BMC Psychiatry最新文献

{"title":"Effect of antipsychotic on mismatch negativity amplitude and evoked theta power in drug-naïve patients with schizophrenia.","authors":"Yan-Bing Xiong, Qi-Jing Bo, Xian-Bin Li, Yi Liu, Qi-Bo Guo, Chuan-Yue Wang","doi":"10.1186/s12888-024-06314-w","DOIUrl":"https://doi.org/10.1186/s12888-024-06314-w","url":null,"abstract":"<p><strong>Background: </strong>Recurrent observations have indicated the presence of deficits in mismatch negativity (MMN) among schizophrenia. There is evidence suggesting a correlation between increased dopaminergic activity and reduced MMN amplitude, but there is no consensus on whether antipsychotic medications can improve MMN deficit in schizophrenia.</p><p><strong>Methods: </strong>We conducted clinical assessments, cognitive function tests, and EEG data collection and analysis on 31 drug-naïve patients with schizophrenia. Comprehensive evaluation tools such as PANSS and MCCB. MMN amplitude was analyzed by event-related potential (ERP) approaches, evoked theta power was analyzed by event-related spectral perturbation (ERSP) approaches.</p><p><strong>Results: </strong>Our findings indicate that antipsychotic treatment significantly improved clinical symptoms, as evidenced by reductions in PANSS positive, negative, general symptoms, and total scores (all p < 0.001). Cognitive function improvements were observed in language learning, working memory, and overall MCCB scores (p < 0.05), although other cognitive domains showed no significant changes. However, no significant improvements were noted in MMN amplitude and evoke theta power after four weeks of antipsychotic treatment (p > 0.05).</p><p><strong>Conclusion: </strong>These results suggest that while antipsychotic medications effectively alleviate clinical symptoms, their impact on MMN amplitude and evoke theta power deficit is limited in the short term. Moreover, the amelioration of cognitive impairment in individuals with schizophrenia is not readily discernible, and it cannot be discounted that the enhancement observed in language acquisition and working memory may be attributed to a learning effect. These findings underscore the complexity of the neurobiological mechanisms involved and highlight the need for further research to optimize individualized treatment strategies for schizophrenia.</p><p><strong>Trial registration: </strong>ChiCTR2000038961, October 10, 2020.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"901"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a relationship between psychiatrist's clinical assessment of medication non-adherence and treatment outcomes? Implications for practice.","authors":"Graham Danzer, David Sugarbaker, Adriano Zanello, Sam Barkin, Doug Cort","doi":"10.1186/s12888-024-06298-7","DOIUrl":"https://doi.org/10.1186/s12888-024-06298-7","url":null,"abstract":"<p><strong>Background: </strong>There is considerable research on the ramifications of medication non-adherence for adults with psychotic illnesses. Much of which has tightly controlled designs and strict inclusion/exclusion procedures (i.e., it is less \"ecologically valid,\" or consistent with real-world challenges in care). The authors sought to determine predictive relationships between psychiatrists' clinical assessments of non-adherence and treatment outcomes, via a design that would be more applicable to practice.</p><p><strong>Method: </strong>Multiple regression analyses were conducted on non-adherence, symptom severity upon admission, number of recent hospitalizations, and length of hospital stay. The sample consisted of 182 inpatients with psychotic spectrum disorders and significant risk and vulnerability factors. Non-adherence was measured via the psychiatrists' diagnosis of V15.81. Symptom severity was measured via the 24-item Brief Psychiatric Rating Scale (BPRS-E).</p><p><strong>Results: </strong>There were null findings on non-adherence and BPRS-E pretest score ( <math><mi>χ</mi></math> ²= 2, p = 0.16), recent hospitalizations ( <math><mi>χ</mi></math> ²= 1.2, p = 0.27), and length of stay (β = 0.003, p = 0.97). Higher symptom severity predicted a modestly longer length of stay ( <math><mi>χ</mi></math> ²= .20, p = 0.007), though Bonferroni correction nullified this finding. White/Caucasian participants were far more likely to be non-adherent than black/African-American participants (t = -8.66; p > .00001).</p><p><strong>Conclusions: </strong>Null findings suggest the psychiatrist's initial, quick-form assessment of non-adherence may not necessarily presume a poor prognosis. Perhaps, because individuals with severe and chronic psychotic disorders may have greater coping, adaptive, and survival skills than is often assumed. In severely under-resourced hospitals, such second thoughts and more reliable information about adherence and contributing factors may improve treatment outcomes.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"925"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of depression among women with polycystic ovary syndrome in mainland China: a systematic review and meta-analysis.","authors":"Zhenzhen Hong, Peiya Wu, Huihong Zhuang, Liying Chen, Shanshan Hong, Jiawei Qin","doi":"10.1186/s12888-024-06378-8","DOIUrl":"https://doi.org/10.1186/s12888-024-06378-8","url":null,"abstract":"<p><strong>Objective: </strong>Polycystic ovary syndrome (PCOS), a prevalent endocrine disorder among women, is frequently comorbid with depression. This systematic review and meta-analysis aimed to estimate the prevalence of depression among women with PCOS in mainland China.</p><p><strong>Method: </strong>A comprehensive literature search was conducted in PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, and Chinese databases (CNKI, WanFang, and VIP) up to August 2024. Random-effects models were applied to estimate the pooled prevalence of depression with 95% confidence intervals. The methodological quality assessment was assessed using the risk of bias tool. The primary outcome was the pooled prevalence of depression in women with PCOS.</p><p><strong>Results: </strong>Thirty-nine studies encompassing 9796 participants were analyzed. The pooled prevalence of depression was 37% (95% CI, 29%-44%), with substantial heterogeneity (I² = 96%, p < 0.001). In subgroup analysis, the prevalence of depression among women with PCOS in West, Central, East, and Northeast China was 37%, 37%, 38%, and 25%, respectively. The prevalence of depression among women with PCOS surveyed before and after 2015 was 40% and 35%, respectively. The prevalence of depression among women with PCOS aged < 26 and > / = 26 years were 42% and 33%, respectively. The prevalence of depression among women with PCOS that participants' BMI < 24 and > / = 24 kg/m² were 38% and 34%, respectively. The prevalence of depression among women with PCOS that used Self-rating Depression Scale (SDS), Patient Health Questionnaire-9 (PHQ-9), Beck Depression Inventory (BDI), and Hospital Anxiety and Depression Scale (HADS) were 40%, 34%, 31%, and 24%, respectively. Sensitivity analysis and meta-regression confirmed the stability of the findings. Evidence of publication bias was detected.</p><p><strong>Conclusions: </strong>The high prevalence of depression among women with PCOS in China underscores the need for integrated screening and management. The results of this meta-analysis show high heterogeneity and indicate publication bias, which reduces the generalizability of the findings. Future research should address heterogeneity and enhance the applicability of results.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"920"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological therapy for the prevention of suicide in prison: study protocol for a randomised controlled trial.","authors":"Daniel Pratt, Tim Kirkpatrick, Yvonne Awenat, Caroline Hendricks, Amanda Perry, Leslie-Anne Carter, Rebecca Crook, Paula Duxbury, Charlotte Lennox, Sarah Knowles, Helen Brooks, Linda Davies, Gemma Shields, David Honeywell, Louis Appleby, Patricia Gooding, Dawn Edge, Richard Emsley, Jenny Shaw, Gillian Haddock","doi":"10.1186/s12888-024-06320-y","DOIUrl":"https://doi.org/10.1186/s12888-024-06320-y","url":null,"abstract":"<p><strong>Background: </strong>Suicide is the leading cause of preventable death in prisons. Deaths from suicide in prison are significantly, and persistently, elevated compared to those living in the community. Psychological therapies have been shown to be a potentially effective means of alleviating suicidal thoughts, plans and behaviours, but patients located in prison often have no access to evidence-based psychological interventions targeting suicide. The objectives of this programme of research are to investigate the clinical and cost effectiveness of a new psychological therapy programme delivered to male prisoners at risk of suicide.</p><p><strong>Methods: </strong>The PROSPECT trial is a two-armed single blind, pragmatic, randomised controlled trial and will recruit a target sample size of 360 male prisoners, identified as at-risk of suicide, across 4 prisons in the North of England. Participants will be randomised to receive a psychological talking therapy (Cognitive Behavioural Suicide Prevention, CBSP) plus treatment as usual, or treatment as usual alone. Co-primary outcomes (Suicide Ideation and Suicide Behaviours), as well as related secondary outcomes, will be assessed at baseline and at 6-months follow-up. An intention to treat analysis will be conducted with primary stratification based on prison site and lifetime history of suicide attempt (yes/no). A nested qualitative process evaluation will investigate the nature and context in which the intervention is delivered, with specific focus upon the facilitators and barriers to the implementation of the therapy within prisons.</p><p><strong>Discussion: </strong>The key outputs from this trial will be to determine whether a psychological therapy for suicidal prisoners is clinically and cost effective; and to generate a project implementation platform that identifies how best to implement the new intervention across the broader prison estate.</p><p><strong>Trial registration: </strong>ISRCTN (reference ISRCTN14056534 https://www.isrctn.com/ISRCTN14056534 ; 24th September 2021). Registration confirmed prior to participant recruitment commencing. Modifications to protocol are listed on the study website at ISRCTN.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"927"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of single sessions of aerobic exercise at varying intensities on depressive symptoms in college students: evidence from resting-state EEG in the parietal region.","authors":"Cong Liu, Shuqi Jia, Xiang Wang, Xingze Wang, Xing Wang","doi":"10.1186/s12888-024-06322-w","DOIUrl":"https://doi.org/10.1186/s12888-024-06322-w","url":null,"abstract":"<p><strong>Background: </strong>The incidence of depression among college students is increasingly high, significantly impacting their daily lives. This study aims to utilize electroencephalography (EEG) to assess the effects of varying intensities of single-session aerobic exercise on depression symptoms in college students.</p><p><strong>Objective: </strong>This study aimed to explore the effects of single sessions of aerobic exercise at varying intensities on depressive symptoms in college students through changes in BDI-II (Beck Depression Inventory-II) scores and resting-state EEG lateralization.</p><p><strong>Methods: </strong>Depressed college students were randomly assigned to low, moderate, high-intensity exercise, and control groups. The study investigated the relationship between BDI-II scores and resting-state EEG parietal region lateralization and the impact of single sessions of aerobic exercise at different intensities on depressive symptoms.</p><p><strong>Results: </strong>BDI-II scores were negatively correlated with parietal region α2 (P < 0.01) and β1 (P < 0.05) lateralization in depressed students. Low-intensity exercise significantly reduced BDI-II scores (P < 0.05). Moderate-intensity exercise resulted in significant changes in BDI-II scores (P < 0.001), α2 lateralization (P = 0.002), and β1 lateralization (P = 0.006). Post-test comparisons showed significant differences in BDI-II (P = 0.048), α2 (P = 0.002), and β1 (P = 0.041) compared to the control group, and differences in α2 (P = 0.021) and β1 (P = 0.041) compared to the low-intensity group. High-intensity exercise also significantly altered BDI-II scores (P < 0.001) and α2 (P = 0.035). Post-test comparisons showed differences in BDI-II compared to low-intensity (P < 0.001), moderate-intensity (P = 0.01), and control groups (P < 0.001), and differences in α2 compared to the control group (P = 0.011). BDI-II changes were negatively correlated with changes in α2 (P < 0.01) and β1 (P < 0.05).</p><p><strong>Conclusion: </strong>From the perspective of the BDI-II, various intensities of a single bout of aerobic exercise can alleviate depressive symptoms in college students. Additionally, regarding the lateralization of resting EEG in the parietal region, moderate-intensity aerobic exercise demonstrates a more comprehensive improvement. The alleviation of depressive symptoms in college students is, to some extent, associated with the synergy within the parietal region.</p><p><strong>Trial registration: </strong>The study was registered in the Chinese Clinical Trial Registry (ChiCTR2400087920, 07/08/2024).</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"928"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered dynamic functional connectivity in antagonistic state in first-episode, drug-naïve patients with major depressive disorder.","authors":"Min Wang, Tao Chen, Zhongyi He, Lawrence Wing-Chi Chan, Qinger Guo, Shuyang Cai, Jingfeng Duan, Danbin Zhang, Xunda Wang, Yu Fang, Hong Yang","doi":"10.1186/s12888-024-06356-0","DOIUrl":"https://doi.org/10.1186/s12888-024-06356-0","url":null,"abstract":"<p><strong>Objective: </strong>Major depressive disorder (MDD) is known to be characterized by disrupted brain functional network connectivity (FNC) patterns, while the dynamic change mode of different functional networks is unclear. This study aimed to characterize specific dynamic alterations pattern on intrinsic FNC in MDD by combining static FNC (sFNC) and dynamic FNC (dFNC).</p><p><strong>Methods: </strong>A total of 48 first-episode drug-naïve MDD and 48 matched healthy controls (HCs) were included in this study. The sFNC and dFNC were analyzed using complete time-series and sliding window approach, respectively. Both sFNC and dFNC differences between groups were analyzed and associations between disease severity and aberrant FNC were explored.</p><p><strong>Results: </strong>MDD patients exhibited lower sFNC within and between sensory and motor networks than HC. Four dFNC states were identified, including a globally-weakly-connected state, a cognitive-control-dominated state, a globally-positively-connected state, and an antagonistic state. The antagonistic state was marked by strong positive connections within the sensorimotor domain and their anti-correlations with the executive-motor control domain. Notably, MDD patients exhibited significantly longer dwell time in the globally-weakly-connected state, at the cost of significantly shorter dwell time in the antagonistic state. Further, only the mean dwell time of this antagonistic state was significantly anticorrelated to disease severity measures.</p><p><strong>Conclusions: </strong>Our study highlights the altered dynamics of the antagonistic state as a fundamental aspect of disrupted FNC in early MDD.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"909"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antidepressant response time across intermittent theta burst stimulation regimens and efficacy indicators in adolescents depression: a secondary analysis from a randomized controlled trial.","authors":"Min Zhang, Weicheng Li, Zhibo Hu, Hanna Lu, Yanling Zhou, Yuping Ning","doi":"10.1186/s12888-024-06346-2","DOIUrl":"https://doi.org/10.1186/s12888-024-06346-2","url":null,"abstract":"<p><strong>Background: </strong>Accelerated intermittent theta burst stimulation (aiTBS), which involves the administration of multiple daily sessions of iTBS, represents a novel regimen of repetitive transcranial magnetic stimulation. Studies have suggested that aiTBS may facilitate a fast response among patients with major depressive disorders. However, whether aiTBS can accelerate antidepressant response in adolescents suffering from depression is still unclear. Additionally, the potential indicators associated with antidepressant response in this population are still understudied.</p><p><strong>Methods: </strong>Ninety adolescents with depression were recruited and randomly assigned to aiTBS (two 600-pulse sessions of iTBS spaced for 10 min, N = 31), iTBS (one 600-pulse session, N = 29), or sham iTBS (N = 30) for two treatment weeks. Kaplan-Meier analysis was used to estimate the mean time to antidepressant response among the three groups. The analysis of covariance and the multiple logistic regression were applied to identify potential indicators associated with treatment response.</p><p><strong>Results: </strong>The mean time to antidepressant response was 7.45 weeks (95% CI: 6.19-8.72) in the aiTBS group, 5.62 weeks (95% CI: 4.09-7.16) in the iTBS group, and 5.07 weeks (95% CI: 3.56-6.58) in the sham group, respectively. The log rank test revealed no significant difference in the mean time to antidepressant response among the three groups (χ² = 4.156, p = 0.125). For the antidepressant response, there were also no significant interactions between iTBS treatment regimens and the baseline characteristics. Notably, participants with higher motor threshold and worse global function at baseline were likely to be associated with early response and final response, respectively, while those who experiencing child-parent separation were associated with both early and final response. In addition, younger participants were more likely to experience recurrence during follow-up.</p><p><strong>Conclusions: </strong>aiTBS did not demonstrate an advantage in terms of a fast antidepressant response. However, some pretreatment characteristics might serve as indicators of antidepressant response. This relatively simple application based on pretreatment characteristics seems to be a cost-effective method to identify adolescents who are more likely to develop an early antidepressant response and sustain it.</p><p><strong>Trial registration: </strong>This is a secondary analysis of a primary RCT, which was officially registered in the Chinese Clinical Trial Registry at 19/1/2021 with the number of ChiCTR2100042346. https://www.chictr.org.cn/bin/project/edit?pid=66118 .</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"905"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between adherence to behavioral intervention and capability well-being among parents of autistic children: a cross-sectional study from China.","authors":"Huanyu Zhang, Shanquan Chen, Jiazhou Yu, Xuejing Niu, Xue Wang, Li Wang","doi":"10.1186/s12888-024-06394-8","DOIUrl":"https://doi.org/10.1186/s12888-024-06394-8","url":null,"abstract":"<p><strong>Background: </strong>High adherence to behavioral interventions among parents of autistic children contribute to improvement in children's behaviors and parental outcomes. However, most of previous studies focused on the effects of intervention adherence on health-related well-being among parents, which is inadequate to capture the multi-dimensional parental burden of caring for autistic children. The aim of this study is to assess the association between parents' adherence to behavioral intervention and their capability well-being.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among caregivers of autistic children aged 1-17 years with a confirmed diagnosis in China. A total of 213 parents of autistic children who were currently receiving behavioral intervention were considered in this study. Parental adherence to behavioral intervention was evaluated by the 5-item General Adherence subscale of the Medical Outcome Study. Capability well-being was assessed using the Investigating Choice Experiments Capability Measures for Adults (ICECAP-A), including the domains of stability, attachment, autonomy, achievement, and enjoyment. The index scores for each domain were computed based on the preference-based value set in the United Kingdom, ranging from 0 to 1. Multivariate linear regression analyses were conducted to assess the relationship between intervention adherence and parental well-being. Intervention adherence as well as the variables with p < 0.1 in the univariate analyses were included in multivariate linear regression analyses.</p><p><strong>Results: </strong>The mean overall score of ICECAP-A was 0.681 (0.205). In the univariate analyses, intervention adherence was positively associated with stability, autonomy, achievement, and enjoyment (p < 0.05), while the relationship between intervention adherence and attachment was not significant (p = 0.07). After controlling for the confounders in the multivariate linear regression analyses, intervention adherence was positively associated with achievement (β = 0.0004) and enjoyment (β = 0.0004).</p><p><strong>Conclusions: </strong>The overall capability well-being among parents of autistic children was worse than that of the general population and caregivers of adult patients with chronic diseases. Adherence to behavioral interventions was positively associated with parental well-being in terms of achievement and enjoyment. Health professionals should involve parents in behavioral interventions and encourage them to implement therapeutic strategies on a routine basis. Customized interventions are warranted to improve capability well-being targeting at vulnerable groups.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"922"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between internet addiction and suicidal ideation in depressed adolescents: the mediating effect of insomnia as well as sex differences.","authors":"Lewei Liu, Yinghan Tian, Haojie Fan, Jiawei Wang, Changhao Chen, Zhiwei Liu, Feng Geng, Daming Mo, Xiangfen Luo, Xiangwang Wen, Xin Zhao, Mingru Hao, Lei Xia, Huanzhong Liu","doi":"10.1186/s12888-024-06357-z","DOIUrl":"https://doi.org/10.1186/s12888-024-06357-z","url":null,"abstract":"<p><strong>Background: </strong>Insomnia may mediate the association between internet addiction (IA) and suicidal ideation (SI). However, such association has not been thoroughly investigated in adolescents with major depressive disorder (MDD). Thus, our study aimed to explore whether insomnia significantly affects the association between IA and SI in adolescents with MDD, as well as any sex differences.</p><p><strong>Methods: </strong>From January 2021 to September 2023, this cross-sectional study included 502 adolescents with MDD and 123 healthy controls (HCs). The Clinical Global Impression-Severity (CGI-S), the Internet Addiction Test (IAT), the Insomnia Severity Index Scale (ISI) and the Positive and Negative Suicidal Ideation Scale (PANSI) were used to assess subjects' severity of depression, IA, insomnia and SI. And we employed the PROCESS macro program to examine the mediating role of insomnia between IA and SI.</p><p><strong>Results: </strong>Compared to HCs, adolescents with MDD had significantly higher levels of SI and their prevalence of IA and insomnia were 50.0% and 35.7%. In patients, PANSI scores correlated negatively with age and age of onset, and positively with disease duration as well as the scores of the CGI-S, IAT, and ISI (all p < 0.01). Moreover, above-mentioned correlations were more significant in girls. Mediation analyses showed that insomnia mediated the effect of IA on SI, and the total, direct, and indirect effects were 0.197 (95% CI: 0.132-0.262), 0.157 (95% CI: 0.096-0.218) and 0.040 (95% CI: 0.014-0.068), respectively. In female patients, the total, direct, and indirect effects were 0.224 (95% CI: 0.151-0.296), 0.191 (95% CI: 0.124-0.257) and 0.033 (95% CI: 0.002-0.068), respectively. In male patients, insomnia acted as a fully mediated effect between IA and SI, with an effect value of 0.045 (95% CI: 0.008-0.093).</p><p><strong>Conclusion: </strong>Depressed adolescents have higher suicide risk, and SI is significantly associated with IA and insomnia, especially in girls. Moreover, insomnia may mediate the association between IA and SI. However, given the small sample size of this study and the limitations of assessment tools used, the results need to be viewed with caution. Regardless, clinical interventions should be strengthened for IA and insomnia in adolescents with MDD to reduce suicide risk.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"929"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auxiliary identification of depression patients using interpretable machine learning models based on heart rate variability: a retrospective study.","authors":"Min Yang, Huiqin Zhang, Minglan Yu, Yunxuan Xu, Bo Xiang, Xiaopeng Yao","doi":"10.1186/s12888-024-06384-w","DOIUrl":"https://doi.org/10.1186/s12888-024-06384-w","url":null,"abstract":"<p><strong>Objective: </strong>Depression has emerged as a global public health concern with high incidence and disability rates, which are timely imperative to identify and intervene in clinical practice. The objective of this study was to explore the association between heart rate variability (HRV) and depression, with the aim of establishing and validating machine learning models for the auxiliary diagnosis of depression.</p><p><strong>Methods: </strong>The data of 465 outpatients from the Affiliated Hospital of Southwest Medical University were selected for the study. The study population was then randomly divided into training and test sets in a 7:3 ratio. Logistic regression (LR), support vector machine (SVM), random forest (RF) and eXtreme gradient boosting (XGBoost) algorithm models were used to construct risk prediction models in the training set, and the model performance was verified in the test set. The four models were evaluated by the area under the receiver operating characteristic curve (ROC), calibration curve and the decision curve analysis (DCA). Furthermore, we employed the SHapley Additive exPlanations (SHAP) method to illustrate the effects of the features attributed to the model.</p><p><strong>Results: </strong>There were 237 people in the depressed group and 228 in the non-depressed group. In the training set (n = 325) and test set (n = 140), the area under of the curve(AUC) values of the XGBoost model are 0.92 [95% confidence interval (CI) 0.888,0.95] and 0.82 (95% CI 0.754,0.892)] respectively, which are higher than the other three models. The XGBoost model has excellent predictive efficacy and clinical utility. The SHAP method was ranked according to the importance of the degree of influence on the model, with age, heart rate, Standard deviation of the NN intervals (SDNN), two nonlinear parameters of HRV and sex considered to be the top 6 predictors.</p><p><strong>Conclusion: </strong>We provided a feasibility study of HRV as a potential biomarker for depression. The proposed model based on HRV provides clinicians with a quantitative auxiliary diagnostic tool, which is assist to improving the accuracy and efficiency of depression diagnosis, and can also be utilized for the monitoring and prevention of depression.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"914"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}