Search Results (176)

Brain-derived neurotrophic factor (BDNF) is associated with nicotine use behaviours, the intensity of nicotine cravings, and the experience of withdrawal symptoms. Given the established influence of sex, brain-derived neurotrophic factor variants, personality traits and anxiety levels on nicotine use, this study aimed to conduct a comprehensive association analysis of these factors within a cohort of women who use nicotine. The study included 239 female participants: 112 cigarette users (mean age = 29.19, SD = 13.18) and 127 never-smokers (mean age = 28.1, SD =10.65). Study participants were examined using the NEO Five-Factor Inventory and the State–Trait Anxiety Inventory. Genotyping of rs6265, rs10767664, and rs2030323 was performed by real-time PCR using an oligonucleotide assay. We did not observe significant differences in the distribution of either genotype or allele of rs6265, rs10767664 and rs2030323 between groups. However, compared to the never-smokers, cigarette users scored significantly lower on the Agreeableness (5.446 vs. 6.315; p = 0.005767; d_Cohen’s = 0.363; η² = 0.032) and the Conscientiousness (5.571 vs. 6.882; p = 0.000012; d_Cohen’s = 0.591; η²= 0.08) scales. There was significant linkage disequilibrium between all three analysed polymorphic variants—between rs6265 and rs10767664 (D′ = 0.9994962; p < 2.2204 × 10⁻¹⁶), between rs6265 and rs2030323 (D′ = 0.9994935; p < 2.2204 × 10⁻¹⁶) and between rs10767664 and rs20330323 (D′ = 0.9838157; p < 2.2204 × 10⁻¹⁶), but the haplotype association analysis revealed no significant differences. While our study did not reveal an association between the investigated brain-derived neurotrophic factor polymorphisms (rs6265, rs10767664 and rs2030323) and nicotine use, it is essential to acknowledge that nicotine dependence is a complex, multifactorial phenotype. Our study expands the current knowledge of BDNF ’s potential role in addictive behaviours by exploring the understudied variants (rs10767664 and rs2030323), offering a novel contribution to the field and paving the way for future research into their functional relevance in addiction-related phenotypes. The lower Agreeableness and Conscientiousness scores observed in women who use nicotine compared to never-smokers suggest that personality traits play a significant role in nicotine use in women. The observed relationship between personality traits and nicotine use lends support to the self-medication hypothesis, suggesting that some women may initiate or maintain nicotine use as a coping mechanism for stress and negative affect. Public health initiatives targeting women should consider personality and psychological risk factors in addition to biological risks. Full article

Background: Insomnia, as one of the most common sleep disorders, is a significant health problem, especially among patients suffering from drug-resistant depression. Problems related to the quality of sleep in that population can significantly affect the effectiveness of treatment and quality of life, which is why it is necessary to search for effective therapeutic interventions in this area. Objective: The aim of this study was to compare the effectiveness of esketamine and other standard antidepressants in improving sleep quality in patients with drug-resistant depression. The main research question is whether and to what extent esketamine improves sleep parameters compared with other antidepressants. Methods: This study involves the analysis of data collected from 50 patients divided into two groups: those using esketamine in combination with other antidepressants and those using other antidepressants. The analysis of the results focuses on the assessment of differences in AIS scores between the groups assessed using the Athens Insomnia Scale (AIS). Results: Insomnia occurs much less frequently among people using esketamine than among people not using this drug. With the increase in the time of using esketamine and with the increase in the dose, the level of insomnia decreases. Conclusions: Esketamine brings about a rapid improvement in sleep quality, which is a significant advance in the treatment of drug-resistant depression. The obtained results not only confirm the effectiveness of esketamine but also show its advantage over traditional treatment methods in improving sleep quality. Full article

Background/Objectives: The scientific literature shows that new scientific and social priorities regarding social impacts and co-creation are leading to profound transformations in all scientific and social contexts. In the field of mental health, one dimension of this transformation is the increasing visibility of dialogic models that support the improvement of mental health. While this is very positive, it carries a risk of deformations that can lead to negative outcomes for both society and science. There is a lack of scientific research about the errors related to the new visibility of the Successful Dialogues in Mental Health (SDMH) model. The objective of this research is to clarify a certain type of error, namely when the excellent results obtained through the use of this model in particular contexts are attributed to a supposed dialogic approach of psychiatric rehabilitation, made by researchers without a degree in medicine. Methods: In order to clarify this error, we use a communicative methodology through a qualitative research design, oriented to unveil the main steps in the original development of the model. Results: The results show that the SDMH model has never presented itself as psychiatric, but instead as a social–dialogic collaboration with psychiatrists with the aim of helping individuals to overcome mental health problems. Conclusions: This study clarifies the purpose of the SDMH model which contributes to benefiting citizens, particularly those with mental health conditions. Full article

Background/Objectives: Anorexia nervosa (AN) is a chronic eating disorder with the highest mortality rate among psychiatric conditions. Malnutrition and starvation lead to long-term impairments in metabolic processes, hormonal regulation, and immune function, offering potential diagnostic and prognostic value. This study aimed to identify immune–metabolic–hormonal markers associated with treatment response and nutritional rehabilitation. Methods: Fifty hospitalized female patients with AN were included. Anthropometric measurements and venous blood samples were collected at admission and discharge, following partial nutritional recovery. Blood analyses included complete blood count, serum levels of total cholesterol, LDL and HDL, triglycerides, glucose, NT-pro-BNP, TSH, free thyroxine (fT4), sodium, chloride, potassium, calcium, iron, and vitamin D. Composite immune-inflammatory indices calculated were neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR); neutrophil-to-high-density lipoprotein (NHR), monocyte-to-high-density lipoprotein (MHR), platelet-to-high-density lipoprotein (PHR) and lymphocyte-to-high-density lipoprotein (LHR) ratios; systemic immune-inflammation (SII), and systemic inflammation response (SIRI) indexes. Results: Responders (R) and non-responders (NR) differed significantly at baseline in levels of sodium, chloride, fT4, monocyte count, MCV, NLR, MLR, SII, and SIRI (all: R < NR; p < 0.05). Predictive ability for treatment response was confirmed by AUC values (95%CI): sodium = 0.791 (0.622–0.960), chloride = 0.820 (0.690–0.950), fT4 = 0.781 (0.591–0.972), monocytes = 0.785 (0.643–0.927), MCV = 0.721 (0.549–0.892), NLR = 0.745 (0.578–0.913), MLR = 0.785 (0.643–0.927), SII = 0.736 (0.562–0.911), SIRI = 0.803 (0.671–0.935). The lower levels of inflammation and chloride are particularly predictive of better nutritional recovery, accounting for 26% of the variability in treatment response. Conclusions: The study demonstrated important insights into the hematological, metabolic, hormonal, and immune-inflammatory mechanisms associated with nutritional recovery in AN. Full article

Introduction: Cerebellar transcranial magnetic stimulation (TMS) has emerged as a promising neuromodulatory intervention for addressing motor, cognitive, and socio-affective deficits across a range of clinical populations. Materials and Methods: This systematic review aimed to synthesize recent evidence (2015–2025) on the efficacy, safety, and methodological characteristics of multi-session cerebellar TMS protocols used in rehabilitation settings. Following PRISMA guidelines, a comprehensive search of PubMed and Scopus was conducted to identify peer-reviewed studies applying multi-session cerebellar TMS in clinical populations for motor, cognitive, or affective rehabilitation. A total of 1750 records were screened, and 46 studies met the inclusion criteria. Data extraction included sample characteristics, study design, TMS protocol, targeted symptoms, outcomes, and risk of bias. Results: The results show that repeated sessions of cerebellar TMS are safe, well-tolerated, and associated with functional improvements primarily in motor disorders—such as spinocerebellar ataxia, Parkinson’s disease, multiple system atrophy, essential tremor, and post-stroke deficits—as well as in psychiatric populations, particularly patients with schizophrenia. Discussion: Evidence regarding the effects of cerebellar TMS on cognitive functions remains limited, though promising. Despite overall positive findings, the literature is limited by variability in stimulation parameters, protocol designs, and outcome measures, small sample sizes and potential publication bias. Conclusions: The review highlights the need for further large-scale and well-controlled trials to refine stimulation protocols, explore long-term effects, and clarify the underlying mechanisms of cerebellar TMS across motor, cognitive, and affective domains. This systematic review has been registered on PROSPERO (registration number: CRD420251067308). Full article

Introduction: Few applications worldwide focus on psychosocial rehabilitation, and none specifically address psychosocial rehabilitation projects. This justifies the need for an application to assist mental health professionals in constructing and managing such projects in the Brazilian mental health scenario. Objective: This study aimed to present a web application, the “Psychosocial Rehabilitation Application” (Psychosocial Rehab App), and describe its development in detail through a technological survey conducted between May 2024 and February 2025. Method: The development process of the web app was carried out in the following four stages, adapted from the Novak method: theoretical basis, requirements survey, prototyping, and development with alpha testing. The active and collaborative participation of the main researcher (a psychiatric nurse) and two undergraduate software engineers, supervised by a software engineer and a professor of nursing and psychology, was essential for producing a suitable operational product available to mental health professionals. Interactions were conducted via video calls, WhatsApp, and email. These interactions were transcribed using the Transkriptor software and inserted into the ATLAS.ti software for thematic analysis. Results: The web app “Psychosocial Rehabilitation Application” displays a home screen for registration and other screens structured into the stages of the psychosocial rehabilitation project (assessment, diagnosis, goals, intervention, agreements, and re-assessment). It also has a home screen, a resource screen, and a function screen with options to add a new project, search for a project, or search for mental health support services. These features facilitate the operation and streamline psychosocial rehabilitation projects by mental health professionals. Thematic analysis revealed three themes and seven codes describing the entire development process and interactions among participants in collaborative, interrelational work. A collaborative approach between researchers and developers was essential for translating the complexity of the psychosocial rehabilitation project into practical and usable functionalities for future users, who will be mental health professionals. Discussion: The Psychosocial Rehab App was developed collaboratively by mental health professionals and developers. It supports the creation of structured rehabilitation projects, improving decision-making and documentation. Designed for clinical use, the app promotes autonomy and recovery by aligning technology with psychosocial rehabilitation theory and the actual needs of mental health services. Conclusions: The Psychosocial Rehab App was developed through collaborative work between mental health and technology professionals. The lead researcher mediated this process to ensure that the app’s functionalities reflected both technical feasibility and therapeutic goals. Empathy and dialog were key to translating complex clinical needs into usable and context-appropriate technological solutions. Full article

Background: Personality traits, particularly Conscientiousness, are recognised as crucial psychological factors contributing to success in elite-level athletes. Emerging evidence suggests that individual differences in these traits are influenced by environmental exposure and genetic variation, especially within the dopaminergic system. The DRD2 promoter polymorphism rs1799732, which affects dopamine D2 receptor expression, may modulate goal-directed behaviour and self-regulation traits. Methods: This study included 323 participants (141 elite mixed martial arts (MMA) athletes and 182 non-athlete controls). Participants completed the NEO Five-Factor Inventory (NEO-FFI). Genotyping for the DRD2 rs1799732 polymorphism was conducted using real-time PCR. Group comparisons and two-way ANOVA were used to assess genotype–phenotype associations and gene × environment interactions. Results: Athletes scored significantly higher on Conscientiousness than controls. A significant main effect of the DRD2 rs1799732 genotype and a genotype × group interaction were observed for Conscientiousness. Specifically, athletes with the ins/ins genotype exhibited the highest levels of Conscientiousness, whereas individuals with the del/del genotype showed the lowest scores. No significant associations were found for other personality traits. Conclusions: These findings suggest that the DRD2 promoter polymorphism rs1799732 moderates the expression of Conscientiousness, particularly under the structured and demanding conditions experienced by elite athletes. Our results support a gene × environment interaction model, highlighting the importance of considering genetic predispositions in high-performance environments. These insights may inform personalised psychological support strategies tailored to athletes’ genetic profiles, enhancing motivation, self-regulation and long-term athletic development. Full article

This review explores the origins and principles of milieu therapy, which is traditionally rooted in psychiatric settings, and examines how these concepts can be adapted for patients with dementia. While milieu therapy initially focused on long-term psychiatric inpatients, the increasing prevalence of dementia—often with complex neuropsychiatric symptoms and extended care needs—warrants a renewed look at structured therapeutic environments. Unlike psychiatric conditions that may show significant improvement with medication, dementia typically involves progressive cognitive decline and multiple comorbidities, calling for a greater emphasis on safety, predictability, and emotional support. Core principles—therapeutic environment, social interaction, consistency, shared responsibility, empowerment, and individualized interventions—can be tailored to address dementia-specific needs, including orientation aids, simplified routines, and nonverbal communication strategies. Moreover, considering that dementia predominantly affects older adults, comprehensive geriatric care becomes crucial, requiring a collaborative team approach that includes medical, psychiatric, and rehabilitative expertise. In such environments, the focus shifts from cure to maximizing well-being, dignity, self-control, and residual abilities, underscoring the relevance of milieu therapy in modern dementia care. Full article

Background: Anorexia nervosa is an eating disorder characterised by distorted eating behaviour, physical and mental health problems, and the highest mortality rate among psychiatric disorders. Although anorexia nervosa appears to be associated with alterations in the spine, studies investigating the characteristics of spinal postures and mobility in individuals with anorexia nervosa are scarce to date. The present study aims to examine the relationship between anorexia nervosa and spinal posture and mobility by comparing people with anorexia nervosa to age-matched, normal-weight controls. Methods: Spinal posture and mobility were evaluated using a radiation-free back scan, the Idiag M360 (Idiag, Fehraltorf, Switzerland). Between-group differences were assessed using a two-way analysis of variance. Results: Adult females suffering from anorexia nervosa exhibited reduced lumbar [difference between groups (Δ) = 10.5°, 95% CI 4.6°–16.5°, p < 0.001] and thoracic (Δ = 8.8°, 95% CI 2.4°–15.2°, p = 0.007) curvatures compared to normal-weight controls. The only difference observed in spinal movements between the two groups was thoracic flexion, which was greater in individuals with anorexia nervosa (Δ = 8.4°, 95% CI 2.1°–14.4°, p = 0.009). Conclusions: These findings emphasise the need to consider spinal posture and thoracic mobility in the musculoskeletal assessment of anorexia nervosa. Interventions aimed at improving spinal postures may help to develop effective rehabilitative strategies for addressing spinal problems associated with anorexia nervosa and thus contributing to counteract the possible further worsening with advancing age. Full article

Deep learning (DL) approaches to natural language processing (NLP) offer powerful tools for creating digital twins (DTs) of patients in psychiatry and neurological rehabilitation by processing unstructured textual data such as clinical notes, therapy transcripts, and patient-reported outcomes. Techniques such as transformer models (e.g., BERT, GPT) enable the analysis of nuanced language patterns to assess mental health, cognitive impairment, and emotional states. These models can capture subtle linguistic features that correlate with symptoms of degenerative disorders (e.g., aMCI) and mental disorders such as depression or anxiety, providing valuable insights for personalized treatment. In neurological rehabilitation, NLP models help track progress by analyzing a patient’s language during therapy, such as recovery from aphasia or cognitive decline caused by neurological deficits. DL methods integrate multimodal data by combining NLP with speech, gesture, and sensor data to create holistic DTs that simulate patient behavior and health trajectories. Recurrent neural networks (RNNs) and attention mechanisms are commonly used to analyze time-series conversational data, enabling long-term tracking of a patient’s mental health. These approaches support predictive analytics and early diagnosis by predicting potential relapses or adverse events by identifying patterns in patient communication over time. However, it is important to note that ethical considerations such as ensuring data privacy, avoiding bias, and ensuring explainability are crucial when implementing NLP models in clinical settings to ensure patient trust and safety. NLP-based DTs can facilitate collaborative care by summarizing patient insights and providing actionable recommendations to medical staff in real time. By leveraging DL, these DTs offer scalable, data-driven solutions to promote personalized care and improve outcomes in psychiatry and neurological rehabilitation. Full article

Background: Methylphenidate is a psychostimulant that enhances dopamine and norepinephrine neurotransmission through the mechanism of reuptake inhibition at the synaptic cleft. Studies indicate that sexual dysfunction is prevalent among psychiatric patients. The objective of our study was to assess the impact of methylphenidate on patients’ sexual health, identify specific types of sexual dysfunction, and analyse the correlations between psychiatric disorders, treatment dosages and durations, and the presence of sexual dysfunction. Additionally, we aimed to evaluate the prevalence of improved sexual function resulting from methylphenidate use. Methods: A systematic literature review was performed using the PubMed database in accordance with PRISMA guidelines. The initial search yielded 186 articles, of which 14 met the inclusion criteria and were analyzed. Clinical studies involving changes in libido, erectile function, ejaculation, semen quality, and sexual behavior due to methylphenidate were reviewed. Results: The findings indicate that methylphenidate can have both negative and positive effects on sexual function. In some patients, particularly those with psychiatric comorbidities, methylphenidate was associated with decreased libido and ejaculation disorders. In other cases, especially in individuals with preexisting dysfunctions or on low doses, it appeared to enhance sexual arousal and performance. Conclusions: Methylphenidate may influence sexual function in complex ways depending on individual patient profiles and treatment variables. Clinicians should be aware of these potential outcomes and consider sexual health as part of the therapeutic discussion when prescribing methylphenidate. Full article

The dysregulation of the serotonin system has been implicated in the pathophysiology of alcohol use disorders. Meta-analytic evidence suggests a significant correlation between genetic variation in the serotonin transporter gene and the risk of alcohol dependence. Hence, we aimed to analyse the association between 5-HTTLPR polymorphism and alcohol use disorder in a group of women and to perform an interaction analysis of 5-HTTLPR variants, personality traits, and AUD. The study group comprised 213 female volunteers; 101 were diagnosed with alcohol addiction, and 112 were not dependent on any substance or behaviour. The 5-HTTLPR variants were identified by PCR, and the resulting products were separated electrophoretically. When comparing the AUD group with the controls, we observed significant differences in the distribution of 5-HTTLPR genotypes (p = 0.0230) and alleles (p = 0.0046). We also observed a significant impact of the 5-HTTLPR genotype (p = 0.0001) on the Neuroticism and Extraversion (p = 0.0037) scales. Additionally, there was a statistically significant impact of 5-HTTLPR genotype interaction and alcohol dependency or lack of it on the Neuroticism scale (p < 0.0001). The observed interaction suggests that the effect of the 5-HTTLPR on neuroticism may be exacerbated or attenuated in the presence of alcohol addiction. Further investigation is needed to elucidate the precise nature of this interaction. Still, it potentially indicates a gene–environment interaction where the genetic predisposition conferred by the 5-HTTLPR polymorphism interacts with the environmental stressor of alcohol dependence to influence neuroticism. Full article

Focused ultrasound (FUS) is an emerging noninvasive technology with significant therapeutic potential across various clinical domains. FUS enables precise targeting of tissues using mechanisms like thermoablation, mechanical disruption, and neuromodulation, minimizing damage to surrounding areas. In movement disorders such as essential tremor and Parkinson’s disease, MR-guided FUS thalamotomy has demonstrated substantial tremor reduction and improved quality of life. Psychiatric applications include anterior capsulotomy for treatment-resistant obsessive-compulsive disorder and major depressive disorder, with promising symptom relief and minimal cognitive side effects. FUS also facilitates blood-brain barrier opening for drug delivery in neurological conditions like Alzheimer’s disease. Musculoskeletal applications highlight its efficacy in managing chronic pain from knee osteoarthritis and lumbar facet joint syndrome through precise thermal ablation. Additionally, FUS has shown potential in neuropathic pain management and peripheral nerve stimulation, offering innovative approaches for amputees and cancer survivors. Cognitive and neuromodulatory research underscores its ability to enhance motor function and interhemispheric cortical balance, benefiting stroke and traumatic brain injury rehabilitation. Despite these conditions frequently leading to various kinds of disabilities, no direct exploration of the possible FUS application in rehabilitation is yet available in the literature. All this considered, this review aims to discuss how FUS could be applied in rehabilitation, exploring the current status of knowledge and highlighting future directions. Full article

Background/Objectives: Despite documented benefits across multiple outcome areas, referral and uptake into pulmonary rehabilitation (PR) following discharge after an exacerbation of chronic obstructive pulmonary disease (COPD) is low in many health care systems. Surveys documenting this underutilization may ignore the fact of disease severity or comorbidity severe enough to make many patients ineligible based on accepted selection criteria for the intervention. The aim of this study was to evaluate the magnitude of non-eligibility for PR following discharge after a COPD exacerbation. Methods: Medical records of COPD patients discharged over a one-year period in two hospitals were reviewed. Records from 353 patients discharged home were reviewed by six clinicians with experience in respiratory medicine and/or PR, three at each hospital. Results: The mean age of the total sample was 71 ± 12 years; 53% were female. Full concordance (all three reviewers agreed on the eligibility or non-eligibility of each patient) was 73%. Our eligibility criterion (two of three reviewers agreed) for PR was 39%. Categories (%) of non-eligibility criteria included the severity of medical condition(s) (44%), cognitive problems, psychiatric disease or substance abuse (24%), incorrect diagnosis (18%), institutionalized post-discharge (9%), and language barriers (4%) (patients may have been placed into more than one criteria category). Conclusions: Our study indicates that a majority of patients with clinical diagnoses of COPD discharged following exacerbations may not be appropriate referrals to PR based on accepted inclusion and/or exclusion criteria for the intervention. However, even after taking this into account, PR uptake is still critically underutilized. Full article

Introduction: Achieving long-term impacts from cognitive remediation (CR) interventions is a key goal in rehabilitative care. Integrating virtual reality (VR) with psychoeducational approaches within CR programs has shown promise in enhancing user engagement and addressing the complex needs of individuals with bipolar disorder (BD). A previous randomized controlled crossover feasibility trial demonstrated the viability of a fully immersive VR-CR intervention for BD, reporting low dropout rates, high acceptability, and significant cognitive improvements. This secondary analysis aimed to evaluate the stability of these outcomes over time. Methods: This paper presents a 6- to 12-month follow-up of the initial trial. Secondary cognitive outcomes were assessed, including visuospatial abilities, memory, attention, verbal fluency, and executive function, using validated assessment tools. Statistical analyses were conducted using Friedman’s test. Results: A total of 36 participants completed the 6- to 12-month follow-up. Overall, cognitive functions showed a trend toward stability or improvement over time, except for visuospatial and executive functions, which demonstrated inconsistent trajectories. Significant improvements were observed in language (p = 0.02). Conclusion: This study highlights the overall stability of cognitive functions 12 months after a fully immersive VR-CR program for individuals with BD. To sustain long-term clinical benefits, an integrated approach, such as incorporating psychoeducational strategies within cognitive remediation interventions, may be essential. Further follow-up studies with control groups and larger sample sizes are needed to validate these findings. Full article