Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society,being mainly represented by major depressive disorder(MDD)and bipolar disorder(BD).The etiopathogenesis of mood disord...Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society,being mainly represented by major depressive disorder(MDD)and bipolar disorder(BD).The etiopathogenesis of mood disorders is extremely complex,with a wide spectrum of biological,psychological,and sociocultural factors being responsible for their appearance and development.In this sense,immune system dysfunction represents a key mechanism in the onset and pathophysiology of mood disorders,worsening mainly the central nervous system(neuroinflammation)and the periphery of the body(systemic inflammation).However,these alterations cannot be understood separately,but as part of a complex picture in which different factors and systems interact with each other.Psychoneuroimmunoendocrinology(PNIE)is the area responsible for studying the relationship between these elements and the impact of mind–body integration,placing the immune system as part of a whole.Thus,the dysfunction of the immune system is capable of influencing and activating different mechanisms that promote disruption of the psyche,damage to the nervous system,alterations to the endocrine and metabolic systems,and disruption of the microbiota and intestinal ecosystem,as well as of other organs and,in turn,all these mechanisms are responsible for inducing and enhancing the immune dysfunction.Similarly,the clinical approach to these patients is usually multidisciplinary,and the therapeutic arsenal includes different pharmacological(for example,antidepressants,antipsychotics,and lithium)and non-pharmacological(i.e.,psychotherapy,lifestyle,and electroconvulsive therapy)treatments.These interventions also modulate the immune system and other elements of the PNIE in these patients,which may be interesting to understand the therapeutic success or failure of these approaches.In this sense,this review aims to delve into the relationship between immune dysfunction and mood disorders and their integration in the complex context of PNIE.Likewise,an attempt will be made to explore the effects on the immune system of different strategies available in the clinical approach to these patients,in order to identify the mechanisms described and their possible uses as biomarkers.展开更多
AIM: To validate a multimodal [structural and functional magnetic resonance (MR)] approach as coincidence brain clusters are hypothesized to correlate with clinical severity of auditory hallucinations. METHODS: Twenty...AIM: To validate a multimodal [structural and functional magnetic resonance (MR)] approach as coincidence brain clusters are hypothesized to correlate with clinical severity of auditory hallucinations. METHODS: Twenty-two patients meeting Diagnostic and Statistical Manual of Mental Disorders (fourth edition, DSM-IV) criteria for schizophrenia and experiencing persistent hallucinations together with 28 healthy controls were evaluated with structural and functional MR imaging with an auditory paradigm designed to replicate those emotions related to the patients’ hallucinatory experiences. Coincidence maps were obtained by combining structural maps of gray matter reduction with emotional functional increased activation. Abnormal areas were correlated with the brief psychiatric rating scale (BPRS) and the psychotic symptom rating scale (PSYRATS) scales. RESULTS: The coincidence analysis showed areas with coexistence gray matter reductions and emotional activation in bilateral middle temporal and superior temporal gyri. Significant negative correlations between BPRS and PSYRATS scales were observed. BPRS scores were negatively correlated in the middle temporal gyrus (right) (t = 6.86, P = 0.001), while negative PSYRATS correlation affected regions in both the superior temporal gyrus (left) (t = 7.85, P = 0.001) and middle temporal gyrus (left) (t = 4.97, P = 0.002). CONCLUSION: Our data identify left superior and middle temporal gyri as relevant areas for the understanding of auditory hallucinations in schizophrenia. The use of multimodal approaches, sharing structural and functional information, may demonstrate areas specifically linked to the severity of auditory hallucinations.展开更多
Background: Eye-tracking has been used to investigate social perception in autism spectrum disorder (ASD) with variable results. This heterogeneity may be due to the types of stimuli used. In this study, we investigat...Background: Eye-tracking has been used to investigate social perception in autism spectrum disorder (ASD) with variable results. This heterogeneity may be due to the types of stimuli used. In this study, we investigated whether the use of moving vs static stimuli or human actors vs cartoons characters would be more sensitive in detecting gaze abnormalities and discriminating children with ASD from typically developing children. Methods: We studied 18 children with ASD (mean age = 12.9 ± 2.9) and 21 typically developing controls (mean age = 11.3 ± 2.5). Gazes were tracked using Tobii-T120 eye-tracker. Four different types of stimuli were presented: movie with human actors, cartoon movie, picture with human actors and cartoon picture. To identify the type of stimuli that best discriminate the ASD group from the control group, a two-way ANOVA was performed using ecological dimension [human-actors/cartoon] and presentation form [movie/picture] as factors. Results: Children with ASD presented significantly less fixations to eyes and faces in the movie with human actors and in the picture with human actors. Children with ASD also presented significantly more fixations to non-social backgrounds in the movie with human actors and in the cartoon movie. A significant ecological effect was observed for the reduction in fixations to the eyes [human-actors > cartoon]. A significant presentation form effect was observed for the increased fixations to the non-social background [movie > picture]. Conclusions: The direct comparison of gaze behavior across four different types of stimuli demonstrates that gaze abnormalities in ASD depend on the type of stimuli that is used. Our results suggest that general gaze abnormalities in children with ASD are better detected when using dynamic stimuli, and finer details of these abnormalities, especially looking less to the eyes, are better detected in a more ecologically relevant situation presenting human characters.展开更多
BACKGROUND Catatonia is a complex psychomotor syndrome that often goes unrecognized and untreated,even though its classification has evolved in recent years.Prompt and correct identification of catatonia allows for hi...BACKGROUND Catatonia is a complex psychomotor syndrome that often goes unrecognized and untreated,even though its classification has evolved in recent years.Prompt and correct identification of catatonia allows for highly effective treatment and prevention of possible complications.The underrecognition of catatonia in older patients is also frequent,and research in this population is scarce.AIM To conduct a systematic review of the literature on catatonia in older people to ascertain its clinical characteristics across settings.METHODS Following the PRISMA guidelines,MEDLINE,EMBASE,and PsycINFO databases were searched from inception to December 2021,with a strategy aimed at identifying all articles published on catatonia in older adults.Titles and abstracts were scanned and selected independently by two authors.Papers investigating issues related to catatonia and/or catatonic symptoms in older people,with English abstracts available,were included.References of selected articles were revised to identify other relevant studies.RESULTS In total,1355 articles were retrieved.After removing duplicates,879 remained.Of the 879 identified abstracts,669 were excluded because they did not meet the inclusion criteria.A total of 210 articles underwent full text review,and 51 were eliminated for various reasons.Fourteen more articles were selected from the references.Overall,173 articles were reviewed:108 case reports,35 case series,11 prospective cohort studies,6 case-control studies,3 retrospective cohort studies and 10 reviews.We found several particular aspects of catatonia in this population.Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology.Older patients,compared to younger patients,have a higher risk of developing catatonia with benzodiazepine(BZD)withdrawal,in bipolar disorder,and in the general hospital.Age,together with other risk factors,was significantly associated with the incidence of deep venous thrombosis,neuroleptic malignant syndrome poor outcome,other complications and mortality.Treatment with BZDs and electroconvulsive therapy is safe and effective.Prompt treatment of its cause is essential to ensure a good prognosis.CONCLUSION Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology.The risk of developing catatonia in some settings and conditions,as well as of developing complications,is high in this population.Symptomatic treatment is safe and effective,and timely etiologic treatment is fundamental.展开更多
Applications of a constitutive framework providing compound complexity analysis and indexing of coarse-grained self-similar time series representing behavioural data are presented. A notion of behavioural entropy and ...Applications of a constitutive framework providing compound complexity analysis and indexing of coarse-grained self-similar time series representing behavioural data are presented. A notion of behavioural entropy and hysteresis is introduced as two different forms of compound measures. These measures provide clinically applicable complexity analysis of behavioural patterns yielding scalar characterisation of time-varying behaviours registered over an extended period of time. The behavioural data are obtained using body attached sensors providing non-invasive readings of heart rate, skin blood perfusion, blood oxygenation, skin temperature, movement and steps frequency. The results using compound measures of behavioural patterns of fifteen healthy individuals are presented. The application of the compound measures is shown to correlate with complexity analysis. The correlation is demonstrated using two healthy subjects compared against a control group. This indicates a possibility to use these measures in place of fractional dimensions to provide a finer characterisation of behavioural patterns observed using sensory data acquired over a long period of time.展开更多
Introduction: The addiction to games of chance and money is frequently encountered among some players. The general objective of this study was to describe the level of the gambling addiction among the players of the T...Introduction: The addiction to games of chance and money is frequently encountered among some players. The general objective of this study was to describe the level of the gambling addiction among the players of the Togolese National Lottery (LONATO) in the city of Lomé. Method: This was a descriptive cross-sectional study through non-random sampling by convenience surveys, conducted on October 09, 2019 in 20 LONATO plying sites which affected 611 players. The screening was done using the South Oaks Gambling Screen (SOGS) questionnaire. Results: Of the 611 players surveyed, 55% were aged 18 to 35 years with an average age of 36 years and the extremes ranging from 14 to 78 years. The male gender was in the majority (84.26%). The prevalence of pathological gambling was 62.52%. Among the pathological gamblers, 16.89% had a family history of pathological gambling, 19.00% had a mood disorder, 28.50% had excessive alcoholism, and 17.15% consumed another psychoactive substance. Cannabis was the most consumed substance (6.87%) followed by tobacco (6.07%) and soporific (6.07%). More than half of players (62.03%) thought that pathological gambling is not a disease. Conclusion: The pathological gambling is a global phenomenon and a reality in Togo. Raising everyone’s awareness will reduce its negative impact on the players.展开更多
Objective: Little is known about the prescription pattern of psychotropic drugs for patients with schizophrenia in Pakistan. The purpose of this study was to evaluate the characteristic features of psychotropic drug p...Objective: Little is known about the prescription pattern of psychotropic drugs for patients with schizophrenia in Pakistan. The purpose of this study was to evaluate the characteristic features of psychotropic drug prescriptions for patients with schizophrenia in Pakistan. Methods: Three centers in Pakistan participated in a large scale collaborative study known as Research on Asian Prescription Pattern (REAP). The 2016 REAP survey included centers from 15 countries in Asia and used a unified research protocol. The design of the study was quantitative and of descriptive epidemiology. Analysis was made on the data collected from three centers i.e., Lahore, Karachi and Islamabad. The data collected in Pakistan were compared with those from other Asian countries. The details of REAP were presented on the homepage of REAP (http://www.REAP.Asia). Results: From Pakistan, 298 patients were included. Patients with schizophrenia in Pakistan received higher rate of antipsychotic polypharmacy and a higher rate of co-prescription of mood stabilizers and anxiolytics when compared with participants from other South Asian countries (India and Bangladesh). Conclusion: The main findings of the study were that a majority of the patients were prescribed antipsychotic polypharmacy drugs in Pakistan. Insufficient training on the use of psychotropic drugs and a lack of treatment guideline are considered to be the major contributing factors. Further education and training on the proper use of psychotropic drugs are recommended to psychiatrists in Pakistan. The guidelines on pharmacotherapy for patients with schizophrenia should also be developed and promoted in Pakistan.展开更多
基金supported by the Instituto de Salud Carlos III(EstataldeI+D+I2020-2027)co-financed by the European Development Regional Fund“A way to achieve Europe”P2022/BMD-7321(Comunidad de Madrid)and ProACapital,Halekulani S.L.and MJR.
文摘Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society,being mainly represented by major depressive disorder(MDD)and bipolar disorder(BD).The etiopathogenesis of mood disorders is extremely complex,with a wide spectrum of biological,psychological,and sociocultural factors being responsible for their appearance and development.In this sense,immune system dysfunction represents a key mechanism in the onset and pathophysiology of mood disorders,worsening mainly the central nervous system(neuroinflammation)and the periphery of the body(systemic inflammation).However,these alterations cannot be understood separately,but as part of a complex picture in which different factors and systems interact with each other.Psychoneuroimmunoendocrinology(PNIE)is the area responsible for studying the relationship between these elements and the impact of mind–body integration,placing the immune system as part of a whole.Thus,the dysfunction of the immune system is capable of influencing and activating different mechanisms that promote disruption of the psyche,damage to the nervous system,alterations to the endocrine and metabolic systems,and disruption of the microbiota and intestinal ecosystem,as well as of other organs and,in turn,all these mechanisms are responsible for inducing and enhancing the immune dysfunction.Similarly,the clinical approach to these patients is usually multidisciplinary,and the therapeutic arsenal includes different pharmacological(for example,antidepressants,antipsychotics,and lithium)and non-pharmacological(i.e.,psychotherapy,lifestyle,and electroconvulsive therapy)treatments.These interventions also modulate the immune system and other elements of the PNIE in these patients,which may be interesting to understand the therapeutic success or failure of these approaches.In this sense,this review aims to delve into the relationship between immune dysfunction and mood disorders and their integration in the complex context of PNIE.Likewise,an attempt will be made to explore the effects on the immune system of different strategies available in the clinical approach to these patients,in order to identify the mechanisms described and their possible uses as biomarkers.
文摘AIM: To validate a multimodal [structural and functional magnetic resonance (MR)] approach as coincidence brain clusters are hypothesized to correlate with clinical severity of auditory hallucinations. METHODS: Twenty-two patients meeting Diagnostic and Statistical Manual of Mental Disorders (fourth edition, DSM-IV) criteria for schizophrenia and experiencing persistent hallucinations together with 28 healthy controls were evaluated with structural and functional MR imaging with an auditory paradigm designed to replicate those emotions related to the patients’ hallucinatory experiences. Coincidence maps were obtained by combining structural maps of gray matter reduction with emotional functional increased activation. Abnormal areas were correlated with the brief psychiatric rating scale (BPRS) and the psychotic symptom rating scale (PSYRATS) scales. RESULTS: The coincidence analysis showed areas with coexistence gray matter reductions and emotional activation in bilateral middle temporal and superior temporal gyri. Significant negative correlations between BPRS and PSYRATS scales were observed. BPRS scores were negatively correlated in the middle temporal gyrus (right) (t = 6.86, P = 0.001), while negative PSYRATS correlation affected regions in both the superior temporal gyrus (left) (t = 7.85, P = 0.001) and middle temporal gyrus (left) (t = 4.97, P = 0.002). CONCLUSION: Our data identify left superior and middle temporal gyri as relevant areas for the understanding of auditory hallucinations in schizophrenia. The use of multimodal approaches, sharing structural and functional information, may demonstrate areas specifically linked to the severity of auditory hallucinations.
文摘Background: Eye-tracking has been used to investigate social perception in autism spectrum disorder (ASD) with variable results. This heterogeneity may be due to the types of stimuli used. In this study, we investigated whether the use of moving vs static stimuli or human actors vs cartoons characters would be more sensitive in detecting gaze abnormalities and discriminating children with ASD from typically developing children. Methods: We studied 18 children with ASD (mean age = 12.9 ± 2.9) and 21 typically developing controls (mean age = 11.3 ± 2.5). Gazes were tracked using Tobii-T120 eye-tracker. Four different types of stimuli were presented: movie with human actors, cartoon movie, picture with human actors and cartoon picture. To identify the type of stimuli that best discriminate the ASD group from the control group, a two-way ANOVA was performed using ecological dimension [human-actors/cartoon] and presentation form [movie/picture] as factors. Results: Children with ASD presented significantly less fixations to eyes and faces in the movie with human actors and in the picture with human actors. Children with ASD also presented significantly more fixations to non-social backgrounds in the movie with human actors and in the cartoon movie. A significant ecological effect was observed for the reduction in fixations to the eyes [human-actors > cartoon]. A significant presentation form effect was observed for the increased fixations to the non-social background [movie > picture]. Conclusions: The direct comparison of gaze behavior across four different types of stimuli demonstrates that gaze abnormalities in ASD depend on the type of stimuli that is used. Our results suggest that general gaze abnormalities in children with ASD are better detected when using dynamic stimuli, and finer details of these abnormalities, especially looking less to the eyes, are better detected in a more ecologically relevant situation presenting human characters.
文摘BACKGROUND Catatonia is a complex psychomotor syndrome that often goes unrecognized and untreated,even though its classification has evolved in recent years.Prompt and correct identification of catatonia allows for highly effective treatment and prevention of possible complications.The underrecognition of catatonia in older patients is also frequent,and research in this population is scarce.AIM To conduct a systematic review of the literature on catatonia in older people to ascertain its clinical characteristics across settings.METHODS Following the PRISMA guidelines,MEDLINE,EMBASE,and PsycINFO databases were searched from inception to December 2021,with a strategy aimed at identifying all articles published on catatonia in older adults.Titles and abstracts were scanned and selected independently by two authors.Papers investigating issues related to catatonia and/or catatonic symptoms in older people,with English abstracts available,were included.References of selected articles were revised to identify other relevant studies.RESULTS In total,1355 articles were retrieved.After removing duplicates,879 remained.Of the 879 identified abstracts,669 were excluded because they did not meet the inclusion criteria.A total of 210 articles underwent full text review,and 51 were eliminated for various reasons.Fourteen more articles were selected from the references.Overall,173 articles were reviewed:108 case reports,35 case series,11 prospective cohort studies,6 case-control studies,3 retrospective cohort studies and 10 reviews.We found several particular aspects of catatonia in this population.Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology.Older patients,compared to younger patients,have a higher risk of developing catatonia with benzodiazepine(BZD)withdrawal,in bipolar disorder,and in the general hospital.Age,together with other risk factors,was significantly associated with the incidence of deep venous thrombosis,neuroleptic malignant syndrome poor outcome,other complications and mortality.Treatment with BZDs and electroconvulsive therapy is safe and effective.Prompt treatment of its cause is essential to ensure a good prognosis.CONCLUSION Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology.The risk of developing catatonia in some settings and conditions,as well as of developing complications,is high in this population.Symptomatic treatment is safe and effective,and timely etiologic treatment is fundamental.
文摘Applications of a constitutive framework providing compound complexity analysis and indexing of coarse-grained self-similar time series representing behavioural data are presented. A notion of behavioural entropy and hysteresis is introduced as two different forms of compound measures. These measures provide clinically applicable complexity analysis of behavioural patterns yielding scalar characterisation of time-varying behaviours registered over an extended period of time. The behavioural data are obtained using body attached sensors providing non-invasive readings of heart rate, skin blood perfusion, blood oxygenation, skin temperature, movement and steps frequency. The results using compound measures of behavioural patterns of fifteen healthy individuals are presented. The application of the compound measures is shown to correlate with complexity analysis. The correlation is demonstrated using two healthy subjects compared against a control group. This indicates a possibility to use these measures in place of fractional dimensions to provide a finer characterisation of behavioural patterns observed using sensory data acquired over a long period of time.
文摘Introduction: The addiction to games of chance and money is frequently encountered among some players. The general objective of this study was to describe the level of the gambling addiction among the players of the Togolese National Lottery (LONATO) in the city of Lomé. Method: This was a descriptive cross-sectional study through non-random sampling by convenience surveys, conducted on October 09, 2019 in 20 LONATO plying sites which affected 611 players. The screening was done using the South Oaks Gambling Screen (SOGS) questionnaire. Results: Of the 611 players surveyed, 55% were aged 18 to 35 years with an average age of 36 years and the extremes ranging from 14 to 78 years. The male gender was in the majority (84.26%). The prevalence of pathological gambling was 62.52%. Among the pathological gamblers, 16.89% had a family history of pathological gambling, 19.00% had a mood disorder, 28.50% had excessive alcoholism, and 17.15% consumed another psychoactive substance. Cannabis was the most consumed substance (6.87%) followed by tobacco (6.07%) and soporific (6.07%). More than half of players (62.03%) thought that pathological gambling is not a disease. Conclusion: The pathological gambling is a global phenomenon and a reality in Togo. Raising everyone’s awareness will reduce its negative impact on the players.
文摘Objective: Little is known about the prescription pattern of psychotropic drugs for patients with schizophrenia in Pakistan. The purpose of this study was to evaluate the characteristic features of psychotropic drug prescriptions for patients with schizophrenia in Pakistan. Methods: Three centers in Pakistan participated in a large scale collaborative study known as Research on Asian Prescription Pattern (REAP). The 2016 REAP survey included centers from 15 countries in Asia and used a unified research protocol. The design of the study was quantitative and of descriptive epidemiology. Analysis was made on the data collected from three centers i.e., Lahore, Karachi and Islamabad. The data collected in Pakistan were compared with those from other Asian countries. The details of REAP were presented on the homepage of REAP (http://www.REAP.Asia). Results: From Pakistan, 298 patients were included. Patients with schizophrenia in Pakistan received higher rate of antipsychotic polypharmacy and a higher rate of co-prescription of mood stabilizers and anxiolytics when compared with participants from other South Asian countries (India and Bangladesh). Conclusion: The main findings of the study were that a majority of the patients were prescribed antipsychotic polypharmacy drugs in Pakistan. Insufficient training on the use of psychotropic drugs and a lack of treatment guideline are considered to be the major contributing factors. Further education and training on the proper use of psychotropic drugs are recommended to psychiatrists in Pakistan. The guidelines on pharmacotherapy for patients with schizophrenia should also be developed and promoted in Pakistan.
