Frontiers in Psychiatry最新文献

{"title":"Network analysis of clinical features in patients with treatment-resistant schizophrenia.","authors":"Wei Li, Jing Zhao, Na Hu, Wanling Zhang","doi":"10.3389/fpsyt.2025.1537418","DOIUrl":"10.3389/fpsyt.2025.1537418","url":null,"abstract":"<p><strong>Objective: </strong>This study compares the clinical features of Treatment-Resistant Schizophrenia (TRS) and Non-Treatment-Resistant Schizophrenia (NTRS) using network analysis.</p><p><strong>Methods: </strong>We recruited 511 patients, dividing them into TRS (N = 269) and NTRS (N = 242) groups. Eight scales were used: Positive and Negative Syndrome Scale (PANSS), Positive Symptom Assessment Scale (SAPS), Scale for Assessment of Negative Symptoms (SANS), Simpson-Angus Scale (SAS), Abnormal Involuntary Movements Scale (AIMS), Barnes Akathisia Rating Scale (BARS), Calgary Schizophrenia Depression Scale (CDSS), and Global Assessment of Functioning Scale (GAF). Demographic and clinical data were analyzed using T-tests and Chi-square tests. Network analysis was then applied to compare clinical features.</p><p><strong>Results: </strong>Significant differences were found in the overall architectures (S = 1.396, <i>p</i> < 0.002) and edge weights (M = 0.289, <i>p</i> < 0.009) of TRS and NTRS networks. Nine edges (<i>p</i> < 0.05) and five nodes (p < 0.01) differed, indicating a correlation between clinical symptoms of the two groups. TRS core symptoms were linked to social functions through both positive (SAPS) and negative symptoms (SANS), while NTRS core symptoms were related to general psychopathological symptoms (PANSS-G).</p><p><strong>Conclusion: </strong>For TRS, it is essential to address both negative and positive symptoms, focusing on the impact of negative symptoms on functioning. Additionally, managing medication side effects is crucial to avoid worsening negative symptoms.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1537418"},"PeriodicalIF":3.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467818","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":"The effect of repetitive transcranial magnetic stimulation on sleep quality in patients with more than mild depressive mood: a systematic review and meta-analysis.","authors":"Yu'ang Liu, Silang Huang, Xinxin Zhang, Huangying Liao, Weiguo Liu, Zhi Zhang, Xianhui Qu, Ziwen Wang","doi":"10.3389/fpsyt.2025.1511930","DOIUrl":"10.3389/fpsyt.2025.1511930","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to systematically evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) therapy on sleep quality in patients with more than mild depressive mood.</p><p><strong>Methods: </strong>Randomized controlled trials in PubMed, Cochrane Library, Web of Science, Embase, Scopus, and ScienceDirect on rTMS to improve sleep quality in patients with more than mild depressive mood up to September 2023 were searched. A meta-analysis was performed using RevMan 5.4 and Stata 17.0 software.</p><p><strong>Results: </strong>A total of 11 studies, which involved 548 patients, were included. After rTMS treatment, the effect on sleep quality improvement in patients with more than mild depressive mood was better in the experimental group than in the control group [<i>I</i> ² = 53%, mean difference (MD) = -2.27, 95%CI = -2.97 to -1.57, <i>p</i> < 0.00001]. The results of the subgroup analyses showed that, in terms of stimulation frequency, compared with the 5-Hz and 10-Hz groups, the treatment effect of the 1-Hz group was better (<i>I</i> ² = 32%, MD = -2.69, 95%CI = -3.78 to -1.60, <i>p</i> < 0.00001). In terms of treatment duration, compared with the 2-week and 4-week groups, the group with more than 4 weeks of treatment had better treatment outcomes (<i>I</i> ² = 0%, MD = -2.81, 95%CI = -3.22 to -2.40, <i>p</i> < 0.00001). In terms of whether combination therapy was used or not, compared with the combination therapy group (<i>I</i> ² = 29%, MD = -1.39, 95%CI = -2.30 to -0.48, <i>p</i> = 0.003), the non-combination therapy group had a better treatment effect (<i>I</i> ² = 0%, MD = -2.93, 95%CI = -3.36 to -2.50, <i>p</i> < 0.00001).</p><p><strong>Conclusion: </strong>rTMS significantly improves sleep quality in patients with more than mild depression. Subgroup analyses showed that the group using the 1-Hz stimulation frequency, the group with more than 4 weeks of treatment time, and the group with rTMS alone had better efficacy in treating the sleep quality of patients with more than mild depressive mood using rTMS, with the use of combination treatment or not being the main source of heterogeneity.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, identifier CRD42023467971.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1511930"},"PeriodicalIF":3.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467820","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":"\"Meaninglessness makes me unhappy\": examining the role of a sense of alienation and life satisfaction in the relationship between the presence of meaning and depression among Chinese high school seniors.","authors":"Xiaoxu Hou, Jinsheng Hu, Zhihong Liu","doi":"10.3389/fpsyt.2025.1494074","DOIUrl":"10.3389/fpsyt.2025.1494074","url":null,"abstract":"<p><strong>Introduction: </strong>Given the high incidence of depression among adolescents and its serious consequences, investigating its influencing factors and mechanisms is of great theoretical and practical significance. This study aims to explore the mediating effects of a sense of alienation and life satisfaction on the relationship between the presence of meaning in life and depression among Chinese high school seniors.</p><p><strong>Methods: </strong>Six hundred and twenty-one senior high school students (17.09 ± 0.45 years, 266 boys) were recruited from Shandong, China, to participate in the study. Participants completed the Adolescent Students' Sense of Alienation (ASAS), Meaning in Life Questionnaire (MLQ), Satisfaction with Life Scale (SWLS), and Beck Depression Inventory-II (BDI-II).</p><p><strong>Results: </strong>Our findings revealed that (1) the sense of alienation and life satisfaction play a chain mediating role between the presence of meaning in life and depression among Chinese high school seniors; (2) the sense of alienation plays a mediating role between the presence of meaning in life and depression; (3) there are gender differences in the chain mediation model of the influence of the presence of meaning in life on depression.</p><p><strong>Conclusion: </strong>This study reveals potential pathways through which the presence of meaning in life affects depression among Chinese high school seniors, offering support and a basis for future mental health interventions for this population.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1494074"},"PeriodicalIF":3.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467752","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":"Integrated treatment of depression and moderate to severe alcohol use disorder in women shows promise in routine alcohol use disorder care - a pilot study.","authors":"Anna Persson, Daniel Wallhed Finn, Alice Broberg, Amanda Westerberg, Åsa Magnusson, Olof Molander","doi":"10.3389/fpsyt.2025.1473988","DOIUrl":"10.3389/fpsyt.2025.1473988","url":null,"abstract":"<p><strong>Introduction: </strong>Major depression and alcohol use disorder affect millions of individuals worldwide and cause significant disability. They often occur together, and their co-occurrence is associated with more negative outcomes than each disorder on its own. Yet, there is a lack of knowledge on how to best treat co-occurring depression and alcohol use disorder. A pilot study was conducted to investigate the feasibility, credibility, patient satisfaction, preliminary effect, and potential negative effects of an integrated treatment for depression and alcohol use disorder, which has shown promising results in an earlier pilot trial.</p><p><strong>Methods: </strong>The study was conducted at an outpatient unit in Stockholm, Sweden. Women (n=7) with current depression and alcohol use disorder were offered integrated group treatment that included evidence-based treatment for depression and alcohol use disorder. Criteria for feasibility were based on an earlier study, treatment credibility was measured using the Credibility/Expectancy Questionnaire and patient satisfaction with the Client Satisfaction Questionnaire.</p><p><strong>Results: </strong>Feasibility, credibility, and patient satisfaction were high. Depression symptom severity and alcohol consumption decreased from baseline to follow up. Negative effects were reported in terms of increased adverse emotional experiences.</p><p><strong>Discussion: </strong>The investigated integrated treatment for co-occurring depression and alcohol use disorder continues to show promise. Randomized clinical trials are needed to evaluate its effectiveness.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1473988"},"PeriodicalIF":3.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467803","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":"Conceptual competence in medicine: promoting psychosomatic awareness in clinics, research and education.","authors":"Dirk von Boetticher","doi":"10.3389/fpsyt.2025.1500638","DOIUrl":"10.3389/fpsyt.2025.1500638","url":null,"abstract":"<p><strong>Introduction: </strong>In recent decades, psychosomatic medicine has developed into a distinct specialty, bringing specific clinical concepts to bear seeking to acknowledge the unity (not the identity) of the mind and body in clinical care. Such concepts form the identity of the psychosomatic field as a distinct discipline and its epistemological status between somatic medicine and psychiatry. Despite the importance of these concepts from an educational and a research perspective, too little attention has been paid to their clinical impact.</p><p><strong>Methods: </strong>This paper investigated the general nature of concepts and their role and significance in structuring the clinical encounter and care, including consideration of their relevance for the hidden curriculum.</p><p><strong>Results: </strong>Conceptual competence is defined as a transformative awareness of the multilayered, fallible, and plural nature of human concepts, which have both descriptive and evaluative and action-guiding properties having both an explicit and an implicit meaning. Conceptual competence in psychosomatic medicine entails dealing competently with the mind-body-distinction and the biopsychosocial model (and criticism of it) with respect to the clinical situation.</p><p><strong>Discussion: </strong>Conceptual research is presented as an autonomous research area and the complement of empirical research, having a descriptive and a normative function: descriptively analyzing the concepts we have and normatively searching for the concepts that we need for the integrated care we strive for.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1500638"},"PeriodicalIF":3.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467801","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":"Investigating the relationship between inflammatory cytokines and adolescent depression: a comparative analysis.","authors":"Mengqi Liu, Jie Tang, Gaoyang Xu, Xu Chen, Kun Fang, Fan He, Yi Zheng","doi":"10.3389/fpsyt.2025.1524015","DOIUrl":"10.3389/fpsyt.2025.1524015","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) in adolescents poses a significant threat to physical health. Previous studies have indicated that adolescents with MDD exhibit immune activation.</p><p><strong>Objective: </strong>This study aimed to compare cytokine levels in adolescents with MDD to healthy controls and assess their diagnostic value.</p><p><strong>Methods: </strong>This cross-sectional study included 58 adolescent patients with depression from Beijing Anding Hospital (outpatients and inpatients) and 40 healthy adolescents recruited from the community. Multiplex cytokine analysis (Luminex xMAP) was used to measure serum levels of several cytokines. Data analysis was performed using SPSS (version 26.0) to compare cytokine levels between adolescents with MDD and healthy controls and assess gender differences. Correlations between cytokine levels and demographic data, clinical features and depressive symptoms were also analyzed. The receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of cytokines.</p><p><strong>Results: </strong>Serum IL-4, IFN-γ, and TNF-α levels were significantly elevated in MDD group compared with healthy controls (<i>p</i> < 0.05). In MDD group, the age of first onset of depression in females was significantly younger than that in males (<i>p</i> < 0.05), and female serum TNF-α levels were significantly higher than those in males (<i>p</i> < 0.05). BMI and serum IL-4 levels were significantly positively correlated in adolescents with MDD. The area under the ROC curve for serum IL-4 and TNF-α in diagnosing adolescent depression was 0.695 (95% confidence interval [CI]: 0.580 - 0.809; <i>p</i> < 0.05), with a sensitivity of 0.793 and specificity of 0.675.</p><p><strong>Conclusion: </strong>Compared with healthy controls, adolescents with depression demonstrated significantly elevated serum cytokine levels, indicating immune activation which were higher in female. Cytokines may have promising diagnostic value in adolescent depression, but further validation with additional indicators is needed.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1524015"},"PeriodicalIF":3.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467816","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":"Validation of a composite outcome measure for inpatient psychiatry using scales from the interRAI-MH.","authors":"Howard E Barbaree, Christopher Perlman, Elke Ham, Gregory P Brown, John P Hirdes","doi":"10.3389/fpsyt.2025.1486734","DOIUrl":"10.3389/fpsyt.2025.1486734","url":null,"abstract":"<p><strong>Background: </strong>Inpatient psychiatry is a critical service in a community-based care system for persons with serious mental illness (SMI). Currently, there are few generally accepted or widely used outcomes to assess the effectiveness of inpatient treatment.</p><p><strong>Method: </strong>Following a Donabedian Model of Health Care Quality, we utilized eight scales from the RAI Mental Health assessment to derive a clinician-scored outcome measure consisting of 4 domains (Psychosis, Depression, Impairment, and Aggression). We combined subscales measuring these domains into a Composite Measure. We used this measure to assess the entire population (N=719) of our large specialized mental health hospital at the beginning (T1) and end (T2) of three months in the hospital (or admission to discharge in shorter stays). We evaluated the content validity of the measure by comparing items and scales with a list of putative contributors to hospital admission (symptoms and complications). To evaluate concurrent validity, we compared mean scores among hospital units with varying lengths of stay and clinical complexity (acute versus chronic versus complex chronic). We used ROC analysis to evaluate the CIIMHS's ability to predict discharge from the hospital. To evaluate construct validity, we examined the measure's responsiveness to changes among patients after treatment in the hospital.</p><p><strong>Results: </strong>We found strong evidence for all four kinds of validity.</p><p><strong>Conclusions: </strong>The composite measure represents a valid measure of inpatient mental health status and will serve as a valuable measure of the quality of care for inpatient psychiatry.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1486734"},"PeriodicalIF":3.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467822","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":"Confronting the anxiety of Generation Z: electroacupuncture therapy regulates oxidative stress and microglia activity in amygdala-basolateral of socially isolated mice.","authors":"Tong Yin, Junyun Yuan, Lu Liu, Yinxin Wang, Yuanfang Lin, Kangwen Ming, Hang Lv","doi":"10.3389/fpsyt.2024.1496201","DOIUrl":"10.3389/fpsyt.2024.1496201","url":null,"abstract":"<p><strong>Introduction: </strong>Anxiety disorders are prevalent mental health conditions characterized by significant impairments in daily functioning and social interactions. Despite the effectiveness of pharmacological treatments, challenges such as medication resistance, adverse side effects, and the high rate of relapse necessitate the exploration of alternative therapies. Recently, electroacupuncture (EA) has garnered attention as a promising non-pharmacological intervention for anxiety disorders; however, the mechanisms by which EA exerts its anxiolytic effects remain poorly understood. This study aims to elucidate the role of microglial cells in anxiety, specifically examining how EA modulates microglial morphology and function within the basolateral amygdala (BLA) in the context of anxiety induced by social isolation.</p><p><strong>Methods: </strong>Utilizing a mouse model of social isolation-induced anxiety, we evaluated anxiety-like behaviors through the Elevated Plus Maze (EPM) and Open Field Test (OFT). Additionally, biochemical analyses and immunofluorescence imaging were performed to assess the expression of NADPH oxidase 2 (NOX2), microglial activation markers, and levels of oxidative stress.</p><p><strong>Results: </strong>Our findings reveal that EA treatment significantly mitigates anxiety-like behaviors in mice, correlating with a reduction in NOX2 expression within BLA microglia and decreased levels of reactive oxygen species (ROS). Furthermore, EA was observed to restore normal microglial morphology, indicating its potential role in modulating microglial activity.</p><p><strong>Discussion: </strong>The results of this study suggest that EA exerts its anxiolytic effects through the modulation of oxidative stress and the activity of microglia in the BLA. These findings provide new insights into the cellular mechanisms underlying the therapeutic effects of EA, highlighting the potential for non-pharmacological strategies in the management of anxiety disorders and paving the way for future research aimed at improving clinical outcomes for individuals suffering from anxiety.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"15 ","pages":"1496201"},"PeriodicalIF":3.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467790","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":"People with symptoms of depression and those at significant risk of suicide show differences in their personality profile and sense of meaning in life.","authors":"Kacper Deska, Grzegorz Mirocha, Bartłomiej Bąk, Anna Mirgos-Wierzchowska, Marcin Kosmalski, Monika Różycka-Kosmalska, Tadeusz Pietras","doi":"10.3389/fpsyt.2025.1508791","DOIUrl":"10.3389/fpsyt.2025.1508791","url":null,"abstract":"<p><strong>Introduction: </strong>Medical students are exposed to various stressors. Among the many factors that determine the possibility of a mental crisis, there is also a personality profile and a sense of meaning in life.</p><p><strong>Materials and methods: </strong>Sets of anonymous surveys were distributed among medical students of different years studying at the Medical University of Lodz. The set of surveys included a sociodemographic survey, Beck's Depression Inventory version II (BDI-II), the NEO Five Factory Inventory (NEO-FFI), Reker's Life Attitude Profile - Revised questionnaire (LAP-R), Osman's Suicidal Behavior Questionnaire (SBQ-R).</p><p><strong>Results: </strong>The study cohort comprised of 276 students (mean age 21.7 years). According to the BDI-II, 79 participants (28.4%) were identified as having depressive symptoms. Additionally, 80 participants (28.9%) were assessed to be at significant risk of suicide according to the SBQ-R scale. Based on the results of these questionnaires, we identified four groups: 1. Participants with depressive symptoms (D). 2. Participants with suicide risk (SR), 3. Participants with both depressive symptoms with suicide risk (D and SR), 4. A control group. Students from D and D and SR groups, exhibited higher neuroticism scores compared to those with suicide risk alone (SR) and the control group. In terms of extroversion, the control and SR groups scored higher compared to the D with SR group. Participants with SR and those with D and SR had higher openness scores compared to the D and control groups. D and SR group obtained statistical lower score then control group in the terms of conscientiousness. In life control score, participants in D and D with SR group has significant lower score then SR and control group. The conditions: personal meaning index and life attitude balance in the control group achieved significantly higher values compared to all other groups.</p><p><strong>Conclusion: </strong>People with depressive symptoms, suicide risk and both of these variables simultaneously differed in terms of personality profile and components influencing the meaning of life.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1508791"},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457588","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":"Ethical dilemmas in the care of patients suffering from psychotic catatonia: a case report.","authors":"Luigi F Saccaro, Barbara Privé, Ambra D'Imperio, Claire Bridel, Othman Sentissi, Alexandre Wullschleger","doi":"10.3389/fpsyt.2025.1543563","DOIUrl":"10.3389/fpsyt.2025.1543563","url":null,"abstract":"<p><strong>Background: </strong>Coercive measures in psychiatric practice are controversial due to their potential for severe negative effects. Ethical debates focus on respecting autonomy, minimizing damaging effects, and acting in the patient's best interest.</p><p><strong>Case: </strong>We present a unique case of a young patient suffering from a first episode of catatonic psychosis, in which striking this balance was especially difficult given the patient's complete mutism and opposition, given the absence of immediate danger to herself or others, the lack of anamnestic information, and her avoidance of social support, which would have meant that she would not have encountered psychiatric care, were it not for an exceptional government plan in place at the time of hospitalization. The patient showed a very favorable, persistent response to nonvoluntary treatment with haloperidol and lorazepam, which could be discussed and debriefed once she recovered, after almost 5 months of hospitalization and follow-up.</p><p><strong>Discussion: </strong>Arguments for and against nonvoluntary treatment are reviewed based on discussion with the local ethics committee, providing a useful reference for future similar cases. Finally, this case highlights an atypical onset of psychosis in a previously high-functioning individual and explores the mental health impact of international tensions, particularly the Russian-Ukrainian war, on individuals.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1543563"},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457519","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}