International Journal of Psychiatry in Medicine最新文献

{"title":"Association Between Serum Uric Acid/Creatinine Ratio and Depressive Symptoms in Middle-Aged and Older Adults: Evidence from Two Large Population-based Studies in China and the United States.","authors":"Jiang-Yu Tu, Meng-Qin Tu","doi":"10.1177/00912174251384015","DOIUrl":"10.1177/00912174251384015","url":null,"abstract":"<p><p>ObjectiveEmerging evidence suggests that serum uric acid (SUA) can modulate depressive symptoms, potentially via mechanisms involving oxidative stress. However, whether the serum uric acid/creatinine ratio (SUA/Cr)-a biomarker reflecting net uric acid production-is linked to depressive symptoms in middle-to-late life populations remains unknown.MethodsLongitudinal and cross-sectional analyses were conducted utilizing nationally representative samples from two countries: the China Health and Retirement Longitudinal Study (CHARLS) involving longitudinal assessment and the U.S. National Health and Nutrition Examination Survey (NHANES) for cross-sectional evaluation. Multivariable Cox and logistic regression analyses were employed to examine the relationship between the SUA/Cr and depressive symptoms. Dose-response relationships were modeled using restricted cubic splines (RCS), while sensitivity analyses assessed the stability of results. ResultsFrom CHARLS (N = 4317), multivariable Cox regression revealed an inverse relationship between SUA/Cr and depressive symptoms (P-linearity<0.05), with each 1-unit increase linked to a 3% lower risk (HR = 0.97, 95% CI = 0.94-0.99). Q4 showed reduced risk vs Q1 (HR = 0.87, 95% CI = 0.77-0.97). NHANES analysis of cross-sectional data (N = 18,677) confirmed this inverse association (P- linearity<0.05), with a 6% lower odds of significant depression per 1-unit SUA/Cr increase (OR = 0.94, 95% CI = 0.87-1.03). Q3 and Q4 had significantly lower odds vs Q1 (OR = 0.78, 95% CI = 0.64-0.95, and OR = 0.79, 95% CI = 0.65-0.98, respectively). RCS curves confirmed dose-response relationships in both cohorts. Findings remained consistent in sensitivity analyses.ConclusionDepressive symptoms in middle-to-late adulthood were found to be negatively correlated with SUA/Cr levels in longitudinal and cross-sectional analyses. These findings suggest that SUA/Cr levels may function as a biological indicator to facilitate early detection and proactive intervention for depressive disorders.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"164-183"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193808","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":"Rapid-Onset SIADH Triggered by Combined Duloxetine and Levodopa Use in an Older Adult With Depression and Parkinsonism: A Previously Unreported Interaction.","authors":"Yavuz Sultan Selim Akgül, Burcu Eren Cengiz, Sibel Akın","doi":"10.1177/00912174251374152","DOIUrl":"10.1177/00912174251374152","url":null,"abstract":"<p><p>ObjectiveThe syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a potentially life-threatening electrolyte disturbance commonly encountered in older adults, particularly in association with serotonergic and dopaminergic medications. Both duloxetine and levodopa have been individually implicated in the development of SIADH, although the mechanism often remains unclear.MethodsSingle case presentation and review.ResultsA 73-year-old woman with newly diagnosed depression and parkinsonism was initiated on duloxetine (30 mg/day) and levodopa/benserazide (tradename Madopar) (100/25 mg, 3 times daily). Within 24 h, she developed fatigue, nausea, confusion, and dizziness. Laboratory evaluation revealed severe hyponatremia (serum sodium: 115 mmol/L), low serum osmolality (230 mOsm/kg), high urine osmolality (310 mOsm/kg), and urinary sodium of 43 mmol/L, with a clinically euvolemic status. Thyroid and adrenal function test were normal. Both medications were discontinued. Fluid restriction and hypertonic saline infusion led to normalization of sodium levels over 72 h, with complete clinical recovery.ConclusionThis case highlights an unusually rapid onset of SIADH after combined initiation of duloxetine and levodopa/benserazide. The temporal proximity of symptom onset suggests a possible synergistic interaction. Clinicians should maintain vigilance for acute hyponatremia in older adults shortly after introducing serotonergic and dopaminergic agents.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"249-256"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977249","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":"Religious Involvement and Human Flourishing: A Review.","authors":"Harold G Koenig","doi":"10.1177/00912174251396207","DOIUrl":"10.1177/00912174251396207","url":null,"abstract":"<p><p>ObjectiveHuman flourishing (HF) has received increasing attention in the academic literature as a common goal towards which all strive. Many individuals are involved in a religious community and practice other forms of religious involvement, which they believe leads to a flourishing life. This general review examines the research exploring the association between religious involvement and HF.MethodsThe review examines the quantitative research published in peer-reviewed medical, nursing, psychiatric, public health, and social science journals that examines the connection between religious involvement and six widely acknowledged dimensions of HF and the four pathways that lead to it. The emphasis here is on previously conducted systematic reviews of the literature and on more recent studies that support the findings from these earlier reviews.ResultsThere is a growing amount of research showing that religious involvement is related to various aspects of human flourishing and the pathways that lead to it. However, there are a number of studies that do not report these positive findings. Hypothetical mechanisms, limitations of this review, clinical implications, and future research needs are discussed.ConclusionsPrimary care physicians and mental health professionals may benefit from knowing about the research on this topic as they care for patients, many of whom are spiritual or religious.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"234-248"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543460","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":"Perceptions and Attitudes of Mental Healthcare Providers Regarding Unconventional Causes and Treatments for Psychiatric Disorders in Saudi Arabia.","authors":"Deemah Ateeq Alateeq, Hussain Altaweel, Sumayah Aljhani, Faten Al Eid, Ebtesam Almajed, Asma Alshammari","doi":"10.1177/00912174251350472","DOIUrl":"10.1177/00912174251350472","url":null,"abstract":"<p><p>ObjectiveThe stigmatization of mental illnesses remains an obstacle to seeking help and proper treatment. This study explored the knowledge and attitudes of mental health providers (MHPs) toward unconventional causes and treatments for psychiatric disorders in Saudi Arabia.MethodsA descriptive cross-sectional study was conducted between July and December 2020 with MHPs working in the governmental and private sectors, including general and mental health hospitals and centers across Saudi Arabia. The questionnaire assessed sociodemographic characteristics, attitudes toward patients with psychiatric disorders, and perceptions of causes and treatments for psychiatric disorders.ResultsIn total, 449 MHPs completed the questionnaire. More than half (51.7%) believed that supernatural causes could contribute to mental illness. In terms of treatment, most MHPs believed cauterization (81.1%) having an occasional alcoholic drink (78.8%), cupping therapy (74.2%), amphetamine or hash (63.5%), and headbands (51%) were helpful. Reluctance to marry a person previously diagnosed with mental illness was the most widely agreed upon attitude toward mental illness. Multivariate analysis indicated that psychiatrists and psychologists (29% of MHPs) were the least likely to believe in supernatural causes compared to other MHPs (<i>P</i> < 0.001).ConclusionThe findings of this study highlight the need for awareness and education about MHPs regarding scientific causes and proven treatments for mental illnesses. Evidence-based information is essential to dispel misconceptions regarding mental health problems. Doing so may help reduce the stigma and discrimination faced by those suffering from mental illnesses, thereby supporting their recovery.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"184-201"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235796","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":"Psychological and Physical Issues in the Identification, Treatment, and Care of Middle Aged and Older Adults.","authors":"Harold G Koenig","doi":"10.1177/00912174261421714","DOIUrl":"https://doi.org/10.1177/00912174261421714","url":null,"abstract":"","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":"61 2","pages":"127-130"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229660","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":"A Case and Intervention for Older Adult Sexual Mistreatment.","authors":"Renee J Flores, Cristina Murdock, John Halphen, Carlos Reyes-Ortiz, Jason Burnett","doi":"10.1177/00912174241276597","DOIUrl":"10.1177/00912174241276597","url":null,"abstract":"<p><p>BackgroundThe sexual mistreatment of older adults is a significant public health issue; like other forms of sexual violence, it is more prevalent than officially reported. Survivors often hesitate to speak out due to feelings of embarrassment, fear, or potential cognitive impairments. Moreover, the concealment of such mistreatment, coupled with societal stigmas surrounding aging and sexuality, creates challenges in recognizing sexual mistreatment during routine or emergency room visits.PurposeThis paper provides a framework for informing physicians, psychiatrists, and other healthcare providers on best practices screening, detection, and management of sexual mistreatment in older adults.MethodsA literature review of older adult sexual mistreatment articles between 2005-2024 was conducted.ResultsMedical professionals and psychiatrists are well-positioned to raise awareness and identify sexual mistreatment in older adults and manage such situations when suspected.ConclusionAssessing suspected sexual mistreatment can improve detection, responsiveness, and patient safety for older adults through an interprofessional approach.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"220-233"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12906608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114357","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":"Baseline and Changes in Internet Use and Incident Depression in Middle-Aged and Older Chinese Adults.","authors":"Qiuqiu Wang, Ting He, Yupeng Zeng, Weijun Hong","doi":"10.1177/00912174251398684","DOIUrl":"10.1177/00912174251398684","url":null,"abstract":"<p><p>ObjectiveInternet use had been correlated with depression previously. But the association between dynamic changes in internet use status and depression remains unclear. Therefore, the objective of this study was to explore whether changes in internet use status could affect the risk of depression.MethodAll the data were from China Health and Retirement Longitudinal Study (CHARLS). We selected wave 3 (2015) and wave 4 (2018) as the baseline and dynamic changes analyses, respectively. A total of 11,335 participants were included. Internet use was assessed by questionnaire, and depression was assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Multivariable logistic regression models were employed to assess the association of internet use and changes with risk of depression.ResultAfter adjusting for potential confounders, baseline internet use was negatively associated with risk of developing depression. After 2-year follow-up, compared with those who did not use the internet in either 2015 or 2018 (non-users), people who ever used (OR = 0.81, 95% CI = 0.58-0.98), or continuously used the internet (OR = 0.64, 95% CI = 0.51-0.82) demonstrated a lower risk of incident depression. Moreover, the risk of the depression significantly declined when the offline individuals commenced using the internet (OR = 0.66, 95% CI = 0.55-0.79).ConclusionInternet use and initiation of Internet use were associated with reduced risk of developing depression in middle aged and older Chinese adults.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"149-163"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490908","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":"Neglect of Older Adults Living with Dementia in Family Caregiving: A Dimensional Concept Analysis.","authors":"Jessica A Hernandez Chilatra, Patricia A Patrician, Pariya L Fazeli, Carolyn Ez Pickering","doi":"10.1177/00912174241272615","DOIUrl":"10.1177/00912174241272615","url":null,"abstract":"<p><p>ObjectiveTo present a concept analysis of neglect, specifically examining its occurrence and implications in the context of family caregiving for older adults living with dementia.MethodsA literature search was conducted in Medline, CINAHL, Scopus, and Embase databases in February 2023. Inclusion criteria targeted articles focusing on neglect in dementia family caregiving, leading to the identification of 11 articles for thorough review. Employing Caron and Bowers' dimensional analysis approach, the concept analysis aimed to elucidate neglect as a social construct shaped by diverse contexts, perspectives, and underlying assumptions.ResultsNeglect in this context emerged as a multidimensional phenomenon, influenced by contextual elements such as activities of daily living and behavioral symptoms of dementia. It encompasses dimensions including \"expectations of unmet needs\", \"maladaptive behaviors\", and \"feelings of guilt\", considering the perspectives of both caregivers and individuals living with dementia. Recognizing neglect as a dyadic phenomenon emphasizes the significance of interactions between caregivers and individuals living with dementia.ConclusionA comprehensive understanding of neglect in dementia family caregiving is crucial for effective interventions and support systems. The dyadic perspective is vital for accurate assessment. Primary care physicians, mental health, nurses, and other health professionals play a key role in prevention and supporting family caregivers. Further research is needed to explore the dynamics of dementia caregiving settings strengthening prevention strategies against elder neglect.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"202-219"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12906610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917924","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":"Association of Relative Fat Mass with Incident Depressive Symptoms among Older Adults: A 14-Year Analysis of the ELSA and HRS Cohorts.","authors":"Jiang-Yu Tu, Tao-Ping Yi, Meng-Qin Tu","doi":"10.1177/00912174251410075","DOIUrl":"10.1177/00912174251410075","url":null,"abstract":"<p><p>ObjectiveNot known is whether relative fat mass (RFM)-a height- and waist-based estimator of total adiposity-predicts late-life depressive symptoms better than conventional anthropometrics.MethodsThis study analyzed harmonized data from two nationally representative aging cohorts: the English Longitudinal Study of Ageing (ELSA) and the US Health and Retirement Study (HRS). Adults ≥50 years without baseline depressive symptoms (CES-D-8 <3) and with valid anthropometrics and covariates were followed biennially for up to 14 years (ELSA n = 4176; HRS n = 5054). RFM was computed from measured height and waist circumference and examined continuously (each 1-standard deviation [SD] increase) and by tertiles. Incident depressive symptoms were defined as CES-D-8 ≥3 at follow-up. Cox models estimated hazard ratios (HR) with progressive adjustment. Dose-response was assessed using restricted cubic splines. Predictive performance was compared with body mass index (BMI) and waist circumference (WC) via time-dependent AUCs. Sensitivity analyses used multiple imputation and propensity-score matching.ResultsOver a mean of 8.60 years (ELSA) and 8.57 years (HRS), 1467 and 1769 participants developed incident depressive symptoms. Higher baseline RFM predicted incident depressive symptoms in both cohorts (for each 1-SD, Model 3: ELSA HR = 1.15, 95% CI = 1.06-1.25; HRS HR = 1.10, 95% CI = 1.05-1.16). Compared with low RFM, high RFM remained associated with higher risk (ELSA HR = 1.37, 95% CI = 1.12-1.67; HRS HR = 1.29, 95% CI = 1.14-1.46). Restricted cubic splines suggested a J-shaped association. Time-dependent AUCs showed RFM consistently outperformed BMI and WC across follow-up. Findings were robust in multiple imputation and propensity-matched analyses.ConclusionsIn two national cohorts of older adults, higher RFM was prospectively associated with incident depressive symptoms and demonstrated superior time-varying discrimination compared with BMI and WC, supporting RFM as a pragmatic tool for late-life depressive symptoms risk stratification.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"131-148"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835191","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":"Serial Infidelity and Psychological Abuse: Diagnostic Blind Spots in Recognising Betrayal Trauma.","authors":"Rebecca C K Ward","doi":"10.1177/00912174261428855","DOIUrl":"10.1177/00912174261428855","url":null,"abstract":"<p><p>ObjectiveThis narrative review examines the intersection of serial infidelity, coercive control, and psychological abuse as an under-recognised form of betrayal trauma.MethodsGuided by PRISMA principles, a systematic search of four databases (PsycINFO, PubMed, Scopus, and Web of Science) identified 47 peer-reviewed studies published between 1990 and 2025 that met inclusion criteria. Studies were included if they examined repeated infidelity within intimate relationships, associated patterns of coercive control, gaslighting (defined here as psychologically manipulating a person into questioning their own perceptions, memory, or sanity), or the psychological sequelae of sustained relational betrayal. Data were analysed using a narrative synthesis approach to identify convergent theoretical, clinical, and diagnostic themes.ResultsFindings indicate that serial infidelity frequently co-occurs with coercive and gaslighting behaviours, producing psychological effects consistent with trauma responses observed in intimate partner violence. Despite these effects, relational betrayal involving sustained deception and control remains largely absent from psychiatric nosology, contributing to diagnostic blind spots and therapeutic misclassification.ConclusionThis review highlights the distinction between moral judgement of behaviour and the clinical recognition of trauma-based harm. An evidence-informed framework is proposed for identifying betrayal trauma within diagnostic and clinical settings, emphasising trauma-informed assessment and intervention rather than behavioural or personality-based explanations.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"912174261428855"},"PeriodicalIF":1.9,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259946","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}