General Psychiatry最新文献

{"title":"Temporal trends and cohort variations of gender-specific major depressive disorders incidence in China: analysis based on the age-period-cohort-interaction model.","authors":"Xiyuan Hu, Chao Guo","doi":"10.1136/gpsych-2023-101479","DOIUrl":"10.1136/gpsych-2023-101479","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorders (MDDs) impose substantial burdens on individuals and society; however, further detailed analysis is still needed for its long-term trends.</p><p><strong>Aims: </strong>This study aimed to analyse the gender-specific temporal trends and cohort variations of MDD incidence among Chinese residents over the past three decades.</p><p><strong>Methods: </strong>Employing the age-period-cohort-interaction model and leveraging data from the Global Burden of Disease Study 2019, this research identified and analysed incidence trends of MDD among Chinese males and females aged 5-94 years from 1990 to 2019 across three dimensions, encompassing age, period and birth cohort.</p><p><strong>Results: </strong>The analysis reveals age-related effects, indicating heightened MDD risk among adolescents and older adults. Specifically, individuals entering the older adulthood at the age of 65-69 significantly increased the risk of MDD by 64.9%. People aged 90-94 years witnessed a 105.4% increase in MDD risk for the overall population, with females and males in this age group experiencing a 75.1% and 103.4% increase, respectively. In terms of period effects, the risk of MDD displayed a decline from 1990 to 1994, followed by a rebound in 2008. Cohort effects demonstrated diverse generational patterns, with generation I and generation III manifesting opposing 'age-as-level' trends. Generation II and generation IV exhibited 'cumulative disadvantage' and 'cumulative advantage' patterns, respectively. Age effects indicated an overall higher risk of MDD incidence in females, while cohort effects showed greater variations of MDD incidence among females.</p><p><strong>Conclusions: </strong>The study underscores the substantial effects of age, period and cohort on MDD across genders in China. Priority interventions targeting vulnerable populations, including children, adolescents, older adults, females and the post-millennium birth cohort, are crucial to mitigate the impact of MDD.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11217997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissecting the association between gut microbiota, body mass index and specific depressive symptoms: a mediation Mendelian randomisation study","authors":"Tong Yu, Chengfeng Chen, Yuqing Yang, Mingqia Wang, Yantianyu Yang, Wanting Feng, Shiqi Yuan, Xiancang Ma, Jie Li, Bin Zhang","doi":"10.1136/gpsych-2023-101412","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101412","url":null,"abstract":"Background Observational studies highlight the association between gut microbiota (GM) composition and depression; however, evidence for the causal relationship between GM and specific depressive symptoms remains lacking. Aims We aimed to evaluate the causal relationship between GM and specific depressive symptoms as well as the mediating role of body mass index (BMI). Methods We performed a two-sample Mendelian randomisation (MR) analysis using genetic variants associated with GM and specific depressive symptoms from genome-wide association studies. The mediating role of BMI was subsequently explored using mediation analysis via two-step MR. Results MR evidence suggested the Bifidobacterium genus (β=–0.03; 95% CI –0.05 to –0.02; p<0.001 and β=–0.03; 95% CI –0.05 to –0.02; p<0.001) and Actinobacteria phylum (β=–0.04; 95% CI –0.06 to –0.02; p<0.001 and β=–0.03; 95% CI –0.05 to –0.03; p=0.001) had protective effects on both anhedonia and depressed mood. The Actinobacteria phylum also had protective effects on appetite changes (β=–0.04; 95% CI –0.06 to –0.01; p=0.005), while the Family XI had an antiprotective effect (β=0.03; 95% CI 0.01 to 0.04; p<0.001). The Bifidobacteriaceae family (β=–0.01; 95% CI –0.02 to –0.01; p=0.001) and Actinobacteria phylum (β=–0.02; 95% CI –0.03 to –0.01; p=0.001) showed protective effects against suicidality. The two-step MR analysis revealed that BMI also acted as a mediating moderator between the Actinobacteria phylum and appetite changes (mediated proportion, 34.42%) and that BMI partially mediated the effect of the Bifidobacterium genus (14.14% and 8.05%) and Actinobacteria phylum (13.10% and 8.31%) on both anhedonia and depressed mood. Conclusions These findings suggest a potential therapeutic effect of Actinobacteria and Bifidobacterium on both depression and obesity. Further studies are required to translate these findings into clinical practice. Data are available in a public, open access repository. All GWAS summary statistics are publicly available for download. The GWASs data for gut microbiota were provided by MiBioGen consortium (<https://mibiogen.gcc.rug.nl/>). The GWASs data for specific depressive symptoms were sourced from UK Biobank (<http://www.nealelab.is/uk-biobank>). The GWASs for BMI were provided by GIANT consortium ([https://portals.broadinstitute.org/collaboration/giant/index.php/GIANT_consortium_data_files][1]). [1]: https://portals.broadinstitute.org/collaboration/giant/index.php/GIANT_consortium_data_files","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141526436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the effectiveness of internet-based interventions for mental health outcomes: an umbrella review","authors":"Mi Zhang, Chuan Fan, Lijun Ma, Huixue Wang, Zhenyue Zu, Linxi Yang, Fenglan Chen, Wenzhuo Wei, Xiaoming Li","doi":"10.1136/gpsych-2023-101355","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101355","url":null,"abstract":"Internet-based interventions (IBIs) for behavioural health have been prevalent for over two decades, and a growing proportion of individuals with mental health concerns prefer these emerging digital alternatives. However, the effectiveness and acceptability of IBIs for various mental health disorders continue to be subject to scholarly debate. We performed an umbrella review of meta-analyses (MAs), conducting literature searches in PubMed, Web of Science, Embase, Cochrane and Ovid Medline from their inception to 17 January 2023. A total of 87 MAs, reporting on 1683 randomised controlled trials and 295 589 patients, were included. The results indicated that IBIs had a moderate effect on anxiety disorder (standardised mean difference (SMD)=0.53, 95% CI 0.44 to 0.62) and post-traumatic stress disorder (PTSD) (SMD=0.63, 95% CI 0.38 to 0.89). In contrast, the efficacy on depression (SMD=0.45, 95% CI 0.39 to 0.52), addiction (SMD=0.23, 95% CI 0.16 to 0.31), suicidal ideation (SMD=0.23, 95% CI 0.16 to 0.30), stress (SMD=0.41, 95% CI 0.33 to 0.48) and obsessive–compulsive disorder (SMD=0.47, 95% CI 0.22 to 0.73) was relatively small. However, no significant effects were observed for personality disorders (SMD=0.07, 95% CI −0.13 to 0.26). Our findings suggest a significant association between IBIs and improved mental health outcomes, with particular effectiveness noted in treating anxiety disorders and PTSD. However, it is noteworthy that the effectiveness of IBIs was impacted by high dropout rates during treatment. Furthermore, our results indicated that guided IBIs proved to be more effective than unguided ones, playing a positive role in reducing dropout rates and enhancing patient adherence rates. PROSPERO registration number: CRD42023417366.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141742427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presurgical structural imaging and clinical outcome in combined bed nucleus of the stria terminalis-nucleus accumbens deep brain stimulation for treatment-resistant depression.","authors":"Fengting Wang, Lulin Dai, Tao Wang, Yingying Zhang, Yuhan Wang, Yijie Zhao, Yixin Pan, Liuguan Bian, Dianyou Li, Shikun Zhan, Yijie Lai, Valerie Voon, Bomin Sun","doi":"10.1136/gpsych-2023-101210","DOIUrl":"10.1136/gpsych-2023-101210","url":null,"abstract":"<p><strong>Background: </strong>Structural imaging holds great potential for precise targeting and stimulation for deep brain stimulation (DBS). The anatomical information it provides may serve as potential biomarkers for predicting the efficacy of DBS in treatment-resistant depression (TRD).</p><p><strong>Aims: </strong>The primary aim is to identify preoperative imaging biomarkers that correlate with the efficacy of DBS in patients with TRD.</p><p><strong>Methods: </strong>Preoperative imaging parameters were estimated and correlated with the 6-month clinical outcome of patients with TRD receiving combined bed nucleus of the stria terminalis (BNST)-nucleus accumbens (NAc) DBS. White matter (WM) properties were extracted and compared between the response/non-response and remission/non-remission groups. Structural connectome was constructed and analysed using graph theory. Distances of the volume of activated tissue (VAT) to the main modulating tracts were also estimated to evaluate the correlations.</p><p><strong>Results: </strong>Differences in fibre bundle properties of tracts, including superior thalamic radiation and reticulospinal tract, were observed between the remission and non-remission groups. Distance of the centre of the VAT to tracts connecting the ventral tegmental area and the anterior limb of internal capsule on the left side varied between the remission and non-remission groups (p=0.010, t=3.07). The normalised clustering coefficient (γ) and the small-world property (σ) in graph analysis correlated with the symptom improvement after the correction of age.</p><p><strong>Conclusions: </strong>Presurgical structural alterations in WM tracts connecting the frontal area with subcortical regions, as well as the distance of the VAT to the modulating tracts, may influence the clinical outcome of BNST-NAc DBS. These findings provide potential imaging biomarkers for the DBS treatment for patients with TRD.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower synaptic density and its association with cognitive dysfunction in patients with obsessive-compulsive disorder.","authors":"Qian Xiao, Jiale Hou, Ling Xiao, Ming Zhou, Zhiyou He, Huixi Dong, Shuo Hu","doi":"10.1136/gpsych-2023-101208","DOIUrl":"10.1136/gpsych-2023-101208","url":null,"abstract":"<p><strong>Background: </strong>Understanding synaptic alteration in obsessive-compulsive disorder (OCD) is crucial for elucidating its pathological mechanisms, but <i>in vivo</i> research on this topic remains limited.</p><p><strong>Aims: </strong>This study aimed to identify the synaptic density indicators in OCD and explore the relationship between cognitive dysfunction and synaptic density changes in OCD.</p><p><strong>Methods: </strong>This study enrolled 28 drug-naive adults with OCD aged 18-40 years and 16 healthy controls (HCs). Three-dimensional T1-weighted structural magnetic resonance imaging and ¹⁸F-SynVesT-1 positron emission tomography were conducted. Cognitive function was assessed using the Wisconsin Cart Sorting Test (WCST) in patients with OCD and HCs. Correlative analysis was performed to examine the association between synaptic density reduction and cognitive dysfunction.</p><p><strong>Results: </strong>Compared with HCs, patients with OCD showed reduced synaptic density in regions of the cortico-striato-thalamo-cortical circuit such as the bilateral putamen, left caudate, left parahippocampal gyrus, left insula, left parahippocampal gyrus and left middle occipital lobe (voxel p<0.001, uncorrected, with cluster level above 50 contiguous voxels). The per cent conceptual-level responses of WCST were positively associated with the synaptic density reduction in the left middle occipital gyrus (R²=0.1690, p=0.030), left parahippocampal gyrus (R²=0.1464, p=0.045) and left putamen (R²=0.1967, p=0.018) in patients with OCD.</p><p><strong>Conclusions: </strong>Adults with OCD demonstrated lower ¹⁸F-labelled difluoro analogue of ¹⁸F-SynVesT-1 compared with HCs, indicating potentially lower synaptic density. This is the first study to explore the synaptic density in patients with OCD and provides insights into potential biological targets for cognitive dysfunctions in OCD.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of post-traumatic stress disorder and depressive symptoms among civilians residing in armed conflict-affected regions: a systematic review and meta-analysis.","authors":"Syed Hassan Ahmed, Aabia Zakai, Maha Zahid, Muhammad Youshay Jawad, Rui Fu, Michael Chaiton","doi":"10.1136/gpsych-2023-101438","DOIUrl":"10.1136/gpsych-2023-101438","url":null,"abstract":"<p><strong>Background: </strong>Globally, populations afflicted by armed conflict are known to have high rates of mental health disorders.</p><p><strong>Aims: </strong>This meta-analysis aims to estimate the prevalence of post-traumatic stress disorder (PTSD) and depressive symptoms among civilians residing in armed conflict-affected regions.</p><p><strong>Methods: </strong>This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A literature search employing MEDLINE(R), Embase Classic+Embase, APA PsycINFO, Ovid Healthstar, Journal@Ovid Full Text, Cochrane, PTSDpubs and CINAHL was conducted from inception until 19 March 2024 to identify relevant studies. Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies, and a Comprehensive Meta-Analysis was used to conduct the statistical analysis.</p><p><strong>Results: </strong>The search yielded 38 595 articles, of which 57 were considered eligible for inclusion. The included studies comprised data from 64 596 participants. We estimated a prevalence of 23.70% (95% CI 19.50% to 28.40%) for PTSD symptoms and 25.60% (95% CI 20.70% to 31.10%) for depressive features among war-afflicted civilians. The subgroup analysis based on time since the war and the country's economic status revealed the highest prevalence for both PTSD and depressive symptoms was present during the years of war and in low/middle-income countries.</p><p><strong>Conclusions: </strong>The results of this study provide conclusive evidence of the detrimental impacts of armed conflict on mental health outcomes. Hence, it is crucial to emphasise the significance of both physical and mental health in the aftermath of war and take appropriate humanistic measures to overcome challenges in the management of psychiatric illnesses.</p><p><strong>Prospero registration number: </strong>CRD42023416096.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11177673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Event segmentation in ADHD: neglect of social information and deviant theta activity point to a mechanism underlying ADHD.","authors":"Astrid Prochnow, Xianzhen Zhou, Foroogh Ghorbani, Veit Roessner, Bernhard Hommel, Christian Beste","doi":"10.1136/gpsych-2023-101486","DOIUrl":"10.1136/gpsych-2023-101486","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD) is one of the most frequently diagnosed psychiatric conditions in children and adolescents. Although the symptoms appear to be well described, no coherent conceptual mechanistic framework integrates their occurrence and variance and the associated problems that people with ADHD face.</p><p><strong>Aims: </strong>The current study proposes that altered event segmentation processes provide a novel mechanistic framework for understanding deficits in ADHD.</p><p><strong>Methods: </strong>Adolescents with ADHD and neurotypically developing (NT) peers watched a short movie and were then asked to indicate the boundaries between meaningful segments of the movie. Concomitantly recorded electroencephalography (EEG) data were analysed for differences in frequency band activity and effective connectivity between brain areas.</p><p><strong>Results: </strong>Compared with their NT peers, the ADHD group showed less dependence of their segmentation behaviour on social information, indicating that they did not consider social information to the same extent as their unaffected peers. This divergence was accompanied by differences in EEG theta band activity and a different effective connectivity network architecture at the source level. Specifically, NT adolescents primarily showed error signalling in and between the left and right fusiform gyri related to social information processing, which was not the case in the ADHD group. For the ADHD group, the inferior frontal cortex associated with attentional sampling served as a hub instead, indicating problems in the deployment of attentional control.</p><p><strong>Conclusions: </strong>This study shows that adolescents with ADHD perceive events differently from their NT peers, in association with a different brain network architecture that reflects less adaptation to the situation and problems in attentional sampling of environmental information. The results call for a novel conceptual view of ADHD, based on event segmentation theory.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11163598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of the expert consensus on the digital therapeutics in addictive-related disorders","authors":"Wei Hao, Xuyi Wang, Dai Li, Gang Wang","doi":"10.1136/gpsych-2023-101392","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101392","url":null,"abstract":"Addictive disorders have gained worldwide attention. The Chinese Association of Drug Abuse Prevention and Treatment, along with the consensus panel on digital therapeutics (DTx) for addictive disorders, has published an expert consensus on DTx for addictive disorders.1 This consensus discusses and summarises the current research and application status of DTx for addictive disorders. It identifies its clinical value, application directions, research and development principles, and future prospects. As the consensus is published in Chinese, it may not be easily accessible to an international audience. To address this, we present here an overview of the expert consensus on DTx for addictive disorders in China. The recommendations from the consensus are summarised in table 1. View this table: Table 1 Summary of the recommendations in the consensus Substance-related and addictive disorders have a significant impact on both physical and mental health and represent a contributing factor to crime.2 According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, substance-related and addictive disorders refer to a broad range of substance-related disorders involving 10 distinct classes of drugs, including opioids, methamphetamines and alcohol.3 The detoxification process for substance-related and addictive disorders consists of three phases: physiological recovery to relieve withdrawal symptoms, psychological rehabilitation to reduce mental dependence and social function restoration to facilitate reintegration into daily life. The second phase, psychological rehabilitation, is often the most challenging.4 Conventional treatments such as pharmacotherapy, psychotherapy and physical therapy face various limitations, including limited effectiveness, a shortage of skilled professional staff, high costs, long treatment duration and high dropout rates.5 DTx, driven by recent digital advancements, have emerged as a potential solution to these challenges. They are convenient, easy to implement and affordable, addressing the uneven distribution of conventional healthcare resources. DTx refer to digital technology measures supported …","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141505515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loneliness, social isolation and incident chronic kidney disease among patients with diabetes","authors":"Rui Tang, Jian Zhou, Xuan Wang, Hao Ma, Xiang Li, Yoriko Heianza, Lu Qi","doi":"10.1136/gpsych-2023-101298","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101298","url":null,"abstract":"Background Individuals with diabetes have a significantly higher risk of developing chronic kidney disease (CKD) and higher levels of social isolation and loneliness compared with those without diabetes. Recently, the American Heart Association highlighted the importance of considering social determinants of health (SDOH) in conjunction with traditional risk factors in patients with diabetes. Aims To investigate the associations of loneliness and social isolation with incident CKD risk in patients with diabetes in the UK Biobank. Methods A total of 18 972 patients with diabetes were included in this prospective study. Loneliness and Social Isolation Scales were created based on self-reported factors. An adjusted Cox proportional hazard model was used to investigate the associations of loneliness and social isolation with CKD risk among patients with diabetes. The relative importance in predicting CKD was also calculated alongside traditional risk factors. Results During a median follow-up of 10.8 years, 1127 incident CKD cases were reported. A higher loneliness scale, but not social isolation, was significantly associated with a 25% higher risk of CKD, independent of traditional risk factors, among patients with diabetes. Among the individual loneliness factors, the sense of feeling lonely emerged as the primary contributing factor to the elevated risk of CKD. Compared with individuals not experiencing feelings of loneliness, those who felt lonely exhibited a 22% increased likelihood of developing CKD. In addition, feeling lonely demonstrated greater relative importance of predicting CKD compared with traditional risk factors such as body mass index, smoking, physical activity and diet. Conclusions This study indicates the significant relationship between loneliness and CKD risk among patients with diabetes, highlighting the need to address SDOH in preventing CKD in this population. Data are available upon reasonable request. This study has been conducted using the UK Biobank Resource, approved project number 29256. The UK Biobank will make the source data available to all bona fide researchers for all types of health-related research that is in the public interest, without preferential or exclusive access for any persons. All researchers will be subject to the same application process and approval criteria as specified by UK Biobank. For more details on the access procedure, see the UK Biobank website (<http://www.ukbiobank.ac.uk/register-apply>).","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141252581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promising outcomes 5 weeks after a surgical cervical shunting procedure to unclog cerebral lymphatic systems in a patient with Alzheimer’s disease","authors":"Xia Li, Chenpeng Zhang, Yuan Fang, Mei Xin, Jianbo Shi, Zhiyuan Zhang, Zhen Wang, Zhenhu Ren","doi":"10.1136/gpsych-2024-101641","DOIUrl":"https://doi.org/10.1136/gpsych-2024-101641","url":null,"abstract":"Recently, the glymphatic system has been recognised as an important ‘waste solutes transport channel’ within the brain.1 Studies have shown that blockage of the glymphatic system leads to increased beta-amyloid deposits, accelerating the onset and progression of Alzheimer’s disease (AD).1 2 Given that cervical lymph nodes receive cerebrospinal fluid from the brain’s glymphatic system,3 4 we speculated that decompression of the lymphatic trunk and cervical lymphatic–venous anastomosis (LVA) could facilitate the flow of cerebrospinal fluid in the cranial glymphatic system, potentially accelerating the clearance of harmful beta-amyloid and tau proteins. We collaborated with surgeons who specialise in LVA supermicrosurgery for maxillofacial tumours and lymphoedema to develop a procedure to relieve the blockage of the glymphatic system. This surgery employs supermicrosurgery techniques to create LVA connecting the bilateral cervical, deep lymphatic vessels to the veins, resulting in lymphatic trunk decompression, which allows the lymph fluid in the high-pressure lymphatic vessels to flow into the low-pressure venous system. The goal of the minimally invasive surgery is to enhance the removal of proteins, such as beta-amyloid and tau, from the brain’s lymphatic systems to the maxillofacial lymphatic vessels, unclogging protein blockages within the brain. This extracranial procedure is safer than intracranial approaches. Following a thorough assessment of the safety and potential efficacy of the procedure, and securing ethics approval from the Ethics Committees of the Shanghai Mental Health Center and Shanghai Ninth People’s Hospital, we initiated an investigator-initiated trial of the ‘Cervical Shunting to Unclog cerebral Lymphatic …","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141505468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}