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Predictors of the placebo response in a nutraceutical randomized controlled trial for depression

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Journal of Integrative Medicine 2024年第1期22卷 46-53页

作者： Rosemary Arnold Jenifer Murphy-Smith Chee H.Ng David Mischoulon Gerard J.Byrne Chad A.Bousman Con Stough Michael Berk Jerome Sarris Professorial Unit the Melbourne ClinicDepartment of PsychiatryUniversity of MelbourneRichmond 3121Australia Depression Clinical and Research program Department of PsychiatryMassachusetts General HospitalHarvard Medical SchoolBostonMA 02115USA Faculty of Medicine Discipline of PsychiatryCentre for Clinical ResearchRoyal Brisbane&Women’s HospitalHerstonthe University of QueenslandBrisbane 4006Australia Departments of Medical Genetics PsychiatryPhysiology&Pharmacology and Community Health SciencesUniversity of CalgaryCalgaryAB T2N 1N4Canada Department of psychiatry the University of MelbourneMelbourne 3052Australia Centre for Human Psychopharmacology Swinburne UniversityMelbourne 3122Australia The Institute for Mental and Physical Health and Clinical Translation School of MedicineBarwon HealthDeakin UniversityGeelong 3220Australia The Centre of Excellence in Youth Mental Health the University of MelbourneParkville 3052Australia Florey Institute of Neuroscience and Mental Health the University of MelbourneParkville 3052Australia NICM Health Research Institute Western Sydney UniversityWestmeadNSW 2145Australia

Objective The placebo response in depression studies is the change in symptoms amongst those who receive an inactive *** well-designed randomized controlled trials(RCTs)of depression have a high proportion of placebo responders,with little understanding as to *** present study assesses characteristics associated with the placebo response in a nutraceutical trial with a large proportion of placebo *** This is a secondary analysis of a nutraceutical depression RCT which identified no overall treatment benefit relative to placebo(n=69 in placebo group).We investigated participant characteristics such as socio-demographics,clinical features,and recruitment methods,and their association with the placebo *** genetic polymorphisms were also *** response was measured based on change in Montgomery-Asberg Depression Rating Scale *** association of these hypothesis-driven variables of interest and the placebo response was examined using linear mixed effects *** Greater levels of education,particularly pursuing post-high school education,better self-reported general health,marriage/de facto,greater improvement in the first trial week,and more failed antidepressant therapies in the current depressive episode were associated with greater placebo *** increased placebo response was not found in those recruited via social media nor in those with concomitant antidepressant *** nucleotide polymorphisms from the tryptophan hydroxylase 1(TPH1)gene(A779C and A218C)were weakly associated with greater placebo response,although the evidence was attenuated after accounting for multiple *** This is,to our knowledge,the first study within nutraceutical research for depression to assess the association between participant characteristics and variation in the placebo *** variables appeared to predict the placebo *** findings may encourage future trial design

关键词： Randomized controlled trial Placebo Depression Nutraceutical psychiatry

Deciding on life-saving treatment after a violent suicide attempt:an ethical case report

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General psychiatry 2024年第2期37卷 289-291页

作者： Robert Wichers Hanna M Heller Sisco van Veen Department of Child and Adolescent psychiatry&Psychosocial Care Amsterdam University Medical CenterLocation AMCAmsterdamThe Netherlands Amsterdam Public Health Mental Health programAmsterdamThe Netherlands Department of Hospital psychiatry Amsterdam University Medical CenterLocation VUmcAmsterdamThe Netherlands Research Department 113 Suicide PreventionAmsterdamThe Netherlands Department of psychiatry&Department of Ethics Law and HumanitiesAmsterdam University Medical CenterAmsterdamThe Netherlands GGZ inGeest Mental Health Care AmsterdamThe Netherlands

To the editor:In the USA alone,there were 1.7 million suicide attempts in 2021.1 Although the majority of suicide attempts are not fatal,immediate medical attention is often necessary,especially when violent methods are used.2 These methods include jumping from heights,using a firearm,crashing a motor vehicle,and lying down or jumping in front of a moving object.

关键词： treatment editor alone

Incidence and risk factors of depression in patients with metabolic syndrome

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World Journal of psychiatry 2024年第2期14卷 245-254页

作者： Li-Na Zhou Xian-Cang Ma Wei Wang Department of psychiatry The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061Shaanxi ProvinceChina

BACKGROUND Many studies have explored the relationship between depression and metabolic syndrome(MetS),especially in older *** has entered an aging ***,there are still few studies on the elderly in Chinese *** To investigate the incidence and risk factors of depression in MetS patients in China's Mainland and to construct a predictive *** Data from four waves of the China Health and Retirement Longitudinal Study were selected,and middle-aged and elderly patients with MetS(n=2533)were included based on the first *** to the center for epidemiological survey-depression scale(CESD),participants with MetS were divided into depression(n=938)and non-depression groups(n=1595),and factors related to depression were screened ***,the 2-,4-,and 7-year follow-up data were analyzed,and a prediction model for depression in MetS patients was *** The prevalence of depression in middle-aged and elderly patients with MetS was 37.02%.The prevalence of depression at the 2-,4-,and 7-year follow-up was 29.55%,34.53%,and 38.15%,*** prediction model,constructed using baseline CESD and Physical Self-Maintenance Scale scores,average sleep duration,number of chronic diseases,age,and weight had a good predictive effect on the risk of depression in MetS patients at the 2-year follow-up(area under the curve=0.775,95%confidence interval:0.750-0.800,P<0.001),with a sensitivity of 68%and a specificity of 74%.CONCLUSION The prevalence of depression in middle-aged and elderly patients with MetS has increased over *** early identification of and intervention for depressive symptoms requires greater attention in MetS patients.

关键词： Depression Metabolic syndrome Prevalence Risk factor

Network analysis of suicide ideation and depression-anxiety symptoms among Chinese adolescents

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General psychiatry 2024年第2期37卷 216-223页

作者： Shuyin Xu Yumeng Ju Xiyu Wei Wenwen Ou Mohan Ma Guanyi Lv Xiaotian Zhao Yaqi Qin Yunjing Li Liang Li Mei Huang Siqi Yang Yimei Lu Yafei Chen Junwu Liu Jin Liu Bangshan Liu Yan Zhang Department of psychiatry National Clinical Research Center for Mental Disordersand National Center for Mental DisordersThe Second Xiangya Hospital of Central South UniversityChangshaHunanChina Mental Health Institute of Central South University China National Technology Institute on Mental DisordersHunan Technology Institute of PsychiatryHunan Key Laboratory of Psychiatry and Mental HealthHunan Medical Center for Mental HealthChangshaHunanChina

Background The co-occurrence of depression and anxiety among adolescents is typically associated with suicide *** The study aimed to investigate the symptom-level relationship between suicide ideation and the comorbidity of depression and *** 1501 adolescents aged 12-19 years were assessed using the Patient Health Questionnaire(PHQ-9)and the Generalized Anxiety Disorder Scale,and 716 adolescents who scored≥5 on both scales were selected as *** analysis was used to identify the network structure of depressive symptoms and anxiety *** were categorised into either the suicide ideation or non-suicide ideation groups based on their scoring on the suicide-related item in PHQ-9.A comparison was made between the depression-anxiety symptom networks of the two ***‘Restlessness’,‘sad mood’and‘trouble relaxing’were the most prominent central symptoms in the depression-anxiety symptom network,and‘restlessness’,‘nervousness’and‘reduced movement’were the bridge symptoms in this network.‘Sad mood’was found to be directly related to‘suicide ideation’with the highest *** network structure was significantly different in properties between the suicide ideation group and the non-suicide ideation group,with‘restlessness’and‘sad mood’exhibiting significantly higher influence in the network of the suicide ideation group than that in the non-suicide ideation *** Restlessness and sad mood could be targeted for the intervention of depression-anxiety symptoms among adolescents with suicide ideation.

关键词： symptoms adolescent assessed

Gut microbiota-derived short-chain fatty acids and depression:deep insight into biological mechanisms and potential

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General psychiatry 2024年第1期37卷 17-32页

作者： Junzhe Cheng Hongkun Hu Yumeng Ju Jin Liu Mi Wang Bangshan Liu Yan Zhang Department of psychiatry National Clinical Research Center for Mental DisordersSecond Xiangya Hospital of Central South UniversityChangshaHunanChina Clinical Medicine Eight-Year program Xiangya School of MedicineCentral South UniversityChangshaHunanChina Mental Health Institute of Central South University China National Technology Institute on Mental DisordersHunan Key Laboratory of Psychiatry and Mental HealthHunan Medical Center for Mental HealthChangshaHunanChina Department of Mental Health Center Xiangya Hospital of Central South UniversityChangshaHunanChina

The gut microbiota is a complex and dynamic ecosystem known as the second brain'.Composing the microbiota-gut-brain axis,the gut microbiota and its metabolites regulate the central nervous system through neural,endocrine and immune pathways to ensure the normal functioning of the organism,tuning individuals'health and disease ***-chain fatty acids(SCFAs),the main bioactive metabolites of the gut microbiota,are involved in several neuropsychiatric disorders,including *** have essential effects on each component of the microbiota-gut-brain axis in *** the present review,the roles of major SCFAs(acetate,propionate and butyrate)in the pathophysiology of depression are summarised with respect to chronic cerebral hypoperfusion,neuroinflammation,host epigenome and neuroendocrine *** remarks on the biological mechanisms related to gut microbiota will hopefully address the clinical value of microbiota-related treatments for depression.

关键词： alterations inflammation perfusion

Effect of novel accelerated intermittent theta burst stimulation on suicidal ideation in adolescent patients with major depressive episode:a randomised clinical trial

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General psychiatry 2024年第2期37卷 292-296页

作者： Dong Huang Shuming Zhong Xiaodong Song Rongxu Zhang Shunkai Lai Yanbin Jia Department of psychiatry First Affiliated Hospital of Jinan UniversityGuangzhouGuangdongChina

To the editor:Affective disorders,including major depressive disorder(MDD)and bipolar disorder,have emerged as the primary cause of adolescent ***,suicide mostly occurs in the major depressive episode(MDE)of affective *** ideation(SI)has been identified as an immediate precursor to suicide,such that reducing its severity is conducive to suicide prevention in adolescents.

关键词： prevention editor stimulation

Need for education of psychiatric evaluation of offenders with mental disorders:A questionnaire survey for Japanese designated psychiatrists

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World Journal of psychiatry 2024年第5期14卷 726-734页

作者： Akihiro Shiina Tomihisa Niitsu Masaomi Iyo Chiyo Fujii Division of Medical Treatment and Rehabilitation Chiba University Center for Forensic Mental HealthChiba-shi 2608670Japan Department of psychiatry Chiba University Graduate School of MedicineChiba-shi 2608670Japan Department of Community Mental Health&Law National Center of Neurology and PsychiatryKodaira-shi 1878553Japan

BACKGROUND The management of offenders with mental disorders has been a significant concern in forensic *** Japan,the introduction of the Medical Treatment and Supervision Act in 2005 addressed the ***,numerous psychiatric patients at risk of violence still find themselves subject to the administrative involuntary hospitalization(AIH)scheme,which lacks clarity and updated *** To explore current as well as optimized learning strategies for risk assessment in AIH decision *** We conducted a questionnaire survey among designated psychiatrists to explore their experiences and expectations regarding training methods for psychiatric assessments of offenders with mental *** The findings of this study’s survey suggest a prevalent reliance on traditional learning approaches such as oral education and on-the-job *** This underscores the pressing need for structured training protocols in AIH ***,feedback derived from inpatient treatment experiences is identified as a crucial element for enhancing risk assessment skills.

关键词： Forensic psychiatry Administrative involuntary hospitalization Psychiatric assessment Risk assessment Mental disorders Training protocols Clinical practice Structured learning Feedback mechanisms program development

Prevalence of prolonged grief disorder and its symptoms among bereaved individuals in China:a systematic review and meta-analysis

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General psychiatry 2024年第2期37卷 177-188页

作者： Meng-Di Yuan Jun-Fa Liu Bao-Liang Zhong Research Center for Psychological and Health Sciences China University of Geosciences(Wuhan)WuhanHubeiChina Department of psychiatry Wuhan Mental Health CentreWuhanHubeiChina

Background The prevalence of prolonged grief disorder(PGD)and its symptoms among the bereaved population in China vary *** This meta-analysis aims to estimate the prevalence of PGD and its symptoms among bereaved individuals in *** We conducted a literature search in major Chinese and English databases from their inception to 4 October 2023,for cross-sectional studies on the prevalence of PGD or its symptoms in bereaved Chinese *** risk of bias of the included studies and certainty of the evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data(‘JBI checklist’)and the Grading of Recommendations,Assessment,Development and Evaluations(GRADE),***‘metaprop’package in R V.4.1.2 was used to synthesise the *** A total of 28 studies involving 10994 bereaved individuals were included in the analysis,with JBI checklist scores between 3 and *** combined prevalence(95%confidence interval)of PGD and its symptoms was 8.9%(4.2%to 17.6%)and 32.4%(18.2%to 50.8%),*** and its symptoms were most prevalent among those who had lost their only child(22.7%)and those bereaved by earthquakes(80.4%),*** GRADE system assigned a very low certainty level to the evidence for the pooled prevalence of PGD and its *** The pooled prevalence of PGD and its symptoms indicate a potential high need for grief counselling services among bereaved individuals in *** need is particularly pronounced in those who have lost their only child and those bereaved due to *** methodologically rigorous studies are needed to provide more accurate prevalence *** registration number CRD42023432553.

关键词： symptoms prevalence analysis

Molecular biomarkers for vascular cognitive impairment and dementia:the current status and directions for the future

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Neural Regeneration Research 2024年第12期19卷 2579-2580页

作者： Satoshi Hosoki Perminder SSachdev Centre for Healthy Brain Ageing Discipline of Psychiatry and Mental HealthSchool of Clinical MedicineFaculty of Medicine and HealthUniversity of New South WalesSydneyAustralia Department of Neurology National Cerebral and Cardiovascular CenterOsakaJapan

Dementia is a syndrome with various underlying pathologies acting independently or in concert to cause cognitive *** development of disease-specific treatments and targeted prevention strategies requires precise clinical sub-typing via etiology and pathophysiological ***,recent research advances in biomarkers,especially for Alzheimer's disease(AD)diagnosis,have improved diagnostic precision for dementia.

关键词： prevention diagnosis impairment