Acta Psychiatrica Scandinavica最新文献

{"title":"Letter to the Editor Concerning \"Glucagon-Like Peptide Agonists for Weight Management in Antipsychotic-Induced Weight Gain: A Systematic Review and Meta-Analysis\".","authors":"Anders Fink-Jensen, Christoph U Correll","doi":"10.1111/acps.13772","DOIUrl":"https://doi.org/10.1111/acps.13772","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of electroconvulsive therapy outcome: A network analysis approach.","authors":"Tessa F Blanken, Rob Kok, Jasmien Obbels, Simon Lambrichts, Pascal Sienaert, Esmée Verwijk","doi":"10.1111/acps.13770","DOIUrl":"https://doi.org/10.1111/acps.13770","url":null,"abstract":"<p><strong>Objective: </strong>While electroconvulsive therapy (ECT) for the treatment of major depressive disorder is effective, individual response is variable and difficult to predict. These difficulties may in part result from heterogeneity at the symptom level. We aim to predict remission using baseline depression symptoms, taking the associations among symptoms into account, by using a network analysis approach.</p><p><strong>Method: </strong>We combined individual patient data from two randomized controlled trials (total N = 161) and estimated a Mixed Graphical Model to estimate which baseline depression symptoms (corresponding to HRSD-17 items) uniquely predicted remission (defined as either HRSD≤7 or MADRS<10). We included study as moderator to evaluate study heterogeneity. For symptoms directly predictive of remission we computed odds ratios.</p><p><strong>Results: </strong>Three baseline symptoms were uniquely predictive of remission: suicidality negatively predicted remission (OR = 0.75; bootstrapped confidence interval (bCI) = 0.44-1.00) whereas retardation (OR = 1.21; bCI = 1.00-2.02) and hypochondriasis (OR = 1.31; bCI = 1.00-2.25) positively predicted remission. The estimated effects did not differ across trials as no moderation effects were found.</p><p><strong>Conclusion: </strong>By using a network analysis approach this study identified that the presence of suicidal ideation predicts an overall worse treatment outcome. Psychomotor retardation and hypochondriasis, on the other hand, seem to be associated with a better outcome.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The not so little matter of how to dose ketamine in patients with depression","authors":"Chittaranjan Andrade","doi":"10.1111/acps.13617","DOIUrl":"https://doi.org/10.1111/acps.13617","url":null,"abstract":"&lt;p&gt;It is almost axiomatic with most drugs and for most disorders in psychiatry that whatever elicits response and remission during the acute phase of illness will prevent relapse and recurrence of illness during the maintenance phase of treatment. Logically, this principle should apply to ketamine, as well, when the drug is used for patients with depression; thus, at the very least, the treatment, if effective, should be continued into the short-term until the patient is stable enough to be maintained on another treatment, such as a conventional oral antidepressant drug.&lt;/p&gt;&lt;p&gt;In this context, in this issue of the journal, d'Andrea et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; propose a different strategy. They suggest that, in patients for whom the treatment is indicated, such as those with treatment-refractory depression (TRD), twice weekly intravenous (IV) ketamine (0.50–0.75 mg/kg) can be used for the first 2–3 weeks followed by twice weekly intranasal (IN) esketamine (56–84 mg), in treatment responders, for the next 2 weeks. IN esketamine can then be continued in the same dose at once-weekly frequency as maintenance therapy. Thus, IV ketamine serves as a bridge to continuation and maintenance with IN ketamine. The authors base their suggestion on the assumption that the IV route is preferable as the initial option because it is associated with faster onset of benefit; and this assumption is based on an examination of secondary outcomes in a retrospective, nonrandomized, nonblind, observational study.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Their suggestion is reasonable in principle. However, there are some matters to be considered. For example, the line of treatment moves from IV to IN routes, from a racemic drug to an enantiomer, and between doses (0.50 mg/kg IV to 56 mg IN and 0.75 mg/kg IV to 84 mg IN) that have not been shown to be bioequivalent. There are also some practical matters: IV ketamine is an elaborate way of dosing the drug and requires at least temporary hospital admission, and IN esketamine is a patented product; in consequence, the former is inconvenient, and both are expensive and therefore impractical in everyday care in developing countries that are poor in medical infrastructure and low in per capita income.&lt;/p&gt;&lt;p&gt;When oral dosing is default for most treatments, how did we get into a situation like this? The story probably started in 1994 when, in a randomized, double-blind, saline-controlled, crossover trial, Krystal et al.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; found that IV ketamine, dosed at 0.5 mg/kg and infused across 40 min, produced positive, negative, dissociative, cognitive, and other symptoms in 19 healthy volunteers; in contrast, a 0.1 mg/kg ketamine infusion resulted in negligible effects. Six years later, in another randomized, double-blind, saline-controlled, crossover trial, Berman et al.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; found that ketamine but not saline was associated with substantial antidepressant improvement, within 72 h of infusion, in nine ","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 4","pages":"313-315"},"PeriodicalIF":6.7,"publicationDate":"2023-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13617","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6942924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life years lost for users of specialized mental healthcare","authors":"Stefan R. A. Konings,&nbsp;Jochen O. Mierau,&nbsp;Ellen Visser,&nbsp;Richard Bruggeman,&nbsp;Talitha L. Feenstra","doi":"10.1111/acps.13608","DOIUrl":"https://doi.org/10.1111/acps.13608","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mental disorders are burdensome and are associated with increased mortality. Mortality has been researched for various mental disorders, especially in countries with national registries, including the Nordic countries. Yet, knowledge gaps exist around national differences, while also relatively less studies compare mortality of those seeking help for mental disorders in specialized mental healthcare (SMH) by diagnosis. Additional insight into such mortality distributions for SMH users would be beneficial for both policy and research purposes. We aim to describe and compare the mortality in a population of SMH users with the mortality of the general population. Additionally, we aim to investigate mortality differences between sexes and major diagnosis categories: anxiety, depression, schizophrenia spectrum and other psychotic disorders, and bipolar disorder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Mortality and basic demographics were available for a population of <i>N</i> = 10,914 SMH users in the north of The Netherlands from 2010 until 2017. To estimate mortality over the adult lifespan, parametric Gompertz distributions were fitted on observed mortality using interval regression. Life years lost were computed by calculating the difference between integrals of the survival functions for the general population and the study sample, thus correcting for age. Survival for the general population was obtained from Statistics Netherlands (CBS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SMH users were estimated to lose 9.5 life years (95% CI: 9.4–9.6). Every major diagnosis category was associated with a significant loss of life years, ranging from 7.2 (95% CI: 6.4–7.9) years for anxiety patients to 11.7 (95% CI: 11.0–12.5) years for bipolar disorder patients. Significant differences in mortality were observed between male SMH users and female SMH users, with men losing relatively more life years: 11.0 (95% CI: 10.9–11.2) versus 8.3 (95% CI: 8.2–8.4) respectively. This difference was also observed between sexes within every diagnosis, although the difference was insignificant for bipolar disorder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There were significant differences in mortality between SMH users and the general population. Substantial differences were observed between sexes and between diagnoses. Additional attention is required, and possibly specific interventions are needed to reduce the amount of life years lost by SMH users.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 4","pages":"338-346"},"PeriodicalIF":6.7,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13608","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6873834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explicating the role of amygdala substructure alterations in the link between hypoleptinemia and rumination in anorexia nervosa","authors":"Marie-Louis Wronski,&nbsp;Charlotte Hohnemann,&nbsp;Fabio Bernardoni,&nbsp;Klaas Bahnsen,&nbsp;Arne Doose,&nbsp;Dominic Arold,&nbsp;Katrin Borucki,&nbsp;Laura M. Holsen,&nbsp;Elizabeth A. Lawson,&nbsp;Franziska Plessow,&nbsp;Kerstin Weidner,&nbsp;Veit Roessner,&nbsp;Stefan Diestel,&nbsp;Joseph A. King,&nbsp;Maria Seidel,&nbsp;Stefan Ehrlich","doi":"10.1111/acps.13607","DOIUrl":"https://doi.org/10.1111/acps.13607","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The amygdaloid complex plays a pivotal role in emotion processing and has been associated with rumination transdiagnostically. In anorexia nervosa (AN), we previously observed differential reductions of amygdala nuclei volumes (rostral-medial cluster substantially affected) and, in another study, elevated food−/weight-related rumination. Both amygdala volumes and rumination frequency correlated with characteristically suppressed leptin levels in AN. Thus, we hypothesized that amygdala nuclei alterations might be associated with AN-related rumination and potentially mediate the leptin-rumination relationship in AN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Rumination (food−/weight-related) was assessed using ecological momentary assessment for a 14-day period. We employed frequentist and Bayesian linear mixed effects models in females with AN (<i>n</i> = 51, 12–29 years, majority admitted to inpatient treatment) and age-matched healthy females (<i>n</i> = 51) to investigate associations between rostral-medial amygdala nuclei volume alterations (accessory basal, cortical, medial nuclei, corticoamygdaloid transitions) and rumination. We analyzed mediation effects using multi-level structural equation models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Reduced right accessory basal and cortical nuclei volumes predicted more frequent weight-related rumination in AN; both nuclei fully mediated the effect of leptin on weight-related rumination. In contrast, we found robust evidence for the absence of amygdala nuclei volume effects on rumination in healthy females.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides first evidence for the relevance of specific amygdala substructure reductions regarding cognitive symptom severity in AN and points toward novel mechanistic insight into the relationship between hypoleptinemia and rumination, which might involve the amygdaloid complex. Our findings in AN may have important clinical value with respect to understanding the beneficial neuropsychiatric effects of leptin (treatment) in AN and potentially other psychiatric conditions such as depression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 4","pages":"368-381"},"PeriodicalIF":6.7,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13607","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6837482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal relationship between sex hormone-binding globulin and major depression: A Mendelian randomization study","authors":"Haohao Zhu,&nbsp;Yifan Sun,&nbsp;Shuaiyi Guo,&nbsp;Qin Zhou,&nbsp;Ying Jiang,&nbsp;Yuan Shen,&nbsp;Zhenhe Zhou,&nbsp;Zhiqiang Du,&nbsp;Hongliang Zhou","doi":"10.1111/acps.13614","DOIUrl":"10.1111/acps.13614","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to explore the causal relationship between sex hormone-binding globulin (SHBG) and major depression using two-sample Mendelian randomization (MR) studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on the genome-wide association study (GWAS) summary data of SHBG and major depression in the European population, which included 214,989 female SHBG samples, 185,221 male SHBG samples, and 500,199 major depression samples, we used genetic factors as instrumental variables to conduct two-sample MR analyses. We used methods including inverse variance weighted (IVW), weighted median, weighted mode, and MR Egger to evaluate the bidirectional causal relationship between SHBG and major depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results showed that there was a causal relationship between female SHBG and major depression, which was positively correlated. The ORs were 1.056 (95% CI: 1.005–1.109, <i>p</i> = 0.031) for the weighted median and 1.067 (95% CI: 1.012–1.126, <i>p</i> = 0.021) for the weighted mode. There was no significant effect of male SHBG on major depression (<i>p</i> &gt; 0.05), and there was no significant effect of major depression on female SHBG (<i>p</i> &gt; 0.05). Major depression was negatively correlated with male SHBG, indicating that major depression could lead to a decrease in male SHBG. The OR was 0.954 (95% CI: 0.916–0.993, <i>p</i> = 0.023) for IVW.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Female SHBG was positively correlated with the risk of major depression, however, major depression was found to be negatively correlated with serum SHBG levels in men, indicating that SHBG plays distinct roles in patients with major depression of different genders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 5","pages":"426-436"},"PeriodicalIF":6.7,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10173397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of smoking habits and concomitant valproic acid use on relapse in patients with treatment-resistant schizophrenia receiving clozapine: A 1-year retrospective cohort study","authors":"Masaru Tsukahara,&nbsp;Ryuhei So,&nbsp;Yusaku Yoshimura,&nbsp;Rieko Yamashita,&nbsp;Yuji Yada,&nbsp;Masafumi Kodama,&nbsp;Shinichiro Nakajima,&nbsp;Yoshiki Kishi,&nbsp;Toshihiko Takeda,&nbsp;Norihito Yamada,&nbsp;Hiroyoshi Takeuchi","doi":"10.1111/acps.13612","DOIUrl":"10.1111/acps.13612","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>No study has investigated the impact of smoking habits and concomitant valproic acid (VPA) use on clinical outcomes in maintenance treatment with clozapine. Thus, we aimed to examine the effect of smoking habits and concomitant VPA use on relapse during the first year after discharge in patients with treatment-resistant schizophrenia (TRS) receiving clozapine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included patients with TRS who were initiated on clozapine during hospitalization and discharged between April 2012 and January 2021 in two tertiary psychiatric hospitals in Japan. Relapse was defined as rehospitalization due to psychiatric exacerbation during the first year after discharge. A multivariable Cox proportional hazards regression analysis was performed to analyze the effect of smoking habits and concomitant VPA use on relapse. Subgroup analyses were also conducted to examine potential interactions between smoking habits and concomitant VPA use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the included 192 patients, 69 (35.9%) met the criteria of relapse. While smoking habits (adjusted hazard ratio [aHR], 2.27; 95% confidence interval [CI], 1.28–4.01; <i>p</i> &lt; 0.01) independently increased the risk of relapse, a significant interaction for relapse risk was found between smoking habits and concomitant VPA use (<i>p</i>-interaction = 0.015). Concomitant VPA use may be an effective modifier of the increased relapse risk associated with smoking habits. Among patients who smoked, those using VPA concomitantly exhibited a higher risk of relapse (aHR, 5.32; 95% CI, 1.68–16.9; <i>p</i> &lt; 0.01) than those not using VPA (aHR, 1.41; 95% CI, 0.73–2.70; <i>p</i> = 0.30).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings suggest that the combination of smoking habits and concomitant VPA use may increase the risk of relapse after discharge. Future studies are required to elucidate the mechanisms underlying these findings, such as a decrease in clozapine blood levels.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 5","pages":"437-446"},"PeriodicalIF":6.7,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13612","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10587162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the potential of a bridge therapy: Synergistic approach integrating intravenous ketamine and intranasal esketamine for treatment-resistant depression","authors":"Giacomo d'Andrea,&nbsp;Mauro Pettorruso,&nbsp;Taeho Greg Rhee,&nbsp;Giorgio Di Lorenzo,&nbsp;Roger S. McIntyre,&nbsp;Giovanni Martinotti","doi":"10.1111/acps.13605","DOIUrl":"https://doi.org/10.1111/acps.13605","url":null,"abstract":"Depressive disorders represent a significant economic and health burden globally. This is particularly evident in treatment-resistant depression (TRD), commonly defined as the absence of a satisfactory response to at least two different antidepressant trials (as defined by the U.S. Food and Drug Administration/FDA and European Medicine Agencies/EMA). The foregoing TRD cases frequently manifest as complex, difficult-to-treat depression, requiring rapid symptom alleviation and innovative strategies for effective management. Recently, the role of novel glutamatergic agents, including intravenous ketamine (KET-IV) and intranasal esketamine (ESK-NS), has been brought into the spotlight for managing TRD. Ketamine, an N-methyl-Daspartate (NMDA) receptor antagonist with effects on multiple cellular and metabolic processes including but not limited to synaptogenesis and brain plasticity, has demonstrated rapid-acting antidepressant effects. Esketamine, the S-enantiomer of racemic ketamine, administered intranasally, has also established efficacy in TRD in replicated several randomized clinical trials (RCTs), being approved by the FDA and the EMA for this indication, and is now considered an evidence-based treatment for TRD. Both treatments have been considered a valuable tool to rapidly alleviate severe depressive symptoms as well as emergency presentations of depression complicated by suicidal ideation or suicide attempts. Recently, KET-IV has been reported to be comparably effective to electroconvulsive therapy (ECT), a treatment traditionally viewed as the most effective approach for treatmentresistant cases. In this perspective article, we propose a “ketamine/ esketamine bridge therapy,” for further empirical testing. The concept of bridge therapy is a well-recognized intervention strategy in internal medicine, particularly applicable to emergent situations associated with coagulation disorders. In these clinical situations, to rapidly achieve anticoagulation, patients are administered intravenous anticoagulants followed by a transition to dose-equivalent oral anticoagulants thereby maintaining tolerability and real-world practice. The notion of considering an approach for further testing like this is provided by recognition of the suboptimal accessibility of intravenous ketamine and the potential for greater scalability of the intranasal formulation. Applying this model to psychiatric clinical practice, we advocate the implementation of “bridge therapy” as a therapeutic strategy for evaluation in TRD subjects and/or in clinical scenarios where on the one hand rapid symptom relief is paramount, yet on the other the need for maintenance of effect with practical approaches persists beyond acute treatment. Conceptually, KET-IV would facilitate rapid antidepressant effects while ESKNS would promote long-term maintenance of effect. The novel therapeutic approach we proposed is suggested by a confluence of study results. Recent findings from real-world stud","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 4","pages":"385-387"},"PeriodicalIF":6.7,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6837736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aberrant resting-state functional connectivity underlies cognitive and functional impairments in remitted patients with bipolar disorder","authors":"Lydia Fortea,&nbsp;Alexander T. Ysbæk-Nielsen,&nbsp;Julian Macoveanu,&nbsp;Jeff Zarp Petersen,&nbsp;Patrick M. Fisher,&nbsp;Lars V. Kessing,&nbsp;Gitte M. Knudsen,&nbsp;Joaquim Radua,&nbsp;Eduard Vieta,&nbsp;Kamilla W. Miskowiak","doi":"10.1111/acps.13615","DOIUrl":"10.1111/acps.13615","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bipolar disorder (BD) is commonly associated with cognitive impairments, that directly contribute to patients' functional disability. However, there is no effective treatment targeting cognition in BD. A key reason for the lack of pro-cognitive interventions is the limited insight into the brain correlates of cognitive impairments in these patients. This is the first study investigating the resting-state neural underpinnings of cognitive impairments in different neurocognitive subgroups of patients with BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Patients with BD in full or partial remission and healthy controls (final sample of <i>n</i> = 144 and <i>n</i> = 50, respectively) underwent neuropsychological assessment and resting-state functional magnetic resonance imaging. We classified the patients into cognitively impaired (<i>n</i> = 83) and cognitively normal (<i>n</i> = 61) subgroups using hierarchical cluster analysis of the four cognitive domains. We used independent component analysis (ICA) to investigate the differences between the neurocognitive subgroups and healthy controls in resting-state functional connectivity (rsFC) in the default mode network (DMN), executive central network (ECN), and frontoparietal network (FPN).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cognitively impaired patients displayed greater positive rsFC within the DMN and less negative rsFC within the ECN than healthy controls. Across cognitively impaired patients, lower positive connectivity within DMN and lower negative rsFC within ECN correlated with worse global cognitive performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Cognitive impairments in BD seem to be associated with a <i>hyper</i>-connectivity within the DMN, which may explain the failure to suppress task-irrelevant DMN activity during the cognitive performance, and blunted anticorrelation in the ECN. Thus, aberrant connectivity within the DMN and ECN may serve as brain targets for pro-cognitive interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 6","pages":"570-582"},"PeriodicalIF":6.7,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13615","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10189378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of antipsychotics and antidepressants in first-episode psychotic depression: A nationwide register-based study","authors":"A. Hamina,&nbsp;T. Paljärvi,&nbsp;A. Tanskanen,&nbsp;M. Lähteenvuo,&nbsp;J. Tiihonen,&nbsp;H. Taipale","doi":"10.1111/acps.13616","DOIUrl":"10.1111/acps.13616","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>According to guidelines, psychotic depression should be treated with both antipsychotics and antidepressants, but current practice is largely unknown. We investigated the prevalence of antipsychotic and antidepressant use in first-episode psychotic depression and factors related to antipsychotic use after the diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We identified individuals aged 16–65 with a first-episode diagnosis of psychotic depression (ICD-10 codes F32.3, F33.3) from nationwide data linkage of Finnish healthcare and population registers during 2000–2018. Point prevalence was measured as 2-week time windows every 3 months, investigating whether the individual had a modeled drug use period ongoing during the window or not, censoring to death and end of data linkage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study population included 18,490 individuals (58.0% women; mean age 39.9 years, standard deviation 14.7). The prevalence of use for antidepressants (75.0%), antipsychotics (56.4%), and both (50.0%) were highest at 3 months after the diagnosis. The prevalence declined to 51.8%, 34.1%, and 28.7%, respectively, at 3 years after the diagnosis. In a logistic regression analysis, younger age (adjusted odds ratio &lt; 25 vs. ≥55, 0.82 [95% confidence interval 0.73–0.91]), eating disorders (0.78 [0.66–0.92]), substance use disorders (0.80 [0.73–0.87]), and occupational inactivity (0.80 [0.73–0.87]) were associated with decreased odds of using antipsychotics at 3 months after diagnosis. Increased odds were found for diagnosis from inpatient care (1.74 [1.62–1.86]), and later year of cohort entry (2010–2014 vs. 2000–2004, 1.56 [1.42–1.70]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>At most, half of the individuals with newly diagnosed psychotic depression used both antidepressants and antipsychotics. This likely has a negative impact on treatment success.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 5","pages":"416-425"},"PeriodicalIF":6.7,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13616","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10542282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}