Acta Psychiatrica Scandinavica最新文献

{"title":"Problem gambling in psychotic disorders: A systematic review and meta-analysis of prevalence","authors":"Olivier Corbeil,&nbsp;Élizabeth Anderson,&nbsp;Laurent Béchard,&nbsp;Charles Desmeules,&nbsp;Maxime Huot-Lavoie,&nbsp;Lauryann Bachand,&nbsp;Sébastien Brodeur,&nbsp;Pierre-Hugues Carmichael,&nbsp;Christian Jacques,&nbsp;Marco Solmi,&nbsp;Isabelle Giroux,&nbsp;Michel Dorval,&nbsp;Marie-France Demers,&nbsp;Marc-André Roy","doi":"10.1111/acps.13686","DOIUrl":"10.1111/acps.13686","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Problem gambling (PBG) is more common in people with mental health disorders, including substance use, bipolar, and personality disorders, than in the general population. Although individuals with psychotic disorders might be expected to be more vulnerable to PBG, fewer studies have focused on this comorbidity. The aim of this review was to estimate the prevalence of PBG in people with psychotic disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Medline (Ovid), EMBASE, PsycINFO (Ovid), CINAHL, CENTRAL, Web of science, and ProQuest were searched on November 1, 2023, without language restrictions. Observational and experimental studies including individuals with psychotic disorders and reporting the prevalence of PBG were included. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal for systematic reviews of prevalence data. The pooled prevalence of PBG was calculated using a fixed effects generalized linear mixed model and presented through forest plots.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1271 records screened, 12 studies (<i>n</i> = 3443) were included. The overall prevalence of PBG was 8.7% (95% CI = 7.8%–9.7%, <i>I</i>² = 69%). A lower prevalence was found in studies with a low risk of bias (5.6%; 95% CI = 4.4%–7.0%) compared with studies with a moderate risk of bias (10.4%; 95% CI = 9.2%–11.7%). Different methods used to assess PBG also contributed to the heterogeneity found.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This meta-analysis found substantial heterogeneity, partly due to the risk of bias of the included studies and a lack of uniformity in PBG assessment. Although more research is needed to identify those at increased risk for PBG, its relatively high prevalence warrants routine screening for gambling in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"149 6","pages":"445-457"},"PeriodicalIF":6.7,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13686","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140578443","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":"Who is at risk for weight gain after weight-gain associated treatment with antipsychotics, antidepressants, and mood stabilizers: A machine learning approach.","authors":"Julia Eder, Catherine Glocker, Barbara Barton, Elif Sarisik, David Popovic, Jana Lämmermann, Alexandra Knaf, Anja Beqiri-Zagler, Katharina Engl, Leonie Rihs, Lisa Pfeiffer, Andrea Schmitt, Peter Falkai, Maria S Simon, Richard Musil","doi":"10.1111/acps.13684","DOIUrl":"https://doi.org/10.1111/acps.13684","url":null,"abstract":"<p><strong>Background: </strong>Weight gain is a common side effect in psychopharmacology; however, targeted therapeutic interventions and prevention strategies are currently absent in day-to-day clinical practice. To promote the development of such strategies, the identification of factors indicative of patients at risk is essential.</p><p><strong>Methods: </strong>In this study, we developed a transdiagnostic model using and comparing decision tree classifiers, logistic regression, XGboost, and a support vector machine to predict weight gain of ≥5% of body weight during the first 4 weeks of treatment with psychotropic drugs associated with weight gain in 103 psychiatric inpatients. We included established variables from the literature as well as an extended set with additional clinical variables and questionnaires.</p><p><strong>Results: </strong>Baseline BMI, premorbid BMI, and age are known risk factors and were confirmed by our models. Additionally, waist circumference has emerged as a new and significant risk factor. Eating behavior next to blood glucose were found as additional potential predictor that may underlie therapeutic interventions and could be used for preventive strategies in a cohort at risk for psychotropics induced weight gain (PIWG).</p><p><strong>Conclusion: </strong>Our models validate existing findings and further uncover previously unknown modifiable factors, such as eating behavior and blood glucose, which can be used as targets for preventive strategies. These findings underscore the imperative for continued research in this domain to establish effective preventive measures for individuals undergoing psychotropic drug treatments.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334007","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":"Alcohol use disorder and risk of specific methods of suicide death in a national cohort","authors":"Alexis C. Edwards,&nbsp;Linda Abrahamsson,&nbsp;Casey Crump,&nbsp;Jan Sundquist,&nbsp;Kristina Sundquist,&nbsp;Kenneth S. Kendler","doi":"10.1111/acps.13683","DOIUrl":"10.1111/acps.13683","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Alcohol use disorder (AUD) is among the strongest correlates of suicide death, but it is unclear whether AUD status is differentially associated with risk of suicide by particular methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors used competing risks models to evaluate the association between AUD status and risk of suicide by poisoning, suffocation, drowning, firearm, instruments, jumping, or other means in a large Swedish cohort born 1932–1995 (total <i>N</i> = 6,581,827; 48.8% female). Data were derived from Swedish national registers, including the Cause of Death Register and a range of medical registers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After adjusting for sociodemographic factors and familial liability to suicidal behavior, AUD was positively associated with risk of suicide for each method evaluated (cumulative incidence differences: 0.006–1.040 for females, 0.046–0.680 for males), except the association with firearm suicide in females. AUD was most strongly associated with risk of suicide by poisoning. Sex differences in the effects of AUD and family liability were observed for some, but not all, methods. Furthermore, high familial liability for suicidal behavior exacerbated AUD's impact on risk for suicide by poisoning (both sexes) and suffocation and jumping (males only), while the inverse interaction was observed for firearm suicide (males only).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AUD increases risk of suicide by all methods examined and is particularly potent with respect to risk of suicide by poisoning. Differences in risk related to sex and familial liability to suicidal behavior underscore AUD's nuanced role in suicide risk. Future research should investigate targeted means restriction effectiveness among persons with AUD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"149 6","pages":"479-490"},"PeriodicalIF":6.7,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13683","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331325","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":"A comprehensive analysis of age of onset and cumulative incidence of mental disorders: A Danish register study","authors":"Christoffer Beck,&nbsp;Carsten Bøcker Pedersen,&nbsp;Oleguer Plana-Ripoll,&nbsp;Søren Dalsgaard,&nbsp;Jean-Christophe Philippe Debost,&nbsp;Thomas Munk Laursen,&nbsp;Katherine Louise Musliner,&nbsp;Preben Bo Mortensen,&nbsp;Marianne Giørtz Pedersen,&nbsp;Liselotte Vogdrup Petersen,&nbsp;Zeynep Yilmaz,&nbsp;John McGrath,&nbsp;Esben Agerbo","doi":"10.1111/acps.13682","DOIUrl":"10.1111/acps.13682","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The age of onset (AOO), incidence and cumulative incidence of mental disorders are critical epidemiological measures, providing essential insights into the development and course of these disorders across the lifespan. This study aims to provide up-to-date estimates of the AOO, age-specific incidence, and cumulative incidence for a comprehensive range of mental disorders using data from Danish registers.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We conducted a follow-up study encompassing all Danish residents from January 1, 2004, to December 31, 2021, totaling 91,613,465 person-years. Data were sourced from the Danish Psychiatric Central Research Register, identifying individuals treated for various mental disorders in psychiatric hospitals, outpatient departments, and accident/emergency departments, that is, treated in secondary care settings. We investigated specific categories of mental disorders, including substance abuse disorders, schizophrenia, mood disorders, anxiety, eating disorders, borderline personality disorders, intellectual disabilities, pervasive developmental disorders, and behavioral and emotional disorders. Age-sex-specific incidence rates were estimated using Poisson generalized linear models, and cumulative incidence was calculated using Aalen–Johansen's competing risks model. The study provides estimates of AOO, incidence, and cumulative incidence for various mental disorders, including their age and sex distributions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The cumulative incidence by age 80 years for any mental disorder was 30.72% (95% confidence interval: 30.62%–30.83%) for males and 34.46% (34.35%–34.57%) for females. The most common types of mental disorders were anxiety-related disorders 16.27% (16.19%–16.36%) for males and 23.39% (23.29%–23.50%) for females, and followed by mood disorder 10.34% (10.27%–10.41%) for males and 16.67% (16.58%–16.77%) for females. For those who develop mental disorder, half will have developed their disorder by approximately age 22 years (median and interquartile range: males 21.37 (11.85–36.00); females 22.55 (16.31–36.08)).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Approximately one in three individuals will seek treatment for at least one mental disorder in a secondary care setting by age 80. Given that half of these individuals develop mental disorders before age 22, it is crucial to tailor service planning to meet the specific needs of young individuals. Web-based interactive data-visualization tools are provided for clinical u","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"149 6","pages":"467-478"},"PeriodicalIF":6.7,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13682","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140205897","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":"Practical application of the biopsychosocial model to medical care—Are we nearly there yet?","authors":"Tom Sensky","doi":"10.1111/acps.13681","DOIUrl":"10.1111/acps.13681","url":null,"abstract":"&lt;p&gt;The paper in this issue by Fava and colleagues&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; highlights features of the Diagnostic Criteria for Psychosomatic Research (DCPR) and stresses how the DCPR was inspired by Engel's biopsychosocial model.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Engel wrote that his ‘proposed biopsychosocial model provides a blueprint for research, a framework for teaching, and a design for action in the real world of healthcare’.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Since then, the biopsychosocial model has been widely adopted, particularly by clinicians and clinical teachers. However, it has also attracted criticism. Some have argued that it says nothing about the subjective experience of the patient.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Others have gone further in their criticism, claiming that individualising treatment to each patient, as the model implies, gives rise to eclectic freedom which ‘borders on anarchy’ and merely replaces the dogmas which the model was intended to protect against (notably the reductionism of the biomedical model) with other dogmas.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Responding to criticisms that Engel's model lacks a sound theoretical basis, Bolton&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; noted that the original model needs to be understood as of its time and that despite its limitations, the model anticipated the crucial role in health and illness of ‘concepts such as regulation and dysregulation, information and communication and function and dysfunction’. It has been argued that the main problem with the model as Engel proposed it is that it is too general. One proposed solution to this is to elaborate specific, evidence-based, models for different diagnoses or conditions.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; The DCPR represents a different but effective solution to the same problem. Instead of elaborating the details of the biopsychosocial model separately for different conditions (a monumental undertaking), the DCPR aims to describe particular transdiagnostic states (termed ‘syndromes’) which can occur as features of the experience of illness.&lt;/p&gt;&lt;p&gt;Fava et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; illustrate the DCPR by characterising some of its syndromes. These are all patterns of responses to life situations involving illness, reflecting dysregulation and/or dysfunction. They are termed syndromes to distinguish them from disorders or diseases which form the basis of standard diagnostic classifications.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; The syndromes were intended to be descriptive and without any pathogenic implications, although with progress in research and understanding, this assumption might now be challenged. The original syndromes were not intended to be exhaustive and indeed the original DCPR has been revised to include two additional syndromes.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; An important feature of the syndromes is that they each include (or overlay) biological, psychological and social components. Allostatic overload is a prime example, manifestly showing biological, psychological and so","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"149 5","pages":"365-367"},"PeriodicalIF":6.7,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13681","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140173651","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":"Prevalence and correlates of ICD-11 prolonged grief disorder among adults living in Ukraine during the war with Russia","authors":"Enya Redican,&nbsp;Philip Hyland,&nbsp;Mark Shevlin,&nbsp;Dmytro Martsenkovskyi,&nbsp;Thanos Karatzias,&nbsp;Menachem Ben-Ezra","doi":"10.1111/acps.13678","DOIUrl":"10.1111/acps.13678","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although high rates of bereavement are evident in war-affected populations, no study has investigated the prevalence and correlates of probable ICD-11 prolonged grief disorder (PGD) under these circumstances.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were 2050 adults who participated in a nationwide survey exploring the effects of the Ukraine-Russia war on the daily lives and mental health of Ukrainian people.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the total sample, 87.7% (<i>n</i> = 1797) of people indicated a lifetime bereavement. In the full sample, 11.4% met the diagnostic requirements for probable ICD-11 PGD, and amongst those with a lifetime bereavement, the conditional rate of probable ICD-11 PGD was 13.0%. Significant risk factors of ICD-11 PGD included the recent loss of a loved one (6 months to a year ago), being most affected by a partner or spouse's death, loved one dying in the war, no recent contact with the deceased prior to their death, and meeting depression and anxiety diagnostic requirements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study reveals that a significant percentage of Ukrainian bereaved individuals have probable ICD-11 PGD, and identifying risk factors, particularly war-related losses, will aid in the development of intervention and prevention programs for bereaved adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"149 5","pages":"425-435"},"PeriodicalIF":6.7,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140139617","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":"Can generative artificial intelligence facilitate illustration of- and communication regarding hallucinations and delusions?","authors":"Søren Dinesen Østergaard","doi":"10.1111/acps.13680","DOIUrl":"10.1111/acps.13680","url":null,"abstract":"&lt;p&gt;In the context of artificial intelligence (AI), the term “hallucinations” is used to refer to false responses generated by conversational agents/chatbots or other generative AI tools (artificial intelligence/machine learning models capable of generating content such as text, speech, images and video).&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; This metaphor is unfortunate as it is both imprecise and, due to its clear negative connotation, stigmatizing for the many individuals experiencing hallucinations—those with schizophrenia and other psychotic disorders in particular.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; While the stigma associated with the misunderstood use of the term hallucinations in relation to generative AI is highly unfortunate, this editorial will propose that it is, however, possible that generative AI may also be helpful and reduce stigma for those experiencing hallucinations and/or delusions.&lt;/p&gt;&lt;p&gt;For individuals with schizophrenia and other psychotic disorders it can be difficult to communicate the nature and quality of their hallucinations and delusions to relatives, friends as well as to the healthcare professionals involved in their treatment—often due to the recipients not handling this communication well enough.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; This may lead to lack of understanding of the suffering associated with these symptoms and could, in turn, contribute to detachment from loved ones, stigma and suboptimal treatment.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Therefore, tools to facilitate communication regarding hallucinations and delusions are sorely needed.&lt;/p&gt;&lt;p&gt;This editorial will propose that AI tools capable of generating images (e.g., DALL·E&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;) and video (e.g., Sora&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt;) may be used to facilitate (highly affordable) illustration of- and, thereby, communication regarding hallucinations and delusions experienced by people with schizophrenia and other psychotic disorders. Interestingly, this approach has recently been described in an ophthalmological case report, where Woods and colleagues report on the diagnosing and treatment of a patient with monocular Charles Bonnet syndrome secondary to optic neuritis, where generative AI was used to successfully illustrate the patient's visual hallucination.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Figure 1 shows three hypothetical examples of hallucinations and delusions illustrated using the version of DALL·E&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; embedded within ChatGPT-4&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; at the time of writing—along with the exact prompts that were used to generate the images. Two images of each set of symptoms are shown (read from left to right)—highlighting the importance of the wording of the prompts and the possibility to revise images if they are not accurately portraying the symptoms in question.&lt;/p&gt;&lt;p&gt;While this is, by no means, a formal assessment of the quality of the generated illustrations or their usefulness, it does seem that this approach has the potential to aid communication r","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"149 6","pages":"441-444"},"PeriodicalIF":6.7,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13680","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140130222","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":"Decreased oxytocin levels related to social cognition impairment in borderline personality disorder","authors":"Alejandra Galvez-Merlin,&nbsp;José M. López-Villatoro,&nbsp;Pilar de la Higuera-González,&nbsp;Alejandro de la Torre-Luque,&nbsp;Karina McDowell,&nbsp;Marina Díaz-Marsá,&nbsp;Juan C. Leza,&nbsp;José L. Carrasco","doi":"10.1111/acps.13679","DOIUrl":"10.1111/acps.13679","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Dysfunctions in the oxytocin system have been reported in patients with borderline personality disorder (BPD). Deficits could be related to interpersonal hypersensitivity, which has been previously associated with failures in social cognition (SC) in this disorder, especially in Theory of Mind (ToM) skills. The aim of this work is to study the links between the oxytocin system and SC impairments in patients with BPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Plasma oxytocin levels (OXT) and protein expression of oxytocin receptors in blood mononuclear cells (OXTR) were examined in 33 patients with a diagnosis of BPD (age: <i>M</i> 28.85, DT = 8.83). Social cognition was assessed using the Movie for the Assessment of Social Cognition (MASC). Statistical associations between biochemical factors and different response errors in MASC were analyzed through generalized linear regression controlling for relevant clinical factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Generalized linear regression showed a significant relationship between lower OXTR and overmentalization in BPD patients (OR = 0.90).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This work supports the relationship between alterations in the oxytocin system and ToM impairments observed in BPD patients, enhancing the search for endophenotypes related to the phenotypic features of the disorder to improve current clinical knowledge and address more specific therapeutic targets.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"149 6","pages":"458-466"},"PeriodicalIF":6.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13679","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140108457","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":"Psychotherapy duration and work disability: A prospective Finnish register study","authors":"Sanna Selinheimo,&nbsp;Kia Gluschkoff,&nbsp;Johanna Kausto,&nbsp;Jarno Turunen,&nbsp;Ari Väänänen","doi":"10.1111/acps.13677","DOIUrl":"10.1111/acps.13677","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The influence of psychotherapy duration on common mental disorder (CMD) outcomes remains a topic of ongoing debate. Whereas most research has focused on CMD symptom change, the evidence on the psychotherapy duration of subsequent CMD-related work disability and the change in psychotropic drug purchases is scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used a register-based cohort representing 33% of the Finnish population. The participants included working-age individuals (<i>N</i> = 12,047, 76% women, mean age = 36) who initiated long-term psychotherapy, between 2014 and 2017. They were followed from 2011 to 2021 and psychotherapy duration ranged from less than a year to over 3 years. We used an interrupted time series design to analyze the psychotherapy duration-dependent changes in CMD-related work disability (primary outcome, operationalized as depression or anxiety-related sickness absence, SA, days) and the annual number of psychotropic drug purchases or distinct drugs purchased (secondary outcomes).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no differences in the levels of work disability or drug purchases before the psychotherapy. We observed a decreasing level and trend in all outcomes across all psychotherapy duration groups. The largest decline in level was observed in the &lt;1-year duration group (88% decline for SA and 43%–44% for drug purchases) while the smallest decline was in the 3+ years duration group (73% for SA and 27% for drug purchases).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Work disability outcomes and duration varied among individuals, even with similar initial mental health-related work disability or use of auxiliary psychotropic treatments. Compared to longer psychotherapy, shorter psychotherapy was associated with sharper improvements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"149 5","pages":"415-424"},"PeriodicalIF":6.7,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13677","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140020364","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":"Clarifying the relationship between physical injuries and risk for suicide attempt in a Swedish national sample","authors":"Mallory Stephenson,&nbsp;Henrik Ohlsson,&nbsp;Séverine Lannoy,&nbsp;Jan Sundquist,&nbsp;Kristina Sundquist,&nbsp;Alexis C. Edwards","doi":"10.1111/acps.13675","DOIUrl":"10.1111/acps.13675","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The Interpersonal-Psychological Theory of Suicide proposes that capability for suicide is acquired through exposure to painful and provocative events (PPEs). Although there is robust evidence for a positive association between aggregate measures of PPEs and risk for suicidal behavior, little is known about the contributions of physical injuries. The present study investigated the relationship between injuries and risk of subsequent suicide attempt (SA).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Data were from Swedish population-based registers. All individuals born in Sweden between 1970 and 1990 were included (&lt;i&gt;N&lt;/i&gt; = 1,011,725 females and 1,067,709 males). We used Cox regression models to test associations between 10 types of injuries (eye injury; fracture; dislocation/sprain/strain; injury to nerves and spinal cord; injury to blood vessels; intracranial injury; crushing injury; internal injury; traumatic amputation; and other or unspecified injuries) and risk for later SA. Analyses were stratified by sex and adjusted for year of birth and parental education. Additional models tested for differences in the pattern of associations based on age group and genetic liability for SA. In co-relative models, we tested the association between each injury type and risk for SA in relative pairs of varying genetic relatedness to control for unmeasured familial confounders.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;All 10 injury types were associated with elevated risk for SA (hazard ratios [HRs] = 1.2–7.0). Associations were stronger in the first year following an injury (HRs = 1.8–7.0), but HRs remained above 1 more than 1 year after injury exposure (HRs = 1.2–2.6). The strength of associations varied across injury type, sex, age, and genetic liability for SA. For example, the magnitude of the association between crushing injury and risk for SA was larger in females than males, whereas other injuries showed a similar pattern of associations across sex. Moreover, there was evidence to support positive additive interaction effects between several injury types and aggregate genetic liability for SA (relative excess risk due to interaction [RERI] = 0.1–0.3), but the majority of these interactions became non-significant or changed direction after accounting for comorbid psychiatric and substance use disorders. In co-relative models, the pattern of associations differed by injury type, such that there was evidence to support a potential causal effect of eye injury, fracture, dislocation/sprain/strain, intracranial injury, and other and unspecified injuries on risk for SA. For the remaining injury types, HRs wer","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"149 5","pages":"389-403"},"PeriodicalIF":6.7,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13675","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139981840","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}