Acta Psychiatrica Scandinavica最新文献

{"title":"Mood, Activity, and Instability in Bipolar Disorder and Unipolar Disorder—An Exploratory Post Hoc Study Using Digital Data","authors":"Maria Faurholt-Jepsen,&nbsp;Jonas Busk,&nbsp;Morten Lindberg Tønning,&nbsp;Darius Rohani,&nbsp;Jakob Eyvind Bardram,&nbsp;Lars Vedel Kessing","doi":"10.1111/acps.13771","DOIUrl":"10.1111/acps.13771","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mood, activity, and instability in symptomatology hold significant roles in bipolar disorder (BD) and unipolar disorder (UD). The objectives were to examine disparities in these symptoms among patients with BD and UD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from two studies including patients with BD and UD, respectively, were combined for exploratory analyses. Patients provided daily smartphone-based evaluations of mood and activity/energy for a 6-month period. A total of 47 patients with BD and 59 patients with UD were included in the analyses. The dataset contains more than 13,000 patient-reported evaluations of mood and activity. Daily mood and activity instability measures were calculated using the root squared successive difference method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In linear mixed effect regression models adjusted for age, sex, and work status, there were statistically significant lower levels of activity in patients with BD as compared with patients with UD overall, during euthymic states and during depressive states (<i>B</i>: −0.61, 95% CI: −0.98; −0.24, <i>p</i> = 0.001). There were no statistically significant differences in mood instability and activity instability between patients with BD and patients with UD overall, during euthymic states and during depressive states, when accounting for multiple testing (<i>p</i> &gt; 0.012).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Limitations</h3>\u0000 \u0000 <p>Analyses were exploratory and post hoc. Findings should be interpreted with caution. The sample size was modest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with BD presented with lower level of activity as compared with patients with UD. There were no differences in mood and activity instability between these groups. Future studies including larger sample sizes should investigate differences between BD and UD.</p>\u0000 \u0000 <p>\u0000 <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT03033420</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 3","pages":"426-433"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765046","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":"Initiation of Antipsychotics During the First Year After First-Episode Psychosis: A Population-Based Study","authors":"I. Odsbu,&nbsp;A. Hamina,&nbsp;V. Hjellvik,&nbsp;M. Handal,&nbsp;M. Haram,&nbsp;M. Tesli,&nbsp;A. Tanskanen,&nbsp;H. Taipale","doi":"10.1111/acps.13776","DOIUrl":"10.1111/acps.13776","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Antipsychotics are recommended after first-episode psychosis. Knowledge on the current use patterns in real-world settings is thus important to inform clinical practice. We aimed to describe antipsychotic initiation during 1 year after first-episode psychosis and its associated factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Population-based cohort study using linked nationwide health and population registers from Norway. The study population comprised 8052 persons aged 16–45 years with first-episode psychosis diagnosed in secondary care (ICD-10 F20, F22–F29) in the period 2011–2019. Initiation of antipsychotic use was defined as being dispensed antipsychotics (ATC N05A, excl. lithium) at least once from −90 to +365 days from secondary care diagnosis of first-episode psychosis. Antipsychotic polypharmacy during follow-up was defined as having at least 90 days with overlapping drug use periods modeled using the Prescriptions to Drug Use Periods method. Adjusted risk ratios (aRRs) with 95% confidence intervals (CIs) for the association between socioeconomic and clinical factors and initiation of antipsychotic use were calculated using modified Poisson regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 4413 persons (54.8%) initiated antipsychotic use after first-episode psychosis with proportions ranging from 45.5% in 2012 to 62.1% in 2019. Oral formulations of olanzapine (34.9%), quetiapine (21.2%), and aripiprazole (11.6%) were most common at initiation, whereas long-acting injectables (LAIs) and clozapine were rarely used. Among the initiators, 13.8% started a polypharmacy period lasting more than 90 days. Factors associated with antipsychotic initiation were lower age (aRR 1.14, 95% CI 1.08–1.21; 26–35 years vs. 36–45 years), higher education (1.11, 1.05–1.18), being employed (1.04, 1.00–1.09), being hospitalized (1.13, 1.09–1.18), being diagnosed late in the study period (1.16, 1.11–1.22; 2017–2019 vs. 2011–2013), or with previously diagnosed bipolar disorder, depression, or anxiety disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The antipsychotic use pattern is largely within the current clinical guideline. Primary non-compliance and disease severity may explain the socioeconomic and clinical differences related to initiation of antipsychotic use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 4","pages":"537-547"},"PeriodicalIF":5.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13776","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754364","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":"Impact of Early Intervention for Early Psychosis on Suicidal Behavior—A Meta-Analysis","authors":"Elkhan Tahmazov,&nbsp;Jordan Bosse,&nbsp;Benjamin Glemain,&nbsp;Patrice Nabbe,&nbsp;Morgane Guillou,&nbsp;Athéna Blachier,&nbsp;Michel Walter,&nbsp;Christophe Lemey","doi":"10.1111/acps.13773","DOIUrl":"10.1111/acps.13773","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;Early-onset psychotic disorders include the prodromal phase and the first-episode psychosis (FEP). They constitute a high-risk period for suicidal behavior. Early intervention for psychosis (EIP) consists of intervening as early as possible. The effectiveness of early intervention on overall prognosis has been reported in numerous studies, and EIP services are emerging worldwide. Several authors report an improvement in suicidal behavior, but no study has looked at all the data.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aims of the Study&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The aim of work is to study whether early intervention for psychosis has an impact on deaths by suicide and suicide attempts, and study which intervention methods have an impact on suicidal behavior.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methodology&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;By respecting the PRISMA criteria, previously declared on PROSPERO, by exploring 5 medical databases (PubMed, Cochrane, PsycINFO, Scopus, Embase), from their creation dates, published until 20/02/2023, in English, we carried out a meta-analysis. The articles selected had to deal with the EIP and deaths by suicide or suicide attempts. Our primary outcome is the deaths by suicide and the secondary outcome the suicide attempt.&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 exhaustive search identified a total of 2310 references. Nine articles were included. Their intervention modalities were pharmacotherapy, psychotherapy, case-management, or related services, and psycho-social therapies. Our meta-analysis shows that early intervention for early-onset psychotic disorders is associated with a statistically significant reduction by a third in deaths by suicide (ORa = 0.66 (0.49–0.88), &lt;i&gt;p&lt;/i&gt; = 0.005) and by a third in suicide attempts (ORa = 0.66 (0.50–0.86), &lt;i&gt;p&lt;/i&gt; = 0.002), with non-significant heterogeneity. Sensitivity analyses excluding the study with statistical difficulties due to the absence of an event and studies with a high risk of bias point in the same direction, that is a statistically significant reduction and non-significant heterogeneity.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The literature shows that early intervention programs are associated with positive impact on deaths by suicide and suicide attempt. This is the first meta-analysis of early intervention in early psychotic disorders and its impact on suicidal risk. The deployment of EIP should be supported worldwide in order to intervene as early as","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 2","pages":"127-141"},"PeriodicalIF":5.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724389","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":"More rTMS pulses or more sessions? The impact on treatment outcome for treatment resistant depression","authors":"E. Oostra,&nbsp;P. Jazdzyk,&nbsp;V. Vis,&nbsp;I. Dalhuisen,&nbsp;A. W. Hoogendoorn,&nbsp;C. H. M. Planting,&nbsp;P. F. van Eijndhoven,&nbsp;Y. D. van der Werf,&nbsp;O. A. van den Heuvel,&nbsp;E. van Exel","doi":"10.1111/acps.13768","DOIUrl":"10.1111/acps.13768","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Repetitive transcranial magnetic stimulation (rTMS) is effective for treatment-resistant depression (TRD). Optimal rTMS parameters remain unclear, especially whether number of sessions or amount of pulses contribute more to treatment outcome. We hypothesize that treatment outcome depends on the number of sessions rather than on the amount of pulses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched databases for randomized clinical trials (RCTs) on high-frequent (HF) or low-frequent (LF)-rTMS targeting the left or right DLPFC for TRD. Treatment efficacy was measured using standardized mean difference (SMD), calculated from pre- and post-treatment depression scores. Meta-regressions were used to explore linear associations between SMD and rTMS pulses, pulses/session and sessions for HF and LF-rTMS, separately for active and sham-rTMS. If these variables showed no linear association with SMD, we divided the data into quartiles and explored subgroup SMDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-seven RCTs were included: 67 studied HF-rTMS, eleven studied LF-rTMS, and nine studied both. No linear association was found between SMD and amount of pulses or pulses/session for HF and LF-rTMS. Subgroup analyses showed the largest SMDs for 1200–1500 HF-pulses/session and 360–450 LF-pulses/session. The number of sessions was significantly associated with SMD for active HF (<i>β</i> = 0.09, <i>p</i> &lt; 0.05) and LF-rTMS (<i>β</i> = 0.06, <i>p</i> &lt; 0.01). Thirty was the maximal number of sessions, in the included RCTs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>More rTMS sessions, but not more pulses, were associated with improved treatment outcome, in both HF and LF-rTMS. Our findings suggest that 1200–1500 HF-pulses/session and 360–450 LF-pulses/session are already sufficient, and that a treatment course should consist of least 30 sessions for higher chance of response.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 4","pages":"485-505"},"PeriodicalIF":5.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13768","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680028","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":"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,&nbsp;Christoph U. Correll","doi":"10.1111/acps.13772","DOIUrl":"10.1111/acps.13772","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 4","pages":"548-549"},"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,&nbsp;Rob Kok,&nbsp;Jasmien Obbels,&nbsp;Simon Lambrichts,&nbsp;Pascal Sienaert,&nbsp;Esmée Verwijk","doi":"10.1111/acps.13770","DOIUrl":"10.1111/acps.13770","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We combined individual patient data from two randomized controlled trials (total <i>N</i> = 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&lt;10). We included study as moderator to evaluate study heterogeneity. For symptoms directly predictive of remission we computed odds ratios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 4","pages":"521-528"},"PeriodicalIF":5.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13770","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to treat antipsychotic-related weight gain and metabolic disturbances: Is there a role for GLP-1 receptor agonists?","authors":"Anders Fink-Jensen,&nbsp;Christoph U. Correll","doi":"10.1111/acps.13769","DOIUrl":"10.1111/acps.13769","url":null,"abstract":"&lt;p&gt;Patients with mental disorders have a significantly reduced lifespan,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; with overweight/obesity and cardiometabolic-related death being the biggest contributors. Both the underlying mental illness and treatments, especially antipsychotics, contribute to this increased cardiometabolic risk, creating a dilemma between efficacy and desired safety. As a point in fact, clozapine is a second-generation antipsychotic with proven antipsychotic efficacy in otherwise treatment-resistant patients with a diagnosis of schizophrenia. However, clozapine is also linked to a substantial increase in body weight and carries a high risk for metabolic disturbances,&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; making clinicians, patients, and caretakers reluctant against its use. Additionally, sedentary lifestyle and unhealthy food intake have become a public health issue for populations in the Western world in general. However, they are an even bigger problem among people with severe mental disorders, such as schizophrenia and bipolar disorder. Also, the use of antipsychotics has expanded beyond schizophrenia and bipolar disorder, being used frequently on-label for unipolar depression, but also off-label for impulsive behaviors, insomnia, and anxiety among other conditions.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Over the last decade, more focus has been paid to monitoring body weight and uncovering potential dysmetabolism by blood sample analysis in people treated with antipsychotics, which are important steps in the right direction. However, clear, and well-established strategies for an effective treatment against overweight/obesity and dysmetabolism in people with mental illness and, especially, those receiving antipsychotics or being mentally ill, remain underdeveloped or, at least, underutilized.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The most effective strategy for preventing antipsychotic-induced weight gain and dysmetabolism is using these medications only when needed or starting with the antipsychotic with the lowest weight gain potential.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; When weight gain and metabolic adverse effects occur, secondary preventive efforts include switching to an antipsychotic linked to less weight gain and dysmetabolism, although the desired weight loss may be limited.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Moreover, in the case of clozapine, which is used in otherwise partial or complete treatment-resistant patients, switching to a less effective antipsychotic, even if it may impose fewer dysmetabolic problems and less increase in body weight, may not be an applicable strategy.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Nonpharmacological interventions such as lifestyle changes against overweight and dysmetabolism are well-known strategies&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; but-as for the background population-are difficult to implement broadly.&lt;/p&gt;&lt;p&gt;Traditionally, the adjunctive pharmacological interventions against antipsychotic-associated weight gain have included topiramate and metformin. However,","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 1","pages":"3-5"},"PeriodicalIF":5.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13769","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602461","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":"Variation of subclinical psychosis as a function of population density across different European settings: Findings from the multi-national EU-GEI study","authors":"Giuseppe D'Andrea,&nbsp;Diego Quattrone,&nbsp;Giada Tripoli,&nbsp;Edoardo Spinazzola,&nbsp;Charlotte Gayer-Anderson,&nbsp;Hannah E. Jongsma,&nbsp;Lucia Sideli,&nbsp;Simona A. Stilo,&nbsp;Caterina La Cascia,&nbsp;Laura Ferraro,&nbsp;Daniele La Barbera,&nbsp;Andrea Tortelli,&nbsp;Eva Velthorst,&nbsp;Lieuwe de Haan,&nbsp;Pierre-Michel Llorca,&nbsp;Jose Luis Santos,&nbsp;Manuel Arrojo,&nbsp;Julio Bobes,&nbsp;Julio Sanjuán,&nbsp;Miguel Bernardo,&nbsp;Celso Arango,&nbsp;James B. Kirkbride,&nbsp;Peter B. Jones,&nbsp;Bart P. Rutten,&nbsp;Franck Schürhoff,&nbsp;Andrei Szöke,&nbsp;Jim van Os,&nbsp;Evangelos Vassos,&nbsp;Jean-Paul Selten,&nbsp;Craig Morgan,&nbsp;Marta Di Forti,&nbsp;Ilaria Tarricone,&nbsp;Robin M. Murray","doi":"10.1111/acps.13767","DOIUrl":"10.1111/acps.13767","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Urbanicity is a well-established risk factor for psychosis. Our recent multi-national study found an association between urbanicity and clinical psychosis in Northern Europe but not in Southern Europe. In this study, we hypothesized that the effect of current urbanicity on variation of schizotypy would be greater in North-western Europe countries than in Southern Europe ones.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We recruited 1080 individuals representative of the populations aged 18–64 of 14 different sites within 5 countries, classified as either North-western Europe (England, France, and The Netherlands) with Southern Europe (Spain and Italy). Our main outcome was schizotypy, assessed through the Structured Interview for Schizotypy-Revised. Our main exposure was current urbanicity, operationalized as local population density. A priori confounders were age, sex, ethnic minority status, childhood maltreatment, and social capital. Schizotypy variation was assessed using multi-level regression analysis. To test the differential effect of urbanicity between North-western and Southern European, we added an interaction term between population density and region of recruitment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Population density was associated with schizotypy (<i>β</i> = 0.248,95%CI = 0.122–0.375;<i>p</i> &lt; 0.001). The addition of the interaction term improved the model fit (likelihood test ratio:<i>χ</i>\u0000 ² = 6.85; <i>p</i> = 0.009). The effect of urbanicity on schizotypy was substantially stronger in North-western Europe (<i>β</i> = 0.620,95%CI = 0.362–0.877;<i>p</i> &lt; 0.001) compared with Southern Europe (<i>β</i> = 0.190,95%CI = 0.083–0.297;<i>p</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The association between urbanicity and both subclinical schizotypy and clinical psychosis, rather than being universal, is context-specific. Considering that urbanization is a rapid and global process, further research is needed to disentangle the specific factors underlying this relationship.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 4","pages":"506-520"},"PeriodicalIF":5.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13767","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556702","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":"Risk and timing of postpartum depression in parents of twins compared to parents of singletons","authors":"Sofie Egsgaard,&nbsp;Mette Bliddal,&nbsp;Lars Christian Lund,&nbsp;Simone N. Vigod,&nbsp;Trine Munk-Olsen","doi":"10.1111/acps.13766","DOIUrl":"10.1111/acps.13766","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Parents of twins appear to be at increased risk of postpartum depression (PPD), yet little is known about the magnitude and timing of onset in the postpartum period compared to singleton parents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cohort study using the Danish nationwide health registers. We defined a study population of parents that is, mothers and fathers of all twin and singleton livebirths between 1997 and 2019. Postpartum depression was defined as incident depression diagnosis or a redeemed antidepressant prescription from childbirth through 365 days postpartum. We performed a parametric time-to-event analysis based on Poisson regression. The time scale was time since birth, modeled using restricted cubic splines. From this we estimated the hazard ratio (HR) representing the momentary risk, and the cumulative risk ratio (RR) over the first year postpartum, in twin compared to singleton parents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study population was based on 27,095 twin and 1,350,046 singleton births. In adjusted analyses, the HR of twins compared to singletons was highest around 2 months postpartum (HR 1.28, 95% CI 1.10–1.49) for mothers, and around 6 months (1.20, 95% CI 1.02–1.42) for fathers. The 6 months adjusted cumulative RR of PPD in twins compared to singletons was 1.24 (95% CI 1.10–1.40) for mothers and 1.11 (95% CI 0.95–1.30) for fathers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Twin mothers had increased risk of PPD compared to singleton mothers, which was driven by an immediate increase after childbirth. The risk among twin fathers was not increased immediately after childbirth, but we found slightly elevated risk around 6 months postpartum. This could suggest diverse patterns of PPD symptomatology in twin parents compared to singleton parents and between mothers and fathers. Our findings underline parents of twins as a potentially vulnerable group to PPD and emphasize the need for increased awareness of their mental health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 2","pages":"163-172"},"PeriodicalIF":5.3,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142491352","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":"Digital phenotyping in bipolar disorder: Using longitudinal Fitbit data and personalized machine learning to predict mood symptomatology","authors":"Jessica M. Lipschitz,&nbsp;Sidian Lin,&nbsp;Soroush Saghafian,&nbsp;Chelsea K. Pike,&nbsp;Katherine E. Burdick","doi":"10.1111/acps.13765","DOIUrl":"10.1111/acps.13765","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Effective treatment of bipolar disorder (BD) requires prompt response to mood episodes. Preliminary studies suggest that predictions based on passive sensor data from personal digital devices can accurately detect mood episodes (e.g., between routine care appointments), but studies to date do not use methods designed for broad application. This study evaluated whether a novel, personalized machine learning approach, trained entirely on passive Fitbit data, with limited data filtering could accurately detect mood symptomatology in BD patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from 54 adults with BD, who wore Fitbits and completed bi-weekly self-report measures for 9 months. We applied machine learning (ML) models to Fitbit data aggregated over two-week observation windows to detect occurrences of depressive and (hypo)manic symptomatology, which were defined as two-week windows with scores above established clinical cutoffs for the Patient Health Questionnaire-8 (PHQ-8) and Altman Self-Rating Mania Scale (ASRM) respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>As hypothesized, among several ML algorithms, Binary Mixed Model (BiMM) forest achieved the highest area under the receiver operating curve (ROC-AUC) in the validation process. In the testing set, the ROC-AUC was 86.0% for depression and 85.2% for (hypo)mania. Using optimized thresholds calculated with Youden's J statistic, predictive accuracy was 80.1% for depression (sensitivity of 71.2% and specificity of 85.6%) and 89.1% for (hypo)mania (sensitivity of 80.0% and specificity of 90.1%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We achieved sound performance in detecting mood symptomatology in BD patients using methods designed for broad application. Findings expand upon evidence that Fitbit data can produce accurate mood symptomatology predictions. Additionally, to the best of our knowledge, this represents the first application of BiMM forest for mood symptomatology prediction. Overall, results move the field a step toward personalized algorithms suitable for the full population of patients, rather than only those with high compliance, access to specialized devices, or willingness to share invasive data.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 3","pages":"434-447"},"PeriodicalIF":5.3,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142453750","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}