moderate,with extrapyramidal symptoms(9.3%)being most common;1.5%of patients gained≥7%body weight at 12 weeks.CONCLUSION Blonanserin effectively alleviated the clinical symptoms of first-episode schizophrenia with an acceptable safety profile.High-dose blonanserin is particularly beneficial for patients with PNS in the acute phase of first-episode schizophrenia.However,due to the limitation of ADR reporting the real world,the ADR incidence observed in this study may be underestimated.
基金Supported by Tianjin Key Medical Discipline(Specialty)Construction Project,No.TJYXZDXK-033A。
文摘BACKGROUND Patients with schizophrenia may lack awareness of the importance of posttracheotomy care due to the impact of their condition,often showing resistance or misunderstanding of care measures.When coupled with the impact of negative symptoms and the risk of complications after tracheotomy,patients may experience emotional fluctuations,restlessness,anxiety,and hostile behaviors,which pose significant challenges to nursing work.CASE SUMMARY We have reported the case of an 87-year-old male patient who was admitted to the hospital because of negative symptoms of schizophrenia and who underwent tracheotomy for severe pneumonia.In this study,we have summarized the nursing experience of a patient with negative symptoms of schizophrenia who underwent tracheotomy.The key nursing strategies included proper tracheotomy care,the management of psychiatric symptoms,a thorough assessment and implementation of enteral and parenteral nutrition,effective skincare,infection prevention,and comprehensive mental care.Individualized nursing skills helped stabilize the patient’s condition,followed by isolation and observation in a psychiatric hospital.CONCLUSION Effective postoperative tracheostomy care in patients with schizophrenia necessitates a tailored,multidisciplinary approach that addresses their psychiatric,physical,and emotional needs to achieve optimal clinical outcomes.
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 State Key Laboratory of Ultrasonic Medical Engineering/the Chongqing Science and Technology Bureau(Project No.2022KFKT7011)the Postdoctoral Fellowship Program of CPSF(GZC20233357)+1 种基金the Health Commission of Sichuan Province Medical Science and Technology Program(24QNMP007)the Medical Research Program of Health Commission of Chengdu(2023535).
文摘Objective:To explore symptom experiences and self-coping patterns during the early and late stages of chemotherapy in these patients to provide a basis for developing targeted symptom management strategies.Methods:A total of 27 patients with pancreatic cancer undergoing chemotherapy at two medical institutions were recruited between November 2023 and August 2024.Semi-structured interviews were conducted in person or over the phone.Data were analyzed using traditional content and thematic analyses.Results:Three themes were identified:symptom experience,self-coping patterns,and existing obstacles.During the early stages of chemotherapy,patients reported a higher frequency of unpleasant symptoms and recognized these symptoms earlier in the treatment course.Patients in the early stages primarily relied on external support to cope with symptoms,while those in the later stages adopted self-care strategies.Several challenges related to unpleasant symptoms were observed,which appeared to correlate with the self-coping patterns employed.Conclusion:Patients with pancreatic cancer undergoing chemotherapy experience a complex and diverse range of symptoms,with varying coping patterns at different stages of treatment.Symptom management during chemotherapy presents significant challenges.Healthcare providers should improve the ongoing monitoring of symptoms post-chemotherapy.By linking patients’symptom experiences and self-coping patterns at different stages of chemotherapy to their specific challenges,personalized symptom management strategies can be developed to enhance care quality.
文摘BACKGROUND Depression is a significant risk factor for diabetes,particularly type 2 diabetes.However,depressive symptoms differ from clinical depression.Previous research has not fully considered the relationship between the trajectory of depressive symptoms and the risk of developing diabetes over time.AIM To investigate the association between depressive symptoms,their trajectories,and the risk of developing diabetes in two prospective cohort studies.METHODS In the first phase we analyzed the association between depressive symptoms and the risk of developing diabetes separately using the Health and Retirement Study(HRS).Depressive symptom trajectories were assessed by examining changes in depressive symptoms at baseline and again 8 years later.We then identified specific depressive symptom trajectories that increased the risk of diabetes in the second phase.Finally,we confirmed the association between depressive symptoms and their trajectories with diabetes risk using the English Longitudinal Study of Ageing(ELSA)as a validation study.Depressive symptom trajectories were categorized into five states based on changes in the modified 8-item Center for Epidemiological Studies-Depression scores:Persistently high;increasing;fluctuating;decreasing;and persistently low.Diabetes mellitus was defined as self-reported,physician-diagnosed diabetes.Cox proportional hazards models were used to assess hazard ratios(HR)and 95%confidence intervals(CI),adjusting for potential confounders.RESULTS In the first phase a total of 27658 participants were included(HRS:18633,ELSA:9025),among whom 6582 had depressive symptoms(HRS:4547,ELSA:2035),6407 had somatic depressive symptoms(HRS:4414,ELSA:1993),and 26415 had cognitive-affective depressive symptoms(HRS:17755,ELSA:8660).We found that overall depressive symptoms(HRS:HR=1.14,95%CI:1.07-1.22;ELSA:HR=1.18,95%CI:1.03-1.34)and somatic depressive symptoms(HRS:HR=1.14,95%CI:1.07-1.22;ELSA:HR=1.25,95%CI:1.10-1.42)increased the risk of diabetes,while cognitive depressive symptoms were not associated with diabetes risk.Over an 8-year follow-up we identified 19729 trajectories of overall,somatic,and cognitive-affective depressive symptoms(HRS:13918,ELSA:5811).In the second phase we found that persistently high(HRS:HR=1.22,95%CI:1.06-1.40,ELSA:HR=1.54,95%CI:1.16-2.05 in total and HRS:HR=1.24,95%CI:1.07-1.43,ELSA:HR=1.79,95%CI:1.36-2.35 in somatic)and fluctuating(HRS:HR=1.09,95%CI:1.01-1.17,ELSA:HR=1.33,95%CI:1.14-1.55 in total and HRS:HR=1.10,95%CI:1.02-1.18,ELSA:HR=1.31,95%CI:1.13-1.53 in somatic)trajectories of overall and somatic depressive symptoms increased the risk of diabetes,while increasing trajectories may also raise diabetes risk.However,decreasing trajectories were not associated with diabetes risk.Cognitive-affective depressive symptoms showed no association with diabetes risk regardless of trajectory changes.Sensitivity analyses confirmed the reliability of the findings.CONCLUSION Persistently high and fluctuating trajectories of overall and somatic depressive symptoms increased the risk of diabetes,while decreasing trajectories were not associated with diabetes risk.In contrast trajectories of cognitiveaffective depressive symptoms show no relationship with diabetes risk.Focusing on depressive symptom trajectories,particularly those of somatic depressive symptoms,represented a viable strategy for future diabetes prevention.
基金Supported by National Natural Science Foundation of China,No.72104058Open Bidding for Selecting the Best Candidates,Guangzhou University of Chinese MedicineUniversity of Macao Research Funding,No.QRCM-IRG2022-001.
文摘BACKGROUND Diabetes mellitus(DM)is a rapidly growing global health emergency of the 21st century.Comorbidities,such as DM and depression,are common,presenting challenges to the healthcare system.AIM To investigate the prevalence of depression and its associated factors in patients with DM and to strengthen the management of depression in this patient group.METHODS Participants were selected from the 2018 China Health and Retirement Longitudinal Study.Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale,with a score of 10 or more indicating depression.Group differences were compared using analysis of variance andχ^(2)tests.Binary logistic regression was conducted to explore the odds ratios(ORs)of independent variables.Following Andersen’s behavioral model,predisposing,enabling,health need,and health behavior variables were introduced stepwise into the logistic model.RESULTS Of the 1673 patients with diabetes,41.4%had depressive symptoms.Regarding the predisposing characteristics,patients who were male(OR 0.426,P<0.05),married(OR 0.634,P<0.05),and received a high school education or higher(OR 0.432,P<0.05)reported fewer depressive symptoms.Healthcare needs,including better self-rated health(OR 0.458 for fair and OR 0.247 for good,P<0.05)and more sleep(OR 0.642,P<0.05),were associated with a lower likelihood of depressive symptoms.In contrast,pain(OR 1.440 for mild and OR 2.644 for severe,P<0.05)and impairment in the basic activities of daily living(OR 1.886,P<0.05)were inversely associated.Additionally,patients highly satisfied with healthcare services(OR 0.579,P<0.05)were less likely to have depressive symptoms.CONCLUSION Nearly half of the patients with DM reported depressive symptoms,which were strongly associated with predisposing characteristics and healthcare needs,particularly physical pain and impairment in basic activities of daily living.Our study emphasizes the significance of enhanced screening and intervention for depression in diabetes care along with improved management of functional impairments.
文摘Breast cancer is the most common cancer in women worldwide.A high percentage of these patients may have depressive symptoms and an early detection is crucial as part of a comprehensive management of the disease.Mao et al recently conducted a study constructing a depression risk predictive model in young and middle-aged breast cancer patients.Four questionnaires(a general one,Patient Health Questionnaire-9,Perceived Social Support From Family Scale and International Physical Activity Questionnaire)and the Visual Analogue Scale were used to examine the correlation between different variables and depressive symptoms.The constructed predictive model showed strong predictive capability with an area under the receiver operating characteristic curve of 0.852 and high sensitivity and specificity values.However,the screening depression tools and questionnaires to assess social support or physical activity are not originally designed for oncological patients and further investigation to corroborate their applicability in this context is relevant.The cross-sectional design of the study prevents establishing clear causal relationships between the identified risk factors and depression.Besides,the study includes only a sample of Chinese patients and the applicability in a different sociocultural context is uncertain.Further investigation is crucial to corroborate the results in larger samples and different contexts.
文摘BACKGROUND Septic shock represents one of the most severe critical illness types,characterized by significant hemodynamic disorders and neuropsychiatric symptoms.This study aimed to investigate the association mechanism between hemodynamic indicators and neuropsychiatric symptoms in patients with septic shock,revealing potential pathophysiological connections.AIM To investigate the link between hemodynamic parameters and neuropsychiatric symptoms in septic shock.METHODS A retrospective case-control study involving 132 patients with septic shock.Multiple assessment tools were employed,including the Confusion Assessment Method,Hospital Anxiety and Depression Scale,Posttraumatic Stress Disorder Scale,and Mini-Mental State Examination,systematically evaluating patients’neuropsychiatric symptoms and hemodynamic indicators.RESULTS Patient mean age was 52.4±12.3 years,with 68.5%males.Multivariate analysis revealed significant correlations between neuropsychiatric symptom severity and mean arterial pressure<65 mmHg[odds ratio(OR)=2.7],lactate levels>4 mmol/L(OR=3.1),and elevated interleukin-6 inflammatory factors(OR=2.4).Neuropsychiatric symptom incidence rates were:Delirium 37.1%;anxiety 28.8%;depression 24.2%;and posttraumatic stress disorder 19.7%.CONCLUSION Hemodynamic disorders in patients with septic shock are closely associated with neuropsychiatric symptoms,influencing central nervous system function through complex inflammatory and neurotransmitter pathways.
基金Supported by The 2023 Government-Funded Project of the Outstanding Talents Training Program in Clinical Medicine,No.ZF2023165Key Research and Development Projects of Hebei Province,No.18277731DNatural Science Foundation of Hebei Province,No.
文摘Breast cancer ranks among the most prevalent cancers worldwide,particularly affecting young and middle-aged women,who face higher recurrence rates,lower survival rates,and substantial psychological health challenges.Depressive symptoms,frequently observed in breast cancer patients,significantly influence treatment outcomes and quality of life.Recent years have seen a growing focus on these symptoms,emphasizing early identification and intervention.This editorial comments on the recent study by Mao et al on a risk prediction model for de-pression in young and middle-aged breast cancer patients.Research suggests that factors such as tumor grade,monthly income,pain perception,family support,and physical activity critically influence the onset of depressive symptoms.By developing personalized risk prediction models,it becomes possible to identify high-risk patients early,allowing healthcare professionals to implement pre-ventive strategies proactively.The editorial advocates for increased attention and resources dedicated to psychological health interventions for breast cancer pa-tients,aiming to foster comprehensive care strategies that mitigate the impacts of depression and enhance overall quality of life.
