Background Intimate partner violence(IPV) and sexual violence(SV) occur commonly and are a violation of basic human rights. There are limited studies to date that examine the impact of IPV, SV and mental health outcom...Background Intimate partner violence(IPV) and sexual violence(SV) occur commonly and are a violation of basic human rights. There are limited studies to date that examine the impact of IPV, SV and mental health outcomes in Thailand.Aims The objective of the present study was to estimate the prevalence of intimate partner physical violence and IPV in Thai women and the association between these forms of violence and psychiatric disorders.Methods The present study used data from a national cross-sectional, population-based, household design survey. This study analysed data from 3009 female respondents above the age of 18 who were interviewed in person using the World Mental Health-Composite International Diagnostic Interview V.3.0(WMH-CIDI 3.0). We estimated the lifetime and the 12-month period prevalence of IPV and SV, the lifetime and the past 12-month period correlation of IPV/SV with psychiatric disorders and the OR for psychiatric disorders associated with these types of violence.Results There was only 5.2 % of the weighted sample that reported experiencing some form of violence, including reported rates of intimate partner physical violence of 3.5% and IPV of 2.0%. Women who had experienced IPV have a lifetime prevalence for common psychiatric disorders of 28.9%, for suicidal behaviours of 12.2% and for substance use disorders of 8.8%. Women who had experienced SV have a lifetime diagnoses for common psychiatric disorders of 21.4%, for suicidal behaviours of 16.5% and for substance use disorders of 19.4%. There was a statistically significant association between IPV/SV and being diagnosed with a psychiatric disorder during the past year and also during one's lifetime.Conclusion The association between IPV/SV and psychiatric disorders is significant; therefore, performing a formal assessment for a history of violence in psychiatric patients is often beneficial in refining the diagnosis and treatment.展开更多
Objective: Baseline characteristics of acute schizophrenia patients were analyzed to identify differences in the baseline characteristics of patients treated with olanzapine monotherapy compared with those treated wit...Objective: Baseline characteristics of acute schizophrenia patients were analyzed to identify differences in the baseline characteristics of patients treated with olanzapine monotherapy compared with those treated with other antipsychotic monotherapies. Methods: This prospective, naturalistic observational study was designed to evaluate discontinuation rates of olanzapine and non-olanzapine antipsychotic monotherapy in Japanese adult patients with acute schizophrenia. Results: A total of 1089 patients were assessed: 578 patients were treated with olanzapine, 487 with non-olanzapine atypical antipsychotics, and 24 with typical antipsychotics. The mean Clinical Global Impression-Severity (CGI-S) Schizophrenia, Brief Psychiatric Rating Scale (BPRS) total, and BPRS positive scores were higher in patients treated with olanzapine compared with most of the non-olanzapine treated patients. The majority of patients with a CGI-S Schizophrenia score of 7 (29/41 patients) as well as patients with a BPRS total score of 90 or higher (14/18 patients) were treated with olanzapine. On the other hand, physicians tended to prescribe antipsychotics other than olanzapine for patients with heavier body weight or diabetes mellitus. Conclusion: The present study demonstrated that olanzapine was more likely to be prescribed to patients with more severe schizophrenia symptoms. However, further studies are warranted to reach a definite conclusion.展开更多
The objectives of e-STAR Romania (NCT00283517) were to collect clinical outcome data of Romania schizophrenia or schizo-affective disorder patients;prospectively to assess the reasons of treatment initiation, medicati...The objectives of e-STAR Romania (NCT00283517) were to collect clinical outcome data of Romania schizophrenia or schizo-affective disorder patients;prospectively to assess the reasons of treatment initiation, medication usage patterns;to document (long-term) clinical efficacy;and to collect safety data, as well as recording 2-year corresponding retrospective data. In total, 378 eligible subjects were enrolled who were initiated either on risperidone long-acting injectable (RLAI) (290) or on an oral antipsychotic (OA) (88) at baseline as required by the local Summary of the Product Characteristics. Data were collected from per patient both retrospectively and prospectively over a 24-month period at 3-month intervals after starting treatment. The results indicated that subjects suffering from schizophrenia or schizo-affective disorder initiated on RLAI were less likely to be hospitalized within the first 24 months after the initiation of treatment. Moreover, subjects treated with RLAI experienced significant improvements in their illness severity and functioning. Discontinuation rates for RLAI were low and doses were stable throughout the 24 months following the initiation of treatment. In addition, the necessity for supplementary concomitant medication was reduced. Adverse events were reported in 20.3% (RLAI) and 11.4% (OA) of the subjects. In general, patients initiated on RLAI and OA at baseline both clinically improved on all assessed parameters but a larger improvement was observed for patients on RLAI. Incidences of reported AEs during the use of RLAI in a naturalistic setting are comparable with those described in clinical studies;however, the incidence of extrapyramidal signs and weight gain was lower than expected.展开更多
Background:Acupuncture therapy provides a complementary and alternative approach to treating major depressive disorder(MDD),but its efficacy and safety have still not been comprehensively assessed.Recently published s...Background:Acupuncture therapy provides a complementary and alternative approach to treating major depressive disorder(MDD),but its efficacy and safety have still not been comprehensively assessed.Recently published systematic reviews remain confusing and inconclusive.Objective:This systematic review evaluated the efficacy and safety of acupuncture therapy alone or combined with antidepressants for adult patients with mild and moderate MDD.Search strategy:Chinese Biomedical Literature Database,China National Knowledge Infrastructure Database,Wanfang Database,Chinese Science and Technology Journal Database,Pub Med,Embase,and Cochrane Library were searched from their inceptions to March 2025.Inclusion criteria:Randomized controlled trials that compared acupuncture therapy with antidepressants,or acupuncture therapy plus antidepressants with acupuncture therapy or antidepressants for adult patients with mild and moderate MDD were included.Data extraction and analysis:Five reviewers independently extracted data from original literature using a standardized form,and the data were verified by two reviewers to ensure accuracy.Statistical meta-analyses,publication bias analyses,and subgroup analyses were performed by using Review Manager 5.3 software.The Grading of Recommendations Assessment,Development,and Evaluation approach was used to assess the certainty of the evidence.Results:A total of 60 eligible studies including 4675 participants were included.Low-certainty evidence showed that compared with antidepressants,acupuncture therapy(standardized mean difference[SMD]=-0.57;95%confidence interval[CI]=[-0.87,-0.27];I^(2)=86%;P=0.006)or acupuncture therapy plus antidepressants(SMD=-1.00;95%CI=[-1.18,-0.81];I^(2)=77%;P<0.00001)may reduce the severity of depression at the end of treatment.Low-certainty evidence indicated that compared with acupuncture therapy alone,acupuncture therapy plus antidepressants slightly reduced the severity of depression at the end of treatment(SMD=-0.38;95%CI=[-0.61,-0.14];I^(2)=18%;P=0.002).Similar results were also found for acupuncture's relief of insomnia.The reported adverse effects of acupuncture therapy were mild and transient.For most of the subgroup analyses,acupuncture type,scale type,and the course of treatment did not show a significant relative effect.Conclusion:Acupuncture therapy may provide antidepressant effects and relieve insomnia with mild adverse effects for adult patients with mild and moderate MDD.But the certainty of evidence was very low.More high-quality,well designed,large-scale studies with long-term follow-up are needed in the future.展开更多
Background: Preliminary evidence among adults suggests that the ways in which individuals think about their physical activity(PA) behavior is more closely associated with their well-being than self-reported PA. This s...Background: Preliminary evidence among adults suggests that the ways in which individuals think about their physical activity(PA) behavior is more closely associated with their well-being than self-reported PA. This study therefore aimed to examine whether and how self-reported PA and personal beliefs about suffbcient PA are associated with sleep and psychological functioning in a sample of Swiss adolescents, using both cross-sectional and prospective data.Methods: An overall sample of 864 vocational students(368 girls, 17.98± 1.36 years, mean ± SD) was followed prospectively over a 10-month period. At each measurement occasion, participants filled in a series of self-report questiocnaires to assess their PA levels, their personal beliefs about whether or not they engage in sufficient PA, sleep(insomnia symptoms, sleep quality, sleep-onset latency, and number of awakenings),and psychological functioning(depressive symptoms, quality of life, perceived stress, and mental toughness).Results: Adolescents who believe that they are sufficiently physically active to maintain good health reported more restoring sleep. No differen?ces in sleep were found between adolescents who meet PA recommendationsvs. those who do not. Additionally, adolescents who believe that they were sufficiently physically active also reported better psychological functioning. This close relationship between adolescents5 beliefs about their PA involvement and their sleep and psychological functioning was corroborated in the prospective analyses.Conclusion: Cognitive factors should be studied more intensively when elucidating the relationship among PA, sleep, and psychological functioning in young people, particularly when aiming to develop new exercise interventions targeting psychological outcomes.展开更多
The recent global economic recession has affected nursing working conditions in terms of salary reductions, increased workload and staff shortages. Poor nursing working conditions are associated with higher levels of ...The recent global economic recession has affected nursing working conditions in terms of salary reductions, increased workload and staff shortages. Poor nursing working conditions are associated with higher levels of burnout. However in Greece this association has not yet been studied. The aim of this study was to explore financial crisis related changes in nurses’ working conditions and their associations with burnout. A cross-sectional quantitative survey was conducted and data were collected through self-reported questionnaires from 299 Greek nurses from two Public Hospitals in 2012. Multiple linear regression analyses were used in order to find independent factors associated with burnout. The results showed that Greek nurses had high levels of burnout. Satisfaction from the job, quality of care and feeling equivalent with other professionals were independent predictors of lower emotional exhaustion. Workload increase and willingness to change career and work department were independent predictors of higher emotional exhaustion. Job satisfaction and satisfaction from care quality were independent predictors of lower depersonalization. Changes in working relationships and willingness to change career were independent predictors of higher depersonalization. Higher personal accomplishments were independently associated with more years in nursing, satisfaction from the salary prior to reductions, better quality of care, feeling suitable for the job and being anxious about future career. Influence on nurse efficiency by income reduction was an independent predictor of lower personal accomplishments. In conclusion, Greek nurses were suffering from high levels of burnout which was independently associated with crisis related working conditions. Interventions are needed in order to reduce the burden of burnout among Greek nurses.展开更多
Kahlbaum was the first to propose catatonia as a separate disease following the example of general paresis of the insane,which served as a model for establishing a nosological entity.However,Kahlbaum was uncertain abo...Kahlbaum was the first to propose catatonia as a separate disease following the example of general paresis of the insane,which served as a model for establishing a nosological entity.However,Kahlbaum was uncertain about the nosological position of catatonia and considered it a syndrome,or "a temporary stage or a part of a complex picture of various disease forms".Until recently,the issue of catatonia as a separate diagnostic category was not entertained,mainly due to a misinterpretation of Kraepelin's influential views on catatonia as a subtype of schizophrenia.Kraepelin concluded that patients presenting with persistent catatonic symptoms,which he called "genuine catatonic morbid symptoms",particularly including negativism,bizarre mannerisms,and stereotypes,had a poor prognosis similar to those of paranoid and hebephrenic presentations.Accordingly,catatonia was classified as a subtype of dementia praecox/schizophrenia.Despite Kraepelin's influence on psychiatric nosology throughout the 20 th century,there have only been isolated attempts to describe and classify catatonia outside of the Kraepelinian system.For example,the Wernicke-KleistLeonhard school attempted to comprehensively elucidate the complexities of psychomotor disturbances associated with major psychoses.However,the Leonhardian categories have never been subjected to the scrutiny of modern investigations.The first three editions of the DSM included the narrow and simplified version of Kraepelin's catatonia concept.Recent developments in catatonia research are reflected in DSM-5,which includes three diagnostic categories: Catatonic Disorder due to Another Medical Condition,Catatonia Associated with another Mental Disorder(Catatonia Specifier),and Unspecified Catatonia.Additionally,the traditional category of catatonic schizophrenia has been deleted.The Unspecified Catatonia category could encourage research exploring catatonia as an independent diagnostic entity.展开更多
Discontinuation of antipsychotic therapy has been a significant clinical issue among patients with schizophrenia, since the patients who discontinued antipsychotic treatment showed worse clinical and functional outcom...Discontinuation of antipsychotic therapy has been a significant clinical issue among patients with schizophrenia, since the patients who discontinued antipsychotic treatment showed worse clinical and functional outcomes, and higher risks of relapse of schizophrenia symptoms and hospitalization. We conducted a post-hoc analysis of a post-marketing research with a 12-month follow-up period to identify the predictors for discontinuation of antipsychotic monotherapy in Japan. This is a prospective, naturalistic multicenter observational study, designed to evaluate the discontinuation rates of olanzapine monotherapy and non-olanzapine antipsychotic monotherapy in Japanese adult patients with acute schizophrenia. Patients were treatment-naive, or had switched from other antipsychotics or from poly-pharmacotherapy to oral antipsychotic monotherapy. We analyzed the correlation of discontinuation of antipsychotic monotherapy with baseline characteristics of patients. A total of 1089 patients (578 patients treated with olanzapine and 511 with non-olanzapine antipsychotics) were eligible for analysis. By the end of the 12-month study period, 614 patients (56.4%) discontinued antipsychotic therapy. Multivariate logistic regression analyses indicated significantly lower discontinuation rates in all patients treated with antipsychotics: older age (Odds ratio [OR], 0.871;95% confidence interval [CI], 0.797 to 0.953;p = 0.003), outpatient status (OR, 0.508;95% CI, 0.383 to 0.675;p < 0.001), prior use of antipsychotics (OR, 0.693;95% CI, 0.516 to 0.930;p = 0.015), and olanzapine group showed lower discontinuation rate than that of non-olanzapine group (OR, 1.416;95% CI, 1.086 to 1.846;p = 0.010). The present study indicated that the outpatient status, older age, and prior use of antipsychotics have better adherence to antipsychotic treatment. In addition to these factors, use of anti-parkinson agents showed lower discontinuation rates in the olanzapine monotherapy group.展开更多
Background: Sweden is known for its strong views on equality between men and women. Nevertheless, if one scratches the surface, one will realize that intimate partner violence (IPV) is a problem meriting much closer a...Background: Sweden is known for its strong views on equality between men and women. Nevertheless, if one scratches the surface, one will realize that intimate partner violence (IPV) is a problem meriting much closer attention. Emergency nurses have an important role in identifying women who have IPV experiences. Objective: To identify and investigate the occurrence of reported experienced IPV during their lifetime among women seeking emergency care. Design: An explorative and comparative design was used based on answers on the Abuse Assessment Screen questionnaire and some demographic data. The data was described and analyzed using the Statistical Package for the Social Sciences version 21. Results: Of the 300 invited women visiting an emergency department in a small town, 234 completed the questionnaire. Of these 234, 82 (35%) reported having experienced emotional;physical or sexual violence and 31 (13%) reported to being afraid of their partner. Of the women 181 had one child or more and 58 (32%) of these reported having been abused. Of all women, with four or more children, 75% (15) reported to have been abused, while only 25% (5) reported no abuse. Of the 82 women who reported having been abused 12 (15%) reported being abused in the course of the year prior to pregnancy and 9 (11%) during pregnancy, often several times. The main abuser was the woman’s husband, boyfriend, cohabitating partner, ex-partner, or someone else who was seen as a relative, e.g., a parent. Conclusion: Using the questionnaire AAS may contribute to identifying victims of intimate partner violence and increasing health care practitioners’ attentiveness concerning the type of injury, frequency of care seeking and actions that may indicate such violence lead to changes of the woman’s situation.展开更多
Health records have played an increasingly important role throughout history as an important legal document for the exercise of individuals’ rights. However, domestic legislation fails to define health records as a l...Health records have played an increasingly important role throughout history as an important legal document for the exercise of individuals’ rights. However, domestic legislation fails to define health records as a legally important collection of health data and documents. Recording facts and storing legally important documents are therefore the tasks of the operator. Using the prescriptive method we will determine which laws are governing the management of medical records, their safety and accessibility. Based on the descriptive method, we will describe the process of handling health records by the provider of health treatment, focusing on exposed regulatory gaps in the area of the protection of the rights of an individual. Through the analysis of the laws governing the management of health records, even after death and operator terminating the service, we will carry out inductive reasoning and provide conclusions regarding the attitude towards health records. Considering different results we can conclude that health information, especially documents relevant to the protection of individual’s rights, is not transparent. Above all, the documents in the collection are not recorded properly, thus allowing for their removal. Even the transfer of health records by the provider of health treatment is not defined, which could result in the disposal of the entire health documentation.展开更多
<strong>Introduction:</strong> Numerous studies show the involvement of the cingulate gyrus in affective disorders, particularly in depression. With a preventive and curative aim, the authors raise questio...<strong>Introduction:</strong> Numerous studies show the involvement of the cingulate gyrus in affective disorders, particularly in depression. With a preventive and curative aim, the authors raise questions leading to therapeutic applications such as focal brain stimulation. The cingulate gyrus is the primary target of these brain stimulation therapies for the treatment of depression. The objective of this work is to establish anatomoclinical correlations and to deduce the therapeutic implications. <strong>Methodology:</strong> Our work is a review of the literature. The inventory of the cingulate gyrus and depression was based on the development of a critical synthesis of bibliographic knowledge. <strong>Results:</strong> We found a bipartite Brodmann subdivision which evolved into a subdivision into four regions of the cingulate gyrus. Descriptions of the cingulate gyrus boundaries are imprecise and divergent. The anterior end of the anterior cingulate cortex is a confirmed target of stimulation in the treatment of major and resistant depression, thus requiring the authors, a consensus in its delineation. Brodmann’s area 25 has been described as the main target of brain stimulation therapies. Dysfunction by local lesion or by alteration of the connectivity of Brodmann’s area has repercussions on these different structures to which it is interconnected. These disturbances when they are in the direction of collapse paint a picture similar to major depression. <strong>Conclusion: </strong>The anterior cingulate cortex is involved in depression. The functional system organization of affectivity will allow new brain stimulation techniques to act on the entire functional system or on one of its components.展开更多
Objective: Patients with diabetes have an increased Odds Ratio (OR) for depressive disor- der. We wanted to investigate if patients with metabolic syndrome and/or diabetes type 2 not treated with antidiabetic agents, ...Objective: Patients with diabetes have an increased Odds Ratio (OR) for depressive disor- der. We wanted to investigate if patients with metabolic syndrome and/or diabetes type 2 not treated with antidiabetic agents, have an OR for concurrent antidepressant use comparable to other types of diabetes. Methods: Drug delivery data from 25 pharmacies were analysed with respect to sale of antidepressants, oral antidiabetic agents, insulin and blood glucose test strips. Results: Total population of the area was 337,019, whereas 254,083 were 18 or older. Of these 20,139 were patients receiving insulin, oral antidiabetics, glucose test strips and/or antidepressants. Those receiving antidepressants were 5.8% of those 18 or older whereas 2.4% received any antidiabetic medication (including test strips for HBGM). For patients receiving no medications but test strips alone, the adjusted OR for use concurrent use of antidepressants was 1.62 (95% confidence interval: 1.19 - 2.23), p = 0.002. For insulin-only receiving patients, the adjusted OR was 1.65 (1.41 - 1.93), p = 0.000, whereas for patients receiving only oral antidiabetics, it was 1.53 (1.38 - 1.71), p = 0.000. Patients receiving both insulin and oral antidiabetics: 2.23 (1.75 - 2.85), p = 0.000. Conclusion: Patients receiving only blood glucose strips have an OR of concurrently receiving antidepressants, not different from those receiving insulin only or oral antidiabetics only.展开更多
BACKGROUND Blonanserin(BNS)is a well-tolerated and effective drug for treating schizophrenia.AIM To investigate which types of patients would obtain the most benefit from BNS treatment.METHODS A total of 3306 particip...BACKGROUND Blonanserin(BNS)is a well-tolerated and effective drug for treating schizophrenia.AIM To investigate which types of patients would obtain the most benefit from BNS treatment.METHODS A total of 3306 participants were evaluated in a 12-week,prospective,multicenter,open-label post-marketing surveillance study of BNS.Brief psychiatric rating scale(BPRS)scores were calculated to evaluate the effectiveness of BNS,and its safety was assessed with the incidence of adverse drug reactions.Linear regression was used to screen the influencing factors for the reduction of BPRS total score,and logistic regression was used to identify patients with a better response to BNS.RESULTS The baseline BPRS total score(48.8±15.03)decreased to 27.7±10.08 at 12 weeks(P<0.001).Extrapyramidal symptoms(14.6%)were found to be the most frequent adverse drug reactions.The acute phase,baseline BPRS total score,current episode duration,number of previous episodes,dose of concomitant antipsychotics,and number of types of sedative-hypnotic agents were found to be independent factors affecting the reduction of BPRS total score after treatment initiation.Specifically,patients in the acute phase with baseline BPRS total score≥45,current episode duration<3 months,and≤3 previous episodes derived greater benefit from 12-week treatment with BNS.CONCLUSION Patients in the acute phase with more severe symptoms,shorter current episode duration,fewer previous episodes,and a lower psychotropic drug load derived the greatest benefit from treatment with BNS.展开更多
Background:There is existing evidence on whether and to what degree regular exercise training improves the quality of life(QoL)among cancer survivors.However,in regards to patients with high-grade glioma(HGG;WHO grade...Background:There is existing evidence on whether and to what degree regular exercise training improves the quality of life(QoL)among cancer survivors.However,in regards to patients with high-grade glioma(HGG;WHO grade III and IV),no conclusive study has been performed so far.The present trial aims to fill this gap by examining whether psychological well-being,sleep,QoL and physical fitness might be improved with two different types of exercise,as compared to an active control condition.Active control condition represent individuals participating at regular meetings to talk about their current life situation,though,the meetings were not intended as that of the psychotherapy group.Regular meetings are of the same frequency,duration,and intensity as the exercise interventions.Methods:A total of 45 patients with HGG after undergoing neurosurgery and adjuvant radiotherapy,chemotherapy,or chemoradiotherapy will be consecutively and randomly assigned to(a)an endurance training,(b)a resistance training or(c)to an active control condition.The intervention will last for 6 consecutive weeks,consisting of 2 weekly sessions(30-45 min per session).Measurements would take place at three time points,namely at the beginning of the study(baseline),3 weeks after the beginning of the study,and 6 weeks after the beginning of the study.The last measurement also represents the end of the study.Aerobic exercise performance will be assessed objectively with a 6-min walking test,and a handgrip test will be used to assess the upper body strength.Further,participants will complete a battery of questionnaires covering sociodemographic information,QoL,sleep quality and sleep patterns,coping with stress,state-and trait-anxiety,depression,and fatigue.In parallel,experts will use the Hamilton Depres-sion Rating Scale to determine and rate participants’symptoms of depression.Significance:The present study will be the first to investigate and compare the impact of two different exercise modalities,namely endurance and resistance training,on physical fitness and dimensions of well-being,and sleep among patients with HGG who underwent neurosurgery followed by adjuvant radiotherapy,chemotherapy,or chemoradiotherapy.Importantly,unlike the majority of previous studies,the control condition consists of an active set-up to detect possible factual beneficial effects of exercise training,irrespective of social interactions.展开更多
基金funded by the Department of Mental Health,Ministry of Public Health
文摘Background Intimate partner violence(IPV) and sexual violence(SV) occur commonly and are a violation of basic human rights. There are limited studies to date that examine the impact of IPV, SV and mental health outcomes in Thailand.Aims The objective of the present study was to estimate the prevalence of intimate partner physical violence and IPV in Thai women and the association between these forms of violence and psychiatric disorders.Methods The present study used data from a national cross-sectional, population-based, household design survey. This study analysed data from 3009 female respondents above the age of 18 who were interviewed in person using the World Mental Health-Composite International Diagnostic Interview V.3.0(WMH-CIDI 3.0). We estimated the lifetime and the 12-month period prevalence of IPV and SV, the lifetime and the past 12-month period correlation of IPV/SV with psychiatric disorders and the OR for psychiatric disorders associated with these types of violence.Results There was only 5.2 % of the weighted sample that reported experiencing some form of violence, including reported rates of intimate partner physical violence of 3.5% and IPV of 2.0%. Women who had experienced IPV have a lifetime prevalence for common psychiatric disorders of 28.9%, for suicidal behaviours of 12.2% and for substance use disorders of 8.8%. Women who had experienced SV have a lifetime diagnoses for common psychiatric disorders of 21.4%, for suicidal behaviours of 16.5% and for substance use disorders of 19.4%. There was a statistically significant association between IPV/SV and being diagnosed with a psychiatric disorder during the past year and also during one's lifetime.Conclusion The association between IPV/SV and psychiatric disorders is significant; therefore, performing a formal assessment for a history of violence in psychiatric patients is often beneficial in refining the diagnosis and treatment.
文摘Objective: Baseline characteristics of acute schizophrenia patients were analyzed to identify differences in the baseline characteristics of patients treated with olanzapine monotherapy compared with those treated with other antipsychotic monotherapies. Methods: This prospective, naturalistic observational study was designed to evaluate discontinuation rates of olanzapine and non-olanzapine antipsychotic monotherapy in Japanese adult patients with acute schizophrenia. Results: A total of 1089 patients were assessed: 578 patients were treated with olanzapine, 487 with non-olanzapine atypical antipsychotics, and 24 with typical antipsychotics. The mean Clinical Global Impression-Severity (CGI-S) Schizophrenia, Brief Psychiatric Rating Scale (BPRS) total, and BPRS positive scores were higher in patients treated with olanzapine compared with most of the non-olanzapine treated patients. The majority of patients with a CGI-S Schizophrenia score of 7 (29/41 patients) as well as patients with a BPRS total score of 90 or higher (14/18 patients) were treated with olanzapine. On the other hand, physicians tended to prescribe antipsychotics other than olanzapine for patients with heavier body weight or diabetes mellitus. Conclusion: The present study demonstrated that olanzapine was more likely to be prescribed to patients with more severe schizophrenia symptoms. However, further studies are warranted to reach a definite conclusion.
文摘The objectives of e-STAR Romania (NCT00283517) were to collect clinical outcome data of Romania schizophrenia or schizo-affective disorder patients;prospectively to assess the reasons of treatment initiation, medication usage patterns;to document (long-term) clinical efficacy;and to collect safety data, as well as recording 2-year corresponding retrospective data. In total, 378 eligible subjects were enrolled who were initiated either on risperidone long-acting injectable (RLAI) (290) or on an oral antipsychotic (OA) (88) at baseline as required by the local Summary of the Product Characteristics. Data were collected from per patient both retrospectively and prospectively over a 24-month period at 3-month intervals after starting treatment. The results indicated that subjects suffering from schizophrenia or schizo-affective disorder initiated on RLAI were less likely to be hospitalized within the first 24 months after the initiation of treatment. Moreover, subjects treated with RLAI experienced significant improvements in their illness severity and functioning. Discontinuation rates for RLAI were low and doses were stable throughout the 24 months following the initiation of treatment. In addition, the necessity for supplementary concomitant medication was reduced. Adverse events were reported in 20.3% (RLAI) and 11.4% (OA) of the subjects. In general, patients initiated on RLAI and OA at baseline both clinically improved on all assessed parameters but a larger improvement was observed for patients on RLAI. Incidences of reported AEs during the use of RLAI in a naturalistic setting are comparable with those described in clinical studies;however, the incidence of extrapyramidal signs and weight gain was lower than expected.
基金supported by the National Natural Science Foundation of China(No.82474644)the National Key R&D Foundation of China(No.2017YFC1703600)+1 种基金the Shenzhen“Sanming Project”(No.202101007)the Shenzhen Science and Technology Program(No.JCYJ2022081810080300)。
文摘Background:Acupuncture therapy provides a complementary and alternative approach to treating major depressive disorder(MDD),but its efficacy and safety have still not been comprehensively assessed.Recently published systematic reviews remain confusing and inconclusive.Objective:This systematic review evaluated the efficacy and safety of acupuncture therapy alone or combined with antidepressants for adult patients with mild and moderate MDD.Search strategy:Chinese Biomedical Literature Database,China National Knowledge Infrastructure Database,Wanfang Database,Chinese Science and Technology Journal Database,Pub Med,Embase,and Cochrane Library were searched from their inceptions to March 2025.Inclusion criteria:Randomized controlled trials that compared acupuncture therapy with antidepressants,or acupuncture therapy plus antidepressants with acupuncture therapy or antidepressants for adult patients with mild and moderate MDD were included.Data extraction and analysis:Five reviewers independently extracted data from original literature using a standardized form,and the data were verified by two reviewers to ensure accuracy.Statistical meta-analyses,publication bias analyses,and subgroup analyses were performed by using Review Manager 5.3 software.The Grading of Recommendations Assessment,Development,and Evaluation approach was used to assess the certainty of the evidence.Results:A total of 60 eligible studies including 4675 participants were included.Low-certainty evidence showed that compared with antidepressants,acupuncture therapy(standardized mean difference[SMD]=-0.57;95%confidence interval[CI]=[-0.87,-0.27];I^(2)=86%;P=0.006)or acupuncture therapy plus antidepressants(SMD=-1.00;95%CI=[-1.18,-0.81];I^(2)=77%;P<0.00001)may reduce the severity of depression at the end of treatment.Low-certainty evidence indicated that compared with acupuncture therapy alone,acupuncture therapy plus antidepressants slightly reduced the severity of depression at the end of treatment(SMD=-0.38;95%CI=[-0.61,-0.14];I^(2)=18%;P=0.002).Similar results were also found for acupuncture's relief of insomnia.The reported adverse effects of acupuncture therapy were mild and transient.For most of the subgroup analyses,acupuncture type,scale type,and the course of treatment did not show a significant relative effect.Conclusion:Acupuncture therapy may provide antidepressant effects and relieve insomnia with mild adverse effects for adult patients with mild and moderate MDD.But the certainty of evidence was very low.More high-quality,well designed,large-scale studies with long-term follow-up are needed in the future.
基金supported by a grant from the Swiss Federal Office for Sports (BASPO)
文摘Background: Preliminary evidence among adults suggests that the ways in which individuals think about their physical activity(PA) behavior is more closely associated with their well-being than self-reported PA. This study therefore aimed to examine whether and how self-reported PA and personal beliefs about suffbcient PA are associated with sleep and psychological functioning in a sample of Swiss adolescents, using both cross-sectional and prospective data.Methods: An overall sample of 864 vocational students(368 girls, 17.98± 1.36 years, mean ± SD) was followed prospectively over a 10-month period. At each measurement occasion, participants filled in a series of self-report questiocnaires to assess their PA levels, their personal beliefs about whether or not they engage in sufficient PA, sleep(insomnia symptoms, sleep quality, sleep-onset latency, and number of awakenings),and psychological functioning(depressive symptoms, quality of life, perceived stress, and mental toughness).Results: Adolescents who believe that they are sufficiently physically active to maintain good health reported more restoring sleep. No differen?ces in sleep were found between adolescents who meet PA recommendationsvs. those who do not. Additionally, adolescents who believe that they were sufficiently physically active also reported better psychological functioning. This close relationship between adolescents5 beliefs about their PA involvement and their sleep and psychological functioning was corroborated in the prospective analyses.Conclusion: Cognitive factors should be studied more intensively when elucidating the relationship among PA, sleep, and psychological functioning in young people, particularly when aiming to develop new exercise interventions targeting psychological outcomes.
文摘The recent global economic recession has affected nursing working conditions in terms of salary reductions, increased workload and staff shortages. Poor nursing working conditions are associated with higher levels of burnout. However in Greece this association has not yet been studied. The aim of this study was to explore financial crisis related changes in nurses’ working conditions and their associations with burnout. A cross-sectional quantitative survey was conducted and data were collected through self-reported questionnaires from 299 Greek nurses from two Public Hospitals in 2012. Multiple linear regression analyses were used in order to find independent factors associated with burnout. The results showed that Greek nurses had high levels of burnout. Satisfaction from the job, quality of care and feeling equivalent with other professionals were independent predictors of lower emotional exhaustion. Workload increase and willingness to change career and work department were independent predictors of higher emotional exhaustion. Job satisfaction and satisfaction from care quality were independent predictors of lower depersonalization. Changes in working relationships and willingness to change career were independent predictors of higher depersonalization. Higher personal accomplishments were independently associated with more years in nursing, satisfaction from the salary prior to reductions, better quality of care, feeling suitable for the job and being anxious about future career. Influence on nurse efficiency by income reduction was an independent predictor of lower personal accomplishments. In conclusion, Greek nurses were suffering from high levels of burnout which was independently associated with crisis related working conditions. Interventions are needed in order to reduce the burden of burnout among Greek nurses.
文摘Kahlbaum was the first to propose catatonia as a separate disease following the example of general paresis of the insane,which served as a model for establishing a nosological entity.However,Kahlbaum was uncertain about the nosological position of catatonia and considered it a syndrome,or "a temporary stage or a part of a complex picture of various disease forms".Until recently,the issue of catatonia as a separate diagnostic category was not entertained,mainly due to a misinterpretation of Kraepelin's influential views on catatonia as a subtype of schizophrenia.Kraepelin concluded that patients presenting with persistent catatonic symptoms,which he called "genuine catatonic morbid symptoms",particularly including negativism,bizarre mannerisms,and stereotypes,had a poor prognosis similar to those of paranoid and hebephrenic presentations.Accordingly,catatonia was classified as a subtype of dementia praecox/schizophrenia.Despite Kraepelin's influence on psychiatric nosology throughout the 20 th century,there have only been isolated attempts to describe and classify catatonia outside of the Kraepelinian system.For example,the Wernicke-KleistLeonhard school attempted to comprehensively elucidate the complexities of psychomotor disturbances associated with major psychoses.However,the Leonhardian categories have never been subjected to the scrutiny of modern investigations.The first three editions of the DSM included the narrow and simplified version of Kraepelin's catatonia concept.Recent developments in catatonia research are reflected in DSM-5,which includes three diagnostic categories: Catatonic Disorder due to Another Medical Condition,Catatonia Associated with another Mental Disorder(Catatonia Specifier),and Unspecified Catatonia.Additionally,the traditional category of catatonic schizophrenia has been deleted.The Unspecified Catatonia category could encourage research exploring catatonia as an independent diagnostic entity.
文摘Discontinuation of antipsychotic therapy has been a significant clinical issue among patients with schizophrenia, since the patients who discontinued antipsychotic treatment showed worse clinical and functional outcomes, and higher risks of relapse of schizophrenia symptoms and hospitalization. We conducted a post-hoc analysis of a post-marketing research with a 12-month follow-up period to identify the predictors for discontinuation of antipsychotic monotherapy in Japan. This is a prospective, naturalistic multicenter observational study, designed to evaluate the discontinuation rates of olanzapine monotherapy and non-olanzapine antipsychotic monotherapy in Japanese adult patients with acute schizophrenia. Patients were treatment-naive, or had switched from other antipsychotics or from poly-pharmacotherapy to oral antipsychotic monotherapy. We analyzed the correlation of discontinuation of antipsychotic monotherapy with baseline characteristics of patients. A total of 1089 patients (578 patients treated with olanzapine and 511 with non-olanzapine antipsychotics) were eligible for analysis. By the end of the 12-month study period, 614 patients (56.4%) discontinued antipsychotic therapy. Multivariate logistic regression analyses indicated significantly lower discontinuation rates in all patients treated with antipsychotics: older age (Odds ratio [OR], 0.871;95% confidence interval [CI], 0.797 to 0.953;p = 0.003), outpatient status (OR, 0.508;95% CI, 0.383 to 0.675;p < 0.001), prior use of antipsychotics (OR, 0.693;95% CI, 0.516 to 0.930;p = 0.015), and olanzapine group showed lower discontinuation rate than that of non-olanzapine group (OR, 1.416;95% CI, 1.086 to 1.846;p = 0.010). The present study indicated that the outpatient status, older age, and prior use of antipsychotics have better adherence to antipsychotic treatment. In addition to these factors, use of anti-parkinson agents showed lower discontinuation rates in the olanzapine monotherapy group.
文摘Background: Sweden is known for its strong views on equality between men and women. Nevertheless, if one scratches the surface, one will realize that intimate partner violence (IPV) is a problem meriting much closer attention. Emergency nurses have an important role in identifying women who have IPV experiences. Objective: To identify and investigate the occurrence of reported experienced IPV during their lifetime among women seeking emergency care. Design: An explorative and comparative design was used based on answers on the Abuse Assessment Screen questionnaire and some demographic data. The data was described and analyzed using the Statistical Package for the Social Sciences version 21. Results: Of the 300 invited women visiting an emergency department in a small town, 234 completed the questionnaire. Of these 234, 82 (35%) reported having experienced emotional;physical or sexual violence and 31 (13%) reported to being afraid of their partner. Of the women 181 had one child or more and 58 (32%) of these reported having been abused. Of all women, with four or more children, 75% (15) reported to have been abused, while only 25% (5) reported no abuse. Of the 82 women who reported having been abused 12 (15%) reported being abused in the course of the year prior to pregnancy and 9 (11%) during pregnancy, often several times. The main abuser was the woman’s husband, boyfriend, cohabitating partner, ex-partner, or someone else who was seen as a relative, e.g., a parent. Conclusion: Using the questionnaire AAS may contribute to identifying victims of intimate partner violence and increasing health care practitioners’ attentiveness concerning the type of injury, frequency of care seeking and actions that may indicate such violence lead to changes of the woman’s situation.
文摘Health records have played an increasingly important role throughout history as an important legal document for the exercise of individuals’ rights. However, domestic legislation fails to define health records as a legally important collection of health data and documents. Recording facts and storing legally important documents are therefore the tasks of the operator. Using the prescriptive method we will determine which laws are governing the management of medical records, their safety and accessibility. Based on the descriptive method, we will describe the process of handling health records by the provider of health treatment, focusing on exposed regulatory gaps in the area of the protection of the rights of an individual. Through the analysis of the laws governing the management of health records, even after death and operator terminating the service, we will carry out inductive reasoning and provide conclusions regarding the attitude towards health records. Considering different results we can conclude that health information, especially documents relevant to the protection of individual’s rights, is not transparent. Above all, the documents in the collection are not recorded properly, thus allowing for their removal. Even the transfer of health records by the provider of health treatment is not defined, which could result in the disposal of the entire health documentation.
文摘<strong>Introduction:</strong> Numerous studies show the involvement of the cingulate gyrus in affective disorders, particularly in depression. With a preventive and curative aim, the authors raise questions leading to therapeutic applications such as focal brain stimulation. The cingulate gyrus is the primary target of these brain stimulation therapies for the treatment of depression. The objective of this work is to establish anatomoclinical correlations and to deduce the therapeutic implications. <strong>Methodology:</strong> Our work is a review of the literature. The inventory of the cingulate gyrus and depression was based on the development of a critical synthesis of bibliographic knowledge. <strong>Results:</strong> We found a bipartite Brodmann subdivision which evolved into a subdivision into four regions of the cingulate gyrus. Descriptions of the cingulate gyrus boundaries are imprecise and divergent. The anterior end of the anterior cingulate cortex is a confirmed target of stimulation in the treatment of major and resistant depression, thus requiring the authors, a consensus in its delineation. Brodmann’s area 25 has been described as the main target of brain stimulation therapies. Dysfunction by local lesion or by alteration of the connectivity of Brodmann’s area has repercussions on these different structures to which it is interconnected. These disturbances when they are in the direction of collapse paint a picture similar to major depression. <strong>Conclusion: </strong>The anterior cingulate cortex is involved in depression. The functional system organization of affectivity will allow new brain stimulation techniques to act on the entire functional system or on one of its components.
文摘Objective: Patients with diabetes have an increased Odds Ratio (OR) for depressive disor- der. We wanted to investigate if patients with metabolic syndrome and/or diabetes type 2 not treated with antidiabetic agents, have an OR for concurrent antidepressant use comparable to other types of diabetes. Methods: Drug delivery data from 25 pharmacies were analysed with respect to sale of antidepressants, oral antidiabetic agents, insulin and blood glucose test strips. Results: Total population of the area was 337,019, whereas 254,083 were 18 or older. Of these 20,139 were patients receiving insulin, oral antidiabetics, glucose test strips and/or antidepressants. Those receiving antidepressants were 5.8% of those 18 or older whereas 2.4% received any antidiabetic medication (including test strips for HBGM). For patients receiving no medications but test strips alone, the adjusted OR for use concurrent use of antidepressants was 1.62 (95% confidence interval: 1.19 - 2.23), p = 0.002. For insulin-only receiving patients, the adjusted OR was 1.65 (1.41 - 1.93), p = 0.000, whereas for patients receiving only oral antidiabetics, it was 1.53 (1.38 - 1.71), p = 0.000. Patients receiving both insulin and oral antidiabetics: 2.23 (1.75 - 2.85), p = 0.000. Conclusion: Patients receiving only blood glucose strips have an OR of concurrently receiving antidepressants, not different from those receiving insulin only or oral antidiabetics only.
文摘BACKGROUND Blonanserin(BNS)is a well-tolerated and effective drug for treating schizophrenia.AIM To investigate which types of patients would obtain the most benefit from BNS treatment.METHODS A total of 3306 participants were evaluated in a 12-week,prospective,multicenter,open-label post-marketing surveillance study of BNS.Brief psychiatric rating scale(BPRS)scores were calculated to evaluate the effectiveness of BNS,and its safety was assessed with the incidence of adverse drug reactions.Linear regression was used to screen the influencing factors for the reduction of BPRS total score,and logistic regression was used to identify patients with a better response to BNS.RESULTS The baseline BPRS total score(48.8±15.03)decreased to 27.7±10.08 at 12 weeks(P<0.001).Extrapyramidal symptoms(14.6%)were found to be the most frequent adverse drug reactions.The acute phase,baseline BPRS total score,current episode duration,number of previous episodes,dose of concomitant antipsychotics,and number of types of sedative-hypnotic agents were found to be independent factors affecting the reduction of BPRS total score after treatment initiation.Specifically,patients in the acute phase with baseline BPRS total score≥45,current episode duration<3 months,and≤3 previous episodes derived greater benefit from 12-week treatment with BNS.CONCLUSION Patients in the acute phase with more severe symptoms,shorter current episode duration,fewer previous episodes,and a lower psychotropic drug load derived the greatest benefit from treatment with BNS.
文摘Background:There is existing evidence on whether and to what degree regular exercise training improves the quality of life(QoL)among cancer survivors.However,in regards to patients with high-grade glioma(HGG;WHO grade III and IV),no conclusive study has been performed so far.The present trial aims to fill this gap by examining whether psychological well-being,sleep,QoL and physical fitness might be improved with two different types of exercise,as compared to an active control condition.Active control condition represent individuals participating at regular meetings to talk about their current life situation,though,the meetings were not intended as that of the psychotherapy group.Regular meetings are of the same frequency,duration,and intensity as the exercise interventions.Methods:A total of 45 patients with HGG after undergoing neurosurgery and adjuvant radiotherapy,chemotherapy,or chemoradiotherapy will be consecutively and randomly assigned to(a)an endurance training,(b)a resistance training or(c)to an active control condition.The intervention will last for 6 consecutive weeks,consisting of 2 weekly sessions(30-45 min per session).Measurements would take place at three time points,namely at the beginning of the study(baseline),3 weeks after the beginning of the study,and 6 weeks after the beginning of the study.The last measurement also represents the end of the study.Aerobic exercise performance will be assessed objectively with a 6-min walking test,and a handgrip test will be used to assess the upper body strength.Further,participants will complete a battery of questionnaires covering sociodemographic information,QoL,sleep quality and sleep patterns,coping with stress,state-and trait-anxiety,depression,and fatigue.In parallel,experts will use the Hamilton Depres-sion Rating Scale to determine and rate participants’symptoms of depression.Significance:The present study will be the first to investigate and compare the impact of two different exercise modalities,namely endurance and resistance training,on physical fitness and dimensions of well-being,and sleep among patients with HGG who underwent neurosurgery followed by adjuvant radiotherapy,chemotherapy,or chemoradiotherapy.Importantly,unlike the majority of previous studies,the control condition consists of an active set-up to detect possible factual beneficial effects of exercise training,irrespective of social interactions.
