CNS Spectrums最新文献_第3页

Rethinking psychometric testing in autism: overcoming the challenges of comorbidity and diagnostic overshadowing. 对自闭症心理测试的反思：克服共病和诊断遮蔽的挑战。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-17 DOI: 10.1017/S1092852925000021

Nihit Gupta, Srinija Srinivasan, Mayank Gupta

{"title":"Rethinking psychometric testing in autism: overcoming the challenges of comorbidity and diagnostic overshadowing.","authors":"Nihit Gupta, Srinija Srinivasan, Mayank Gupta","doi":"10.1017/S1092852925000021","DOIUrl":"10.1017/S1092852925000021","url":null,"abstract":"Epidemiological data indicates a rising prevalence of autism spectrum disorder (ASD) among eight-year-old children, with rates increasing from 1 in 44 to 1 in 36 between 2022 and 2023. This growing prevalence poses significant challenges in achieving accurate diagnoses, particularly due to comorbid conditions and diagnostic overshadowing. Certain subgroups-such as females with ASD, individuals with high cognitive abilities, and ethnic minorities-remain at heightened risk of underdiagnosis. Diagnostic tools like the Autism Diagnostic Observation Schedule (ADOS-2) have limitations, particularly in clinical settings where gender biases and cultural differences in symptom presentation can complicate accurate assessment. Moreover, rural areas face additional burdens due to limited access to care, further exacerbating diagnostic challenges. The review underscores the necessity for improved screening and diagnostic methods tailored to diverse populations, acknowledging the current limitations of existing tools. It also highlights significant barriers such as workforce shortages and lengthy wait times for evaluations. Emphasizing the importance of clinician education and targeted diagnostic approaches, the review calls for attention to cultural and gender differences in ASD evaluation.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e19"},"PeriodicalIF":3.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Esketamine nasal spray versus quetiapine XR in adults with treatment-resistant depression: a secondary analysis of the ESCAPE-TRD randomized clinical trial. 艾氯胺酮鼻喷雾剂与奎硫平XR治疗成人难治性抑郁症：ESCAPE-TRD随机临床试验的二次分析

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-17 DOI: 10.1017/S1092852924002451

Roger S McIntyre, Gregory Mattingly, Yordan Godinov, Jozefine Buyze, Ibrahim Turkoz, Patricia Cabrera, Manish Patel, Larry Martinez, Mai Himedan, Oliver Lopena

{"title":"Esketamine nasal spray versus quetiapine XR in adults with treatment-resistant depression: a secondary analysis of the ESCAPE-TRD randomized clinical trial.","authors":"Roger S McIntyre, Gregory Mattingly, Yordan Godinov, Jozefine Buyze, Ibrahim Turkoz, Patricia Cabrera, Manish Patel, Larry Martinez, Mai Himedan, Oliver Lopena","doi":"10.1017/S1092852924002451","DOIUrl":"10.1017/S1092852924002451","url":null,"abstract":"Objective: Esketamine nasal spray (ESK) is approved in combination with an oral antidepressant (OAD) for the treatment of adults with treatment-resistant depression (TRD); however, direct comparisons with atypical antipsychotics for TRD are limited. This secondary analysis of the ESCAPE-TRD study compared rates of remission and response, and improvements in depressive symptoms over time, between ESK and quetiapine extended-release (XR) in patients with TRD treated in accordance with US prescribing information (USPI).Methods: ESCAPE-TRD (NCT04338321) was a randomized, open-label, rater-blinded phase 3b trial investigating ESK versus quetiapine XR for acute and maintenance treatment of patients with TRD. This secondary analysis included patients aged 18-64 years who were treated/dosed according to USPI. The primary endpoint was remission, defined as Montgomery-Åsberg Depression Rating Scale (MADRS) total score ≤ 10. Treatment-emergent adverse events (TEAEs) leading to discontinuation were summarized descriptively.Results: Among 636 patients in this secondary analysis (ESK, n = 316; quetiapine XR, n = 320), significantly more ESK-treated patients achieved remission starting at week 8 (28.3% versus 18.6%; P = 0.005) through week 32 (55.7% versus 36.3%; P < 0.001), compared with quetiapine XR-treated patients. There were clinically and statistically significant improvements in MADRS scores with ESK versus quetiapine XR at each visit from day 8 onwards. Fewer patients discontinued treatment because of TEAEs with ESK (4.5%) versus quetiapine XR (10.1%).Conclusions: Consistent with the primary analysis, this secondary analysis demonstrated that ESK improves short- and long-term outcomes compared with quetiapine XR in patients with TRD treated according to USPI.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e26"},"PeriodicalIF":3.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What role did serious mental illness play in Jackson Pollock's drip paintings? Abstract expressionism and possible links to serious mental illness and encrypted images (polloglyphs). 严重的精神疾病在杰克逊·波洛克的水滴画中扮演了什么角色？抽象表现主义和可能与严重精神疾病和加密图像（polloglyphs）有关。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-13 DOI: 10.1017/S1092852924002347

Stephen M Stahl, Debbi Ann Morrissette, Jahon Jabali, Jon A Gates

{"title":"What role did serious mental illness play in Jackson Pollock's drip paintings? Abstract expressionism and possible links to serious mental illness and encrypted images (polloglyphs).","authors":"Stephen M Stahl, Debbi Ann Morrissette, Jahon Jabali, Jon A Gates","doi":"10.1017/S1092852924002347","DOIUrl":"10.1017/S1092852924002347","url":null,"abstract":"The link between creativity and serious mental illness (SMI) is widely discussed. Jackson Pollock is one example of a giant in the field of art who was both highly creative and experiencing an SMI. Pollock created a new genre of art known as abstract expressionism (\"action painting\") defined as showing the frenetic actions of painting. The question arises whether his SMI played any role in the way he created his drip paintings, especially when he was overactive and manic. Furthermore, did visual hallucinations or enhanced visual perception associated with mania or psychosis facilitate Pollock in embedding and camouflaging images under layers of thrown paint? Seeing images in Pollocks drip paintings has been a controversy ever since these paintings were created. Some experts attribute this to pareidolia-perceiving specific images out of random or ambiguous visual patterns-a phenomenon known to be enhanced by fractal fuzzy edges such as seen in Rorschach ink blots as well as in Pollock drip paintings. So, are Pollock's drip paintings merely giant Rorschach images, or did Pollock insert polloglyphs-images that are encrypted that tell a story about Pollock's inner being-into his paintings and then disguise them with drippings? Here, we explore answers to these questions and discuss images that Pollock included in his earliest sketches and used repeatedly in his abstract paintings and later in his drip paintings to argue that these images are not accidental.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e9"},"PeriodicalIF":3.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Beyond the hot flashes: how machine learning is uncovering the complexity of menopause-related depression. 除了潮热：机器学习如何揭示更年期相关抑郁症的复杂性。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-06 DOI: 10.1017/S1092852924002463

Graziella Orrù, Rebecca Ciacchini, Anna Conversano, Ciro Conversano, Angelo Gemignani

{"title":"Beyond the hot flashes: how machine learning is uncovering the complexity of menopause-related depression.","authors":"Graziella Orrù, Rebecca Ciacchini, Anna Conversano, Ciro Conversano, Angelo Gemignani","doi":"10.1017/S1092852924002463","DOIUrl":"10.1017/S1092852924002463","url":null,"abstract":"Background: The transition into menopause marks a significant stage in a woman's life, indicating the end of reproductive capability. This period, encompassing perimenopause and menopause, is characterized by declining levels of estrogen and progesterone, leading to various symptoms such as hot flashes, sleep disturbances, sexual dysfunction, and mood irregularities. Moreover, cognitive functions, notably memory, may decline during this phase.Objective: This exploratory study aimed to evaluate psychological factors in a sample of 98 women recruited from a diagnostic-assistance hospital pathway (AOUP).Methods: Psychological variables, including depression, anxiety, stress, sleep quality, memory, personality traits, and mindfulness, were assessed using psychometric questionnaires. Machine learning techniques were employed to identify independent variables strongly correlated with higher levels of depression measured by BDI-II.Results: The findings revealed positive associations between depression and anxiety, stress, low mood, poor sleep quality, and memory complaints, while mindfulness showed a negative correlation. Remarkably, the machine learning analysis achieved a high classification accuracy in distinguishing between individuals with different levels of depression (low vs high).Conclusions: These results underscore the importance of addressing psychological factors during menopause and offer valuable insights for future research and the development of targeted clinical interventions aimed at enhancing mental health and quality of life for women during this transitional phase.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e33"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correlation analysis of the platelet-to-lymphocyte ratio with attention-deficit hyperactivity disorder in children aged 6-14: based on the National Health and Nutrition Examination Survey database. 6-14岁儿童血小板/淋巴细胞比值与注意缺陷多动障碍的相关性分析：基于全国健康与营养检查调查数据库

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-06 DOI: 10.1017/S1092852924002475

Xianhua Li, Yan Luo, Xiaodan Zeng, Xuewen Qiu, Yang Hua, Lingling Zhan

{"title":"Correlation analysis of the platelet-to-lymphocyte ratio with attention-deficit hyperactivity disorder in children aged 6-14: based on the National Health and Nutrition Examination Survey database.","authors":"Xianhua Li, Yan Luo, Xiaodan Zeng, Xuewen Qiu, Yang Hua, Lingling Zhan","doi":"10.1017/S1092852924002475","DOIUrl":"10.1017/S1092852924002475","url":null,"abstract":"Objective: This study aimed to elucidate the association between the platelet-to-lymphocyte ratio (PLR) and the risk of attention deficit hyperactivity disorder (ADHD) in children aged 6-14 based on National Health and Nutrition Examination Survey (NHANES) data.Method: We utilized data from NHANES 2013-2014 for analysis, with PLR as the independent variable and ADHD as the dependent variable. Weighted logistic regression was used to construct the relationship model. The subgroup analysis with stratification and adjustment for confounding factors was conducted to explore the association between PLR and ADHD risk in children aged 6-14. Finally, the restricted cubic spline (RCS) analysis was carried out to explore the non-linear relationship between PLR and ADHD.Results: The study included 1455 samples with 91 ADHD cases. A significant positive association (OR > 1, P < 0.05) was observed between PLR and ADHD risk in the multivariate weighted logistic regression model. Race and asthma status remarkably influenced the relationship between PLR and ADHD (P for interaction<0.05). The positive association between PLR and ADHD risk was particularly significant (P < 0.05) in boys, children born to mothers aged 20-29, and children with asthma. The RCS curve indicated a non-linear association between PLR and ADHD risk (P-non-linear = 0.0040), with OR > 1 when PLR ≥ 106.40.Conclusion: Increased PLR elevated the risk of ADHD, especially in males, children born to mothers aged 20-29, and children with asthma, with 106.40 possibly being an effective threshold for PLR's impact on ADHD risk.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e20"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Liberty or life: the Aotearoa New Zealand perspective. 自由还是生活：新西兰人的视角。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-02 DOI: 10.1017/S1092852924000579

Justin Barry-Walsh

引用次数: 0

Anosognosia in schizophrenia. 精神分裂症的病感失认症。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2024-12-26 DOI: 10.1017/S1092852924002323

Benjamin Rose, Philip D Harvey

{"title":"Anosognosia in schizophrenia.","authors":"Benjamin Rose, Philip D Harvey","doi":"10.1017/S1092852924002323","DOIUrl":"10.1017/S1092852924002323","url":null,"abstract":"Anosognosia, defined as a lack of knowledge of the disease, was originally identified in neurological disorders and is common in schizophrenia. These deficits are commonly referred to as \"lack of insight\" or \"unawareness of illness.\" They include challenges in accurate judgments of the reality of experience, as well as global and specific personal abilities. Related to inaccuracies in self-assessment are response biases when an incorrect self-assessment is made. We adopted a perspective focused on Introspective Accuracy (IA) and Introspective Bias (IB). IA is the ability to accurately judge several domains of experience and functioning. These include the reality of clinical symptoms, the experience of mood states, momentary competence in the performance of cognitive assessments and everyday functional skills, and the ability to accurately anticipate the success of future performance. IB is the direction of response bias in the context of impairments in IA. Deficits in insight, judgment inaccuracies, and response bias are highly relevant as these difficulties come with downstream impacts including difficulties with treatment adherence, an increase in severity of symptoms, greater everyday disability, reduced response to cognitive training interventions, and a need for increased intensity of interventions to maintain community residence. In this article, we review the research in IA and IB in schizophrenia, including differences in momentary versus global self-assessments, and the clinical correlates and functional impacts of inaccurate self-assessments and response biases in the context of self-assessment errors. We also examine the existing data regarding the neurobiological basis of impairments in IA.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e24"},"PeriodicalIF":3.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dignity restored: the power of treatment first. 恢复尊严：首先是治疗的力量。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2024-12-23 DOI: 10.1017/S109285292400052X

Jhilam Biswas

引用次数: 0

A neuroethical approach to human life, identity, and liberty of schizophrenic patients. 精神分裂症患者的生命、身份和自由的神经伦理学方法。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2024-12-12 DOI: 10.1017/S1092852924000506

Alberto Carrara

{"title":"A neuroethical approach to human life, identity, and liberty of schizophrenic patients.","authors":"Alberto Carrara","doi":"10.1017/S1092852924000506","DOIUrl":"10.1017/S1092852924000506","url":null,"abstract":"This article presents a comprehensive neuroethical framework that seeks to deepen our understanding of human consciousness and free will, particularly in the context of psychiatric and neurological disorders. By integrating insights from neuroscience with philosophical reflections on freedom and personal identity, the paper examines how various states of consciousness from interoception to self-awareness influence an individual's autonomy and decision-making capabilities. The discussion utilizes a multidimensional, bottom-up approach to explore how neurobiological processes underlie different levels of conscious experience and their corresponding types of freedom, such as \"intero-freedom\" related to internal bodily states and \"self-freedom\" associated with higher self-awareness. This stratification reveals the profound impact of neurological conditions on patients' freedom of choice and the ethical implications therein. The insights gained from this analysis aim to inform more tailored and effective treatments for psychiatric patients, emphasizing the restoration of autonomy and respect for their inherent dignity. This work underscores the essential unity of the human person through the lens of neuroethics, advocating for healthcare policies that recognize and enhance the personal freedom of those with mental health challenges.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e4"},"PeriodicalIF":3.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of esketamine for perinatal depression: a systematic review and meta-analysis - CORRIGENDUM. 艾氯胺酮对围产期抑郁症的疗效：一项系统回顾和荟萃分析-勘误。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2024-12-10 DOI: 10.1017/S1092852924002396

Sabrina Wong, Gia Han Le, Angela T H Kwan, Kayla M Teopiz, Taeho Greg Rhee, Roger Ho, Joshua D Rosenblat, Rodrigo Mansur, Roger S McIntyre

引用次数: 0