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Frontiers in Psychiatry 2024The risk of suicide can be decreased by accurately identifying high-risk suicide groups and implementing the right interventions. The aim of this study was to develop a...
OBJECTIVE
The risk of suicide can be decreased by accurately identifying high-risk suicide groups and implementing the right interventions. The aim of this study was to develop a nomogram for suicide attempts (SA) in patients with first-episode drug-naïve (FEDN) major depressive disorder (MDD).
METHODS
This study undertook a cross-sectional analysis of 1,718 patients diagnosed with FEDN MDD, providing comprehensive clinical data from September 2016 to December 2018. Data on anthropometric and sociodemographic factors were gathered, and the severity of depression and anxiety was evaluated using the 17-item Hamilton Depression Scale (HAMD-17) and the Hamilton Anxiety Scale (HAMA), respectively. Additionally, thyroid hormone levels, lipid profile parameters, and fasting blood glucose (FBG) were measured. Suicide attempt (SA) history was verified based on an amalgamation of medical records, patient interviews, and family interviews. Participants were randomly divided into a training group (70%, n = 1,204) and a validation group (30%, n = 514). In the training group, LASSO analysis and multivariate regression were used to identify variables associated with SA. A nomogram was then constructed using the identified risk factors to estimate the likelihood of SA within the training group. To assess the accuracy, the area under the receiver operating characteristic curve (AUC) was utilized, and calibration plots were employed to evaluate calibration. Additionally, decision curve analysis (DCA) was performed to assess the precision of the model. Finally, internal validation was carried out using the validation group.
RESULTS
A practical nomogram has been successfully constructed, incorporating HAMD, HAMA, thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and systolic blood pressure (SBP) parameters, to estimate the probability of SA in Chinese patients diagnosed with FEDN MDD. The pooled area under the ROC for SA risk in both the training and validation groups was found to be 0.802 (95% CI: 0.771 to 0.832) and 0.821 (95% CI: 0.774 to 0.868), respectively. Calibration analysis revealed a satisfactory correlation between the nomogram probabilities and the actual observed probabilities. The clinical applicability of the nomogram was confirmed through decision curve analysis. To enhance accessibility for clinicians and researchers, an online version of the nomogram can be accessed at https://doctorjunjunliu.shinyapps.io/dynnomapp/.
CONCLUSIONS
We constructed and validated a nomogram for the early detection of FEDN MDD patients with a high risk of SA, thereby contributing to the implementation of effective suicide prevention programs.
PubMed: 38903642
DOI: 10.3389/fpsyt.2024.1398733 -
Frontiers in Psychiatry 2024Although extensive research has explored the link between mental disorders and asthma, the characteristics and patterns of this association are still unclear. Our study...
OBJECTIVE
Although extensive research has explored the link between mental disorders and asthma, the characteristics and patterns of this association are still unclear. Our study aims to examine the genetic causal links between common mental disorders (specifically, anxiety and depression) and asthma.
METHODS
We conducted genetic analyses including linkage disequilibrium score regression (LDSC) and bidirectional two-sample Mendelian randomization (MR) analyses, and utilized summary statistics from recent large-scale Genome-Wide Association Studies (GWASs) in European populations, covering sensation of anxiety or depression, anxiety sensation, depression sensation, anxiety disorders, major depression disorder (MDD), and asthma.
RESULTS
LDSC revealed significant genetic correlations among sensation of anxiety or depression, MDD and asthma ( < 0.017), highlighting potential genetic correlation between anxiety disorders and asthma ( < 0.05 yet > 0.017). In bidirectional two-sample MR, inverse-variance weighted (IVW) analyses suggested that genetic liability to asthma was significantly associated with an increased risk of sensation of anxiety or depression (OR = 4.760, 95%CI: 1.645-13.777), and MDD (OR = 1.658, 95%CI: 1.477-1.860). Conversely, IVW analyses indicated that genetic liability to anxiety disorders was not associated with an increased risk of asthma ( > 0.01), nor was genetic liability to asthma associated with an increased risk of anxiety disorders ( > 0.01). Furthermore, no significant genetic causal relationships were observed for other studied traits. Multivariate MR, after adjusting for body mass index and alcohol consumption, further corroborated the independent causal effect of genetic predisposition to MDD on the risk of asthma (OR = 1.460, 95% CI: 1.285-1.660).
CONCLUSION
Our study establishes MDD as a predisposing factor for asthma. Meanwhile, anxiety disorders are not causal risk factors for asthma, nor is the reverse true. It is recommended to closely monitor asthma symptoms in patients with MDD.
PubMed: 38903633
DOI: 10.3389/fpsyt.2024.1372842 -
Frontiers in Public Health 2024The wellbeing of retired teachers is often easily overlooked. This study aims to explore the mental health status and influencing factors of retired teachers.
INTRODUCTION
The wellbeing of retired teachers is often easily overlooked. This study aims to explore the mental health status and influencing factors of retired teachers.
METHOD
From October to December 2022, a convenient sampling survey was conducted on retired teachers using the Symptom Checklist 90 (SCL-90), mainly using the χ-test and logistic regression analysis.
RESULTS
A sampling survey was conducted on 353 retired teachers, with an overall positive detection rate of 16.1%. The five factors with the highest positive detection rate were found to be obsessive-compulsive disorder (30.3%), interpersonal sensitivity (21.5%), paranoia (20.1%), anxiety (19.3%), and others (19.3%). The detection rates for the five factors, namely psychosis, depression, hostility, terror, and somatization, are all below 19%. The data on sex (χ = 4.626, = 0.043), professional title (χ = 17.670, = 0.003), income (χ = 9.960, = 0.041), life satisfaction (χ = 27.348, = 0.000), family relationships (χ = 51.451, = 0.000), and physical health status (χ = 50.361, = 0.000) show that the difference in mental health among retired teachers is statistically significant. The multivariate binary logistic regression analysis revealed that family relationships, life satisfaction, and physical health were important factors leading to mental health problems among retired teachers.
DISCUSSION
Retired teachers should cultivate a wide range of interests and hobbies, engage in regular physical exercise, develop healthy living habits, foster a positive family atmosphere, establish harmonious family relationships, promote community cultural construction, strengthen psychological intervention, and prevent psychological diseases.
Topics: Humans; Male; Female; Middle Aged; Retirement; Mental Health; School Teachers; Surveys and Questionnaires; Health Status; Adult; Aged; China; Mental Disorders; Logistic Models
PubMed: 38903565
DOI: 10.3389/fpubh.2024.1358285 -
Cureus May 2024We present a case of a young woman having recurrent admissions secondary to cyclical vomiting syndrome complicated with stress-induced cardiomyopathy/takotsubo...
We present a case of a young woman having recurrent admissions secondary to cyclical vomiting syndrome complicated with stress-induced cardiomyopathy/takotsubo cardiomyopathy (TC). She not only had left ventricular dysfunction but also suffered from anxiety and post-traumatic stress disorder for which professional help was sought. TC is defined as reversible, transient ventricular dysfunction in the absence of coronary artery disease. Due to the similarity of TC to acute coronary syndrome, TC is often left as a diagnosis of exclusion as it relies heavily on diagnosis by history, physical examination, and ultrasound imaging. Extreme emotional or physical stress can act as a trigger and timely identification and management of triggers causing TC are important to improve the outcome. In addition to physiological impact, TC also puts a toll on psychological health. Although the mechanism is not completely understood, reportedly plasma levels of epinephrine and norepinephrine were significantly elevated in patients with TC which might contribute to depression, anxiety, and psychological distress. Along with proper medical care, psychological care is equally important for patients with TC.
PubMed: 38903280
DOI: 10.7759/cureus.60764 -
BMC Psychiatry Jun 2024Generalized anxiety disorder (GAD) is a devastating mental health condition characterized by constant, uncontrolled worrying. Recent hypotheses indicate that...
BACKGROUND
Generalized anxiety disorder (GAD) is a devastating mental health condition characterized by constant, uncontrolled worrying. Recent hypotheses indicate that pro-inflammatory cytokines and chemokines are potential contributors to the pathogenesis of GAD. Here, we aimed to assess the role of interleukin-2 (IL-2) and interleukin-10 (IL-10) in the pathophysiology and development of GAD.
METHODS
This study recruited 50 GAD patients diagnosed according to the DSM-5 criteria and 38 age-sex-matched healthy controls (HCs). A qualified psychiatrist evaluated all study subjects. The socio-demographic and clinical characteristics of the study population were determined using pre-structured questionnaires or interviews, and cytokine serum levels were estimated using commercially available ELISA kits.
RESULTS
We observed reduced serum IL-10 levels in GAD patients compared to HCs (33.69 ± 1.37 pg/ml vs. 44.12 ± 3.16 pg/ml). Also, we observed a significant negative correlation between altered IL-10 levels and GAD-7 scores (r=-0.315, p = 0.039). Moreover, IL-10 serum measurement exhibited good predictive value in receiver operating characteristics (ROC) analysis with an area under the curve (AUC) value of 0.793 (p < 0.001) with 80.65% sensitivity and 62.79% specificity at a cutoff value of 33.93 pg/ml. Conversely, we noticed elevated serum IL-2 levels in GAD patients than in HCs (14.81 ± 2.88 pg/ml vs. 8.08 ± 1.1 pg/ml); however, it failed to maintain any significant association with GAD-7 scores, implying that IL-2 might not be involved in GAD pathogenesis. The lower AUC value (0.640; p > 0.05) exhibited by IL-2 serum measurement in ROC analysis further supported that IL-2 might not be associated with GAD.
CONCLUSION
This study provides new insights into the complex interplay between anti-inflammatory cytokines and GAD pathogenesis. Based on the present findings, we can assume that IL-10 but not IL-2 may be associated with the pathophysiology and development of GAD. However, further research with a larger population size and longitudinal design is required to confirm the potential diagnostic efficacy of IL-10.
Topics: Humans; Interleukin-2; Interleukin-10; Female; Case-Control Studies; Anxiety Disorders; Male; Adult; Middle Aged; Biomarkers; ROC Curve
PubMed: 38902708
DOI: 10.1186/s12888-024-05911-z -
BMC Pulmonary Medicine Jun 2024Chronic cough has been associated with reduced health-related quality of life, negative impacts on sleep, work, and other daily activities, and increased use of health...
BACKGROUND
Chronic cough has been associated with reduced health-related quality of life, negative impacts on sleep, work, and other daily activities, and increased use of health care resources. Little is known about the prevalence of chronic cough in Italy. In the present study we sought to estimate the prevalence of chronic cough in Italy, describe sociodemographic and clinical characteristics associated with chronic cough, and characterize the impact of chronic cough on overall health and wellness, work and other daily activities, and health care resource use.
METHODS
We conducted a cross-sectional study to collect sociodemographic and health-related data from Italian residents who participated in the 2020 National Health and Wellness Survey (N = 10,026). To assess the characteristics and burden of chronic cough, adults who indicated that they had experienced chronic cough during the prior 12 months were compared with propensity score-matched controls without chronic cough.
RESULTS
The estimated weighted lifetime and 12-month prevalence of chronic cough were estimated as 9.2% and 6.3%, respectively. Compared with matched controls, respondents with chronic cough had significantly lower measures of overall physical and mental health (P < .001 for both comparisons), and significantly higher rates of anxiety, depression, and sleep disorders (P < .001 for all comparisons). Chronic cough was significantly associated with higher rates of impairment of work and other activities (P < .001 for all comparisons) in the past 7 days, any-cause emergency department visits and hospitalizations in the prior 6 months (P < .001 for both comparisons), and more visits to general and specialist health care providers (P < .001 for both comparisons) in the prior 6 months.
CONCLUSIONS
In Italy, chronic cough affects an estimated 3.3 million adults annually and represents a significant burden to individuals and the health care system.
TAKE HOME MESSAGE
Little is known about the prevalence of chronic cough in Italy. We found that, in Italy chronic cough represents a significant burden to individuals and the health care system, affecting an estimated 3.3 million adults annually.
Topics: Humans; Cough; Italy; Cross-Sectional Studies; Male; Female; Chronic Disease; Prevalence; Middle Aged; Adult; Aged; Cost of Illness; Quality of Life; Young Adult; Adolescent; Health Surveys; Sleep Wake Disorders; Activities of Daily Living; Chronic Cough
PubMed: 38902654
DOI: 10.1186/s12890-024-03095-6 -
Translational Psychiatry Jun 2024Whereas meta-analytical data highlight abnormal frontocortical macrostructure (thickness/surface area/volume) in Major Depressive Disorder (MDD), the underlying...
Whereas meta-analytical data highlight abnormal frontocortical macrostructure (thickness/surface area/volume) in Major Depressive Disorder (MDD), the underlying microstructural processes remain uncharted, due to the use of conventional MRI scanners and acquisition techniques. We uniquely combined Ultra-High Field MRI at 7.0 Tesla with Quantitative Imaging to map intracortical myelin (proxied by longitudinal relaxation time T) and iron concentration (proxied by transverse relaxation time T*), microstructural processes deemed particularly germane to cortical macrostructure. Informed by meta-analytical evidence, we focused specifically on orbitofrontal and rostral anterior cingulate cortices among adult MDD patients (N = 48) and matched healthy controls (HC; N = 10). Analyses probed the association of MDD diagnosis and clinical profile (severity, medication use, comorbid anxiety disorders, childhood trauma) with aforementioned microstructural properties. MDD diagnosis (p's < 0.05, Cohen's D = 0.55-0.66) and symptom severity (p's < 0.01, r = 0.271-0.267) both related to decreased intracortical myelination (higher T values) within the lateral orbitofrontal cortex, a region tightly coupled to processing negative affect and feelings of sadness in MDD. No relations were found with local iron concentrations. These findings allow uniquely fine-grained insights on frontocortical microstructure in MDD, and cautiously point to intracortical demyelination as a possible driver of macroscale cortical disintegrity in MDD.
Topics: Humans; Depressive Disorder, Major; Magnetic Resonance Imaging; Female; Male; Adult; Prefrontal Cortex; Gyrus Cinguli; Myelin Sheath; Middle Aged; Iron; Case-Control Studies
PubMed: 38902245
DOI: 10.1038/s41398-024-02976-y -
Pharmacological Reviews Jun 2024The orexin system consists of the peptide transmitters orexin-A and -B and the G protein-coupled orexin receptors OX and OX Orexin receptors are capable of coupling to...
The orexin system consists of the peptide transmitters orexin-A and -B and the G protein-coupled orexin receptors OX and OX Orexin receptors are capable of coupling to all four families of heterotrimeric G proteins, and there are also other complex features of the orexin receptor signaling. The system was discovered 25 years ago and was immediately identified as a central regulator of sleep and wakefulness; this is exemplified by the symptomatology of the disorder narcolepsy with cataplexy, in which orexinergic neurons degenerate. Subsequent translation of these findings into drug discovery and development has resulted to date in three clinically used orexin receptor antagonists to treat insomnia. In addition to sleep and wakefulness, the orexin system appears to be a central player at least in addiction and reward, and has a role in depression, anxiety and pain gating. Additional antagonists and agonists are in development to treat, for instance, insomnia, narcolepsy with or without cataplexy and other disorders with excessive daytime sleepiness, depression with insomnia, anxiety, schizophrenia, as well as eating and substance use disorders. The orexin system has thus proved an important regulator of numerous neural functions and a valuable drug target. Orexin prepro-peptide and orexin receptors are also expressed outside the central nervous system, but their potential physiological role there remains unknown. The orexin system was discovered 25 years ago and immediately emerged as an essential sleep-wakefulness regulator. This discovery has tremendously increased the understanding of these processes and has thus far resulted in the market approval of three orexin receptor antagonists, which promote more physiological sleep than previous hypnotics. Further, orexin receptor agonists and antagonists with different pharmacodynamic properties are in development since research has revealed additional potential therapeutic indications. Orexin receptor signaling is complex and may represent novel features.
PubMed: 38902035
DOI: 10.1124/pharmrev.123.000953 -
BMJ Mental Health Jun 2024
Topics: Humans; Obsessive-Compulsive Disorder; Selective Serotonin Reuptake Inhibitors; Child; Adolescent
PubMed: 38901870
DOI: 10.1136/bmjment-2024-300999 -
JMIR Rehabilitation and Assistive... Jun 2024Impaired cognitive function is observed in many pathologies, including neurodegenerative diseases such as Alzheimer disease. At present, the pharmaceutical treatments...
BACKGROUND
Impaired cognitive function is observed in many pathologies, including neurodegenerative diseases such as Alzheimer disease. At present, the pharmaceutical treatments available to counter cognitive decline have only modest effects, with significant side effects. A nonpharmacological treatment that has received considerable attention is computerized cognitive training (CCT), which aims to maintain or improve cognitive functioning through repeated practice in standardized exercises. CCT allows for more regular and thorough training of cognitive functions directly at home, which represents a significant opportunity to prevent and fight cognitive decline. However, the presence of assistance during training seems to be an important parameter to improve patients' motivation and adherence to treatment. To compensate for the absence of a therapist during at-home CCT, a relevant option could be to include a virtual assistant to accompany patients throughout their training.
OBJECTIVE
The objective of this exploratory study was to evaluate the interest of including a virtual assistant to accompany patients during CCT. We investigated the relationship between various individual factors (eg, age, psycho-affective functioning, personality, personal motivations, and cognitive skills) and the appreciation and usefulness of a virtual assistant during CCT. This study is part of the THERADIA (Thérapies Digitales Augmentées par l'Intelligence Artificielle) project, which aims to develop an empathetic virtual assistant.
METHODS
A total of 104 participants were recruited, including 52 (50%) young adults (mean age 21.2, range 18 to 27, SD 2.9 years) and 52 (50%) older adults (mean age 67.9, range 60 to 79, SD 5.1 years). All participants were invited to the laboratory to answer several questionnaires and perform 1 CCT session, which consisted of 4 cognitive exercises supervised by a virtual assistant animated by a human pilot via the Wizard of Oz method. The participants evaluated the virtual assistant and CCT at the end of the session.
RESULTS
Analyses were performed using the Bayesian framework. The results suggest that the virtual assistant was appreciated and perceived as useful during CCT in both age groups. However, older adults rated the assistant and CCT more positively overall than young adults. Certain characteristics of users, especially their current affective state (ie, arousal, intrinsic relevance, goal conduciveness, and anxiety state), appeared to be related to their evaluation of the session.
CONCLUSIONS
This study provides, for the first time, insight into how young and older adults perceive a virtual assistant during CCT. The results suggest that such an assistant could have a beneficial influence on users' motivation, provided that it can handle different situations, particularly their emotional state. The next step of our project will be to evaluate our device with patients experiencing mild cognitive impairment and to test its effectiveness in long-term cognitive training.
PubMed: 38901017
DOI: 10.2196/48129