Journal of Neuropsychiatry and Clinical Neurosciences最新文献

{"title":"Mid- and Late-Life Physical Activity and Neuropsychiatric Symptoms in Dementia-Free Older Adults: Mayo Clinic Study of Aging.","authors":"Janina Krell-Roesch, Jeremy A Syrjanen, Jelena Bezold, Sandra Trautwein, Bettina Barisch-Fritz, Walter K Kremers, Julie A Fields, Eugene L Scharf, David S Knopman, Gorazd B Stokin, Ronald C Petersen, Darko Jekauc, Alexander Woll, Maria Vassilaki, Yonas E Geda","doi":"10.1176/appi.neuropsych.20220068","DOIUrl":"10.1176/appi.neuropsych.20220068","url":null,"abstract":"<p><strong>Objective: </strong>This study examined associations between physical activity (PA) and neuropsychiatric symptoms (NPS) in older adults free of dementia.</p><p><strong>Methods: </strong>This cross-sectional study included 3,222 individuals ≥70 years of age (1,655 men; mean±SD age=79.2±5.6; cognitively unimpaired, N=2,723; mild cognitive impairment, N=499) from the population-based Mayo Clinic Study of Aging. PA (taken as a presumed predictor) in midlife (i.e., when participants were 50-65 years of age) and late life (i.e., the year prior to assessment) was assessed with a self-reported, validated questionnaire; PA intensity and frequency were used to calculate composite scores. NPS (taken as presumed outcomes) were assessed with the Neuropsychiatric Inventory Questionnaire, Beck Depression Inventory (BDI-II), and Beck Anxiety Inventory (BAI). Regression analyses included midlife and late-life PA in each model, which were adjusted for age, sex, education, apolipoprotein E ɛ4 status, and medical comorbidity.</p><p><strong>Results: </strong>Higher late-life PA was associated with lower odds of having apathy (OR=0.89, 95% CI=0.84-0.93), appetite changes (OR=0.92, 95% CI=0.87-0.98), nighttime disturbances (OR=0.95, 95% CI=0.91-0.99), depression (OR=0.94, 95% CI=0.90-0.97), irritability (OR=0.93, 95% CI=0.89-0.97), clinical depression (OR=0.92, 95% CI=0.88-0.97), and clinical anxiety (OR=0.90, 95% CI=0.86-0.94), as well as lower BDI-II (β estimate=-0.042, 95% CI=-0.051 to -0.033) and BAI (β estimate=-0.030, 95% CI=-0.040 to -0.021) scores. Higher midlife PA was associated only with higher BDI-II scores (β estimate=0.011, 95% CI=0.004 to 0.019). Sex modified the associations between PA and NPS.</p><p><strong>Conclusions: </strong>Late-life PA was associated with a lower likelihood of clinical depression or anxiety and subclinical NPS. These findings need to be confirmed in a cohort study.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"35 2","pages":"133-140"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9306933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations in Resting-State Interhemispheric Coordination With Refractory Auditory Verbal Hallucinations in Schizophrenia.","authors":"Huichang Qian,&nbsp;Xiaozheng Liu,&nbsp;Zhongwei Guo,&nbsp;Guanjun Wang,&nbsp;Xiuhong Chen,&nbsp;Jian Liu","doi":"10.1176/appi.neuropsych.20220054","DOIUrl":"10.1176/appi.neuropsych.20220054","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to investigate resting-state interhemispheric functional connectivity in patients with schizophrenia and refractory auditory verbal hallucinations (RAVHs) by using voxel-mirrored homotopic connectivity (VMHC).</p><p><strong>Methods: </strong>Thirty-four patients with schizophrenia and RAVHs (RAVH group), 23 patients with schizophrenia but no auditory verbal hallucinations (non-AVH group), and 28 matched healthy volunteers (healthy control group) were recruited in China. VMHC analyses were used to identify brain areas with significant differences in functional connectivity among the three groups, and correlations between symptom scores and neurological measures were examined.</p><p><strong>Results: </strong>VMHC analyses showed aberrant bilateral connectivity between several homotopic brain regions: the RAVH and non-AVH groups showed differences in bilateral connectivity of the superior and middle temporal gyri, and the RAVH and healthy control groups showed differences in bilateral connectivity of the gyrus rectus, inferior frontal gyrus, and putamen. In addition, interhemispheric connectivity of the superior and middle temporal gyri correlated with patients' positive symptom scores.</p><p><strong>Conclusions: </strong>These findings may help to elucidate the pathophysiological mechanisms underlying auditory verbal hallucinations. The results revealed interhemispheric functional dysconnectivity among patients with schizophrenia and suggest that the dysconnectivity of homotopic brain regions may play an important role in the development of auditory verbal hallucinations.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"385-392"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9551903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Posttraumatic Stress Disorder Symptoms With Integrative Psychotherapy for Functional Neurological Symptom Disorder.","authors":"Alex Calderbank,&nbsp;Cordelia Gray,&nbsp;Aimee Morgan-Boon,&nbsp;Markus Reuber","doi":"10.1176/appi.neuropsych.21070184","DOIUrl":"10.1176/appi.neuropsych.21070184","url":null,"abstract":"<p><strong>Objective: </strong>Patients with functional neurological symptom disorder (FNSD) report high rates of traumatization and have high levels of posttraumatic stress disorder (PTSD) symptoms. Psychotherapy is a mainstay of treatment for persons with FNSD. In this study, the investigators explored changes in PTSD symptoms and health-related quality of life after psychotherapy among persons with FNSD and examined factors contributing to these changes.</p><p><strong>Methods: </strong>Data were prospectively collected for patients with FNSD attending a specialist outpatient psychotherapy service in the United Kingdom (N=210) as part of an ongoing routine service evaluation. Pre- and posttherapy questionnaires included self-report measures of PTSD symptoms (Posttraumatic Stress Disorder Checklist-Civilian version), depressive symptoms (Patient Health Questionnaire-9), anxiety symptoms (General Anxiety Disorder-7 scale), somatic symptoms (Patient Health Questionnaire-15), health-related quality of life (Short-Form Health Survey-36), and social functioning (Work and Social Adjustment Scale). Independent contributions to psychotherapy-related changes in PTSD symptoms and health-related quality of life were explored through multivariate analyses.</p><p><strong>Results: </strong>All outcome measures revealed improvements after psychotherapy (p<0.001). Psychotherapy-related changes in depression and somatic symptoms and employment status at baseline explained 51% of the variance in PTSD symptom changes. Changes in PTSD symptoms, depressive symptoms, and somatic symptoms made independent contributions to improvements in health-related quality of life (R²=0.54). Improvements were unrelated to FNSD subtype (dissociative seizures or other FNSD), age, marital status, or number of sessions attended.</p><p><strong>Conclusions: </strong>Reductions in self-reported PTSD, depressive, anxiety, and somatic symptoms, as well as improved health-related quality of life, were observed among patients who received one or more sessions of psychotherapy. Randomized controlled trials of psychotherapy for patients with FNSD are warranted.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"398-403"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9392005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative Effect of Head Injuries on Nonmotor Outcomes in Parkinson's Disease.","authors":"Jacob D Jones, Holly Timblin, Fawn Baxter","doi":"10.1176/appi.neuropsych.21100257","DOIUrl":"10.1176/appi.neuropsych.21100257","url":null,"abstract":"<p><strong>Objective: </strong>Parkinson's disease (PD) is a neurodegenerative movement disorder that is a result of dopamine depletion in the basal ganglia. Individuals with a PD diagnosis experience motor symptoms (e.g., tremors) and nonmotor symptoms (e.g., cognitive decline). Previous studies suggest that progression of cognitive dysfunction in other neurologic populations can be predicted by cumulative head injuries. The study examined the association between lifelong number of head injuries and nonmotor outcomes (cognitive complaints, depression, and quality of life).</p><p><strong>Methods: </strong>Participants consisted of 3,483 individuals with PD diagnoses who were enrolled in the Fox Insight study. Participants completed a self-report questionnaire to quantify the number of head injuries experienced throughout life. Participants also completed measures of nonmotor outcomes (cognitive complaints, depression, and quality of life) every 6 months over a 3-year period.</p><p><strong>Results: </strong>Cognitive complaints were more common among those experiencing more head injuries. Further, more severe depression and greater difficulties in quality of life were reported among individuals experiencing a greater number of head injuries. Additional analyses revealed the effect between cognitive complaints and number of head injuries was driven by individuals who experienced five or more head injuries in their lifetime.</p><p><strong>Conclusions: </strong>Among individuals with PD, a patient report of past head injuries may have prognostic implications for important nonmotor outcomes. Report of multiple head injuries may be particularly concerning.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"35 2","pages":"165-170"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9680666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Zarrella et al.","authors":"","doi":"10.1176/appi.neuropsych.21080196correction","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.21080196correction","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"35 3","pages":"315"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9822457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Appreciation.","authors":"","doi":"10.1176/appi.neuropsych.20233503","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20233503","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"35 4","pages":"404"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41236151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing <i>JNCN</i> Editor's Choice: Curated Collections From <i>The Journal of Neuropsychiatry and Clinical Neurosciences</i>.","authors":"David B Arciniegas","doi":"10.1176/appi.neuropsych.20230144","DOIUrl":"10.1176/appi.neuropsych.20230144","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"35 4","pages":"321-322"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41236152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Metaverse, Part 2: Artificial Intelligence Algorithms and Large Language Models in Psychiatry and Clinical Neurosciences.","authors":"Wilfredo López-Ojeda,&nbsp;Robin A Hurley","doi":"10.1176/appi.neuropsych.20230117","DOIUrl":"10.1176/appi.neuropsych.20230117","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"35 4","pages":"316-320"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41236153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Changes in Poststroke Depressive Symptoms: Effects of Functional Disability and Social Support.","authors":"Jae-Chan Ryu,&nbsp;Jong S Kim","doi":"10.1176/appi.neuropsych.20220134","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20220134","url":null,"abstract":"<p><strong>Objective: </strong>Long-term changes in specific depressive symptoms have rarely been studied in stroke patients. Such changes and the effects of social support and functional disability on specific symptoms after a long-term follow-up period (LTP) were investigated.</p><p><strong>Methods: </strong>The Montgomery-Åsberg Depression Rating Scale (MADRS), ENRICHD Social Support Instrument, and modified Rankin Scale (mRS) for functional disability were administered at baseline, a 6-month follow-up, and an LTP (35-83 months). Effects of social support and poor functional outcome (mRS score of 3 to 6) on the 10 single items included on the MADRS were identified.</p><p><strong>Results: </strong>Among 222 patients, mRS score, total MADRS score, and all single-item scores except \"concentration difficulties,\" \"inability to feel,\" and \"suicidal thoughts\" improved at the 6-month follow-up. From the 6-month follow-up to the LTP, the total MADRS score and half of the single-item scores worsened, although the functional outcome measure continued to improve. In multivariable linear regression tests, low social support was associated with \"reduced sleep\" (standardized β=0.20; 95% CI=0.06 to 0.34, p=0.005) and \"pessimistic thoughts\" (standardized β=0.16, 95% CI=0.03 to 0.30, p=0.019), and poor functional outcome was associated with all specific symptoms (standardized β values=0.18-0.43, all p<0.02) except \"reduced sleep.\"</p><p><strong>Conclusions: </strong>Although total MADRS and single-item scores improved in parallel with improvements in functional outcome at the 6-month follow-up, these scores worsened afterward. The lack of social support and presence of functional disability were both associated with total MADRS scores. However, specific symptoms were differentially affected, suggesting that tailored strategies should be applied to manage depression in stroke patients.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"35 3","pages":"244-249"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9787075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posttraumatic Stress Symptoms Among COVID-19 Survivors After Hospitalization.","authors":"Evie Sobczak, Emily P Swafford, Daniel Samano, Danielle Bass, Pardis Ghamasaee, Mohan Kottapally, Amedeo Merenda, Kristine O'Phelan, Jose G Romano, Ralph L Sacco, Tatjana Rundek, Ayham Alkhachroum","doi":"10.1176/appi.neuropsych.20220126","DOIUrl":"10.1176/appi.neuropsych.20220126","url":null,"abstract":"<p><strong>Objective: </strong>Limited data are available on posttraumatic stress symptoms (PTSS) among COVID-19 survivors. This study aimed to contribute to this knowledge base.</p><p><strong>Methods: </strong>PTSS among COVID-19 survivors who had been hospitalized were investigated. Patients were identified as COVID-19 positive at hospital admission. COVID-19 survivors were surveyed with the Posttraumatic Stress Disorder Checklist (PCL-5) between March and October 2020 at 5- and 12-month postdischarge follow-up points.</p><p><strong>Results: </strong>Of 411 patients, 331 (81%) survived to hospital discharge. Of these survivors, 83 (25%) completed the PCL-5 at the 5-month follow-up. Of those patients, 12 (14%) screened positive for PTSS. At the 12-month follow-up, four of eight patients remained PTSS positive. Mean age of follow-up participants was 62±15 years; 47% were women, 65% were White, and 63% were Hispanic. PTSS-positive patients were predominantly non-White (67% vs. 30%, p=0.02), and although the differences were not statistically significant, these patients tended to be younger (56 vs. 63 years, p=0.08) and have shorter intensive care unit stays (2.0 vs. 12.5 days, p=0.06). PTSS-positive and PTSS-negative groups did not differ significantly in prehospitalization neurological diagnoses (11% vs. 8%), psychiatric diagnoses (17% vs. 21%), and intensive care admission status (25% vs. 25%). More patients in the PTSS-positive group had returned to the emergency department (50% vs. 14%, p<0.01) and reported fatigue at follow-up (100% vs. 42%, p<0.001). In the multivariate logistic regression model, non-White race (OR=11, 95% CI=2-91) and returning to the emergency department (OR=19, 95% CI=3-252) were associated with PTSS-positive status.</p><p><strong>Conclusion: </strong>PTSS were twice as common among hospitalized COVID-19 survivors than among those in the general population.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"35 3","pages":"256-261"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9789822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}