Acta Psychiatrica Scandinavica最新文献

{"title":"Bidirectional causal association between ischemic stroke and five mental disorders","authors":"Yingying Ji,&nbsp;Zhiqiang Du,&nbsp;Kai Zheng,&nbsp;Ying Jiang,&nbsp;Caili Ren,&nbsp;Haohao Zhu,&nbsp;Ming Xiao,&nbsp;Tong Wang","doi":"10.1111/acps.13606","DOIUrl":"https://doi.org/10.1111/acps.13606","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the bidirectional causal association between ischemic stroke and five mental disorders from a genetic perspective using two-sample Mendelian randomization (TSMR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Single-nucleotide polymorphisms (SNPs) associated with ischemic stroke were obtained from the genome-wide association study (GWAS) database, and those closely related to the exposure phenotype and satisfying the three core assumptions of Mendelian randomization were selected as instrumental variables (IVs). The main TSMR analysis was conducted using the inverse variance-weighted (IVW) method, and the robustness of the results was assessed using the weighted median, weighted mode, and MR Egger methods. Heterogeneity test, pleiotropy test, and sensitivity analysis were also conducted to further ensure the accuracy and stability of the research results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study found a positive correlation between ischemic stroke and depression [IVW method (FEM): OR = 1.002, 95%CI: 1.000–1.003, <i>P</i> = 0.023&lt;0.05], but no significant causal association with schizophrenia, bipolar disorder, insomnia, or anxiety (<i>P</i> &gt; 0.05). Reverse TSMR analysis showed no causal association between depression, schizophrenia, bipolar disorder, insomnia, anxiety, and ischemic stroke (<i>P</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study used TSMR to demonstrate from a genetic perspective that there is a positive correlation between ischemic stroke and depression, which increases the risk of depression. Proactive intervention for ischemic stroke might reduce the risk of depression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 4","pages":"359-367"},"PeriodicalIF":6.7,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6798118","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":"Use of hypnotic-sedative medication and risk of falls and fractures in adults: A self-controlled case series study","authors":"Maarten Pieter Rozing,&nbsp;Marie Kim Wium-Andersen,&nbsp;Ida Kim Wium-Andersen,&nbsp;Terese Sara Høj Jørgensen,&nbsp;Martin Balslev Jørgensen,&nbsp;Merete Osler","doi":"10.1111/acps.13610","DOIUrl":"10.1111/acps.13610","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the risk of falls and fractures in users of benzodiazepines, Z-drugs, or melatonin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We followed 699,335 adults with a purchase of benzodiazepines, Z-drugs, or melatonin in the Danish National Prescription Registry between 2003 and 2016 for falls and fractures in the Danish National Patient Registry between 2000 and 2018. A self-controlled case-series analysis and conditional Poisson regression were used to derive incidence rate ratios (IRR) of falls and fractures during six predefined periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total 62,105 and 36,808 adults, respectively, experienced a fall or fracture. For older adults, the risk of falls was highest during the 3-month pre-treatment period (IRR_men+70, 4.22 (95% confidence interval, 3.53–5.05), IRR_{women + 70}, 3.03 (2.59–3.55)) compared to the baseline (&gt;1 year before initiation). The risk continued to be higher in the later treatment periods. Contrarily, in men and women aged 40–69 years, the risk was only higher in the 3-month pre-treatment period. The incidence of falls among young men and women was slightly lower after initiation of sedating medication (treatment period, IRR_men15–39, 0.66 (0.50–0.86), IRR_women15–39, 0.65 (0.51–0.83)). Analyses with fractures as outcome yielded similar results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although falls and fractures occur more often in persons using sedative-hypnotic medication, the higher risk of falls and fractures in the pre-treatment period relative to the period directly after treatment, suggests that this association is better explained by other factors that elicited the prescription of this medication rather than the adverse effects of the sedative-hypnotic medication.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 5","pages":"394-404"},"PeriodicalIF":6.7,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13610","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10526165","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":"Online peer-delivered group cognitive-behavioral therapy for postpartum depression: A randomized controlled trial","authors":"Donya Merza,&nbsp;Bahar Amani,&nbsp;Calan Savoy,&nbsp;Zoryana Babiy,&nbsp;Peter J. Bieling,&nbsp;David L. Streiner,&nbsp;Mark A. Ferro,&nbsp;Ryan J. Van Lieshout","doi":"10.1111/acps.13611","DOIUrl":"10.1111/acps.13611","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Postpartum depression (PPD) affects up to one in five mothers and birthing parents, yet just 10% receive evidence-based care. This randomized controlled trial aimed to determine if a synchronous online 9-week group cognitive-behavioral therapy (CBT) intervention delivered by mothers who have recovered from postpartum depression (i.e., peers) could effectively improve PPD and its comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 183) in this study lived in Ontario, Canada, were ≥18 years-old, had an infant &lt;12 months, were fluent in English, and scored ≥10 on the Edinburgh Postnatal Depression Scale (EPDS). They were randomized to experimental (received intervention plus treatment as usual (TAU)) or waitlist control (TAU plus the intervention after a 9-week wait) groups. Depression, anxiety, social support, mother-infant bonding, and infant temperament were assessed at baseline and 9 weeks later. Outcomes were assessed in the experimental group 3 months post-intervention to assess stability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Statistically significant reductions were observed in EPDS (<i>B</i> = 5.99; <i>p</i> &lt; 0.001; <i>d</i> = 1.32) and Generalized Anxiety Disorder Questionnaire-7 scores (<i>B</i> = 5.94; <i>p</i> &lt; 0.001; <i>d</i> = 1.22), improvements that remained stable 3 months post-intervention in the experimental group. Maternal social support (<i>p</i> = 0.02; <i>d</i> = 0.40), infant-focused anxiety (<i>p</i> = 0.02; <i>d</i> = 0.54), and infant negative emotionality (<i>p</i> &lt; 0.01; <i>d</i> = 0.23) also improved post-intervention and remained stable 3 months later.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Online peer-delivered group CBT for PPD can effectively treat PPD and anxiety, and improve social support, infant-focused anxiety, and negative emotionality in infants. This intervention could provide the means to increase access to treatment for those experiencing PPD and improve outcomes for mothers, birthing parents, and families.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"150 5","pages":"422-432"},"PeriodicalIF":5.3,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10476962","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":"Changes in self-reported suicidal ideation during treatment with electroconvulsive therapy: A retrospective cohort study","authors":"James Luccarelli,&nbsp;Daniel Humphrey,&nbsp;Thomas H. McCoy Jr.,&nbsp;Michael E. Henry,&nbsp;Martina Mueller,&nbsp;Stephen J. Seiner","doi":"10.1111/acps.13603","DOIUrl":"10.1111/acps.13603","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Suicidal ideation (SI) is common in patients with depressive symptoms, who are the most common recipients of electroconvulsive therapy (ECT). We sought to quantify changes in self-reported SI occurring during treatment with ECT, and to identify factors associated with persistence of SI in patients beginning treatment with SI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Retrospective, single-center cohort study of patients receiving ECT and who self-reported symptoms using Quick Inventory of Depressive Symptomatology (QIDS) prior to ECT and after treatment #5 or #10. Changes in QIDS-reported SI over the course of ECT were calculated, and logistic regression models were performed to assess factors associated with reporting SI at the end of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>2554 provided baseline and follow-up SI scores, of whom, 1931 (75.6%) endorsed SI at baseline. There was a reduction in SI with ECT treatment (McNemar's test; df = 1, Χ² = 803.7; <i>p</i> &lt; 0.001), and in adjusted models 64.0% of individuals with baseline SI reported resolution of SI with ECT treatment, while 3.3% without baseline SI reported SI at the end of treatment. Higher baseline SI severity and outpatient treatment were associated with a higher odds of persistent SI among individuals beginning treatment with SI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Electroconvulsive therapy treatment was associated with reductions in self-reported SI. These results support the use of ECT in the treatment of patients with SI, but further research is needed to determine the effects of ECT on suicidal behavior.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 6","pages":"553-560"},"PeriodicalIF":6.7,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10207493","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":"Transdiagnostic suicidality in depression: More similar than different?","authors":"Simina Toma,&nbsp;Mark Sinyor,&nbsp;Rachel H. B. Mitchell,&nbsp;Ayal Schaffer","doi":"10.1111/acps.13600","DOIUrl":"https://doi.org/10.1111/acps.13600","url":null,"abstract":"&lt;p&gt;While extensive work has been conducted regarding risk factors for suicide attempts and deaths, clinical prediction of suicide-related behaviour at an individual level remains an unmet challenge.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Given this reality, some have recommended a shift from risk prediction to risk management and a focus on formulation and therapeutic engagement.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; There is a paucity of prospective data directly comparing suicidal behaviour across commonly encountered psychiatric conditions and their symptom severity. Major depressive disorder (MDD), bipolar disorder (BD) and borderline personality disorder (BPD) are known to be associated with higher risk for suicidal ideation, suicide attempt and death by suicide than the general population, especially during the course of major depressive episodes (MDEs).&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Mood disorders and BPD also frequently co-occur, with about 20% of adults with BD having comorbid BPD and an even higher frequency of BPD traits.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; The dynamic interplay between depressive symptom fluctuation, baseline BPD traits and emergence of suicidal behaviour is of great clinical relevance.&lt;/p&gt;&lt;p&gt;In this edition of the journal, Isometsä et al. examine suicide attempts and suicidal ideation prospectively in a cohort of outpatients with an MDE within the context of MDD, BD or comorbid with BPD.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Findings include higher rates of suicide attempts in those with BPD, a correlation between suicide attempts/suicidal ideation and BPD symptom severity as measured by the borderline personality disorder severity index (BPDSI) at baseline, and a correlation between severity of suicidal ideation and depressive symptom severity. Although the rates of suicidal ideation and attempts are lower over the period of follow up in the BD group than in the other two groups, the link between depression severity changes and suicidality is greater in this group. Hopelessness is found to be a transdiagnostic predictor of suicidal ideation. Interestingly, non-suicidal self-injury (NSSI) is also high in the MDD group, and not only in the BPD group. NSSI is lower in the BD group.&lt;/p&gt;&lt;p&gt;This work provides an important contribution to the field based on the prospective design and direct comparison of uniform and relevant outcomes between these three commonly encountered clinical groups. The sample is comprised of treatment-seeking subjects in an outpatient clinic, with on average moderate depression severity at baseline. While the strictly outpatient setting may reduce generalizability to other settings, the outpatient setting is particularly salient as past work has demonstrated the most common mental health contact prior to suicide completion is an ambulatory care visit, rather than emergency room visit or psychiatric hospitalisation.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; Furthermore, the rate of lifetime suicide attempts in this group is 15.6% for the MDD group, 30% for the BD gro","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 3","pages":"219-221"},"PeriodicalIF":6.7,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5689431","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":"Using polygenic risk scores to investigate the evolution of smoking and mental health outcomes in UK biobank participants","authors":"Lloyd Balbuena,&nbsp;Evyn Peters,&nbsp;Doug Speed","doi":"10.1111/acps.13601","DOIUrl":"10.1111/acps.13601","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Mendelian randomization studies report a bi-directional relation between cigarette smoking and mental disorders, yet from a clinical standpoint, mental disorders are the focus of treatment. Here, we used an event history framework to understand their evolution in the life course. Our objective was to estimate the relative contribution of genetic predispositions and self-reported smoking status (never, former, and present smoker) to hospitalizations for major depression, bipolar disorder, and schizophrenia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We calculated polygenic risk scores (PRS) for ever smoking, pack-years of smoking as a proportion of adult life, and neuroticism in 337,140 UK Biobank participants of white British ancestry. These PRS and self-reported smoking status were entered as explanatory variables in survival models for hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The estimated single nucleotide polymorphisms heritabilities (<i>h</i>²) were 23%, 5.7%, and 5.7% for pack-years, ever smoking, and neuroticism respectively. PRS pack-years and PRS neuroticism were associated with higher hospitalization risk for mental disorders in all smoking status groups. The hazard for mental health hospitalization was higher in both previous (HR: 1.50, CI: 1.35–1.67) and current (HR: 3.58, 2.97–4.31) compared to never smokers, after adjusting for confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Since genetic liabilities for smoking and neuroticism are fixed at conception and smoking initiation generally started before age 20, our results show that preventing smoking in adolescents probably prevents the development of mental disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 5","pages":"447-456"},"PeriodicalIF":6.7,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13601","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10041404","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":"Unfavorable cancer mortality-to-incidence ratios in patients with schizophrenia: A nationwide cohort study in Taiwan, 2000–2019","authors":"Chu-Syuan Cheng,&nbsp;Wen-Yin Chen,&nbsp;Hu-Ming Chang,&nbsp;Chun-Hung Pan,&nbsp;Sheng-Siang Su,&nbsp;Shang-Ying Tsai,&nbsp;Chiao-Chicy Chen,&nbsp;Chian-Jue Kuo","doi":"10.1111/acps.13604","DOIUrl":"https://doi.org/10.1111/acps.13604","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Studies on cancer incidence and mortality in patients with schizophrenia have reported inconsistent findings. In this study, we simultaneously investigated cancer incidence and mortality in patients with schizophrenia and evaluated the cancer mortality-to-incidence ratio (MIR), which is rare in the literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From the Taiwan National Health Insurance Database, we collected the data of 107,489 patients who received a diagnosis of schizophrenia between 2000 and 2019. Data regarding cancer incidence and mortality were obtained from the Taiwan Cancer Registry and National Mortality Database, respectively. In total, 3881 incident cancer cases and 2288 cancer mortality cases were identified. Standardized incidence ratios (SIRs), mortality rate ratios (MRRs), and MIRs were compared between patients with schizophrenia and the general population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall rate of cancer incidence was slightly lower (SIR: 0.95; 95% confidence interval [CI]: 0.92–0.98; <i>p</i> &lt; 0.001) and that of cancer mortality was higher (MRR: 1.29; 95% CI: 1.23–1.3; <i>p</i> &lt; 0.001) in patients with schizophrenia than in the general population. The MIR for overall cancer was significantly higher in the patients with schizophrenia. The relative MIR (MIR of patients with schizophrenia divided by that of the general population) was 1.36 (95% CI: 1.30–1.42).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The MIR was significantly higher in the patients with schizophrenia than in the general population, indicating the possible presence of healthcare disparities. Additional studies are required to investigate the potential association between the significantly higher MIR in patients with schizophrenia and healthcare disparities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 4","pages":"347-358"},"PeriodicalIF":6.7,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6975191","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":"Perineal tear and childbirth-related posttraumatic stress: A prospective cohort study","authors":"Sophie Baumann,&nbsp;Andreas Staudt,&nbsp;Danny Horesh,&nbsp;Malin Eberhard-Gran,&nbsp;Susan Garthus-Niegel,&nbsp;Antje Horsch","doi":"10.1111/acps.13595","DOIUrl":"10.1111/acps.13595","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Quantitative studies examining the occurrence of childbirth-related posttraumatic stress disorder (CB-PTSD) following severe perineal rupture are lacking. The objective of this population-based study was to investigate the prospective associations between the degree of perineal tear during childbirth and CB-PTSD symptoms, when adjusting for known covariates (maternal age, years of school education, premature birth, and parity). We hypothesized that women with different degrees of perineal tear will differ regarding (1) the level of CB-PTSD symptoms at 8 weeks and 2 years postpartum and (2) the rate of change in CB-PTSD symptoms from 8 weeks to 2 years postpartum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Secondary data analysis from the Akershus Birth Cohort, a large population-based prospective cohort study using self-report questionnaires and hospital record data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The degree of perineal tear was significantly associated with CB-PTSD symptoms at 8 weeks and 2 years postpartum. However, the degree of perineal tear was not significantly associated with the change in CB-PTSD symptoms over time. Similar patterns were found for both total CB-PTSD symptoms as well as for avoidance and intrusion symptoms only.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Results seem to support a dose–response model, suggesting that the higher the severity of the perineal tear, the higher the posttraumatic morbidity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"150 5","pages":"446-457"},"PeriodicalIF":5.3,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13595","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10325957","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":"Heart's tale of trauma: Fear-conditioned heart rate changes in post-traumatic stress disorder","authors":"Simone Battaglia,&nbsp;C. Nazzi,&nbsp;J. F. Thayer","doi":"10.1111/acps.13602","DOIUrl":"10.1111/acps.13602","url":null,"abstract":"The study of emotional memories in neuroscience is now more than ever linked to the use of fear conditioning paradigms, which represent a direct and controlled way to study this phenomenon in humans. Repeated pairings of a neutral stimulus with a negative consequence leads to the creation of a transiently threatening entity, which can be used to assess explicit and implicit ratings of fear. In fact, the use of psychophysiological indices (i.e., skin conductance responses, fear potentiated startle, pupillary responses) represents a less biased tool compared with verbal ratings, as they are harder to control voluntarily. Among those, the use of heart rate (HR) responses is on the rise, as it reveals the presence of fear-induced bradycardia, a phenomenon by which a conditioned stimulus elicits a brief cardiac deceleration upon its presentation. This stems from an intricate interplay among the central and the peripheral nervous systems, by means of the vagus nerve which extends to the heart. The neurovisceral integration model of fear (NVI-f) proposes that high level cognitive structures (i.e., prefrontal cortex) influence both the amygdala and the hippocampus, generating neurovisceral responses via projections that govern heart behaviour. Compromised functioning of those high-level structures can, thus, engender aberrant fear conditioning, which is known to lead to the development of different psychiatric disorders, including post-traumatic stress disorder (PTSD). As these populations of patients show differences from the norm in their conditioned responses when measured by more widely used techniques, it is possible to assume that the same would be true for HR responses. This hypothesis has been investigated with a particular focus on PTSD patients (see Table 1 for a summary). Here, we aim at discussing in a single work the research endeavours made in this field. Moreover, our goal is to provide an interpretation of the various results taken together. PTSD is tightly related to second-order conditioning, a phenomenon by which a conditioned stimulus (CS) can acquire the properties of an unconditioned stimulus (US) and become a US by itself. Moreover, the affective properties of the CS can be further transferred to a second stimulus. This is actually relevant for these patients since cues related to the traumatic event can serve as a US and negatively impact on everyday life. Accordingly, to study this phenomenon, Wessa and Flor recruited trauma exposed individuals, some of which suffered from PTSD, and healthy controls. They had them undergo a fear conditioning paradigm during which one geometrical shape was followed by a picture of an airplane crash, while the other never was. Crucially, HR results showed no differences between the two CSs, in none of the groups, revealing how fear bradycardia does not emerge in situations where the US causes cognitive distress instead of a painful physical sensation. Similarly, Orr et al recruited trauma exposed i","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 5","pages":"463-466"},"PeriodicalIF":6.7,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9937941","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":"Effects of malnutrition on length of stay in patients hospitalized in an acute psychiatric ward","authors":"Anna Giménez-Palomo,&nbsp;Susana Gomes-da-Costa,&nbsp;Roger Borràs,&nbsp;M. T. Pons-Cabrera,&nbsp;Antonio Doncel-Moriano,&nbsp;Néstor Arbelo,&nbsp;Pere Leyes,&nbsp;Maria Forga,&nbsp;Manuel Mateu-Salat,&nbsp;Pedro Miguel Pereira-Fernandes,&nbsp;Antonio Benabarre,&nbsp;Isabella Pacchiarotti,&nbsp;Eduard Vieta","doi":"10.1111/acps.13598","DOIUrl":"https://doi.org/10.1111/acps.13598","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Psychiatric patients are considered at risk for malnutrition due to pharmacological treatments, lifestyle habits and the mental illness by itself. Even though metabolic risk factors have been related to worse outcomes in certain conditions, the evidence regarding the nutritional status and its impact on the length of stay in psychiatric inpatients is scarce. This study aims to characterize the nutritional status in acute psychiatric patients, to correlate it with the length of stay, and to find specific potential indicators of malnutrition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adult patients admitted to the Hospital Clínic of Barcelona acute psychiatric ward throughout a 1-year period were included in this cross-sectional study. Sociodemographic and clinical variables were registered, including length of stay and the nutritional status measured with the CONUT score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Malnutrition was observed in 42.5% of patients. Plasmatic transferrin saturation, protein and iron levels were inversely correlated with length of stay, having low iron levels an association with longer hospitalizations. The length of stay was not influenced by diagnosis or treatment. Negative correlations with the nutritional status were found in: BMI, cholesterol, triglycerides, albumin, total proteins, prealbumin, iron, lymphocytes and zinc levels, and transferrin saturation. The multivariate analysis showed a significant association for cholesterol and zinc levels, lymphocyte count, and BMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results suggest that nutritional status might influence the course of psychiatric admissions. Cholesterol and zinc levels, lymphocyte count, and BMI might be factors strongly associated with malnutrition. This consideration might allow the identification of profiles in which lifestyle interventions could be implemented.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 4","pages":"316-326"},"PeriodicalIF":6.7,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13598","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6788244","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}