Psychiatric Symptoms In Patients Research Articles

Post-COVID condition: a focus on psychiatric symptoms and diagnoses in patients with cognitive complaints.

Cognitive and psychiatric symptoms are frequently reported after SARS-CoV-2 infection, but their interplay has been only partially explored. We investigated frequency and severity of psychiatric symptoms in patients with persistent cognitive complaints after COVID-19. We conducted a cross-sectional study. Neurologists assessed 101 patients reporting cognitive symptoms after COVID-19. Patients were invited to fill a screening battery with self-reported psychometric scales (Depression Anxiety Stress Scales-21, Impact of Event Scale-Revised, Insomnia Severity Index). Patients scoring above validated cut-offs in ≥1 scale were referred to psychiatrists who administered the Mini-International Neuropsychiatric Interview (M.I.N.I.), Hamilton Anxiety (HAM-A), and Hamilton Depression (HAM-D) rating scales and asked to complete the Personality Inventory for DSM-5-Brief Form (PID-5-BF). Out of the 57 referred patients, 38 (64.4%) accepted to undergo the psychiatric examination. Among these, 18 (47.4%) were diagnosed with adjustment disorder (23.7%), anxiety disorder (10.5%), major depressive disorder (7.9%), and post-traumatic stress disorder (2.6%). Pharmacologic treatment before post-COVID condition (present in 12 patients, 31.6%) was associated with a score above cut-off on the HAM-A and HAM-D scales. A longer duration of untreated psychiatric illness after COVID-19 was associated with worse scores on the same scales. Patients with a higher PID-5-BF total score had a higher probability of receiving a psychiatric diagnosis. Almost half of patients with post-COVID-19 conditions reporting cognitive symptoms were found to suffer from a psychiatric condition after psychiatric evaluation. The application of a psychiatric screening in a population suffering from long-term effects of COVID-19 can lead to early diagnosis and timely treatment.

Psychiatric Symptoms in Patients with Immune-Related Mucocutaneous Lichen Planus

Background: Lichen planus (LP) is one of the most common chronic mucocutaneous diseases with an underlying immunological component. Although the pathogenesis of this condition is not exactly known, numerous studies have been conducted due to the significance of this disease and its high prevalence. Several risk factors and various contexts have been identified for this condition; however, the primary cause is still not fully understood. Some genetic and environmental factors may be involved in the development of the disease. The present study was conducted to examine psychiatric symptoms in patients with cutaneous-oral LP (COLP) referred to the dermatology clinic of Sina Hospital of Tabriz city, northwest of Iran. Methods: This descriptive study was conducted on 31 patients with LP and 31 healthy individuals referred to the dermatology clinic of Sina Hospital in Tabriz. The information required was collected using the SCL-90-R standard questionnaire, and the data were analyzed using descriptive and inferential statistics with the help of SPSS v.23 and multivariate analysis of variance (MANOVA). Results: The results showed that people with COLP do not suffer from serious psychiatric conditions but may have merely mild to moderate psychiatric symptoms. However, the MANOVA test indicated that the symptoms had a significantly higher incidence in patients with oral LP compared to matched control subjects (F (12,47)=13.86, P<0.05). Conclusion: As shown by the SCL-90-R standard checklist, patients with oral LP expressed significantly more psychiatric symptoms than normal individuals, reflecting the need for these patients for more regular assessments.

Gaze behaviors during free viewing revealed differences in visual salience processing across four major psychiatric disorders: a mega-analysis study of 1012 individuals.

Aberrant salience processing has been proposed as a pathophysiological mechanism underlying psychiatric symptoms in patients with schizophrenia. The gaze trajectories of individuals with schizophrenia have been reported to be abnormal when viewing an image, suggesting anomalous visual salience as one possible pathophysiological mechanism associated with psychiatric diseases. This study was designed to determine whether visual salience is affected in individuals with schizophrenia, and whether this abnormality is unique to patients with schizophrenia. We examined the gaze behaviors of 1012 participants recruited from seven institutes (550 healthy individuals and 238, 41, 50 and 133 individuals with schizophrenia, bipolar disorder, major depressive disorder and autism spectrum disorder, respectively) when they looked at stationary images as they liked, i.e., free-viewing condition. We used an established computational model of salience maps derived from low-level visual features to measure the degree to which the gaze trajectories of individuals were guided by visual salience. The analysis revealed that the saliency at the gaze of individuals with schizophrenia were higher than healthy individuals, suggesting that patients' gazes were guided more by low-level image salience. Among the low-level image features, orientation salience was most affected. Furthermore, a general linear model analysis of the data for the four psychiatric disorders revealed a significant effect of disease. This abnormal salience processing depended on the disease and was strongest in patients with schizophrenia, followed by patients with bipolar disorder, major depressive disorder, and autism spectrum disorder, suggesting a link between abnormalities in salience processing and strength/frequency for psychosis of these disorders.

Spontaneous neural activity underlying neutral and happy speech recognition in noise and its association with psychiatric symptoms in patients with schizophrenia

BackgroundDeficits in speech and emotion perception are intertwined with psychiatric symptoms. How the happy prosody embedded in speech affects target speech-in-noise recognition (TSR) and relates to psychiatric symptoms in patients with schizophrenia (SCHs) remains unclear. This study examined spontaneous brain activity underlying happy TSR and its association with psychiatric symptom dimensions in SCHs. MethodsFifty-four SCHs and 59 healthy control participants (HCs) underwent the TSR task, Positive and Negative Syndrome Scale (PANSS) assessment, and magnetic resonance imaging scanning. Multivariate analyses of partial least squares (PLS) regression were used to explore the associations between whole-brain fractional amplitude of low-frequency fluctuations (fALFF), happy-neutral TSR (target pseudo-sentences were uttered in happy and neutral prosodies), and five PANSS factor scores (excitement/hostility, depression/anxiety, cognition, positive, and negative). ResultsThe happy prosody did not alter TSR or TSR changing rates in either SCHs or HCs. SCHs exhibited lower happy and neutral TSR than HCs. A fALFF PLS component (including precentral/postcentral gyrus, Subcallosal Cortex, several temporal regions, and cerebellum) was associated with happy and neutral TSR. SCHs demonstrated higher PLS fALFF scores and PLS TSR scores than HCs. In SCHs, PLS fALFF scores were correlated with the PANSS positive factor score, and PLS TSR scores were correlated with the PANSS cognition factor score. ConclusionsThe positive-psychiatric-symptoms-related spontaneous activity profile was associated with happy and neutral TSR, contributing to the cognition psychiatric symptoms dimension. The findings suggest the potential to improve positive and cognitive symptoms by enhancing happy and neutral TSR in schizophrenia based on neuroplasticity.

Exploring the Link Between Somatic and Psychiatric Symptoms in Patients With Medically Unexplained Physical Symptoms: A Cross-Sectional Survey From North India.

The association between somatic symptoms and psychiatric co-morbidities remains unexplored among patients with medically unexplained physical symptoms (MUPS) in Asian populations. This study aims to bridge this gap by investigating psychiatric morbidities and their determinants among patients presenting with MUPS in an Indian setup. This cross-sectional study, conducted in the outpatient department (OPD) of a tertiary care hospital in India, assessed 200 patients diagnosed with MUPS. Assessment tools, such as the Somatic Symptom Scale (SSS-8), Presumptive Stressful Life Event Scale (PSLES), and Depression, Anxiety, and Stress Scale (DASS), were administered to collect data. The study examined patients (mean age 36.51±9.82 years), predominantly comprising females (67.5%), presenting with MUPS. Common presenting symptoms were general (96.3%), musculoskeletal pain (91.7%), and gastrointestinal symptoms reported by 81.7%. Medium somatic symptom severity (57%) was more prevalent in females. Prevalent psychiatric co-morbid conditions included depression (mild: 22.0%, moderate: 26.5%), moderate anxiety (41.5%), and moderate stress (26%). Strong associations were observed between the SSS-8score and depression (χ²(6, N = 200) = 49.26, p < 0.001), anxiety (χ²(8, N = 200) = 37.90, p < 0.001), stress (χ²(6, N = 200) = 44.45, p < 0.001), and the experience of stressful life events (χ²(3, N = 200) = 6.5, p < 0.05). The study indicates an intertwined association between MUPS and psychiatric disorders. Individuals with MUPS commonly experience heightened anxiety and depression, emphasizing the complex interplay between somatic symptoms and emotional well-being. Consideration of environmental and social factors may be crucial for a comprehensive understanding.

Short-term antipsychotic treatment reduces functional connectivity of the striatum in first-episode drug-naïve early-onset schizophrenia

BackgroundThe striatum is thought to play a critical role in the pathophysiology and antipsychotic treatment of schizophrenia. Previous studies have revealed abnormal functional connectivity (FC) of the striatum in early-onset schizophrenia (EOS) patients. However, no prior studies have examined post-treatment changes of striatal FC in EOS patients. MethodsWe recruited 49 first-episode drug-naïve EOS patients to have resting-state functional magnetic resonance imaging scans at baseline and after 8 weeks of treatment with antipsychotics, along with baseline scanning of 34 healthy controls (HCs) for comparison purposes. We examined the FC values between each seed in striatal subregion and the rest of the brain. The Positive and Negative Syndrome Scale (PANSS) was applied to measure psychiatric symptoms in patients. ResultsCompared with HCs at baseline, EOS patients exhibited weaker FC of striatal subregions with several brain regions of the salience network and default mode network. Meanwhile, FC between the dorsal caudal putamen (DCP) and left supplementary motor area, as well as between the DCP and right postcentral gyrus, was negatively correlated with PANSS negative scores. Furthermore, after 8 weeks of treatment, EOS patients showed decreased FC between subregions of the putamen and the triangular part of inferior frontal gyrus, middle frontal gyrus, supramarginal gyrus and inferior parietal lobule. ConclusionsDecreased striatal FC is evident, even in the early stages of schizophrenia, and enhance our understanding of the neurodevelopmental abnormalities in schizophrenia. The findings also demonstrate that reduced striatal FC occurs after antipsychotic therapy, indicating that antipsychotic effects need to be accounted for when considering striatal FC abnormalities in schizophrenia.

Altered pattern of theta and gamma oscillation to visual stimuli in patients with postconcussion syndrome.

Although many patients with mild traumatic brain injury (mTBI) suffer from postconcussional syndrome (PCS) including abnormal emotional responses, most conventional imaging studies fail to detect any causative brain lesion. We hypothesized that event-related electroencephalography (EEG) recordings with time-frequency analysis would show a distinguishable pattern in patients with mTBI with PCS compared with normal healthy controls. EEG signals were collected from a total of 18 subjects: eight patients with mTBI with PCS and 10 healthy control subjects. The signals were recorded while the subjects were presented with affective visual stimuli, including neutral, pleasant, and unpleasant emotional cues. Event-related spectral perturbation analysis was performed to calculate frontal midline theta activity and posterior midline gamma activity, followed by statistical analysis to identify whether patients with mTBI with PCS have distinct patterns of theta or gamma oscillations in response to affective stimuli. Compared with the healthy control group, patients with mTBI with PCS did not show a significant increase in the power of frontal theta activity in response to the pleasant stimuli, indicating less susceptibility toward pleasant cues. Moreover, the patient group showed attenuated gamma oscillatory activity, with no clear alteration in gamma oscillations in response to either pleasant or unpleasant cues. This study demonstrates that patients with mTBI with PCS exhibited altered patterns of oscillatory activities in the theta and gamma bands in response to affective visual stimuli compared with the normal control group. The current finding implicates that these distinguishable patterns of brain oscillation may represent the mechanism behind various psychiatric symptoms in patients with mTBI.NEW & NOTEWORTHY Patients with mild traumatic brain injury (mTBI) with postconcussional syndrome (PCS) exhibited altered patterns of changes in oscillatory activities in the theta and gamma bands in response to visual affective stimuli. Distinguishable patterns of brain oscillation may represent the mechanism behind various psychiatric symptoms in patients with mTBI.

Psychiatric Diagnoses and Their Treatment in Women With Breast Cancer: A Latent Class Analysis of 1062 Inpatients

IntroductionPsycho-oncological support (POS) and psychopharmacological interventions are effective in treating psychiatric symptoms in patients with breast cancer. However, despite high prevalences of psychiatric disorders in patients with breast cancer, a significant proportion remains untreated. MethodsData from 1062 breast cancer patients who had been diagnosed and treated at a Comprehensive Cancer Center between 2012 and 2019 were analyzed retrospectively. We descriptively evaluated the number of patients with a psychiatric diagnosis, POS and psychiatric medication. Latent class analysis was used to examine the relationship between ICD-10 coded psychiatric diagnoses, POS, psychiatric medication, and, as important prognostic factors, tumor stage and somatic comorbidity. Results31.5% of all patients had a psychiatric diagnosis, 20% received POS and up to 60% received psychiatric medication. Latent class analysis revealed three subgroups: 1) patients with a low cancer stage, low somatic comorbidity, no psychiatric diagnosis, no POS and no psychiatric medication; 2) patients with a low cancer stage, low somatic comorbidity, a psychiatric diagnosis, and a higher probability of POS and psychiatric medication than class 1 and class 3; 3) patients with advanced cancer stage, high somatic comorbidity, a higher probability of a psychiatric diagnosis and POS than class 1, and no psychiatric medication. ConclusionThis study indicated a high prevalence of psychiatric disorders among patients with breast cancer and a discrepancy between the number of patients having a psychiatric disorder and those receiving psychiatric medication. The identification of subgroups might contribute to better tailored treatment for those patients whose needs are insufficiently met.

Prevalence and correlates of depression, anxiety and trauma-like symptoms in Chinese psychiatric patients during the fifth wave of COVID-19 pandemic: a cross-sectional study in Hong Kong.

Psychiatric patients are susceptible to adverse mental health outcome during COVID-19 pandemic, but its associated factors are understudied. This observational cross-sectional study aimed to comprehensively examine prevalence and correlates of psychological distress, in terms of depression, anxiety and post-traumatic-stress-disorder (PTSD)-like symptoms, among Chinese adult psychiatric outpatients amidst the peak of fifth COVID-19 wave in Hong-Kong. A total of 415 patients (comprising 246 patients with common-mental-disorders [CMD] and 169 with severe-mental-disorders [SMD]) and 399 demographically-matched controls without mental disorders were assessed with self-rated questionnaires between 28-March and 8-April-2022, encompassing illness profile, mental health symptoms, psychosocial measures (loneliness, resilience, coping styles) and COVID-19 related factors. Univariate and multivariable logistic regression analyses were conducted to determine variables associated with moderate-to-severe depressive, anxiety and PTSD-like symptoms among psychiatric patients. Our results showed that CMD patients had the greatest psychological distress relative to SMD patients and controls. Approximately 40-55% CMD patients and 25% SMD patients exhibited moderate-to-severe depression, anxiety and PTSD-like symptoms. Multivariable regression analyses revealed that female gender, lower educational attainment, single marital status, being housewife, more severe insomnia, psychotic-like symptoms and cognitive complaints, self-harm behavior, lower resilience, avoidance coping, never contracting COVID-19 infection, greater fear of contagion, and longer exposure to pandemic-related information were independently associated with depression, anxiety and/or PTSD-like symptoms in psychiatric patients. Our results affirm increased vulnerability of psychiatric patients toward psychological distress during pandemic. An array of identified correlates facilitates early detection of high-risk psychiatric patients for targeted strategies to minimize pandemic-related negative psychological impact.

The impact of COVID-19 mRNA vaccination on somatic and psychiatric symptoms in patients with treatment-resistant schizophrenia: a cohort study

IntroductionPatients with mental illness, particularly those with treatment-resistant schizophrenia, are at increased risk of severe COVID-19. The protective effect of vaccination against severe disease has been demonstrated, and vaccination of vulnerable individuals was a priority during the vaccination campaign. However, the effect of vaccination on the psychiatric symptoms of the disease is not well understood.ObjectivesTo investigate the impact of COVID-19 vaccination on psychiatric symptoms and somatic symptoms in patients hospitalized for treatment-resistant schizophrenia.MethodsThirty patients hospitalized for treatment-resistant schizophrenia with a history of medico-legal acts were admitted to the forensic psychiatry department at Razi Hospital in Manouba, Tunisia. The consent of patients and/or their relatives was obtained before vaccination, and potential side effects were explained to patients and their families. A neuropsychiatric assessment and clinical examination of patients were performed by their referring psychiatrist before vaccination and one month after.ResultsThe patients were all male, with a mean age of 42.3 years.No patient had an allergic reaction to the vaccine. No patient was infected with the virus one month after vaccination. On the clinical level, 30% of patients had general symptoms such as fatigue and myalgia, which improved spontaneously within a few days. On the psychiatric level, exacerbation of positive symptoms such as hallucinations and delusions was found in 26% of patients. No increase in the frequency of agitation episodes or risk of hetero-aggressive behavior was reported. Sleep disturbances such as difficulty falling asleep and fragmented sleep were reported. The most common functional complaints reported by patients were palpitations, which were a source of somatic concern.ConclusionsSeveral side effects of the vaccine have been documented and are taken into account in the daily practice of practitioners, but psychiatric effects are poorly reported and are sometimes attributed to the underlying disease. A complete examination, objective assessment, and regular follow-up are necessary to identify symptoms early and prevent relapses.Because of the small size of the sample;results could not be generelized.Further studies on a larger scale should be conducted.Disclosure of InterestNone Declared

Accelerated epigenetic aging in alcohol dependence

Alcohol dependence poses a global health threat associated with aging and reduced life expectancy. Recently, aging research through deoxyribonucleic acid (DNA) methylation has gained attention. New epigenetic clocks have been developed; however, no study has investigated GrimAge components, GrimAge2 components and DunedinPACE in patients with alcohol dependence. In this study, we aimed to perform epigenetic clock analysis to evaluate epigenetic age acceleration and DNA methylation-based age-predictive components in patients with alcohol dependence and controls. We utilized publicly available DNA methylation data (GSE98876) for our analysis. Additionally, we compared the values of the same items before and after the patients underwent a treatment program. The dataset comprised 23 controls and 24 patients. We observed that DunedinPACE accelerated more in patients with alcohol dependence. AgeAccelGrim and AgeAccelGrim2 decelerated more after the treatment program than before, and beta-2-microglobulin and Cystatin C decreased after the treatment program than before. These findings are crucial as they affect the cranial nerve area, potentially contributing to cognitive dysfunction and psychiatric symptoms in patients with alcohol dependence.

Cognitive, behavioral and psychiatric symptoms in patients with spinal cord injury: a scoping review.

Spinal Cord Injury (SCI) is a condition where the spinal cord is damaged and experiences partial or complete loss of motor and/or sensory function, which is typically less than normal. After SCI, patients may exhibit more severe psychiatric symptoms and experience cognitive impairments, including reduced speed and attention processing capacity, as well as difficulties with executive function and episodic memory retention. Among the behavioral and psychiatric symptoms, depression, anxiety, substance use disorder, and posttraumatic stress disorder are the most common. This review aims to investigate the cognitive, behavioral, or psychiatric symptoms of the patient with SCI and their influence on the rehabilitation process. Studies were identified from an online search of PubMed, Web of Science, Cochrane Library, and Embase databases. Studies published between 2013-2023 were selected. This review has been registered on OSF (n) 3KB2U. We have found that patients with SCI are at high risk of cognitive impairment and experience a wide range of difficulties, including tasks based on processing speed and executive function. This clinical population may experience adjustment disorders with depression and anxiety, as well as other psychiatric symptoms such as fatigue, stress, and suicidal ideation. This review has demonstrated that SCI patients may experience psychiatric symptoms and cognitive impairments that affect their functioning. At the same time, these patients may be more prone to various adjustment and mood disorders. Moreover, these two aspects may interact with each other, causing a range of symptoms, increasing the risk of hospitalization, and delaying the rehabilitation process.

Relationship Between Insomnia and Continued Outpatient Treatment in Psychiatric Patients.

Sleep plays an essential role in maintaining both physical and mental well-being. Many patients in psychiatric outpatient settings complain of insomnia. However, the causal relationship between insomnia and depressive symptoms in all mental illnesses remains unclear. Moreover, research on insomnia and the continuation of outpatient treatment is lacking. We hypothesize a high correlation between depression and insomnia among patients with diverse mental illnesses. Additionally, we posit that insomnia significantly influences the continuity of outpatient visits. To this end, we evaluated insomnia and depression symptoms in psychiatric patients both at their initial visit and one year later. We also examined factors related to insomnia at the outset and factors associated with the ongoing utilization of outpatient treatment. The participants of the study consisted of patients who made their first visit to the outpatient department of psychiatry and neurology at Showa University East Hospital between June 1, 2021, and March 31, 2023, and who continued attending the outpatient clinic for one year. Clinical characteristics were assessed using the Self-rating Depression Scale (SDS) and the Athens Insomnia Scale (AIS). The study's findings were collected from a cohort of 1106 patients and revealed that more than 70% experienced insomnia at the time of their initial visit. In total 137 patients continued to receive outpatient treatment for one year, and their AIS scores improved from 9 points to 5 points. A multivariate analysis revealed that the SDS items of depressed mood and insomnia were confounding factors influencing AIS improvement. Given that 70% of patients complained of insomnia at the time of their first visit and that sleep improved in many of the 12.4% of patients who continued to receive outpatient treatment for at least one year, the results suggest that sleep status is an important determinant of whether a patient continues to attend outpatient clinics.

Muscarinic control of cardiovascular function in humans: a review of current clinical evidence.

To review the available evidence on the impact of muscarinic receptor modulation on cardiovascular control in humans. In this narrative Review we summarize data on cardiovascular endpoints from clinical trials of novel subtype-selective or quasi-selective muscarinic modulators, mostly PAMs, performed in the last decade. We also review the cardiovascular phenotype in recently described human genetic and autoimmune disorders affecting muscarinic receptors. Recent advancements in the development of compounds that selectively target muscarinic acetylcholine receptors are expanding our knowledge about the physiological function of each muscarinic receptor subtype (M1, M2, M3, M4, M5). Among these novel compounds, positive allosteric modulators (PAMs) have emerged as the preferred therapeutic to regulate muscarinic receptor subtype function. Many muscarinic allosteric and orthosteric modulators (including but not limited to xanomeline-trospium and emraclidine) are now in clinical development and approaching regulatory approval for multiple indications, including the treatment of cognitive and psychiatric symptoms in patients with schizophrenia as well as Alzheimer's disease and other dementias. The results of these clinical trials provide an opportunity to understand the influence of muscarinic modulation on cardiovascular autonomic control in humans. While the results and the impact of each of these therapies on heart rate and blood pressure control have been variable, in part because the clinical trials were not specifically designed to measure cardiovascular endpoints, the emerging data is valuable to elucidate the relative cardiovascular contributions of each muscarinic receptor subtype. Understanding the muscarinic control of cardiovascular function is of paramount importance and may contribute to the development of novel therapeutic strategies for treating cardiovascular disease.

Report of Lupus Encephalopathy in Two Patients with Systemic Lupus Erythematosus

How do you make a diagnosis of lupus encephalopathy (LE) in patients with systemic lupus erythematosus (SLE) concurrent with neurological and psychiatric abnormalities? This is a challenging question. We encountered two cases of SLE associated with LE. One involving the rigidity of the lefs due to extraparamidal vasculitis while the other involved mental illness due to frontal lobe atrophy respectively. The patient in case 2 experienced the attacks of Renault's sign, suggesting a systemic vasculitis. A final diagnosis of LE was established on the basis of elevated concentration of anti-ds-DNA in serum. The authors realized that the neurological or psychiatric symptoms in patients with rheumatic diseases should be carefully recognized in order to avoid a missed diagnosis of LE.

Alterations of serum neuropeptide levels and their relationship to cognitive impairment and psychopathology in male patients with chronic schizophrenia

Serum neuropeptide levels may be linked to schizophrenia (SCZ) pathogenesis. This study aims to examine the relation between five serum neuropeptide levels and the cognition of patients with treatment-resistant schizophrenia (TRS), chronic stable schizophrenia (CSS), and in healthy controls (HC). Three groups were assessed: 29 TRS and 48 CSS patients who were hospitalized in regional psychiatric hospitals, and 53 HC. After the above participants were enrolled, we examined the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the blood serum levels of α-melanocyte stimulating hormone (α-MSH), β-endorphin (BE), neurotensin (NT), oxytocin (OT) and substance.P (S.P). Psychiatric symptoms in patients with SCZ were assessed with the Positive and Negative Syndrome Scale. SCZ patients performed worse than HC in total score and all subscales of the RBANS. The levels of the above five serum neuropeptides were significantly higher in SCZ than in HC. The levels of OT and S.P were significantly higher in CSS than in TRS patients. The α-MSH levels in TRS patients were significantly and negatively correlated with the language scores of RBANS. However, the BE and NT levels in CSS patients were significantly and positively correlated with the visuospatial/constructional scores of RBANS. Moreover, the interaction effect of NT and BE levels was positively associated with the visuospatial/constructional scores of RBANS. Therefore, abnormally increased serum neuropeptide levels may be associated with the physiology of SCZ, and may cause cognitive impairment and psychiatric symptoms, especially in patients with TRS.

Efficacy of a Smartphone App in Enhancing Medication Adherence and Accuracy in Individuals With Schizophrenia During the COVID-19 Pandemic: Randomized Controlled Trial.

Poor medication adherence or inaccuracy in taking prescribed medications plays an important role in the recurrence or worsening of psychiatric symptoms in patients with schizophrenia, and the COVID-19 pandemic impacted their medication adherence with exacerbated symptoms or relapse. The use of mobile health services increased during the COVID-19 pandemic, and their role in improving mental health is becoming clearer. This study aimed to explore the effectiveness of a smartphone app (MedAdhere) on medication adherence and accuracy among patients with schizophrenia and to measure their psychiatric symptoms and cognitive functions. In this 12-week experimental study, participants were provided interventions with the MedAdhere app, and data were collected between June 2021 and September 2022. A total of 105 participants were randomly assigned to either the experimental or control groups. We used the Positive and Negative Syndrome Scale and Mini-Mental State Examination to measure the participants' psychiatric symptoms and cognitive functions. Generalized estimating equations were used for data analysis. A total of 94 participants met the inclusion criteria and completed the protocol, and the medication adherence rate of the experimental group was 94.72% (2785/2940) during the intervention. Psychotic symptoms (positive, negative, and general psychopathology symptoms) and cognitive functions (memory, language, and executive function) were significantly improved in the experimental group compared to the control group after the intervention. The MedAdhere app effectively and significantly improved medication adherence and, thereby, the psychiatric symptoms of patients with schizophrenia. This artificial intelligence assisted app could be extended to all patients who need to be reminded to take medication on schedule. ClinicalTrials.gov NCT05892120; https://clinicaltrials.gov/study/NCT05892120.

Sex-based influential factors for dental caries in patients with schizophrenia

BackgroundSchizophrenia is a common mental disorder that seriously affects patients’ daily lives and brings heavy psychological and economic burdens to their families and society. The oral problems of patients with schizophrenia are gradually gaining attention, among which dental caries are among the most common oral diseases. Sex differences may be related not only to the various clinical symptoms of schizophrenia but also to different oral hygiene statuses; therefore, the main purpose of this paper is to investigate sex differences related to influencing factors for dental caries in patients with schizophrenia.MethodInpatients with schizophrenia over 18 years old were included in this study, and multidimensional indicators such as demographics, symptom and cognitive impairment assessments, medications, and the caries index of decayed, missing, and filled teeth (DMFT) were collected. An analysis of sex-based influential factors for dental caries in schizophrenia patients was performed.ResultsFour-hundred and ninety-six patients with schizophrenia were included, with a mean age of 46.73 ± 12.23 years, of which 142 were females and 354 were males. The mean DMFT was significantly higher in males (8.81 ± 8.50) than in females (5.63 ± 6.61, p < 0.001), and the odd ratio of caries in males to females was significantly higher as well (OR = 2.305, p < 0.001). The influential factors of caries in male patients were independently associated with age and smoking status, in which current smokers were at the highest risk for developing caries, and different smoking statuses had various influencing factors for caries. The influencing factors for caries in female patients were independently associated with age, antipsychotic dose, PANSS-positive symptoms, and MMSE levels.ConclusionOur findings suggest sex differences exist among influential factors for caries in patients with schizophrenia. These risk factors may even be associated with and affect the treatment and prognosis of psychiatric symptoms in patients. Therefore, oral hygiene management of patients with schizophrenia should be enhanced. These differential factors provide new visions and ideas for formulating individual interventions, treatments, and care priorities.

Exosomal miR-320e through wnt2targeted inhibition of the Wnt/β-catenin pathway allevisate cerebral small vessel disease and cognitive impairment.

Exosomal miRNAs play crucial roles in many central nervous system diseases. Cerebral small vessel disease (CVSD) is a small vessel disease that is affected by various factors. This study aimed to investigate the role of exosomal miR-320e in the Wnt/β-catenin pathway stimulated by oxidative stress and assess its clinical correlation with psychiatric symptoms in patients with CVSD. To explore whether exosomal miR-320e could suppress the Wnt/β-catenin pathway and play a protective role in CVSD progression, as well as examine its potential correlation with cognitive impairment and depression in patients with CVSD. Differentially expressed exosomal miRNAs were filtered by sequencing plasma exosomes from patients with CVSD and healthy controls. Bioinformatics and dual luciferase analyses were used to confirm the binding of miR-320e to Wnt2, and the mRNA and protein levels of downstream components in the Wnt/β-catenin pathway were evaluated when overexpressed or with knockdown of miR-320e under H2O2-induced oxidative stress. In addition, Wnt2-targeting siRNA was used to confirm the role of miR-320e in the Wnt2-mediated inhibition of the Wnt/β-catenin pathway. A retrospective analysis was conducted among patients with CVSD to confirm the correlation between miR-320e expression and the severity of cognitive impairment and depression, which were quantified using the Montreal Cognitive Assessment (MoCA)/Executive Function Assessment (EFA), and the Hamilton Depression Scale (HAMD)/Beck Depression Inventory (BDI), respectively. High-throughput sequencing revealed that exosomal miR-320e was downregulated in patients with CVSD. Bioinformatics analysis and dual-luciferase reporter gene experiments showed that exosomal miR-320e inhibited the Wnt/β-catenin pathway in response to oxidative stress by targeting the 3' noncoding region of Wnt2. Uptake of exosomes carrying miR-320e into endothelial cells could also target Wnt2 and inhibit the Wnt2/β-catenin pathway. Elevated miR-320e expression may protect patients with CVSD from relatively severe cognitive impairment and depression, as it was found to have a positive correlation with the MoCA/EFA and HAMD/BDI scores. Our results suggest that exosomal miR-320e suppresses the Wnt/β-catenin pathway and may play a protective role in CVSD progression.

Educational Needs for Psychiatric Nursing Competencies among Non-Psychiatric Nurses

Purpose: The purpose of this study is to identify and prioritize educational needs for psychiatric nursing competencies among 142 non-psychiatric nurses from general hospitals.Methods: Data were collected from November 13 to 19 2022 through self-administered questionnaires consisting of measures of psychiatric nursing competencies. Data were analyzed using descriptive statistics, paired t-test, Borich's needs assessment model, and the Locus for Focus model to determine the priority of educational needs.Results: Non-psychiatric nurses reported that enhancing skills in psychiatric nursing were more significant than improving knowledge and attitude using Borich’s Needs Assessment Model and the Locus for Focus Model. The highest priority educational needs were ‘Skill to distinguish whether symptoms in psychiatric patients are symptoms of mental illness or side effects of psychiatric drugs’, ‘Skill to calm and supportive communication in psychiatric emergency when psychiatric patients are at risk of harm’, ‘Attitude to remain calm about the psychotic behaviors of psychiatric patients’, and ‘Knowledge of non-therapeutic communication that interferes with effective communication with psychiatric patients’. These items should be considered as priorities among the 39 items to improve psychiatric nursing competencies.Conclusion: Results of this study suggest that developing intervention programs to enhance psychiatric nursing competencies are needed among non-psychiatric Nurses.