Acta Psychiatrica Scandinavica最新文献

{"title":"Frequency and types of emotional dysregulation in referrals to child and adolescent mental health services","authors":"Emilie Ellehauge, Christine Thoustrup, Mette N?rgaard Nielsen, Anne Katrine Pagsberg, Julie Hagstr?m","doi":"10.1111/acps.13544","DOIUrl":"https://doi.org/10.1111/acps.13544","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Emotional dysregulation (ED) is a transdiagnostic phenomenon that has received increased attention, because of its potential ability to explain the development and maintenance of various psychiatric disorders. The identification of ED may serve as a potential target for both preventive and treatment interventions, however, the frequency of transdiagnostic ED among children and adolescents has not previously been evaluated. Our aim was to evaluate the frequency and types of ED in accepted and rejected referrals to the Child and Adolescent Mental Health Center (CAMHC), Mental Health Services, Copenhagen, Denmark, regardless of psychiatric status and across diagnoses. We aimed to evaluate how often ED would be a leading cause in seeking professional help, and whether children with ED not directly reflecting symptoms of known psychopathology would have higher rejection rates than children with more distinct symptoms of psychopathology. Finally, we assessed associations between sex and age with various types of ED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We examined ED in a retrospective chart review of referrals of children and adolescents aged 3–17 years to the CAMHC between August 1st, 2020, and August 1st, 2021. We ranked problems described in the referral as primary, secondary, and tertiary depending on severity. Further, we examined group differences in the frequency of ED in accepted versus rejected referrals, as well as group differences in types of ED in age and sex distributions, and diagnoses occurring with specific types of ED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ED was present in 62.3% of the 999 referrals and was assessed as the primary issue in twice as many rejected referrals (11.4%) compared to accepted referrals (5.7%). Boys were significantly more often described with externalizing and internalizing behavior (55.5% vs. 31.6%; 35.1% vs. 26.5%) as well as incongruent affect (10.0% vs. 4.7%), whereas girls were more often described with depressed mood (47.5% vs. 38.0%) and self-harm (23.8% vs. 9.4%). The frequency of different types of ED varied with age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present study is the first to evaluate the frequency of ED in children and adolescents referred to mental health services. The study offers insights into the high frequency of ED and the associations between ED and subsequent diagnoses, which may prove to be a method of early identification of risk of psychopathology. Our findings suggest that ED may rightly be considered a transdiagnostic factor, independent of specific psychiatric disorders, and that an ED-c","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 2","pages":"165-178"},"PeriodicalIF":6.7,"publicationDate":"2023-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6182111","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":"Antidepressants and quality of life in patients with major depressive disorder – Systematic review and meta-analysis of double-blind, placebo-controlled RCTs","authors":"Teresa Wiesinger,&nbsp;Stefanie Kremer,&nbsp;Tom Bschor,&nbsp;Christopher Baethge","doi":"10.1111/acps.13541","DOIUrl":"https://doi.org/10.1111/acps.13541","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Quality of Life (QoL) is an important outcome in mental disorders. We investigated whether antidepressant pharmacotherapy improved QoL vs. placebo among patients with MDD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systematic literature search in CENTRAL, Medline, PubMed Central, and PsycINFO of double-blind, placebo-controlled RCTs. Screening, inclusion, extraction, and risk of bias assessment were conducted independently by two reviewers. We calculated summary standardized mean differences (SMD) with 95%-CIs. We followed Cochrane Collaboration's Handbook of Systematic Reviews and Meta-Analyses and PRISMA guidelines (protocol registration at OSF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We selected 46 RCTs out of 1807 titles and abstracts screened, including 16.171 patients, 9131 on antidepressants and 7040 on placebo, a mean age of 50.9 years, with 64.8% women. Antidepressant drug treatment resulted in a SMD in QoL of 0.22 ([95%-CI: 0.18; 0.26] I² 39%) vs. placebo. SMDs differed by indication: 0.38 ([0.29; 0.46] I² 0%) in maintenance studies, 0.21 ([0.17; 0.25] I² 11%) in acute treatment studies, and 0.11 ([−0.05; 0.26], I² 51%) in studies focussing on patients with a physical condition and major depression. There was no indication of subtstantial small study effects, but 36 RCTs had a high or uncertain risk of bias, particularly maintenance trials. QoL and antidepressive effect sizes were associated (Spearman's rho 0.73, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Antidepressants' effects on QoL are small in primary MDD, and doubtful in secondary major depression and maintenance trials. The strong correlation of QoL and antidepressive effects indicates that the current practice of measuring QoL may not provide sufficient additional insights into the well-being of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"147 6","pages":"545-560"},"PeriodicalIF":6.7,"publicationDate":"2023-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13541","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6208643","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":"Functional and structural brain abnormalities in substance use disorder: A multimodal meta-analysis of neuroimaging studies","authors":"Hong Yan,&nbsp;Shu Xiao,&nbsp;Siying Fu,&nbsp;Jiaying Gong,&nbsp;Zhangzhang Qi,&nbsp;Guanmao Chen,&nbsp;Pan Chen,&nbsp;Guixian Tang,&nbsp;Ting Su,&nbsp;Zibin Yang,&nbsp;Ying Wang","doi":"10.1111/acps.13539","DOIUrl":"https://doi.org/10.1111/acps.13539","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Numerous neuroimaging studies of resting-state functional imaging and voxel-based morphometry (VBM) have revealed that patients with substance use disorder (SUD) may present brain abnormalities, but their results were inconsistent. This multimodal neuroimaging meta-analysis aimed to estimate common and specific alterations in SUD patients by combining information from all available studies of spontaneous functional activity and gray matter volume (GMV).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A whole-brain meta-analysis on resting-state functional imaging and VBM studies was conducted using the Seed-based <i>d</i> Mapping with Permutation of Subject Images (SDM-PSI) software, followed by multimodal overlapping to comprehensively investigate function and structure of the brain in SUD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this meta-analysis, 39 independent studies with 47 datasets related to resting-state functional brain activity (1444 SUD patients; 1446 healthy controls [HCs]) were included, as well as 77 studies with 89 datasets for GMV (3457 SUD patients; 3774 HCs). Patients with SUD showed the decreased resting-state functional brain activity in the bilateral anterior cingulate cortex/medial prefrontal cortex (ACC/mPFC). For the VBM meta-analysis, patients with SUD showed the reduced GMV in the bilateral ACC/mPFC, insula, thalamus extending to striatum, and left sensorimotor cortex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This multimodal meta-analysis exhibited that SUD shows common impairment in both function and structure in the ACC/mPFC, suggesting that the deficits in functional and structural domains could be correlated together. In addition, a few regions exhibited only structural impairment in SUD, including the insula, thalamus, striatum, and sensorimotor areas.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"147 4","pages":"345-359"},"PeriodicalIF":6.7,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5730153","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":"Extending the specificity of mood stabilizers from clinical response to mortality reduction","authors":"Mirko Manchia","doi":"10.1111/acps.13533","DOIUrl":"https://doi.org/10.1111/acps.13533","url":null,"abstract":"&lt;p&gt;Mood stabilizers are a heterogeneous class of drugs including pharmacological agents with diverse mechanisms of actions (anticonvulsants, second generation antipsychotics, and lithium) but sharing one fundamental clinical property: the ability to treat and prevent episode recurrences in patients affected by major affective disorders. An attempt to formulate some evidence-based taxonomic criteria suggested that an ideal mood stabilizer should be effective in: (a) treating acute manic symptoms; (b) treating acute depressive symptoms; (c) preventing manic symptoms; and (d) preventing depressive symptoms.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Lithium is probably the only mood stabilizer satisfying all these criteria, although it is less effective in treating bipolar depression.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Similarly, the clinical profile of anticonvulsants appears to be specific depending on the illness phase (acute and/or continuation/maintenance) and on the mood polarity. Indeed, lamotrigine is more effective in preventing depression, but not mania, and possibly in treating acute bipolar depression and rapid cycling.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Conversely, carbamazepine and valproic acid are effective in the treatment of acute mania, as well as in maintenance.&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; The latter also shows more effectiveness in certain subgroups of patients presenting with mixed mania or mania with irritability, compared with other treatments.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; Finally, antipsychotics also show effectiveness in preventing mood relapses,&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; with possibly higher efficacy in treating acute mixed episodes in bipolar disorder.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; These patterns of efficacy/effectiveness appear to be associated with distinct clinical presentations that also show a degree of predictive power. This has indeed been demonstrated for lithium, where specific clinical characteristics, namely an episodic (mania-depression-interval) clinical course sequence, absence of rapid cycling, absence of psychotic symptoms, family history of bipolar disorder, shorter pre-lithium illness duration and later age of onset,&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; predict a good clinical response to lithium. Interestingly, a recent machine learning study, evaluated whether lithium responsiveness was predictable using clinical markers in a large multicenter sample of patients with bipolar disorder.&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; The authors showed that lithium responsiveness was predictable in the pooled sample with good accuracy area under the receiver operating characteristic curve of 0.80 and a particularly low false-positive rate (0.91).&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; More importantly, features related to clinical course and the absence of rapid cycling appeared consistently informative in predicting lithium responsiveness.&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; Although identified with less robust analytical methodology, similar patterns of clinical features have been associated to valproic a","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"147 3","pages":"231-233"},"PeriodicalIF":6.7,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13533","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6115867","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":"Response to the Editorial from Micali and Herle on the research article entitled ‘Mortality and Care of Eating Disorders’","authors":"Giovanni Castellini,&nbsp;Saverio Caini,&nbsp;Emanuele Cassioli,&nbsp;Eleonora Rossi,&nbsp;Giorgia Marchesoni,&nbsp;Francesco Rotella,&nbsp;Nora De Bonfioli Cavalcabo',&nbsp;Miriam Fontana,&nbsp;Barbara Mezzani,&nbsp;Brunetto Alterini,&nbsp;Stefano Lucarelli,&nbsp;Valdo Ricca","doi":"10.1111/acps.13538","DOIUrl":"https://doi.org/10.1111/acps.13538","url":null,"abstract":"We are pleased to note that our study entitled ‘Mortality and Care of Eating Disorders’ received attention from other researchers and stimulated the debate in the field of clinical management of Eating Disorders (EDs). In their editorial entitled ‘Gone too soon: Studying mortality in eating disorders’, Micali and Herle highlighted the importance of studying mortality in EDs, given the number of psychiatric and medical comorbidities of these disorders, as well as their increasing burden. Furthermore, the authors considered possible explanations for the discrepancy of our study's low standardised mortality ratios compared with previous observations. First, the authors considered methodological differences between our study and that of Plana-Ripoll et al., which analysed data from the entire Danish population (7,378,598 individuals) between 2000 and 2018. PlanaRipoll found that EDs were associated with 3.8-fold increased mortality compared to age and sex-matched populations. These findings were coherent with several other observations demonstrating increased mortality in patients with EDs. Indeed, the mentioned study was based on a larger population with a longer follow-up period. As highlighted by Micali and Herle, sample compositions might account for discrepancies between studies in this field. Indeed, our study included patients from a clinical population, specifically those who were under treatment within the Tuscan Eating Disorder Treatment Network (EDTN); thus, the sample was not comparable to those derived from national registries, nor to those including only hospitalised patients (which obviously showed greater mortality rate as compared to our more heterogeneous sample). Patients included in our study were all under the same protocol of treatment, while subjects included in a national registry refer to heterogenous settings of care. While it is true that the average follow-up duration in our study was not long, as compared to other studies, this does not imply that the results are not valid. In particular, our finding that mortality rates are not increased in the first years upon clinical diagnosis is robust, and uncertainty is limited to long-term risk of death. Regarding the sample composition, our study was based on a population-based sample of patients, not selected based on severity (as it is often the case in hospital-based studies), as a further demonstration of the Tuscan health system's inclusiveness. Studies with large samples based on national registries are obviously important; however, these studies do not focus on treatment strategies and clinical management and often pool patients from different care services. Undoubtedly, a larger sample size and a longer follow-up would have ensured larger statistical power, less uncertainty, and eventually more confidence in the results (which is valid for all studies). However, what is essential in epidemiology is also the representativeness of the study sample regarding the question tha","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"147 4","pages":"389-391"},"PeriodicalIF":6.7,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6042739","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":"Physical and mental health status of former smokers and non-smokers patients with bipolar disorder","authors":"Bénédicte Nobile,&nbsp;Ophélia Godin,&nbsp;Sébastien Gard,&nbsp;Ludovic Samalin,&nbsp;Georges Brousse,&nbsp;Joséphine Loftus,&nbsp;Valérie Aubin,&nbsp;Raoul Belzeaux,&nbsp;Caroline Dubertret,&nbsp;Yann Le Strat,&nbsp;Nicolas Mazer,&nbsp;Alix de Prémorel,&nbsp;Paul Roux,&nbsp;Mircea Polosan,&nbsp;Thomas Schwintzer,&nbsp;Pierre-Michel Llorca,&nbsp;FondaMental Advanced Center of Expertise for Bipolar Disorders (FACE-BD) collaborators,&nbsp;Isabelle Biseul,&nbsp;Bruno Etain,&nbsp;Remi Moirand,&nbsp;Emilie Olié,&nbsp;Emmanuel Haffen,&nbsp;Marion Leboyer,&nbsp;Philippe Courtet,&nbsp;Sébastien Guillaume,&nbsp;Romain Icick","doi":"10.1111/acps.13535","DOIUrl":"https://doi.org/10.1111/acps.13535","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Up to 70% individuals with bipolar disorder (BD) are lifetime tobacco smokers, a major modifiable risk factor for morbidity. However, quitting smoking is rarely proposed to individuals with BD, mainly because of fear of unfavorable metabolic or psychiatric changes. Evaluating the physical and mental impact of tobacco cessation is primordial. The aim of this study was to characterize the psychiatric and nonpsychiatric correlates of tobacco smoking status (never- vs. current vs. former smokers) in individuals with BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>3860 individuals with ascertained BD recruited in the network of Fondamental expert centers for BD between 2009 and 2020 were categorized into current, former, and never tobacco smokers. We compared the sociodemographic and clinical characteristics assessed by standard instruments (e.g., BD type, current symptoms load, and non-psychiatric morbidity—including anthropometric and biological data) of the three groups using multinomial regression logistic models. Corrections for multiple testing were applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Current smokers had higher depression, anxiety, and impulsivity levels than former and never-smokers, and also higher risk of comorbid substance use disorders with a gradient from never to former to current smokers—suggesting shared liability. Current smokers were at higher risk to have a metabolic syndrome than never-smokers, although this was only evidenced in cases, who were not using antipsychotics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Tobacco smoking was associated with high morbidity level. Strikingly, as in the general population, quitting smoking seemed associated with their return to the never-smokers' levels. Our findings strongly highlight the need to spread strategies to treat tobacco addiction in the BD population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"147 4","pages":"373-388"},"PeriodicalIF":6.7,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13535","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6112313","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":"Delirium-related psychiatric and neurocognitive impairment and the association with post-intensive care syndrome—A narrative review","authors":"Dharmanand Ramnarain,&nbsp;Sjaak Pouwels,&nbsp;Sol Fernández-Gonzalo,&nbsp;Guillem Navarra-Ventura,&nbsp;Vicent Balanzá-Martínez","doi":"10.1111/acps.13534","DOIUrl":"https://doi.org/10.1111/acps.13534","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Delirium is common among patients admitted to the intensive care unit (ICU) and its impact on the neurocognitive and psychiatric state of survivors is of great interest. These new-onset or worsening conditions, together with physical alterations, are called post-intensive care syndrome (PICS). Our aim is to update on the latest screening and follow-up options for psychological and cognitive sequelae of PICS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This narrative review discusses the occurrence of delirium in ICU settings and the relatively new concept of PICS. Psychiatric and neurocognitive morbidities that may occur in survivors of critical illness following delirium are addressed. Future perspectives for practice and research are discussed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There is no “gold standard” for diagnosing delirium in the ICU, but two extensively validated tools, the confusion assessment method for the ICU and the intensive care delirium screening checklist, are often used. PICS complaints are frequent in ICU survivors who have suffered delirium and have been recognized as an important public health and socio-economic problem worldwide. Depression, anxiety, post-traumatic stress disorder, and long-term cognitive impairment are recurrently exhibited. Screening tools for these deficits are discussed, as well as the suggestion of early assessment after discharge and at 3 and 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Delirium is a complex but common phenomenon in the ICU and a risk factor for PICS. Its diagnosis is challenging with potential long-term adverse outcomes, including psychiatric and cognitive difficulties. The implementation of screening and follow-up protocols for PICS sequelae is warranted to ensure early detection and appropriate management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"147 5","pages":"460-474"},"PeriodicalIF":6.7,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13534","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5998914","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":"Factors associated with early and late response to electroconvulsive therapy","authors":"Kamber L. Hart,&nbsp;Thomas H. McCoy Jr.,&nbsp;Michael E. Henry,&nbsp;Stephen J. Seiner,&nbsp;James Luccarelli","doi":"10.1111/acps.13537","DOIUrl":"https://doi.org/10.1111/acps.13537","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Electroconvulsive therapy (ECT) is an effective treatment for severe depressive symptoms, yet more research is needed to examine predictors of treatment response, and factors associated with response in patients not initially improving with treatment. This study reports factors associated with time to response (early vs. late) to ECT in a real-world setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective, single-center cohort study of patients endorsing moderate to severe depressive symptoms using the Quick Inventory of Depressive Symptomatology (QIDS; QIDS&gt;10). Response was defined as 50% or greater decrease in QIDS score from baseline. We used logistic regression to predict response at treatment #5 (early response) as well as after treatment #5 (late response) and followed patients through ECT discontinuation or through treatment #20.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 1699 patients included in this study, 555 patients (32.7%) responded to ECT treatment at treatment #5 and 397 (23.4%) responded after treatment #5. Among patients who did not respond by treatment #5, those who switched to brief pulse width ECT from ultrabrief pulse ECT had increased odds of response after treatment #5 compared with patients only receiving ultrabrief pulse (aOR = 1.55, 95% CI: 1.16–2.07). Additionally, patients with less improvement in QIDS from baseline to treatment #5 had decreased odds of response after treatment #5 (aOR = 0.97, 95% CI = 0.97–0.98).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among depressed patients treated with ECT, response occurred in 56.0% of patients by treatment #20. Patient receiving ultrabrief pulse ECT at baseline and who did not respond by treatment #5 had greater odds of subsequent response if switched to brief pulse ECT than if continued with ultrabrief pulse.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"147 4","pages":"322-332"},"PeriodicalIF":6.7,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5727072","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 factors for suicide among patients having received treatment with electroconvulsive therapy: A nationwide study of 11,780 patients","authors":"Anders Spangg?rd,&nbsp;Christopher Rohde,&nbsp;S?ren Dinesen ?stergaard","doi":"10.1111/acps.13536","DOIUrl":"https://doi.org/10.1111/acps.13536","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Despite the putative anti-suicidal effect of electroconvulsive therapy (ECT), patients receiving ECT remain at high risk of dying from suicide due to the severity of their underlying mental illness. We aimed to quantify this risk and to identify risk factors for suicide among patients receiving ECT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using nationwide Danish registers, we identified all patients that initiated ECT between 2006 and 2016. These patients were matched on sex and age to 10 reference individuals from the general Danish population. Firstly, we compared 2-year suicide risk between patients initiating ECT and the matched reference individuals. Secondly, we investigated if any patient characteristics were associated with suicide following ECT via Cox proportional hazards regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 11,780 patients receiving ECT and 117,800 reference individuals were included in the analyses. Among the patients receiving ECT, 161 (1.4%) died from suicide within two years. Compared to the reference individuals, patients having received ECT had a substantially elevated suicide rate (Hazard rate ratio (HRR) = 44.48, 95%CI = 31.12–63.59). Among those having received ECT, the following characteristics were associated with suicide: Male sex (adjusted HRR (AHRR) = 2.32, 95%CI = 1.63–3.30), medium-term higher education (AHRR = 2.64, 95%CI = 1.57–4.44); long-term higher education (AHRR = 3.16, 95%CI = 1.68–5.94), history of substance use disorder (AHRR = 1.51, 95%CI = 1.01–2.26) and history of intentional self-harm/suicide attempt (AHRR = 4.18, 95%CI = 2.76–6.32).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Those who are male, have obtained medium-/long-term higher education, or have a history of substance use disorder or intentional self-harm/suicide attempt, are at particularly elevated risk of suicide following ECT. These findings may guide clinical initiatives to reduce suicides.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"147 4","pages":"333-344"},"PeriodicalIF":6.7,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13536","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5724128","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":"Gone too soon: Studying mortality in eating disorders","authors":"Nadia Micali,&nbsp;Moritz Herle","doi":"10.1111/acps.13527","DOIUrl":"https://doi.org/10.1111/acps.13527","url":null,"abstract":"<p>Eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, and other specified feeding and eating disorder) are not only common mental health disorders but they also affect an individual's physical, psychological, and social well-being, with high impact and burden. Importantly, previous research has found that eating disorders have high mortality, higher than many other psychiatric disorders. Here, we discuss findings from Castellini and colleagues in the context of previous studies.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"147 2","pages":"119-121"},"PeriodicalIF":6.7,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13527","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5932872","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}