Annals of General Psychiatry最新文献

{"title":"Assessing suicidality in adult ADHD patients: prevalence and related factors : Suicidality in adult ADHD patients.","authors":"Gabriele Di Salvo, Camilla Perotti, Lorenzo Filippo, Camilla Garrone, Gianluca Rosso, Giuseppe Maina","doi":"10.1186/s12991-024-00528-8","DOIUrl":"10.1186/s12991-024-00528-8","url":null,"abstract":"<p><strong>Background: </strong>The association between Attention-deficit hyperactivity disorder (ADHD) and suicidality has been subject of growing interest for research in the latest years. Suicidality was generally assessed categorically and without the use of validated instruments, leading to heterogeneous or even conflicting evidence. The prevalence of both suicidal ideation and attempts varies considerably, and the associated risk factors remain unclear. Our study investigated suicidality in ADHD using a dimensional approach and a validated and internationally recognized instrument. Our primary aim was to evaluate the prevalence of suicidal ideation (SI), severe suicidal ideation (SSI), suicidal behavior (SB) and non suicidal self-injury behavior (NSSIB) in a sample of adult patients with ADHD. The second objective was to identify sociodemographic and clinical features associated with increased risk of suicidality in these patients.</p><p><strong>Methods: </strong>The sample included 74 adult patients with clinical diagnosis of ADHD. Suicidality was assessed by administering the Columbia-Suicide Severity Rating Scale. Logistic regressions were used to examine predictors of SI, SSI, SB and NSSIB.</p><p><strong>Results: </strong>The lifetime prevalence of SI and SSI were 59.5% and 16.2%, respectively. The 9.5% of patients showed lifetime SB, while NSSIB was found in 10.8% of the subjects. Lifetime SI was associated with severity of inattentive symptoms during adulthood, low self-esteem and impairment in social functioning. Lifetime SSI appeared related to severity of inattentive symptoms during childhood, attentional impulsiveness and number of hospitalizations, while physical activity appeared to be protective. The prevalence of lifetime SB and NSSIB did not appear significantly related to any socio-demographic or clinical feature.</p><p><strong>Conclusions: </strong>Adults with ADHD should be considered at risk of suicide and it is important to determine which patients are at higher risk, in order to guide preventive interventions. The association between ADHD and suicidal ideation did not appear to be influenced by psychiatric comorbidities, but rather by inattention itself, which represents the core symptom of ADHD.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of 8-week TReatment with vortioxetine on depressive symptoms in major depressive disorder patients with comorbid generalized anxiety disorder in UAE (TRUE).","authors":"Bassem Badr, Hana Al Gailani, Samia Alkhoori, Hania Butt, Michel Daher, Bassam Dheyaa, Nasser El Hindy, Mohamed Wafeek Eid, Nisrin Elsaadouni, Valentina Faia, Alaa Haweel, Tarek Khammas, Hussein Omar, George Tadros, Charles Yacoub, Tamer Talaat, Ahmed El-Shafei","doi":"10.1186/s12991-024-00526-w","DOIUrl":"10.1186/s12991-024-00526-w","url":null,"abstract":"<p><strong>Background: </strong>Major Depressive Disorder (MDD) is a leading cause of disability and results in excessive utilization of healthcare resources worldwide. The Middle East and North Africa (MENA) region shows a high prevalence of depressive disorders. Generalized Anxiety Disorder (GAD) and MDD have the highest rate of comorbidity of all mood and anxiety disorders, ranging from 40 to 98% in drug studies. Comorbid GAD results in more significant impairment in MDD and increases the severity of symptoms. Although several clinical trials supported the safety and effectiveness of vortioxetine, no data regarding these aspects has been revealed in the MENA region. This study aimed to assess the safety and efficacy of vortioxetine in patients with comorbid GAD in the United Arab Emirates (UAE).</p><p><strong>Method: </strong>In a multicenter observational study, 118 patients with confirmed anxiety and depressive disorders were evaluated over four visits (baseline visit, two weeks, four weeks, and eight weeks) using MADRS and HAM-A scales to assess depression and anxiety severity, respectively by calculating mean change and the percent using Kendall's W test.</p><p><strong>Results: </strong>A significant mean difference in MADRS score was observed, with a gradual decrease of mean MADRS total scores over the assessment weeks (p < 0.001) as well as in HAM-A scores, from severe to moderate-severe anxiety through the four visits (p < 0.001). Furthermore, only one case was reported as a serious side effect. Nausea and insomnia were the most predominant side effects reported among the studied population.</p><p><strong>Conclusion: </strong>Vortioxetine was found effective and safe among patients with MDD and comorbid GAD.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of schizophrenia and comorbid substance use disorders: expert review and guidance.","authors":"Adrián Neyra, Carlos Parro-Torres, Elena Ros-Cucurull, Indalecio Carrera, Eduardo Echarri, Marta Torrens","doi":"10.1186/s12991-024-00529-7","DOIUrl":"10.1186/s12991-024-00529-7","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia and substance use disorders (SUDs) are often comorbid conditions that present clinical challenges due to their heterogeneity and the difficulties associated with poor physical health, low medication adherence, high relapse and hospitalization rates, and increased risk of mortality. This is often exacerbated by a fragmented health care system that treats addiction and mental illness separately, leading to delays in proper diagnosis and treatment.</p><p><strong>Main text: </strong>The aim of this narrative review, based on an extensive literature search and experts' clinical experience, is to synthesize evidence on the psychopathological and clinical characteristics of patients, the burden and management at the level of healthcare system, and possible gaps in the treatment of schizophrenia with comorbid SUD in order to understand and address the needs of patients. Treatment options, differences between antipsychotic medications, and the benefits of long-acting formulations and partial dopaminergic agonists are described. Partial dopamine agonists (aripiprazole, cariprazine, and brexpiprazole) have demonstrated good control of psychotic symptoms and SUDs with a favorable safety profile.</p><p><strong>Conclusion: </strong>Pharmacological interventions should be accompanied by psychosocial support within an integrated and multidisciplinary approach that promotes shared decision-making and a good therapeutic alliance between the entire medical team and the patient.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the effect of lithium use on the amygdalar volume of adult patients diagnosed with bipolar disorder: a scoping review.","authors":"Anshika Solleti, Aleena Naeem","doi":"10.1186/s12991-024-00523-z","DOIUrl":"10.1186/s12991-024-00523-z","url":null,"abstract":"<p><strong>Introduction: </strong>Bipolar disorder is a psychiatric condition commonly treated with lithium. This treatment has various biological effects on the brain; however, variability in the areas and types of changes as a result of lithium treatment has resulted in discourse over lithium's effect. As a result, a comprehensive synthesis is needed to understand lithium's true neurological effect. This review aims to identify a common result of lithium use in the neurobiology of bipolar patients, specifically in the amygdala, to determine whether volumetric changes in the amygdala are a common effect.</p><p><strong>Methods: </strong>We conducted a preliminary search to identify key search terms across electronic databases, including Google Scholar and PubMed. After screening and application of inclusion and exclusion criteria, 9 cross-sectional studies were identified.</p><p><strong>Results: </strong>The evidence from these cross-sectional studies showed either an increase or no change in amygdalar volume. While this fails to identify a definite pattern in amygdalar volume changes, it highlights a need for further research to identify sources of heterogeneity and minimize them to ascertain accurate results.</p><p><strong>Conclusions: </strong>The present review may be used to influence future work concerning neurobiological changes in the amygdala as a result of lithium treatment for bipolar patients by summarizing patterns in the current literature.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional magnetic resonance imaging of depression: a bibliometrics and meta-analysis.","authors":"Xiaotong Wang, Xi Nie, Feng Zhang, Yuhan Wei, Weiting Zeng, Yuchuan Zhang, Haixiong Lin","doi":"10.1186/s12991-024-00525-x","DOIUrl":"10.1186/s12991-024-00525-x","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to reveal the current knowledge map, research hotspots of functional magnetic resonance imaging (fMRI) studies on depression, as well as identify the brain regions associated with depression.</p><p><strong>Methods: </strong>CiteSpace was conducted to analyze the publication outputs, country, institution, cited journals, author and cited author, references, keyword cocurrence and burst keywords of fMRI studies in depression from 2010 to 2024. And a meta-analysis of fMRI was used to identify brain regions associated with depression using Neurosynth.</p><p><strong>Results: </strong>A total of 4,049 publications were included, and Gong Qiyong was the most prolific authors. Neuroimage, Biological Psychiatry, and Human Brain Mapping were prominent journals. Default mode network (DMN), prefrontal cortex, amygdala, and anterior cingulate cortex were the popular keywords. The fMRI studies on depression have mainly focused on major depression, especially the DMN. Functional connectivity and regional homogeneity of brain regions were research hotspots. The meta-analysis revealed significant differences in brain regions between patients with depression and healthy controls, including the Amygdala_L, Insula_R, Frontal_Inf_Oper_R, Cingulum_Post_L, Putamen_L, Thalamus_R, Angular_L, Precuneus_R, Frontal_Sup_R, Occipital_Inf_L.</p><p><strong>Conclusions: </strong>This study sheds light on key issues and future directions in fMRI research on depression, elucidating the brain regions related to depression.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum L-selectin levels as predictive markers for chronic major depressive disorder progression.","authors":"Yeeun Yun, Sora Mun, Seungyeon Lee, Hee-Gyoo Kang, Jiyeong Lee","doi":"10.1186/s12991-024-00522-0","DOIUrl":"https://doi.org/10.1186/s12991-024-00522-0","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) exhibits a recurrence rate of up to 70%. Frequent recurrence can lead to chronic depression, which has considerable personal and societal consequences. This study aims to identify a serum protein biomarker to predict MDD recurrence and progression to chronicity.</p><p><strong>Methods: </strong>Serum samples from the MDD with single episode group (MDD-S), MDD with recurrence group (MDD-R), and a healthy control group were collected. Non-targeted analysis of the serum proteome was conducted using liquid chromatography-tandem mass spectrometry. Statistically significant common proteins when comparing the three groups were chosen. The selected marker candidates were subsequently validated through multiple response monitoring (MRM), incorporating a healthy control, MDD-S, MDD-R(2) (two episodes), and MDD-R(> 2) (more than two episodes) groups.</p><p><strong>Results: </strong>L-selectin levels showed an upward trend in the MDD-R group compared to the healthy control and MDD-S groups. MRM validation revealed a decreased tendency for L-selectin in the MDD-R(> 2) group, indicative of a chronic state, versus the healthy control and MDD-S groups. The receiver operating characteristic analysis highlighted L-selectin as the chosen biomarker due to its classification efficacy for the MDD-R(> 2) group.</p><p><strong>Conclusion: </strong>L-selectin emerged as a predictive biomarker for MDD recurrence and its potential evolution into chronic depression. This marker offers insights into changes in leukocyte-mediated inflammatory responses characteristic of chronic depression. Consequently, it may forecast the transition from acute to chronic inflammation in depressive patients.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Mental Health: A Review of the Most Influential Research on Depression in Children and Adolescents.","authors":"Fuyu Mei, Zhidan Wang","doi":"10.1186/s12991-024-00520-2","DOIUrl":"https://doi.org/10.1186/s12991-024-00520-2","url":null,"abstract":"<p><strong>Background: </strong>Depression is a common mental disorder in children and adolescents, with a global prevalence of approximately 33%, severely affecting their physical, mental health, and academic performance. This study aims to identify and assess the 100 most-cited articles (T100 articles) on depression in children and adolescents.</p><p><strong>Methods: </strong>The T100 articles in the field of depression were retrieved from the SCI-E and SSCI databases. A comprehensive analysis of the T100 articles was conducted, including the number of citations, countries, journals, keywords, authors, and topics.</p><p><strong>Results: </strong>Between 1981 and 2021, T100 articles in child and adolescent depression received 423 to 3949 citations. Most articles originated from the USA, with Kovacs M as the top-ranked author. The University of Pittsburgh and Columbia University published the top two T100 articles. The T100 articles were published in 36 journals, led by AMA Psychiatry. Co-occurrence keywords analyses reveal six key foci: Pathogenesis of Depression, Treatment of MDD in Children, Early Childhood Treatment, Adolescent Depression Manifestations, Gender and Depression, and Primary Care Considerations, with pathogenesis as a future trend.</p><p><strong>Conclusions: </strong>Our research presents an exhaustive list of the most highly cited articles on depression in children and adolescents. Our findings not only underscore the significance of international cooperation but also reveal a pressing need to prioritize and bolster preventive research, particularly the development and refinement of early screening and intervention programs.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerating depression intervention: identifying critical psychological factors using MCDM-MOORA technique for early therapy initiation.","authors":"Pratham Majumder, Arkita Pal, D Ramya Dorai, B Gopinathan, Saurav Mallik, Naim Ahmad, Ahmed Said Badawy, Suresh Babu Changalasetty","doi":"10.1186/s12991-024-00518-w","DOIUrl":"10.1186/s12991-024-00518-w","url":null,"abstract":"<p><strong>Background: </strong>A thorough psychosocial assessment is time-consuming, often requiring multiple sessions to uncover the psychological factors contributing to mental illness, such as depression. The duration varies depending on the severity of the patient's condition and how effectively the psychotherapist can establish rapport. However, prolonged assessment periods pose a significant risk of patient deterioration.</p><p><strong>Methods: </strong>The comprehensive psychosocial intervention, led by the Multi-Criteria Decision-Making (MCDM) approach utilizing the Multi-Objective Optimization by Ratio Analysis (MOORA) method, played a pivotal role in identifying the key psychological factors contributing to the depression of the client among the 21 factors specified by BDI-II analysis.</p><p><strong>Results: </strong>The integration of the MOORA strategy compared to traditional psychotherapy on 254 samples demonstrates a Jaccard similarity coefficient of 0.8, with a minimum error margin of 7% (vulnerability index = 0.57), indicating a significant agreement between the two approaches, both converging towards a similar solution. For patients with extreme depression, the number of sessions reduced from 18 ± 2 to 11 ± 2, showing a 33-35% reduction (χ² = 6.94, p = 0.008). Severe depression patients experienced a reduction from 14 ± 2 to 8 ± 1 sessions i.e., 34-39% reduction (χ² = 8.32, p = 0.004). Moderate depression patients saw sessions drop from 9 ± 1 to 5 ± 1, i.e., 37-43% reduction (χ² = 0.29, p = 0.001). The accuracy for detecting dominant psychological factors improved to 82.88% for extreme, 86.74% for severe, and 90.34% for moderate depression, respectively.</p><p><strong>Conclusion: </strong>The implementation of MOORA facilitated the identification and prioritization of key psychosocial intervention strategies, making the process significantly faster compared to traditional methods. This acceleration greatly enhanced the precision and efficacy of the work. Additionally, critical vulnerable factors were identified through ordered statistics and correlation analysis [Pearson (r) = 0.8929 and Spearman's rank (ρ) = 0.7551] on the Beck Depression Inventory-II model. These findings were supported by other MCDM schemes such as EDAS and TOPSIS, demonstrating high stability and robustness in dynamic decision-making environments, maintaining consistency across scenarios adapted by different psychotherapists. Overall, the combined application of MCDM (MOORA) and targeted psychological interventions yielded substantial positive outcomes in enhancing the well-being of individuals with psychological illnesses, such as depression, cognitive, affective, and somatic syndromes.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of metabolites and metabolic ratios with schizophrenia: a mendelian randomization study.","authors":"Yu Huang, Hanxuan Wang, Jiayu Zheng, Na Zhou","doi":"10.1186/s12991-024-00521-1","DOIUrl":"10.1186/s12991-024-00521-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study aims to investigate the causal relationship of human plasma metabolites and metabolic ratios with schizophrenia (SCZ).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We employed Mendelian Randomization (MR) approach to comprehensively analyze two large-scale metabolomics and schizophrenia Genome-Wide Association Study (GWAS) datasets, incorporating a total of 1091 metabolites and 309 metabolic ratios, with 52017 schizophrenia patients and 75889 healthy controls. The inverse variance-weighted (IVW) method was utilized to estimate the causal relationship between exposure and outcome. To provide a more comprehensive evaluation, additional Mendelian Randomization (MR) approaches were employed, including MR-Egger regression, weighted median, simple mode, and weighted mode methods. These analyses assessed the causal effects between blood metabolites, metabolic ratios, and schizophrenia. Tests for pleiotropy and heterogeneity were conducted. False Discovery Rate (FDR) correction was applied to account for multiple comparisons and heterogeneity, ensuring the robustness and reliability of our findings. Consistent with previous studies, an FDR threshold of &lt; 0.2 was considered suggestive of a causal relationship, while an FDR of &lt; 0.05 was considered to indicate a significant causal relationship.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The final results revealed that a significant causal association was found between the levels of two metabolites and schizophrenia, Alliin (OR = 0.915, 95%CI = 0.879-0.953, P = 1.93 × 10&lt;sup&gt;- 5&lt;/sup&gt;, FDR = 0.013) was associated with a decreased risk of schizophrenia, N-actylcitrulline (OR = 1.058, 95%CI = 1.034-1.083, P = 1.4 × 10&lt;sup&gt;- 6&lt;/sup&gt;, FDR = 0.002) was associated with increased risk of schizophrenia. When adjusting FDR to 0.2, the results showed that 4 metabolite levels and 2 metabolite ratios were suggestively causally associated with a reduced risk of schizophrenia including 2-aminooctanoate (OR = 0.904, 95%CI = 0.847-0.964, P = 0.002, FDR = 0.160), N-lactoylvaline (OR = 0.853, 95%CI = 0.775-0.938, P = 0.001,FDR = 0.122), X - 21310 (OR = 0.917, 95%CI = 0.866-0.971, P = 0.003,FDR = 0.195), X - 26111 (OR = 0.932, 95%CI = 0.890-0.976, P = 0.003,FDR = 0.189), Arachidonate (20:4n6) to oleate to vaccenate (18:1) ratio (OR = 0.945, 95%CI = 0.914-0.977, P = 8.2 × 10&lt;sup&gt;- 4&lt;/sup&gt;, FDR = 0.104), and Citrulline to ornithine ratio (OR = 0.924, 95%CI = 0.881-0.969, P = 0.001, FDR = 0.122), while 4 metabolite levels and 2 metabolite ratios were suggestively causally associated with an increased risk of schizophrenia including N2, N5-diacetylornithine (OR = 1.090, 95%CI = 1.031-1.153, P = 0.003, FDR = 0.185), N - acetyl - 2-aminooctanoate (OR = 1.069, 95%CI=(1.027-1.114, P = 0.001, FDR = 0.127), N - acetyl - 2-aminoadipate (OR = 1.081, 95%CI = 1.030-1.133, P = 0.001, FDR = 0.128), X - 13844 (OR = 1.110, 95%CI = 1.036-1.190, P = 0.003, FDR = 0.196), X - 24556 (OR = 1.083, 95%CI = 1.036-1.132, P = 4.5 × 10&lt;","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An economic model to understand the cost-effectiveness of olanzapine orally dispersible tablets (ODT) and olanzapine film coated tablets as a group compared with other oral atypical antipsychotics for treating schizophrenia in Morocco","authors":"Ahmed Tazi, Faouzi Errachidi, Dipesh Sonawane, Ghizlane Tahri, Sameer Rao, Suyog Mehta","doi":"10.1186/s12991-024-00516-y","DOIUrl":"https://doi.org/10.1186/s12991-024-00516-y","url":null,"abstract":"Antipsychotic medications are the primary treatment for schizophrenia, with olanzapine being an effective medication for schizophrenia. The economic cost for each individual with schizophrenia is high, with antipsychotic medication being a major expense. This study aims to develop an economic decision model that compares different treatment options for schizophrenia patients, including olanzapine Orally Dispersible Tablets (ODT), olanzapine [ODT + Standard Oral Tablet (SOT)], risperidone (ODT + SOT), and aripiprazole (ODT + SOT), to determine their cost-effectiveness with an objective to optimize healthcare resource allocation in Morocco. The study used published medical literature and a clinical expert panel to develop a decision analytic model. This model was designed to capture parameters such as adherence levels, treatment discontinuation, relapse with and without hospitalization, quality-adjusted life years (QALYs), treatment-related adverse events, healthcare resource utilization, and associated costs. The main outcomes of interest included the total annual direct cost per treatment, QALYs, and incremental cost-effectiveness ratio (ICER) per 1 QALY gained. One-way and probabilistic sensitivity analyses were employed to account for parameter uncertainty. According to the simulation model, the ODT and ODT + SOT as a group form of olanzapine was the most effective treatment option in terms of the lowest percentages of inpatient relapse, and patients who remained stable (11% and 79% respectively) than risperidone (19% and 62% respectively) and aripiprazole ODT (26% and 50% respectively) and ODT + SOT formulation groups. Olanzapine (ODT + SOT) therapy group was cost-effective when compared to the combined group of ODT + SOT forms of risperidone [ICER: Moroccan Dirham (MAD) 103,907], and aripiprazole (ICER: MAD 65,047). Additionally, olanzapine ODT was found to be cost-effective compared to olanzapine SOT with an ICER of MAD 3921, risperidone ODT with an ICER of MAD 1,02,298, risperidone SOT with an ICER of MAD 31,088, and aripiprazole ODT or SOT formulations. All the above ICERs fall under the willingness-to-pay threshold in Morocco of MAD 250,832.40. Sensitivity analyses confirmed the reliability of the findings. The model concluded that olanzapine ODT is the most cost-effective first-line treatment option for schizophrenia in Morocco when compared to other atypical antipsychotic medications in ODT and SOT formulations.","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}