This letter provides a concise review of the pertinent literature on visual and tactile hallucinations in elderly patients.The discussion addresses differential diagnoses and potential underlying mechanisms,as well as...This letter provides a concise review of the pertinent literature on visual and tactile hallucinations in elderly patients.The discussion addresses differential diagnoses and potential underlying mechanisms,as well as the psychopathology associated with tactile hallucinations,and emphasizes the necessity for invest-igation into the possibility of coexisting delusional infestation(parasitosis).These symptoms frequently manifest in patients with primary psychotic disorders,organic mental disorders,and substance use disorders.The proposed pathophy-siological mechanisms may involve dopaminergic imbalances and dysfunction of the striatal dopamine transporter.展开更多
Podophyllotoxin is a well-studied natural product.Because of its unique structure and ability to inhibit cancer cells,it has been changed in different ways to find out its pharmacological properties.This paper discuss...Podophyllotoxin is a well-studied natural product.Because of its unique structure and ability to inhibit cancer cells,it has been changed in different ways to find out its pharmacological properties.This paper discusses the common chemical modifications of podophyllotoxin molecules,including the C-4 and E-4 site replacements.Furthermore,its common inhibitory effects on cancer cells and antiparasitic activities,among others,are outlined by the connection between conformational changes and pharmacological activities.Importantly,Podophyllotoxin can effectively overcome the phenomenon of multidrug resistance through a dual-targeting mechanism,including inhibition of microtubule protein synthesis and topoisomerase II activity,and induces cell cycle arrest and apoptosis.Recent findings reveal its potential to modulate immune responses through the cyclic GMP-AMP synthase(cGAS)-stimulator of interferon genes(STING)pathway,further extending beyond its classical mechanisms.This study finally provides a systematic summary of the activity ofpodophyllotoxin in common cancer cells,including those in the breast,lung,and prostate.展开更多
Following an acute stroke,patients often encounter a range of impairments affecting their physical,cognitive,verbal,and social capabilities.Poststroke depression(PSD)has been identified as a significant consequence of...Following an acute stroke,patients often encounter a range of impairments affecting their physical,cognitive,verbal,and social capabilities.Poststroke depression(PSD)has been identified as a significant consequence of stroke and serves as a crucial predictor of patient outcomes.The diagnosis of PSD presents a challenge,as the physical manifestations following a stroke can overlap with certain depressive symptoms,leading to a potential underdiagnosis of this condition.This review employs a narrative approach to synthesize diverse findings within this domain.PSD is categorized as an organic mood disorder,and a more accurate diagnosis may be achieved by considering the location of the stroke,the patient's specific symptoms,and the timeline of depressive symptom onset.Notably,if depressive symptoms emerge at more than one year poststroke,the likelihood of PSD diminishes.The etiology of PSD is currently understood to stem from a combination of physiological and psychosocial factors,as well as their interactions.Several mechanisms associated with PSD have been identified,including inflammation,dysregulation of the hypothalamic-pituitary-adrenal axis,oxidative stress,autophagy,apoptosis,abnormal neurotrophic responses,glutamate-mediated excitotoxicity,dysfunction within brain networks,reduced monoamine levels,locations of brain lesions,and psychosocial influences.This review also outlines potential directions for future research.展开更多
BACKGROUND Nervonic acid(NA,C24:1,w9)is a monounsaturated fatty acid that plays a crucial role in myelination and motor function.It also regulates cognitive and metabolic functions,suggesting that impaired NA metaboli...BACKGROUND Nervonic acid(NA,C24:1,w9)is a monounsaturated fatty acid that plays a crucial role in myelination and motor function.It also regulates cognitive and metabolic functions,suggesting that impaired NA metabolism may contribute to the pathophysiology of schizophrenia.Although several studies have measured erythrocyte membrane NA in first-episode psychosis(FEP),findings are conflicting,and the fate of NA in patients with chronic schizophrenia(CSZ)or under long-term antipsychotic treatment schedules remains unknown.AIM To measure erythrocyte membrane NA and determine its association with psychopathology and metabolic parameters in drug-naive patients with FEP and antipsychotic-treated patients with CSZ.METHODS In this study,twenty-one drug-naive patients with FEP,twenty patients with CSZ treated with atypical antipsychotics,and fourteen healthy male subjects were analyzed.Erythrocyte membrane NA was measured using ultrathin capillary gas chromatography,plasma leptin was measured using enzyme-linked immunosorbent assay,and body mass index(BMI)was calculated by using the formula:Weight(kg)/height(m^(2)).Psychiatric symptoms were evaluated using the brief psychiatry rating scale and the positive and negative syndrome scale(PANSS).Pearson correlation coefficient(r)was computed to find the association between erythrocyte membrane NA,PANSS scores,plasma leptin,and BMI.RESULTS In patients with FEP,erythrocyte NA was non-significantly increased(about 12%)and negatively correlated with negative symptoms(PANSS-negative symptom scores,r=-0.4323,P=0.023)but not with positive symptoms(PANSS-positive symptom scores,r=-0.2915,P=0.09).In patients with CSZ,erythrocyte NA was reduced considerably(about 40%,P<0.001 vs FEP and about 30%vs control(CNT)subjects,P=0.037)and negatively correlated with both PANSS-negative symptom scores(r=-0.4562,P=0.013)and PANSS-positive symptom scores(r=-0.3911,P=0.041).Additionally,in patients with FEP,erythrocyte NA was not significantly correlated either with BMI(r=-0.2532,P=0.231)or plasma leptin(r=-0.3001,P=0.102).However,in patients with CSZ,it did negatively correlate with both BMI(r=-0.4721,P=0.029)and plasma leptin(r=-0.4701,P=0.031).CONCLUSION Erythrocyte membrane NA level could be used for predicting the development of metabolic abnormalities,treatment resistance,and prognosis in schizophrenia.展开更多
Insulin plays a crucial role in the metabolic priming and proliferation of neural stem cells(NSCs).However,insulin resistance(IR)is associated with impaired NSC proliferation and cognitive dysfunction,which are the ha...Insulin plays a crucial role in the metabolic priming and proliferation of neural stem cells(NSCs).However,insulin resistance(IR)is associated with impaired NSC proliferation and cognitive dysfunction,which are the hallmarks of psychiatric disorders(PDs).In addition to insulin,de novo lipogenesis(DNL)also plays an essential role in NSC proliferation and function as it supplies fatty acids for membrane phospholipid synthesis and cell signaling.However,enhanced DNL is associated with lipid/fatty acid accumulation,IR,and impaired NSC proliferation.Intriguingly,data from lipidomic studies suggest that DNL could be enhanced before the onset of classical symptoms in patients with PDs.Further,evidence suggests that patients with PDs may develop IR during childhood or before adolescence;therefore,DNL could be enhanced preceding the development of IR.Regarding treatment,while most antidepressants and antipsychotic drugs have been shown to further deteriorate IR and stimulate DNL,various adjunctive drugs/therapies,including chemical,physical,and stem cell therapy,which have shown promising success in treating PDs,reduce DNL while enhancing insulin sensitivity,NSC proliferation,and cognitive function in laboratory animals.Preliminary clinical outcomes and future prospects of these adjunctive drugs/therapies,especially stem cell therapy in treating PDs including schizophrenia and depression,are discussed.展开更多
Background Post-stroke depression(PSD)is a common neuropsychiatric problem associated with a high disease burden and reduced quality of life(QoL).To date,few studies have examined the network structure of depressive s...Background Post-stroke depression(PSD)is a common neuropsychiatric problem associated with a high disease burden and reduced quality of life(QoL).To date,few studies have examined the network structure of depressive symptoms and their relationships with QoL in stroke survivors.Aims This study aimed to explore the network structure of depressive symptoms in PSD and investigate the interrelationships between specific depressive symptoms and QoL among older stroke survivors.Methods This study was based on the 2017–2018 collection of data from a large national survey in China.Depressive symptoms were assessed using the 10-item Centre for Epidemiological Studies Depression Scale(CESD),while QoL was measured with the World Health Organization Quality of Life-brief version.Network analysis was employed to explore the structure of PSD,using expected influence(EI)to identify the most central symptoms and the flow function to investigate the association between depressive symptoms and QoL.Results A total of 1123 stroke survivors were included,with an overall prevalence of depression of 34.3%(n=385;95%confidence interval 31.5%to 37.2%).In the network model of depression,the most central symptoms were CESD3(‘feeling blue/depressed’,EI:1.180),CESD6(‘feeling nervous/fearful’,EI:0.864)and CESD8(‘loneliness’,EI:0.843).In addition,CESD5(‘hopelessness’,EI:−0.195),CESD10(‘sleep disturbances’,EI:−0.169)and CESD4(‘everything was an effort’,EI:−0.150)had strong negative associations with QoL.Conclusion This study found that PSD was common among older Chinese stroke survivors.Given its negative impact on QoL,appropriate interventions targeting central symptoms and those associated with QoL should be developed and implemented for stroke survivors with PSD.展开更多
The potential shortage of psychiatrists over the next 5 - 10 years has focused attention on the need to recruit more IMGs to fill the needs rather than use nurse practitioners or physician assistants. IMGs make up abo...The potential shortage of psychiatrists over the next 5 - 10 years has focused attention on the need to recruit more IMGs to fill the needs rather than use nurse practitioners or physician assistants. IMGs make up about 1/3 of first year psychiatry residents. These individuals have been found to provide services to the poor, the elderly and the psychotic. The quality of their medical work has been found to be satisfactory. The training needs of these physicians require an understanding on the part of their teachers that they come from cultures with different values that we have. The extended families of these primarily Asian residents clash with our strong commitment to individualism. It leads to a We-self rather than our I-Self. This difference coupled with the stress of leaving to come to a new culture is a great stress. Their exposure to psychiatry has been limited. They request and need more interview demonstration and practice, ore feedback and examinations. They should have help in accent reduction. They should be exposed to the working of the hospital by sitting on departmental and hospital committees. The faculty should extend their social opportunities and work as mentors on joint projects. Courses on the history of American culture should be taught. Psychotherapy for them should be encouraged as well as teaching medical ethics. They must become the major educational concern for the department that they are in.展开更多
Backgrounds: Mental illness is a common phenomenon at all ages. Various independent studies have shown that psychopathology is often expressed on a continuum from youth to adulthood. The aim of our study was to answer...Backgrounds: Mental illness is a common phenomenon at all ages. Various independent studies have shown that psychopathology is often expressed on a continuum from youth to adulthood. The aim of our study was to answer the question what are the problems that are likely to bring a child or an adolescent for the admission in the child and adolescent psychiatry Unit. Methods: The case records of all inpatient children and adolescents younger than 18 years, who were admitted to the child psychiatric unit at SQUH, Muscat, Sultanate of Oman over a period of 10 years between Jan 2007 and Dec 2017, were retrospectively reviewed in regard to sociodemographic data, referring specialties and reason for referral. Result: A total of 255 cases were admitted in child psychiatry unit in a period of 10 yrs, the average age was 14.15 years, 95% patients were Omani nationals, 47.5% were male, 52.5 were females, 17.65% Acute and transient psychotic disorder, 13.7% bipolar affective disorder, current episode manic without psychotic symptoms, 12.94% Intentional self-harm by other specified means and 12.55% schizophrenia, were the most common diagnoses observed in this population who needed inpatient care;the average length of stay in the majority of cases was less than 3 weeks. Conclusion: The child and adolescent inpatient unit of SQUH from where the data was collected happens to be the only child psychiatric admitting unit in Oman till the end of 2017 and can be considered as representative;the children and adolescence in-patient unit exemplifies a short-term care set-up.展开更多
Context: Exposure to burnout of staff involved with elderly patients is dependent on many factors either personal or linked to the professional environment. Social stress and systemic problems created particularly by ...Context: Exposure to burnout of staff involved with elderly patients is dependent on many factors either personal or linked to the professional environment. Social stress and systemic problems created particularly by difficulties inherent in the French hospital management system and the way people feel it, lead to a risk of burnout. One illustration of this is the rise in suicides at work. Quality of life at work, harassment and psycho-social risks are intimately linked. Affective factors, such as suffering for the medical carers in response to the distress of their patients aggravate the risk of burnout. Methods: We have evaluated these parameters using a self-filled questionnaire form sent to all staff and filled in by computer, anonymously, in 4 establishments, in December 2012 and over the first semester of 2013. After the three factors studied by the ProQOL scale of quality of life at work, to do with burnout, satisfaction compassion and fatigue compassion, 5 other questions were added, connected with a feeling of harassment and several social and demographic matters. Burnout risk was retained on reaching a threshold of 30 for this ProQOL scale item. Results: After multivariate analysis including the parameters of the Stamm scale, harassment and the socio-demographic factors studied, (age, sex, seniority, profession, and work departments) 4 factors are significantly associated with the risk of burnout, one negatively, compassion satisfaction, three positively, compassion fatigue, harassment experience and seniority. Conclusions: The risk of burnout is linked to subjective factors—the way quality of life at work is perceived and harassment experienced. Some professions, such as nurses, are particularly exposed and require these risk factors to be foreseen.展开更多
Although significant advances have been made in understanding the pathophysiology of psychiatric disorders(PDs),therapeutic advances have not been very convincing.While psychotropic medications can reduce classical sy...Although significant advances have been made in understanding the pathophysiology of psychiatric disorders(PDs),therapeutic advances have not been very convincing.While psychotropic medications can reduce classical symptoms in patients with PDs,their long-term use has been reported to induce or exaggerate various pre-existing metabolic abnormalities including diabetes,obesity and non-alcoholic fatty liver disease(NAFLD).The mechanism(s)underlying these metabolic abnormalities is not clear;however,lipid/fatty acid accumulation due to enhanced de novo lipogenesis(DNL)has been shown to reduce membrane fluidity,increase oxidative stress and inflammation leading to the development of the aforementioned metabolic abnormalities.Intriguingly,emerging evidence suggest that DNL dysregulation and fatty acid accumulation could be the major mechanisms associated with the development of obesity,diabetes and NAFLD after long-term treatment with psychotropic medications in patients with PDs.In support of this,several adjunctive drugs comprising of anti-oxidants and antiinflammatory agents,that are used in treating PDs in combination with psychotropic medications,have been shown to reduce insulin resistance and development of NAFLD.In conclusion,the above evidence suggests that DNL could be a potential pathological factor associated with various metabolic abnormalities,and a new avenue for translational research and therapeutic drug designing in PDs.展开更多
Objectives: To assess the socio-professional determinants of burnout among the medical staff of Dakar University Hospitals. The aim was to propose effective means of prevention. Material and Methods: This was a cross-...Objectives: To assess the socio-professional determinants of burnout among the medical staff of Dakar University Hospitals. The aim was to propose effective means of prevention. Material and Methods: This was a cross-sectional, descriptive, and analytical study of physicians in permanent contact with patients at the Fann and Aristide Le Dantec teaching hospitals in Dakar, Senegal. Results: A total of 159 doctors were included in the study, with a sex ratio (M/F) of 1.3 in favor of men. The prevalence of burnout was 91.8%. Burnout was significantly associated (p Conclusion: Burnout is a threat to doctors at university hospitals in Senegal. It has several determinants linked above all to work organization. It is essential to set up psychological support units in hospitals and integrate occupational medicine into various organizational processes.展开更多
Background Non-invasive brain stimulation(NIBS)techniques,such as transcranial magnetic stimulation(TMS)and transcranial direct current stimulation(tDCS),may offer an alternative treatment strategy for impulsive behav...Background Non-invasive brain stimulation(NIBS)techniques,such as transcranial magnetic stimulation(TMS)and transcranial direct current stimulation(tDCS),may offer an alternative treatment strategy for impulsive behaviour.By modulating brain activity,these techniques could potentially enhance impulse control and mitigate impulsivity.Aims To provide a comprehensive analysis of the correlation between NIBS parameters,targeted brain regions and impulsivity.Methods We systematically searched PubMed,Scopus and Embase on 5April 2023for randomised controlled trials(RCTs)of NIBS on impulsivity.Unbiased Hedges'g with 95%Cls was used to define the effect size.Cochran Qtest and12 statistics were used to assess for heterogeneity;p values inferior to 0.10 and 12>25%were considered significant for heterogeneity.Publication bias was investigated by funnel plot analysis of point estimates according to study weights,by Egger's regression test and by non-parametric rank correlation(Begg)test.Results A total of 18 studies were included,comprising 655patients from 14RCTs and four randomised crossover studies.The meta-analysis of effect sizes from 9 tDCS studies on impulsivity did not show a significant effect(g=-0.18;95%Cl-0.46 to 0.10;p=0.210)and from 9 repetitive TMS(rTMS)studies also did not yield a statistically significant effect(g=0.21;95%Cl-0.38 to 0.80;p=0.490).When analysing active tDcS using Barratt Impulsiveness Scale version 11,the scores showed a trend towards improvement with active tDcs over placebo(g=-0.54;95%Cl-0.97 to-0.12;p<0.05;12=0%).Conclusions There is currently insufficient evidence to support the clinical use of rTMS or tDCS as a means of reducing impulsivity in individuals with mental disorders.The main limitations of this study are the lack of available patient-level data,a limited number of studies,the lack of consensus on the structure of impulsivity and variability in how impulsivity is measured and conceptualised.展开更多
Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear ...Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.展开更多
Clozapine is widely recognized as an effective antipsychotic medication for treatment-resistant schizophrenia, but it is typically associated with significant weight gain. This case report presents two unusual cases o...Clozapine is widely recognized as an effective antipsychotic medication for treatment-resistant schizophrenia, but it is typically associated with significant weight gain. This case report presents two unusual cases of patients with schizophrenia who experienced substantial weight loss while on long-term clozapine therapy. The first case involves a 35-year-old male who lost 21.3% of his initial body weight, and the second case describes a 54-year-old female who lost 30.2% of her initial weight, despite having comorbid hypothyroidism. Both patients showed improvement in psychiatric symptoms concurrent with the weight loss. Comprehensive investigations did not reveal other clear etiologies for the weight reduction. These cases challenge the conventional understanding of clozapine’s metabolic effects and highlight the potential for atypical responses in some individuals. The report discusses possible mechanisms for this unusual phenomenon, including genetic factors and altered pharmacokinetics. It also emphasizes the need for individualized monitoring and management strategies in clozapine therapy. These findings contribute to the growing body of evidence suggesting that metabolic responses to clozapine may be more complex and varied than previously thought, underscoring the importance of personalized approaches in schizophrenia treatment.展开更多
TToo tthhee eeddiittoorr::Eating disorder(ED),as defined by the Diagnostic and Statistical Manual of Mental Disorders(DSM-5),is a persistent disturbance of eating or eating-related behaviour that results in the altere...TToo tthhee eeddiittoorr::Eating disorder(ED),as defined by the Diagnostic and Statistical Manual of Mental Disorders(DSM-5),is a persistent disturbance of eating or eating-related behaviour that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning.^(1)The DSM-5 outlines criteria for EDs,including anorexia nervosa,bulimia nervosa,binge-eating disorder,pica,rumination disorder and avoidant/restrictive food intake disorder.EDs are relatively common in young people,affecting 5.5%-17.9%of young women and 0.6%-2.4%of young men by the time they reach early adulthood.展开更多
Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in de...Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in depression and CPDs,promotes the establishment of emotional eating,activation of the reward system,onset of overweight and obesity and,ultimately the increased risk of developing T2D.The plausibility of the proposed pathophysiological mechanism is supported by the mechanism of action of drugs such as naltrexonebupropion currently approved for the treatment of both obesity/overweight with T2D and as separate active pharmaceutical ingredients in drug addiction,but also from initial evidence that is emerging regarding glucagon-like peptide 1 receptor agonists that appear to be effective in the treatment of drug addiction.We hope that our hypothesis may be useful in interpreting the higher prevalence of CPDs and depression in patients with T2D compared with the general population and may help refine the integrated psychiatric-diabetic therapy approach to improve the treatment and or remission of T2D.展开更多
Background Good interpersonal relationships can improve the negative mood and, to a certain extent, may help relieve dysmenorrhea symptoms. However, there has been no study examining the role of interpersonal relation...Background Good interpersonal relationships can improve the negative mood and, to a certain extent, may help relieve dysmenorrhea symptoms. However, there has been no study examining the role of interpersonal relationships in dysmenorrhea and how they may interact with negative emotions. Aims To investigate the connection between negative affect and dysmenorrhea, and the role of interpersonal relationships plays in this relationship. Methods The Cox Menstrual Symptom Scale (CMSS), short-form of Depression Anxiety Stress Scale, Interpersonal Comprehensive Diagnostic Scale and UCLA (University of California at Los Angeles) Loneliness Scale were applied to 855 adolescent nursing students to collect information on severity and frequency of dysmenorrheal symptoms, negative emotions (including depression, anxiety and stress), interpersonal problems and subjective experience of loneliness among them, and the relationship among these variables was examined. Results (1) Both the severity and frequency of dysmenorrhea were positively correlated with negative emotions, loneliness experience and interpersonal problems, while negatively correlated with age at menarche.(2) The negative emotions, romantic relationship and menarche age, but not loneliness and interpersonal problems, significantly contributed to both the severity and frequency of dysmenorrhea.(3) Mediation analysis revealed that the effects of loneliness and interpersonal problems on dysmenorrhea were totally mediated by negative emotions. Conclusions This investigation indicates that the relationship between interpersonal relationships and dysmenorrhea is mediated by negative emotions.展开更多
It is well established that various mental stress conditions contribute, or at least influence, underlying pathophysiological mechanisms in somatic, as well as in psychiatric disorders; blood platelets are supposed to...It is well established that various mental stress conditions contribute, or at least influence, underlying pathophysiological mechanisms in somatic, as well as in psychiatric disorders; blood platelets are supposed to represent a possible link in this respect. The anculeated platelets are the smallest corpuscular elements circulating in the human blood. They display different serotonergic markers which seem to reflect the central nervous serotonin metabolism. They are known as main effectors in haematological processes but recent research highlights their role in the innate and adaptive immune system. Platelets are containing a multitude of pro-inflammatory and immune-modulatory bioactive compounds in their granules and are expressing immune-competent surface markers. Research gives hint that platelets activation and reactivity is increased by mental stress. This leads to enhanced cross talk with the immune system via paracrine secretion, receptor interaction and formation of platelet leucocyteaggregates. Recently it has been demonstrated that the immune system can have a remarkable impact in the development of psychiatric disorders. Thereforeplatelets represent an interesting research area in psychiatry and their role as a possible biomarker has been investigated. We review the influence of mental stress on what is termed platelet bioactivity in this article, which subsumes the mainly immune-modulatory activity of platelets in healthy volunteers, elderly persons with chronic care-giving strain, patients with cardiovascular diseases who are prone to psychosocial stress, as well as in patients with posttraumatic stress disorder. Research data suggest that stress enhances platelet activity, reactivity and immune-modulatory capacities.展开更多
It has since long been known, from everyday experience as well as from animal and human studies, that psychological processes-both affective and cognitive- exert an influence on gastrointestinal sensorimotor function....It has since long been known, from everyday experience as well as from animal and human studies, that psychological processes-both affective and cognitive- exert an influence on gastrointestinal sensorimotor function. More specifically, a link between psychological factors and visceral hypersensitivity has been suggested, mainly based on research in functional gastrointestinal disorder patients. However, until recently, the exact nature of this putative relationship remained unclear, mainly due to a lack of non-invasive methods to study the （neurobiological） mechanisms underlying this relationship in non-sleeping humans. As functional brain imaging, introduced in visceral sensory neuroscience some 10 years ago, does provide a method for in vivo study of brain-gut interactions, insight into the neurobiological mechanisms underlying visceral sensation in general and the influence of psychological factors more particularly, has rapidly grown. In this article, an overview of brain imaging evidence on gastrointestinal sensation will be given, with special emphasis on the brain mechanisms underlying the interaction between affective ＆ cognitive processes and visceral sensation. First, the reciprocal neural pathways between the brain and the gut （brain- gut axis） will be briefly outlined, including brain imaging evidence in healthy volunteers. Second, functional brain imaging studies assessing the influence of psychological factors on brain processing of visceral sensation in healthy humans will be discussed in more detail. Finally, brain imaging work investigating differences in brain responses to visceral distension between healthy volunteers and functional gastrointestinal disorder patients will be highlighted.展开更多
文摘This letter provides a concise review of the pertinent literature on visual and tactile hallucinations in elderly patients.The discussion addresses differential diagnoses and potential underlying mechanisms,as well as the psychopathology associated with tactile hallucinations,and emphasizes the necessity for invest-igation into the possibility of coexisting delusional infestation(parasitosis).These symptoms frequently manifest in patients with primary psychotic disorders,organic mental disorders,and substance use disorders.The proposed pathophy-siological mechanisms may involve dopaminergic imbalances and dysfunction of the striatal dopamine transporter.
基金funded by FDCT grants from Macao Science and Technology University to PC(Project Code:0005-2023-RIA1)。
文摘Podophyllotoxin is a well-studied natural product.Because of its unique structure and ability to inhibit cancer cells,it has been changed in different ways to find out its pharmacological properties.This paper discusses the common chemical modifications of podophyllotoxin molecules,including the C-4 and E-4 site replacements.Furthermore,its common inhibitory effects on cancer cells and antiparasitic activities,among others,are outlined by the connection between conformational changes and pharmacological activities.Importantly,Podophyllotoxin can effectively overcome the phenomenon of multidrug resistance through a dual-targeting mechanism,including inhibition of microtubule protein synthesis and topoisomerase II activity,and induces cell cycle arrest and apoptosis.Recent findings reveal its potential to modulate immune responses through the cyclic GMP-AMP synthase(cGAS)-stimulator of interferon genes(STING)pathway,further extending beyond its classical mechanisms.This study finally provides a systematic summary of the activity ofpodophyllotoxin in common cancer cells,including those in the breast,lung,and prostate.
文摘Following an acute stroke,patients often encounter a range of impairments affecting their physical,cognitive,verbal,and social capabilities.Poststroke depression(PSD)has been identified as a significant consequence of stroke and serves as a crucial predictor of patient outcomes.The diagnosis of PSD presents a challenge,as the physical manifestations following a stroke can overlap with certain depressive symptoms,leading to a potential underdiagnosis of this condition.This review employs a narrative approach to synthesize diverse findings within this domain.PSD is categorized as an organic mood disorder,and a more accurate diagnosis may be achieved by considering the location of the stroke,the patient's specific symptoms,and the timeline of depressive symptom onset.Notably,if depressive symptoms emerge at more than one year poststroke,the likelihood of PSD diminishes.The etiology of PSD is currently understood to stem from a combination of physiological and psychosocial factors,as well as their interactions.Several mechanisms associated with PSD have been identified,including inflammation,dysregulation of the hypothalamic-pituitary-adrenal axis,oxidative stress,autophagy,apoptosis,abnormal neurotrophic responses,glutamate-mediated excitotoxicity,dysfunction within brain networks,reduced monoamine levels,locations of brain lesions,and psychosocial influences.This review also outlines potential directions for future research.
文摘BACKGROUND Nervonic acid(NA,C24:1,w9)is a monounsaturated fatty acid that plays a crucial role in myelination and motor function.It also regulates cognitive and metabolic functions,suggesting that impaired NA metabolism may contribute to the pathophysiology of schizophrenia.Although several studies have measured erythrocyte membrane NA in first-episode psychosis(FEP),findings are conflicting,and the fate of NA in patients with chronic schizophrenia(CSZ)or under long-term antipsychotic treatment schedules remains unknown.AIM To measure erythrocyte membrane NA and determine its association with psychopathology and metabolic parameters in drug-naive patients with FEP and antipsychotic-treated patients with CSZ.METHODS In this study,twenty-one drug-naive patients with FEP,twenty patients with CSZ treated with atypical antipsychotics,and fourteen healthy male subjects were analyzed.Erythrocyte membrane NA was measured using ultrathin capillary gas chromatography,plasma leptin was measured using enzyme-linked immunosorbent assay,and body mass index(BMI)was calculated by using the formula:Weight(kg)/height(m^(2)).Psychiatric symptoms were evaluated using the brief psychiatry rating scale and the positive and negative syndrome scale(PANSS).Pearson correlation coefficient(r)was computed to find the association between erythrocyte membrane NA,PANSS scores,plasma leptin,and BMI.RESULTS In patients with FEP,erythrocyte NA was non-significantly increased(about 12%)and negatively correlated with negative symptoms(PANSS-negative symptom scores,r=-0.4323,P=0.023)but not with positive symptoms(PANSS-positive symptom scores,r=-0.2915,P=0.09).In patients with CSZ,erythrocyte NA was reduced considerably(about 40%,P<0.001 vs FEP and about 30%vs control(CNT)subjects,P=0.037)and negatively correlated with both PANSS-negative symptom scores(r=-0.4562,P=0.013)and PANSS-positive symptom scores(r=-0.3911,P=0.041).Additionally,in patients with FEP,erythrocyte NA was not significantly correlated either with BMI(r=-0.2532,P=0.231)or plasma leptin(r=-0.3001,P=0.102).However,in patients with CSZ,it did negatively correlate with both BMI(r=-0.4721,P=0.029)and plasma leptin(r=-0.4701,P=0.031).CONCLUSION Erythrocyte membrane NA level could be used for predicting the development of metabolic abnormalities,treatment resistance,and prognosis in schizophrenia.
文摘Insulin plays a crucial role in the metabolic priming and proliferation of neural stem cells(NSCs).However,insulin resistance(IR)is associated with impaired NSC proliferation and cognitive dysfunction,which are the hallmarks of psychiatric disorders(PDs).In addition to insulin,de novo lipogenesis(DNL)also plays an essential role in NSC proliferation and function as it supplies fatty acids for membrane phospholipid synthesis and cell signaling.However,enhanced DNL is associated with lipid/fatty acid accumulation,IR,and impaired NSC proliferation.Intriguingly,data from lipidomic studies suggest that DNL could be enhanced before the onset of classical symptoms in patients with PDs.Further,evidence suggests that patients with PDs may develop IR during childhood or before adolescence;therefore,DNL could be enhanced preceding the development of IR.Regarding treatment,while most antidepressants and antipsychotic drugs have been shown to further deteriorate IR and stimulate DNL,various adjunctive drugs/therapies,including chemical,physical,and stem cell therapy,which have shown promising success in treating PDs,reduce DNL while enhancing insulin sensitivity,NSC proliferation,and cognitive function in laboratory animals.Preliminary clinical outcomes and future prospects of these adjunctive drugs/therapies,especially stem cell therapy in treating PDs including schizophrenia and depression,are discussed.
基金supported by Beijing High Level Public Health Technology Talent Construction Project(Discipline Backbone-01-028)the Beijing Municipal Science&Technology Commission(No.Z181100001518005)+2 种基金the Capital's Funds for Health Improvement and Research(CFH 2024-2-1174)the University of Macao(MYRG-GRG2023-00141-FHS,CPG2025-00021-FHS)the Science and Technology Plan Foundation of Guangzhou(No.202201011663).
文摘Background Post-stroke depression(PSD)is a common neuropsychiatric problem associated with a high disease burden and reduced quality of life(QoL).To date,few studies have examined the network structure of depressive symptoms and their relationships with QoL in stroke survivors.Aims This study aimed to explore the network structure of depressive symptoms in PSD and investigate the interrelationships between specific depressive symptoms and QoL among older stroke survivors.Methods This study was based on the 2017–2018 collection of data from a large national survey in China.Depressive symptoms were assessed using the 10-item Centre for Epidemiological Studies Depression Scale(CESD),while QoL was measured with the World Health Organization Quality of Life-brief version.Network analysis was employed to explore the structure of PSD,using expected influence(EI)to identify the most central symptoms and the flow function to investigate the association between depressive symptoms and QoL.Results A total of 1123 stroke survivors were included,with an overall prevalence of depression of 34.3%(n=385;95%confidence interval 31.5%to 37.2%).In the network model of depression,the most central symptoms were CESD3(‘feeling blue/depressed’,EI:1.180),CESD6(‘feeling nervous/fearful’,EI:0.864)and CESD8(‘loneliness’,EI:0.843).In addition,CESD5(‘hopelessness’,EI:−0.195),CESD10(‘sleep disturbances’,EI:−0.169)and CESD4(‘everything was an effort’,EI:−0.150)had strong negative associations with QoL.Conclusion This study found that PSD was common among older Chinese stroke survivors.Given its negative impact on QoL,appropriate interventions targeting central symptoms and those associated with QoL should be developed and implemented for stroke survivors with PSD.
文摘The potential shortage of psychiatrists over the next 5 - 10 years has focused attention on the need to recruit more IMGs to fill the needs rather than use nurse practitioners or physician assistants. IMGs make up about 1/3 of first year psychiatry residents. These individuals have been found to provide services to the poor, the elderly and the psychotic. The quality of their medical work has been found to be satisfactory. The training needs of these physicians require an understanding on the part of their teachers that they come from cultures with different values that we have. The extended families of these primarily Asian residents clash with our strong commitment to individualism. It leads to a We-self rather than our I-Self. This difference coupled with the stress of leaving to come to a new culture is a great stress. Their exposure to psychiatry has been limited. They request and need more interview demonstration and practice, ore feedback and examinations. They should have help in accent reduction. They should be exposed to the working of the hospital by sitting on departmental and hospital committees. The faculty should extend their social opportunities and work as mentors on joint projects. Courses on the history of American culture should be taught. Psychotherapy for them should be encouraged as well as teaching medical ethics. They must become the major educational concern for the department that they are in.
文摘Backgrounds: Mental illness is a common phenomenon at all ages. Various independent studies have shown that psychopathology is often expressed on a continuum from youth to adulthood. The aim of our study was to answer the question what are the problems that are likely to bring a child or an adolescent for the admission in the child and adolescent psychiatry Unit. Methods: The case records of all inpatient children and adolescents younger than 18 years, who were admitted to the child psychiatric unit at SQUH, Muscat, Sultanate of Oman over a period of 10 years between Jan 2007 and Dec 2017, were retrospectively reviewed in regard to sociodemographic data, referring specialties and reason for referral. Result: A total of 255 cases were admitted in child psychiatry unit in a period of 10 yrs, the average age was 14.15 years, 95% patients were Omani nationals, 47.5% were male, 52.5 were females, 17.65% Acute and transient psychotic disorder, 13.7% bipolar affective disorder, current episode manic without psychotic symptoms, 12.94% Intentional self-harm by other specified means and 12.55% schizophrenia, were the most common diagnoses observed in this population who needed inpatient care;the average length of stay in the majority of cases was less than 3 weeks. Conclusion: The child and adolescent inpatient unit of SQUH from where the data was collected happens to be the only child psychiatric admitting unit in Oman till the end of 2017 and can be considered as representative;the children and adolescence in-patient unit exemplifies a short-term care set-up.
文摘Context: Exposure to burnout of staff involved with elderly patients is dependent on many factors either personal or linked to the professional environment. Social stress and systemic problems created particularly by difficulties inherent in the French hospital management system and the way people feel it, lead to a risk of burnout. One illustration of this is the rise in suicides at work. Quality of life at work, harassment and psycho-social risks are intimately linked. Affective factors, such as suffering for the medical carers in response to the distress of their patients aggravate the risk of burnout. Methods: We have evaluated these parameters using a self-filled questionnaire form sent to all staff and filled in by computer, anonymously, in 4 establishments, in December 2012 and over the first semester of 2013. After the three factors studied by the ProQOL scale of quality of life at work, to do with burnout, satisfaction compassion and fatigue compassion, 5 other questions were added, connected with a feeling of harassment and several social and demographic matters. Burnout risk was retained on reaching a threshold of 30 for this ProQOL scale item. Results: After multivariate analysis including the parameters of the Stamm scale, harassment and the socio-demographic factors studied, (age, sex, seniority, profession, and work departments) 4 factors are significantly associated with the risk of burnout, one negatively, compassion satisfaction, three positively, compassion fatigue, harassment experience and seniority. Conclusions: The risk of burnout is linked to subjective factors—the way quality of life at work is perceived and harassment experienced. Some professions, such as nurses, are particularly exposed and require these risk factors to be foreseen.
文摘Although significant advances have been made in understanding the pathophysiology of psychiatric disorders(PDs),therapeutic advances have not been very convincing.While psychotropic medications can reduce classical symptoms in patients with PDs,their long-term use has been reported to induce or exaggerate various pre-existing metabolic abnormalities including diabetes,obesity and non-alcoholic fatty liver disease(NAFLD).The mechanism(s)underlying these metabolic abnormalities is not clear;however,lipid/fatty acid accumulation due to enhanced de novo lipogenesis(DNL)has been shown to reduce membrane fluidity,increase oxidative stress and inflammation leading to the development of the aforementioned metabolic abnormalities.Intriguingly,emerging evidence suggest that DNL dysregulation and fatty acid accumulation could be the major mechanisms associated with the development of obesity,diabetes and NAFLD after long-term treatment with psychotropic medications in patients with PDs.In support of this,several adjunctive drugs comprising of anti-oxidants and antiinflammatory agents,that are used in treating PDs in combination with psychotropic medications,have been shown to reduce insulin resistance and development of NAFLD.In conclusion,the above evidence suggests that DNL could be a potential pathological factor associated with various metabolic abnormalities,and a new avenue for translational research and therapeutic drug designing in PDs.
文摘Objectives: To assess the socio-professional determinants of burnout among the medical staff of Dakar University Hospitals. The aim was to propose effective means of prevention. Material and Methods: This was a cross-sectional, descriptive, and analytical study of physicians in permanent contact with patients at the Fann and Aristide Le Dantec teaching hospitals in Dakar, Senegal. Results: A total of 159 doctors were included in the study, with a sex ratio (M/F) of 1.3 in favor of men. The prevalence of burnout was 91.8%. Burnout was significantly associated (p Conclusion: Burnout is a threat to doctors at university hospitals in Senegal. It has several determinants linked above all to work organization. It is essential to set up psychological support units in hospitals and integrate occupational medicine into various organizational processes.
文摘Background Non-invasive brain stimulation(NIBS)techniques,such as transcranial magnetic stimulation(TMS)and transcranial direct current stimulation(tDCS),may offer an alternative treatment strategy for impulsive behaviour.By modulating brain activity,these techniques could potentially enhance impulse control and mitigate impulsivity.Aims To provide a comprehensive analysis of the correlation between NIBS parameters,targeted brain regions and impulsivity.Methods We systematically searched PubMed,Scopus and Embase on 5April 2023for randomised controlled trials(RCTs)of NIBS on impulsivity.Unbiased Hedges'g with 95%Cls was used to define the effect size.Cochran Qtest and12 statistics were used to assess for heterogeneity;p values inferior to 0.10 and 12>25%were considered significant for heterogeneity.Publication bias was investigated by funnel plot analysis of point estimates according to study weights,by Egger's regression test and by non-parametric rank correlation(Begg)test.Results A total of 18 studies were included,comprising 655patients from 14RCTs and four randomised crossover studies.The meta-analysis of effect sizes from 9 tDCS studies on impulsivity did not show a significant effect(g=-0.18;95%Cl-0.46 to 0.10;p=0.210)and from 9 repetitive TMS(rTMS)studies also did not yield a statistically significant effect(g=0.21;95%Cl-0.38 to 0.80;p=0.490).When analysing active tDcS using Barratt Impulsiveness Scale version 11,the scores showed a trend towards improvement with active tDcs over placebo(g=-0.54;95%Cl-0.97 to-0.12;p<0.05;12=0%).Conclusions There is currently insufficient evidence to support the clinical use of rTMS or tDCS as a means of reducing impulsivity in individuals with mental disorders.The main limitations of this study are the lack of available patient-level data,a limited number of studies,the lack of consensus on the structure of impulsivity and variability in how impulsivity is measured and conceptualised.
文摘Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.
文摘Clozapine is widely recognized as an effective antipsychotic medication for treatment-resistant schizophrenia, but it is typically associated with significant weight gain. This case report presents two unusual cases of patients with schizophrenia who experienced substantial weight loss while on long-term clozapine therapy. The first case involves a 35-year-old male who lost 21.3% of his initial body weight, and the second case describes a 54-year-old female who lost 30.2% of her initial weight, despite having comorbid hypothyroidism. Both patients showed improvement in psychiatric symptoms concurrent with the weight loss. Comprehensive investigations did not reveal other clear etiologies for the weight reduction. These cases challenge the conventional understanding of clozapine’s metabolic effects and highlight the potential for atypical responses in some individuals. The report discusses possible mechanisms for this unusual phenomenon, including genetic factors and altered pharmacokinetics. It also emphasizes the need for individualized monitoring and management strategies in clozapine therapy. These findings contribute to the growing body of evidence suggesting that metabolic responses to clozapine may be more complex and varied than previously thought, underscoring the importance of personalized approaches in schizophrenia treatment.
基金Funding Effort for some personnel was supported by grants K12 DA041449(KYX,PI:Laura Bierut,Patricia Cavazos-Rehg),and the American Psychiatric Association Psychiatric Research Fellowship(KYX).Authors BYL and C-FS were American Psychiatric Association(APA)/APA Foundation(APAF)fellows at the time of publication.Research grant funding received from Gilead Pharmaceuticals,Liva Nova Therapeutics,Curemark and Alto Neuroscience(ASK).
文摘TToo tthhee eeddiittoorr::Eating disorder(ED),as defined by the Diagnostic and Statistical Manual of Mental Disorders(DSM-5),is a persistent disturbance of eating or eating-related behaviour that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning.^(1)The DSM-5 outlines criteria for EDs,including anorexia nervosa,bulimia nervosa,binge-eating disorder,pica,rumination disorder and avoidant/restrictive food intake disorder.EDs are relatively common in young people,affecting 5.5%-17.9%of young women and 0.6%-2.4%of young men by the time they reach early adulthood.
文摘Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in depression and CPDs,promotes the establishment of emotional eating,activation of the reward system,onset of overweight and obesity and,ultimately the increased risk of developing T2D.The plausibility of the proposed pathophysiological mechanism is supported by the mechanism of action of drugs such as naltrexonebupropion currently approved for the treatment of both obesity/overweight with T2D and as separate active pharmaceutical ingredients in drug addiction,but also from initial evidence that is emerging regarding glucagon-like peptide 1 receptor agonists that appear to be effective in the treatment of drug addiction.We hope that our hypothesis may be useful in interpreting the higher prevalence of CPDs and depression in patients with T2D compared with the general population and may help refine the integrated psychiatric-diabetic therapy approach to improve the treatment and or remission of T2D.
基金the Sichuan Provincial Science and Technology Department (2017JY0324)Joint Project of Southwest Medical University and Sichuan Luzhou (2017LZXNYD-Z02)+3 种基金Natural Science Foundation of China (81701322)Humanity and Social Science Youth Foundation of Ministry of Education of China (17YJC190001,17YJC190009)the joint project of Southwest Medical University & Affiliated Hospital of Southwest Medical University (2015-QB-003)Sichuan Applied Psychology Research Center Project (CSXL-172012).
文摘Background Good interpersonal relationships can improve the negative mood and, to a certain extent, may help relieve dysmenorrhea symptoms. However, there has been no study examining the role of interpersonal relationships in dysmenorrhea and how they may interact with negative emotions. Aims To investigate the connection between negative affect and dysmenorrhea, and the role of interpersonal relationships plays in this relationship. Methods The Cox Menstrual Symptom Scale (CMSS), short-form of Depression Anxiety Stress Scale, Interpersonal Comprehensive Diagnostic Scale and UCLA (University of California at Los Angeles) Loneliness Scale were applied to 855 adolescent nursing students to collect information on severity and frequency of dysmenorrheal symptoms, negative emotions (including depression, anxiety and stress), interpersonal problems and subjective experience of loneliness among them, and the relationship among these variables was examined. Results (1) Both the severity and frequency of dysmenorrhea were positively correlated with negative emotions, loneliness experience and interpersonal problems, while negatively correlated with age at menarche.(2) The negative emotions, romantic relationship and menarche age, but not loneliness and interpersonal problems, significantly contributed to both the severity and frequency of dysmenorrhea.(3) Mediation analysis revealed that the effects of loneliness and interpersonal problems on dysmenorrhea were totally mediated by negative emotions. Conclusions This investigation indicates that the relationship between interpersonal relationships and dysmenorrhea is mediated by negative emotions.
文摘It is well established that various mental stress conditions contribute, or at least influence, underlying pathophysiological mechanisms in somatic, as well as in psychiatric disorders; blood platelets are supposed to represent a possible link in this respect. The anculeated platelets are the smallest corpuscular elements circulating in the human blood. They display different serotonergic markers which seem to reflect the central nervous serotonin metabolism. They are known as main effectors in haematological processes but recent research highlights their role in the innate and adaptive immune system. Platelets are containing a multitude of pro-inflammatory and immune-modulatory bioactive compounds in their granules and are expressing immune-competent surface markers. Research gives hint that platelets activation and reactivity is increased by mental stress. This leads to enhanced cross talk with the immune system via paracrine secretion, receptor interaction and formation of platelet leucocyteaggregates. Recently it has been demonstrated that the immune system can have a remarkable impact in the development of psychiatric disorders. Thereforeplatelets represent an interesting research area in psychiatry and their role as a possible biomarker has been investigated. We review the influence of mental stress on what is termed platelet bioactivity in this article, which subsumes the mainly immune-modulatory activity of platelets in healthy volunteers, elderly persons with chronic care-giving strain, patients with cardiovascular diseases who are prone to psychosocial stress, as well as in patients with posttraumatic stress disorder. Research data suggest that stress enhances platelet activity, reactivity and immune-modulatory capacities.
文摘It has since long been known, from everyday experience as well as from animal and human studies, that psychological processes-both affective and cognitive- exert an influence on gastrointestinal sensorimotor function. More specifically, a link between psychological factors and visceral hypersensitivity has been suggested, mainly based on research in functional gastrointestinal disorder patients. However, until recently, the exact nature of this putative relationship remained unclear, mainly due to a lack of non-invasive methods to study the （neurobiological） mechanisms underlying this relationship in non-sleeping humans. As functional brain imaging, introduced in visceral sensory neuroscience some 10 years ago, does provide a method for in vivo study of brain-gut interactions, insight into the neurobiological mechanisms underlying visceral sensation in general and the influence of psychological factors more particularly, has rapidly grown. In this article, an overview of brain imaging evidence on gastrointestinal sensation will be given, with special emphasis on the brain mechanisms underlying the interaction between affective ＆ cognitive processes and visceral sensation. First, the reciprocal neural pathways between the brain and the gut （brain- gut axis） will be briefly outlined, including brain imaging evidence in healthy volunteers. Second, functional brain imaging studies assessing the influence of psychological factors on brain processing of visceral sensation in healthy humans will be discussed in more detail. Finally, brain imaging work investigating differences in brain responses to visceral distension between healthy volunteers and functional gastrointestinal disorder patients will be highlighted.
