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The Primary Care Companion For CNS... Jun 2024To review the literature on the neurobiological mechanisms of obsessive-compulsive symptoms (OCS) in people with dementia. MEDLINE/PubMed, CENTRAL, and PsycNet... (Review)
Review
To review the literature on the neurobiological mechanisms of obsessive-compulsive symptoms (OCS) in people with dementia. MEDLINE/PubMed, CENTRAL, and PsycNet databases were searched from inception to March 2023. Original studies of any methodology with newly published data on the neurobiological underpinnings of OCS in patients with dementia, regardless of patient age or comorbidity and publication year, were included. The following search terms were used: (Obses* OR compul* OR OCD) AND (cognitive de* OR cognitive dysfunction OR cognitive disfunction OR dementia). Individual study data were extracted onto a piloted extractions sheet. Patients with dementia and OCS were reported to have atrophy and hypoperfusion of frontal, temporal, striatal, and limbic structures. Serotonergic agents may be efficacious in reducing OCS. One randomized controlled trial of paroxetine in behavioral symptoms of dementia did not show efficacy. Evidence of dopaminergic dysfunction is too sparse to draw conclusions. Microglia dysfunction mediates obsessive-compulsive-like symptoms. Mutations of microtubule-associated protein τ may increase the risk of OCS. Cognitive self-consciousness and obsessive-compulsive-related cognitions may mediate OCS in old age. Dysfunction of the processing of one class of stimuli may increase the salience of other classes of stimuli, leading to OCS. Frontal lobe hypometabolism and temporal lobe atrophy and hypometabolism are unexpected given previous research in obsessive compulsive disorder. Serotonergic agents have encouraging efficacy in case reports but require more specific research. .
Topics: Humans; Obsessive-Compulsive Disorder; Dementia
PubMed: 38905511
DOI: 10.4088/PCC.23r03689 -
Medicine Jun 2024To assess stress levels and life hardships of patients with phenylketonuria and their parents. Between January 2020 and June 2020, 156 patients with PKU and their...
To assess stress levels and life hardships of patients with phenylketonuria and their parents. Between January 2020 and June 2020, 156 patients with PKU and their parents who arrived for regular examinations were included. Parents were asked to complete the parenting stress index, Zarit Burden Scale, and the Strengths and Difficulties Questionnaire (SDQ), and children over the age of 11 were asked to fill the Rosenberg Self-Esteem Scale, the State-Trait Anxiety Inventory, and the SDQ. We found a significant negative correlation between the Rosenberg Self-Esteem Scale and age at diagnosis (r = -0.27, P = .035), mother's age (r = -0.33, P = .009), and father's age (r = -0.38, P = .004). There was a significant positive correlation between the State-Trait Anxiety Inventory and patient's age (r = 0.36, P = .006), mother's age (r = 0.29, P = .031) and father's age (r = 0.38, P = .024). In the child form of the SDQ, emotional problems were significantly positively correlated with serum phenylalanine (Phe) levels at diagnosis (r = 0.35, P = .036), total points were significantly positively correlated with serum Phe levels at clinical examination (r = -0.34, P = .004), and social problems were significantly negatively correlated with the father's age (r = -0.34, P = .047). We found a significant positive correlation between the Zarit Burden Scale and number of siblings (r = 0.195, P = .023). In the parent form of the SDQ, emotional problems were significantly positively correlated with patient age (r = 0.217, P = .032), peer problems were significantly positively correlated with age at diagnosis (r = 0.211, P = .037), behavioral problems (r = 0.203, P = .045), and attention deficit and hyperactivity (r = 0.203, P = .045) were significantly positively correlated with serum Phe levels at diagnosis. Phenylketonuria is difficult to cope with both for the patients and their parents because of diet obligation, high expenditures for the formulas required for the diet, requirement of regular clinical examinations, and possible development of mental disability and psychiatric disorders. Patients and their families should be psychologically evaluated and support should be provided if needed.
Topics: Humans; Phenylketonurias; Female; Male; Child; Stress, Psychological; Adult; Caregivers; Adolescent; Parents; Anxiety; Child, Preschool; Phenylalanine; Surveys and Questionnaires; Self Concept; Young Adult; Middle Aged
PubMed: 38905389
DOI: 10.1097/MD.0000000000038678 -
Medicine Jun 2024Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects approximately 8% to 13% of women of reproductive age worldwide. It is characterized by a... (Review)
Review
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects approximately 8% to 13% of women of reproductive age worldwide. It is characterized by a range of symptoms, including hirsutism, acne, and menstrual irregularities, and poses a significant psychological burden, including anxiety and depression. The evolving definition of PCOS, from the 1990 NIH conference to the 2003 Rotterdam conference, highlights its multifaceted nature, encompassing metabolic, reproductive, and psychological aspects. This overview aims to elucidate the complex interplay between PCOS's physiological and psychological dimensions. It focuses on understanding the heightened risk of psychiatric disorders, including depression and anxiety, among women with PCOS and explores the contributing factors, such as obesity, body image issues, and stress. The etiology of PCOS involves a complex mixture of genetic, hormonal, and lifestyle factors that contribute to its pathophysiology and the associated mental health challenges. Stress, in various forms, including metabolic, inflammatory, oxidative, and emotional, is identified as a significant contributor to the pathogenesis of PCOS. Management strategies highlighted include lifestyle modifications, dietary and exercise interventions, and psychological therapies, underscoring the need for comprehensive and integrated care approaches that address the broad spectrum of PCOS effects. A multifaceted treatment approach that goes beyond just the physical symptoms of PCOS to also include its significant psychological effects is emphasized, reinforcing the necessity for a comprehensive, integrated care strategy to manage this complex condition effectively.
Topics: Humans; Polycystic Ovary Syndrome; Female; Mental Health; Stress, Psychological; Women's Health; Depression; Anxiety; Obesity; Life Style
PubMed: 38905372
DOI: 10.1097/MD.0000000000038647 -
PloS One 2024Advances have been made in understanding the aetiology of functional neurological disorder (FND); however, its pathophysiological mechanisms have not been definitively...
INTRODUCTION
Advances have been made in understanding the aetiology of functional neurological disorder (FND); however, its pathophysiological mechanisms have not been definitively demonstrated. Evidence suggests interacting roles for altered emotional processing and interoception, elevated autonomic arousal, and dissociation, but there is limited evidence demonstrating their causal influence on specific FND symptoms. Our superordinate aim is to elucidate potentially shared and distinct aetiological factors and mechanisms in two common FND subtypes, functional seizures (FS) and functional motor symptoms (FMS).
METHODS
This study has a multimodal, mixed between- and within-groups design. The target sample is 50 individuals with FS, 50 with FMS, 50 clinical controls (anxiety/depression), and 50 healthy controls. Potential aetiological factors (e.g., adverse life events, physical/mental health symptoms, dissociative tendencies, interoceptive insight/sensibility) will be assessed with a detailed medical history interview and self-report questionnaires. A laboratory session will include a neurocognitive battery, psychophysiological testing, cardiac interoception and time estimation tasks and an isometric handgrip task. A subsample will undergo magnetic resonance imaging, including structural, resting-state and task-based scans combined with psychophysiological recording. Remote monitoring with ecological momentary assessment and wearables will measure variability in FND symptoms and their potential predictors/correlates for ≥2 weeks in patients' daily lives. Longitudinal follow-ups at 3, 6, and 12-months will monitor longer-term outcomes in the clinical groups.
DISCUSSION
This study employs multimodal research methods to rigorously examine several putative mechanisms in FND, at subjective/experiential, behavioural, and physiological levels. The study will test causal hypotheses about the role of altered emotional processing, autonomic arousal, dissociation and interoception in the initiation or exacerbation of FND symptoms, directly comparing these processes in FS and FMS to healthy and clinical controls. This is the first study of its kind, with potential to reveal important targets for prevention and treatment of FND in future.
Topics: Humans; Seizures; Adult; Male; Female; Middle Aged; Magnetic Resonance Imaging; Young Adult; Interoception; Adolescent; Case-Control Studies
PubMed: 38905248
DOI: 10.1371/journal.pone.0305015 -
Discover Mental Health Jun 2024Community Mental Health Centers (CMHCs) offer affordable mental health services in a less stigmatized environment, in a domiciliary setting. This study aimed to shed...
BACKGROUND
Community Mental Health Centers (CMHCs) offer affordable mental health services in a less stigmatized environment, in a domiciliary setting. This study aimed to shed light on the epidemiological factors of patients attending CMHCs of Mashhad, their referral status, and treatment.
METHODS
This study was conducted over the medical records of patients seen by psychiatrists between January 2014 and December 2021 in Mashhad's CMHC, the northeast of Iran. A detailed questionnaire was used to extract data from medical records about the epidemiological characteristics, diagnosed mental illnesses, referral status, and how often they visited the psychiatrist. The association between epidemiological findings and patient referral (referral system or self-referral) as well as the association between epidemiological findings and the number of psychiatric revisits were examined using the Chi-square test.
RESULTS
Out of 662 patients, 472 (71%) were female and 190 (29%) were male, with an average age of 29 years. Among the 475 adult patients, 367 (77.3%) were married, with the majority being homemakers (56.4%). Major Depression Disorder (MDD) (32%) and Generalized Anxiety Disorder (GAD) (18.3%) were the most prevalent mental health conditions among patients. The majority of patients (74.9%) were referred to the CMHC of Mashhad from Primary Healthcare centers (PHCs) and psychiatric hospitals. Furthermore, female gender and patients with lower level of education were associated with more referral through from referral system. Of note, 431 patients (65.1%) did not return for a second visit, the ratio of treatment dropout was higher for patients with lower education levels.
CONCLUSIONS
Referral system should be more practical in Iran to enhance health services in CMHCs. It is recommended that PHCs undergo certain modifications to enhance the referral process for patients with mental health conditions, focusing on common mental disorders and individuals with low socioeconomic level.
PubMed: 38904905
DOI: 10.1007/s44192-024-00078-1 -
Noise & HealthThis study aimed to evaluate the management effect of music therapy on the psychological health of patients undergoing maintenance hemodialysis (MHD), with focus on...
OBJECTIVE
This study aimed to evaluate the management effect of music therapy on the psychological health of patients undergoing maintenance hemodialysis (MHD), with focus on improving levels of depression, anxiety and stress.
METHODS
A retrospective analysis of clinical data was conducted for 218 patients with sleep disorders accompanied by hemodialysis (HD) from January 2020 to December 2023. The subjects were categorized into a control group comprising 122 cases and an observational group comprising 96 cases. The observation group received music therapy in addition to routine management for 3 months. The psychological health status of patients was assessed using the Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), and Hemodialysis Stressor Scale (HSS), among other indicators. t Tests, χ2 test and Wilcoxon test were performed.
RESULTS
After 3 months, the SDS and SAS scores of the observation group were significantly lower than those of the control group (P < 0.05). The scores for the "psychological stressors," "physiological stressors" and "social stressors" dimensions of HSS were also significantly lower in the observation group compared with those in the control group (P < 0.05). The overall satisfaction rate of the observation group was significantly higher than that of the control group (96.88% vs. 88.52%, P = 0.022).
CONCLUSION
Music therapy exerted a positive effect on improving the psychological health of HD patients, particularly in reducing stress levels. This study provides clinical evidence for music therapy as a low-cost and effective adjunctive treatment.
Topics: Humans; Music Therapy; Renal Dialysis; Male; Retrospective Studies; Female; Middle Aged; Stress, Psychological; Anxiety; Depression; Adult; Aged; Sleep Wake Disorders; Psychological Well-Being
PubMed: 38904822
DOI: 10.4103/nah.nah_56_24 -
Noise & HealthNoise sensitivity results from a series of variables and processes, and it can be used to predict the annoyance caused by noise and health-related outcomes. This study...
BACKGROUND
Noise sensitivity results from a series of variables and processes, and it can be used to predict the annoyance caused by noise and health-related outcomes. This study aimed to compare the noise sensitivity between cataract patients and healthy subjects and explore the effect of high noise sensitivity on cataract patients.
METHODS
A retrospective analysis was conducted on the clinical data of 100 cataract patients and 78 healthy subjects who underwent physical examination in Jiaozhou Central Hospital of Qingdao from February 2020 to February 2023. Noise sensitivity was evaluated by adopting the 8-Item Weinstein Noise Sensitivity Scale (WNSS-8). Comparisons were conducted on the psychological state scores, blood pressure (BP), and heart rate (HR) of the high- (HG) and low-noise-sensitivity (LG) groups.
RESULTS
Cataract patients exhibited lower visual acuity (P < 0.001) and higher WNSS-8 scores than the healthy subjects (P < 0.05). On the basis of the median of WNSS-8, the cataract patients were divided into HG (n = 42) and LG (n = 58). Compared with the LG, the HG presented higher Generalized Anxiety Disorder-7 scores, Beck Depression Inventory scores, systolic BP, diastolic BP and HR (P < 0.05).
CONCLUSIONS
High noise sensitivity in cataract patients may be associated with vision disorders, and it may affect their BP and HR and damage physical and mental health.
Topics: Humans; Cataract; Male; Retrospective Studies; Female; Middle Aged; Aged; Noise; Heart Rate; Blood Pressure; Visual Acuity; Case-Control Studies; Adult
PubMed: 38904820
DOI: 10.4103/nah.nah_46_24 -
Eating and Weight Disorders : EWD Jun 2024Although insecure attachment and interpersonal problems have been acknowledged as risk and maintaining factors of eating disorders (EDs), the mediating role of...
PURPOSE
Although insecure attachment and interpersonal problems have been acknowledged as risk and maintaining factors of eating disorders (EDs), the mediating role of interpersonal problems between attachment style and ED psychopathology has been poorly explored. The purpose of this study was to investigate the mediating role of interpersonal problems between insecure attachment and ED psychopathology.
METHODS
One-hundred-nine women with anorexia nervosa and 157 women with bulimia nervosa filled in the Eating Disorder Inventory-2 (EDI-2) and the Experiences in Close Relationships (ECR) revised scale to assess ED core symptoms and attachment styles, respectively. Interpersonal difficulties were evaluated by the Inventory of Interpersonal Problems (IIP-32). A mediator's path model was conducted with anxious and avoidant attachment subscores as independent variables, ED core symptoms as dependent variables and interpersonal difficulties as mediators. The diagnosis was entered in the model as a confounding factor.
RESULTS
The socially inhibited/avoidant interpersonal dimension was a mediator between avoidant attachment and the drive to thinness as well as between avoidant attachment and body dissatisfaction. An indirect connection was found between attachment-related anxiety and bulimic symptoms through the mediation of intrusive/needy score.
CONCLUSIONS
Social avoidance and intrusiveness mediate the relationships between avoidant and anxious attachment styles and ED psychopathology. These interpersonal problems may represent specific targets for psychotherapeutic treatments in individuals with EDs and insecure attachment.
LEVEL OF EVIDENCE
Level III: Evidence obtained from well-designed cohort or case-control analytic studies.
Topics: Humans; Female; Adult; Object Attachment; Interpersonal Relations; Young Adult; Feeding and Eating Disorders; Adolescent; Anorexia Nervosa; Bulimia Nervosa; Anxiety
PubMed: 38904743
DOI: 10.1007/s40519-024-01673-5 -
BMJ Open Jun 2024Mental health problems after discharge from the intensive care unit (ICU) interfere with physical recovery and seriously affect daily life. Social support has been...
OBJECTIVES
Mental health problems after discharge from the intensive care unit (ICU) interfere with physical recovery and seriously affect daily life. Social support has been suggested to be associated with mental health but has not been sufficiently characterised. This study aimed to evaluate the association of social support before ICU admission with mental health after ICU discharge.
DESIGN
Prospective cohort study.
SETTING
Medical-surgical ICU of a hospital in Japan.
PARTICIPANTS
Patients admitted to the ICU for more than 48 hours were surveyed on social support prior to ICU admission, and 3 months after discharge from the ICU, mental health questionnaires were mailed to the patient.
PRIMARY OUTCOME MEASURES
Post-traumatic stress disorder (PTSD)-related symptoms were measured using the Impact of Event Scale-Revised, and anxiety and depressive symptoms were measured using the Hospital Anxiety and Depression Scale.
RESULTS
A total of 153 patients were enrolled; the prevalence of PTSD-related symptoms, anxiety and depressive symptoms 3 months after discharge from the ICU was 11.3%, 14.0% and 24.6%, respectively. Multivariate analysis using linear regression models adjusted for age, sex and years of education for PTSD-related symptoms, anxiety and depressive symptoms revealed that social support (β=-0.018, 95% CI: -0.029 to 0.006, p=0.002) and female sex (β=0.268, 95% CI: 0.005 to 0.531, p=0.046) were independent factors associated with the severity of depressive symptoms. In addition, sex differences were observed in the association between depressive symptoms and social support (p for interaction=0.056).
CONCLUSIONS
Higher social support before ICU admission was not associated with PTSD symptoms after ICU discharge, although it may be associated with a lower prevalence depressive symptoms after ICU discharge. Therefore, it is important to provide necessary social support when needed.
Topics: Humans; Social Support; Female; Male; Prospective Studies; Intensive Care Units; Japan; Patient Discharge; Middle Aged; Depression; Aged; Stress Disorders, Post-Traumatic; Anxiety; Mental Health; Surveys and Questionnaires; Prevalence; Adult
PubMed: 38904131
DOI: 10.1136/bmjopen-2023-082810 -
Frontiers in Endocrinology 2024Epidemiologic studies have suggested co-morbidity between hypothyroidism and psychiatric disorders. However, the shared genetic etiology and causal relationship between...
BACKGROUND
Epidemiologic studies have suggested co-morbidity between hypothyroidism and psychiatric disorders. However, the shared genetic etiology and causal relationship between them remain currently unclear.
METHODS
We assessed the genetic correlations between hypothyroidism and psychiatric disorders [anxiety disorders (ANX), schizophrenia (SCZ), major depressive disorder (MDD), and bipolar disorder (BIP)] using summary association statistics from genome-wide association studies (GWAS). Two disease-associated pleiotropic risk loci and genes were identified, and pathway enrichment, tissue enrichment, and other analyses were performed to determine their specific functions. Furthermore, we explored the causal relationship between them through Mendelian randomization (MR) analysis.
RESULTS
We found significant genetic correlations between hypothyroidism with ANX, SCZ, and MDD, both in the Linkage disequilibrium score regression (LDSC) approach and the high-definition likelihood (HDL) approach. Meanwhile, the strongest correlation was observed between hypothyroidism and MDD (LDSC: rg=0.264, =7.35×10; HDL: rg=0.304, =4.14×10). We also determined a significant genetic correlation between MDD with free thyroxine (FT4) and thyroid-stimulating hormone (TSH) levels. A total of 30 pleiotropic risk loci were identified between hypothyroidism and psychiatric disorders, of which the 15q14 locus was identified in both ANX and SCZ ( values are 6.59×10 and 2.10×10, respectively) and the 6p22.1 locus was identified in both MDD and SCZ ( values are 1.05×10 and 5.75×10, respectively). Sixteen pleiotropic risk loci were identified between MDD and indicators of thyroid function, of which, four loci associated with MDD (1p32.3, 6p22.1, 10q21.1, 11q13.4) were identified in both FT4 normal level and Hypothyroidism. Further, 79 pleiotropic genes were identified using Magma gene analysis (<0.05/18776 = 2.66×10). Tissue-specific enrichment analysis revealed that these genes were highly enriched into six brain-related tissues. The pathway analysis mainly involved nucleosome assembly and lipoprotein particles. Finally, our two-sample MR analysis showed a significant causal effect of MDD on the increased risk of hypothyroidism, and BIP may reduce TSH normal levels.
CONCLUSIONS
Our findings not only provided evidence of a shared genetic etiology between hypothyroidism and psychiatric disorders, but also provided insights into the causal relationships and biological mechanisms that underlie their relationship. These findings contribute to a better understanding of the pleiotropy between hypothyroidism and psychiatric disorders, while having important implications for intervention and treatment goals for these disorders.
Topics: Humans; Hypothyroidism; Genome-Wide Association Study; Mendelian Randomization Analysis; Genetic Predisposition to Disease; Mental Disorders; Polymorphism, Single Nucleotide; Schizophrenia; Bipolar Disorder; Depressive Disorder, Major; Linkage Disequilibrium; Anxiety Disorders
PubMed: 38904036
DOI: 10.3389/fendo.2024.1370019