BMC Psychiatry最新文献

{"title":"Personality functioning in bipolar 1 disorder and borderline personality disorder.","authors":"Karin Feichtinger, Clarissa Laczkovics, Johanna Alexopoulos, Maria Gruber, Miriam Klauser, Karoline Parth, Antonia Wininger, Michael Ossege, Josef Baumgartner, Stephan Doering, Victor Blüml","doi":"10.1186/s12888-024-06297-8","DOIUrl":"10.1186/s12888-024-06297-8","url":null,"abstract":"<p><strong>Background: </strong>Differentiation of borderline personality disorder (BPD) and bipolar I disorder (BD) has been challenging. The assessment of shared symptoms in the context of the overall personality functioning, the patient's sense of self, and the quality of his object (interpersonal) relations is proposed to be valuable for the differential diagnosis of these disorders.</p><p><strong>Methods: </strong>We empirically investigated the level of personality organization (PO), identity integration, and quality of object relations in patients suffering from BD or BPD using the Structured Interview of Personality Organization (STIPO) and the Level of Personality Functioning Scale (LPFS) in 34 BPD and 28 BD patients as well as 27 healthy control persons. Group comparisons and a logistic regression model were calculated to analyze group differences.</p><p><strong>Results: </strong>The BPD group showed significantly greater impairment in several domains of personality functioning, namely \"identity\", and \"self- and other-directed aggression\", while showing lower impairment in \"moral values\". The overall level of PO in the BPD group was significantly lower when excluding not only BPD but any personality disorder (PD) in the BD sample. Severity of impaired personality structure had a major impact on symptom load independent of the main diagnosis BD or BPD.</p><p><strong>Conclusions: </strong>Our data show greater impairment in personality functioning in BPD than in BD patients. BD patients present with varying levels of PO, whereas in BPD severe deficits in PO are pathognomonic. The level of PO has a significant impact on symptom severity in both BD and BPD patients. Therefore, careful assessment of PO should be considered for differential diagnosis and adequate treatment planning.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"846"},"PeriodicalIF":3.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loneliness, emotional support and the mental health of young adults and their parents in New York, US during the COVID-19 pandemic: a cohort study.","authors":"Abosede Akinkuowo, Keely Cheslack-Postava, Norbert Skokauskas, Christina W Hoven","doi":"10.1186/s12888-024-06305-x","DOIUrl":"10.1186/s12888-024-06305-x","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease (COVID-19) pandemic led to social isolation and widespread lockdown, resulting in loneliness and lack of emotional support, which have been associated with adverse mental health outcomes. This study aims to explore the relationship of loneliness and emotional support with depression and substance use among young adults and their parents during the COVID-19 pandemic.</p><p><strong>Methods: </strong>A cohort of 1227 participants was recruited from three ongoing cohort studies in the metropolitan area of New York City, USA. Data was collected through telephone interviews using preset questionnaires during wave 1 (March-August 2020), wave 2 (September 2020-February 2021) and wave 3 (March-August 2021) of the COVID-19 pandemic. Logistic regression models were used to test the association between loneliness and emotional support, and the mental health outcomes; depression and substance use, with adjustments made for age, gender, race, employment status, living conditions, and marital status. Additionally, the effect modification of respondent type and living alone or with others was examined.</p><p><strong>Results: </strong>At wave 1, loneliness showed a significant positive association with depressive symptoms (OR: 2.56, 95%CI: 2.19-3.00, P = < 0.001) and an increase in substance use, such as smoking tobacco using cigarettes, pipes, or cigar (OR: 1.59, 95%CI: 1.24-2.04, P = < 0.001), alcohol consumption (OR: 1.23, 95%CI: 1.07-1.42, P = 0.003), and marijuana/other substances (OR: 1.57, 95%CI: 1.26-1.96, P = < 0.001). Conversely, emotional support showed a significant negative association with depressive symptoms (OR: 0.71, 95%CI: 0.62-0.81, P = < 0.001) but a non-significant association with increase in tobacco smoking using vapes and e-cigarettes, alcohol consumption and marijuana and other substances. However, a significant negative association was observed between emotional support, and increased tobacco smoking using cigarettes, pipes, or cigar (OR: 0.73, 95%CI: 0.58-0.93, P = 0.011). The associations of loneliness and emotional support with mental health outcomes were stronger at wave 2 compared to wave 1. The modifier effects of respondent type and living condition were non-significant.</p><p><strong>Conclusions: </strong>This study indicates that increased loneliness is associated with a higher likelihood of depression and substance use, while higher emotional support is linked to a reduced likelihood of depressive symptoms during the COVID-19 pandemic.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"849"},"PeriodicalIF":3.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep brain stimulation of Hippocampus in Treatment-resistant Schizophrenia (DBS-HITS): protocol for a crossover randomized controlled trial.","authors":"Chang Lu, Zhaolin Zhai, Kaiming Zhuo, Qiong Xiang, Jingxin Xue, Yuqing Zhao, Liqin Lang, Chunhong Shao, Liang Chen, Dengtang Liu","doi":"10.1186/s12888-024-06318-6","DOIUrl":"10.1186/s12888-024-06318-6","url":null,"abstract":"<p><strong>Background: </strong>Ventral hippocampus (vHipp) in schizophrenia is in a state of hyperactivity and hypermetabolism, where the glutamate/gamma-aminobutyric acid (GABA) imbalance leads to downstream dopamine hyperactivity in the midbrain-limbic system. High-frequency deep brain stimulation (DBS) can disrupt the abnormal synchronization of functional circuits and modulate local brain networks.</p><p><strong>Methods: </strong>The DBS-HITS study is a crossover randomized controlled trial. DBS will be applied to bilateral vHipp in six patients. They will be randomly assigned to receive 3-month high-frequency active stimulation and then 3-month sham stimulation, or vice versa. After 6-month crossover trial phase, all participants will undergo personalized active stimulation. Researchers will assess clinical symptoms and neurocognition, collect EEG and PET-CT data during planned follow-ups. Adverse event will be researcher-assessed or participant self-reported throughout the trial.</p><p><strong>Discussion: </strong>To our knowledge, the DBS-HITS study is the first hippocampal DBS randomized controlled trial for schizophrenia. The goal of the DBS-HITS study is to assess the efficacy and safety of hippocampal DBS in treatment-resistant schizophrenia (TRS) and to investigate its impact on hippocampal activity and glutamate/GABA metabolism. The study is expected to deepen our understanding of the effects and side-effects of neuromodulation in TRS to facilitate individualized DBS treatment.</p><p><strong>Trial registration: </strong>NCT05694000 in ClinicalTrial.gov, registered on January 23, 2023.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"847"},"PeriodicalIF":3.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse childhood experiences leading to narcissistic personality disorder: a case report.","authors":"Allen G Ross, Santosh Giri, Anayochukwu E Anyasodor, Shakeel Mahmood, Feleke H Astawesegn, M Mamun Huda, Kedir Y Ahmed, Utpal K Mondal, Subash Thapa","doi":"10.1186/s12888-024-06307-9","DOIUrl":"10.1186/s12888-024-06307-9","url":null,"abstract":"<p><strong>Background: </strong>Narcissistic personality disorder (NPD) is associated with a complex interplay of genetic, neurobiological, and environmental factors. In this case report, we discuss the association between adverse childhood experiences (ACEs) and the development of NPD in adulthood.</p><p><strong>Case presentation: </strong>Here, we report a clinical case of NPD to illustrate how ACEs, particularly physical and emotional neglect, combined with early life parental overvaluation, can impair emotional regulation and self-worth, contributing to the development of narcissistic traits. We analyse, in light of existing literature, how ACEs are associated with a wide spectrum of personality disorders, how parental overvaluation is linked to grandiose narcissism, and how childhood neglect and abuse are associated with vulnerable narcissism.</p><p><strong>Conclusion: </strong>ACEs are the primary risk factor for the development of NPD in adulthood. Dysfunctional household environments and parenting practices compound the association between ACEs and pathological narcissism. It is important to address childhood trauma for the prevention and treatment of NPD. Further research is necessary to clarify how individual factors influence the relationship between ACEs and pathological narcissism.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"842"},"PeriodicalIF":3.4,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the association between childhood trauma and limbic system subregion volumes in healthy individuals: a neuroimaging study.","authors":"Shaojia Lu, Yuwei Xu, Dong Cui, Shaohua Hu, Manli Huang, Lingjiang Li, Lei Zhang","doi":"10.1186/s12888-024-06306-w","DOIUrl":"10.1186/s12888-024-06306-w","url":null,"abstract":"<p><strong>Background: </strong>Childhood trauma (CT) is a major risk factor for psychiatric disorders. Emotional and cognitive functions are often affected in many psychiatric conditions, and these functions are mediated by the limbic system. However, previous research has primarily focused on patient populations. Therefore, we aim to examine the impact of CT on the limbic brain structure in healthy individuals.</p><p><strong>Methods: </strong>We enrolled 48 individuals in health, evenly split into two groups: 24 healthy participants with CT (HP-CT) and 24 healthy participants without CT (HP-nCT). They underwent scale assessments and MRI data acquisition. Comparisons between the two groups were performed after subcortical subregion volume segmentation using FreeSufer. Lastly, we examined correlations between volume changes and scale scores.</p><p><strong>Results: </strong>We found that HP-CT group had smaller volumes in several subregions of the hippocampus, amygdala, and cortical limbic structures, including the subiculum (Sub) head and body, cornu ammonis (CA)1 head, molecular layer (ML) head, granule cell layer of the dentate gyrus (GC-ML-DG) body, CA4 body, fimbria, hippocampus-amygdala transition area (HATA), whole hippocampus head and body, whole hippocampus, basal nucleus (Ba), accessory basal nucleus (AB), cortico-amygdaloid transition area (CAT), paralaminar nucleus (PL) of the left hemisphere; and hippocampal tail, presubiculum (PreSub) body, and basal forebrain of the right hemisphere. Volume changes in the CA4 body and GC-ML-DG body were correlated with sexual abuse. Changes in the volume of the right basal forebrain were linked to emotional neglect. However, these findings were not significant after correction for multiple comparisons.</p><p><strong>Conclusion: </strong>CT impacts multiple structures of the limbic system, including the hippocampus, and amygdala. This also suggests that region-specific changes within the limbic system can serve as clinical biomarkers supporting cross-diagnostic psychiatric illnesses.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"843"},"PeriodicalIF":3.4,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide-related risk among patients using branded and generic fluoxetine: a propensity score-matched, new-user design in Taiwan.","authors":"Cong-Wei Zheng, Yu-Chieh Huang, Yuan-Liang Wen, Hui-Wen Yang, Sheng-Yin To, Li-Ting Kao","doi":"10.1186/s12888-024-06293-y","DOIUrl":"10.1186/s12888-024-06293-y","url":null,"abstract":"<p><strong>Background: </strong>To date, the clinical equivalence between branded and generic medications remains debate and may sometimes be a reason why psychiatrists are hesitant to prescribe generic medications. Depression is recognized to exacerbate suicide risk globally and selective serotonin reuptake inhibitors, such as fluoxetine are common treatment options. Therefore, this study aimed to explores differences in suicidal risks between users of branded and generic fluoxetine in Taiwan.</p><p><strong>Methods: </strong>This cohort study used Taiwan Longitudinal Health Insurance Database, encompassing 2 million individuals covered by National Health Insurance (NHI) program. The full cohort consisted of 32,298 fluoxetine new users. Then, 7,380 branded and 7,380 propensity score matched (PSM) generic fluoxetine new users were identified. The study further utilized Cox proportional hazards models to assess risk of 5-year suicidal ideation, suicide mortality, and all-cause mortality.</p><p><strong>Results: </strong>The study revealed that the adjusted hazard ratios (HRs) for suicidal ideation, suicide mortality and all-cause mortality in branded users were 0.766 (95% CI, 0.497 - 1.181), 0.660 (95% CI, 0.447 - 0.975), and 0.942 (95% CI, 0.849 - 1.045), respectively, when compared with matched generic fluoxetine users. Stratified and sensitivity analyses showed the lower risk of suicide mortality in specific subgroups, such as male (adjusted HRs = 0.536, 95% CI = 0.306-0.939) and young branded users (adjusted HRs = 0.549, 95% CI = 0.334-0.904).</p><p><strong>Conclusion: </strong>This study observed trends in the prevention effects of suicide-related risks. However, only suicide mortality was statistically significant, especially in males and those aged < 40 years. These insights may assist clinicians and policymakers in decision-making.</p><p><strong>Clinical trial number: </strong>NA (This study is a cohort study utilizing the national health insurance database, not a clinical trial).</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"844"},"PeriodicalIF":3.4,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbid anxiety, loneliness, and chronic pain as predictors of intervention outcomes for subclinical depressive symptoms in older adults: evidence from a large community-based study in Hong Kong.","authors":"Stephanie Ming Yin Wong, Dara Kiu Yi Leung, Tianyin Liu, Zuna Loong Yee Ng, Gloria Hoi Yan Wong, Wai Chi Chan, Terry Yat Sing Lum","doi":"10.1186/s12888-024-06281-2","DOIUrl":"10.1186/s12888-024-06281-2","url":null,"abstract":"<p><strong>Background: </strong>Depression is among the leading causes of the global burden of disease and is associated with substantial morbidity in old age. The importance of providing timely intervention, particularly those with subclinical symptoms, has thus increasingly been emphasised. Despite their overall effectiveness, a small but notable subgroup tends to be less responsive to interventions. Identifying predictors of non-remission and non-response is critical to inform future strategies for optimising intervention outcomes.</p><p><strong>Methods: </strong>A total of 4153 older adults aged 60 years and above with subclinical depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] = 5-19) were recruited from JC JoyAge, a large-scale collaborative stepped-care intervention service across Hong Kong. A wide range of clinical and modifiable risk and protective factors at baseline were assessed, including depressive symptoms, anxiety symptoms, loneliness, suicidal ideation, cognitive capacity, multimorbidity, chronic pain, need for informal care due to mental health reasons, history of abuse, and sociodemographic characteristics. Separate multivariable logistic regression models were applied to identify predictors of non-remission (PHQ-9 ≥ 5) and non-response (< 50% reduction in PHQ-9) following intervention.</p><p><strong>Results: </strong>The rates of non-remission and non-response were 18.9% (n = 784) and 23.0% (n = 956), respectively. Comorbid anxiety symptoms (adjusted odds ratio [aOR] = 2.08, CI = 1.72-2.51; 1.28, 1.05-1.57), loneliness (2.00, 1.66-2.42; 1.67, 1.38-2.01), need for informal care (1.86, 1.49-2.33; 1.48, 1.18-1.85), lower cognitive capacity (0.95, 0.93-0.97; 0.94, 0.92-0.96), and absence of chronic pain (0.59, 0.48-0.72; 0.76, 0.64-0.91) predicted both non-remission and non-response. Meanwhile, moderate-to-severe depressive symptoms predicted higher odds of non-remission (1.41, 1.18-1.69) and lower odds of non-response (0.28, 0.23-0.34), respectively. Subgroup analyses conducted separately in older adults with mild and moderate-to-severe depressive symptoms at baseline revealed that comorbid anxiety, loneliness, need for informal care, and absence of chronic pain were consistent predictors of non-remission. Those with non-remission and non-response showed more depression-related functional impairments and poorer health-related quality of life post-intervention.</p><p><strong>Conclusions: </strong>Older adults with subclinical depressive symptoms showing comorbid anxiety, higher loneliness, need for informal care, and chronic pain may be offered more targeted interventions in future services. A personalised risk-stratification approach may be helpful.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifiers: NCT03593889 (registered 29 May 2018), NCT04863300 (registered 23 April 2021).</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"839"},"PeriodicalIF":3.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 interpersonal resources and mental health professional help-seeking among Chinese adolescents with probable depression: mediations via personal resources and active coping.","authors":"Hui Lu, Yanqiu Yu, Deborah Baofeng Wang, Anise M S Wu, Juliet Honglei Chen, Guohua Zhang, Yili Wu, Joseph T F Lau","doi":"10.1186/s12888-024-06271-4","DOIUrl":"10.1186/s12888-024-06271-4","url":null,"abstract":"<p><strong>Background: </strong>Globally, adolescent depression is prevalent. There is, however, a dearth of studies investigating behavioral intention to professional help-seeking regarding mental health problems among adolescents having probable depression. Based on the Stress Coping Theory, the hypothesis that personal resources and active coping would mediate between interpersonal resources and behavioral intention to professional help-seeking was investigated.</p><p><strong>Methods: </strong>Students from five junior middle schools, three senior high schools, and one vocational school were selected to participate in the survey from February to March 2022 via convenient sampling. The questionnaire collected participants' characteristics, depression, peer acceptance/support, resilience, self-compassion, active coping, and behavioral intention to professional help-seeking. The final sample included 1,425 Chinese adolescents having probable depression (Patient Health Questionnaire score ≥ 10). SPSS 23.0 and Mplus 8.3 were employed to analyze the data.</p><p><strong>Results: </strong>The prevalence of behavioral intention to professional help-seeking was 15.4%. Adjusted for background factors, peer acceptance, resilience, self-compassion, and active coping were significantly associated with behavioral intention to professional help-seeking (ORa ranged from 1.05 to 1.31). The indirect effects via active coping (β = 0.020) and a serial indirect effect via personal resources and active coping (β = 0.029) were statistically significant. The direct effect from interpersonal resources to behavioral intention to professional help-seeking was non-significant.</p><p><strong>Conclusion: </strong>The prevalence of behavioral intention to professional help-seeking among adolescents with probable depression was low and might render early detection/intervention ineffective. It is important to increase the intention to seek help from professionals. One possibility is to enhance interpersonal/personal resources and active coping.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"840"},"PeriodicalIF":3.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting suicidal behavior outcomes: an analysis of key factors and machine learning models.","authors":"Mohammad Bazrafshan, Kourosh Sayehmiri","doi":"10.1186/s12888-024-06273-2","DOIUrl":"10.1186/s12888-024-06273-2","url":null,"abstract":"<p><strong>Background: </strong>Suicidal behaviors, which may lead to death (suicide) or survival (suicide attempt), are influenced by various factors. Identifying the specific risk factors for suicidal behavior mortality is critical for improving prevention strategies and clinical interventions. Predicting the outcomes of suicidal behaviors can help identify individuals at higher risk of death, enabling timely and targeted interventions. This study aimed to determine the critical risk factors associated with suicidal behavior mortality and identify an effective classification model for predicting suicidal behavior outcomes.</p><p><strong>Materials and methods: </strong>This study utilized data recorded in the suicidal behavior registry system of hospitals in Ilam Province. In the first phase, duplicate records were removed, and the data was numerically encoded via Python version 3.11; then, the data was analyzed using chi-square and Fisher's exact tests in SPSS version 22 software to identify the factors influencing suicidal behavior mortality. In the second phase, missing data were removed, and the dataset was standardized. Five binary classification algorithms were utilized, including Random Forest, Logistic Regression, and Decision Trees, with hyperparameters optimized using the area under the receiver operating characteristic curve (AUC) and F1 score metrics. These models were compared based on accuracy, recall, precision, F1 score, and AUC.</p><p><strong>Results: </strong>Among 3833 cases of suicidal behavior in various hospitals in Ilam Province, the results indicated that the method of suicidal behavior (P < 0.001), reason for suicidal behavior (P < 0.001), age group (P < 0.001), education level (P < 0.001), marital status (P = 0.004), and employment status (P = 0.042) were significantly associated with suicide. Variables such as the season of suicidal behavior, gender, father's education, and mother's education were not significantly related to suicidal behavior mortality. Furthermore, the random forest model demonstrated the highest area under the ROC curve (0.79) and the highest classification accuracy and F1 score on both the training data (0.85 and 0.2, respectively) and test data (0.86 and 0.31, respectively) for predicting suicidal behaviors outcomes among the models tested.</p><p><strong>Conclusion: </strong>This study identified key factors such as older age, lower education, divorce or widowhood, employment, physical methods, and socioeconomic issues as significant predictors of suicidal behavior outcomes. A combination of statistical models for feature selection and machine learning algorithms for prediction was used, with Random Forest showing the best performance. This approach highlights the potential of integrating statistical methods with machine learning to improve suicide risk prediction and intervention strategies.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"841"},"PeriodicalIF":3.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 Weight-Adjusted Waist Index and Depression in NAFLD: the modulating roles of sex and BMI.","authors":"Jingwen Zhang, Yan Wang, Sunkui Ke, Tianyu Xie, Lijun Liu, Xiaoyu Fu, Chenhao Wang, Xiao Huang","doi":"10.1186/s12888-024-06308-8","DOIUrl":"10.1186/s12888-024-06308-8","url":null,"abstract":"<p><strong>Background: </strong>The Weight-Adjusted Waist Index (WWI) is a novel indicator of obesity that accurately reflects body composition. However, the association between WWI and depression in patients with non-alcoholic fatty liver disease (NAFLD) remains unclear. This study aims to explore this relationship through a nationally representative cross-sectional analysis.</p><p><strong>Methods: </strong>This study included adult participants diagnosed with NAFLD from NHANES 2017-2020. WWI was calculated as the waist circumference (cm) divided by the square root of body weight (kg). NAFLD diagnosis relied on vibration-controlled transient elastography (VCTE) with a controlled attenuation parameter (CAP) exceeding 248 dB/m to indicate hepatic steatosis. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), with scores ≥ 10 indicating the presence of major depression.</p><p><strong>Results: </strong>After adjusting for all covariates, a significant positive association was found between WWI and depression in NAFLD (OR = 1.725, 95% CI: 1.442-2.063, p < 0.00001), with a dose-response relationship indicated by restricted cubic spline analysis. The association was stronger in men and lean/normal weight NAFLD patients. Adjusting further for BMI did not alter these findings (OR = 1.643, 95% CI: 1.357-1.989, p < 0.00001). BMI's association with depression was negated after adjusting for WWI.</p><p><strong>Conclusions: </strong>WWI had a positive association with depression in NAFLD, independent of BMI. This association was more pronounced in men and lean/normal weight NAFLD. These findings suggest that WWI may be a novel indicator of depression in NAFLD and potentially valuable in depression prevention.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"838"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}