World Journal of Psychiatry最新文献

{"title":"Sleep disorders and mental health: Understanding the cognitive connection.","authors":"Eguono Deborah Akpoveta, Uchenna Esther Okpete, Haewon Byeon","doi":"10.5498/wjp.v15.i6.105362","DOIUrl":"10.5498/wjp.v15.i6.105362","url":null,"abstract":"<p><p>Sleep disorders, particularly insomnia, have emerged as a critical public health challenge, with the situation worsened by the coronavirus disease-2019 pandemic. Insomnia symptoms, which affected up to 45% of the population during this period, highlight the urgent need to understand the mechanisms linking sleep disturbances to mental health outcomes. Recent findings suggest that cognitive failures, such as memory lapses and attentional deficits, mediate the relationship between insomnia and emotional disorders such as anxiety and depression. The role of personality traits, particularly neuroticism, adds further complexity, as it may either exacerbate or buffer these effects under specific conditions. This review explores the study by Li <i>et al</i>, which offers valuable insights into the cognitive-emotional pathways influenced by sleep disturbances. The study makes significant contributions by identifying key cognitive mechanisms and proposing the dual role of neuroticism in shaping emotional outcomes. To advance these findings, this letter advocates for future longitudinal research and the integration of targeted interventions, such as cognitive-behavioral therapy for insomnia, into public health frameworks. By addressing insomnia-induced cognitive dysfunction, these strategies can enhance emotional regulation and foster resilience, particularly in vulnerable populations facing the mental health impacts of the pandemic.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 6","pages":"105362"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508588","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":"Targeting muscarinic receptors in schizophrenia treatment: Novel antipsychotic xanomeline/trospium chloride.","authors":"Ana V Pejčić","doi":"10.5498/wjp.v15.i6.105409","DOIUrl":"10.5498/wjp.v15.i6.105409","url":null,"abstract":"<p><p>This minireview explores the role of acetylcholine and muscarinic receptors in the pathophysiology of schizophrenia and summarizes the latest data on xanomeline/trospium chloride, a novel antipsychotic approved by the United States Food and Drug Administration in September 2024. Evidence suggests that cholinergic dysfunction, particularly an imbalance in the expression of the M1 and M4 muscarinic receptors, may contribute to the pathophysiology and symptoms of schizophrenia. Xanomeline/trospium chloride combines xanomeline, an M1 and M4 receptor agonist, with trospium chloride, a non-selective peripheral muscarinic receptor antagonist that reduces peripheral cholinergic side effects. Clinical trials have demonstrated significant reductions in the positive and negative symptoms of schizophrenia, with improvements in Positive and Negative Syndrome Scale scores observed as early as two weeks. A post-hoc analysis of one trial revealed cognitive improvements in patients with baseline cognitive impairment. This medication was generally well-tolerated, with mild-to-moderate gastrointestinal symptoms being the most common adverse events. While these results are promising, further research is needed to better understand its effectiveness and safety in real-world clinical practice, and to define its optimal role in managing this complex psychiatric disorder.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 6","pages":"105409"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508601","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":"Cerebral hemodynamic characteristics of patients with auditory verbal hallucinations and the construction of nomogram models.","authors":"Zi-Yao Cai, Ce Chen, Zi-Ye Huang, Xin-Wu Ye, Xiao-Zhuang Jin, Hao-Ran Chen, Jian-Min Sha","doi":"10.5498/wjp.v15.i6.106775","DOIUrl":"10.5498/wjp.v15.i6.106775","url":null,"abstract":"<p><strong>Background: </strong>The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations (AVHs) was not clear.</p><p><strong>Aim: </strong>To explore the characteristics of cerebral hemodynamic indexes of patients with different types of AVHs and construct the risk nomogram prediction model of patients with different types of AVHs.</p><p><strong>Methods: </strong>Patients with different types of verbal hallucinations who visited Wenzhou Seventh People's Hospital were retrospectively selected from March 2021 to March 2023, and these patients were classified into 117 cases of schizophrenia (SCZ) with AVHs, 108 cases of post-traumatic stress disorder (PTSD) with AVHs, and 105 cases of recurrent depressive disorder with AVHs according to type. Transcranial doppler was performed to measure the hemodynamic parameters of the anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), basilar artery (BA) and vertebral artery (VA). Logistic regression modelling was used to explore the factors affecting patients with different types of AVHs and odds ratio, 95% confidence interval (CI). A clinical prediction model was constructed, and the efficacy of the clinical prediction model was evaluated by using receiver operating characteristic, Hosmer-Lemeshow Goodness-of-Fit test, calibration curves and decision curve analysis.</p><p><strong>Results: </strong>The differences between the three groups of patients in mean velocity (Vm)-MCA, end-diastolic velocity (Vd)-MCA, Vm-ACA, pulsatility index (PI)-ACA, Vm-PCA, peak systolic velocity (Vs)-PCA, Vd-PCA, Vm-BA, Vs-BA, Vd-BA, PI-BA, resistance index (RI)-BA, Vm-VA, Vs-VA, Vd-VA, PI-VA, and RI-VA indexes were statistically significant. Rising Vm-ACA is an independent risk factor for SCZ with AVHs, and falling Vm-VA, Vd-MCA, and Vd-VA are independent risk factors for SCZ with AVHs. Rising Vm-ACA, Vm-PCA, Vs-PCA, Vd-PCA, Vm-BA, and Vs-BA are independent risk factors for PTSD with AVHs, and Vm-MCA, Vs-MCA, Vd-MCA, PI-PCA, and RI-BA are independent protective factors for PTSD with AVHs. Elevated Vm-MCA, Vd-MCA, RI-BA, Vm-VA, and Vd-VA were independent risk factors, and elevated Vm-ACA, Vs-ACA, Vm-PCA, Vs-PCA, and Vd-PCA were independent protective factors. The areas under the curve of the three models were 0.82 (95%CI: 0.76-0.87), 0.88 (95%CI: 0.83-0.92), and 0.81 (95%CI: 0.77-0.86), respectively; the Hosmer-Lemeshow Goodness-of-Fit test of the calibration curves of the three models suggests that <i>P</i> > 0.05.</p><p><strong>Conclusion: </strong>Monitoring the cerebral hemodynamic indexes of patients with AVHs is of practical significance in determining the type of mental disorder, which helps clinicians identify the type of AVHs and adopt more efficient treatment strategies to help patients recover.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 6","pages":"106775"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508648","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":"Central obesity and post-stroke depression: Implications for stroke recovery.","authors":"Eguono Deborah Akpoveta, Uchenna Esther Okpete, Haewon Byeon","doi":"10.5498/wjp.v15.i6.107795","DOIUrl":"10.5498/wjp.v15.i6.107795","url":null,"abstract":"<p><p>Post-stroke depression (PSD) is a prevalent but often underdiagnosed complication affecting stroke survivors, with significant implications for recovery and quality of life. Emerging evidence suggests that central obesity, as measured by the weight-to-waist index (WWI), may play a crucial role in PSD risk and severity. Traditional obesity metrics, such as body mass index, may not accurately capture the impact of visceral fat distribution on neuropsychiatric outcomes. This letter highlights the growing recognition of WWI as a precise indicator of metabolic and inflammatory disturbances linked to post-stroke mental health. Integrating WWI into routine stroke rehabilitation assessments could facilitate early identification of high-risk patients and improve intervention strategies. Further research is needed to establish standardized WWI cutoff values and explore potential therapeutic targets for PSD prevention.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 6","pages":"107795"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508647","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":"Clinical manifestations of anxiety and depression in sepsis-associated encephalopathy and multi-omics identification of cluster of differentiation 38 as an early biomarker.","authors":"Chun-Rong Wu, Hang-Li Zhu, Yu-Ting Sun, Shi-Hui Shen, Pei-Lin Shi, Yu-Hui Cui, Jian-Guo Tang, Chun-Hui Yang, Shang-Yuan Wang, Xiao-Li Ge, Shu-Ming Pan","doi":"10.5498/wjp.v15.i6.105889","DOIUrl":"10.5498/wjp.v15.i6.105889","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-associated encephalopathy (SAE) is a common complication of sepsis, characterized by cognitive impairment, altered consciousness, and psychiatric symptoms, including anxiety and depression. These psychiatric symptoms often exacerbate the overall prognosis and quality of life of affected patients. However, the underlying metabolic and proteomic features associated with SAE-induced psychiatric symptoms remain poorly understood.</p><p><strong>Aim: </strong>To investigate the clinical manifestations of anxiety and depression in patients with sepsis and SAE and to explore their associated metabolic and proteomic characteristics.</p><p><strong>Methods: </strong>A total of 88 patients were enrolled, comprising 30 healthy controls, 29 patients with sepsis, and 29 with SAE. Anxiety and depression symptoms were evaluated using the Hamilton anxiety rating scale (HAM-A) and Hamilton depression rating scale (HAM-D) in sepsis and SAE. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and quality of life was measured using the 36-Item Short Form Health Survey. Plasma samples were analyzed for metabolomic and proteomic profiling. Metabolic alterations were identified through liquid chromatography-mass spectrometry, while protein expression was assessed using Olink targeted proteomics.</p><p><strong>Results: </strong>Compared to the sepsis group, patients with SAE exhibited significantly higher levels of anxiety (HAM-A: 15.2 ± 4.0 <i>vs</i> 10.4 ± 3.0, <i>P</i> = 0.012) and depression (HAM-D: 16.0 ± 3.5 <i>vs</i> 9.1 ± 2.3, <i>P</i> = 0.003). Cognitive function, as measured by MoCA, was notably impaired in the SAE group (MoCA: 18.5 ± 4.0 <i>vs</i> 24.5 ± 3.2, <i>P</i> = 0.007). Quality of life scores, particularly in physical functioning, emotional well-being, and mental health, were significantly lower in patients with SAE. Metabolomic and proteomic analyses revealed substantial alterations in oxidative stress and nicotinamide adenine dinucleotide (NAD⁺) metabolism pathways, with cluster of differentiation (CD) 38 emerging as a potential biomarker associated with psychiatric symptoms in SAE. Further validation in an independent cohort confirmed the diagnostic relevance of CD38.</p><p><strong>Conclusion: </strong>This study highlights the significant psychological burden of SAE, manifested as anxiety and depression. Multi-omics analysis identified distinct metabolic alterations, particularly in NAD⁺ metabolism, that may contribute to psychiatric symptom development and progression. Furthermore, CD38 was identified as a promising biomarker for the early detection of SAE, providing potential avenues for early intervention and therapeutic targeting.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 6","pages":"105889"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508649","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":"Prevalence and risk factors of depressive and anxiety symptoms and functional constipation among university students in Eastern China.","authors":"Bo-Chen Jiang, Jing Zhang, Man Yang, Hai-Dong Yang, Xiao-Bin Zhang","doi":"10.5498/wjp.v15.i6.106451","DOIUrl":"10.5498/wjp.v15.i6.106451","url":null,"abstract":"<p><strong>Background: </strong>Depression and anxiety are prevalent among university students worldwide, often coexisting with functional constipation (FC). Family relationships have been identified as crucial factors affecting mental health, yet the gender-specific associations between these conditions remain underexplored.</p><p><strong>Aim: </strong>To assess prevalence of depressive symptoms, anxiety symptoms, and FC among Chinese university students and explore their associations.</p><p><strong>Methods: </strong>Using a cross-sectional survey design, data were collected from 12721 students at two universities in Jiangsu Province and Shandong Province. Depressive symptoms were assessed using the Patient Health Questionnaire-9, anxiety symptoms using the Generalized Anxiety Disorder-7 scale, and FC using the ROME IV. Gender-stratified analyses and population attributable risk proportions were calculated to evaluate risk factor patterns and population impact.</p><p><strong>Results: </strong>The prevalence of self-reported depressive, anxiety, and comorbid depressive and anxiety symptoms was 16.3%, 24.9%, and 13.3%, respectively, whereas that of FC was 22%. Students with depressive symptoms were 1.811 times more likely to have FC than those without. Female gender, parental relationships, and lower household income were significant risk factors for both mental health conditions. For depressive symptoms, females experienced stronger effects from both parental conflict [odds ratio (OR) = 8.006 <i>vs</i> OR = 7.661 in males] and FC (OR = 1.954 <i>vs</i> OR = 1.628 in males). For anxiety symptoms, conflicted parental relationships had stronger effects in males (OR = 5.946) than females (OR = 4.262). Overall, poor parental relationships contributed to 38.6% of depressive and 33.5% of anxiety symptoms.</p><p><strong>Conclusion: </strong>Family relationships significantly impact student mental health, with gender-specific patterns. Targeted interventions addressing family dynamics could reduce mental health burden in university settings.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 6","pages":"106451"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508582","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":"Status of anxiety and depression among chronic heart failure patients: Factors influencing poor fluid restriction adherence.","authors":"Yun-Tao Luo, Ai-Zhi Ou, Di-Sha Lin, Hong Li, Fang Zhou, Yue-Mei Liu, Xin-Ping Ye, Xu Deng","doi":"10.5498/wjp.v15.i6.103765","DOIUrl":"10.5498/wjp.v15.i6.103765","url":null,"abstract":"<p><strong>Background: </strong>Anxiety and depression are prevalent among patients with chronic heart failure (CHF) and can adversely contribute to treatment adherence and clinical outcomes. Poor fluid restriction adherence is a widespread challenge in the management of CHF. To effectively manage disease progression and alleviate symptoms, it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.</p><p><strong>Aim: </strong>To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.</p><p><strong>Methods: </strong>Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study. Questionnaires, including the Psychosomatic Symptom Scale, Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Fluid Restriction Adherence Questionnaire were administered to patients. Based on their anxiety and depression scores, patients were categorized into anxiety/depression and non-anxiety/depression groups, as well as fluid restriction adherence and fluid restriction non-adherence groups. General patient data were collected, and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety. Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.</p><p><strong>Results: </strong>Statistically significant differences in age, New York Heart Association (NYHA) grading, marital status, educational attainment, and family support were observed between depressed and non-depressed CHF patients (<i>P</i> < 0.05). Age, NYHA grading, marital status, educational attainment, and family support were identified as factors influencing the development of depression. The anxiety and non-anxiety groups differed statistically in terms of gender, age, NYHA grading, smoking history, alcohol consumption history, monthly income, educational attainment, and family support (<i>P</i> < 0.05). Gender, smoking, alcohol consumption, monthly income, and educational attainment affected anxiety in these patients. The fluid restriction adherence rate was 28.0%, and thirst sensation, anxiety, and depression were identified as independent influencing factors.</p><p><strong>Conclusion: </strong>CHF patients are susceptible to anxiety and depression, with multiple associated influencing factors. Moreover, anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 6","pages":"103765"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508600","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":"Efficacy of electroconvulsive therapy in treating auditory verbal hallucinations in a deaf patient with schizophrenia: A case report.","authors":"Juan Wang, Juan Li, Yan-Ge Wei, Xin-Xin Lu, Zhao-Hui Zhang","doi":"10.5498/wjp.v15.i6.105934","DOIUrl":"10.5498/wjp.v15.i6.105934","url":null,"abstract":"<p><strong>Background: </strong>Auditory verbal hallucinations (AVHs) are believed to be characteristic symptoms of schizophrenia. The prevalence of AVHs in deaf patients with schizophrenia is comparable to that in patients with schizophrenia who have normal hearing ability. AVHs in deaf patients with schizophrenia require treatment.</p><p><strong>Case summary: </strong>A 22-year-old deaf woman with schizophrenia had experienced AVHs for 3 months. Her psychotic symptoms were not alleviated by antipsychotic medication alone. Modified electroconvulsive therapy in combination with antipsychotic drugs effectively alleviated her AVHs and disorganized behavior. During outpatient follow-up for 6 months, her condition have remained stable, and she has been able to take care of herself.</p><p><strong>Conclusion: </strong>Treatment with modified electroconvulsive therapy was found to be safe and might be indicated for deaf patients whose symptoms are not well managed with antipsychotic medication alone. Deaf people might be unable to communicate through spoken language; therefore, to make proper diagnoses and provide appropriate treatment for these patients, psychiatrists must have patience and seek to understand patients' mental state.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 6","pages":"105934"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508562","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":"Literary case study of psychosis: <i>The Vegetarian</i>.","authors":"Gabor S Ungvari, Stanley N Caroff, Levente Csihi, Gábor Gazdag","doi":"10.5498/wjp.v15.i6.104247","DOIUrl":"10.5498/wjp.v15.i6.104247","url":null,"abstract":"<p><p>In the award-winning and widely-acclaimed fictional novel, <i>The Vegetarian</i>, the author, Han Kang, relates a compelling and dramatic story of inexorable psychotic deterioration from the perspective of a tragically affected young woman and her close family members. Apart from a variety of interpretations of psychosis from historical, social, psychological, and feminist perspectives, the book also presents a detailed and realistic picture of objective psychotic symptoms that reveals insights into historic and nearly forgotten phenomenological concepts. In this literary case study, we analyze the symptoms remarkably described by the author and briefly review the medical literature on the phenomena of catatonia, schizophrenic autism, paragnomen and the praecox-feeling.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 6","pages":"104247"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508568","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":"Psychiatric symptoms in stroke patients: Clinical features of depression and anxiety.","authors":"Jie-Min Li, Su-Sheng Long, Teng-Xiang Lu, Yi-Chun Jiang, Xiao-Wei Zhang, You-Quan Ren","doi":"10.5498/wjp.v15.i6.103888","DOIUrl":"10.5498/wjp.v15.i6.103888","url":null,"abstract":"<p><strong>Background: </strong>Post-stroke psychiatric complications, particularly depression and anxiety, significantly impact rehabilitation outcomes and quality of life. Despite their prevalence and clinical significance, these conditions often remain underrecognized in routine stroke care. Understanding their clinical features and temporal patterns is crucial for improving patient outcomes.</p><p><strong>Aim: </strong>To investigate the prevalence, temporal evolution, and clinical correlates of depression and anxiety post-stroke and their impact on functional recovery.</p><p><strong>Methods: </strong>In this prospective observational study, 127 patients first-ever ischemic stroke were enrolled between June 2022 and June 2024. Depression and anxiety were assessed using the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale at baseline and follow-up intervals (2 weeks, 1 month, 3 months, and 6 months). Stroke severity was evaluated using the National Institutes of Health Stroke Scale, and functional outcomes were measured using the modified Rankin Scale.</p><p><strong>Results: </strong>Among 120 patients who completed follow-up (94.5% completion rate), 37.5% had depression (mild: 18.3%, moderate: 12.5%, severe: 6.7%) and 41.7% had anxiety at baseline. Depression prevalence showed a biphasic pattern, peaking at 2 weeks (37.5%), declining at 3 months (28.3%), and slightly increasing at 6 months (30.8%). Stroke severity significantly correlated with both depression (odds ratio = 1.18, 95%CI: 1.06-1.31, <i>P</i> = 0.003) and anxiety (odds ratio = 1.15, 95%CI: 1.04-1.27, <i>P</i> = 0.008). Left hemisphere lesions had a stronger association with psychiatric symptoms than right hemisphere lesions (<i>P</i> = 0.035). Patients with psychiatric complications demonstrated poorer functional outcomes at 6 months (median modified Rankin Scale 3 <i>vs</i> 2, <i>P</i> = 0.015) and longer hospital stays (mean difference: 3.2 days, <i>P</i> = 0.002).</p><p><strong>Conclusion: </strong>Identifying the clinical and neuroanatomical correlates of depression and anxiety will enable effective risk stratification and patient management. Integrating routine psychiatric screening and early intervention is essential in stroke care.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 6","pages":"103888"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508583","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}