Psychopathology

精神病理学
  • 文章类型: Case Reports
    避免性限制性食品摄入障碍(ARFID)是一种新分类的饮食障碍,需要对其表现进行进一步了解。以前没有关于儿童扁桃体切除术后ARFID的报道。ARFID可能是儿童口咽手术后的潜在负面结果。
    一名10岁零2个月的女性儿童出现与抑郁症相关的ARFID,扁桃体切除术后的焦虑和营养缺乏。她吞下固体比吞下液体更困难,咀嚼食物后反复呕吐和吐痰。她脱水和营养不良,BMI为10.5,并被误诊为重症肌无力。
    据我们所知,这是儿童扁桃体切除术后ARFID的首例报告.我们讨论了ARFID的病理生理学,仍然难以捉摸,并建议在评估儿童扁桃体切除术后进行精神病学评估。
    UNASSIGNED: Avoidant Restrictive Food Intake Disorder (ARFID) is a newly classified eating disorder that requires further understanding of its presentation. There is no previous report of ARFID in a child post-tonsillectomy. ARFID may be a potential negative outcome for children following oropharyngeal surgery.
    UNASSIGNED: A female child aged 10 years and 2 months presented with ARFID associated with depression, anxiety and nutritional deficiency following tonsillectomy. She had more difficulty in swallowing solids than fluids and had repeated vomiting and spitting food after chewing it. She became dehydrated and malnourished with a BMI of 10.5 and was misdiagnosed with myasthenic gravis.
    UNASSIGNED: To our knowledge, this is the first case report of ARFID in a child post-tonsillectomy. We discuss the pathophysiology of ARFID, which remains elusive, and recommend psychiatric assessment when evaluating children post operative tonsillectomy.
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  • 文章类型: Journal Article
    背景:人格的五因素模型,使用五大库存等工具进行量化,由广泛的人格域组成,包括外向,宜人,责任心,神经质(情绪不稳定),和开放。这样的仪器通常包括>40个项目。然而,在对多个量表进行测序的临床和队列研究中,具有许多项目的仪器可能是笨拙的,并且是测量误差的原因。相反,建立的5项和10项版本的五大清单可靠性较差。这里,我们开发并验证了一个简化的18项五大库存,它平衡了效率,可靠性和灵敏度。
    方法:我们分析了三个数据集(N=59,797,N=21,177和N=87,983),这些数据来自参与在线英国大智力测验(GBIT)研究的个人,与BBC2Horizon合作的公民科学项目。我们应用了因子分析(FA),预测性规范建模,和单样本t检验,以验证大五的18项版本,并调查其与精神和神经系统疾病的关联。
    结果:与文献中其他先前缩短的版本相比,大五清单的18项版本具有更高的有效性和重测可靠性,与完整的五大清单具有可比的人口关联。它与精神疾病表现出强烈的(即大效应大小)关联,与神经系统疾病的中度(中小)关联。神经质(情绪不稳定)在所有精神疾病中都高得多,而责任心,开放性和外向性显示了不同条件下的不同关联。
    结论:新验证的18项版本的“大五”提供了一种测量人格特征的便捷方法,适合在一系列研究中进行应用。它保留了心理测量结构,重测信度和临床组敏感度,与完整的原始规模相比。
    BACKGROUND: The five-factor model of personality, as quantified using instruments such as the Big Five Inventory, consists of broad personality domains including Extraversion, Agreeableness, Conscientiousness, Neuroticism (emotional instability), and Openness. Such instruments typically include >40 items. However, instruments with many items can be unwieldly and a cause of measurement error in clinical and cohort studies where multiple scales are sequenced. Conversely, established 5- and 10-item versions of the Big Five Inventory have poor reliability. Here, we developed and validated an abbreviated 18-item Big Five Inventory that balances efficiency, reliability and sensitivity.
    METHODS: We analysed three datasets (N = 59,797, N = 21,177, and N = 87,983) from individuals who participated in the online Great British Intelligence Test (GBIT) study, a collaborative citizen science project with BBC2 Horizon. We applied factor analyses (FA), predictive normative modelling, and one-sample t-tests to validate the 18-item version of the Big Five and to investigate its associations with psychiatric and neurological conditions.
    RESULTS: The 18-item version of the Big Five Inventory had higher validity and retest reliability compared to the other previously shortened versions in the literature, with comparable demographic associations to the full Big Five Inventory. It exhibited strong (i.e. large effect size) associations with psychiatric conditions, and moderate (small-medium) associations with neurological conditions. Neuroticism (emotional instability) was substantially higher in all psychiatric conditions, whereas Conscientiousness, Openness and Extraversion showed differential associations across conditions.
    CONCLUSIONS: The newly validated 18-item version of the Big Five provides a convenient means of measuring personality traits that is suitable for deployment in a range of studies. It retains psychometric structure, retest reliability and clinical-group sensitivity, as compared to the full original scale.
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  • 文章类型: Journal Article
    体重和体形的高估是饮食失调的诊断标准,除了暴饮暴食症(BED),它受到的关注较少。在没有进食障碍的超重或肥胖人群中,通常也不会分析这方面的情况。这项研究旨在确定症状学的指标,以及自我建构和认知结构,这与肥胖的高估有关,单独或与床一起使用。
    获取了102名超重或肥胖参与者的样本。样本分为四组:一组没有高估或BED(n=33);第二组没有高估,没有BED(n=21);第三组有BED,但没有高估(n=15),第四名是BED和高估(n=33)。小组完成了关于饮食症状学的工具,焦虑,抑郁症,和压力。此外,他们被管理了话术网格技术,半结构化访谈,评估自我和他人理解中涉及的认知结构。
    高估因素和BED的存在独立解释了饮食症状学,后者也表现出影响焦虑的倾向,抑郁症,和压力。就认知结构而言,权重极化被解释为高估,而BED与认知冲突的高度存在有关。在自我建构中,床是解释差异的因素,特别是在自我理想的差异。
    结果突出了高估肥胖的重要性,即使没有床。建议对其进行评估和治疗。此外,在床的情况下,还建议评估权重和形状的高估,因为它可以是严重性说明符。
    UNASSIGNED: The overvaluation of weight and shape is a diagnostic criterion in eating disorders, except in binge eating disorder (BED), where it has received less attention. This aspect is also not usually analyzed in people with overweight or obesity without an eating disorder. This research aims to identify the indicators of symptomatology, as well as those of self-construction and cognitive structure, that are associated with overvaluation in obesity, either alone or in conjunction with BED.
    UNASSIGNED: A sample of 102 overweight or obese participants was accessed. The sample was divided into four groups: one without overvaluation or BED (n = 33); a second with overvaluation and without BED (n = 21); a third with BED, but without overvaluation (n = 15), and a fourth with BED and overvaluation (n = 33). The groups completed instruments regarding eating symptomatology, anxiety, depression, and stress. In addition, they were administered the Repertory Grid Technique, a semi-structured interview to evaluate the cognitive structure involved in the construal of the self and others.
    UNASSIGNED: The factors of overvaluation and the presence of BED independently explained eating symptomatology, and the latter also showed a tendency to influence anxiety, depression, and stress. In terms of cognitive structure, weight polarization was explained by overvaluation, while BED was associated with a high presence of cognitive conflicts. In self-construction, BED was the factor that explained the differences, particularly in Self-Ideal discrepancy.
    UNASSIGNED: The results highlight the importance of overvaluation in obesity, even in the absence of BED. Its evaluation and treatment are recommended. Furthermore, in the case of BED, it is also advisable to evaluate the overvaluation of weight and shape since it can be a severity specifier.
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  • 文章类型: Journal Article
    背景:童年虐待,特别是情感虐待(EA),已被确定为饮食失调(ED)发展的重要风险因素。这项研究调查了EA和ED症状之间的关联,同时考虑了多种潜在的介质。
    方法:参与者包括151名神经性厌食症(AN)患者,115与神经性贪食症(BN),和108个健康对照。童年创伤问卷,多伦多述情障碍量表,行为抑制系统,治疗前完成进食障碍量表2量表。每组进行中介路径模型:EA设置为自变量,饮食症状作为因变量和无效,对惩罚的敏感性,述情障碍,作为中介的冲动。
    结果:在患有AN的个体中,冲动是EA与瘦身和暴食行为欲望之间的重要媒介。相反,在拥有BN的个人中,发现对惩罚的敏感性可以调解EA与对身体的不满之间的联系。在两个临床组中,无效和难以识别情绪都被确定为诊断介质。在健康个体中未发现调解作用。
    结论:在一个独特的模型中同时评估多种介质概述了儿童EA和ED精神病理学之间复杂的相互作用。改善无效性,情感识别,对惩罚和冲动的敏感性以及探索它们与早期情感虐待的关系可能代表患有ED和童年创伤的个体的治疗目标。
    BACKGROUND: Childhood maltreatment, particularly emotional abuse (EA), has been identified as a significant risk factor for the development of eating disorders (EDs). This study investigated the association between EA and ED symptoms while considering multiple potential mediators.
    METHODS: Participants included 151 individuals with Anorexia Nervosa (AN), 115 with Bulimia Nervosa (BN), and 108 healthy controls. The Childhood trauma questionnaire, the Toronto Alexithymia scale, the Behavioral inhibition System, and the Eating Disorder Inventory 2 scale were completed before treatment. A mediator path model was conducted in each group: EA was set as independent variable, eating symptoms as dependent variables and ineffectiveness, sensitivity to punishment, alexithymia, and impulsivity as mediators.
    RESULTS: In individuals with AN, impulsivity emerged as a significant mediator between EA and desire for thinness and bulimic behaviors. Conversely, in individuals with BN, sensitivity to punishment was found to mediate the association between EA and dissatisfaction with one\'s body. Ineffectiveness and difficulty identifying emotions were identified as transdiagnostic mediators in both clinical groups. No mediation effect was found in healthy individuals.
    CONCLUSIONS: The simultaneous assessment of multiple mediators in a unique model outlines the complex interplay between childhood EA and ED psychopathology. Improving ineffectiveness, emotion identification, sensitivity to punishment and impulsivity and exploring their relations with early emotional abuse may represent treatment targets in individuals with EDs and childhood trauma.
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  • 文章类型: Journal Article
    背景:许多癌症幸存者经历癌症相关的认知障碍(CRCI),通常会在各个生活领域产生重大的负面影响。新出现的证据表明,在采取行动之前允许更多的时间来处理信息,对于那些有CRCI的人来说,这可能是一个有用的策略,以减轻其影响。威斯康星州卡片分类任务(WCST),衡量一般认知,已经表明,对于一些癌症幸存者来说,更长的任务完成时间有助于类似的任务绩效结果,以控制有关毅力错误的人群;WCST的关键绩效指标。然而,评估这个策略是否有用,以及确定它可能对谁有用,关于选择认知领域的优势和劣势,由于任务杂质问题等因素,具有挑战性。因此,这项研究提供了初步的计算和实验评估,即对于那些患有CRCI的人来说,在采取行动之前额外处理信息的时间是否是有用的策略.
    方法:我们通过执行功能成分的不同贡献(更新,shifting,抑制)产生48个不同的WCST计算模型。然后,我们的主要操作是在模型执行动作以对给定卡进行排序之前,为这些模型提供或多或少的时间(在20、40和60周期的三个级别)。我们比较了计算模型在WCST上产生的坚持错误的数量。此外,我们通过将模型产生的坚持错误数与人类数据进行比较,确定了模拟癌症幸存者在WCST上表现的模型.
    结果:额外的处理时间导致模型产生的坚持错误显著减少,支持我们的假设。此外,8个独特的模型模拟了癌症幸存者在WCST上的表现。额外的时间似乎主要通过减轻严重抑制损伤的影响而对性能产生积极影响。对于更严重的全球执行功能障碍,需要大量的额外时间来减轻减损的影响。对于最严重的损伤,额外的时间无法充分减轻对绩效的影响。
    结论:额外的处理时间可能是纠正患有CRCI的癌症幸存者的坚持错误的有用策略。我们的发现对实际战略的制定有意义,例如职业环境中的工作量和截止日期管理,这可能会减轻CRCI的负面影响。
    BACKGROUND: Many cancer survivors experience cancer-related cognitive impairment (CRCI), often with significant negative consequences across various life domains. Emerging evidence suggests that allowing additional time to process information before acting may be a useful strategy for those with CRCI to mitigate some of its impacts. The Wisconsin Card Sorting Task (WCST), a measure of general cognition, has shown that for some cancer survivors, longer task completion time facilitates similar task performance outcomes to control populations concerning perseveration errors; a key performance metric of the WCST. However, assessing if this strategy may be useful, as well as determining for whom it may be useful, with regard to strengths and weaknesses among select cognitive domains, is challenging due to factors such as the problem of task impurity. Accordingly, this study provides an initial computational and experimental assessment of whether additional time to process information before acting is a useful strategy for those with CRCI.
    METHODS: We simulated individual cognitive differences observed in humans by varying contributions of executive functioning components (updating, shifting, inhibition) to yield 48 distinct computational models of the WCST. Our main manipulation was then to provide these models with more or less time (at three levels of 20, 40 and 60 cycles) before models executed an action to sort a given card. We compared the number of perseveration errors on the WCST produced by the computational models. Additionally, we determined models that simulated the performance of cancer survivors on the WCST by comparing the number of perseveration errors produced by the models to human data.
    RESULTS: Additional processing time resulted in the models producing significantly fewer perseveration errors, supporting our hypothesis. In addition, 8 unique models simulated the performance of cancer survivors on the WCST. Additional time appeared to have a positive influence on performance primarily by mitigating the impacts of severe inhibition impairments. For more severe global executive function impairments, a substantial amount of additional time was required to mitigate the impacts of the impairments. For the most severe impairments, additional time was unable to adequately mitigate the impact on performance.
    CONCLUSIONS: Additional processing time may be a useful strategy to rectify perseveration errors among cancer survivors with CRCI. Our findings have implications for the development of practical strategies, such as workload and deadline management in occupational settings, which may mitigate the negative effects of CRCI.
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  • 文章类型: Journal Article
    相当比例的癌症幸存者会经历某种形式的精神健康妥协,包括情绪,焦虑,精神病,饮食失调,和物质使用。癌症幸存者的这种心理病理学与一系列负面结果有关,也可能对生活质量产生重大负面影响。除了精神病理学,认知障碍也很常见,导致记忆力不足,推理,决策,处理速度,和浓度,统称为癌症相关认知障碍(CRCI)。在非肿瘤学文献中,认知缺陷一直被证明是精神病理学的关键转化诊断病因特征,在功能上有助于症状的发展和延续。尽管人们认识到心理健康问题在CRCI的发展和认识中可能发挥的作用,但对于CRCI在功能上对癌症幸存者的诊断性心理病理学发展做出贡献的潜力的认识和研究有限。鉴于理论和经验证据表明认知缺陷是精神病理学的病因因素,我们提供了CRCI可能成为癌症幸存者诊断性心理病理学发展和延续的一个因素的基本原理.这种潜在的功能关联对风险识别有重大影响,预防,治疗,以及关于癌症幸存者心理病理学的支持性癌症护理方法。最后,我们为该领域的未来研究提供了方向。
    A significant proportion of cancer survivors will experience some form of mental health compromise across domains including mood, anxiety, psychosis, eating disorders, and substance use. This psychopathology within cancer survivors is related to a range of negative outcomes and can also have a substantial negative impact on quality of life. Along with psychopathology, cognitive impairments are also commonly experienced, resulting in deficits in memory, reasoning, decision-making, speed of processing, and concentration, collectively referred to as cancer-related cognitive impairment (CRCI). Within the non-oncology literature, cognitive deficits are consistently demonstrated to be a key transdiagnostic aetiological feature of psychopathology, functionally contributing to the development and perpetuation of symptoms. Whilst there is an acknowledgement of the role mental health concerns might play in the development of and perception of CRCI, there has been limited acknowledgement and research exploring the potential for CRCI to functionally contribute toward the development of transdiagnostic psychopathology in cancer survivors beyond simply psychosocial distress. Given the theoretical and empirical evidence suggesting cognitive deficits to be an aetiological factor in psychopathology, we provide a rationale for the potential for CRCI to be a factor in the development and perpetuation of transdiagnostic psychopathology in cancer survivors. This potential functional association has significant implications for risk identification, prevention, treatment, and supportive cancer care approaches regarding psychopathology in cancer survivorship. We conclude by providing directions for future research in this area.
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  • 文章类型: Journal Article
    虽然怀孕期间使用咖啡因很常见,其与儿童行为和身体健康结果的纵向关联仍然知之甚少。这里,我们估计了产前咖啡因暴露之间的关联,体重指数(BMI),以及儿童进入青春期的行为。
    纵向数据和照顾者报告的产前咖啡因暴露来自正在进行的青少年大脑和认知发育(ABCD)SM研究,从2016年6月1日开始,该组织从美国21个地点招募了11,875名9-11岁的基线儿童。将产前咖啡因暴露作为4级分类变量进行分析,并使用进一步的组对比来表征“任何暴露”和“每日暴露”组。结果包括儿童的精神病理学特征,睡眠问题,BMI。潜在的混杂协变量包括家族性(例如,收入,家族性精神病理学),怀孕(例如,产前物质暴露),和孩子(例如,咖啡因使用)变量。
    在10,873名儿童中(5,686名男孩[52.3%];平均[SD]年龄,9.9[0.6]年),具有非缺失的产前咖啡因暴露数据,6,560(60%)在产前暴露于咖啡因。相对于没有暴露,每日咖啡因暴露与较高的儿童BMI相关(β=0.08;FDR校正p=0.02),但与儿童行为无关。那些每天暴露于两杯或更多杯咖啡因的人(n=1,028)比那些暴露于较低/不暴露的人有更大的睡眠问题(β>0.92;FDR校正p<0.04)。
    每日产前咖啡因暴露与儿童BMI升高有关,每天多次使用时,即使考虑到潜在的困惑,睡眠问题也会更严重。这种关系是否是产前咖啡因暴露或其相关因素的结果仍然未知。
    UNASSIGNED: Though caffeine use during pregnancy is common, its longitudinal associations with child behavioral and physical health outcomes remain poorly understood. Here, we estimated associations between prenatal caffeine exposure, body mass index (BMI), and behavior as children enter adolescence.
    UNASSIGNED: Longitudinal data and caregiver-reported prenatal caffeine exposure were obtained from the ongoing Adolescent Brain and Cognitive Development (ABCD) SM Study, which recruited 11,875 children aged 9-11 years at baseline from 21 sites across the United States starting June 1, 2016. Prenatal caffeine exposure was analyzed as a 4-level categorical variable, and further group contrasts were used to characterize \"any exposure\" and \"daily exposure\" groups. Outcomes included psychopathology characteristics in children, sleep problems, and BMI. Potentially confounding covariates included familial (e.g., income, familial psychopathology), pregnancy (e.g., prenatal substance exposure), and child (e.g., caffeine use) variables.
    UNASSIGNED: Among 10,873 children (5,686 boys [52.3%]; mean [SD] age, 9.9 [0.6] years) with nonmissing prenatal caffeine exposure data, 6,560 (60%) were exposed to caffeine prenatally. Relative to no exposure, daily caffeine exposure was associated with higher child BMI (β=0.08; FDR-corrected p=0.02), but was not associated with child behavior. Those exposed to two or more cups of caffeine daily (n=1,028) had greater sleep problems than those with lower/no exposure (β>0.92; FDR-corrected p<0.04).
    UNASSIGNED: Daily prenatal caffeine exposure is associated with heightened childhood BMI, and when used multiple times a day greater sleep problems even after accounting for potential confounds. Whether this relationship is a consequence of prenatal caffeine exposure or its correlated factors remains unknown.
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  • 文章类型: Journal Article
    新诊断的弥漫性低度胶质瘤(DLGG)患者神经外科切除术后的治疗时机和选择仍存在争议。的确,这种治疗的效果必须与可能的副作用相平衡。这项研究评估了接受一线替莫唑胺治疗的DLGG患者的纵向力竭生活质量(QoL)和神经心理学评估的可行性。
    QoL,神经认知,和心理障碍进行前瞻性评估,直到疾病进展,使用测试,临床医生报告,和自我报告的问卷。主要终点是基线时(替莫唑胺开始前)对这一完整评估的参与和依从性,6个月和12个月的治疗,和治疗后6个月。还描述了QoL和神经心理学随时间的变化。
    29名符合条件的患者中有26名入组(参与率:89.7%,95%CI:72.6-97.8)。依从率为95.7%(95%CI:78.1-99.9;n=23,因为3名患者在治疗的前12个月内进展)。治疗后6个月,QoL和疲劳保持稳定(EORTCQLQC30和BN20,MFI-20);一些特定症状是短暂的。主观(FACT-Cog)和客观(神经认知测试的Z得分)神经认知结果均保持稳定或趋于改善。重度抑郁症患者(BDI-II)的百分比,焦虑(STAI-Y),或愤怒(STAXI-II)随着时间的推移是稳定的。
    这项前瞻性研究证明了对QoL进行详尽和纵向评估的可行性,神经认知,和心理障碍,接受化疗的DLGG患者具有很高的可接受性。一线替莫唑胺似乎对QoL和神经认知的短期影响有限。这些发现必须在长期和更大的队列中得到证实。
    UNASSIGNED: The treatment timing and choice after neurosurgical resection in patients with newly diagnosed diffuse low-grade glioma (DLGG) remain controversial. Indeed, the effect of such treatments must be balanced with the possible side effects. This study evaluated the feasibility of longitudinal exhaustive quality of life (QoL) and neuropsychological assessments in patients with DLGG receiving first-line temozolomide.
    UNASSIGNED: QoL, neurocognition, and psychological disorders were assessed prospectively until disease progression, using testing, clinician-reported, and self-reported questionnaires. The primary endpoint was the participation and adherence to this complete assessment at Baseline (before temozolomide initiation), months 6 and 12 of treatment, and month 6 post-treatment. The QoL and neuropsychological changes over time also were described.
    UNASSIGNED: Twenty-six of the twenty-nine eligible patients were enrolled (participation rate: 89.7%, 95% CI: 72.6-97.8). The adherence rate was 95.7% (95% CI: 78.1-99.9; n = 23 because 3 patients progressed in the first 12 months of treatment). Up to month 6 post-treatment, QoL and fatigue remained stable (EORTC QLQC30 and BN20, MFI-20); some specific symptoms were transitory. Both subjective (FACT-Cog) and objective (Z-scores of neurocognitive tests) neurocognitive outcomes remained stable or tended to improve. The percentage of patients with severe depression (BDI-II), anxiety (STAI-Y), or anger (STAXI-II) was stable over time.
    UNASSIGNED: This prospective study demonstrated the feasibility of an exhaustive and longitudinal evaluation of QoL, neurocognition, and psychological disorders, with high acceptability by patients with DLGG undergoing chemotherapy. First-line temozolomide seems to have limited short-term effects on QoL and neurocognition. These findings must be confirmed in the long term and in a larger cohort.
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  • 文章类型: Journal Article
    这项研究检查了临床因素的关联,独立于性别和高度心理社会逆境(HPAd),多动症或其他精神障碍的存在,特别是在非高加索人口的中等收入国家。在哥伦比亚的三个地点进行了多中心横断面研究。我们的研究招募了多动症先证者的三人,一个兄弟姐妹,和一个父母。我们使用有效的工具来评估父母和兄弟姐妹。样本包括223个兄弟姐妹,平均年龄12.3岁(标准差3.9),女性占51.1%。ADHD复发风险比(λ)为12。临床因素主要与ADHD的存在有关,独立于性别和HPAd,1)妊娠和分娩并发症,2)精神运动发育迟缓,3)气质,4)睡眠障碍。我们的研究表明,独立于HPAd和男性,在该人群中,存在与ADHD和其他精神疾病相关的其他临床因素.这些发现需要在全球类似人群中复制。
    This study examined the association of clinical factors, independent of sex and high psychosocial adversity (HPAd), with the presence of ADHD or other mental disorders, specifically within a middle-income country with a non-Caucasian population. A multi-centric cross-sectional study was conducted in three sites in Colombia. Our study recruited trios of an ADHD proband, one sibling, and one parent. We used valid instruments for assessing parents and siblings. The sample included 223 siblings, an average age of 12.3 (SD 3.9), and 51.1% Females. The ADHD recurrence risk ratio (λ) was 12. The clinical factors mainly associated with the presence of ADHD, independent of sex and HPAd, were 1) Pregnancy and childbirth complications, 2) Delayed psychomotor development, 3) Temperament, and 4) Sleep disturbances. Our research showed that, independently of HPAd and the male sex, there were other clinical factors associated with ADHD and other psychiatric disorders in this population. These findings need to be replicated in similar populations globally.
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  • 文章类型: Journal Article
    在精神分裂症患者中,自发的语音产生被认为与右半球的激活有关,包括下额叶和上颞回作为言语相关区域。然而,这种关联的有力证据仍然缺失。本功能磁共振成像研究的目的是检查自然过程中的BOLD信号变化,精神分裂症患者在其疾病的慢性期的流利的言语生产。
    使用病例对照设计,该研究包括15名患有精神分裂症谱系障碍的右撇子患者以及15名健康对照。参与者从主题感知测试中描述了八张图片,每张图片1分钟,用3TfMRI测量BOLD信号变化。使用标准化的心理病理学评估来确定阳性和阴性形式思维障碍的发生。
    我们发现,与健康对照组相比,精神分裂症患者在自发言语产生过程中的BOLD信号发生了显着变化,特别是在右半球网络中。事后分析表明,这种右半球偏侧化主要是由实验休息期间的激活驱动的。此外,患者的TLI和值与右侧Rolandic手术的BOLD信号变化呈负相关。
    语音相关区域的右半球反偏侧化可能的潜在因素是结构变化和发射机系统改变,以及由于执行功能失调,精神分裂症患者在休息期间缺乏神经下调。当将自发言语视为最自然的语言形式时,其他影响因素,比如社会认知或情绪处理,应该考虑。我们的结果表明,未来的研究应该考虑休息期间的群体差异,这可能会提供通常覆盖在差异对比中的额外信息。
    UNASSIGNED: In schizophrenia patients, spontaneous speech production has been hypothesized as correlating with right hemispheric activation, including the inferior frontal and superior temporal gyri as speech-relevant areas. However, robust evidence for this association is still missing. The aim of the present fMRI study is to examine BOLD signal changes during natural, fluent speech production in patients with schizophrenia in the chronic phase of their disease.
    UNASSIGNED: Using a case-control design, the study included 15 right-handed patients with schizophrenia spectrum disorders as well as 15 healthy controls. The participants described eight pictures from the Thematic Apperception Test for 1 min each, while BOLD signal changes were measured with 3T fMRI. The occurrence of positive and negative formal thought disorders was determined using standardized psychopathological assessments.
    UNASSIGNED: We found significant BOLD signal changes during spontaneous speech production in schizophrenia patients compared to healthy controls, particularly in the right hemispheric network. A post-hoc analysis showed that this right-hemispheric lateralization was mainly driven by activation during experimental rests. Furthermore, the TLI sum value in patients correlated negatively with BOLD signal changes in the right Rolandic operculum.
    UNASSIGNED: Possible underlying factors for this inverse right-hemispheric lateralization of speech-associated areas are structural changes and transmitter system alterations, as well as a lack of neural downregulation in schizophrenia patients during rest periods due to dysfunctional executive functions. When examining spontaneous speech as the most natural form of language, other influencing factors, such as social cognition or emotional processing, should be considered. Our results indicate that future studies should consider group differences during rest, which might provide additional information typically covered in differential contrasts.
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