The lancet. Psychiatry最新文献

{"title":"Using The Wire in medical education.","authors":"Kwame Nuako, Akeem Sule","doi":"10.1016/S2215-0366(22)00334-0","DOIUrl":"https://doi.org/10.1016/S2215-0366(22)00334-0","url":null,"abstract":"","PeriodicalId":240194,"journal":{"name":"The lancet. Psychiatry","volume":" ","pages":"858-859"},"PeriodicalIF":64.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33512902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal infection during pregnancy and likelihood of autism and intellectual disability in children in Sweden: a negative control and sibling comparison cohort study.","authors":"Martin Brynge, Hugo Sjöqvist, Renee M Gardner, Brian K Lee, Christina Dalman, Håkan Karlsson","doi":"10.1016/S2215-0366(22)00264-4","DOIUrl":"https://doi.org/10.1016/S2215-0366(22)00264-4","url":null,"abstract":"<p><strong>Background: </strong>Maternal infections during pregnancy are associated with intellectual disability and autism in exposed children. Whether these associations are causal, and therefore should be targets of preventive strategies, remains unknown. We aimed to investigate these associations, to determine whether there is a causal role of maternal infection during pregnancy for children's risk of autism and intellectual disability, by accounting for unmeasured familial factors.</p><p><strong>Methods: </strong>We used a register-based cohort study design, and included children living in Stockholm County, Sweden, who were born in 1987-2010. We excluded children not born in Sweden, adopted children, and children with unknown biological mothers or fathers. Maternal infections during pregnancy, defined by ICD-8, ICD-9, and ICD-10 codes, were identified in the National Patient Register and Medical Birth Register. Children were followed up from birth to an outcome or a censoring event (death, migration from Stockholm, age 18 years, or Dec 31, 2016, whichever occurred first). The primary outcomes were diagnosis of autism or diagnosis of intellectual disability. We did a survival analysis to examine the association between inpatient and outpatient specialised care for any infection during pregnancy and likelihood of autism or intellectual disability in the child. To address potential residual confounding, we also estimated the relationship between maternal infection in the year preceding pregnancy as a negative control exposure and conducted a matched sibling analysis of sibling pairs who were discordant for autism or intellectual disability.</p><p><strong>Findings: </strong>647 947 children living in Stockholm County were identified and, after excluding 97 980 children, we included 549 967 in the study (267 995 [48·7%] were female and 281 972 [51·3%] were male; mean age at censoring 13·5 years [SD 5·0; range <1 to 18]; 142 597 [25·9%] had a mother who was not born in Sweden). 445 (1·3%) of 34 013 children exposed to maternal infection during pregnancy were diagnosed with intellectual disability and 1123 (3·3%) with autism. 5087 (1·0%) of 515 954 unexposed children were diagnosed with intellectual disability and 13 035 (2·5%) with autism. Maternal infection during pregnancy was associated with autism (hazard ratio [HR] 1·16, 95% CI 1·09-1·23) and intellectual disability (1·37, 1·23-1·51) in exposed children compared with unexposed children. Maternal infection in the year before pregnancy (negative control exposure) was also associated with autism (HR 1·25, 95% CI 1·14-1·36), but was not associated with intellectual disability (1·09, 0·94-1·27). In sibling comparisons, the associations with maternal infection during pregnancy were attenuated for autism (HR 0·94, 95% CI 0·82-1·08; n=21 864), but not to the same extent for intellectual disability (1·15, 0·95-1·40; n=9275).</p><p><strong>Interpretation: </strong>Although infections in pregnant women ","PeriodicalId":240194,"journal":{"name":"The lancet. Psychiatry","volume":" ","pages":"782-791"},"PeriodicalIF":64.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33457742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low use of the Management and Treatment Services for Psychosis in China.","authors":"Wei Zhou, Shuiyuan Xiao","doi":"10.1016/S2215-0366(22)00303-0","DOIUrl":"https://doi.org/10.1016/S2215-0366(22)00303-0","url":null,"abstract":"","PeriodicalId":240194,"journal":{"name":"The lancet. Psychiatry","volume":" ","pages":"763-764"},"PeriodicalIF":64.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40365842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney function in patients with bipolar disorder with and without lithium treatment compared with the general population in northern Sweden: results from the LiSIE and MONICA cohorts.","authors":"Filip Fransson, Ursula Werneke, Vesa Harju, Louise Öhlund, Julia de Man Lapidoth, P Andreas Jonsson, Bernd Stegmayr, Elinor Salander Renberg, Michael Ott","doi":"10.1016/S2215-0366(22)00265-6","DOIUrl":"https://doi.org/10.1016/S2215-0366(22)00265-6","url":null,"abstract":"<p><strong>Background: </strong>The clinical relevance of lithium nephropathy is subject to debate. Kidney function decreases with age and comorbidities, and this decline might lead to attribution bias when erroneously ascribed to lithium. We aimed to investigate whether patients with bipolar or schizoaffective disorder had faster decline in estimated glomerular filtration rate (eGFR) compared with the general population, whether observed differences in the steepness of the decline were attributable to lithium, and whether such changes depended on the length of lithium exposure.</p><p><strong>Methods: </strong>In this cross-sectional cohort study, we used clinical data from the Lithium-Study into Effects and Side-effects (LiSIE) retrospective cohort study, which included patients with bipolar disorder or schizoaffective disorder whose medical records were reviewed up to Dec 31, 2017, and the WHO Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study, covering a representative sample of the general population in northern Sweden aged 25-74 years. The primary outcome was the age-associated decline of creatinine-based eGFR, assessed using linear regression. We adjusted for sex and grouped for different lengths of lithium exposure (never or <1 year, 1-5 years, >5-10 years, and >10 years). For patients with moderate-to-severe kidney disease we identified the underlying nephropathy in the case records.</p><p><strong>Findings: </strong>From LiSIE, we included 785 patients (498 [63%] female and 287 [37%] male), with a mean age of 49·8 years (SD 13·2; range 25-74). From MONICA, we included 1549 individuals (800 [52%] female and 749 [48%] male), with a mean age of 51·9 years (13·8; 25-74). No ethnicity data were collected. Adjusted for duration of lithium exposure, eGFR declined by 0·57 mL/min/1·73 m<sup>2</sup>/year (95% CI 0·50-0·63) in patients with bipolar disorder or schizoaffective disorder and by 0·57 mL/min/1·73 m<sup>2</sup>/year (0·53-0·61) in the reference population. Lithium added 0·54 mL/min/1·73 m<sup>2</sup> (0·43-0·64) per year of treatment (p<0·0001). After more than 10 years on lithium, decline was significantly steeper than in all other groups including the reference population (p<0·0001). Lithium nephropathy was judged to be the commonest cause of moderate-to-severe chronic kidney disease, but comorbidities played a role. The effect of lithium on eGFR showed a high degree of inter-individual variation.</p><p><strong>Interpretation: </strong>Steeper eGFR decline in patients with bipolar disorder or schizoaffective disorder can be attributed to lithium, but the trajectory of kidney function decline varies widely. Comorbidities affecting kidneys should be treated assertively as one possible means to affect the trajectory. In patients with a fast trajectory, a trade-off is required between continuing lithium to treat mental health problems and discontinuing lithium for the sake of renal health.</p><p><strong>Funding: ","PeriodicalId":240194,"journal":{"name":"The lancet. Psychiatry","volume":" ","pages":"804-814"},"PeriodicalIF":64.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40360887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All-cause and cause-specific mortality among people with severe mental illness in Brazil's public health system, 2000-15: a retrospective study.","authors":"Ana Paula Souto Melo, Ilse N Dippenaar, Sarah Charlotte Johnson, Nicole Davis Weaver, Francisco de Assis Acurcio, Deborah Carvalho Malta, Antônio Luiz P Ribeiro, Augusto Afonso Guerra Júnior, Eve E Wool, Mohsen Naghavi, Mariangela Leal Cherchiglia","doi":"10.1016/S2215-0366(22)00237-1","DOIUrl":"https://doi.org/10.1016/S2215-0366(22)00237-1","url":null,"abstract":"<p><strong>Background: </strong>People with severe mental illness have a mortality rate higher than the general population, living an average of 10-20 years less. Most studies of mortality among people with severe mental illness have occurred in high-income countries (HICs). We aimed to estimate all-cause and cause-specific relative risk (RR) and excess mortality rate (EMR) in a nationwide cohort of inpatients with severe mental illness compared with inpatients without severe mental illness in a middle income country, Brazil.</p><p><strong>Methods: </strong>This national retrospective cohort study included all patients hospitalised through the Brazilian Public Health System (Sistema Único de Saúde [SUS]-Brazil) between Jan 1, 2000, and April 21, 2015. Probabilistic and deterministic record linkages integrated data from the Hospital Information System (Sistema de informações Hospitalares) and the National Mortality System (Sistema de Informação sobre Mortalidade). Follow-up duration was measured from the date of the patients' first hospitalisation until their death, or until April 21, 2015. Severe mental illness was defined as schizophrenia, bipolar disorder, or depressive disorder by ICD-10 codes used for the admission. RR and EMR were calculated with 95% CIs, comparing mortality among patients with severe mental illness with those with other diagnoses for patients aged 15 years and older. We redistributed deaths using the Global Burden of Diseases, Injuries, and Risk Factors Study methodology if ill-defined causes of death were stated as an underlying cause.</p><p><strong>Findings: </strong>From Jan 1, 2000, to April 21, 2015, 72 021 918 patients (31 510 035 [43·8%] recorded as male and 40 974 426 [56·9%] recorded as female; mean age 41·1 (SD 23·8) years) were admitted to hospital, with 749 720 patients (372 458 [49·7%] recorded as male and 378 670 [50·5%] as female) with severe mental illness. 5 102 055 patient deaths (2 862 383 [56·1%] recorded as male and 2 314 781 [45·4%] as female) and 67 485 deaths in patients with severe mental illness (39 099 [57·9%] recorded as male and 28 534 [42·3%] as female) were registered. The RR for all-cause mortality in patients with severe mental illness was 1·27 (95% CI 1·27-1·28) and the EMR was 2·52 (2·44-2·61) compared with non-psychiatric inpatients during the follow-up period. The all-cause RR was higher for females and for younger age groups; however, EMR was higher in those aged 30-59 years. The RR and EMR varied across the leading causes of death, sex, and age groups. We identified injuries (suicide, interpersonal violence, and road injuries) and cardiovascular disease (ischaemic heart disease) as having the highest EMR among those with severe mental illness. Data on ethnicity were not available.</p><p><strong>Interpretation: </strong>In contrast to studies from HICs, inpatients with severe mental illness in Brazil had high RR for idiopathic epilepsy, tuberculosis, HIV, and acute hepatitis, and no sig","PeriodicalId":240194,"journal":{"name":"The lancet. Psychiatry","volume":" ","pages":"771-781"},"PeriodicalIF":64.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9477749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40707232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More than a little sound.","authors":"Michelle Izmaylov","doi":"10.1016/S2215-0366(22)00306-6","DOIUrl":"https://doi.org/10.1016/S2215-0366(22)00306-6","url":null,"abstract":"","PeriodicalId":240194,"journal":{"name":"The lancet. Psychiatry","volume":" ","pages":"769-770"},"PeriodicalIF":64.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40365847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The way forward against intimate partner violence in the Philippines.","authors":"Lea Elora A Conda, Gianica Reena S Monteagudo, Bradley Ashley G Ong, Aubrey Melody R Rocimo","doi":"10.1016/S2215-0366(22)00274-7","DOIUrl":"https://doi.org/10.1016/S2215-0366(22)00274-7","url":null,"abstract":"","PeriodicalId":240194,"journal":{"name":"The lancet. Psychiatry","volume":" ","pages":"e45"},"PeriodicalIF":64.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40365848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide prevention in Syria.","authors":"Sarya Swed, Mohammed Amir Rais, Ahmed Aljabali, Abdelmonem Siddiq, Mohamed Elsayed, Sheikh Shoib","doi":"10.1016/S2215-0366(22)00299-1","DOIUrl":"https://doi.org/10.1016/S2215-0366(22)00299-1","url":null,"abstract":"","PeriodicalId":240194,"journal":{"name":"The lancet. Psychiatry","volume":" ","pages":"e47"},"PeriodicalIF":64.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40365850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social thinning and stress generation after childhood maltreatment: a neurocognitive social transactional model of psychiatric vulnerability.","authors":"Eamon McCrory,&nbsp;Lucy Foulkes,&nbsp;Essi Viding","doi":"10.1016/S2215-0366(22)00202-4","DOIUrl":"https://doi.org/10.1016/S2215-0366(22)00202-4","url":null,"abstract":"<p><p>Childhood maltreatment is associated with significant, enduring risk of psychiatric disorder. In this paper, we review how neurocognitive alterations after maltreatment might indirectly increase the risk of psychiatric disorder via their impact on social functioning. We propose a neurocognitive social transactional model, within which the neurocognitive sequelae of maltreatment are postulated to affect how an individual's social architecture is constructed across development, including the quality and quantity of relationships in an individual's social network. We review extant evidence in two areas in relation to maltreatment: stress generation (a process by which individuals are more likely to experience interpersonal stressor events) and social thinning (an attenuation in the number and quality of relationships over time). We consider how neurocognitive alterations could contribute to these interactive and autocatalytic social processes, which gradually impoverish an individual's actual or potential social environment and ultimately increase psychiatric risk. We conclude by considering the implications of this neurocognitive social transactional model for the prevention of psychiatric disorder after childhood maltreatment.</p>","PeriodicalId":240194,"journal":{"name":"The lancet. Psychiatry","volume":" ","pages":"828-837"},"PeriodicalIF":64.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40669803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The meaning in grandiose delusions: measure development and cohort studies in clinical psychosis and non-clinical general population groups in the UK and Ireland.","authors":"Louise Isham,&nbsp;Bao Sheng Loe,&nbsp;Alice Hicks,&nbsp;Natalie Wilson,&nbsp;Jessica C Bird,&nbsp;Richard P Bentall,&nbsp;Daniel Freeman","doi":"10.1016/S2215-0366(22)00236-X","DOIUrl":"https://doi.org/10.1016/S2215-0366(22)00236-X","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The content of grandiose delusions-inaccurate beliefs that one has special powers, wealth, mission, or identity-is likely to be highly meaningful. The meaning, for example providing a sense of purpose, could prove to be a key factor in the delusion taking hold. We aimed to empirically define and develop measures of the experience of meaning in grandiose delusions and the sources of this meaning, and to test whether severity of grandiosity in clinical and non-clinical populations is associated with level of meaning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We did a cross-sectional self-report questionnaire study in two cohorts: non-clinical participants aged 18 years and older, with UK or Irish nationality or residence; and patients with affective or non-affective psychosis diagnoses, aged 16 years and older, and accessing secondary care mental health services in 39 National Health Service providers in England and Wales. Participants with high grandiosity completed two large item pools: one assessing the experience of meaning in grandiose delusions (Grandiosity Meaning Measure [termed gram]) and one assessing the sources of meaning (Grandiosity Meaning Measure-Sources [termed grams]). The Grandiosity Meaning Measure and Grandiosity Meaning Measure-Sources were developed using exploratory factor analysis and confirmatory factor analysis. Structural equation modelling was used to test the associations of meaning with the severity of grandiosity. The primary outcome measure for grandiosity was the Specific Psychotic Experiences Questionnaire (grandiosity subscale) and associations were tested with the Grandiosity Meaning Measure and the Grandiosity Meaning Measure-Sources.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;From Aug 30, 2019, to Nov 21, 2020, 13 323 non-clinical participants were enrolled. 2821 (21%) were men and 10 134 (76%) were women, 11 974 (90%) were White, and the mean age was 39·5 years (SD 18·6 [range 18-93]). From March 22, 2021, to March 3, 2022, 798 patients with psychosis were enrolled. 475 (60%) were men and 313 (39%) were women, 614 (77%) were White, and the mean age was 43·4 years (SD 13·8 [range 16-81]). The experience of meaning in relation to grandiose delusions had three components: coherence, purpose, and significance. The sources of meaning had seven components: positive social perceptions, spirituality, overcoming adversity, confidence in self among others, greater good, supporting loved ones, and happiness. The measurement of meaning was invariant across clinical and non-clinical populations. In the clinical population, each person typically endorsed multiple meanings and sources of meaning for the grandiose delusion. Meaning in grandiose delusions was strongly associated with severity of grandiosity, explaining 53·5% of variance, and with grandiose delusion conviction explaining 27·4% of variance. Grandiosity was especially associated with sense of purpose, and grandiose delusion conviction with coherence.","PeriodicalId":240194,"journal":{"name":"The lancet. Psychiatry","volume":" ","pages":"792-803"},"PeriodicalIF":64.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40335039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}