Search Results (146)

Background: Cognitive behavioral therapy (CBT) has shown consistent efficacy in individuals with psychosis, as supported by many trials. One classical distinction is that between affective and non-affective psychosis. Few studies have specifically examined the possible moderating role of substantial affective elements. In this systematic review and meta-regression analysis, we assess how CBT response differs across the affective spectrum in psychosis. Methods: We included studies assessing various CBT modalities, including third-wave therapies, administered in people with psychosis. The study protocol is published in the Open Science Framework. Meta-regression was conducted to assess whether the proportion of participants with affective psychosis (AP), as proxied by a documented diagnosis of schizoaffective (SZA) disorder, moderated CBT efficacy across positive, negative, and depressive symptom domains. Results: The literature search identified 4457 records, of which 39 studies were included. The median proportion of SZA disorder participants was 17%, with a total of 422 AP participants represented. Meta-regression showed a trend toward lower CBT efficacy for positive symptoms with a higher SZA disorder proportion (β = +0.10 SMD per 10% increase in AP; p = 0.12), though it was not statistically significant. No significant associations were found for negative (β = +0.05; p = 0.73) or depressive symptoms (β = −0.02; p = 0.78). Heterogeneity was substantial across all models (I² ranging from 54% to 80%), and funnel plot asymmetry was observed in negative and depressive symptoms, indicating possible publication bias. Risk of bias assessment showed the anticipated inherent difficulty of psychotherapies in blinding and possibly dropout rates affecting some studies. Conclusions: Affective symptoms may reduce the effectiveness of CBT for positive symptoms in psychotic disorders, although the findings did not reach statistical significance. Other patient-level characteristics in psychosis could indicate which patients can benefit most from CBT modalities. Full article

Background: About half of all Major Depressive Disorder (MDD) patients have anxiety disorder. There is a neurologic basis for the comorbidity of balance (vestibular) disorders and anxiety. To detect comorbid anxiety disorder in MDD patients and, importantly, to investigate its relationship with depressive severity, we use Electrovestibulography (EVestG), which is predominantly a measure of vestibular response. Methods: In a population of 42 (26 with anxiety disorder) MDD patients, EVestG signals were measured. Fourteen (eight with anxiety disorder) were not on any anti-depressants, anti-psychotics or mood stabilizers. Using standard questionnaires, participants were depression-wise labelled as reduced symptomatic (MADRS ≤ 19, R) or symptomatic (MADRS > 19, S) as well as with or without anxiety disorder. Analyses were conducted on the whole data set, matched (age/gender/MADRS) subsets and compared with medication free subsets. Low-frequency EVestG firing pattern modulation was measured. Results: The main differences between MDD populations with and without anxiety disorder populations, regardless of being medicated or not, were (1) the presence of an increased 10.8 Hz component in the dynamic movement phase recordings, (2) the presence of asymmetric right versus left 7.6–8.9 Hz and 12.1–13.8 Hz frequency bands in the no motion (static) phase recordings, and (3) these differences were dependent on depressive severity. Conclusions: The EVestG measures are capable of quantifying anxiety in MDD patients. These measures are functions of depressive severity and are hypothesized to be linked to Hippocampal Theta (~4–12 Hz). Full article

The protozoan parasite Toxoplasma gondii (T. gondii) has been implicated in various neuropsychiatric disorders, including depression. Our aim in this study was to assess the seroprevalence of T. gondii IgG antibodies as well as potential risk factors associated with seropositivity in patients with depression compared to healthy blood donors. This seroepidemiological study included 230 participants from Western Romania, divided equally into two groups: 115 patients diagnosed with depressive disorders which represented the study group and 115 age and gender-matched healthy blood donors, representing the control group. A structured questionnaire was used to assess risk factors potentially linked to T. gondii infection. The T. gondii IgG antibodies overall seroprevalence was significantly higher in the depression group (70.43%) compared to the control group (45.22%) (OR = 2.89; 95% CI: 1.68–4.97; p < 0.001). Higher seropositivity was noted in patients aged 50–59, 60+ years and in females. Patients with lower educational attainment showed significantly increased odds of T. gondii seropositivity (72.29% vs. 44.3%, OR = 3.28; 95% CI: 1.71–6.31; p < 0.001) compared with the control group. Stratification by ICD-10 diagnostic subtypes revealed significantly higher seropositivity in all categories, with the strongest association in patients with recurrent severe depressive episodes without psychotic symptoms (F33.2) (81.25%, OR = 3.5; 95% CI: 1.51–8.13; p = 0.004). These findings suggest a possible link between T. gondii infection and depression, particularly in relation to disease severity and sociodemographic factors. To our knowledge, this is the first study to investigate T. gondii seroprevalence and associated risk factors in Romanian patients with depression, providing a foundation for future longitudinal and preventive research. Full article

Background: Cataract is the leading cause of severe, non-traumatic vision loss worldwide, leading to multiple adverse outcomes in mental health, including depression, anxiety, and cognitive decline; however, the relationship to psychotic symptoms remains unclear. While congenital vision loss appears protective against psychosis, acquired vision loss or acute deprivation are inducing psychotic symptoms. Methods: This study of 200 consecutive cataract patients, with severe vision loss, compares Paranoid Ideation and Psychoticism symptoms pre surgery, measured with the SCL-90-R scale, to those symptoms that persisted two months post-surgery. Results: The results confirm the hypothesis that cataract surgery is associated with a reduction in those symptoms (Wilcoxon Z = 5.425, p < 0.001 for Paranoid Ideation and Wilcoxon Z = 6.478, p < 0.001 for Psychoticism). Higher improvement in those variables was associated with higher improvement in visual acuity while controlling for age, gender and stressful life events during the past six months. Conclusions: Those results point to the importance of addressing loss of visual function especially in patients with pre-existing psychotic symptoms or signs of cognitive decline. Full article

Major Depressive Disorder (MDD) is a chronic mental disorder characterized by anhedonia, loss of desire, guilt, suicidal thoughts, and appetite changes. It is reported that individuals with MDD resort to binge eating to escape from negative feelings. In this study, we aimed to determine the relationship between binge eating behavior and the concept of psychological pain associated with emotions such as shame, guilt, and anger in individuals with MDD. We conducted the study in the Psychiatry Outpatient Clinics of Balcalı Hospital, Çukurova University Faculty of Medicine. The sample consisted of 147 individuals with MDD without psychotic symptoms and 128 healthy controls with sociodemographic characteristics similar to the MDD group. We administered a sociodemographic data form, the Hamilton Depression Rating Scale (HDRS), Psychache Scale (PS), Tolerance for Mental Pain Scale-10 (TMPS-10), Barratt Impulsiveness Scale (BIS-11), and Eating Disorder Examination Questionnaire (EDE-Q-13). Eighty-two (55.7%) of the patients with MDD were diagnosed with binge eating disorder (BED). In the group of MDD patients with BED comorbidity, the EDE-Q-13 total, binging subscale, and HDRS scores were significantly higher than those of the other groups (p < 0.05 for each group), with large to very large effect sizes (e.g., EDE-Q-13 binging d = 1.04; HDRS d = 1.91; PS d = 1.22). There was no significant difference between the MDD groups (with and without BED) regarding the BIS and BIS subscales’ subscores, PS, and TMPS scores. For participants with MDD, there was a significant same-directional correlation between EDE-Q-13 binging, HDRS, BIS, and PS scores (p < 0.05 for each), with moderate to strong effect sizes (EDE-Q-13 binging and HDRS: r = 0.398, p < 0.001; binging and PS: r = 0.273, p < 0.001; binging and BIS: r = 0.233, p = 0.005; binging and TMPS-10: r = –0.257, p = 0.002). Additionally, a negative correlation was observed between TMPS and the scores for EDE-Q-13 binging, HDRS, BIS, and PS. A linear regression analysis indicated that depression severity and BMI were the strongest predictors of binge eating behavior (R² = 0.243; f² = 0.32). Based on our results, we concluded that the presence of binge eating behavior in patients with MDD is associated with more severe depressive symptoms, psychological pain, impulsivity, and lower tolerance to psychological pain. The finding that binge eating behavior was most strongly associated with depression severity and body mass index (BMI) supports the notion that binge eating behavior is a maladaptive attitude. Longitudinal studies comparing individuals with different BMIs in different clinical samples are needed to confirm our results. Full article

Introduction: In the literature, depression is a medical condition that is well known and has been studied for decades, yet in clinical practice it often happens that depressive symptoms are confused with structured disorders or complexes. This incorrect interpretation can lead the psychiatrist to choose to make a psychopharmacological prescription, relegating psychotherapy to mere support or in any case reducing its importance, risking making the patient’s symptoms chronic and overloading the healthcare system. Materials and Methods: The literature up to December 2024 was reviewed and 40 articles were included in the review. A pilot study was conducted to verify the effectiveness and validation of the proposed theoretical model. Results: We propose the use of the “Perrotta Depressive Symptoms Assessment” (PDSYA) for the differential diagnosis in disorders with the manifestation of depressive symptoms, to facilitate the correct diagnosis and to reduce interpretative errors, both at a nosographic and therapeutic level. Conclusions: In the pilot study, in the content validity analysis, all items obtained a CVR score greater than the cut-off value, with a minimum score of 0.811. Therefore, all items of the scale were considered essential; also, regarding the relevance of the items in exploring the constructs investigated, optimal values of I-CVI (>0.93) and scale (S-CVI > 0.98) were obtained. Therefore, all items were rated as relevant. The validation study of the model is underway with a representative sample. Full article

Background: Cognitive functions and brain connectivity could be influenced by psychoanalytic psychotherapy (PP), thus representing neurobiological parameters for therapy-induced changes. This study searched empirical studies on cognition and the brain to evaluate which functions have been assessed, with which instruments, and what changes have been documented in brain connectivity after PP. Methods: We used the guidelines and checklist of the Preferred Reporting Items of Systematic Reviews and Meta-analyses Extension for Scoping Reviews. The literature search was performed on the Medline–PubMed, American Psychological Association-PsycINFO, Elton Bryson Stephens Company, and Cochrane databases, and Google Scholar, including articles on patients with non-psychotic disturbances published from 1980 to September 2024. Results: Fifty-nine articles were collected. Five articles reported on cognitive outcomes. Abstraction and mentalization remained stable after individual PP in patients with adjustment disorders or anorexia nervosa. Executive functions, emotional intelligence, spatial short-term memory, attention, and balance between relatedness and self-definition improved after group PP applied alone or combined with individual PP. Twelve studies using functional magnetic resonance imaging, positron emission tomography, single-photon emission computerized tomography, or electroencephalography showed functional brain changes after different types of PP. Conclusions: An empirical approach has rarely been used to evaluate the impact of PP on the brain and cognition. The results of selected studies on neurotic and depressive disorders suggest that PP can stimulate cognitive function and brain connectivity. Further literature reviews are needed to clarify these issues and provide an avenue for research studies targeting PP in different conditions. Communication between neurology and psychoanalysis is indispensable. Full article

Background/Objectives: Dance intervention, as a non-pharmacological therapy, has shown promising potential in alleviating menopausal symptoms among perimenopausal, menopausal, and postmenopausal women. However, a systematic evaluation of its overall effectiveness based on existing trials remains unavailable. This study aims to investigate the effectiveness of dance intervention on health-related outcomes in perimenopausal, menopausal, and postmenopausal women through a systematic review and meta-analysis. Methods: This study systematically searched the relevant databases on 18 October 2024. The risk of bias was assessed using the Cochrane RoB 2 and ROBINS-I tools. Meta-analysis was performed using Review Manager version 5.4. software. For results unsuitable for meta-analysis, narrative synthesis was conducted. The study was registered in PROSPERO (number: CRD42024613134). Results: Meta-analysis demonstrated significant positive effects of dance intervention on psychological symptoms, including depression (I² = 87%, p < 0.001), anxiety (I² = 90%, p = 0.01), vitality (I² = 0%, p = 0.03), interpersonal relationships (I² = 0%, p < 0.001), and somatization (I² = 85%, p = 0.01), in menopausal women, but no significant impact was observed on psychotic symptoms (I² = 89%, p = 0.33). However, the high heterogeneity suggests the presence of potential confounding factors among studies. Sensitivity analysis indicated that the flexibility of the intervention protocol and intra-group differences among participants may have been the main sources of heterogeneity. Further subgroup analysis revealed that interventions conducted less than three times per week had significant effects on depressive symptoms (SMD = −1.93), while a total intervention duration of ≤1800 min significantly improved anxiety symptoms (SMD = −2.15). Conclusions: Dance interventions have significant positive effects on health-related outcomes in perimenopausal, menopausal, and postmenopausal women, except for psychotic symptoms, offering a promising intervention option for clinical practice. Full article

Stigma and discrimination remain significant challenges to the quality of life and social integration of individuals with chronic mental disorders, particularly schizophrenia, one of the most stigmatized conditions. The paradox of insight, in which greater awareness of illness correlates with poorer psychosocial outcomes in the presence of high internalized stigma, provides a critical framework for understanding these challenges. This study examined the moderation between insight and internalized stigma and its influence on psychosocial outcomes in 83 male participants diagnosed with psychotic spectrum disorders. Using K-means clustering, three distinct profiles emerged: (1) good insight and minimal stigma, (2) poor insight and mild stigma, and (3) good insight and severe stigma. These profiles showed significant differences in depression, quality of life, and global functioning. Findings confirmed that internalized stigma moderates the relationship between insight and psychosocial well-being, exacerbating the negative influence of insight on quality of life and psychological health when stigma levels are high. The results emphasize the need for psychoeducational interventions to normalize experiences of psychosis, family and community engagement to reduce stigma, and cognitive-behavioral therapies to address stigma-related beliefs. These strategies are essential for improving psychosocial well-being and supporting recovery in this population. Full article

FKBP5 has been of special scientific interest in the behavioral sciences since it has been involved in the pathophysiology of several mental disorders. It is a gene with pleiotropic effects which encodes the protein FKBP5, a cochaperone that decreases glucocorticoid receptor (GR) affinity for glucocorticoids by competing with FKBP4, altering the GR chaperone complex, and impairing GR activation. As a key modulator of the stress response, FKBP5 plays a critical role in regulating cortisol levels in the organism. The FKBP5 gene is regulated through a combination of transcriptional, epigenetic, post-transcriptional, and environmental mechanisms, as well as genetic polymorphisms that influence its transcription and stress responsiveness. Notably, the rs1360780 T-allele in FKBP5 significantly affects FKBP5 regulation and has been linked to stress-related disorders by influencing transcription and stress responsiveness. In this narrative review, we aim to provide an overview of the role played by the single-nucleotide polymorphism rs1360780 in the FKBP5 locus in gene expression, its epigenetic regulation, and the impact of early stress in its functioning. We discuss some brain regions with differential expression of FKBP5 and some behavioral phenotypes linked to the locus. The T-allele of rs1360780 is considered a risk variant, as it leads to high FKBP5 induction, which delays negative feedback and increases GR resistance. This results in states of relative hypercortisolemia and brain morphofunctional alterations, particularly in regions sensitive to glucocorticoid activity during critical periods of neurodevelopment. Additionally, exposure to childhood maltreatment is associated with demethylation of the glucocorticoid response elements of FKBP5, further increasing its expression levels. Among the psychological dimensions analyzed in which FKBP5 is involved are neurocognition, aggression, suicidality, and social cognition. At the level of mental disorders, the gene may play a role in the pathogenesis of post-traumatic stress disorder, depression, and bipolar disorder. In psychotic disorders, its role is less clear. This knowledge enhances the understanding of disease mechanisms that operate through psychopathological dimensions, and highlights the need to design specific, person-centered psychopharmacological and environmental therapeutic interventions. Full article

Aripiprazole (ARZ) is an atypical antipsychotic drug used to treat a variety of mood and psychotic disorders, such as schizophrenia, bipolar disorder, major depressive disorder, autism, and Tourette’s syndrome. Although ARZ offers significant therapeutic benefits, its poor solubility in water requires the development of delivery systems aimed at improving the solubility and bioavailability of the drug. In this work, cryogels based on two natural products—agar and β-cyclodextrin (CD)—were developed and evaluated as a drug delivery system for ARZ. The cryogels were prepared by cryogenic treatment of aqueous solutions of agar and the β-CD/ARZ complex, followed by thawing. The main characteristics of the material, including gel fraction yield, swelling degree, pore volume, elastic properties, and morphology were studied in detail. The release of ARZ from composite cryogels was assessed in two media resembling the pH in stomach and intestine. The system exhibited a pH-dependent release of ARZ, with a slower rate in acidic media (pH 1.2) than in the neutral phosphate buffer (pH 6.8). Under in vitro conditions, the amount of released ARZ over 48 h reached 33%. Full article

Background and Objectives: Growing evidence suggested that abnormal lipid metabolism (ALM) was associated with an increased severity of depressive symptoms, but no previous studies have examined the differences in comorbid ALM in major depressive disorder (MDD) patients of different ages of onset. We aim to compare the differences in the prevalence and clinical correlates of ALM between early-onset and late-onset patients with first-episode and drug-naive (FEDN) MDD patients. Methods: Using a cross-sectional design, we recruited a total of 1718 FEDN MDD outpatients in this study. We used the 17-item Hamilton Rating Scale for Depression (HAMD-17), The Hamilton Anxiety Rating Scale (HAMA), the Positive and Negative Syndrome Scale (PANSS) positive subscale, and Clinical Global Impression-Severity Scale (CGI-S) to assess their depression, anxiety, and psychotic symptoms and clinical severity, respectively. Results: There were 349 patients (20.3%) in the early-onset subgroup and 1369 (79.7%) in the late-onset subgroup. In this study, 65.1% (1188/1718) of patients were diagnosed with ALM. The prevalence of ALM in the late-onset group (81.5%, 1116/1369) was significantly higher than that in the early-onset group (20.6%, 72/349) (p = 0.36, OR = 1.147, 95%CI = 0.855–1.537). The HAMD total score (OR = 1.34, 95% CI = 1.18–1.53, p < 0.001) was the only risk factor for ALM in early-onset MDD patients. In late-onset MDD patients, the HAMD total score (OR = 1.19, 95% CI = 1.11–1.28, p < 0.001), TSH (OR = 1.25, 95% CI = 1.16–1.36, p < 0.001), CGI (OR = 1.7, 95% CI = 1.31–2.19, p < 0.001), and anxiety (OR = 2.22, 95% CI = 1.23–4.02, p = 0.008) were risk factors for ALM. Conclusion and Scientific Significance: Our results suggest that there are significant differences in the prevalence and clinical factors of comorbid ALM between early-onset and late-onset FEND MDD patients. Full article

Background/Objectives: Adolescence is a developmental stage characterized by profound physical and psychological transformations, often leading to vulnerabilities such as body dissatisfaction, identity challenges, and the use of maladaptive coping strategies. This often leads to body-related psychopathologies, including headaches, restrictive eating disorders, and non-suicidal self-injury (NSSI). The present study aimed to describe the typical functioning and features of these conditions and the differences between the three groups, and to identify the most effective assessment for predicting these conditions. Methods: Sixty adolescent patients (51 female; mean age = 15.34 ± 1.80) were divided into three groups: headaches, restrictive eating disorders, and NSSI, and assessed for differences in symptoms, cognitive performance, personality, functioning, and illness severity using semi-structured interviews, clinician-based scales, and performance-based tests like the Rorschach inkblot test, according to the Rorschach Performance Assessment System (R-PAS). Results: Individuals with headaches experienced more internalizing symptoms, had an average IQ, maintained some functioning areas, and had distorted patterns of self–other relationships with the tendency to project malevolent aspects onto others. Patients with restrictive eating disorders had high levels of depressive symptoms, above-average IQ scores, negative symptoms, moderate presence of obsessive–compulsive personality traits, disorganized thinking, and a tendency to interpret situations subjectively. Patients with NSSI showed the highest level of depressive symptoms and social anxiety symptoms, and a considerable presence of psychotic symptoms and perceptual distortions. Negative symptoms, borderline personality traits, and psychosis symptoms had the strongest predictivity. Conclusions: The study provides clinicians with relevant insights into the features of these conditions and highlights assessment strategies, tailored interventions, and enhanced outcomes for these vulnerable populations. Full article

Background/Objectives: The present study examined the link between sociodemographic variables, anthropometric indices, and psychiatric disorders among patients in Saudi Arabia’s Eastern Region (Al-Hassa), as well as health outcomes, including basic hematological and biochemical markers. Methods: The patients included 89 females and 79 males with psychiatric disorders, with ages ranging from 19 to 59. Sociodemographic characteristics, anthropometric proxies, and fundamental hematological and biochemical markers were assessed. Results: The sociodemographic characteristics of the patients were poor and varied within and between sexes. This study observed that male psychiatric patients had greater anthropometric proxies, particularly those who were overweight or obese, than females. Most of the patients’ hematological and biochemical parameters were below the normal level, with some higher than normal. Moreover, anemia was identified in 40.51% of the male participants in the study, with a higher percentage among those diagnosed with depressive disorders (Dep-d, 57.14%) and schizophrenia spectrum and other psychotic disorders (SsP-d, 32.43%), and 49.44% of the female participants, with a higher percentage among those diagnosed with depressive disorders (52.50%) and other psychotic disorders (46.15%). Furthermore, to confirm the link between sociodemographic variables, anthropometric indices, and psychiatric disorders among patients, the Spearman correlation coefficient and simple regression analysis of such variables was carried out. The results revealed that the majority of sociodemographic characteristics were either favorably or adversely correlated with patients’ anthropometrics and type of depression in both sexes. Conclusion: Low sociodemographic characteristics and high anthropometric variables may be risk factors for people with psychotic disorders, which have been linked to negative health consequences. Full article

Background: Schizophrenia is a complex disorder characterized by positive symptoms (e.g., hallucinations), negative symptoms (e.g., social withdrawal), and disorganized symptoms (e.g., thought disorder). Alongside these, cognitive and depressive symptoms often emerge, with depressive symptoms sometimes dominating the clinical picture. Understanding the factors that influence the development of depressive symptoms in schizophrenia could clarify the dynamics between depressive and psychotic symptoms and guide clinical interventions. Methods: A total of 105 patients with schizophrenia (66 women, 39 men) were assessed using several clinical scales: PANSS, BPRS, DOCS, DES, HAM-D, and the Luria-Nebraska Neuropsychological Battery for cognitive evaluation. Statistical analyses, including correlation and regression, were conducted using SPSS to determine the significance of associations. Results: Disorganized and obsessive-compulsive symptoms were identified as primary factors associated with depressive symptoms in patients with schizophrenia. Conversely, a longer duration of untreated psychosis was linked to a lower severity of depressive symptoms, suggesting that early intervention may alter the depressive symptom trajectory. Conclusions: Here, we suggest a complex interaction between psychotic and depressive symptoms, possibly indicating a biological antagonism. The association of depressive symptoms with disorganized and obsessive-compulsive features may reflect an adaptive psychological response, attempting to stabilize amidst the disintegration of schizophrenia. These insights support a more integrated approach to treatment, addressing both psychotic and depressive symptoms to improve patient outcomes. Full article