mania

躁狂症
  • 文章类型: Journal Article
    目的:本研究旨在创建和验证基于机器学习的可靠预测模型,用于患有躁狂症的儿童和青少年的抗精神病药物(利培酮)持续使用一年以上,并发现临床治疗的潜在变量。
    方法:研究人群来自中国国家索赔数据库。在2013年9月至2019年10月期间,共有4,532名4-18岁的患者开始利培酮治疗躁狂症。数据被随机分为两个数据集:训练(80%)和测试(20%)。采用了五种常用的机器学习方法,除了SuperLearner(SL)算法,建立非典型抗精神病药物继续治疗的预测模型。使用具有95%置信区间(CI)的接收器工作特征曲线(AUC)下面积。
    结果:在预测利培酮治疗延续的辨别力和稳健性方面,广义线性模型(GLM)表现最好(AUC:0.823,95%CI:0.792-0.854,截距接近0,斜率接近1.0).SL模型(AUC:0.823,95%CI:0.791-0.853,截距接近0,斜率接近1.0)也表现出显著性能。此外,本研究结果强调了几个独特的临床和社会经济变量的重要性,例如非心理健康障碍的急诊室就诊频率。
    结论:GLM和SL模型对患有躁狂和轻躁狂发作的儿童和青少年的利培酮继续治疗提供了准确的预测。因此,在非典型抗精神病药物中应用预测模型可能有助于循证决策.
    OBJECTIVE: This study aimed to create and validate robust machine-learning-based prediction models for antipsychotic drug (risperidone) continuation in children and teenagers suffering from mania over one year and to discover potential variables for clinical treatment.
    METHODS: The study population was collected from the national claims database in China. A total of 4,532 patients aged 4-18 who began risperidone therapy for mania between September 2013 and October 2019 were identified. The data were randomly divided into two datasets: training (80%) and testing (20%). Five regularly used machine learning methods were employed, in addition to the SuperLearner (SL) algorithm, to develop prediction models for the continuation of atypical antipsychotic therapy. The area under the receiver operating characteristic curve (AUC) with a 95% confidence interval (CI) was utilized.
    RESULTS: In terms of discrimination and robustness in predicting risperidone treatment continuation, the generalized linear model (GLM) performed the best (AUC: 0.823, 95% CI: 0.792-0.854, intercept near 0, slope close to 1.0). The SL model (AUC: 0.823, 95% CI: 0.791-0.853, intercept near 0, slope close to 1.0) also exhibited significant performance. Furthermore, the present findings emphasize the significance of several unique clinical and socioeconomic variables, such as the frequency of emergency room visits for nonmental health disorders.
    CONCLUSIONS: The GLM and SL models provided accurate predictions regarding risperidone treatment continuation in children and adolescents with episodes of mania and hypomania. Consequently, applying prediction models in atypical antipsychotic medicine may aid in evidence-based decision-making.
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  • 文章类型: Journal Article
    抑郁和躁狂状态对全球社会负担有很大贡献,但是仍然缺乏客观的检测工具。这项研究调查了利用语音作为生物标志物来检测这些情绪状态的可行性。方法:从真实世界的情感日志录音,在这项研究中检索到22个特征,其中21个显示出情绪状态之间的显着差异。此外,我们应用留一科策略来训练和验证四个分类模型:汉语-语音-预训练-GRU,登机口经常性单位(GRU),双向长短期记忆(BiLSTM),和线性判别分析(LDA)。
    我们的结果表明,中文语音预训练GRU模型表现最好,检测抑郁和躁狂状态的灵敏度分别为77.5%和54.8%,特异性分别为86.1%和90.3%,分别,总体准确率为80.2%。
    这些发现表明,机器学习可以通过语音分析可靠地区分抑郁和躁狂情绪状态。允许更客观和精确的方法来评估情绪障碍。
    UNASSIGNED: Depressive and manic states contribute significantly to the global social burden, but objective detection tools are still lacking. This study investigates the feasibility of utilizing voice as a biomarker to detect these mood states. Methods:From real-world emotional journal voice recordings, 22 features were retrieved in this study, 21 of which showed significant differences among mood states. Additionally, we applied leave-one-subject-out strategy to train and validate four classification models: Chinese-speech-pretrain-GRU, Gate Recurrent Unit (GRU), Bi-directional Long Short-Term Memory (BiLSTM), and Linear Discriminant Analysis (LDA).
    UNASSIGNED: Our results indicated that the Chinese-speech-pretrain-GRU model performed the best, achieving sensitivities of 77.5% and 54.8% and specificities of 86.1% and 90.3% for detecting depressive and manic states, respectively, with an overall accuracy of 80.2%.
    UNASSIGNED: These findings show that machine learning can reliably differentiate between depressive and manic mood states via voice analysis, allowing for a more objective and precise approach to mood disorder assessment.
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  • 文章类型: Journal Article
    睾酮对心理特征和行为有复杂的影响;它与社会支配和竞争有关,是一种潜在的人类性信息素。这项研究旨在调查睾丸激素水平之间的关系,攻击性行为,使用精神科急诊科(PED)的双相情感障碍(BD)患者的网络分析和躁狂症状。分析了2021年1月和2022年3月PEDBD患者的数据。使用年轻躁狂症评定量表(YMRS)评估躁狂症状。使用PANSS量表(PANSS-AG)的子量表评估攻击性。睾酮水平的无方向网络结构,攻击性行为,估计了躁狂症状,研究了中心性和桥梁中心性指数。使用案例删除程序检查了网络稳定性。进行网络比较测试(NCT)以评估网络特征是否因性别而异。我们共招募了898名BD患者,平均YMRS评分为13.30±9.58。II级攻击的患病率为35.6%(95CI=32.5%-38.7%),III级攻击性为29.5%(95CI=26.3%-32.6%),VI级攻击性为7.0%(95CI=5.4%-8.8%)。男性参与者的平均睾丸激素水平为391.71(标准偏差(SD):223.39),而女性参与者在整个样本中为36.90(SD:30.50)。通过网络分析,“运动活动能量增加”作为中心症状出现,具有最高的中心预期影响力,其次是“情绪不稳定”和“破坏性/攻击行为”。值得注意的是,“情绪不稳定”似乎是将躁狂症状与攻击行为联系起来的桥梁症状。在流网络模型中,“语速和量”与睾酮水平表现出最强的正相关性,紧随其后的是“破坏性/侵略行为”。所构建的网络模型具有鲁棒稳定性,性别对结构没有显著影响。在这项研究中,“运动活动能量增加”是最有影响力的症状,“语速和语量”是联系睾酮水平的主要桥梁症状,攻击性行为,躁狂症状.针对中央和桥梁症状可能会改善精神病急诊护理中BD患者实施的侵略干预措施的结果。
    Testosterone has complex effects on psychological traits and behavior; it is associated with social dominance and competition and is a potential human sex pheromone. This study aimed to investigate the associations between testosterone levels, aggressive behavior, and manic symptoms using a network analysis among bipolar disorder (BD) patients in psychiatric emergency departments (PED). Data from January 2021 and March 2022 BD patients in PED were analyzed. Manic symptoms were assessed using the Young Mania Rating Scale (YMRS). Aggression was assessed with subscale of the PANSS scale (PANSS-AG). The undirected network structures of testosterone levels, aggressive behavior, and manic symptoms were estimated, and centrality and bridge centrality indices were examined. Network stability was examined using the case-dropping procedure. The Network Comparison Test (NCT) was conducted to evaluate whether network characteristics differed by gender. We recruited a total of 898 BD patients, with the mean YMRS score as 13.30 ± 9.58. The prevalence of level II aggression was 35.6% (95%CI = 32.5%-38.7%), level III aggression was 29.5% (95%CI = 26.3%-32.6%), and level VI aggression was 7.0% (95%CI = 5.4%-8.8%). The male participants had a mean testosterone level of 391.71 (Standard Deviation (SD):223.39) compared to 36.90 (SD:30.50) for female participants in the whole sample. Through network analysis, \"Increased motor activity-energy\" emerged as the central symptom, with the highest centrality expected influence, followed by \"Emotional Instability\" and \"Disruptive/aggression behavior\". Notably, \"Emotional Instability\" appeared to be the bridge symptom linking manic symptoms to aggressive behavior. Within the flow network model, \"Speech rate and amount\" exhibited the strongest positive correlation with testosterone levels, followed closely by \"Disruptive/aggression behavior\". The constructed network model demonstrated robust stability, with gender showing no significant impact on the structure. In this study, \"Increased motor activity-energy\" stood out as the most influential symptom, and \"Speech rate and amount\" acted as the main bridge symptom linking testosterone levels, aggressive behavior, and manic symptoms. Targeting the central and bridge symptoms may improve the outcomes of aggression interventions implemented among BD patients in psychiatric emergency care.
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  • 文章类型: Journal Article
    背景:作为认知和情感大脑回路的中心枢纽,纹状体被认为可能与双相情感障碍(BD)的精神病理学有关。然而,目前尚不清楚纹状体功能的改变如何在不同的情绪状态下导致BD的不同症状。
    方法:行为评估(即,情绪症状和认知表现)和神经影像学数据从125名参与者中收集,其中包括31名(低)躁狂,31名抑郁症和31名抑郁症患者,和32个健康对照。我们比较了BD情绪状态与健康对照的纹状体亚区域的功能连接(FC),然后使用多变量数据驱动的方法来探索纹状体连接与行为表现之间的维度关联。最后,我们比较了FC和行为综合得分,反映了协会的个人加权代表性,在不同的情绪状态中。
    结果:所有情绪状态的患者在双侧腹侧头端壳核(VRP)和腹外侧丘脑之间均表现出FC增加。双极(低度)躁狂独特地表现出增加的VRP连通性和优越的腹侧纹状体连通性。确定了一个潜在的成分,纹状体亚区域的FC增加与不同的精神病理学症状相关(更多的躁狂症状,提升了积极的情绪,抑郁症状较少,认知能力较差)。双相(低)躁狂患者的FC和行为综合评分最高,而双相抑郁患者的FC和行为综合评分最低。
    结论:我们的数据显示了BD的特征和双相性躁狂(低度)的特定状态特征。这些发现强调了纹状体在所有情绪状态下特定症状学的病理生理过程中的基本作用。
    BACKGROUND: As a central hub in cognitive and emotional brain circuits, the striatum is considered likely to be integrally involved in the psychopathology of bipolar disorder (BD). However, it remains unclear how alterations in striatal function contribute to distinct symptomatology of BD during different mood states.
    METHODS: Behavioral assessment (i.e., emotional symptoms and cognitive performance) and neuroimaging data were collected from 125 participants comprising 31 (hypo)manic, 31 depressive, and 31 euthymic patients with BD, and 32 healthy control participants. We compared the functional connectivity (FC) of striatal subregions across BD mood states with healthy control participants and then used a multivariate data-driven approach to explore dimensional associations between striatal connectivity and behavioral performance. Finally, we compared the FC and behavioral composite scores, which reflect the individual weighted representation of the associations, among different mood states.
    RESULTS: Patients in all mood states exhibited increased FC between the bilateral ventral rostral putamen and ventrolateral thalamus. Bipolar (hypo)mania uniquely exhibited increased ventral rostral putamen connectivity and superior ventral striatum connectivity. One latent component was identified, whereby increased FCs of striatal subregions were associated with distinct psychopathological symptomatology (more manic symptoms, elevated positive mood, less depressive symptoms, and worse cognitive performance). Patients with bipolar (hypo)mania had the highest FC and behavioral composite scores while bipolar patients with depression had the lowest scores.
    CONCLUSIONS: Our data demonstrated both trait features of BD and state features specific to bipolar (hypo)mania. The findings underscored the fundamental role of the striatum in the pathophysiological processes underlying specific symptomatology across all mood states.
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  • 文章类型: Journal Article
    背景:双相情感障碍(BD)是一种进行性疾病。研究患有亚阈值躁狂(SubMD)的抑郁症青少年的神经影像学机制有助于早期识别BD。然而,亚MD患者的全局脑连接(GBC)模式,以及在全面BD开始之前与处理速度的关系,仍然不清楚。
    方法:该研究涉及72个SubMD,77名没有阈值下躁狂(nSubMD)的抑郁青少年,和69个性别和年龄匹配的健康青少年(HCs)。所有患者均接受了6至12个月的临床随访。我们计算了GBC图的基于体素的图论分析,并进行了TMT-A测试以测量处理速度。
    结果:与HC和nSubMD相比,SubMD患者表现出独特的GBC指数模式:右内侧上前回GBC指数降低(SFGmed。R)/上额叶回(SFG),而在右前突和左中央后回增加。两组患者均显示右下颞骨GBC指数升高。在nSubMD组中仅观察到右补充运动区的GBC值增加。SFGmed的GBC指数有相反的变化。两组患者之间的R/SFG,AUC为0.727。此外,以SFGmed表示的GBC值。在SubMD组中,R/SFG与TMT-A评分呈正相关。
    结论:随访时间相对较短,药物混杂,和适度的样本量。
    结论:这些发现表明,患有亚阈值BD的青少年在整个大脑连接水平上具有与处理速度障碍相关的特定障碍模式,提供对BD早期识别和干预策略的见解。
    BACKGROUND: Bipolar disorder (BD) is a progressive condition. Investigating the neuroimaging mechanisms in depressed adolescents with subthreshold mania (SubMD) facilitates the early identification of BD. However, the global brain connectivity (GBC) patterns in SubMD patients, as well as the relationship with processing speed before the onset of full-blown BD, remain unclear.
    METHODS: The study involved 72 SubMD, 77 depressed adolescents without subthreshold mania (nSubMD), and 69 gender- and age-matched healthy adolescents (HCs). All patients underwent a clinical follow-up ranging from six to twelve months. We calculated the voxel-based graph theory analysis of the GBC map and conducted the TMT-A test to measure the processing speed.
    RESULTS: Compared to HCs and nSubMD, SubMD patients displayed distinctive GBC index patterns: GBC index decreased in the right Medial Superior Frontal Gyrus (SFGmed.R)/Superior Frontal Gyrus (SFG) while increased in the right Precuneus and left Postcentral Gyrus. Both patient groups showed increased GBC index in the right Inferior Temporal Gyrus. An increased GBC value in the right Supplementary Motor Area was exclusively observed in the nSubMD-group. There were opposite changes in the GBC index in SFGmed.R/SFG between two patient groups, with an AUC of 0.727. Additionally, GBC values in SFGmed.R/SFG exhibited a positive correlation with TMT-A scores in SubMD-group.
    CONCLUSIONS: Relatively shorter follow-up duration, medications confounding, and modest sample size.
    CONCLUSIONS: These findings suggest that adolescents with subthreshold BD have specific impairments patterns at the whole brain connectivity level associated with processing speed impairments, providing insights into early identification and intervention strategies for BD.
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  • 文章类型: Journal Article
    背景:双相情感障碍(BD)是一种严重的精神障碍,具有沉重的疾病负担。患有BD的女性是特殊人群,她们遭受了很多童年创伤,社会支持,认知缺陷,和自杀。在这项研究中,童年创伤之间的关系,社会支持,调查女性BD患者的临床症状,探讨女性BD患者自杀的危险因素。
    方法:本研究包括57例未服用药物的女性BD患者,64名长期服药的女性BD患者,和50个年龄匹配的女性健康对照。童年创伤,社会支持,临床症状,认知,和自杀(自杀意念,自杀计划,自杀未遂,自杀频率)用量表测量。
    结果:与健康对照组相比,患有BD的女性表现出更高水平的儿童创伤和自杀倾向,和较低水平的社会支持和认知缺陷。在药物幼稚BD组中,社会支持介导了童年创伤与失眠症状之间的关系(间接效应:ab=0.025)。在长期用药的BD组中,躁狂症状与自杀计划相关(OR=1.127,p=0.030),童年创伤与自杀未遂有关(OR=1.088,p=0.018),和受教育年限(OR=0.773,p=0.028),童年创伤(OR=1.059,p=0.009),延迟记忆(OR=1.091,p=0.016)与自杀频率(OR=1.091,p=0.016)相关。
    结论:这项研究提供了初步证据,表明社会支持部分解释了BD女性的童年创伤与临床症状之间的关系。此外,躁狂症症状,童年创伤,和延迟记忆是自杀的危险因素。提供社会支持和改善认知功能的干预措施可能对暴露于童年创伤和高自杀风险的BD女性有益。
    BACKGROUND: Bipolar disorder (BD) is a severe mental disorder with heavy disease burden. Females with BD are special populations who suffer a lot from childhood trauma, social support, cognitive deficits, and suicidality. In this study, the relationship among childhood trauma, social support, and clinical symptoms of BD was investigated and the risk factors for suicidality were explored in female patients with BD.
    METHODS: This study included 57 drug-naive female BD patients, 64 female BD patients with long-term medication, and 50 age-matched female healthy controls. Childhood trauma, social support, clinical symptoms, cognition, and suicidality (suicide ideation, suicide plan, suicide attempt, suicide frequency) were measured with scales.
    RESULTS: Compared with healthy controls, females with BD showed higher levels of childhood trauma and suicidality, and lower levels of social support and cognitive deficits. In the drug-naïve BD group, social support mediated the relationship between childhood trauma and insomnia symptoms (indirect effect: ab = 0.025). In the BD with long-term medication group, mania symptom was associated with suicide plan (OR = 1.127, p = 0.030), childhood trauma was associated with suicide attempt (OR = 1.088, p = 0.018), and years of education (OR = 0.773, p = 0.028), childhood trauma (OR = 1.059, p = 0.009), and delayed memory (OR= 1.091, p= 0.016) was associated with suicide frequency (OR = 1.091, p = 0.016).
    CONCLUSIONS: This study provides initial evidence that social support partially explains the relationship between childhood trauma and clinical symptoms in females with BD. Additionally, mania symptoms, childhood trauma, and delayed memory were risk factors for suicidality. Interventions providing social support and improving cognitive function may be beneficial for females with BD who are exposed to childhood trauma and with high suicide risk.
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  • 文章类型: Journal Article
    背景:喹硫平单药被推荐作为急性躁狂和急性双相抑郁的一线选择。然而,喹硫平的作用机制尚不清楚.采用网络药理学和分子对接研究喹硫平双向调节双相抑郁和躁狂症的分子机制。
    方法:从GeneCard收集喹硫平的推定靶基因,SwissTargetPrediction,和DrugBank数据库。从DisGeNet和GeneCards数据库中确定了双相抑郁和双相躁狂症的目标。使用String数据库生成蛋白质-蛋白质相互作用(PPI)网络,并将其导入Cytoscape。采用DAVID和生物信息学平台来执行前15个核心靶标的基因本体论(GO)和京都基因和基因组百科全书(KEGG)分析。使用Cytoscape构建药物-途径-靶标-疾病网络。最后,进行分子对接以评估喹硫平与潜在靶标之间的相互作用.
    结果:确定了喹硫平抗双相抑郁(126个目标)和双相躁狂(81个目标)的作用靶点。基于PPI和KEGG通路分析,喹硫平可能通过BDNF靶向MAPK和PI3K/AKT胰岛素信号通路影响双相抑郁,INS,EGFR,IGF1和NGF,它可能通过HTR1A靶向神经活性配体-受体相互作用信号通路来影响双相躁狂症,HTR1B,HTR2A,DRD2和GRIN2B。分子对接显示喹硫平与潜在靶标之间具有良好的结合亲和力。
    结论:应该进行药理学实验来验证和进一步探索这些结果。
    结论:我们的研究结果表明,喹硫平通过不同的生物学核心靶点影响双相抑郁和双相躁狂,因此通过不同的机制。此外,本研究结果为喹硫平的临床应用及新药开发的可能方向提供了理论依据。
    BACKGROUND: Quetiapine monotherapy is recommended as the first-line option for acute mania and acute bipolar depression. However, the mechanism of action of quetiapine is unclear. Network pharmacology and molecular docking were employed to determine the molecular mechanisms of quetiapine bidirectional regulation of bipolar depression and mania.
    METHODS: Putative target genes for quetiapine were collected from the GeneCard, SwissTargetPrediction, and DrugBank databases. Targets for bipolar depression and bipolar mania were identified from the DisGeNET and GeneCards databases. A protein-protein interaction (PPI) network was generated using the String database and imported into Cytoscape. DAVID and the Bioinformatics platform were employed to perform the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of the top 15 core targets. The drug-pathway-target-disease network was constructed using Cytoscape. Finally, molecular docking was performed to evaluate the interactions between quetiapine and potential targets.
    RESULTS: Targets for quetiapine actions against bipolar depression (126 targets) and bipolar mania (81 targets) were identified. Based on PPI and KEGG pathway analyses, quetiapine may affect bipolar depression by targeting the MAPK and PI3K/AKT insulin signaling pathways via BDNF, INS, EGFR, IGF1, and NGF, and it may affect bipolar mania by targeting the neuroactive ligand-receptor interaction signaling pathway via HTR1A, HTR1B, HTR2A, DRD2, and GRIN2B. Molecular docking revealed good binding affinity between quetiapine and potential targets.
    CONCLUSIONS: Pharmacological experiments should be conducted to verify and further explore these results.
    CONCLUSIONS: Our findings suggest that quetiapine affects bipolar depression and bipolar mania through distinct biological core targets, and thus through different mechanisms. Furthermore, our results provide a theoretical basis for the clinical use of quetiapine and possible directions for new drug development.
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  • 文章类型: Journal Article
    狂热给患者造成了无法估量的经济损失,他们的家人,甚至社会,但是目前尚无有效的治疗方案。
    使用生物信息学和孟德尔随机化方法,在mRNA水平上探索了与躁狂症相关的潜在药物靶基因和关键物质。我们使用GEO数据库中的芯片表达谱筛选差异基因,并使用IEU数据库中的eQTL和躁狂症GWAS数据进行双样本孟德尔随机化(MR),通过共定位确定核心基因。接下来,我们利用生物信息学分析鉴定了参与作用机制的关键物质,并确定了相关基因靶标作为药物靶标。
    经过差异表达分析和MR,发现46个基因的表达与躁狂症之间存在因果关系。共定位分析产生了六个核心基因。通过富集分析确定了五种关键物质,免疫相关分析,和核心基因的单基因GSVA分析。MR显示苯丙氨酸是唯一与躁狂症具有单向因果关系的关键物质。最后,SBNO2、PBX2、RAMP3和QPCT,与苯丙氨酸代谢途径密切相关,被鉴定为药物靶基因。
    SBNO2、PBX2、RAMP3和QPCT可作为躁狂症治疗的潜在靶基因,值得进一步的基础和临床研究。药物靶基因调控苯丙氨酸代谢途径实现对躁狂症的治疗。苯丙氨酸是治疗躁狂症的重要中间物质,受药物靶基因调控。
    UNASSIGNED: Mania has caused incalculable economic losses for patients, their families, and even society, but there is currently no effective treatment plan for this disease without side effects.
    UNASSIGNED: Using bioinformatics and Mendelian randomization methods, potential drug target genes and key substances associated with mania were explored at the mRNA level. We used the chip expression profile from the GEO database to screen differential genes and used the eQTL and mania GWAS data from the IEU database for two-sample Mendelian randomization (MR) to determine core genes by colocalization. Next, we utilized bioinformatics analysis to identify key substances involved in the mechanism of action and determined related gene targets as drug targets.
    UNASSIGNED: After differential expression analysis and MR, a causal relationship between the expression of 46 genes and mania was found. Colocalization analysis yielded six core genes. Five key substances were identified via enrichment analysis, immune-related analysis, and single-gene GSVA analysis of the core genes. MR revealed phenylalanine to be the only key substance that has a unidirectional causal relationship with mania. In the end, SBNO2, PBX2, RAMP3, and QPCT, which are significantly associated with the phenylalanine metabolism pathway, were identified as drug target genes.
    UNASSIGNED: SBNO2, PBX2, RAMP3, and QPCT could serve as potential target genes for mania treatment and deserve further basic and clinical research. Medicinal target genes regulate the phenylalanine metabolism pathway to achieve the treatment of mania. Phenylalanine is an important intermediate substance in the treatment of mania that is regulated by drug target genes.
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  • 文章类型: Journal Article
    双相情感障碍(BD)是一种严重损害行为和社会功能的主要精神障碍。这项研究评估了BD患者在指数情绪发作之前的前驱症状的网络结构。采用双相前驱症状回顾性量表(BPSS-R)进行半结构化访谈,以检查患者的前驱症状。进行网络分析以阐明前驱症状之间的相互关系。共有120名符合条件的患者参加了这项研究。网络分析表明,观察到的模型是稳定的。边缘疯狂3-抑郁9(\'赛车思想\'-\'思考自杀\',边权重=14.919)显示出模型中最强的正连接,其次是边缘Mania1-抑郁1(\'极度精力充沛/活跃\'-\'抑郁情绪\',边重=14.643)。模型中唯一的负相关是Mania7-depression2(\'过度自信\'-\'疲劳或缺乏能量\',边重=-1.068)。节点Mania3(\'赛车思想\'),抑郁9(“思考自杀”),Mania1(\'极其精力充沛/活跃\'),抑郁1(“抑郁情绪”)是最主要的症状。抑郁和躁狂或轻躁狂症状均出现在前驱期。反映“赛车思想”的症状,\'思考自杀\',\'极其精力充沛/活跃\',和“抑郁情绪”应彻底评估并作为干预措施中的关键前驱症状,以降低BD发作的风险。
    Bipolar disorder (BD) is a major mental disorder that significantly impairs behavior and social functioning. This study assessed the network structure of prodromal symptoms in patients with BD prior to their index mood episode. Semi-structured interviews were conducted with the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R) to examine patients\' prodromal symptoms. Network analysis was conducted to elucidate inter-relations between prodromal symptoms. A total of 120 eligible patients participated in this study. Network analysis indicated that the observed model was stable. The edge Mania3-Depression9 (\'Racing thoughts\' - \'Thinking about suicide\', edge weight = 14.919) showed the strongest positive connection in the model, followed by the edge Mania1-depression1 (\'Extremely energetic/active\' - \'Depressed mood\', edge weight = 14.643). The only negative correlation in the model was for Mania7-depression2 (\'Overly self-confident\' - \'Tiredness or lack of energy\', edge weight = -1.068). Nodes Mania3 (\'Racing thoughts\'), Depression9 (\'Thinking about suicide\'), Mania1 (\'Extremely energetic/active\'), and Depression1 (\'Depressed mood\') were the most central symptoms. Both depressive and manic or hypomanic symptoms appeared in the prodromal phase. Symptoms reflecting \'Racing thoughts\', \'Thinking about suicide\', \'Extremely energetic/active\', and \'Depressed mood\' should be thoroughly assessed and targeted as crucial prodromal symptoms in interventions to reduce the risk of BD episodes.
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  • 文章类型: Journal Article
    背景:失眠在精神疾病中非常常见,但是,在各种精神疾病中失眠的多导睡眠图(PSG)特征仍未达成共识。本研究旨在探讨情感障碍失眠患者和原发性失眠(PI)患者PSG的特点及其与代谢指标的关系。
    方法:共38例PI患者,44例重度抑郁症伴失眠(DI)患者,49例广泛性焦虑症伴失眠(GI)患者,纳入19例伴失眠(BI)的双相躁狂症患者。PSG用于检测受试者的睡眠问题,并收集生化指标。
    结果:这项研究的结果发现,患有BI的受试者在REM睡眠潜伏期(RL)上较低,觉醒号码(AN),微觉醒次数(NM),和呼吸暂停低通气指数(AHI)比DI和GI,RL和AN低于PI。PI受试者的NM和AHI低于DI和GI受试者。DI患者的RL高于GI患者。所有结果均通过Bonferroni校正(p<0.00078)。四组受试者的生化指标没有差异。此外,发现AHI与受试者的游离三碘甲状腺原氨酸(FT3)和空腹血糖呈正相关。
    结论:这项研究表明,就PSG参数而言,各种精神疾病可能具有其特征,这促使我们在评估这些疾病时关注这些疾病的PSG特征,以及关注他们的生化指标。
    BACKGROUND: Insomnia is very common in psychiatric disorders, but the polysomnographic (PSG) characteristics of insomnia in various psychiatric disorders are still not agreed upon. This study aimed to investigate the characteristics of PSG and its relationship with metabolic indicators in insomnia patients with affective disorders and primary insomnia (PI) patients.
    METHODS: A total of 38 patients with PI, 44 major depressive disorder patients with insomnia (DI), 49 generalized anxiety disorder patients with insomnia (GI), and 19 bipolar mania patients with insomnia (BI) were included. PSG was used to detect sleep problems in subjects, and biochemical indicators were also collected.
    RESULTS: The results of this study found that subjects with BI were lower on REM sleep latency (RL), awakenings number (AN), number of microarousals (NM), and apnea-hypopnea index (AHI) than those with DI and GI, and lower on RL and AN than those with PI. Subjects with PI had lower NM and AHI than those with DI and GI. Patients with DI had a higher RL than those with GI. All results passed Bonferroni correction (p < 0.00078). No differences in biochemical indices were found among the four groups of subjects. Also, AHI was found to be positively correlated with free triiodothyronine (FT3) and fasting blood glucose in subjects.
    CONCLUSIONS: This study suggests that various psychiatric disorders may have their characteristics in terms of PSG parameters, which prompted us to focus on the PSG characteristics of these disorders when assessing them, as well as to focus on their biochemical indicators.
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