psychiatric disorder

精神障碍
  • 文章类型: Journal Article
    线粒体疾病是已知的影响能量代谢的先天性错误,与糖尿病等慢性疾病一样常见,影响了大约5000人中的1人。线粒体疾病/功能障碍的作用在神经发育障碍如ASD中得到了强调,多动症,智力残疾,和说话延迟,以及各种精神病。神经发育障碍越来越被认为具有行为和精神症状。我们的研究旨在调查线粒体疾病的报道,注意神经发育障碍和精神/行为状况。
    这是通过对PubMed/MEDLINE文献的系统回顾完成的,Scopus,和Cochrane图书馆至2022年11月。
    我们发现了277种出版物,其中139人符合纳入标准。我们主要发现综述文章提及与ASD相关的线粒体功能障碍/疾病,并简要提及精神病/行为合并症。
    这表明需要在ASD之外进行更广泛的研究,以了解线粒体疾病或功能障碍与各种神经发育和精神/行为合并症之间的关系。
    UNASSIGNED: Mitochondrial diseases are known inborn errors affecting energy metabolism and are as common as chronic diseases such as diabetes, affecting approximately 1 in 5,000 people. The role of mitochondrial diseases/dysfunction has been highlighted in neurodevelopmental disorders like ASD, ADHD, intellectual disability, and speech delay, as well as various psychiatric conditions. Neurodevelopmental disorders are increasingly recognized as having behavioral and psychiatric symptoms. Our study aimed to investigate reports of mitochondrial disorders, noting neurodevelopmental disorders and psychiatric/behavioral conditions.
    UNASSIGNED: This was done through a systematic review of literature from PubMed/MEDLINE, Scopus, and Cochrane Library up to November 2022.
    UNASSIGNED: We found 277 publications, of which 139 met the inclusion criteria. We mostly found review articles with mention of mitochondrial dysfunction/disorder in relation to ASD with brief mentions of psychiatric/behavioral comorbidities.
    UNASSIGNED: This suggests a need for broader research efforts beyond ASD to understand the relationship between mitochondrial disorder or dysfunction and various neurodevelopmental and psychiatric/behavioral comorbidities.
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  • 文章类型: Journal Article
    简介:精神疾病之间的关系,包括抑郁症,和侵入性干预一直是最近文献中争论的话题。虽然这些情况会影响生活质量和对手术结果的主观看法,关于抑郁症与客观的围手术期内科和外科并发症之间的关系,文献缺乏共识。尤其是在神经外科领域。方法:MEDLINE(PubMed),EMBASE,PsycINFO,从成立到2023年11月10日,对Cochrane图书馆进行了全面的查询,没有语言限制,对于调查抑郁症和住院时间之间关系的引文,医疗和外科并发症,和客观的术后结果,包括再入院,再操作,脊柱手术患者的非常规出院。结果:本系统评价共纳入26篇文献。在对主要结果进行汇总分析后,统计学上观察到几种并发症的发生率显着提高,包括谵妄(OR:1.92),深静脉血栓形成(OR:3.72),发烧(或:6.34),血肿形成(OR:4.7),低血压(OR:4.32),肺栓塞(OR:3.79),神经损伤(OR:6.02),手术部位感染(OR:1.36),尿潴留(OR:4.63),尿路感染(OR:1.72)。而再入院(OR:1.35)和再手术(OR:2.22)率,以及非常规放电(OR:1.72)率,在抑郁症患者中明显更高,住院时间与非抑郁对照组相当.结论:本综述的结果强调了在接受脊柱手术的抑郁症患者中,并发症和不良结局的显着增加。虽然可能无法建立直接的因果关系,解决患者护理中的精神病方面对于提供全面的医疗护理至关重要。
    Introduction: The relationship between psychiatric disorders, including depression, and invasive interventions has been a topic of debate in recent literature. While these conditions can impact the quality of life and subjective perceptions of surgical outcomes, the literature lacks consensus regarding the association between depression and objective perioperative medical and surgical complications, especially in the neurosurgical domain. Methods: MEDLINE (PubMed), EMBASE, PsycINFO, and the Cochrane Library were queried in a comprehensive manner from inception until 10 November 2023, with no language restrictions, for citations investigating the association between depression and length of hospitalization, medical and surgical complications, and objective postoperative outcomes including readmission, reoperation, and non-routine discharge in patients undergoing spine surgery. Results: A total of 26 articles were considered in this systematic review. Upon pooled analysis of the primary outcome, statistically significantly higher rates were observed for several complications, including delirium (OR:1.92), deep vein thrombosis (OR:3.72), fever (OR:6.34), hematoma formation (OR:4.7), hypotension (OR:4.32), pulmonary embolism (OR:3.79), neurological injury (OR:6.02), surgical site infection (OR:1.36), urinary retention (OR:4.63), and urinary tract infection (OR:1.72). While readmission (OR:1.35) and reoperation (OR:2.22) rates, as well as non-routine discharge (OR:1.72) rates, were significantly higher in depressed patients, hospitalization length was comparable to non-depressed controls. Conclusions: The results of this review emphasize the significant increase in complications and suboptimal outcomes noted in patients with depression undergoing spinal surgery. Although a direct causal relationship may not be established, addressing psychiatric aspects in patient care is crucial for providing comprehensive medical attention.
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  • 文章类型: Journal Article
    这项研究的目的是探讨学校拒绝行为的临床意义,它对儿童和青少年心理健康的负面影响及其与儿童和青少年时期最常见的精神病理学状况的关系(例如神经发育障碍,精神疾病)。学校拒绝行为是指儿童和青少年所经历的一种令人痛苦的状况,这种状况损害了正常的入学率,并确定了对心理健康和适应功能的负面影响。对2019年1月至2023年3月发表的文献进行了叙述性回顾。从电子数据库PubMed的文献检索中纳入了10项研究(n=10),CINAHL,PsycInfo,MedLine,科克伦图书馆结果表明,由于存在行为问题和沟通技巧缺陷,自闭症和注意力缺陷/多动症等神经发育障碍中高度存在拒绝学校。至于精神疾病,拒绝上学似乎在焦虑症中非常常见,抑郁症,和躯体症状。我们还发现,学校拒绝行为可能与作为危险因素的各种情绪和行为状况有关。尤其是,但不限于,它可能与自我概念减弱有关,暴露于网络欺凌,具体的情感概况和过度的技术使用。我们的结果表明,拒绝上学是许多临床方面的条件。这可以归因于两个脆弱性因素,气质和关系,以及各种不同的精神病理学状况,如神经发育障碍和精神疾病。认识到这些方面可以改善患者量身定制的治疗干预措施的实施,从而更有可能产生有效的结果。治疗干预应促进对学校作为威胁环境的认知偏见的认识,同时调节与出勤率相关的负面情绪。此外,与社交技能培训和解决问题培训相关的治疗干预计划,直接在学校环境中进行,可以提高孩子应对学习成绩和社会关系的能力,最终阻止学校拒绝。
    The aim of the study was to explore the clinical significance of school refusal behavior, its negative impact on psychological well-being of children and adolescents and its relationship with the most common psychopathological conditions during childhood and adolescence (e.g. neurodevelopmental disorders, psychiatric disorders). School refusal behavior refers to a distressing condition experienced by children and adolescents that compromise regular school attendance and determine negative consequences on mental health and adaptive functioning. A narrative review of the literature published between January 2019 and March 2023 was conducted. Ten studies (n = 10) were included from a literature search of the electronic databases PubMed, CINAHL, PsycInfo, MedLine, and Cochrane Library. The results indicate that school refusal is highly present in neurodevelopmental disorders such as autism and attention-deficit/hyperactivity disorder due to the presence of behavioral problems and deficits in communication skills. As for psychiatric disorders, school refusal appears to be highly common in anxiety disorders, depressive disorders, and somatic symptoms. We also found that school refusal behavior may be associated with various emotional and behavioral conditions that act as risk factors. Especially, but are not limited to, it may be associated with a diminished self-concept, exposure to cyberbullying, specific affective profiles and excessive technology usage. Our results indicate that school refusal is a condition with many clinical facets. It can be attributed to both vulnerability factors, both temperamental and relational, and to various psychopathological conditions that differ significantly from each other, such as neurodevelopmental disorders and psychiatric disorders. Recognizing these aspects can improve the implementation of patient-tailored therapeutic interventions that are consequently more likely to produce effective outcomes. The therapeutic intervention should facilitate the recognition of cognitive biases regarding school as a threatening environment, while regulating negative emotions associated with school attendance. Additionally, therapeutic intervention programs linked to social skill training and problem-solving training, conducted directly within the school setting, can enhance children\'s abilities to cope with academic performance and social relationships, ultimately preventing school refusal.
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  • 文章类型: Journal Article
    精神疾病是现代科学中的隐性流行病,已逐渐在世界范围内传播。根据世界卫生组织(WHO)的估计,全世界每年大约有10%的人口患有各种精神疾病。全球,社会的财政和健康负担逐年增加。因此,了解可能影响精神疾病的不同因素,需要制定新颖有效的治疗方法和干预措施来对抗精神疾病。肠道菌群,由居住在胃肠道中的不同微生物群落组成,通过肠脑轴对中枢神经系统产生深远的影响。肠脑轴是两个系统之间双向通信的管道,使肠道微生物群能够影响情绪和认知功能。菌群失调,或者肠道微生物群的不平衡,与心理健康障碍和精神疾病的易感性增加有关。肠道微生物群是最多样化和最丰富的微生物群之一,已被发现与中枢神经系统相互作用并在人体肠道中发挥重要的生理功能,从而极大地影响了精神疾病的发展。肠道微生物群与心理健康相关疾病之间的相互作用是一个多方面且有前途的研究领域。这篇综述探讨了肠道微生物群影响心理健康的机制。包括神经递质产生的调制,神经炎症,和肠道屏障的完整性。此外,它强调了对肠道微生物组如何影响各种精神疾病的透彻理解。
    Mental illness is a hidden epidemic in modern science that has gradually spread worldwide. According to estimates from the World Health Organization (WHO), approximately 10% of the world\'s population suffers from various mental diseases each year. Worldwide, financial and health burdens on society are increasing annually. Therefore, understanding the different factors that can influence mental illness is required to formulate novel and effective treatments and interventions to combat mental illness. Gut microbiota, consisting of diverse microbial communities residing in the gastrointestinal tract, exert profound effects on the central nervous system through the gut-brain axis. The gut-brain axis serves as a conduit for bidirectional communication between the two systems, enabling the gut microbiota to affect emotional and cognitive functions. Dysbiosis, or an imbalance in the gut microbiota, is associated with an increased susceptibility to mental health disorders and psychiatric illnesses. Gut microbiota is one of the most diverse and abundant groups of microbes that have been found to interact with the central nervous system and play important physiological functions in the human gut, thus greatly affecting the development of mental illnesses. The interaction between gut microbiota and mental health-related illnesses is a multifaceted and promising field of study. This review explores the mechanisms by which gut microbiota influences mental health, encompassing the modulation of neurotransmitter production, neuroinflammation, and integrity of the gut barrier. In addition, it emphasizes a thorough understanding of how the gut microbiome affects various psychiatric conditions.
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    求助全文

  • 文章类型: Journal Article
    失眠等睡眠障碍会导致一系列健康问题。传统药物疗法的副作用和药物滥用的高风险要求更安全的非药物疗法。
    研究加权毛毯在改善不同人群睡眠和相关疾病中的使用和功效,并探索可能的机制。
    使用PubMed进行了文献检索,Embase,WebofScience,MEDLINE,Cochrane图书馆与CNKI数据库符合条件的研究包括使用加权毛毯进行干预,结果涵盖睡眠和/或相关疾病(行为障碍,负面情绪和白天症状)。使用其他深层压力的研究,压缩,或排除与运动相关的干预措施.
    纳入的大部分研究表明,加权毛毯能有效改善睡眠质量,缓解睡眠障碍患者的负面情绪和日间症状,注意缺陷多动障碍,自闭症谱系障碍,和其他相关疾病,具有深压力接触的可能机制。
    加权毛毯可能是临床上睡眠障碍患者睡眠干预的有希望的工具。需要更多高质量和大规模的随机对照试验来进一步验证加权毛毯的安全性和有效性,并探索确切的机制。
    UNASSIGNED: Sleep disorders such as insomnia can lead to a range of health problems. The high risk of side effects and drug abuse of traditional pharmacotherapy calls for a safer non-pharmacotherapy.
    UNASSIGNED: To examine the use and efficacy of weighted blankets in improving sleep and related disorders in different populations and explore the possible mechanisms.
    UNASSIGNED: A literature search was conducted using PubMed, Embase, Web of Science, MEDLINE, Cochrane Library and CNKI databases. Eligible studies included an intervention with weighted blankets and outcomes covering sleep and/or related disorders (behavioral disturbance, negative emotions and daytime symptoms). Studies using other deep pressure, compression, or exercise-related interventions were excluded.
    UNASSIGNED: Most of the included studies showed that weighted blankets could effectively improve sleep quality and alleviate negative emotions and daytime symptoms in patients with sleep disorders, attention deficit hyperactivity disorder, autism spectrum disorder, and other related disorders, with a possible mechanism of deep pressure touch.
    UNASSIGNED: Weighted blankets might be a promising tool for sleep interventions among individuals with sleep disorders in clinical settings. More high-quality and large-scale randomized controlled trials are needed to further validate the safety and efficacy of weighted blankets and explore precise mechanisms.
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  • 文章类型: Journal Article
    慢性肾脏病(CKD)患者,尤其是那些血液透析患者,经常与焦虑和抑郁等心理健康问题作斗争。众所周知,心理治疗可以治疗心理问题,但其在治疗CKD患者方面的有效性仍很少得到科学证实.本研究旨在分析心理治疗对改善CKD血液透析患者心理健康的作用。我们全面回顾了发表在PubMed上的相关研究,谷歌学者,ScienceDirect,和过去十年的临床钥匙,到2023年6月7日。在搜索引擎策略中使用了关键字组合,纳入了所有关于接受血液透析和心理治疗的CKD患者的文章。根据资格标准,在最终分析中,在18,830项研究中,有13项纳入了716例患者。399例CKD患者抱怨心理问题。心理治疗包括认知行为治疗(在四项研究中报道,n=4),膈肌呼吸松弛(n=1),冥想(n=1),催眠疗法(n=1),肾脏最佳健康计划(KOHP)(n=1),心理干预(n=1),穆罗托尔古兰经治疗(n=3),和精神治疗(n=1)。这些干预措施每周进行一到四次,在血液透析两到十周的过程中十分钟到五个小时。冥想和KOHP在焦虑和抑郁方面没有显着改善。其余的心理治疗通过减少血液透析患者的焦虑和抑郁以及提高睡眠质量,显著改善了患者的生活质量。自尊,充满希望,药物依从性,和身体状况。总之,心理治疗应考虑在一个跨学科的团队,以全面治疗CKD患者。仍需要进一步的研究来确定每种心理干预对患有精神病的CKD患者的疗效。
    Chronic kidney disease (CKD) patients, especially those with hemodialysis, frequently struggle with mental health issues like anxiety and depression. Psychotherapy has been known to treat psychological problems, but its effectiveness in managing CKD patients is still rarely scientifically proven. The aim of this study was to analyze the role of psychological treatments in improving the mental health of CKD patients with hemodialysis. We comprehensively reviewed the related studies published in PubMed, Google Scholar, ScienceDirect, and Clinical Key over the last ten years, up to June 7, 2023. A keyword combination was used in the search engine strategies, and all articles about CKD patients receiving hemodialysis and psychotherapy were included. Based on the eligibility criteria, 716 patients were included in 13 out of 18,830 studies in the final analysis. Psychological problem was complained by 399 CKD patients. The psychotherapy included cognitive behavioral therapy (reported in four studies, n=4), diaphragmatic breathing relaxation (n=1), meditation (n=1), hypnotherapy (n=1), Kidney Optimal Health Program (KOHP) (n=1), psychological intervention (n=1), murottal Al-Qur\'an therapy (n=3), and spiritual therapy (n=1). These interventions were performed once to four times a week, for ten minutes to five hours during hemodialysis for two to ten weeks. Meditation and KOHP showed no significant improvement in anxiety and depression. The remaining psychotherapies significantly improved the quality of life by reducing anxiety and depression in hemodialysis patients and enhancing sleep quality, self-esteem, hopefulness, medication adherence, and physical condition. In conclusion, psychotherapy should be considered in an interdisciplinary team to treat CKD patients comprehensively. Further studies are still necessary to determine the efficacy of each psychological intervention in CKD patients with psychiatric problems.
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  • 文章类型: Journal Article
    在COVID-19大流行之前,性和性别多样化(SGD)年轻人的精神疾病患病率和严重程度高于异性恋/顺性同龄人.我们系统地回顾了研究患病率的文献,严重程度,以及大流行期间25岁及以下SGD年轻人中精神疾病的危险因素。四个数据库(MEDLINE,PsycInfo,搜索了Scopus和WebofScience)。合格标准是评估患病率的研究,使用同期筛查措施或诊断的平均症状学评分和精神疾病的危险因素。确定了13项混合质量研究。大多数研究表明,与普通人群相比,SGD年轻人患有多种精神疾病的风险很高,包括抑郁症和广泛性焦虑症。与异性恋/顺性同龄人相比,该组还经历了各种精神疾病的严重症状。风险因素包括大流行特有的因素,以及大流行前导致更大风险的因素。这项系统评价表明,有证据表明,在COVID-19大流行期间,SGD年轻人患精神疾病的风险增加。对于临床医生来说,重要的是要承认SGD年轻人的需求,在应对大流行的影响时,与他们合作,共同开发更具包容性的医疗服务。
    为什么要进行这项研究?在COVID-19大流行之前,性和性别多样化(SGD)年轻人的精神疾病患病率和严重程度高于异性恋/顺性同龄人,基于几个风险因素。使用经过验证的筛查措施的研究评估了这种情况在大流行期间是否持续。然而,这些研究并没有以有组织的方式汇集在一起,以提供这一证据的全面总结。研究人员做了什么?我们回顾了研究患病率的文献,严重程度,以及大流行期间25岁及以下SGD年轻人中精神疾病的危险因素。合格标准是评估患病率的研究,使用同期筛查措施或诊断的平均症状学评分或精神疾病的危险因素。研究人员发现了什么?确定了13项混合质量研究。大多数研究表明,与普通人群相比,SGD年轻人更有可能报告患有多种精神疾病,包括抑郁症和广泛性焦虑症。与异性恋/顺性同龄人相比,SGD年轻人还经历了各种精神疾病的严重症状。风险因素包括大流行特有的因素以及大流行之前存在的因素。这项审查表明,在COVID-19大流行期间,SGD年轻人患精神疾病的风险更大。临床医生应该承认SGD年轻人的需求,在应对大流行的影响时,与他们合作,共同开发更具包容性的医疗服务。
    Before the COVID-19 pandemic, the prevalence and severity of psychiatric disorders among sexual and gender diverse (SGD) young people was greater than in their heterosexual/cisgender peers. We systematically reviewed literature examining the prevalence, severity, and risk factors for psychiatric disorders among SGD young people aged 25 and under during the pandemic. Four databases (MEDLINE, PsycInfo, Scopus and Web of Science) were searched. Eligibility criteria were studies assessing prevalence rates, mean symptomology scores and risk factors of psychiatric disorders using contemporaneous screening measures or diagnosis. Thirteen studies of mixed quality were identified. Most studies indicated SGD young people were at high risk of experiencing several psychiatric disorders including depressive and generalised anxiety disorder compared to the general population. This group also experienced more severe symptomology of various psychiatric disorders compared to their heterosexual/cisgender peers. Risk factors included those specific to the pandemic along with factors that led to greater risk before the pandemic. This systematic review has indicated evidence of heightened risk of psychiatric disorders among SGD young people during the COVID-19 pandemic. It is important for clinicians to acknowledge the needs of SGD young people, working with them to co-develop more inclusive care as they deal with the pandemic\'s fallout.
    Why was the study done?Before the COVID-19 pandemic, the prevalence and severity of psychiatric disorders in sexual and gender diverse (SGD) young people was greater than in their heterosexual/cisgender peers, based on several risk factors. Research using validated screening measures assessed whether this continued during the pandemic. Yet, these studies have not been brought together in an organised fashion to provide a comprehensive summary of this evidence.What did the researchers do?We reviewed literature examining the prevalence, severity, and risk factors for psychiatric disorders among SGD young people aged 25 and under during the pandemic. Eligibility criteria were studies assessing prevalence rates, mean symptomology scores or risk factors of psychiatric disorders using contemporaneous screening measures or diagnosis.What did the researchers find?Thirteen studies of mixed quality were identified. Most studies indicated SGD young people were more likely to report experiencing several psychiatric disorders including depressive and generalised anxiety disorders compared to the general population. SGD young people also experienced more severe symptomology of various psychiatric disorders compared to their heterosexual/cisgender peers. Risk factors included those specific to the pandemic along with factors that existed before the pandemic.What do the findings mean?This review suggests SGD young people were at greater risk of psychiatric disorders during the COVID-19 pandemic. Clinicians should acknowledge the needs of SGD young people, working with them to co-develop more inclusive care as they deal with the pandemic\'s fallout.
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  • 文章类型: Journal Article
    长期以来,精神病再入院一直被认为是医疗保健计划的重要指标。这项研究的目的是确定影响急性精神病病房早期(30天)再入院的因素。根据流行病学观察性研究(MOOSE)指南进行Meta分析和系统评价。使用在线数据库进行全面的数据库搜索,包括PubMed和谷歌学者,搜索确定与急性精神科病房早期(30天)再入院相关因素的文章。用于搜索相关文章的关键词包括“精神疾病,\"\"重新接纳,“以及它们的同义词和医学主题词(MeSH)术语。该搜索包括2011年至2023年6月之间发表的研究。本荟萃分析共纳入13项研究。30天再入院的合并率为16%(95%置信区间:13%-20%)。汇总分析显示,与计划外再入院显着相关的因素包括性别,逗留时间,和保险状况是精神病患者计划外再入院的预测因素。此外,我们还发现,精神分裂症患者30天计划外入院率更高,其次是人格障碍,双相情感障碍,抑郁症,和物质使用。这项研究强调了为患有这些疾病的个人提供有针对性的干预措施和支持以降低再入院风险的重要性。
    Psychiatric readmissions have long been considered significant indicators for healthcare planning. The aim of this study was to identify factors influencing early (30-day) readmissions to acute psychiatric wards. A meta-analysis and systematic review were conducted according to Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Comprehensive database searching was conducted using online databases, including PubMed and Google Scholar, to search for articles identifying factors associated with early (30-day) readmissions to acute psychiatric wards. Keywords used to search for relevant articles included \"Mental illness,\" \"readmission,\" and factors along with their synonyms and Medical Subject Headings (MeSH) terms. The search included studies published between 2011 and June 2023. A total of 13 studies were included in this meta-analysis. The pooled rate of the 30-day readmission was 16% (95% confidence interval: 13%-20%). A pooled analysis showed that factors significantly associated with an unplanned hospital readmission included gender, length of stay, and insurance status as predictors of the unplanned hospital readmission among individuals with psychiatric illness. Additionally, we also found that the rate of 30-day unplanned admissions was greater in patients with schizophrenia, followed by personality disorder, bipolar disorder, depression, and substance use. This study highlights the importance of providing targeted interventions and support for individuals with these conditions to reduce the risk of readmissions.
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  • 文章类型: Meta-Analysis
    最近的证据表明,早期母体肠道菌群的变化可能会产生与精神病相关异常相关的神经生物学后果。然而,关于人类研究这个问题的研究数量有限,和临床前发现有时冲突。因此,我们进行了一项荟萃分析,以检查神经发育过程中的母体微生物群紊乱(MMD)是否会影响成年后的后代.我们发现了13项研究,从PROSPERO(#289224)上注册的策略选择的459条记录中,针对临床前研究,评估受围产期肠道菌群扰动的水坝产生的啮齿动物的行为结果。分析显示出显著的效应大小(SMD=-0.51,95%CI=-0.79至-0.22,p<.001,T2=0.54,I2=79.85%),表明MMD可能会引起成年后代的行为障碍。MMD还诱导了社交行为(SMD=-0.63,95%CI=-1.18至-0.07,p=0.011,T2=0.30,I2=76.11%)和强迫性行为(SMD=-0.68,95%CI=-0.01至-1.36,p=0.009,T2=0.25,I2=62.82%)。对于记忆和焦虑样行为,效应大小不显著或不确定,或不确定精神分裂症样和抑郁样行为。因此,实验性围产期MMD垂直传播给后代,对与精神疾病相关的行为参数产生负面影响。
    Recent evidence has suggested that changes in maternal gut microbiota in early life may generate neurobiological consequences associated with psychiatric-related abnormalities. However, the number of studies on humans investigating this problem is limited, and preclinical findings sometimes conflict. Therefore, we run a meta-analysis to examine whether maternal microbiota disturbance (MMD) during neurodevelopment might affect the offspring during adulthood. We found thirteen studies, from a set of 459 records selected by strategy registered on PROSPERO (#289224), to target preclinical studies that evaluated the behavioral outcomes of the rodents generated by dams submitted to perinatal enteric microbiota perturbation. The analysis revealed a significant effect size (SMD = -0.51, 95% CI = -0.79 to -0.22, p < .001, T2 = 0.54, I2 = 79.85%), indicating that MMD might provoke behavioral impairments in the adult offspring. The MMD also induces a significant effect size for the reduction of the sociability behavior (SMD = -0.63, 95% CI = -1.18 to -0.07, p = 0.011, T2 = 0.30, I2 = 76.11%) and obsessive-compulsive-like behavior (SMD = -0.68, 95% CI = -0.01 to -1.36, p = 0.009, T2 = 0.25, I2 = 62.82%) parameters. The effect size was not significant or inconclusive for memory and anxiety-like behavior, or inconclusive for schizophrenia-like and depressive-like behavior. Therefore, experimental perinatal MMD is vertically transmitted to the offspring, negatively impacting behavioral parameters related to psychiatric disorders.
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  • 文章类型: Journal Article
    背景:氯胺酮是一系列精神疾病的有效短期治疗方法。一个关键问题是在氯胺酮治疗中加入心理治疗是否可以改善预后或延迟复发。
    目的:确定所有将心理治疗与氯胺酮结合用于治疗精神疾病的研究,以总结其效果并为未来的研究提出建议。
    方法:审查方案在PROSPERO(注册号CRD42022318120)进行了前瞻性注册。在MEDLINE中搜索了潜在的研究,Embase,PsycINFO,Scopus,科克伦图书馆和谷歌学者。符合条件的研究将氯胺酮和心理治疗相结合,用于治疗精神疾病,并且没有使用病例报告或定性设计。与心理治疗类型有关的关键发现,诊断,氯胺酮方案,报道了心理治疗的顺序和研究设计。使用改进的JoannaBriggs关键评估工具评估偏倚风险。
    结果:19项评估1006例患者的研究纳入了系统评价。各种支持的个人和团体,使用人工和非人工心理治疗.大多数研究评估了物质使用障碍,创伤后应激障碍和难治性抑郁症。氯胺酮方案和氯胺酮/心理治疗治疗的顺序在研究之间差异很大。在氯胺酮治疗中增加心理治疗的结果在很大程度上是积极的。
    结论:心理治疗和氯胺酮的结合为精神疾病的治疗提供了希望,但研究异质性阻碍了对它们整合的明确建议。建议使用人工心理治疗和标准化氯胺酮方案的较大随机对照试验,以阐明在氯胺酮中添加心理治疗在多大程度上改善了氯胺酮单独治疗的结果。
    BACKGROUND: Ketamine is an effective short-term treatment for a range of psychiatric disorders. A key question is whether the addition of psychotherapy to ketamine treatment improves outcomes or delays relapse.
    OBJECTIVE: To identify all studies combining psychotherapy with ketamine for the treatment of psychiatric disorders to summarise their effects and make recommendations for future research.
    METHODS: The review protocol was prospectively registered with PROSPERO (registration number CRD42022318120). Potential studies were searched for in MEDLINE, Embase, PsycINFO, SCOPUS, the Cochrane library and Google Scholar. Eligible studies combined ketamine and psychotherapy for the treatment of psychiatric disorders and did not use case reports or qualitative designs. Key findings relating to psychotherapy type, diagnosis, ketamine protocol, sequencing of psychotherapy and study design are reported. Risk of bias was assessed using modified Joanna Briggs critical appraisal tools.
    RESULTS: Nineteen studies evaluating 1006 patients were included in the systematic review. A variety of supportive individual and group, manualised and non-manualised psychotherapies were used. The majority of studies evaluated substance use disorders, post-traumatic stress disorder and treatment-resistant depression. Ketamine protocols and sequencing of ketamine/psychotherapy treatment varied substantially between studies. Outcomes were largely positive for the addition of psychotherapy to ketamine treatment.
    CONCLUSIONS: The combination of psychotherapy and ketamine offers promise for the treatment of psychiatric disorders, but study heterogeneity prevents definitive recommendations for their integration. Larger randomised controlled trials using manualised psychotherapies and standardised ketamine protocols are recommended to clarify the extent to which the addition of psychotherapy to ketamine improves outcomes over ketamine treatment alone.
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