General Psychiatry最新文献

{"title":"Association between the frontoparietal network, clinical symptoms and treatment response in individuals with untreated anorexia nervosa.","authors":"Qianqian He, Hui Zheng, Jialin Zhang, Ling Yue, Qing Kang, Cheng Lian, Lei Guo, Yan Chen, Yanran Hu, Yuping Wang, Sufang Peng, Zhen Wang, Qiang Liu, Jue Chen","doi":"10.1136/gpsych-2023-101389","DOIUrl":"10.1136/gpsych-2023-101389","url":null,"abstract":"<p><strong>Background: </strong>Anorexia nervosa (AN) has been characterised as a psychiatric disorder associated with increased control. Currently, it remains difficult to predict treatment response in patients with AN. Their cognitive abilities are known to be resistant to treatment. It has been established that the frontoparietal control network (FPCN) is the direct counterpart of the executive control network. Therefore, the resting-state brain activity of the FPCN may serve as a biomarker to predict treatment response in AN.</p><p><strong>Aims: </strong>The study aimed to investigate the association between resting-state functional connectivity (RSFC) of the FPCN, clinical symptoms and treatment response in patients with AN.</p><p><strong>Methods: </strong>In this case-control study, 79 female patients with AN and no prior treatment from the Shanghai Mental Health Center and 40 matched healthy controls (HCs) were recruited from January 2015 to March 2022. All participants completed the Questionnaire Version of the Eating Disorder Examination (version 6.0) to assess the severity of their eating disorder symptoms. Additionally, RSFC data were obtained from all participants at baseline by functional magnetic resonance imaging. Patients with AN underwent routine outpatient treatment at the 4th and 12th week, during which time their clinical symptoms were evaluated using the same measures as at baseline.</p><p><strong>Results: </strong>Among the 79 patients, 40 completed the 4-week follow-up and 35 completed the 12-week follow-up. The RSFC from the right posterior parietal cortex (PPC) and dorsolateral prefrontal cortex (dlPFC) increased in 79 patients with AN vs 40 HCs after controlling for depression and anxiety symptoms. By multiple linear regression, the RSFC of the PPC to the inferior frontal gyrus was found to be a significant factor for self-reported eating disorder symptoms at baseline and the treatment response to cognitive preoccupations about eating and body image, after controlling for age, age of onset and body mass index. The RSFC in the dlPFC to the middle temporal gyrus and the superior frontal gyrus may be significant factors in the treatment response to binge eating and loss of control/overeating in patients with AN.</p><p><strong>Conclusions: </strong>Alterations in RSFC in the FPCN appear to affect self-reported eating disorder symptoms and treatment response in patients with AN. Our findings offer new insight into the pathogenesis of AN and could promote early prevention and treatment.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161355","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":"Shared genetic architecture highlights the bidirectional association between major depressive disorder and fracture risk.","authors":"Pianpian Zhao, Zhimin Ying, Chengda Yuan, Haisheng Zhang, Ao Dong, Jianguo Tao, Xiangjiao Yi, Mengyuan Yang, Wen Jin, Weiliang Tian, David Karasik, Geng Tian, Houfeng Zheng","doi":"10.1136/gpsych-2023-101418","DOIUrl":"10.1136/gpsych-2023-101418","url":null,"abstract":"<p><strong>Background: </strong>There is limited evidence suggesting that osteoporosis might exacerbate depressive symptoms, while more studies demonstrate that depression negatively affects bone density and increases fracture risk.</p><p><strong>Aims: </strong>To explore the relationship between major depressive disorder (MDD) and fracture risk.</p><p><strong>Methods: </strong>We conducted a nested case-control analysis (32 670 patients with fracture and 397 017 individuals without fracture) and a matched cohort analysis (16 496 patients with MDD and 435 492 individuals without MDD) in the same prospective UK Biobank data set. Further, we investigated the shared genetic architecture between MDD and fracture with linkage disequilibrium score regression and the MiXeR statistical tools. We used the conditional/conjunctional false discovery rate approach to identify the specific shared loci. We calculated the weighted genetic risk score for individuals in the UK Biobank and logistic regression was used to confirm the association observed in the prospective study.</p><p><strong>Results: </strong>We found that MDD was associated with a 14% increase in fracture risk (hazard ratio (HR) 1.14, 95% CI 1.14 to 1.15, p<0.001) in the nested case-control analysis, while fracture was associated with a 72% increase in MDD risk (HR 1.72, 95% CI 1.64 to 1.79, p<0.001) in the matched cohort analysis, suggesting a longitudinal and bidirectional relationship. Further, genetic summary data suggested a genetic overlap between MDD and fracture. Specifically, we identified four shared genomic loci, with the top signal (rs7554101) near <i>SGIP1</i>. The protein encoded by <i>SGIP1</i> is involved in cannabinoid receptor type 1 signalling. We found that genetically predicted MDD was associated with a higher risk of fracture and <i>vice versa</i>. In addition, we found that the higher expression level of <i>SGIP1</i> in the spinal cord and muscle was associated with an increased risk of fracture and MDD.</p><p><strong>Conclusions: </strong>The genetic pleiotropy between MDD and fracture highlights the bidirectional association observed in the epidemiological analysis. The shared genetic components (such as <i>SGIP1</i>) between the diseases suggest that modulating the endocannabinoid system could be a potential therapeutic strategy for both MDD and bone loss.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911694","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":"Effectiveness of mindfulness-based interventions on the well-being of healthcare workers: a systematic review and meta-analysis.","authors":"Natasha Yixuan Ong, Finn Jing Jie Teo, Jane Zi Ying Ee, Chun En Yau, Julian Thumboo, Hiang Khoon Tan, Qin Xiang Ng","doi":"10.1136/gpsych-2023-101115","DOIUrl":"10.1136/gpsych-2023-101115","url":null,"abstract":"<p><strong>Background: </strong>Growing evidence attests to the efficacy of mindfulness-based interventions (MBIs), but their effectiveness for healthcare workers remains uncertain.</p><p><strong>Aims: </strong>To evaluate the evidence for MBIs in improving healthcare workers' psychological well-being.</p><p><strong>Methods: </strong>A systematic literature search was conducted on Medline, Embase, Cumulative Index for Nursing and Allied Health Literature, PsycINFO and Cochrane Central Register of Controlled Trials up to 31 August 2022 using the keywords 'healthcare worker', 'doctor', 'nurse', 'allied health', 'mindfulness', 'wellness', 'workshop' and 'program'. Randomised controlled trials with a defined MBI focusing on healthcare workers and quantitative outcome measures related to subjective or psychological well-being were eligible for inclusion. R V.4.0.3 was used for data analysis, with the standardised mean difference as the primary outcome, employing DerSimonian and Laird's random effects model. Grading of Recommendations, Assessment, Development and Evaluation framework was used to evaluate the quality of evidence. Cochrane's Risk of Bias 2 tool was used to assess the risk of bias in the included studies.</p><p><strong>Results: </strong>A total of 27 studies with 2506 participants were included, mostly from the USA, involving various healthcare professions. MBIs such as stress reduction programmes, apps, meditation and training showed small to large effects on anxiety, burnout, stress, depression, psychological distress and job strain outcomes of the participants. Positive effects were also seen in self-compassion, empathy, mindfulness and well-being. However, long-term outcomes (1 month or longer postintervention) varied, and the effects were not consistently sustained.</p><p><strong>Conclusions: </strong>MBIs offer short-term benefits in reducing stress-related symptoms in healthcare workers. The review also highlights limitations such as intervention heterogeneity, reduced power in specific subgroup analyses and variable study quality.</p><p><strong>Prospero registration number: </strong>CRD42022353340.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911688","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":"Human lineage mutations regulate RNA-protein binding of conserved genes NTRK2 and ITPR1 involved in human evolution","authors":"Wenxiang Cai, Weichen Song, Shunying Yu, Min Zhao, Guan Ning Lin","doi":"10.1136/gpsych-2023-101425","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101425","url":null,"abstract":"Background The role of human lineage mutations (HLMs) in human evolution through post-transcriptional modification is unclear. Aims To investigate the contribution of HLMs to human evolution through post-transcriptional modification. Methods We applied a deep learning model Seqweaver to predict how HLMs impact RNA-binding protein affinity. Results We found that only 0.27% of HLMs had significant impacts on RNA-binding proteins at the threshold of the top 1% of human common variations. These HLMs enriched in a set of conserved genes highly expressed in adult excitatory neurons and prenatal Purkinje neurons, and were involved in synapse organisation and the GTPase pathway. These genes also carried excess damaging coding mutations that caused neurodevelopmental disorders, ataxia and schizophrenia. Among these genes, NTRK2 and ITPR1 had the most aggregated evidence of functional importance, suggesting their essential roles in cognition and bipedalism. Conclusions Our findings suggest that a small subset of human-specific mutations have contributed to human speciation through impacts on post-transcriptional modification of critical brain-related genes. Data are available in a public, open access repository.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141063493","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":"Systemic low-grade inflammation associated with specific depressive symptoms: insights from network analyses of five independent NHANES samples","authors":"Jingyu Lin, Haiming Huang, Tianmei Si, Lin Chen, Jingxu Chen, Yun-Ai Su","doi":"10.1136/gpsych-2023-101301","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101301","url":null,"abstract":"To the editor: Major depressive disorder (MDD) is a heterogeneous disorder with varying symptom presentations and underlying biological mechanisms.1 The mainstream neurobiological hypotheses of depression involve monoamine neurotransmitters, hypothalamic–pituitary–adrenal axis, immune-inflammation and the glutamate system.1 Numerous meta-analyses have reported that patients with MDD have a higher level of peripheral and cerebrospinal inflammatory markers, including C- reactive protein (CRP), interleukin 1beta (IL-1β), IL-6 and tumour necrosis factor-alpha (TNF-α).2 3 CRP, as an acute marker of reactant, is the most well-studied biomarker of MDD; numerous investigations revealed that elevated CRP was linked to core symptoms of MDD, including increased depressive mood4 and greater anhedonia.5 Several studies also have discovered links between CRP and cognitive symptoms (eg, difficulty concentrating)6 and suicidal behaviours.7 Moreover, CRP is more commonly reported in association with neurovegetative symptoms, including fatigue or loss of energy, changes in appetite and sleep problems.6 The association between CRP and specific symptoms remains unknown; uncovering specific symptoms driven by CRP could help identify the possible inflammatory subtypes of depression to pave the way for more specific anti-inflammatory treatments. The data for this secondary analysis was derived from five National Health and Nutrition Examination Survey (NHANES) samples (2005–2006, 2007–2008, 2009–2010, 2015–2016 and 2017–2020). NHANES encompasses nationally representative community samples within the USA, and the surveys are designed to examine the nutritional status and physical and mental health. NHANES has been conducting ongoing 2-year cycles of surveys of a representative, stratified, multistage probability sample of the US population since 1999. Each wave of surveys recruits a different set of participants. Those who were chosen and consented to participate completed a computer-assisted interview done in their homes by trained staff. Following the home interview, all tests (including the blood draw) and additional interviews (including the assessment of depressive …","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140798885","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":"Understanding and addressing the challenges of online gambling addiction in mainland China","authors":"Gangliang Zhong, Jiang Du, Min Zhao","doi":"10.1136/gpsych-2023-101477","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101477","url":null,"abstract":"Gambling in China has a long and evolving history, from ancient court cockfighting to preliberation casinos with games like baccarat.1 Over time, gambling in China has evolved to include a wide range of activities, including gaming machines, online gambling and commercial gambling. Despite being declared illegal and regulated after the establishment of the People’s Republic of China, gambling remains deeply ingrained in Chinese culture. While recreational gambling is widely accepted, it often leads to excessive time spent and an increased risk of problematic gambling behaviours. In recent years, the situation has been exacerbated due to the rise of online gambling, which is emerging as the predominant form of gambling in China.2 Online gambling platforms provide a virtual environment that offers short-term relief, excitement and distraction. Their clandestine nature makes them more appealing to vulnerable groups, including adolescents and problem gamblers. The diverse forms of online gambling increase the risk of excessive gambling and present greater challenges for regulation and management. Addressing the associated harms requires simultaneous attention from both regulatory and medical perspectives. Gambling in China has a complex landscape that includes various forms of recreational activities. While generally considered a major vice alongside pornography and drugs, certain forms of recreational gambling are widely accepted during social gatherings. Favourable attitudes towards gambling increase intention and the likelihood of engagement, as per expectancy-value models like the theory of planned behaviour.3 The perception that insignificant stakes mitigate potential consequences has led to widespread participation, excessive time spent and frequent engagement in gambling activities. However, these factors crucially contribute to the development of gambling disorder.4 In China, this has resulted in a distinct group of problem gamblers primarily experiencing negative consequences in terms of time loss rather than financial loss. Consequently, this outcome poses challenges to current screening and …","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140563267","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":"Mediating effect of resilience on the relationship between rumination and suicide attempts in Chinese adolescents with mood disorders","authors":"Dianying Liu, Gang Lei, Hongdong Deng, Xiangyang Zhang, Yonghui Dang","doi":"10.1136/gpsych-2023-101233","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101233","url":null,"abstract":"To the editor: Mood disorders (MD) are serious mental illnesses that commonly affect adolescents, leading to a high incidence of suicidal behaviour.1 In China, the suicide attempt (SA) rate for adolescents with MD is 51.96%,2 and over 500 000 adolescent SA are reported annually in the USA due to depression.3 Risk factors for SA include gender, hormone levels, family conflict and, particularly, negative cognitive styles such as rumination.2–6 Our recent study2 has demonstrated a significant positive association between rumination and SA in adolescents with MD; rumination fully mediated the relationship between depression and SA. Additionally, our previous finding has revealed a negative correlation between rumination and resilience and that resilience mediates the relationship between rumination and depression.5 Furthermore, the protective model of resilience suggests that higher resilience buffers the harmful effects of risk and adversity, reduces adverse consequences, enhances cognitive flexibility and reduces rumination tendencies.7 However, there is a lack of evidence on the potential mediating role of resilience in the relationship between rumination and SA among adolescents with MD. Therefore, the main aims of this study are as follows: (1) to examine possible associations between rumination, resilience and SA in Chinese adolescents with MD; and (2) to test whether resilience mediates the relationship between rumination and SA in Chinese adolescents with MD. ### Participants In our current cross-sectional study, 611 adolescents with depressive episodes were recruited from October 2019 to June 2022 in the child and adolescent outpatient and inpatient departments of the Third People’s Hospital (a psychiatric hospital) in Ganzhou, Jiangxi Province, China. All patients were included if they met the following criteria: (1) Han Chinese, aged 11–18 with at least 5 years of education; (2) met the criteria of a current depressive episode as independently determined by two experienced psychiatrists and according …","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140563314","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":"New role of platelets in schizophrenia: predicting drug response","authors":"Yamin Zhang, Yanghao Zheng, Peiyan Ni, Sugai Liang, Xiaojing Li, Hua Yu, Wei Wei, Xueyu Qi, Xueli Yu, Rui Xue, Liansheng Zhao, Wei Deng, Qiang Wang, Wanjun Guo, Tao Li","doi":"10.1136/gpsych-2023-101347","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101347","url":null,"abstract":"Background Elevated platelet count (PLTc) is associated with first-episode schizophrenia and adverse outcomes in individuals with precursory psychosis. However, the impact of antipsychotic medications on PLTc and its association with symptom improvement remain unclear. Aims We aimed to investigate changes in PLTc levels following antipsychotic treatment and assess whether PLTc can predict antipsychotic responses and metabolic changes after accounting for other related variables. Methods A total of 2985 patients with schizophrenia were randomised into seven groups. Each group received one of seven antipsychotic treatments and was assessed at 2, 4 and 6 weeks. Clinical symptoms were evaluated using the positive and negative syndrome scale (PANSS). Additionally, we measured blood cell counts and metabolic parameters, such as blood lipids. Repeated measures analysis of variance was used to examine the effect of antipsychotics on PLTc changes, while structural equation modelling was used to assess the predictive value of PLTc on PANSS changes. Results PLTc significantly increased in patients treated with aripiprazole (F=6.00, p=0.003), ziprasidone (F=7.10, p<0.001) and haloperidol (F=3.59, p=0.029). It exhibited a positive association with white blood cell count and metabolic indicators. Higher baseline PLTc was observed in non-responders, particularly in those defined by the PANSS-negative subscale. In the structural equation model, PLTc, white blood cell count and a latent metabolic variable predicted the rate of change in the PANSS-negative subscale scores. Moreover, higher baseline PLTc was observed in individuals with less metabolic change, although this association was no longer significant after accounting for baseline metabolic values. Conclusions Platelet parameters, specifically PLTc, are influenced by antipsychotic treatment and could potentially elevate the risk of venous thromboembolism in patients with schizophrenia. Elevated PLTc levels and associated factors may impede symptom improvement by promoting inflammation. Given PLTc’s easy measurement and clinical relevance, it warrants increased attention from psychiatrists. Trial registration number ChiCTR-TRC-10000934. Data are available on reasonable request.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140563587","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":"Thirty-year trends of anxiety disorders among adolescents based on the 2019 Global Burden of Disease Study","authors":"Xiaohan Liu, Fan Yang, Ning Huang, Shan Zhang, Jing Guo","doi":"10.1136/gpsych-2023-101288","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101288","url":null,"abstract":"Background Anxiety disorders are the most common psychiatric problems, affecting approximately 1 in 12 children and 1 in 4 adolescents. Understanding the incidence, burden and correlated risks of anxiety disorders among children and adolescents can help identify areas of success, stagnation and emerging threats, thereby facilitating effective improvement strategies. Aims To estimate the incidence and burden trends of anxiety disorders in children and adolescents from 1990 to 2019 in 204 countries and compare the incidence and disease burden in different countries. To examine the association between anxiety disorders and social indicators (healthcare access and quality of life). Methods Data were obtained from the Global Burden of Disease Study 2019. The age-standardised incidence rates (ASIRs) and disability-adjusted life years (DALYs) were reported to assess the burden of anxiety disorders, and the estimated annual percentage change was calculated to quantify the temporal trends. Pearson’s correlation was used to investigate country-level risk factors for incidence and DALYs. Results Globally, there were 932 million incident cases of anxiety disorders in children and adolescents, 739.29 per 100 000 ASIRs and 380.62 million DALYs in 2019. From 1990 to 2019, the estimated annual percentage change of incidence of anxiety disorders decreased by 2.2%. Significant variations were observed in the age-standardised burden rate and the changing trend of anxiety disorders among countries. Portugal reported the highest ASIR of anxiety disorders, while Mexico had the largest increase rate of ASIR. In 2019, Portugal reported the highest number of DALYs (1001.71 million), and India (212.09 million) reported the lowest number of DALYs. The burden of anxiety disorders was positively correlated with the average number of psychiatrists, psychologists and nurses in the mental health sector (per 100 000), and quality of life and the correlation coefficients were 0.58, 0.67, 0.43 and 0.53, respectively. Conclusions The incidence and global burden of anxiety disorders in adolescents have continued to decrease over the past 30 years. However, the incidence and disease burden in developed countries are still increasing steadily. Policymakers should design and implement mental health strategies for adolescents based on their specific developmental status, as well as the cultural and regional characteristics of each country. Data are available in a public, open access repository. The GBD database provides a tool to quantify health loss from hundreds of diseases, injuries and risk factors.The data can be reused by registering on the website:<http://ghdx.healthdata.org>.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140563830","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":"Virtual reality-based cognitive–behavioural therapy for the treatment of anxiety in patients with acute myocardial infarction: a randomised clinical trial","authors":"Yuan Yuan Li, Juan Peng, Yuan Yang Ping, Weng Jia Jun, Yan'e Lu, Jia Jia Liu, Shi Kun Xu, Li Hua Guan, Dong Huang, Qi Bing Wang, Ju Ying Qian, Ze Xin Zhao, Ya Bin Wei, Jun Bo Ge, Xiao Huang","doi":"10.1136/gpsych-2023-101434","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101434","url":null,"abstract":"Background The presence of mental health conditions is pervasive in patients who experienced acute myocardial infarction (AMI), significantly disrupting their recovery. Providing timely and easily accessible psychological interventions using virtual reality-based cognitive–behavioural therapy (VR-CBT) could potentially improve both acute and long-term symptoms affecting their mental health. Aims We aim to examine the effectiveness of VR-CBT on anxiety symptoms in patients with AMI who were admitted to the intensive care unit (ICU) during the acute stage of their illness. Methods In this single-blind randomised clinical trial, participants with anxiety symptoms who were admitted to the ICU due to AMI were continuously recruited from December 2022 to February 2023. Patients who were Han Chinese aged 18–75 years were randomly assigned (1:1) via block randomisation to either the VR-CBT group to receive VR-CBT in addition to standard mental health support, or the control group to receive standard mental health support only. VR-CBT consisted of four modules and was delivered at the bedside over a 1-week period. Assessments were done at baseline, immediately after treatment and at 3-month follow-up. The intention-to-treat analysis began in June 2023. The primary outcome measure was the changes in anxiety symptoms as assessed by the Hamilton Anxiety Rating Scale (HAM-A). Results Among 148 randomised participants, 70 were assigned to the VR-CBT group and 78 to the control group. The 1-week VR-CBT intervention plus standard mental health support significantly reduced the anxiety symptoms compared with standard mental health support alone in terms of HAM-A scores at both post intervention (Cohen’s d=−1.27 (95% confidence interval (CI): −1.64 to −0.90, p<0.001) and 3-month follow-up (Cohen’s d=−0.37 (95% CI: −0.72 to −0.01, p=0.024). Of the 70 participants who received VR-CBT, 62 (88.6%) completed the entire intervention. Cybersickness was the main reported adverse event (n=5). Conclusions Our results indicate that VR-CBT can significantly reduce post-AMI anxiety at the acute stage of the illness; the improvement was maintained at the 3-month follow-up. Trial registration number The trial was registered at [www.chictr.org.cn][1] with the identifier: ChiCTR2200066435. Data are available on reasonable request. Not applicable. [1]: http://www.chictr.org.cn","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140563292","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}