BACKGROUND Affective disorders(AD)have been linked to inflammatory processes,although the underlying mechanisms of this relationship are still not fully elucidated.It is hypothesized that demographic,somatic,lifestyle...BACKGROUND Affective disorders(AD)have been linked to inflammatory processes,although the underlying mechanisms of this relationship are still not fully elucidated.It is hypothesized that demographic,somatic,lifestyle,and personality variables predict inflammatory parameters in AD.AIM To identify biopsychosocial factors contributing to inflammation in AD measured with two parameters,C-reactive protein(CRP)and leukocytes.METHODS This observational study investigated 186 hospital inpatients diagnosed with AD using demographic parameters,serum inflammatory markers,somatic variables,psychological questionnaires,and lifestyle parameters.Hierarchical regression analyses were used to predict inflammatory markers from demographic,somatic,lifestyle,and personality variables.RESULTS Analyses showed that 33.8%of the variance of CRP was explained by body mass index and other somatic medication(e.g.anti-diabetics),age and education,and age of affective disorder diagnosis.For leukocytes,20.1%of the variance was explained by smoking,diet,metabolic syndrome(MetS),and anti-inflammatory medication(e.g.non-steroidal anti-inflammatory drugs).Other psychiatric or behavioural variables did not reach significance.CONCLUSION Metabolic components seem important,with mounting evidence for a metabolic affective disorder subtype.Lifestyle modifications and psychoeducation should be employed to prevent or treat MetS in AD.展开更多
Objective: To assess preferences for participation in shared decision making in a representative sample of psychiatric outpatients with affective disorders and to understand how clinical and socio-demographic variable...Objective: To assess preferences for participation in shared decision making in a representative sample of psychiatric outpatients with affective disorders and to understand how clinical and socio-demographic variables influence patients’ preferences for participation. Method: A cross-sectional survey of 172 consecutive psychiatric outpatients with affective disorders attending at Community Mental Health Care setting was carried out. Patients expressed preferences on each of 3 aspects of decision making (seeking information, discussing options, making the final decision). The “CGI Severity and Improvement Scales” and the “Beck Depression Inventory” scale were used for severity assessment. Additionally the “Drug Attitude Inventory”, the “Beliefs about Medicine Questionnaire” and the “Leeds Attitude toward Concordance Scale” were applied to all participants. Effects of variables considered on preferences were assessed using proportional odds regression models. Results: We registered a high response rate of 85%. Nearly all patients (91%) preferred to leave final decisions to their treating psychiatrists and 87% preferred to rely on psychiatrists for medical knowledge rather than seeking their own information. In contrast, 81% of patients preferred to be offered options and to be asked their opinion by their doctors. Gender, age, educational level, number of psychotropics used and belief about psychiatric medication overuse were significant predictors in decision making dimensions considered. Conclusion: Shared decision making approach of patients with affective disorder must take into consideration a more doctor-directed approach preferred by the patients in which the desire to be offered options is not automatically linked with the willingness of taking decisions or getting more knowledge.展开更多
The presence of white matter hyperintensities(WMHs) has been commonly associated with poor outcome in subjects with major affective disorders. Unfortunately, WMHs may be frequently confounded by the use of psychoactiv...The presence of white matter hyperintensities(WMHs) has been commonly associated with poor outcome in subjects with major affective disorders. Unfortunately, WMHs may be frequently confounded by the use of psychoactive medications and duration of illness. Al-though findings from the current literature are quite conflicting, we proposed that subjects with WMHs may be at higher suicidal risk when compared to other sub-groups without. Based on the Fazekas modified scale, the severity of WMHs may serve as a trait marker of disease. Interestingly, the presence of WMHs may rep-resent a neurobiological marker between the underlying vulnerability and clinical presentation of major affective disorders.展开更多
Glutamate is the predominant excitatory neurotransmitter in the human brain and it has been shown that prolonged activation of the glutamatergic system leads to nerve damage and cell death. Following release from the ...Glutamate is the predominant excitatory neurotransmitter in the human brain and it has been shown that prolonged activation of the glutamatergic system leads to nerve damage and cell death. Following release from the pre-synaptic neuron and synaptic transmission, glutamate is either taken up into the presynaptic neuron or neighbouring glia by transmembrane glutamate transporters. Excitatory amino acid transporter(EAAT) 1 and EAAT2 are Na+-dependant glutamate transporters expressed predominantly in glia cells of the central nervous system. As the most abundant glutamate transporters, their primary role is to modulate levels of glutamatergic excitability and prevent spill over of glutamate beyond the synapse. This role is facilitated through the binding and transportation of glutamate into astrocytes and microglia. The function of EAAT1 and EAAT2 is heavily regulated at the levels of gene expression, post-transcriptional splicing, glycosylation states and cell-surface trafficking of the protein. Both glutamatergic dysfunction and glial dysfunction have been proposed to be involved in psychiatric disorder. This review will present an overview of the roles that EAAT1 and EAAT2 play in modulating glutamatergic activity in the human brain, and mount an argument that these two transporters could be involved in the aetiologies of schizophrenia and affective disorders as well as represent potential drug targets for novel therapies for those disorders.展开更多
Background: Positive associations between asthma and a range of mental disorders have been increasingly reported in cross-sectional studies. It is important to determine whether the association between asthma and ment...Background: Positive associations between asthma and a range of mental disorders have been increasingly reported in cross-sectional studies. It is important to determine whether the association between asthma and mental disorders may be causal. Objectives: We conducted a retrospective cohort study using data collected from the 2007 Australia Mental Health and Wellbeing survey (MHW) to examine whether preexisting asthma may predict the likelihood of various types of anxiety disorders and affective disorders. Design, Settings and Subjects: The 2007 MHW survey was a nationally representative household survey. Its data included 8841 Australian adults aged 18 - 85 yrs. Age at first onset of asthma and mental disorders were used to reveal the order of occurrence of asthma and mental disorders, and to define time at risk and asthma exposure. Kaplan-Meier failure function and multivariate Poisson regression models were employed in analysis. Results: Participants who had a history of asthma that lasted six months or more were at higher risk of panic disorder, obsessive compulsive disorder, posttraumatic stress disorder, bipolar disorder, mania and hypomania. The association between asthma history and risk of mental disorder subtypes differed by gender. Conclusion: The findings of this study support the hypothesis that pre-existing asthma increases the risk of a number of anxiety disorders and affective disorders. Predisposition to carbon dioxide hypersensitivity and corticosteroid therapy may partly explain the observed associations.展开更多
In the 1980s it was discovered that quantitative IgG titers for antibodies directed against the hu-man-obligate DNA viruses were reliably and reproducibly correlated negatively with mood in in-dividuals with major aff...In the 1980s it was discovered that quantitative IgG titers for antibodies directed against the hu-man-obligate DNA viruses were reliably and reproducibly correlated negatively with mood in in-dividuals with major affective disorders. This knowledge was lost to confirmation bias and uncontrolled studies that only looked at Epstein-Barr virus antibodies. The latter led to a long American fad of misdiagnosing major affective disorders as a “chronic Epstein-Barr virus syndrome.” This misdiagnosis even became part of the American popular culture during the 1980s. In light of fatal airline crashes intentionally caused by pilots, the antiviral IgG titers should be revisited as a means of screening pilots for current dysphoria or mania/hypomania due to major affective disorders.展开更多
BACKGROUND Lifetime psychotic symptoms are present in over half of the patients with bipolar disorder(BD)and can have an adverse effect on its course,outcome,and treatment.However,despite a considerable amount of rese...BACKGROUND Lifetime psychotic symptoms are present in over half of the patients with bipolar disorder(BD)and can have an adverse effect on its course,outcome,and treatment.However,despite a considerable amount of research,the impact of psychotic symptoms on BD remains unclear,and there are very few systematic reviews on the subject.AIM To examine the extent of psychotic symptoms in BD and their impact on several aspects of the illness.METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed.An electronic literature search of six English-language databases and a manual search was undertaken to identify published articles on psychotic symptoms in BD from January 1940 to December 2021.Combinations of the relevant Medical Subject Headings terms were used to search for these studies.Articles were selected after a screening phase,followed by a review of the full texts of the articles.Assessment of the methodological quality of the studies and the risk of bias was conducted using standard tools.RESULTS This systematic review included 339 studies of patients with BD.Lifetime psychosis was found in more than a half to two-thirds of the patients,while current psychosis was found in a little less than half of them.Delusions were more common than hallucinations in all phases of BD.About a third of the patients reported first-rank symptoms or mood-incongruent psychotic symptoms,particularly during manic episodes.Psychotic symptoms were more frequent in bipolar type I compared to bipolar type II disorder and in mania or mixed episodes compared to bipolar depression.Although psychotic symptoms were not more severe in BD,the severity of the illness in psychotic BD was consistently greater.Psychosis was usually associated with poor insight and a higher frequency of agitation,anxiety,and hostility but not with psychiatric comorbidity.Psychosis was consistently linked with increased rates and the duration of hospitalizations,switching among patients with depression,and poorer outcomes with mood-incongruent symptoms.In contrast,psychosis was less likely to be accompanied by a rapid-cycling course,longer illness duration,and heightened suicidal risk.There was no significant impact of psychosis on the other parameters of course and outcome.CONCLUSION Though psychotic symptoms are very common in BD,they are not always associated with an adverse impact on BD and its course and outcome.展开更多
BACKGROUND The subsequent waves of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic have represented a dramatic health emergency characterized by significant consequences on mental health.Diachr...BACKGROUND The subsequent waves of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic have represented a dramatic health emergency characterized by significant consequences on mental health.Diachronic variations in the incidence rates of acute relapse of psychiatric disorders may represent significant"sentinel events"for assessing the mental health response to an unprecedented stressful event.AIM To investigate the variation in psychiatric hospitalization rates and differences in sociodemographic and clinical-psychopathological peculiarities at Bologna"Maggiore"General Hospital Psychiatric Ward(GHPW)between the first two waves SARS-CoV-2 pandemic and the same periods of the previous 3 years.The secondary purpose of the study was to suggest a diachronic response pathway to stress by reporting additional literature data on coping strategies.METHODS This observational and retrospective study collected information on admission to the GHPW at the"Maggiore"Hospital in Bologna in the index periods defined as follows:the first period between February 24,2020 and April 30,2020(first epidemic wave)and the second period between October 8,2020,and January 7,2021(second pandemic wave).Absolute numbers and proportion of admitted patients,their sociodemographic and clinical-psychopathological characteristics were compared with the same parameters recorded in the two same periods of the previous 3 years.No strict inclusion or exclusion criteria were provided in the data collection to collect information on all patients requiring acute psychiatric hospitalization.RESULTS During the first wave,there was a significant reduction in hospitalization rates,although there was a simultaneous increase in compulsory hospitalizations and the acute relapse of schizophrenia spectrum and other psychotic disorders.During the second wave,hospitalization rates reached those recorded during the same period of the previous 3 years,mainly due to the rise of bipolar and related disorders,depressive disorders,anxiety disorders,trauma-and stressor-related disorders and suicidal behaviors.CONCLUSION The coping strategies adopted during the first wave of the SARS-CoV-2 pandemic protected the vulnerable population from the general risk of clinical-psychopathological acute relapse,even if they increased the susceptibility to run into schizophrenia spectrum and other psychotic disorder relapses.In the medium-long term(as in the second pandemic wave),the same strategies do not play protective roles against the stress associated with the pandemic and social restriction measures.Indeed,during the second wave of the SARS-CoV-2 pandemic,an increase in total hospitalization rate,suicidal behaviors and the incidence rate of bipolar and related disorders,depressive disorders,anxiety disorders,trauma-and stressorrelated disorders was observed.展开更多
Objective To investigate the correlative factors for organic psychotic symptoms following traumatic brain injury(TBI). Methods In the current study, 391 subjects who had undergone forensic identification of the organi...Objective To investigate the correlative factors for organic psychotic symptoms following traumatic brain injury(TBI). Methods In the current study, 391 subjects who had undergone forensic identification of the organic mental disorders due to TBI were included, both the demographic and post-traumatic information collected. The relevant data were statistically analyzed in those confirmed as organic psychotic syndrome according to Chinese Classification of Mental Disorders 3rd version(CCMD-3). Results Fifty-two subjects(13.3%) were identified as organic psychotic symptoms. The chi-square test showed that the detectable organic psychotic symptoms were associated with the marriage status, damage nature,injury severity and treatment, and the multivariate logistic regression analysis revealed good fitness of treatment and injury severity with the regression model(OR=0.044, 95% CI: 0.017-0.114; OR=2.145,95% CI: 1.201-3.832, respectively). Conclusion The risks of organic psychotic symptoms following TBI can be involved in the alternative of craniotomy for the cases with trauma and moderate brain injury.展开更多
Recently, two researches by Doucet et al. and Collin et al. used functional neuroimaging as a tool to improve the management of schizophrenia and other psychotic disorders [1, 2]. We would like to highlight several is...Recently, two researches by Doucet et al. and Collin et al. used functional neuroimaging as a tool to improve the management of schizophrenia and other psychotic disorders [1, 2]. We would like to highlight several issues in relation to cardiopulmonary comorbidity, radiomics and machine learning, and therapeutic regimens, along with their clinical implications.展开更多
Affective disorders are often accompanied by circadian rhythm disruption and the major symptoms of mental illness occur in a rhythmic manner.Chronotype,also known as circadian preference for rest or activity,is believ...Affective disorders are often accompanied by circadian rhythm disruption and the major symptoms of mental illness occur in a rhythmic manner.Chronotype,also known as circadian preference for rest or activity,is believed to exert a substantial influence on mental health.Here,we review the connection between chronotypes and affective disorders,and discuss the potential underlying mechanisms between these two phenomena.展开更多
Mood disorders/psychosis have been associated with dysfunctions in the default mode network(DMN).However,the relative contributions of DMN regions to state and trait disturbances in pediatric bipolar disorder(PBD)rema...Mood disorders/psychosis have been associated with dysfunctions in the default mode network(DMN).However,the relative contributions of DMN regions to state and trait disturbances in pediatric bipolar disorder(PBD)remain unclear.The aim of this study was to investigate the possible mechanisms of PBD through brain imaging and explore the influence of psychotic symptoms on functional alterations in PBD patients.Twenty-nine psychotic and 26 non-psychotic PBD patients,as well as 19 age-and sex-matched healthy controls underwent a restingstate functional MRI scan and the data were analyzed by independent component analysis.The DMN component from the fMRI data was extracted for each participant.Spearman's rank correlation analysis was performed between aberrant connectivity and clinical measurements.The results demonstrated that psychotic PBD was characterized by aberrant DMN connectivity in the anterior cingulate cortex/medial prefrontal cortex,bilateral caudate nucleus,bilateral angular gyri,and left middle temporal gyrus,while non-psychotic PBD was not,suggesting further impairment with the development of psychosis.In summary,we demonstrated unique impairment in DMN functional connectivity in the psychotic PBD group.These specific neuroanatomical abnormalities may shed light on the underlying pathophysiology and presentation of PBD.展开更多
文摘BACKGROUND Affective disorders(AD)have been linked to inflammatory processes,although the underlying mechanisms of this relationship are still not fully elucidated.It is hypothesized that demographic,somatic,lifestyle,and personality variables predict inflammatory parameters in AD.AIM To identify biopsychosocial factors contributing to inflammation in AD measured with two parameters,C-reactive protein(CRP)and leukocytes.METHODS This observational study investigated 186 hospital inpatients diagnosed with AD using demographic parameters,serum inflammatory markers,somatic variables,psychological questionnaires,and lifestyle parameters.Hierarchical regression analyses were used to predict inflammatory markers from demographic,somatic,lifestyle,and personality variables.RESULTS Analyses showed that 33.8%of the variance of CRP was explained by body mass index and other somatic medication(e.g.anti-diabetics),age and education,and age of affective disorder diagnosis.For leukocytes,20.1%of the variance was explained by smoking,diet,metabolic syndrome(MetS),and anti-inflammatory medication(e.g.non-steroidal anti-inflammatory drugs).Other psychiatric or behavioural variables did not reach significance.CONCLUSION Metabolic components seem important,with mounting evidence for a metabolic affective disorder subtype.Lifestyle modifications and psychoeducation should be employed to prevent or treat MetS in AD.
基金The Instituto de Salud Carlos III, FEDER Union Europea (Grant No. PI10/00955).
文摘Objective: To assess preferences for participation in shared decision making in a representative sample of psychiatric outpatients with affective disorders and to understand how clinical and socio-demographic variables influence patients’ preferences for participation. Method: A cross-sectional survey of 172 consecutive psychiatric outpatients with affective disorders attending at Community Mental Health Care setting was carried out. Patients expressed preferences on each of 3 aspects of decision making (seeking information, discussing options, making the final decision). The “CGI Severity and Improvement Scales” and the “Beck Depression Inventory” scale were used for severity assessment. Additionally the “Drug Attitude Inventory”, the “Beliefs about Medicine Questionnaire” and the “Leeds Attitude toward Concordance Scale” were applied to all participants. Effects of variables considered on preferences were assessed using proportional odds regression models. Results: We registered a high response rate of 85%. Nearly all patients (91%) preferred to leave final decisions to their treating psychiatrists and 87% preferred to rely on psychiatrists for medical knowledge rather than seeking their own information. In contrast, 81% of patients preferred to be offered options and to be asked their opinion by their doctors. Gender, age, educational level, number of psychotropics used and belief about psychiatric medication overuse were significant predictors in decision making dimensions considered. Conclusion: Shared decision making approach of patients with affective disorder must take into consideration a more doctor-directed approach preferred by the patients in which the desire to be offered options is not automatically linked with the willingness of taking decisions or getting more knowledge.
文摘The presence of white matter hyperintensities(WMHs) has been commonly associated with poor outcome in subjects with major affective disorders. Unfortunately, WMHs may be frequently confounded by the use of psychoactive medications and duration of illness. Al-though findings from the current literature are quite conflicting, we proposed that subjects with WMHs may be at higher suicidal risk when compared to other sub-groups without. Based on the Fazekas modified scale, the severity of WMHs may serve as a trait marker of disease. Interestingly, the presence of WMHs may rep-resent a neurobiological marker between the underlying vulnerability and clinical presentation of major affective disorders.
文摘Glutamate is the predominant excitatory neurotransmitter in the human brain and it has been shown that prolonged activation of the glutamatergic system leads to nerve damage and cell death. Following release from the pre-synaptic neuron and synaptic transmission, glutamate is either taken up into the presynaptic neuron or neighbouring glia by transmembrane glutamate transporters. Excitatory amino acid transporter(EAAT) 1 and EAAT2 are Na+-dependant glutamate transporters expressed predominantly in glia cells of the central nervous system. As the most abundant glutamate transporters, their primary role is to modulate levels of glutamatergic excitability and prevent spill over of glutamate beyond the synapse. This role is facilitated through the binding and transportation of glutamate into astrocytes and microglia. The function of EAAT1 and EAAT2 is heavily regulated at the levels of gene expression, post-transcriptional splicing, glycosylation states and cell-surface trafficking of the protein. Both glutamatergic dysfunction and glial dysfunction have been proposed to be involved in psychiatric disorder. This review will present an overview of the roles that EAAT1 and EAAT2 play in modulating glutamatergic activity in the human brain, and mount an argument that these two transporters could be involved in the aetiologies of schizophrenia and affective disorders as well as represent potential drug targets for novel therapies for those disorders.
文摘Background: Positive associations between asthma and a range of mental disorders have been increasingly reported in cross-sectional studies. It is important to determine whether the association between asthma and mental disorders may be causal. Objectives: We conducted a retrospective cohort study using data collected from the 2007 Australia Mental Health and Wellbeing survey (MHW) to examine whether preexisting asthma may predict the likelihood of various types of anxiety disorders and affective disorders. Design, Settings and Subjects: The 2007 MHW survey was a nationally representative household survey. Its data included 8841 Australian adults aged 18 - 85 yrs. Age at first onset of asthma and mental disorders were used to reveal the order of occurrence of asthma and mental disorders, and to define time at risk and asthma exposure. Kaplan-Meier failure function and multivariate Poisson regression models were employed in analysis. Results: Participants who had a history of asthma that lasted six months or more were at higher risk of panic disorder, obsessive compulsive disorder, posttraumatic stress disorder, bipolar disorder, mania and hypomania. The association between asthma history and risk of mental disorder subtypes differed by gender. Conclusion: The findings of this study support the hypothesis that pre-existing asthma increases the risk of a number of anxiety disorders and affective disorders. Predisposition to carbon dioxide hypersensitivity and corticosteroid therapy may partly explain the observed associations.
文摘In the 1980s it was discovered that quantitative IgG titers for antibodies directed against the hu-man-obligate DNA viruses were reliably and reproducibly correlated negatively with mood in in-dividuals with major affective disorders. This knowledge was lost to confirmation bias and uncontrolled studies that only looked at Epstein-Barr virus antibodies. The latter led to a long American fad of misdiagnosing major affective disorders as a “chronic Epstein-Barr virus syndrome.” This misdiagnosis even became part of the American popular culture during the 1980s. In light of fatal airline crashes intentionally caused by pilots, the antiviral IgG titers should be revisited as a means of screening pilots for current dysphoria or mania/hypomania due to major affective disorders.
文摘BACKGROUND Lifetime psychotic symptoms are present in over half of the patients with bipolar disorder(BD)and can have an adverse effect on its course,outcome,and treatment.However,despite a considerable amount of research,the impact of psychotic symptoms on BD remains unclear,and there are very few systematic reviews on the subject.AIM To examine the extent of psychotic symptoms in BD and their impact on several aspects of the illness.METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed.An electronic literature search of six English-language databases and a manual search was undertaken to identify published articles on psychotic symptoms in BD from January 1940 to December 2021.Combinations of the relevant Medical Subject Headings terms were used to search for these studies.Articles were selected after a screening phase,followed by a review of the full texts of the articles.Assessment of the methodological quality of the studies and the risk of bias was conducted using standard tools.RESULTS This systematic review included 339 studies of patients with BD.Lifetime psychosis was found in more than a half to two-thirds of the patients,while current psychosis was found in a little less than half of them.Delusions were more common than hallucinations in all phases of BD.About a third of the patients reported first-rank symptoms or mood-incongruent psychotic symptoms,particularly during manic episodes.Psychotic symptoms were more frequent in bipolar type I compared to bipolar type II disorder and in mania or mixed episodes compared to bipolar depression.Although psychotic symptoms were not more severe in BD,the severity of the illness in psychotic BD was consistently greater.Psychosis was usually associated with poor insight and a higher frequency of agitation,anxiety,and hostility but not with psychiatric comorbidity.Psychosis was consistently linked with increased rates and the duration of hospitalizations,switching among patients with depression,and poorer outcomes with mood-incongruent symptoms.In contrast,psychosis was less likely to be accompanied by a rapid-cycling course,longer illness duration,and heightened suicidal risk.There was no significant impact of psychosis on the other parameters of course and outcome.CONCLUSION Though psychotic symptoms are very common in BD,they are not always associated with an adverse impact on BD and its course and outcome.
文摘BACKGROUND The subsequent waves of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic have represented a dramatic health emergency characterized by significant consequences on mental health.Diachronic variations in the incidence rates of acute relapse of psychiatric disorders may represent significant"sentinel events"for assessing the mental health response to an unprecedented stressful event.AIM To investigate the variation in psychiatric hospitalization rates and differences in sociodemographic and clinical-psychopathological peculiarities at Bologna"Maggiore"General Hospital Psychiatric Ward(GHPW)between the first two waves SARS-CoV-2 pandemic and the same periods of the previous 3 years.The secondary purpose of the study was to suggest a diachronic response pathway to stress by reporting additional literature data on coping strategies.METHODS This observational and retrospective study collected information on admission to the GHPW at the"Maggiore"Hospital in Bologna in the index periods defined as follows:the first period between February 24,2020 and April 30,2020(first epidemic wave)and the second period between October 8,2020,and January 7,2021(second pandemic wave).Absolute numbers and proportion of admitted patients,their sociodemographic and clinical-psychopathological characteristics were compared with the same parameters recorded in the two same periods of the previous 3 years.No strict inclusion or exclusion criteria were provided in the data collection to collect information on all patients requiring acute psychiatric hospitalization.RESULTS During the first wave,there was a significant reduction in hospitalization rates,although there was a simultaneous increase in compulsory hospitalizations and the acute relapse of schizophrenia spectrum and other psychotic disorders.During the second wave,hospitalization rates reached those recorded during the same period of the previous 3 years,mainly due to the rise of bipolar and related disorders,depressive disorders,anxiety disorders,trauma-and stressor-related disorders and suicidal behaviors.CONCLUSION The coping strategies adopted during the first wave of the SARS-CoV-2 pandemic protected the vulnerable population from the general risk of clinical-psychopathological acute relapse,even if they increased the susceptibility to run into schizophrenia spectrum and other psychotic disorder relapses.In the medium-long term(as in the second pandemic wave),the same strategies do not play protective roles against the stress associated with the pandemic and social restriction measures.Indeed,during the second wave of the SARS-CoV-2 pandemic,an increase in total hospitalization rate,suicidal behaviors and the incidence rate of bipolar and related disorders,depressive disorders,anxiety disorders,trauma-and stressorrelated disorders was observed.
文摘Objective To investigate the correlative factors for organic psychotic symptoms following traumatic brain injury(TBI). Methods In the current study, 391 subjects who had undergone forensic identification of the organic mental disorders due to TBI were included, both the demographic and post-traumatic information collected. The relevant data were statistically analyzed in those confirmed as organic psychotic syndrome according to Chinese Classification of Mental Disorders 3rd version(CCMD-3). Results Fifty-two subjects(13.3%) were identified as organic psychotic symptoms. The chi-square test showed that the detectable organic psychotic symptoms were associated with the marriage status, damage nature,injury severity and treatment, and the multivariate logistic regression analysis revealed good fitness of treatment and injury severity with the regression model(OR=0.044, 95% CI: 0.017-0.114; OR=2.145,95% CI: 1.201-3.832, respectively). Conclusion The risks of organic psychotic symptoms following TBI can be involved in the alternative of craniotomy for the cases with trauma and moderate brain injury.
基金supported by grants from the National Natural Science Foundation of China (81801675)the Military Medical Major Program during the Thirteenth Five-Year Plan Period of China (AWS17J012)
文摘Recently, two researches by Doucet et al. and Collin et al. used functional neuroimaging as a tool to improve the management of schizophrenia and other psychotic disorders [1, 2]. We would like to highlight several issues in relation to cardiopulmonary comorbidity, radiomics and machine learning, and therapeutic regimens, along with their clinical implications.
基金supported by grants from the Natural Science Foundation of China(No.31930021,No.31671360)to Luoying ZhangChina Postdoctoral Science Foundation(No.2018M632826)to Qiang Gao.
文摘Affective disorders are often accompanied by circadian rhythm disruption and the major symptoms of mental illness occur in a rhythmic manner.Chronotype,also known as circadian preference for rest or activity,is believed to exert a substantial influence on mental health.Here,we review the connection between chronotypes and affective disorders,and discuss the potential underlying mechanisms between these two phenomena.
基金supported by National Natural Science Foundation of China (81171291, 81371531, 81571344, 81871344)the Natural Science Foundation of Jiangsu Province, China (BK20161109)+2 种基金the Key Program for Guangming Lu (BWS11J063, and 10z026)the Natural Science Foundation of the Higher Education Institutions of Jiangsu Province, China (18KJB190003)the Postdoctoral Science Foundation of China (2014M552700)
文摘Mood disorders/psychosis have been associated with dysfunctions in the default mode network(DMN).However,the relative contributions of DMN regions to state and trait disturbances in pediatric bipolar disorder(PBD)remain unclear.The aim of this study was to investigate the possible mechanisms of PBD through brain imaging and explore the influence of psychotic symptoms on functional alterations in PBD patients.Twenty-nine psychotic and 26 non-psychotic PBD patients,as well as 19 age-and sex-matched healthy controls underwent a restingstate functional MRI scan and the data were analyzed by independent component analysis.The DMN component from the fMRI data was extracted for each participant.Spearman's rank correlation analysis was performed between aberrant connectivity and clinical measurements.The results demonstrated that psychotic PBD was characterized by aberrant DMN connectivity in the anterior cingulate cortex/medial prefrontal cortex,bilateral caudate nucleus,bilateral angular gyri,and left middle temporal gyrus,while non-psychotic PBD was not,suggesting further impairment with the development of psychosis.In summary,we demonstrated unique impairment in DMN functional connectivity in the psychotic PBD group.These specific neuroanatomical abnormalities may shed light on the underlying pathophysiology and presentation of PBD.
