Acta Psychiatrica Scandinavica最新文献

{"title":"The Efficacy and Acceptability of Non-Invasive Brain Stimulation Interventions for Obsessive-Compulsive Disorder Management: A Network Meta-Analysis Based on 24 Stimulation Methods.","authors":"Ping-Tao Tseng, Chih-Wei Hsu, Chao-Ming Hung, Chih-Sung Liang, Hung-Yu Wang, Brendon Stubbs, Andre F Carvalho, Andre R Brunoni, Kuan-Pin Su, Yu-Kang Tu, Yi-Cheng Wu, Tien-Yu Chen, Dian-Jeng Li, Pao-Yen Lin, Yen-Wen Chen, Kuo-Chuan Hung, Jiann-Jy Chen, Bing-Syuan Zeng, Cheng-Ta Li","doi":"10.1111/acps.13809","DOIUrl":"https://doi.org/10.1111/acps.13809","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the high lifetime prevalence and elevated disability rates, treatments for obsessive-compulsive disorder (OCD) have limited efficacy. Considering the abnormal connectivity in the cortical-striatal-thalamic-cortical loop circuits in OCD, several randomized controlled trials (RCTs) have addressed the efficacy of different non-invasive brain stimulation (NIBS) modalities for the management of OCD. However, these RCTs yielded inconclusive results.</p><p><strong>Methods: </strong>This network meta-analysis (NMA) included RCTs of NIBS interventions, such as transcranial direct current stimulation (tDCS) and various repetitive transcranial magnetic stimulation (rTMS), in OCD patients. The primary outcomes were changes in the overall severity of OCD and acceptability (i.e., dropout rates).</p><p><strong>Results: </strong>This NMA of 34 eligible RCTs (1089 participants) and 24 different NIBS interventions revealed that three NIBS interventions significantly improved overall OCD severity compared with sham controls, which were high-frequency rTMS over the dorsolateral prefrontal cortex (DLPFC) [mean difference (MD) = -10.81, 95% confidence intervals (95% CIs) = -20.80 to -0.82], high-frequency deep TMS over the dorsal medial prefrontal cortex/anterior cingulate cortex (dmPFC/ACC) (MD = -9.74, 95% CIs = -16.42 to -3.06), and low-frequency rTMS over the right DLPFC (MD = -4.70, 95% CIs = -8.84 to -0.57).</p><p><strong>Conclusions: </strong>This study highlighted that excitatory stimulation over the dmPFC/ACC and bilateral DLPFC, or inhibitory stimulation over the right DLPFC, was associated with significant improvements in overall OCD severity. Further large-scale RCTs with longer follow-up periods are needed to investigate the true impact of NIBS-based intervention to manage OCD.</p><p><strong>Trial registration: </strong>PROSPERO: CRD42023394953.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750216","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":"Interrelationships of Changes in Outcome Domains in Patients With Schizophrenia Spectrum Disorders: A Meta-Analysis.","authors":"Lars de Winter, Auke Jelsma, Jentien M Vermeulen, Astrid Vellinga, Jaap van Weeghel, Ilanit Hasson-Ohayon, Cornelis L Mulder, Nynke Boonstra, Wim Veling, Lieuwe de Haan","doi":"10.1111/acps.13808","DOIUrl":"https://doi.org/10.1111/acps.13808","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with schizophrenia spectrum disorders (SSD) improve in several outcome domains over the course of illness, but to different degrees. In this meta-analysis, we investigated whether longitudinal changes in different outcome domains are associated with each other and which factors moderate these changes over time.</p><p><strong>Methods: </strong>Our protocol was preregistered in PROSPERO (CRD42024504253). We included 109 studies, identified through searches in PsycInfo, PubMed, CINAHL, and Cochrane up until November 2023, investigating longitudinal changes in at least two outcome domains (symptoms, social functioning, cognition or personal recovery) for patients with SSD with at least 1 year follow-up. We calculated Pearson correlation coefficients for associations of changes between outcome domains. Potential moderating effects of demographic, clinical, social, or study characteristics were explored. Quality assessment was executed using the QUIPS tool.</p><p><strong>Results: </strong>We found substantial positive associations between changes in symptoms, social functioning, and cognition. Especially, changes in negative symptoms and overall social functioning were associated with changes in several outcome domains. Changes in personal recovery were only associated with changes in symptoms. We found more substantial improvements in combinations of outcomes for patients with a shorter illness duration, females, a lower percentage of patients diagnosed with schizophrenia, and patients receiving treatment focused on targeted outcomes.</p><p><strong>Conclusions: </strong>Symptoms, social functioning, and cognition often concurrently improve and may boost each other. This suggests that an integrated approach targeting several outcome domains jointly boosts long-term improvement. However, changes in personal recovery seem to occur separately from other outcome domains. Therefore, targeted attention for personal recovery is needed.</p><p><strong>Trial registration: </strong>PROSPERO: CRD42024504253.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750213","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 Higher Dose-Adjusted Clozapine Concentrations in Non-Smokers With High CRP Levels May Be Associated With the Lower Daily Doses of Clozapine.","authors":"Yuki Kikuchi","doi":"10.1111/acps.13810","DOIUrl":"https://doi.org/10.1111/acps.13810","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750218","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":"Prevalence and Incidence of Attention Deficit/Hyperactivity Disorder in Denmark. A National Register-Based Open Cohort Study.","authors":"Simon Grøntved, Kathrine Hald, Christina Mohr-Jensen, Søren Paaske Johnsen, Jan Mainz, Jan Brink Valentin","doi":"10.1111/acps.13804","DOIUrl":"https://doi.org/10.1111/acps.13804","url":null,"abstract":"<p><strong>Introduction: </strong>Rises in prevalence and incidence of the neurodevelopmental disorder Attention-deficit/Hyperactivity Disorder (ADHD) have been reported globally and estimated in Denmark previously. Nevertheless, differences in methodology hinder an assessment of the temporal evolution of ADHD based on published literature. The aim of this study was to consistently calculate the yearly prevalence and incidence proportions of ADHD and the use of ADHD medication in Denmark from 2000 to 2022.</p><p><strong>Methods: </strong>We conducted an open cohort study using register data covering the entire Danish population. We defined ADHD as either having a hospital diagnosis of ADHD (ICD-10: F90.0, F90.1, F90.8, or F98.8), or having redeemed a prescription for ADHD medication.</p><p><strong>Results: </strong>Of the included 7,748,837 persons, 2.52% had ADHD, of whom 58.33% were males. The prevalence of ADHD has increased from 0.10% in 2000 to 3.03% in 2022. Specifically for the 18-27-year-olds, the prevalence was 8.16% for males and 6.12% for females in the year 2022. For the incidence, the same age group peaked within the females in 2022 at 1.10%, whereas the male incidence was consistently highest in the 6-18-year-olds, peaking in 2022 at 0.94%. Total use of ADHD medication in the population also increased. Methylphenidate was used by 97.58% of the ADHD medicated patients in 2000 and 70.60% in 2022. Lisdexamphetamine was the second most common in 2022, where 24.03% redeemed a prescription.</p><p><strong>Limitations: </strong>Incidence and prevalence were calculated specifically for the Danish population and may not be directly generalizable to other countries.</p><p><strong>Conclusions: </strong>The prevalence of ADHD has consistently increased throughout the past two decades. The main contribution to this increase is the ADHD incidence in females, especially young females in the most recent years 2020-2022. Methylphenidate was consistently the most common ADHD drug prescribed, though lisdexamphetamine use has increased in recent years.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727206","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":"Is There Solid Evidence to Corroborate the Augmentation With Prazosin in Depression With Trauma?","authors":"Victor Domingueti Vallim Fonseca, Letícia Braga Martins, Luísa Weber Bisol, Fabio Gomes de Matos E Souza","doi":"10.1111/acps.13807","DOIUrl":"https://doi.org/10.1111/acps.13807","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727203","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":"Comment on \"A Systematic Review and Meta-Analysis of the Association Between Childhood Maltreatment and Adult Depression\".","authors":"Shubham Kumar, Rachana Mehta, Ranjana Sah","doi":"10.1111/acps.13805","DOIUrl":"https://doi.org/10.1111/acps.13805","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699193","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 Role of Antipsychotics and Mood Stabilizers in Preventing Sickness Absence Among Employed Individuals With Bipolar Disorder: A Nationwide Register-Based Study.","authors":"Minna Holm, Antti Tanskanen, Jari Tiihonen, Heidi Taipale","doi":"10.1111/acps.13806","DOIUrl":"https://doi.org/10.1111/acps.13806","url":null,"abstract":"<p><strong>Introduction: </strong>Medication use may significantly affect work ability in bipolar disorder, but this area has been largely overlooked in research. We aimed to investigate how specific mood stabilizer and antipsychotic agents are associated with the risk of sickness absence among employed individuals with bipolar disorder.</p><p><strong>Methods: </strong>We identified a nationwide cohort of 22,408 employed individuals with bipolar disorder, including 10,000 first-episode cases, and followed them from 2005 to 2018 through the nationwide administrative registers. The risk of sickness absence was analyzed using within-individual Cox regression where each person serves as their own control to eliminate selection bias.</p><p><strong>Results: </strong>In the whole cohort, the monotherapies of lithium (HR = 0.75, 95% CI = 0.66-0.84), valproate (HR = 0.77, 0.70-0.85), and lamotrigine (HR = 0.87, 0.80-0.95) were associated with a lower risk of sickness absence than nonuse of mood stabilizers. In contrast, pregabalin monotherapy was associated with an increased risk of sickness absence (HR = 1.63, 1.34-1.99). Of antipsychotics, olanzapine was associated with a lower risk of sickness absence (HR = 0.75, 0.66-0.86) than antipsychotic nonuse. In the first-episode sample, lithium (HR = 0.51, 0.41-0.64), valproate (HR = 0.63, 0.52-0.75), lamotrigine (HR = 0.79, 0.68-0.91), and olanzapine (HR = 0.69, 0.54-0.87) monotherapies were associated with a lower hazard of sickness absence than nonuse.</p><p><strong>Conclusions: </strong>Mood stabilizers including lithium, valproate, and lamotrigine, as well as olanzapine, of antipsychotics may reduce the risk of sickness absence, particularly, in first-episode patients. These findings encourage the continuous use of these medications to support occupational functioning among people with bipolar disorder.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690445","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":"Testing the Use of \"Clinical Checks\" With the International Trauma Questionnaire to Measure PTSD and Complex PTSD.","authors":"Mark Shevlin, Philip Hyland, Chris R Brewin, Marylene Cloitre, Thanos Karatzias, Enya Redican","doi":"10.1111/acps.13799","DOIUrl":"https://doi.org/10.1111/acps.13799","url":null,"abstract":"<p><strong>Background: </strong>The International Trauma Questionnaire (ITQ) is the most widely used measure of ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). This self-report scale has been used to estimate prevalence rates of these disorders in general populations and clinical samples, but concerns abound that prevalence estimates derived from self-report measures are too high. To address this concern, we previously introduced the concept of adding \"clinical checks\" to self-report measures to ensure initial responses reflected the intended clinical meaning of the scale item. Here we provide a rationale for adding clinical checks to the ITQ, describe the process of developing them, and demonstrate their effect at the symptom, cluster, and disorder levels in a general population sample.</p><p><strong>Methods: </strong>A team of researchers and clinicians, including those who developed the ITQ, developed clinical checks for all ITQ items. These were tested using data from a non-probability quota-based representative sample of adults from the United Kingdom (N = 975).</p><p><strong>Results: </strong>Use of clinical checks led to decreases in symptom endorsements ranging from 18.0% to 43.9%, and symptom cluster requirements from 19.1% to 35.9%. Disorder prevalence estimates without the clinical checks were 5.4% for PTSD and 9.5% for CPTSD. With the clinical checks, prevalence estimates dropped to 3.8% for PTSD (relative decrease = 29.6%) and 4.9% for CPTSD (relative decrease = 48.4%).</p><p><strong>Conclusion: </strong>Clinical checks can be easily embedded into the ITQ and have a significant effect on prevalence estimates. We contextualize these results in relation to existing literature on population prevalence estimates derived from clinical interviews and discrepancies between clinical interviews and self-report measures.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690440","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":"Confusional States During Electroconvulsive Therapy for Late-Life Depression: A Prospective Cohort Study.","authors":"Thomas C Feenstra, Nathalie Denayer, Kristof Vansteelandt, Jasmien Obbels, Kaat Hebbrecht, Liese Van den Eynde, Shauni Verspecht, Esmée Verwijk, Eric van Exel, Rob M Kok, Filip Bouckaert, Anton C M Vergouwen, Adriano van der Loo, Aartjan T F Beekman, Pascal Sienaert, Didi Rhebergen","doi":"10.1111/acps.13803","DOIUrl":"https://doi.org/10.1111/acps.13803","url":null,"abstract":"<p><strong>Introduction: </strong>Cognitive side effects, such as memory loss, associated with electroconvulsive therapy (ECT) have been extensively studied. However, knowledge about (sub)acute confusional states during ECT is limited, particularly in older adults with depression. Their incidence, recurrence, and co-occurrence remain unclear. This study aimed to describe the incidence, recurrence, co-occurrence, and clinical course of various subtypes of confusional states during ECT.</p><p><strong>Methods: </strong>Data were derived from the 'Rivastigmine for ECT-induced Cognitive Adverse effects in Late-Life depression' (RECALL) prospective cohort study, involving 145 older adults (≥ 55 years) with a major depressive episode receiving ECT. We assessed different subtypes of confusional states: postictal and interictal delirium (PID and IID), postictal agitation (PIA), prolonged time to reorientation (TRO), and subacute general cognitive decline (Mini Mental State Examination decline ≥ 4 points) throughout the ECT course.</p><p><strong>Results: </strong>Over half of the older adults (55.9%) experienced at least one subtype of confusional state during their ECT course. The most prevalent subtypes were PIA (29.5%) and prolonged TRO (28.3%), while postictal (5.9%) and interictal delirium (4.2%) were less common. Recurrence rates varied, with interictal delirium (66.7%) and prolonged TRO (50.0%) showing the highest rates compared to postictal delirium (12.5%). Notably, 18.0% of older adults experienced more than one subtype of confusional state during their ECT course, and these states could emerge at any time during the ECT course.</p><p><strong>Conclusion: </strong>This is the first study to comprehensively examine the clinical course of various subtypes of confusional states during ECT in older adults with depression Our findings reveal that confusional states are highly prevalent, heterogeneous, and may emerge at any time during the ECT course. Notably, since the instruments used were not designed to measure (subtypes of) confusional states during ECT, further research into the differentiation of (sub)acute confusional states is warranted.</p><p><strong>Trial registration: </strong>EudraCT 2014-003385-24.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655692","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":"Pharmacological Treatments in Alcohol Use Disorder and Risk of Alcohol-Related Hospitalizations: A Register Study.","authors":"Patrick Bach, Johan Franck, Jonas Hällgren, Härje Widing, Mika Gissler, Jeanette Westman","doi":"10.1111/acps.13802","DOIUrl":"https://doi.org/10.1111/acps.13802","url":null,"abstract":"<p><strong>Objectives: </strong>Despite the high prevalence of alcohol use disorder (AUD), only a minority of patients receive recommended pharmacological treatments, possibly owing to uncertainty about the real-world effectiveness of these medications. Here, we analyzed nationwide, register-based data to investigate the association between approved AUD medications (naltrexone, acamprosate, disulfiram, and nalmefene) and the risk of alcohol-related hospitalizations among individuals with AUD.</p><p><strong>Methods: </strong>People aged 18-64 with a registered first-time diagnosis of AUD between 2009 and 2019 (N = 93,727) were identified from the Swedish National Patient Register. Cox regression models were used to analyze the association between AUD medication exposure and the risk of alcohol-related hospitalizations.</p><p><strong>Results: </strong>Exposure to naltrexone (hazard ratio [HR] = 0.80; 95% confidence interval [CI] = 0.73-0.87) or disulfiram (HR = 0.83, 95% CI = 0.79-0.88) as monotherapy, or a combination of naltrexone/disulfiram (HR = 0.68, 95% CI = 0.49-0.96), or disulfiram/acamprosate (HR = 0.57 95% CI = 0.44-0.74) was significantly associated with a lower risk of alcohol-related hospitalizations compared to periods without exposure to any of these medications. In contrast, no significant associations were observed for acamprosate, nalmefene, or the combination of acamprosate/naltrexone. Sensitivity analyses in individuals with severe AUD and stratified subgroup analyses by different socioeconomic groups confirmed the robustness of the results.</p><p><strong>Conclusion: </strong>Results indicate a significant association between disulfiram and naltrexone monotherapy, as well as the combination of disulfiram with naltrexone or acamprosate, with a lower risk of alcohol-related hospitalizations among individuals with AUD. Low prescription rates suggest that AUD medications are currently underutilized. Increasing the availability of these medications for individuals with AUD could help reduce alcohol-related hospitalizations.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646390","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}