CNS Spectrums最新文献

{"title":"Neuropsychiatric phenotypes in functional movement disorder.","authors":"Gabriela S Gilmour, Laura K Langer, Anthony E Lang, Lindsey MacGillivray, Sarah C Lidstone","doi":"10.1017/S1092852923002353","DOIUrl":"10.1017/S1092852923002353","url":null,"abstract":"<p><strong>Objective: </strong>Functional movement disorder (FMD), the motor-dominant subtype of functional neurological disorder, is a complex neuropsychiatric condition. Patients with FMD also manifest non-motor symptoms. Given that patients with FMD are diagnosed based on motor phenotype, the contribution of non-motor features to the neuropsychiatric syndrome is not well characterized. The objective of this hypothesis-generating study was to explore potential novel, neuropsychiatric FMD phenotypes by combining movement disorder presentations with non-motor comorbidities including somatic symptoms, psychiatric diagnoses, and psychological traits.</p><p><strong>Methods: </strong>This retrospective chart review evaluated 158 consecutive patients with a diagnosis of FMD who underwent deep phenotyping across neurological and psychiatric domains. Demographic, clinical, and self-report features were analyzed. A data-driven approach using cluster analysis was performed to detect patterns when combining the movement disorder presentation with somatic symptoms, psychiatric diagnoses, and psychological factors. These new neuropsychiatric FMD phenotypes were then tested using logistic regression models.</p><p><strong>Results: </strong>Distinct neuropsychiatric FMD phenotypes emerged when stratifying by episodic vs. constant motor symptoms. Episodic FMD was associated with hyperkinetic movements, hyperarousal, anxiety, and history of trauma. In contrast, constant FMD was associated with weakness, gait disorders, fixed dystonia, activity avoidance, and low self-agency. Pain, fatigue, somatic preoccupation, and health anxiety were common across all phenotypes.</p><p><strong>Conclusion: </strong>This study found patterns spanning the neurological-psychiatric interface that indicate that FMD is part of a broader neuropsychiatric syndrome. Adopting a transdisciplinary view of illness reveals readily identifiable clinical factors that are relevant for the development and maintenance of FMD.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9918357","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}

{"title":"Standardized diagnostic assessment for child and adolescents mental health services: a leap forward in measurement-based care.","authors":"Mayank Gupta, Nihit Gupta","doi":"10.1017/S1092852923000093","DOIUrl":"10.1017/S1092852923000093","url":null,"abstract":"","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10748941","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}

{"title":"CNS volume 28 issue 6 Cover and Back matter","authors":"","doi":"10.1017/S1092852923006375","DOIUrl":"https://doi.org/10.1017/S1092852923006375","url":null,"abstract":"","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138618237","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}

{"title":"Associations between peripheral inflammation and clinical phenotypes of bipolar depression in a lower-middle income country.","authors":"Brett D M Jones, Urbee Mahmood, John Hodsoll, Imran B Chaudhry, Ameer B Khoso, Mohammed O Husain, Abigail Ortiz, Nusrat Husain, Benoit H Mulsant, Allan H Young, Muhammad I Husain","doi":"10.1017/S1092852923002316","DOIUrl":"10.1017/S1092852923002316","url":null,"abstract":"<p><strong>Objective: </strong>There has been increased interest in repurposing anti-inflammatories for the treatment of bipolar depression. Evidence from high-income countries suggests that these agents may work best for specific depressive symptoms in a subset of patients with biochemical evidence of inflammation but data from lower-middle income countries (LMICs) is scarce. This secondary analysis explored the relationship between pretreatment inflammatory markers and specific depressive symptoms, clinical measures, and demographic variables in participants with bipolar depression in Pakistan.</p><p><strong>Methods: </strong>The current study is a cross-sectional secondary analysis of a randomized controlled trial of two anti-inflammatory medications (minocycline and celecoxib) for bipolar depression (n = 266). A series of logistic and linear regression models were completed to assess the relationship between C-reactive protein (CRP) (CRP > or < 3 mg/L and log10CRP) and clinical and demographic features of interest and symptoms of depression. Baseline clinical trial data was used to extract clinical and demographic features and symptoms of depression were assessed using the 24-item Hamilton Depression Rating Scale.</p><p><strong>Results: </strong>The prevalence of low-grade inflammation (CRP > 3 mg/L) in the sample was 70.9%. After adjusting for baseline body mass index, socioeconomic status, age, gender, symptoms related to anhedonia, fatigue, and motor retardation were most associated with low-grade inflammation.</p><p><strong>Conclusions: </strong>Bipolar disorder (BD) patients from LMICs may experience higher rates of peripheral inflammation than have been reported in Western populations with BD. Future trials of repurposed anti-inflammatory agents that enrich for participants with these symptom profiles may inform the development of personalized treatment for bipolar depression in LMICs.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9513610","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}

{"title":"Response to the letter to the editor: \"The price of love: how sleep, and dysregulated clocks may account for its obsessive-compulsive related behaviors\" by Miguel Meira e Cruz.","authors":"Donatella Marazziti","doi":"10.1017/S1092852923000068","DOIUrl":"10.1017/S1092852923000068","url":null,"abstract":"","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10801023","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}

{"title":"Lurasidone and risk of metabolic syndrome: results from short and long-term studies in patients with bipolar depression.","authors":"Michael Tocco, John W Newcomer, Yongcai Mao, Andrei Pikalov","doi":"10.1017/S1092852923001190","DOIUrl":"10.1017/S1092852923001190","url":null,"abstract":"<p><strong>Objective: </strong>The elevated prevalence of metabolic syndrome (MetS) in patients with depression has been associated with increased mortality. This post hoc analysis assessed the effect of treatment with lurasidone on risk of MetS in patients with bipolar depression.</p><p><strong>Methods: </strong>Data used in the current analyses consisted of 3 double-blind (DB), placebo-controlled, 6-week studies in adults with bipolar I depression (N = 1192), consisting of 1 monotherapy, and 2 adjunctive trials (lithium or valproate). Also analyzed was a 6-month open-label (OL) extension study (monotherapy, N = 316; adjunctive therapy, N = 497); and a 5-month, OL, stabilization phase followed by randomization to a 28-week DB, placebo-controlled, adjunctive therapy study with lurasidone (N = 490). MetS was defined based on NCEP ATP III criteria (2005 revision).</p><p><strong>Results: </strong>The proportion of patients with new-onset MetS was similar for lurasidone vs placebo in the short-term studies (monotherapy, 13.9% vs 15.3%; adjunctive therapy, 13.6% vs 11.0%); and remained stable during both the 6-month extension phase study (monotherapy, 15.2%; adjunctive therapy, 16.9%), and the 5-month stabilization study (adjunctive therapy, 12.2%). After 28 weeks of DB treatment (following 5-month treatment in the stabilization study), new onset MetS was observed at endpoint (OC) in 26.2% of the lurasidone group, and 30.8% of the placebo group.</p><p><strong>Conclusions: </strong>This post hoc analysis found that both short and long-term treatment with lurasidone was associated with a relatively low risk for the development of MetS in patients with bipolar I disorder. These findings are consistent with similar analyses in patients with schizophrenia.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9536121","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}

{"title":"Chronotype is differentially associated with lifetime mood and panic-agoraphobic spectrum symptoms in patients with bipolar disorder and healthy controls.","authors":"Francy Cruz-Sanabria, Miriam Violi, Andrea Bazzani, Simone Bruno, Leonardo Massoni, Carlo Antonio Bertelloni, Valerio Dell'Oste, Paolo Frumento, Ugo Faraguna, Liliana Dell'Osso, Claudia Carmassi","doi":"10.1017/S1092852923001207","DOIUrl":"10.1017/S1092852923001207","url":null,"abstract":"<p><strong>Objective: </strong>Although the association between chronotype and mood disorders has been consistently reported, conversely, attempts to measure the association between chronotype and anxiety symptoms have generated inconsistent results. We aimed at evaluating whether chronotype (assessed through subjective and objective measures) is associated with lifetime mood and panic-agoraphobic spectrum symptoms in healthy controls (HCs) and in patients with bipolar disorder (BD).</p><p><strong>Methods: </strong>Overall, 173 subjects, patients with BD in euthymic phase (<i>n =</i> 76) and HC (<i>n =</i> 97), were evaluated through the reduced Morningness-Eveningness Questionnaire (rMEQ), actigraphy monitoring and mood and panic-agoraphobic spectrum self-report (MOODS-SR and PAS-SR). The discrepancy between objective (actigraphic-based) versus subjective (rMEQ-based) circadian typology was estimated through the Circadian Classification Discrepancy Index (CCDI).</p><p><strong>Results: </strong>rMEQ-based evening chronotype (ET) was associated with higher scores in MOODS-SR depressive and rhythmicity and vegetative functions domains in HC and BD.Both ET and morning chronotypes (MT) were associated with higher PAS-SR scores in BD only. Actigraphic-based MT was associated with higher MOODS-SR depressive scores in HC. Likewise, the discrepancy between actigraphic-based and rMEQ-based circadian typology was associated with depressive symptoms in HC only.</p><p><strong>Conclusion: </strong>Self-reported ET was consistently associated with mood symptoms, while associations with panic-agoraphobic symptoms only emerged in BD and involved both extreme chronotypes. The discrepancy between the preferred circadian typology (rMEQ-based) and the actual one (actigraphic-based) could contribute to depressive symptoms in HC. These results pave the way for interventional studies targeting circadian typology in an attempt to prevent or treat mental health disorders.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9691746","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}

{"title":"Impaired cognitive flexibility across psychiatric disorders.","authors":"Jon E Grant, Samuel R Chamberlain","doi":"10.1017/S1092852923002237","DOIUrl":"10.1017/S1092852923002237","url":null,"abstract":"<p><strong>Objective: </strong>Problems with cognitive flexibility have been associated with multiple psychiatric disorders, but there has been little understanding of how cognitive flexibility compares across these disorders. This study examined problems of cognitive flexibility in young adults across a range of psychiatric disorders using a validated computerized <i>trans</i>-diagnostic flexibility paradigm. We hypothesized that obsessive-compulsive spectrum disorders (eg, obsessive-compulsive disorder, trichotillomania, and skin-picking disorder) would be associated with pronounced flexibility problems as they are most often associated with irrational or purposeless repetitive behaviors.</p><p><strong>Methods: </strong>A total of 576 nontreatment seeking participants (aged 18-29 years) were enrolled from general community settings, provided demographic information, and underwent structured clinical assessments. Each participant undertook the intra-extra-dimensional task, a validated computerized test measuring set-shifting ability. The specific measures of interest were total errors on the task and performance on the extra-dimensional (ED) shift, which reflects the ability to inhibit and shift attention away from one stimulus dimension to another.</p><p><strong>Results: </strong>Participants with depression and PTSD had elevated total errors on the task with moderate effect sizes; and those with the following had deficits of small effect size: generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), antisocial personality disorder, and binge-eating disorder. For ED errors, participants with PTSD, GAD, and binge-eating disorder exhibited deficits with medium effect sizes; those with the following had small effect size deficits: depression, social anxiety disorder, OCD, substance dependence, antisocial personality disorder, and gambling disorder.</p><p><strong>Conclusions: </strong>These data indicate cognitive flexibility deficits occur across a range of mental disorders. Future work should explore whether these deficits can be ameliorated with novel treatment interventions.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827634","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}

{"title":"University music and ideological reform on treating depression through fostering healthy personality","authors":"Juanjuan Zhang, Jiayu Wu","doi":"10.1017/s1092852923003668","DOIUrl":"https://doi.org/10.1017/s1092852923003668","url":null,"abstract":"Background Depression poses a serious threat to the physical and mental health of students. Music and ideology courses have an important position in college education, which is significant for improving the mental health of students. Subjects and Methods 100 college students with depression were selected for the study. They were randomly divided into an experimental group and a control group, with 50 people in each group. The experimental group received music and ideology and politics curriculum reform based on sound personality cultivation; the control group received traditional music and ideology and politics curriculum education. The Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to assess before treatment, after treatment and during the follow-up period, respectively, and the data were analyzed by using SPSS23.0. Results The mean HAMD scores of the experimental and control groups decreased by 9.8 and 7.3 points after treatment, respectively. The mean HAMA score decreased by 6.8 and 5.2 points in the experimental and control groups, respectively. During the post-treatment follow-up period, the symptoms of depression and anxiety in the experimental group continued to improve while the symptoms in the control group rebounded, and the results showed that the difference was significant ( P <0.05). Conclusions The reform of music and ideology courses in colleges and universities based on the cultivation of sound personality has a positive impact on the treatment of students’ depression and has a positive role in promoting the improvement of students’ mental health. Acknowledgement The 8th Teaching and Research Project of Hulunbuir University in 2021, No. JYZC2021001.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136159569","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}

{"title":"Enhancing deficit schizophrenia treatment in college students through the integration of paliperidone and reformed civic education in higher education","authors":"Hao Yang, Yingling Pan","doi":"10.1017/s1092852923003474","DOIUrl":"https://doi.org/10.1017/s1092852923003474","url":null,"abstract":"Background College students face challenges in communication, employment, learning, and emotional interaction, contributing to a range of psychological issues. Deficit schizophrenia, though uncommon among college students, can exhibit symptoms of delayed thinking and cognitive impairment. Prolonged use of traditional medications can lead to tolerance. This study investigates the synergy of reformed ideological and political education in higher education with Paliperidone to offer comprehensive intervention for college students with deficit schizophrenia. Subjects and Methods A study was conducted on 85 college students with defective schizophrenia at a certain university. They were divided into Group C and Group D. Group C received a single treatment with Paliperidone, while Group B received combined treatment with reformed ideological and political education and teaching in universities. The treatment lasted for 3 months, and after treatment, SPSS 20.0 was used for data analysis, and the Mental Classification Cognitive Test Scale was used to quantify the mental status of college students. Results Post-treatment, positive symptoms in Group D reduced to 15.46 ± 1.53 points, negative symptoms dropped to 15.61 ± 3.51 points, and general psychiatric symptoms decreased to 15.12 ± 1.21 points. These values were lower than pre-treatment levels and Group C scores. The effective treatment rate for Group D reached 96.67%, surpassing Group C. Conclusions The intervention involving the combined use of reformed ideological and political education in universities with Paliperidone exhibited efficacy in addressing deficit schizophrenia in college students. This approach showcases the potential of interdisciplinary interventions in higher education for improving psychological well-being.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136159834","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}