Risk Factor For Disorders Research Articles

Cardiovascular Risk Factors for the Diagnosis of Insomnia in End-Stage Renal Disease

BackgroundInsomnia, a known cardiovascular risk factor, is common in end-stage renal disease (ESRD) patients. There is growing acknowledgment of a potential bidirectional relationship between cardiovascular diseases and sleep disorders. We previously assessed the risk factors for common sleep disorders in ESRD patients. This follow-up study assesses the demographic and clinical cardiovascular-related risk factors for insomnia diagnosis in ESRD patients, given their increased cardiovascular burden. MethodsThis study is a retrospective analysis of the United States Renal Data System to evaluate risk factors for insomnia diagnosis. All patients in the USRDS who started dialysis between 2005 and 2019 were eligible for inclusion. Demographic risk factors analyzed were age, race, sex, ethnicity, dialysis modality, and access type. Cardiovascular risk factors, including obstructive sleep apnea (OSA) and central sleep apnea (CSA), were also evaluated. ResultsFemale sex, OSA, CSA, myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, diabetes, chronic obstructive pulmonary disease, obesity, and hypertension were associated with an increased risk of insomnia. Increasing age, non-white race, Hispanic ethnicity, and catheter or other/peritoneal dialysis access type were associated with a decreased risk of an insomnia diagnosis. ConclusionVarious cardiovascular diseases were independent risk factors for an insomnia diagnosis in this retrospective cohort. Further study is indicated to investigate potential mechanisms underlying this connection.

The Underestimated Role of the Sports Psychiatrist in Athletic Performance Restoration, Maintenance, and Enhancement in Sports

ABSTRACTIn competitive and elite sports, mental health and athletic performance cannot be considered separately. Mental disorders in sports are bidirectionally associated with reduced athletic performance. A decline in performance, both within and outside of sport, can be a sign of mental disorder. Additionally, poor athletic performance is a potential risk factor for mental disorders in athletes. The central role sports psychiatrists play in the mental health of athletes is well‐established. However, their role in athletic performance is less well‐described and more controversial, perhaps due to a perception that performance is purely a secondary outcome of good mental health. This paper discusses the role that sports psychiatrists can play in athletic performance within competitive and elite sports. Performance can be distinguished into three key focus areas for sports psychiatrists: (i) performance restoration, (ii) performance maintenance, and (iii) performance enhancement. These should be considered throughout the continuum of mental health care, from prevention, treatment, to ongoing care for mental disorders. When reduced performance is due to a mental disorder, psychiatric treatment should purposefully aim to restore functioning and performance as part of management. Maintenance of performance is, similarly, an important element of the prevention, psychiatric treatment, and ongoing care of mental disorders. Holistic sports psychiatrists may also choose to aim for athletic performance enhancement beyond the context of mental health symptoms and disorders, to help athletes flourish and achieve their goals.

Risk and predictive factors of oral feeding skills disorder in preterm infants: An observational study using flexible endoscopic evaluation of swallowing

Risk and predictive factors of oral feeding skills disorder in preterm infants: An observational study using flexible endoscopic evaluation of swallowing

Pregnancy and delivery outcomes after abdominal vs. laparoscopic myomectomy: an evaluation of an American population database

ObjectiveTo evaluate population characteristics and obstetrical complications after abdominal myomectomy vs. laparoscopic myomectomy. DesignRetrospective cohort study, using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, with hospital discharge between 2004 and 2014. SettingsPopulation-based. Subject(s)13868 and 338 pregnancies following abdominal or laparoscopic myomectomy, respectively. ExposureObstetrics outcomes following abdominal and laparoscopic myomectomy were collected. MethodsMultiple and Binomial logistic regression were used and adjusted in different models for age, obesity, chronic hypertension, and pre-gestational diabetes mellitus. Main Outcome Measure(s)Pregnancy, delivery, and neonatal outcomes were analyzed. Result(s)Abdominal myomectomy were characterized by younger patients, lower rates of Caucasian, chronic hypertension, pregestational diabetes, active smoking, illicit drug use, and higher rates of previous cesarean delivery, and multiple gestations when compared to laparoscopic myomectomy. Pregnant women with laparoscopic myomectomy had decreased rates of pregnancy-induced hypertension [adjusted risk ratios (aRR) 0.12, 95% confidence intervals (CI) 0.006-0.24)], gestational hypertension (aRR 0.24, 95%CI 0.08-0.76), preeclampsia (aRR 0.18, 95%CI 0.07-0.48), and preeclampsia or eclampsia superimposed on chronic hypertension (aRR 0.03, 95%CI 0.005-0.3), gestational diabetes mellitus (aRR 0.14, 95%CI 0.06-0.34), preterm premature rupture of membranes (aRR 0.14, 95%CI 0.02-0.96), preterm delivery (aRR 0.36, 95%CI 0.23-0.55), and cesarean delivery (CD) (aRR 0.01, 95%CI 0.007-0.01) and small for gestational age (aRR 0.15, 95%CI 0.005-0.04), compared to abdominal myomectomy group. Laparoscopic myomectomy group had a higher rate of spontaneous aRR 35.57, 95%CI 22.53-62.66), and operative vaginal delivery (aRR 10.2, 95%CI 8.3-12.56), uterine rupture (aRR 6.1. 95%CI 3.2-11.63), postpartum hemorrhage (aRR 3.54, 95%CI 2.62-4.8), hysterectomy (aRR 7.74, 95%CI 5.27-11.4), transfusion (aRR 3.34, 95%CI 2.54-4.4), pulmonary embolism (aRR 7.44, 95%CI 2.44-22.71), disseminated intravascular coagulation (aRR 2.77, 95% CI 1.47-5.21), maternal infection (aRR 1.66, 95%CI 1.1-2.5) and death (aRR 2.04 95%CI 1.31-3.2)) and intra-uterine fetal death (aRR 2.99, 95%CI 1.72-5.2) compared to the abdominal myomectomy group. ConclusionsWomen who had a previous abdominal myomectomy have underlying risk factors for hypertension disorders of pregnancy and gestational diabetes. Women who underwent laparoscopic myomectomies have higher risks of bleeding, uterine rupture, resultant complications, and death, and should be monitored as high-risk patients, like abdominal myomectomies.

Altered prefrontal and cerebellar parvalbumin neuron counts are associated with cognitive changes in male rats.

Exposure to valproic acid (VPA), a common anti-seizure medication, in utero is a risk factor for autism spectrum disorder (ASD). People with ASD often display changes in the cerebellum, including volume changes, altered circuitry, and changes in Purkinje cell populations. ASD is also characterized by changes in the medial prefrontal cortex (mPFC), where excitatory/inhibitory balance is often altered. This study exposed rats to a high dose of VPA during gestation and assessed cognition and anxiety-like behaviors during young adulthood using a set-shifting task and the elevated plus maze. Inhibitory parvalbumin-expressing (PV +) neuron counts were assessed in the mPFC and cerebellar lobules VI and VII (Purkinje cell layers), which are known to modulate cognition. VPA males had increased PV + counts in crus I and II of lobule VII. VPA males also had decreased parvalbumin-expressing neuron counts in the mPFC. It was also found that VPA-exposed rats, regardless of sex, had increased parvalbumin-expressing Purkinje cell counts in lobule VI. In males, this was associated with impaired intra-dimensional shifting on a set-shifting task. Purkinje cell over proliferation may be contributing to the previously observed increase in volume of Lobule VI. These findings suggest that altered inhibitory signaling in cerebellar-frontal circuits may contribute to the cognitive deficits that occur within ASD.

Pain, obesity, adenosine salvage disruption, and smoking behavior mediate the effect of gut microbiota on sleep disorders: results from network Mendelian randomization and 16S rDNA sequencing.

The objective of this study is to investigate the indirect causalities between gut microbiota and sleep disorders. In stage 1, we utilized 196 gut microbiota as the exposure factor and conducted a two-sample univariable Mendelian randomization (MR) analysis on five sleep disorders: insomnia, excessive daytime sleepiness (EDS), sleep-wake rhythm disorders (SWRD), obstructive sleep apnea (OSA), and isolated REM sleep behavior disorder (iRBD). In stage 2, we validated the MR findings by comparing fecal microbiota abundance between patients and healthy controls through 16S rDNA sequencing. In stage 3, we explored the indirect pathways by which the microbiota affects sleep, using 205 gut microbiota metabolic pathways and 9 common risk factors for sleep disorders as candidate mediators in a network MR analysis. In stage 1, the univariable MR analysis identified 14 microbiota potentially influencing five different sleep disorders. In stage 2, the results from our observational study validated four of these associations. In stage 3, the network MR analysis revealed that the Negativicutes class and Selenomonadales order might worsen insomnia by increasing pain [mediation: 12.43% (95% CI: 0.47, 24.39%)]. Oxalobacter could raise EDS by disrupting adenosine reuptake [25.39% (1.84, 48.95%)]. Allisonella may elevate OSA risk via obesity promotion [36.88% (17.23, 56.54%)], while the Eubacterium xylanophilum group may lower OSA risk by decreasing smoking behavior [7.70% (0.66, 14.74%)]. Triangulation of evidence from the MR and observational study revealed indirect causal relationships between the microbiota and sleep disorders, offering fresh perspectives on how gut microbiota modulate sleep.

Risk factors for neurological disorders at an early age in premature babies with different gestational ages

Risk factors for neurological disorders at an early age in premature babies with different gestational ages

Research on sleep disorders and related risk factors among healthcare workers from Fujian province supporting Hubei province during the COVID-19 pandemic.

To explore the impact of COVID-19 on the sleep of healthcare workers from Fujian Province supporting Hubei Province and its related risk factors. A cross-sectional, anonymous, self-reported online questionnaire survey was conducted among all participants. The questionnaire consisted of five parts: sociodemographic characteristics and COVID-19 epidemic-related factors, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Morningness-Eveningness Questionnaire-5 (MEQ-5), and 12-item General Health Questionnaire (GHQ-12). Among 552 participants, 203 (36.8%) had a PSQI score > 7, indicating the presence of sleep disorders. Logistic regression analysis revealed that sleep disorders were independently associated with a history of previously diagnosed sleep disorders (OR 6.074, 95% CI 2.626-14.049, P < 0.001), rotating night shifts > 3 times per week (OR 3.089, 95% CI 1.650-5.781, P < 0.001), using electronic devices before sleep >1 h (OR 1.685, 95% CI 1.131-2.511, P = 0.010), concern about contracting COVID-19 (OR 1.116, 95% CI 1.034-1.204, P = 0.005), perception of societal support for supporting healthcare workers in Hubei (OR 0.861,95% CI 0.744-0.998, P = 0.047) (OR 0.861, 95% CI 0.744-0.998, P = 0.047), non-medical staff (OR 0.257, 95% CI 0.067-0.987, P = 0.048), ESS score (OR 1.068, 95% CI 1.018-1.121, P = 0.007), and GHQ-12 score (OR 1.511, 95% CI 1.281-1.782, P < 0.001). Sleep disorders were highly prevalent among healthcare workers from Fujian Province supporting Hubei Province during the COVID-19 pandemic. Risk factors for sleep disorders included a history of previously diagnosed sleep disorders, rotating night shifts > 3 times per week, using electronic devices before sleep >1 h, excessive concern about contracting COVID-19, and poorer psychological health. Higher perceived societal support and understanding of support for healthcare workers supporting Hubei were associated with a reduced risk of sleep disorders, as was being non-medical staff. Providing more sleep hygiene education and psychological health services for frontline healthcare workers is necessary.

Evaluation of neutrophile-to-lymphocyte ratio and lipid profile in non-violent suicide attempters: a mechanistic study.

Suicide is one of the most common causes of juvenile death. Screening suicide risk is quite challenging and even more difficult in subjects who have no psychiatric disorder or other suicide risk factors in their medical history. To date, the association of serum lipid profile and suicidal risk has been evaluated in patients with different psychiatric disorders, yielding conflicting results. Here, we aimed to investigate the lipid panel and neutrophil-to-lymphocyte ratio in the sera of people with a first episode of suicide attempt in western Iran. A total of 159 suicide attempters and 186 volunteers without history of suicide, aged 18-35 years, were evaluated in this experiment. Blood samples were collected between 8-10 AM and kept at 37 °C for blood clotting. We then analyzed the concentration of various lipid markers, including triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), using a series of enzymatic reactions. Additionally, we determined the neutrophil-to-lymphocyte ratio (NLR) by dividing the total number of neutrophils by the total number of lymphocytes after conducting peripheral blood cell counts. The concentration of TG was 94.2±5.8 mg/dL in males and 92.3±5.3 mg/dL in females. TC was 136.3±3.6 mg/dL in males and 152.7±4.4 in females, with a significant decrease in comparison with the control subjects (p less than 0.0001). NLR was 4.34±0.9 with a significant increase compared with the controls (P less than 0.002). (TG), (TC) and (LDL) levels in suicide attempters were significantly lower than in the control groups. Nevertheless, serum (HDL) levels in male and female suicide attempters were significantly higher than in the control group. Furthermore, NLR was significantly lower in the subjects with suicide attempts compared with the controls. Lower concentrations of (TG), (TC) and (LDL) along with higher NLR were associated with non-violent suicide attempts. These findings might be an effective tool in screening suicide risk in young adults.

Prolactin mitigates chronic stress-induced maladaptive behaviors and physiology in ovariectomized female rats

Stress is a major risk factor for several neuropsychiatric disorders in women, including postpartum depression. During the postpartum period, diminished ovarian hormone secretion increases susceptibility to developing depressive symptoms. Pleiotropic peptide hormones, like prolactin, are markedly released during lactation and suppress hypothalamic-pituitary-adrenal axis responses in women and acute stress-induced behavioral responses in female rodents. However, the effects of prolactin on chronic stress-induced maladaptive behaviors remain unclear. Here, we used chronic variable stress to induce maladaptive physiology in ovariectomized female rats and concurrently administered prolactin to assess its effects on several depression-relevant behavioral, endocrine, and neural characteristics. We found that chronic stress increased sucrose anhedonia and passive coping in saline-treated, but not prolactin-treated rats. Prolactin treatment did not alter stress-induced thigmotaxis, corticosterone (CORT) concentrations, hippocampal cell activation or survival. However, prolactin treatment reduced basal CORT concentrations and increased dopaminergic cells in the ventral tegmental area. Further, prolactin-treated rats had reduced microglial activation in the ventral hippocampus following chronic stress exposure. Together, these data suggest prolactin mitigates chronic stress-induced maladaptive behaviors and physiology in hypogonadal females. Moreover, these findings imply neuroendocrine-immune mechanisms by which peptide hormones confer stress resilience during periods of low ovarian hormone secretion.

Prevalence and influencing factors of sleep disorders in medical students after the COVID-19 pandemic

BackgroundThe prevalence of sleep disorders among medical students was high during the COVID-19 pandemic. However, fewer studies have been conducted on sleep disorders among medical students after the COVID-19 pandemic. This study investigated the prevalence and factors influencing sleep disorders among Chinese medical students after COVID-19.MethodsA total of 1,194 Chinese medical students were included in this study from 9th to 12th July 2023. We used the Self-administered Chinese scale to collect the demographic characteristics. In addition, we used the Chinese versions of the Self-rating Depression Scale (SDS), the Self-rating Anxiety Scale (SAS), and the Pittsburgh Sleep Quality Index (PSQI) to assess subjects’ depression, anxiety, and sleep disorders, respectively. The chi-square test and binary logistic regression were used to identify factors influencing sleep disorders. The receiver operating characteristic (ROC) curve was utilized to assess the predictive value of relevant variables for sleep disorders.ResultsWe found the prevalence of sleep disorders among medical students after COVID-19 was 82.3%. According to logistic regression results, medical students with depression were 1.151 times more likely to have sleep disorders than those without depression (OR = 1.151, 95% CI 1.114 to 1.188). Doctoral students were 1.908 times more likely to have sleep disorders than graduate and undergraduate students (OR = 1.908, 95% CI 1.264 to 2.880).ConclusionThe prevalence of sleep disorders among medical students is high after COVID-19. In addition, high academic levels and depression are risk factors for sleep disorders. Therefore, medical colleges and administrators should pay more attention to sleep disorders in medical students after the COVID-19 pandemic. Regular assessment of sleep disorders and depression is essential.

Development and validation of a prediction nomogram for sleep disorders in hospitalized patients with acute myocardial infarction

PurposeSleep disorders are becoming more prevalent in hospitalized patients with acute myocardial infarction (AMI). We aimed to investigate the risk factors for sleep disorders in hospitalized patients with AMI, then develop and validate a prediction nomogram for the risk of sleep disorders.MethodsClinical data were collected from patients with AMI hospitalized in our hospital from January 2020 to June 2023. All patients were divided into the training group and the validation group with a ratio of 7:3 in sequential order. The LASSO regression analysis and multivariate logistic regression analysis were used to screen potential risk factors for sleep disorders. The concordance index (C-index), calibration curves, and decision curve analysis (DCA) were plotted.ResultsA total of 256 hospitalized patients with AMI were enrolled. Patients were divided into the training group (180) and the validation group (76) according to a scale of 7:3. Of the 256 patients, 90 patients (35.16%) suffered from sleep disorders, and 33 patients (12.89%) needed hypnotics. The variables screened by LASSO regression included age, smoking, NYHA class, anxiety status at admission, depression status at admission, and strangeness of environment. A nomogram model was established by incorporating the risk factors selected. The C-index, calibration curve, and DCA showed good predictive performance.ConclusionsWe identified six clinical characteristics as predictors of sleep disorders in hospitalized patients with AMI. It helps nurses make appropriate decisions in clinical practice.

Coping style as a risk factor for future alcohol use disorder: A 16-year longitudinal study in a Canadian military sample

BackgroundCoping strategies used in response to stress have the potential to influence the development of mental health disorders, including alcohol use disorders. The current study investigated whether coping strategies placed an individual at greater likelihood for developing a future alcohol use disorder. MethodsThis study used data from the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey; a nationally representative 16-year follow-up survey, with initial data collected in the 2002 Canadian Community Health Survey – Canadian Forces Supplement. The total sample from the two datasets included 2941 individuals who were Regular Force members in 2002. Coping styles included problem-focused, avoidant, and self-medication. Adjusted logistic regression analyses examined relationships between coping style (in 2002) and alcohol use disorders (developed between 2002 and 2018). ResultsSelf-medication coping in 2002 was associated with any alcohol disorder since last interview (i.e., 2002–2018) (AOR 1.26; 95 % CI, 1.02–1.57) and during the past year (adjusted odds ratios [AOR 1.26; 95 % CI, 1.08–1.47]), as well as past-year binge drinking (AOR 1.19; 95 % CI, 1.09–1.29). Problem-focused coping was protective against past-year alcohol abuse (AOR 0.84; 95 % CI, 0.71–1.00) and any alcohol use disorder (AOR 0.87; 95 % CI 0.76–1.00). ConclusionCoping styles were strongly associated with future alcohol use disorders. Notably, results show the risk extended over a 16-year period. Findings suggest the use of self-medicating coping strategies places an individual at increased risk of developing alcohol use disorders, while problem-focused coping may decrease future risk of alcohol use disorders.

Risk of Pediatric Bipolar Disorder After General Anesthesia in Infants and Toddlers: A Propensity Score-Matched Population-Based Cohort Study.

The potential role of anesthesia as an independent risk factor for childhood bipolar disorder (BD) remains unclear. To address this, we conducted a population-based cohort study employing propensity score matching to compare BD incidence between pediatric patients undergoing surgery with and without general anesthesia. Our study included patients aged 0-3 years who received at least 1 episode of general anesthesia and were hospitalized for over 1 day in Taiwan between January 2004 and December 2014. They were matched 1:1 with a population not receiving general anesthesia to assess pediatric BD incidence. The study cohort comprised 15 070 patients, equally distributed between the general anesthesia and nongeneral anesthesia groups (7535 each). Multivariate Cox regression analysis revealed adjusted hazard ratios (aHRs; 95% CIs) for pediatric BD in the general anesthesia group as 1.26 (1.04-1.54; P = .021) compared to the nongeneral anesthesia group. Moreover, the incidence rate ratio (95% CI) for the general anesthesia group was 1.26 (1.03-1.53) compared to the nongeneral anesthesia group. Early childhood exposure to general anesthesia is significantly associated with an increased risk of pediatric BD. This expands understanding of pediatric BD's complex development, informing preventive strategies, and enhancing mental health outcomes for vulnerable young patients and global pediatric healthcare.

A mixed methods approach to describe the efficacy of lift assist device use to reduce low back musculoskeletal disorder risk factors during three common patient extrication scenarios

This mixed-method study evaluated the efficacy of lift assist device use (Binder®, Eagle®, Maxi Air®) relative to manual lifting/care-as-usual in reducing low back muscle activity and perceived exertion during simulated patient extrication tasks. User feedback was recorded to identify factors that might influence use. Twenty paramedics performed a floor to stretcher lift, lateral transfer, and confined space extrication care-as-usual and with lift assist devices. Use of a lift assist reduced low back muscle activity during floor to stretcher and confined space tasks by 34–47%. Paramedics perceived exertion decreased from ‘somewhat hard’ to ‘light’ or ‘very light’ when using an assistive device. Paramedics noted that ease of use, patient comfort, task time, patient acuity, among other considerations would influence use decisions. Lift assist devices were efficacious at reducing low back muscle activity and perceived exertion during floor to stretcher and patient extrication tasks.

Workstation Risk Factors for Work-related Musculoskeletal Disorders Among IT Professionals in Indonesia.

This study aimed to identify workstation factors influencing work-related musculoskeletal disorders (WMSDs) among information technology (IT) professionals in Indonesia. A cross-sectional study was conducted among 150 IT workers at small-enterprise companies who were randomly selected across East Java, Indonesia. The data were modeled using multiple linear regression, with a 95% level of confidence for determining statistical significance. The respondents reported that the neck had the highest level of discomfort and was the most at risk of WMSDs, followed by the lower back, right shoulder, and upper back. Screen use duration (p=0.040) was associated with whole-body WMSDs, along with seat width (p=0.059), armrest (p=0.027), monitor (p=0.046), and a combined telephone and monitor score (p=0.028). Meanwhile, the factors significantly related to the risk of WMSDs in the hands and wrist were working period (p=0.039), night shift (p=0.024), backrest (p=0.008), and mouse score (p=0.032). Occupational safety authorities, standards-setting departments, and policymakers should prioritize addressing the risk factors for WMSDs among IT professionals.

Correlation analysis and predictive model construction of metabolic syndrome, complete blood count-derived inflammatory markers, and overall burden of cerebral small vessel disease

BackgroundThe high burden of cerebral small vessel disease (CSVD) on neuroimaging is a significant risk factor for stroke, cognitive dysfunction, and emotional disorders. Currently, there is a lack of studies investigating the correlation between metabolic syndrome (MetS), complete blood count-derived inflammatory markers, and total CSVD burden. This study aims to evaluate the total CSVD imaging load using machine learning (ML) algorithms and to explore further the relationship between MetS, complete blood count-derived inflammatory markers, and CSVD load. MethodsWe included CSVD patients from Xijing Hospital (2012–2022). Univariate and lasso regression analyses identified variables linked to CSVD neuroimaging burden. Six ML models predicted CSVD burden based on MetS and inflammatory markers. Model performance was evaluated using ROCauc, PRauc, DCA, and calibration curves. The SHAP method validated model interpretability. The best-performing model was selected to develop a web-based calculator using the Shiny package. ResultsThe Logistic regression model outperformed others in predicting CSVD burden. The model incorporated MetS, neutrophil-to-lymphocyte ratio (NLR), homocysteine (Hcy), age, smoking status, cystatin C (CysC), uric acid (UA), and prognostic nutritional index (PNI). ConclusionMetS, NLR, Hcy and CSVD high load were positively correlated, and the Logistic regression model could accurately predict the total CSVD load degree.

Profile of chronic pain patients with opioid withdrawal syndrome according to psychological factors: a Latent Class Analysis.

Withdrawal syndrome stands out as the strongest risk factor for Prescription Opioid-Use Disorder (POUD) and is related to psychological and pain impairment in chronic pain population. This study aimed to identify profiles of chronic pain patients with opioid withdrawal based on psychological factors, and to explore the association between the classes and demographic, clinical, and substance use variables. This cross-sectional descriptive study involved 391 patients, 221 of them with interdose withdrawal (mean age=57.91±13.61 years; 68.3% female). Latent Class Analysis (LCA) and bivariate and logistic regression analyses were performed. Two latent classes were identified (BIC=4020.72, entropy=0.70, LRTs p<0.01): Withdrawal syndrome with No Psychological Distress (WNPD; 45.2%, n=100) and Withdrawal syndrome with Psychological Distress (WPD; 54.8%, n=121). The WPD class was more likely to experience craving, anxiety, and depression, and to report higher levels of pain intensity and interference (p<0.01). Patients in this class were younger, visited a higher number of specialists, and showed higher rates of high-dose opioid use, misuse, moderate-severe POUD, and tobacco and anxiolytics use (p<0.05). Only moderate-severe POUD (OR=2.64) and tobacco use (OR=2.28) increased the risk of WPD class membership. Although it is common for chronic pain patients to experience withdrawal symptoms during opioid treatment, more than a half of the participants reported concomitant psychological distress. Establishing differential profiles can help to improve withdrawal syndrome management during the treatment of chronic pain with opioids.

Semaglutide Attenuates Anxious and Depressive-Like Behaviors and Reverses the Cognitive Impairment in a Type 2 Diabetes Mellitus Mouse Model Via the Microbiota-Gut-Brain Axis.

Newly conducted research suggests that metabolic disorders, like diabetes and obesity, play a significant role as risk factors for psychiatric disorders. This connection presents a potential avenue for creating novel antidepressant medications by repurposing drugs originally developed to address antidiabetic conditions. Earlier investigations have shown that GLP-1 (Glucagon-like Peptide-1) analogs exhibit neuroprotective qualities in various models of neurological diseases, encompassing conditions such as Alzheimer's disease, Parkinson's disease, and stroke. Moreover, GLP-1 analogs have demonstrated the capability to enhance neurogenesis, a process recognized for its significance in memory formation and the cognitive and emotional aspects of information processing. Nonetheless, whether semaglutide holds efficacy as both an antidepressant and anxiolytic agent remains uncertain. To address this, our study focused on a mouse model of depression linked to type 2 diabetes induced by a High Fat Diet (HFD). In this model, we administered semaglutide (0.05mg/Kg intraperitoneally) on a weekly basis to evaluate its potential as a therapeutic option for depression and anxiety. Diabetic mice had higher blood glucose, lipidic profile, and insulin resistance. Moreover, mice fed HFD showed higher serum interleukin (IL)-1β and lipopolysaccharide (LPS) associated with impaired humor and cognition. The analysis of behavioral responses revealed that the administration of semaglutide effectively mitigated depressive- and anxiety-like behaviors, concurrently demonstrating an enhancement in cognitive function. Additionally, semaglutide treatment protected synaptic plasticity and reversed the hippocampal neuroinflammation induced by HFD fed, improving activation of the insulin pathway, demonstrating the protective effects of semaglutide. We also found that semaglutide treatment decreased astrogliosis and microgliosis in the dentate gyrus region of the hippocampus. In addition, semaglutide prevented the DM2-induced impairments of pro-opiomelanocortin (POMC), and G-protein-coupled receptor 43 (GPR43) and simultaneously increased the NeuN + and Glucagon-like Peptide-1 receptor (GLP-1R+) neurons in the hippocampus. Our data also showed that semaglutide increased the serotonin (5-HT) and serotonin transporter (5-HTT) and glutamatergic receptors in the hippocampus. At last, semaglutide changed the gut microbiota profile (increasing Bacterioidetes, Bacteroides acidifaciens, and Blautia coccoides) and decreased leaky gut, improving the gut-brain axis. Taken together, semaglutide has the potential to act as a therapeutic tool for depression and anxiety.

The Relationship Between Post-Traumatic Stress, Hopelessness and Resources Adequacy in Fire Disaster Survivors: A Mediation Analysis

AbstractThis study explores the psychosocial aftermath of the fire disaster by focusing on the levels of post-traumatic stress, hopelessness and perception of adequacy of resources of the affected population in the Manavgat district of Antalya province. The data of this study, which is a descriptive correlational research, were collected between 01 March-31 May 2022. The Information form, Impact of Events Scale, Beck Hopelessness Scale and Perception of Adequacy of Resource Scale were used as the data collection tools. A total of 245 individuals, predominantly farmers and with a low-income status, participated in the study. Field data revealed a high level post-traumatic stress (39.56 ± 15.71), moderate hopelessness (10.53 ± 6.83), and moderate perception of adequacy of resources (104.17 ± 32.15) among the participants. Another important finding of the study is; sociodemographic variables were significantly associated with the impact of events, hopelessness, and perception of adequacy of resources. Being female, low education and income level, being farmer, having heavily damaged house and living in a prefabricated house emerged as risk factors for Post-Traumatic Stress Disorder (PTSD). The results demonstrated a strong correlation between hopelessness, perception of adequacy of resources and post-traumatic stress. Hopelessness partially mediated the relationship between adequacy of resources and post-traumatic stress. The massive physical, economic and social losses caused by wildfire have led to persistent psychosocial problems among the affected population. The findings highlight the importance of assessing losses related to socioeconomic status and applying risk management accordingly. The data obtained in this study can shed light on the determination of risky groups after fire disaster, psychosocial interventions to be applied and the duration of interventions.