Actas espanolas de psiquiatria最新文献

{"title":"The Role of Social Contagion in Initiating Non-Suicidal Self-Injury in Schizophrenia: A Case Report.","authors":"Jonathan Shaw, Peter Bota, Charles Lai, Aidan Yong, Justin Cheng, Tina Allee","doi":"10.62641/aep.v54i3.2190","DOIUrl":"10.62641/aep.v54i3.2190","url":null,"abstract":"<p><p>Non-suicidal self-injury (NSSI) is a highly prevalent maladaptive behavior with studies indicating that it can affect between 40-80% of individuals with schizophrenia spectrum disorder. NSSI can arise during any point during the course of schizophrenia spectrum disorder and has the potential to suddenly manifest as major-self mutilation (MSM), a particularly severe and catastrophic form of NSSI. Although the motivation for NSSI/MSM varies by patient, the literature indicates that there are factors associated with these behaviors such as first-episode psychosis, command hallucinations, and past self-harming episodes. In this case report, the authors discuss a rare case of a 25-year-old male with schizophrenia who presented with ligature of multiple digits on both hands. The authors examine this rare presentation and how it is suspected to be linked to a similar case in nearby Los Angeles county through social contagion. Through this case, the authors aim to highlight the prevalence of NSSI, the potential for NSSI to transform to MSM, and the need for ongoing screening for these behaviors in those with psychotic disorder diagnoses.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"949-955"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315126","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":"Bridging Three Decades: Global Self-Harm Trends From 1990-2021 and Projections to 2040.","authors":"Hong Zhu, Xuhong Zhang, Tiantian Chen, Zhixin Lim, Saboor Saeed, Jianping Tong, Ye Shen","doi":"10.62641/aep.v54i3.2111","DOIUrl":"10.62641/aep.v54i3.2111","url":null,"abstract":"<p><strong>Background: </strong>Self-harm, which includes both nonsuicidal self-injury and suicidal behaviors, poses a major global public health challenge. This study provides a comprehensive analysis of trends in self-harm worldwide, the socioeconomic disparities associated with it, and future projections, using data from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021.</p><p><strong>Methods: </strong>Self-harm data were extracted from GBD 2021, including incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years(DALYs) for 204 countries and territories from 1990 to 2021. Age-standardized rates and estimated annual percentage change (EAPC) were calculated. Inequality was assessed using the Slope Index of Inequality (SII) and Concentration Index (CI). Autoregressive Integrated Moving Average (ARIMA) models were employed to generate projections of self-harm burden from 2022 to 2040.</p><p><strong>Results: </strong>The global burden of self-harm is projected to change substantially by 2040, with deaths estimated to increase to 829,853 (95% Uncertainty Interval (UI), 262,233-1,397,474) and prevalence projected to rise to 35,863,341 (95% UI, 8,079,108-63,647,574) cases (representing a 131.9% increase from the 2021 baseline of 15,467,153 cases). From 1990 to 2021, age-standardized rates of self-harm demonstrated decreasing trends globally and across sociodemographic index (SDI) levels, with the largest declines observed in high-middle SDI countries. Gender disparities were evident, with more pronounced decreases in females. Inequalities in DALYs due to self-harm decreased over time but remained higher among females in lower-SDI populations.</p><p><strong>Conclusions: </strong>Despite decreasing age-standardized rates, the global burden of self-harm is projected to increase substantially by 2040, with driven by increasing incidence and prevalence in incidence and prevalence. Inequities persist, particularly among females in lower-SDI populations. Implementation of targeted prevention and intervention strategies, strengthening of mental health systems, and addressing social determinants of health are imperative to reduce the growing burden of self-harm worldwide.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"644-656"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315332","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":"Factors Influencing Anxiety and Depression Symptoms in Patients With Acute Ischaemic Stroke and the Development and Validation of a Risk Prediction Model.","authors":"Ruorui Yang, Xiaoying Meng, Jingjing Feng, Qiong Zhang","doi":"10.62641/aep.v54i3.2226","DOIUrl":"10.62641/aep.v54i3.2226","url":null,"abstract":"<p><strong>Background: </strong>To analyse the factors influencing anxiety and depression symptoms in patients with acute ischaemic stroke (AIS) and construct a nomogram model for predicting the risk of developing anxiety and depression.</p><p><strong>Methods: </strong>A total of 354 patients with AIS admitted to the Anhui Provincial Corps Hospital of Chinese People's Armed Police Force between May 2023 and April 2025 were selected. They were divided into anxiety and depression (n = 180) and nonanxiety and depression (n = 174) groups on the basis of the presence of anxiety (Hamilton Anxiety Rating Scale ≥ 7 points) and depression (Hamilton Depression Rating Scale ≥ 8 points). Baseline patient data, laboratory indicators and anxiety-depression status were extracted from medical records. Logistic multivariable analysis was employed to identify factors influencing the occurrence of anxiety and depression in patients with AIS, establishing a nomogram prediction model. Internal validation was conducted by using receiver operating characteristic (ROC) and calibration curves and decision curve analysis.</p><p><strong>Results: </strong>Comparative analysis revealed statistically significant differences between the two patient groups in terms of age, neutrophil count, angiogenin-like protein 4 (ANGPTL4), silencing information regulator protein 1 (SIRT1), Krüppel-like transcription factor 2 (KLF2), retinol-binding protein (RBP), lipoprotein (a) levels and plaque stability (p < 0.05). Multivariate logistic regression analysis revealed that age (odds ratio [OR] = 1.311, 95% confidence interval [95%CI]: 1.031-1.667), ANGPTL4 (OR = 0.057, 95%CI: 0.023-0.144), SIRT1 (OR = 0.096, 95%CI: 0.016-0.554), KLF2 (OR = 0.001, 95%CI: 0.000- 0.401), RBP (OR = 1.476, 95%CI: 1.068-2.040), lipoprotein (a) (OR = 1.130, 95%CI: 1.024-1.247) and plaque stability (OR = 23.941, 95%CI: 5.178-32.186) were factors influencing anxiety and depression symptoms in patients with AIS (p < 0.05). The established regression model equation is log(P) = 0.271 × age - 0.044 × ANGPTL4 - 2.348 × SIRT1 - 7.453 × KLF2 + 0.390 × RBP + 0.122 × lipoprotein (a) + 3.176 × plaque stability. The area under the ROC curve was 0.901 (95%CI: 0.867-0.934). Internal validation using the bootstrap method demonstrated high concordance between the predictive and standard model curves.</p><p><strong>Conclusions: </strong>Age, ANGPTL4, SIRT1, KLF2, RBP, lipoprotein (a) and plaque stability are factors influencing the occurrence of anxiety and depression symptoms in patients with AIS. The nomogram model constructed on the basis of these factors demonstrates predictive validity.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"867-877"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148314892","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":"Effects of Neuromuscular Electrical Stimulation of Gluteus Medius Muscle on Hip Function and Sleep Quality in Patients With Sleep Disorders After Hip Arthroplasty.","authors":"Yang Zhou, Yanmei Shen, Xianping Lin, Chaohui Huang, Jie Sun, Zizheng Wu, Liang Lu, Chunxia Qian, Ting Zhang","doi":"10.62641/aep.v54i3.2248","DOIUrl":"10.62641/aep.v54i3.2248","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the effects of neuromuscular electrical stimulation (NMES) of gluteus medius on hip function and sleep quality in patients with sleep disorders after hip arthroplasty (HA).</p><p><strong>Methods: </strong>This retrospective analysis included 100 patients who underwent HA between January 2022 and August 2025 and developed postoperative sleep disorders. Patients were divided into in a control group (n = 45) and an NMES group (n = 55) based on the treatment received. The NMES group received NMES applied to the gluteus medius; both groups were treated for 4 weeks. Patient data extracted from the medical record system included hip function scores and sleep records: visual analogue scale (VAS), Harris Hip score, Berg Balance Scale (Berg) score, and Pittsburgh Sleep Quality Index (PSQI) score. These measures were compared between the two groups before and after treatment. Therefore, the correlation between VAS score and PSQI score was analysed.</p><p><strong>Results: </strong>After treatment, hip function and sleep quality improved in both groups. VAS scores decreased significantly after 4 weeks of treatment in both groups (p < 0.05), with the NMES group showing lower scores than the control group (p < 0.05), Harris and Berg scores increased significantly in both groups(p < 0.05), and both were higher in the NMES group (p < 0.05). The PSQI score in the NMES group was lower than that in the control group (p < 0.05). Correlation analysis showed a strongly positively correlated between VAS and PSQI scores in both groups before treatment (p < 0.05); after treatment, a weak positive correlation remained in the NMES group, whereas a moderate positive correlation persisted in the control group.</p><p><strong>Conclusions: </strong>Applying NMES to the gluteus medius is associated with reduced pain intensity in patients with sleep disorders after HA. This may contribute to improved sleep quality and help alleviate the reciprocal interaction between pain and sleep disorders.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"692-700"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148314936","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":"Relationship Between Postoperative Pain in Surgery and the Onset of Psychological Symptoms Such as Mental Anxiety and Depression.","authors":"Yunyun Chen, Wenting Hu, Liangliang Tan, Jing Ren, Xiang Bao","doi":"10.62641/aep.v54i3.2216","DOIUrl":"10.62641/aep.v54i3.2216","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain is not only a primary source of physical discomfort but also a significant risk factor that can trigger or exacerbate mental and psychological symptoms such as anxiety and depression. This study aimed to explore the interrelationship between postoperative pain and mental psychological symptoms, such as anxiety and depression, and analyse the risk factors influencing postoperative mental psychological symptoms.</p><p><strong>Methods: </strong>This study retrospectively collected clinical data of 411 surgical patients from March 2023 to April 2025 through an electronic medical record system. The Numeric Rating Scale (NRS) was used to assess preoperative and postoperative pains during rest and exercise. Postoperative pain was defined as a resting or exercise-evoked NRS score > 3 (moderate to severe pain). The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety (Hospital Anxiety and Depression Scale-Anxiety [HADS-A]) and depression (Hospital Anxiety and Depression Scale-Depression [HADS-D]). The relationship between postoperative pain and psychological symptoms, such as anxiety and depression, was explored through Spearman's correlation analysis and univariate and multivariate logistic regression analysis.</p><p><strong>Results: </strong>After surgery, 59.12% (243/411) of patients had chronic postsurgical pain (CPSP), 36.25% (149/411) had anxiety symptoms (HADS-A > 7) and 31.63% (130/411) had depression symptoms (HADS-D > 7). Regarding surgical specialty, orthopaedic surgery patients had the highest proportion of CPSP, accounting for 63.64% (91/143) of orthopaedic cases, which represented 22.14% (91/411) of the total cohort. Gynaecologic surgery patients showed the highest rates of postoperative anxiety (41.76%, 38/91) and depression (45.05%, 41/91) within their specialty. After surgery, the average resting and exercise NRS scores of patients were significantly reduced compared with preoperative levels (both p < 0.01). However, the average HADS-A and HADS-D scores were significantly higher than before surgery (p < 0.01). Spearman's correlation analysis showed that postoperative resting NRS score was positively correlated with exercise NRS, HADS-A and HADS-D scores (p < 0.01). The correlation between HADS-A score and HADS-D score was not strong, whereas the correlation between exercise NRS score and these psychological indicators was strong. Multivariate logistic regression analysis showed that postoperative pain is an independent risk factor for the occurrence of mental symptoms.</p><p><strong>Conclusions: </strong>A statistically significant mutual association exists between postoperative pain and psychological symptoms in surgery.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"786-796"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315095","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":"Age-Stratified Analysis of Social Environmental Drivers of Depression Among Chinese Young People Aged 10-24 Years.","authors":"Xiongwei Xiang, Mingyu Fu, Jianing Wu, Ruiyang Chen, Xionggen Xiang, Yao Zhou, Yongchun Li, Weiwei Gao, Shuji Li","doi":"10.62641/aep.v54i3.2236","DOIUrl":"10.62641/aep.v54i3.2236","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study aimed to evaluate the effect of key social environmental determinants on trends in depression burden amongst Chinese adolescents aged 10-24 years and to examine the age- and gender-specific variations and lagged effects of these factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Nationwide data spanning 2003-2021 were collected from the Global Burden of Disease database for depression burden indicators, World Bank socioeconomic datasets and the Chinese General Social Survey for education and social metrics. The primary variables analysed were gross domestic product (GDP) per capita, higher education enrolment rate (HEER), per capita current health expenditure and urban population percentage. Descriptive statistics and Pearson correlations were used to explore variable distributions and associations. Mixed-effects regression models quantified relationships between social factors and depression burden, and autoregressive distributed lag models assessed short-term lagged effects across age groups(10-14, 15-19 and 20-24 years). Interaction terms (HEER × total public expenditure on education (TPEE); unemployment × dependency ratio) were included on the basis of theoretical and empirical support from prior studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Between 2003 and 2021, the overall burden of depression amongst young Chinese people decreased, but the 10- to 14-year age group showed a notable upward trend in disability‑adjusted life‑years since 2017. High GDP per capita, urbanisation and per capita health expenditure were significantly associated with reduced depression burden (p &lt; 0.05). Conversely, increasing HEER- indicative of rising educational competition-was associated with a high disease burden, particularly amongst females aged 15-19 and 20-24 years. Short-term lagged effects revealed that the psychological burden of education competition manifested within 1 year, particularly amongst younger adolescents. Economic improvements and health investments exerted protective lagged effects. Age-stratified analyses underscored distinct vulnerability patterns: 10- to 19-year-olds were highly sensitive to family and educational support, and 20- to 24-year-olds were greatly affected by social structural pressures. Pearson correlation analysis identified significant negative associations between several social factors and depression burden. The mechanisms were explained by China-specific social contexts and data characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This nationwide longitudinal study reveals that multidimensional social determinants exert age- and gender-specific influences on depression burden amongst young Chinese people aged 10-24 years. The findings emphasise the urgent need for stratified policies, including enhancing family and educational support for individuals under 20 years old and reducing structural social pressures on young adults. Public mental health interventions should target these modifiable s","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"663-679"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315306","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":"Gender Identity and Gender Dysphoria in Autism Spectrum Disorders: A Systematic Review.","authors":"Sara Zekri, Esperanza Navarro-Pardo, Francisco Alcantud-Marín","doi":"10.62641/aep.v54i3.2056","DOIUrl":"10.62641/aep.v54i3.2056","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorders (ASD) are a set of neurodevelopmental disorders characterised by social-communication deficits and repetitive behaviours. Research on gender differences in ASD has so far been limited although, recently, there has been increased interest in exploring how ASD relates to gender identity (GI) and gender disorders, such as gender dysphoria (GD); in this sense, some studies suggest a significant correlation between ASD and GD, finding that individuals with ASD more frequently exhibit GD traits compared to the general population. This article systematically reviews the relationship between ASD and GD on adults without cognitive impairment.</p><p><strong>Methods: </strong>The search was performed in the Web of Science (WOS) database, as well as in ScopusElsevier, PubMed, PsycInfo and Embase, with the keywords \"autism\" AND \"gender\", \"autism disorder\" AND \"gender\", \"ASD\" AND \"gender\", limiting it by title and published since 2013, after the publication of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders 5th Edition).</p><p><strong>Results: </strong>The screening process shows a low number of papers (12 articles) with diverse research methodologies and mostly small and convenience samples, composed of individuals from Western societies with a medium-high sociocultural background; four of them have focused on GD, four have studied GI, four both of them. The results indicate a relationship about ASD and diversity of GI, as well as a certain positive correlation between ASD and GD. Some studies also found influence of ASD on sexual orientation and on libido.</p><p><strong>Conclusions: </strong>It is suggested that ASD may influence GI formation and that may have some influence on GD. The importance of recognising diversity in GI in individuals with ASD, is emphasised for a better clinical support. This review highlights the need for further research with larger samples and more representative samples, including more gender-balanced samples, as most of the reviewed studies focused on males. The registration number in the International Prospective Register of Systematic Reviews PROSPERO is CRD42024360335.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"907-918"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148314923","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":"Associations Between Miscarriage and Postpartum Depression, Perceived Social Support, and Medical Needs in Pregnant Women: A Single-Center Retrospective Study.","authors":"Nana Kong, Xiaoyuan Wu, Cui Li, Ruifang Cao, Zhuo Chen, Xiaobing Guo, Jing Zhang","doi":"10.62641/aep.v54i3.2201","DOIUrl":"10.62641/aep.v54i3.2201","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Fetal loss constitutes a major obstetric adverse outcome, and is frequently followed by marked psychological distress; the prevalence of depressive symptoms after fetal loss is substantially higher, and this elevation is intertwined with psychosocial determinants whose clinical profiles and intervention targets await systematic synthesis. This study examines the clinical characteristics and psychosocial determinants of maternal depression following fetal loss, aiming to inform targeted psychological support strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Thisretrospective study included 200 mothers following fetal loss (fetal loss group) and 200 mothers after normal delivery (term delivery group), selected via 1:1 nearest-neighbour propensity score matching (PSM) between June 2022 and October 2025. At 42 days postevent, participants in both groups completed the Edinburgh Postnatal Depression Scale (EPDS), Hospital Anxiety and Depression Scale (HADS), Multidimensional Scale of Perceived Social Support (MSPSS), and the Olson Marital Quality Questionnaire (ENRICH). Depression was defined as EPDS ≥13. Depression prevalence and scale scores were compared between groups, and multivariable logistic regression identified risk factors associated with depression. Changes in EPDS score reduction (Δ = score at 3 months postpartum - baseline score) was compared between those who received and those who did not receive clinical management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Following PSM, baseline characteristics were well-balanced between the two groups(p &gt; 0.05). The prevalence of depression was significantly higher among women with the fetal loss than among those with term delivery group (35.0% vs. 8.50%, p &lt; 0.05). Multivariate analysis identified fetal loss as an independent predictor of depression (odds ratio (OR) = 2.84, 95% confidence interval (CI): 1.96-4.12). EPDS scores were significantly higher in the fetal loss group than in the term delivery group (13.1 ± 4.0 vs. 8.5 ± 2.0, p &lt; 0.001). The predominant symptoms included persistent low mood (87.1%), insomnia (75.7%), guilt or self-blame (68.6%) and fear or avoidance of future pregnancy (62.9%). Within the fetal loss group, Low social support (OR = 3.15), marital dissatisfaction (OR = 2.43), ≥2 abortions (OR = 1.98), and lack of clinical management (OR = 2.27) were independently predicted depression. Only 27.6% of affected mothers received treatment, and this was associated with significantly greater improvement in EPDS scores (△ = -5.2 ± 2.4 vs. -1.9 ± 2.0, p &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Fetal loss is associated with a substantially increased risk of maternal depression, characterized by self-blame and fear of future pregnancy. Modifiable factors including low social support and absent professional care, are associated with more persistent depressive symptoms. These Findings support the intervention integration for high-risk mothers, although further validat","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"741-754"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315288","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 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":"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":2.1,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180666/pdf/","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":"OA","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":"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":2.1,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180665/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}