Actas espanolas de psiquiatria最新文献

{"title":"Association Between C-Reactive Protein-Triglyceride Glucose Index and Depressive Symptoms Among US Adults: A Nationally Representative Cross-Sectional Study From 2005 to 2023.","authors":"Dan Liu, Wenye Qi, Chunying Zhu","doi":"10.62641/aep.v54i2.2163","DOIUrl":"https://doi.org/10.62641/aep.v54i2.2163","url":null,"abstract":"<p><strong>Background/objective: </strong>Depressive disorders represent a major global health challenge, with inflammation and insulin resistance identified as key pathophysiological factors. The C-reactive protein-triglyceride glucose index (CTI), a novel composite biomarker integrating the inflammatory and metabolic pathways, has demonstrated enhanced predictive value in cardiometabolic diseases. However, its relationship with depression remains unexplored. This study examined the association between CTI and depressive symptoms in a nationally representative U.S. adult population.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using National Health and Nutrition Examination Survey data from 2005 to 2023. Depressive symptoms were assessed using the Patient Health Questionnaire-9, with scores ≥10 indicating clinically significant symptoms. CTI was calculated as 0.412 × Ln(CRP) + Ln[triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Multivariable logistic regression models were employed to evaluate CTI-depression associations, adjusting for sociodemographic factors, comorbidities and laboratory parameters. Restricted cubic spline analysis assessed dose-response relationships, and subgroup analyses examined consistency across demographic and clinical strata.</p><p><strong>Results: </strong>Among 15,318 participants (mean age 48.97 years; 49.78% female), 8.73% exhibited depressive symptoms. After comprehensive adjustment, each unit increase in CTI corresponded to a 23% increase in the risks of depression (odds ratio (OR) = 1.23, 95% confidence interval (CI): 1.11-1.36, p = 0.0001). Participants in the highest CTI tertile demonstrated 48% elevated odds compared with those in the lowest tertile (OR = 1.48, 95% CI: 1.17- 1.86, p = 0.0009), with a significant linear trend (p for trend = 0.0005). Restricted cubic spline analysis confirmed a linear dose-response relationship (p for nonlinearity = 0.1665). Associations remained consistent across age, sex, race/ethnicity and comorbidity subgroups (all p for interaction >0.05).</p><p><strong>Conclusion: </strong>Elevated CTI levels are independently associated with increased depression risk in U.S. adults, demonstrating a linear dose-response relationship. CTI may serve as a practical screening tool for identifying individuals at heightened depression risk, enabling integrated cardiometabolic-mental health interventions.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 2","pages":"455-466"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759420","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":"Impact of Sleep Quality on Cognitive Function in Elderly Patients With Alzheimer's Disease.","authors":"Wanzheng Qi, Jingtong Wang, Xiang Gao, Yanan Liu","doi":"10.62641/aep.v54i2.2126","DOIUrl":"https://doi.org/10.62641/aep.v54i2.2126","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyse the effect of sleep quality on cognitive function in elderly patients with Alzheimer's disease (AD).</p><p><strong>Methods: </strong>This retrospective study extracted clinical data from the hospital's electronic medical record system for elderly patients with AD admitted to the Departments of Neurology or Geriatrics between June 2022 and June 2024. Cognitive function was assessed using the MiniMental State Examination (MMSE), subjective sleep quality was evaluated with the Athens Insomnia Scale (AIS) and objective sleep architecture parameters were measured via overnight polysomnography (PSG). Participants were stratified into mild and moderate-to-severe cognitive impairment groups according to their MMSE scores. General characteristics and sleep-related indicators were compared between the two groups. A binary logistic regression model was employed to analyse independent factors influencing cognitive impairment severity. In this model, cognitive impairment severity served as the dependent variable, and PSG parameters and AIS score served as the core independent variables. Adjustments were made for potential confounding factors, including age, gender, years of education, disease duration, Hospital Anxiety and Depression Scale (HADS) scores and  Instrumental Activities of Daily Living Scale (IADL) scores.</p><p><strong>Results: </strong>The cohort comprised 61 (40.67%) moderate-to-severe and 89 (59.33%) mild impairment patients. Compared with the mild impairment group, the moderate-to-severe group showed significantly poorer subjective (higher AIS) and objective sleep profiles, including reduced total sleep time, efficiency, and N2/N3 sleep and increased N1 sleep, latency and awakenings (p < 0.05). Adjusted regression identified the N3 stage/total sleep time ratio as a protective factor (odds ratio [OR] = 0.720, 95% CI: 0.576-0.900, p = 0.004) and the AIS score (OR = 1.850, 95% CI: 1.405-2.434, p < 0.001) and number of awakenings (OR = 3.101, 95% CI: 1.879-5.116, p < 0.001) as independent risk factors.</p><p><strong>Conclusion: </strong>In elderly patients with AD, impaired objective sleep architecture and subjective insomnia are significantly associated with poor cognitive function. This study highlighted sleep parameters as potential indicators for cognitive status assessment.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 2","pages":"328-334"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759483","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":"The Role of Exosome-miRNA as Biomarkers of Alzheimer's Disease: A Systematic Review of Case-Control and Longitudinal Studies.","authors":"Haiqing Zhou, Ying Liu, Kaijun Li, Shangdong Mou, Xia Cao, Qingjuan Chen","doi":"10.62641/aep.v54i2.2109","DOIUrl":"https://doi.org/10.62641/aep.v54i2.2109","url":null,"abstract":"<p><p>Alzheimer's disease (AD) is a progressive neurodegenerative disorder, and its diagnosis emains challenging. Exosomal microRNAs (miRNAs), due to their stability, tissue specificity, and ability to cross the blood-brain barrier, show significant promise as ideal biomarkers for AD. The present study aimed to systematically elucidate the relationship between the exosomal miRNA expression changes and AD pathogenesis (including Aβ deposition, Tau protein phosphorylation, and neuroinflammation) and to evaluate their potential utility in clinical screening and therapeutic interventions. A systematic literature search was conducted in the PubMed and Web of Science databases to identify human case-control or cohort studies reporting expressions of mature exosomal miRNAs in the serum, plasma, cerebrospinal fluid, saliva, or central nervous system cells. After evaluating the quality of the studies using the National Institutes of Health quality assessment tool, the identified differentially expressed miRNAs were summarized and functionally integrated. Among the 390 screened records, 48 studies (n = 3046 AD patients) met the inclusion criteria. The analysis identified 120 exosomal miRNAs that are differentially expressed at different AD ages. Six miRNAs (miR-125b, miR-146a, miR-193b, miR-185-5p, miR-29b/c, miR-21-5p) were most consistently reported and showed significant correlation with AD pathology.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 2","pages":"556-567"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759322","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":"Antidepressant Use and Bone Health: Evidence From Mendelian Randomisation.","authors":"Yinqing Huang, Lingzhi Lin, Mian Lin, Xiuxiu Ye","doi":"10.62641/aep.v54i2.2164","DOIUrl":"https://doi.org/10.62641/aep.v54i2.2164","url":null,"abstract":"<p><strong>Background: </strong>Antidepressant use has been associated with adverse skeletal outcomes in observational studies, but whether this association is causal remains unclear due to potential confounding factors. This study employed Mendelian randomisation (MR) to systematically evaluate the causal associations between genetically predicted antidepressant use and the risks of osteoporosis and fractures at multiple anatomical sites.</p><p><strong>Methods: </strong>Using publicly available genome-wide association studies (GWAS) datasets, we defined genetically predicted antidepressant use as the exposure and osteoporosis and fractures (spine, leg, and wrist) as outcomes. Genome-wide significant single nucleotide polymorphisms (SNPs) were selected as instrumental variables following dataset harmonisation. The inverse-variance weighted (IVW) method was used as the primary MR approach, supplemented by MR-Egger regression, weighted median, and weighted/simple mode methods. Heterogeneity tests, funnel plots, and leave-one-out sensitivity analyses were performed to assess the robustness and consistency of the results.</p><p><strong>Results: </strong>MR analysis demonstrated significant positive causal associations between antidepressant use and osteoporosis across two independent datasets (ukb-a-87 and ukb-b-12141), with IVW odds ratios of 1.0035 and 1.0016, respectively. Genetically proxied antidepressant use showed significant causal effects on fractures at all examined sites, with wrist fractures displaying the strongest association (IVW: odds ratio (OR) = 1.0027, p = 0.0041). Effect directions remained consistent across multiple MR methods, with no significant heterogeneity detected. Leave-one-out analyses confirmed no single SNP disproportionately influenced the results.</p><p><strong>Conclusion: </strong>This MR study provides evidence that antidepressant use may directly influence bone metabolism and increase fracture susceptibility, particularly at the wrist. These findings highlight the importance of bone health monitoring in patients receiving antidepressant therapy, especially those at elevated fracture risk. Further mechanistic studies and longitudinal validation are warranted.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 2","pages":"467-479"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759364","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":"Development and Validation of Machine Learning-Based Models for Predicting Postoperative Depression Risk in Patients With Ovarian Cancer.","authors":"Jitong Zhao, Kaige Pei, Junhan Liu, Ce Bian, Chen Ling","doi":"10.62641/aep.v54i2.2177","DOIUrl":"https://doi.org/10.62641/aep.v54i2.2177","url":null,"abstract":"<p><strong>Objective: </strong>To develop machine learning-based prediction models for postoperative depression risk in patients with ovarian cancer and to evaluate their predictive performance and clinical application value.</p><p><strong>Objective: </strong>To develop machine learning-based prediction models for postoperative depression risk in patients with ovarian cancer and to evaluate their predictive performance and clinical application value.</p><p><strong>Results: </strong>Among 850 patients, 268 (31.5%) were positive for postoperative depression risk. Feature selection identified 13 predictive variables: age, operation time, length of hospital stay, pain score, white blood cell count, albumin, C-reactive protein, CA125, education level, history of depression/anxiety, postoperative insomnia, fatigue, and opioid analgesic use. Among the five models, random forest demonstrated superior performance with an AUC of 0.776 in the validation set, a Brier score of 0.182, sensitivity of 0.771, and an F1 score of 0.792, along with satisfactory calibration and clinical net benefit. SHAP analysis revealed that pain score, postoperative insomnia, albumin level, and opioid use contributed substantially to model predictions. A nomogram based on logistic regression model was constructed for intuitive individual risk assessment.</p><p><strong>Conclusion: </strong>The machine learning-based prediction models for postoperative depression risk in patients with ovarian cancer demonstrated satisfactory discriminative ability and clinical utility, with random forest model showing optimal performance. A clinical nomogram was additionally constructed to enable individualised and visual risk quantification suitable for bedside application. Together, these tools facilitate early identification of high-risk patients and provide evidence for clinical intervention.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 2","pages":"480-499"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759509","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":"Pharmacogenes Associated with Suicidal Behavior: Addressing a Potential Therapeutic Window.","authors":"Janette Andrea Becerra López, Alma Delia Genis Mendoza, Humberto Nicolini","doi":"10.62641/aep.v54i2.2055","DOIUrl":"https://doi.org/10.62641/aep.v54i2.2055","url":null,"abstract":"<p><p>Suicide rates in Mexico have been rising, and because suicidal behavior has a genetic component, several pharmacogenes potentially linked with suicide risk have been investigated. This review aims to summarize articles addressing pharmacogenes, their relationship with suicidal behavior phenotypes, and their role in pharmacological treatment response. Among the identified pharmacogenes, variants in genes such as ATP-binding cassette subfamily B member 1 Gene (ABCB1) and FKBP Prolyl Isomerase 5 Gene (FKBP5) have been repeatedly observed across suicide attempt and completed suicide phenotypes. With these we could hypothesize that there is a possibility of finding shared genetic mechanisms among suicide phenotypes. When studying the response to treatment, the presence of certain variants may result in reduced drug response, yielding no benefit and possibly worsening symptoms, potentially culminating in suicidal behavior. Moreover, overlapping variants have been identified between suicidal behavior and altered response to psychotropic drugs in pharmacogenes involved in different functional pathways such as neurotransmission, hypothalamic-pituitary-adrenal (HPA) regulation and neuroinflammation, so this combination could lead to an increased genetic vulnerability to suicidal behavior. In summary, although data on pharmacogenes related to suicide exist, further research is required to replicate findings in the Mexican population. The insights presented in this review may support the inclusion of other pharmacogenes or variants in existing pharmacogenomic panels to advance precision medicine approaching suicide prevention.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 2","pages":"568-585"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759583","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":"Mental Health Screening in Prison: Psychometric Evaluation of the PHQ-9 and GAD-7 Among Incarcerated Men in Mexico.","authors":"Josué-Edgardo Hinojosa-López, Rebeca Robles-García, Sofía Rivera-Aragón, Damaris Chávez-Pedrote, Ana Fresán","doi":"10.62641/aep.v54i2.2115","DOIUrl":"https://doi.org/10.62641/aep.v54i2.2115","url":null,"abstract":"<p><strong>Background: </strong>Psychometric screening tools for persons in penitentiary centers (PPC) are key to assessing their mental health needs, given the shortage of both time and mental health personnel. Depression and anxiety are among the most prevalent mental health problems in PPC. Inadequate diagnosis can lead to increased symptom severity and even suicide. Therefore, validating instruments to assess depression and anxiety in PPC populations is essential to reduce the risk of misdiagnosis and its consequences.</p><p><strong>Methods: </strong>A cross-sectional study was conducted to evaluate the reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) in 272 men (>18 years old) deprived of liberty in a penitentiary center in Mexico. Both exploratory and confirmatory factor analyses were performed. Concurrent and discriminant validity were assessed using the depression and anxiety scales of the International Statistical Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11) Primary Health Care (PHC). Receiver Operating Characteristic curves were plotted to determine the best cut-off points in both instruments.</p><p><strong>Results: </strong>Both the PHQ-9 and GAD-7 showed items that were representative of their underlying constructs and supported the original one-factor structure, with satisfactory goodness-of-fit indices in both exploratory and confirmatory analyses. Both instruments exhibited good internal consistency in the sample of Mexican men incarcerated in penitentiary centers (α = 0.87 and α = 0.89, respectively). Furthermore, both scales showed strong correlations with the ICD-11 PHC depression and anxiety scales, along with adequate sensitivity, specificity, false positive, and false negative rates, resulting in a low misclassification rate.</p><p><strong>Conclusions: </strong>The PHQ-9 and GAD-7 can be used to briefly and reliably assess depression and anxiety among male PPC in Mexico City and in populations with similar institutional and sociodemographic conditions Given the specific characteristics of PPC populations across different countries, it remains necessary to continue testing these instruments in underrepresented populations to ensure the development of reliable and valid tools that help identify potentially confusing items and minimize diagnostic errors.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 2","pages":"443-454"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759626","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":"The Gut Microbiome in Sleep Disorders: A Review of Recent Evidence.","authors":"Alejandro Borrego-Ruiz, Juan J Borrego","doi":"10.62641/aep.v54i2.2123","DOIUrl":"https://doi.org/10.62641/aep.v54i2.2123","url":null,"abstract":"<p><p>Alterations in the gut microbiome have been shown to influence sleep through gut-brain interactions. However, the interplay between the gut microbiome and sleep disorders remains insufficiently understood. This narrative review provides an overview of recent evidence on the role of the gut microbiome in sleep disorders, examining host-microbial regulation of the sleep cycle, the relationship between gut microbiome dysbiosis and sleep disorders, the influence of the gut microbiome on sleep-related breathing disorders, sleep deprivation, and sleep fragmentation, as well as microbial therapeutic approaches to sleep disorders. Through its effects on bacterial metabolites, immune responses, and neuronal signaling, the gut microbiome might be potentially involved in the regulation of sleep-wake cycles. Disturbances in sleep have been associated with shifts in gut microbiome composition, but this relationship remains incompletely understood and it suggests a bidirectional nature. Evidence indicates that interventions targeting the gut microbiome, such as the use of psychobiotics and fecal microbiota transplantation, may have potential for improving sleep outcomes, but further research is needed to determine their actual effectiveness. Understanding the full range of factors influencing the gut microbiome and their interactions with other variables will be essential for elucidating the mechanisms behind gut-sleep interactions. Thus, future studies should focus on clarifying causality, identifying key biomarkers, and developing microbial-based interventions to establish effective therapeutic strategies.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 2","pages":"586-601"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759289","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":"Severity of Cognitive Impairment and Its Correlation With Depressive Symptoms and Influencing Factors in Elderly Patients With Chronic Diseases.","authors":"Xing Liu, Wenxuan Ma, Xiaoyong Wei, Xiaoxia Yang, Xinli Ni","doi":"10.62641/aep.v54i2.2166","DOIUrl":"https://doi.org/10.62641/aep.v54i2.2166","url":null,"abstract":"<p><strong>Background: </strong>Elderly individuals frequently suffer from chronic underlying disease like hypertension and diabetes. These illnesses not only impair physical health but also show a close link to elevated rates of cognitive impairment and depressive symptoms. The mutual influence between these two issues can further diminish the quality of life of elderly patients. Nevertheless, there remains a shortage of systematic investigations into the cognitiveemotional relationship within this specific population.</p><p><strong>Methods: </strong>A total of 206 elderly patients with chronic underlying disease were enrolled retrospectively. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Depressive symptoms were evaluated via the 15-item Geriatric Depression Scale (GDS-15). To analyse the correlation between cognitive impairment and depressive symptoms, the Spearman correlation analysis, univariate analysis, and multivariate Logistic regression were employed.</p><p><strong>Results: </strong>Among the 206 patients, the primary chronic underlying diseases were hypertension (64.56%), diabetes mellitus (39.32%), coronary heart disease (27.67%), and chronic obstructive pulmonary disease (21.84%). Additionally, 45.15% of the patients had two or more chronic diseases. The prevalence of cognitive impairment stood at 49.51% (102 cases), while the prevalence of depressive symptoms was 40.78% (84 cases). No significant differences were observed in the prevalence of cognitive impairment and depressive symptoms among patients with different types of chronic diseases (all p > 0.05). Spearman correlation analysis revealed a significant negative correlation between MoCA scores and GDS-15 scores (r = -0.552, p < 0.001). Binary Logistic regression analysis indicated that factors such as body mass index ≥21.42 kg/m² , number of chronic diseases ≥2.5, GDS-15 score ≥4.5 points, and Multidimensional Scale of Perceived Social Support score ≥52.5 were independent risk factorsfor moderate-to-severe cognitive impairment (all p < 0.05).  Conclusions: The severity of cognitive impairment in elderly patients with comorbid chronic underlying diseases increases with the exacerbation of depressive symptoms.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 2","pages":"369-379"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759339","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":"Correlation Between Insecure Attachment Style and Symptomatology in Patients With Bipolar Disorder: A Systematic Review.","authors":"Lorena Suárez, María Cruz-Fortún, María Martín-González, Olaya Tamayo-Morales, Nelson Andrade-González","doi":"10.62641/aep.v54i2.2108","DOIUrl":"https://doi.org/10.62641/aep.v54i2.2108","url":null,"abstract":"<p><strong>Background: </strong>Attachment style describes the bond between a child and their caregivers, and its effect on subsequent relationships. Bipolar disorder (BD) is a mood disorder characterized by fluctuations in mood and energy levels. The aim of this work is to update the evidence on the relationship between two insecure attachment styles (anxious and avoidant) and the symptomatology of patients with BD.</p><p><strong>Methods: </strong>To achieve the objectives of this systematic review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines were followed. Searches were conducted from inception until July 24, 2025 in the PsycInfo, PubMed, Scopus, and Web of Science databases. A structured process was carried out for study selection, data extraction, and risk of bias assessment of the included studies.</p><p><strong>Results: </strong>A total of six articles were included, five of which were cross-sectional and one was a case-control study. These six studies included a total of 466 patients, with a weighted mean age of 41.4 years old. The weighted mean age was calculated according to the sample size of each of the selected articles. The female-to-male ratio was 1.53:1. Patients with insecure attachment experienced depressive, anxiety, and somatization symptoms, as well as greater symptom severity (increased risk of suicidal behavior, greater number of hospitalizations, higher frequency of affective episodes, and greater substance use).</p><p><strong>Conclusions: </strong>In patients with BD, insecure attachment is associated with greater symptom severity. Future research should investigate the explanatory mechanisms underlying the relationship between insecure attachment and the symptomatology of these patients.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 2","pages":"516-527"},"PeriodicalIF":1.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759360","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}