BMC Psychiatry最新文献

{"title":"The prevalence and correlates of low resilience in patients prior to discharge from acute psychiatric units in Alberta, Canada.","authors":"Ernest Owusu, Wanying Mao, Reham Shalaby, Hossam Eldin Elgendy, Belinda Agyapong, Ejemai Eboreime, Mobolaji A Lawal, Nnamdi Nkire, Yifeng Wei, Peter H Silverstone, Pierre Chue, Xin-Min Li, Wesley Vuong, Arto Ohinmaa, Valerie Taylor, Carla T Hilario, Andrew J Greenshaw, Vincent I O Agyapong","doi":"10.1186/s12888-025-06704-8","DOIUrl":"10.1186/s12888-025-06704-8","url":null,"abstract":"<p><strong>Background: </strong>Many people experience at least one traumatic event in their lifetime. Although such traumatic events can precipitate psychiatric disorders, many individuals exhibit high resilience by adapting to such events with little disruption or may recover their baseline level of functioning after a transient symptomatic period. Low levels of resilience are under-explored, and this study investigates the prevalence and correlates of low resilience in patients before discharge from psychiatric acute care facilities.</p><p><strong>Methods: </strong>Respondents for this study were recruited from nine psychiatric in-patient units across Alberta. Demographic and clinical information were collected via a REDCap online survey. The brief resilience scale (BRS) was used to measure levels of resilience where a score of less than 3.0 was indicative of low resilience. A chi-square analysis followed by a binary logistic regression model was employed to identify significant predictors of low resilience.</p><p><strong>Results: </strong>A total of 1,004 individuals took part in this study. Of these 35.9% were less than 25 years old, 34.7% were above 40 years old, 54.8% were female, and 62.3% self-identified as Caucasian. The prevalence of low resilience in the study cohort was 55.3%. Respondents who identified as females were one and a half times more likely to show low resilience (OR = 1.564; 95% C.I. = 1.79-2.10), while individuals with 'other gender' identity were three and a half times more likely to evidence low resilience (OR = 3.646; 95% C.I. = 1.36-9.71) compared to males. Similarly, Caucasians were two and one-and-a-half times respectively more likely to present with low resilience compared with respondents who identified as Black (OR = 2.21; 95% C.I. = 1.45-3.70) or Asian (OR = 1.589; 95% C.I. = 1.45-2.44). Additionally, individuals with a diagnosis of depression were significantly more likely to have low resilience than those with a diagnosis of either bipolar disorder (OR = 2.567; 95% C.I. = 1.72-3.85) or schizophrenia (OR = 4.081;95% C.I. = 2.63-6.25).</p><p><strong>Conclusion: </strong>Several demographic and clinical factors were identified as predictors of likely low resilience. The findings may facilitate the identification of vulnerable groups to enable their increased access to support programs that may enhance resilience.</p><p><strong>Clinical trial registration: </strong>clinicaltrials.gov, NCT05133726. Registered on the 24th of November 2021.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"295"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728392","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":"A 10-week remote monitoring study of sleep features and their variability in individuals with and without ADHD.","authors":"Hayley Denyer, Ewan Carr, Qigang Deng, Philip Asherson, Andrea Bilbow, Amos Folarin, Madeleine J Groom, Chris Hollis, Heet Sankesara, Richard Jb Dobson, Jonna Kuntsi","doi":"10.1186/s12888-025-06729-z","DOIUrl":"10.1186/s12888-025-06729-z","url":null,"abstract":"<p><strong>Background: </strong>People with attention deficit hyperactivity disorder (ADHD) often report disturbed sleep, as well as co-occurring symptoms of anxiety and depression. Yet studies employing objective assessments often do not show as many sleep disturbances compared to subjective measures. These discrepancies may relate to subjective reports capturing problematic nights, which may not be captured in a single night's sleep or by averaging objective measurements over several nights. Given that variability in behaviours is in general strongly linked to ADHD, individuals with ADHD could have greater sleep variability than individuals without ADHD. Using active and passive remote monitoring, we investigate differences in the level and variability of daily sleep behaviours between individuals with and without ADHD and explore if sleep is associated with changes in anxiety and depressive symptoms across a 10-week remote monitoring period.</p><p><strong>Methods: </strong>Forty individuals (20 with ADHD, 20 without) took part in a 10-week remote monitoring study. Active monitoring involved participants completing questionnaires on ADHD and co-occurring psychiatric symptoms at weeks 2, 6 and 10. Passive monitoring involved participants wearing a wearable device (Fitbit) that measured sleep each night.</p><p><strong>Results: </strong>Individuals with and without ADHD were similar in the levels of sleep recorded each night. However, compared to those without ADHD, participants with ADHD had more variable sleep duration, sleep onset and offset, and sleep efficiency over 10 weeks. Within-individual associations of co-occurring anxiety and depressive symptoms with the sleep features were non-significant.</p><p><strong>Conclusions: </strong>In a 10-week remote monitoring study of sleep using a wearable device, we show that what distinguishes individuals with ADHD from those without is their greater variability in sleep features: participants with ADHD had a more variable sleep duration, sleep onset and offset, and sleep efficiency. Inconsistency and high variability are hallmarks of ADHD, and we show that this characteristic extends also to sleep among adolescents and adults with ADHD.</p><p><strong>Trial registration: </strong>Clinical trial number: not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"294"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728385","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":"Correction: Prevalence of depression and its correlates among undergraduate health science students in Mogadishu, Somalia: a cross-sectional study.","authors":"Bashiru Garba, Samiro Ali Mohamed, Maria Mowlid Mohamed, Hodo Aideed Asowe, Najib Isse Dirie, Yushau Umar, Jamal Hassan Mohamoud, Mohamed Hussein Adam, Jihaan Hassan, Fartun Abdullahi Hassan Orey, Abdullahi Abdirahman Omar, Ibrahim Abdullahi Mohamed, Mohamed Mustaf Ahmed, Samira Abdullahi Moalim","doi":"10.1186/s12888-025-06645-2","DOIUrl":"10.1186/s12888-025-06645-2","url":null,"abstract":"","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"293"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728387","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":"Smoking impairs cognitive function through the mediating effect of periodontitis in older adults.","authors":"Xiaoqian Luan, Zhou Jin, Shenhang Xia, Jin Li, Yao An, Jiaqi Gao, Shengya Wang, Huwei Xia, Sipei Pan, Yao Zhang, Weihong Song, Yili Wu","doi":"10.1186/s12888-025-06699-2","DOIUrl":"10.1186/s12888-025-06699-2","url":null,"abstract":"<p><strong>Objectives: </strong>Evidence has shown that both smoking and periodontitis were linked to cognitive impairment. This study examines whether periodontitis mediates the effects of smoking status on cognitive function in older adults.</p><p><strong>Methods: </strong>Using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014, the study included 1728 older participants who have data on smoking, serum cotinine, periodontal examination, and cognitive function. Mediation analysis was performed to test whether extent of periodontitis mediated associations between smoking status and cognitive function, adjusted for sociodemographic and basic health factors.</p><p><strong>Results: </strong>Compared to never-smokers, daily smokers exhibited significantly worse global cognitive function, with periodontitis mediating this effect (effect= -0.16; 95% CI= -0.29, -0.05). Similarly, periodontitis mediated the association between serum cotinine levels and cognitive function in the total sample (effect= -0.02; 95% CI= -0.03, -0.00).</p><p><strong>Conclusions: </strong>Periodontitis significantly mediates the impact of smoking on cognitive function. The findings highlight the potential roles of maintaining oral health and smoking cessation in mitigating cognitive decline.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"292"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728390","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":"Longitudinal trajectories of subjective cognitive complaints in patients with major depressive disorder and similar objective cognitive trajectories.","authors":"Xuequan Zhu, Xiongying Chen, Yuanzhen Wu, Lei Feng, Xu Chen","doi":"10.1186/s12888-025-06538-4","DOIUrl":"10.1186/s12888-025-06538-4","url":null,"abstract":"<p><strong>Background: </strong>We examined the factors influencing various subtypes of subjective cognitive change in patients who shared similar objective cognitive trajectories within 6 months.</p><p><strong>Method: </strong>We used data from an observational, prospective, cohort study, including 598 patients with major depressive disorder (MDD) in latent class mixed models based on the digit symbol substitution test performance. Participants were stratified into four distinct objective cognitive layers: \"low cognitive performance,\" \"lower-middle cognitive performance,\" \"upper-middle cognitive performance,\" and \"high cognitive performance.\" Within each of the four layers, the trajectories of subjective cognitive complaints were identified. Multinomial regression was employed, with cognitive complaint trajectories as the outcome, and depressive symptoms, clinical features, and other covariates as predictors.</p><p><strong>Results: </strong>The factors influencing the subjective trajectories varied among the different objective layers. Patients with comorbid anxiety disorders or functional syndromes had more prominent self-reported cognitive symptoms and a slower rate of improvement. Younger age and lower education level were also influential factors for delayed remission of subjective cognitive function. Disease severity and antidepressant type did not contribute to dedifferentiating subjective cognitive trajectory subtypes within different subjective cognitive trajectories.</p><p><strong>Conclusion: </strong>Despite similar objective cognitive trajectories, subjective perceptions of these cognitive changes are heterogeneous. These findings deepen our understanding of the multifaceted nature of cognitive change in individuals with MDD and underscore the importance of considering a range of factors when interpreting and treating cognitive impairment at an early stage.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"287"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717559","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":"Machine learning-driven development of a stratified CES-D screening system: optimizing depression assessment through adaptive item selection.","authors":"Ruo-Fei Xu, Zhen-Jing Liu, Shunan Ouyang, Qin Dong, Wen-Jing Yan, Dong-Wu Xu","doi":"10.1186/s12888-025-06693-8","DOIUrl":"10.1186/s12888-025-06693-8","url":null,"abstract":"<p><strong>Objective: </strong>To develop a stratified screening tool through machine learning approaches for the Center for Epidemiologic Studies Depression Scale (CES-D-20) while maintaining diagnostic accuracy, addressing the efficiency limitations in large-scale applications.</p><p><strong>Methods: </strong>Data were derived from the Chinese Psychological Health Guard Project (primary sample: n = 179,877; age 9-18) and China Labor-force Dynamics Survey (validation samples across age spans). We employed a two-stage machine learning approach: first applying Recursive Feature Elimination with multiple linear regression to identify core predictive items for total depression scores, followed by logistic regression for optimizing depression classification (CES-D ≥ 16). Model performance was systematically evaluated through discrimination (ROC analysis), calibration (Brier score), and clinical utility analyses (decision curve analysis), with additional validation using random forest and support vector machine algorithms across independent samples.</p><p><strong>Results: </strong>The resulting stratified screening system consists of an initial four-item rapid screening layer (encompassing emotional, cognitive, and interpersonal dimensions) for detecting probable depression (AUC = 0.982, sensitivity = 0.945, specificity = 0.926), followed by an enhanced assessment layer with five additional items. Together, these nine items enable accurate prediction of the full CES-D-20 total score (R² = 0.957). This stratified approach demonstrated robust generalizability across age groups (R² > 0.94, accuracy > 0.91) and time points. Calibration analyses and decision curve analyses confirmed optimal clinical utility, particularly in the critical risk threshold range (0.3-0.6).</p><p><strong>Conclusions: </strong>This study contributes to the refinement of CES-D by developing a machine learning-derived stratified screening version, offering an efficient and reliable approach that optimizes assessment burden while maintaining excellent psychometric properties. The stratified design makes it particularly valuable for large-scale mental health screening programs, enabling efficient risk stratification and targeted assessment allocation.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"286"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708119","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":"Schema therapy in partially sighted individuals with a focus on social isolation and self-esteem: an interventional study.","authors":"Amirhossein Abbasi, Jamileh Farokhzadian, Mahya Torkaman, Sakineh Miri","doi":"10.1186/s12888-025-06732-4","DOIUrl":"10.1186/s12888-025-06732-4","url":null,"abstract":"<p><strong>Background: </strong>Visual impairment can lead to low self-esteem and social isolation for partially sighted individuals. Schema therapy offers a systematic approach to identifying and modifying maladaptive schemas formed in the past. This therapy has proven effective in treating mental disorders and preventing their recurrence. This study aimed to investigate the effectiveness of schema therapy in addressing social isolation and enhancing self-esteem among partially sighted individuals.</p><p><strong>Methods: </strong>This interventional study involved 66 partially sighted individuals who referred to Tavangaran Institute in Shiraz, southwestern Iran. Participants were randomly assigned to two groups: an intervention group (n = 33) and a control group (n = 33). The intervention group received eight sessions of schema therapy over four weeks, with two sessions per week. Data were collected from both groups using the University of California at Los Angeles Loneliness Scale and the Rosenberg Self-Esteem Scale at three time points: before the intervention, immediately after the intervention, and one month post-intervention.</p><p><strong>Results: </strong>Mean social isolation scores in the intervention group decreased significantly from 65.03 ± 2.76 before the intervention to 35.93 ± 2.80 immediately after the intervention, and 38.36 ± 3.19 one month later (p < 0.001). Additionally, mean self-esteem scores increased significantly from 13.27 ± 1.27 to 22.30 ± 2.24 immediately after the intervention and 20.75 ± 2.43 one month after the intervention (p < 0.001). These post-intervention scores were significantly higher than that in the control group (p-value < 0.001).</p><p><strong>Conclusion: </strong>The results of this study demonstrated the effectiveness of schema therapy in improving self-esteem and reducing social isolation among partially sighted individuals. Healthcare providers, including psychologists and psychiatric nurses, are encouraged to consider using this intervention with other vulnerable groups, such as individuals with disabilities or physical impairments, who may experience similar challenges in self-esteem and social interaction.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"289"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717560","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":"Impact of an opioid use disorder medication implementation intervention on hospitalization and emergency department utilization in the Veterans Health Administration.","authors":"Madeline C Frost, Carol A Malte, Amy J Kennedy, Andrew J Saxon, Adam J Gordon, Hildi J Hagedorn, Emily C Williams, Ryan S Trim, Aline Lott, Anissa N Danner, Eric J Hawkins","doi":"10.1186/s12888-025-06722-6","DOIUrl":"10.1186/s12888-025-06722-6","url":null,"abstract":"<p><strong>Background: </strong>It is important to evaluate how medication for opioid use disorder (MOUD) implementation interventions impact downstream outcomes, however little is known about impact on hospitalization and emergency department (ED) utilization. Stepped Care for Opioid Use Disorder Train the Trainer (SCOUTT) is a national United States Veterans Health Administration (VHA) effort initially implemented at 18 facilities that increased MOUD receipt in primary care, mental health, and pain clinics. This evaluation assessed SCOUTT's impact on hospitalization and ED utilization.</p><p><strong>Methods: </strong>This evaluation used a controlled interrupted time series analysis. We extracted electronic health record data for patients with OUD and ≥ 1 visit in an intervention clinic (N = 35) or matched comparison clinic (N = 35) in the post-implementation year. We examined monthly measures of hospitalization and ED utilization in the pre-implementation (9/1/2017-8/31/2018) and post-implementation (9/1/2018-8/31/2019) years. Segmented regression models estimated pre-post immediate and trend changes in intervention relative to comparison clinics, adjusting for pre-implementation trends and patient characteristics. Sensitivity analyses were conducted among patients with ≥ 1 visit in both the pre-/post-implementation years, and post-hoc secondary analyses were conducted among patients with OUD and ≥ 1 other SUD vs. OUD only.</p><p><strong>Results: </strong>Patients with OUD in both intervention (N = 7,488) and comparison (N = 7,558) clinics had a mean age of 53 years, and the majority were male, White, and not married. During the pre-implementation period, hospitalization and ED utilization increased over time in both intervention and comparison clinics; during the post-implementation period, hospitalization and ED utilization decreased over time in intervention clinics and remained stable in comparison clinics. There was no significant difference in pre-post changes between intervention and comparison clinics for most analyses. In sensitivity analyses the pre-to-post decrease in monthly trend for ED visits was larger in intervention clinics and, in secondary analyses, the pre-to-post decrease in monthly trend for hospitalizations was larger in intervention clinics among patients with OUD and ≥ 1 other SUD.</p><p><strong>Conclusions: </strong>This evaluation did not find evidence that SCOUTT substantially impacted hospitalization or ED utilization relative to comparison clinics, though there may have been positive impacts for patients with longer engagement in SCOUTT clinics and patients with OUD and ≥ 1 other SUD.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"288"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717555","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":"Relationship between time perspective and depressive symptoms in young people working in high-altitude environments.","authors":"Nan Mu, Lili Zhang, Mengyin Zhu, Zhengzhi Feng, Yan-Jiang Wang","doi":"10.1186/s12888-025-06710-w","DOIUrl":"10.1186/s12888-025-06710-w","url":null,"abstract":"<p><strong>Background: </strong>Depression rates are significantly higher in high-altitude regions, making it important to understand its underlying mechanisms. Time perspective, which refers to how individuals perceive their past, present, and future, is closely linked to depression in low-altitude areas. However, its relationship with depression in high-altitude regions remains unclear.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted with 4942 young male workers from high-altitude regions. The association between time perspectives and depressive symptoms were examined by univariate and multivariate analyses. Network analysis was employed to identify central symptoms and their interactions, and to compare the differences between individuals with and without depression.</p><p><strong>Results: </strong>The study identified that elevated past negative (PN), reduced past positive (PP), increased present fatalistic (PF) and present hedonistic (PH) orientations, and lower future (F) were significant risk factors for depressive symptoms in plateau populations. In the network structure of the depression group, PN, PF, PH, SDS18 \"emptiness\", and SDS13 \"psychomotor agitation\" were key elements influencing depressive symptoms and the strongest edge was F-PP. Significant differences were detected between the depressive and non-depressive groups, with the depressive group demonstrating significantly greater global strength invariance and a more robust network invariance.</p><p><strong>Conclusions: </strong>Abnormal time perspectives, especially PN, PF and PH were strongly associated with depression in high-altitude environments, and the strong connection between F-PP provides a potential intervention target. Future research should further explore the causal relationship.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"278"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708376","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":"\"Pharmacological management of acute agitation in psychiatric patients: an umbrella review\".","authors":"Erasmo Saucedo Uribe, Cynthia Alejandra Bravo Rodríguez, Miguel Emanuel Navarrete Juárez, Samantha Medrano Juárez, Rodrigo Huereca Lucio, Kevin Eduardo Rojas Guzmán, Luis Carlos Lozano Carrillo","doi":"10.1186/s12888-024-06426-3","DOIUrl":"10.1186/s12888-024-06426-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The main characteristics present in patients with psychomotor agitation include restlessness, excessive motor activity, irritability, and heightened responsiveness to internal and external stimuli. This umbrella review evaluates the efficacy and safety of pharmacological interventions for patients with psychiatric disorders presenting psychomotor agitation, aged 18 years or older. A comprehensive literature search was conducted to identify umbrella reviews that met our study's inclusion criteria. However, no reviews were found that specifically investigated the efficacy and safety of pharmacological interventions for agitated psychiatric patients presenting with both behavioral and psychological symptoms, such as emotional lability, decreased attention span, and cognitive and behavioral alterations. The primary objective is to assess the effectiveness of pharmacological interventions in controlling patients within a short time frame, measured in hours rather than days. The focus was placed on studies addressing treatment in emergency settings, whether in general hospitals or psychiatric facilities, with an emphasis on managing acute psychomotor agitation rather than long-term maintenance treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;A comprehensive literature search for meta-analyses and systematic reviews assessing the efficacy and safety of pharmacological treatment for psychomotor agitation in psychiatric inpatients and emergency department patients was conducted across various databases such as PubMed, Scopus, EMBASE, Web of Science and COCHRANE Central database. Included reviews comprised those that incorporated randomized controlled trials (RCTs) or non-randomized controlled trials (NRCTs) comparing the efficacy and safety of pharmacological interventions for agitated psychiatric patients (with both psychological and behavioral symptoms).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Loxapine (10 mg) demonstrated superior efficacy over 5 mg in reducing agitation within 120 min, with inhaled formulations providing rapid relief in patients with acute psychosis. Aripiprazole was effective and caused less sedation compared to Olanzapine, although Haloperidol required fewer additional doses but was less effective at 60 min. Ziprasidone, administered intramuscularly, offered a faster onset and was better tolerated than Haloperidol. Lorazepam proved effective with fewer side effects than antipsychotics and showed enhanced efficacy when combined with them. Midazolam provided rapid sedation but posed risks of severe side effects, especially in older adults. Droperidol was as effective as Olanzapine but provided faster sedation. Combination therapy, such as Haloperidol with Promethazine, effectively reduced aggression with a lower incidence of adverse effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This umbrella review offers a comprehensive overview of the pharmacological management of psychomotor agitation in patients with psychiatric dis","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"273"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708372","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}