anxiety disorder

焦虑症
  • 文章类型: Journal Article
    OBJECTIVE: To study the effectiveness and the quality of life impact of the mobile application Zdorovye.ru in people with subclinical and clinical anxiety disorder (AD).
    METHODS: 200 patients with more than 7 points on the Hospital Anxiety and Depression Scale (HADS) were included. Participants were randomized into two groups: experimental one (EG, n=133) - to receive standard treatment with temgicoluril (Adaptol), 500 mg (Olainfarm JSC, Latvia) and the Zdorovye.ru application; control group (CG, n=52) - standard treatment with temgicoluril (Adaptol).
    RESULTS: There were a significant decrease in the HADS-A score, PSS-10 score and an increase in the visual analog scale EQ-5D score in both groups after 3 months of treatment (p<0.001). Clinical improvement was noticeable after 1.5 months in EG group: a decrease in HADS-A scores (p=0.001) and in tension and stress on PSS-10 subscales (p<0.001) were noted. This effect was not observed in the CG. After 3 months, all participants noted an improvement in quality of life (p<0.001), without a statistically significant difference between groups (p=0.233). The application left a positive impression on users and doctors - most respondents rated it as useful and clear.
    CONCLUSIONS: Taking temgicoluril (Adaptol) for 3 months led to symptoms decrease and the quality of life and well-being improvement in patients with AD. Using the mobile application Zdorovye.ru in conjunction with drug therapy made it possible to achieve a clinical effect earlier, in 1.5 months.
    UNASSIGNED: Изучить эффективность и влияние на качество жизни мобильного приложения Здоровье.ру у пациентов с субклиническим и клинически выраженным тревожным расстройством (ТР), получающих противотревожную терапию препаратом темгиколурил (Адаптол).
    UNASSIGNED: Обследованы 200 пациентов, имевших более 7 баллов при тестировании по госпитальной шкале тревоги и депрессии (HADS-A), которые были рандомизированы в две группы: основная группа (ОГ, n=133) — получали препарат темгиколурил (Адаптол), таблетки 500 мг (АО «Олайнфарм», Латвия) и пользовались приложением Здоровье.ру; группа сравнения (ГС, n=52) — получали только Адаптол.
    UNASSIGNED: В обеих группах через 3 мес лечения отмечено значимое снижение балла по опросникам HADS-A, PSS-10 и увеличение значений по визуально-аналоговой шкале EQ-5D (p<0,001). В ОГ клиническое улучшение было заметно уже через 1,5 мес: отмечено снижение количества баллов по HADS-A (p=0,001); уменьшение напряжения и стресса по субшкалам опросника PSS-10 (p<0,001). В ГС такой эффект отсутствовал. Через 3 мес все участники исследования отметили повышение качества жизни (p<0,001) без статистически значимой разницы между группами (p=0,233). Приложение оставило положительное впечатление у пользователей и врачей: большинство респондентов оценили его как полезное и интуитивно понятное.
    UNASSIGNED: Прием темгиколурила (Адаптола) пациентами с ТР в течение 3 мес приводил к уменьшению выраженности тревожности, повышению качества жизни и улучшению самочувствия. Использование приложения Здоровье.ру совместно с лекарственной терапией позволяло достичь клинического эффекта в более короткие сроки (через 1,5 мес).
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  • 文章类型: Journal Article
    目的:目的是评估在18个月的随访中,每月在瑞典初级卫生保健中与仅有CAU相比,在工作场所参与(PSI-WPI)的护理(CAU)中增加了解决问题的干预措施的有效性。
    方法:我们进行了一项整群随机对照试验,包括197名对分配不了解的员工(85PSI-WPI和112CAU)。由于病假数据扭曲和过度分散,在随访期间的每个月,使用广义估计方程对干预组和对照组进行比较.
    结果:在18个月的随访中,疾病缺席天数的中位数为78天,接受PSI-WPI和64天的员工的四分位数间距(IQR)18-196,接收CAU的员工的IQR18-161。时间x组广义估计方程分析显示,每月病假天数没有统计学上的显着差异。
    结论:在CAU中添加PSI-WPI并不能更有效地减少病假天数。这可以解释为初级卫生保健的背景,缺乏职业健康和瑞典社会保险制度的专业化,有特定的时间限制。
    背景:该试验已在ClinicalTrials.gov注册,标识符:NCT03346395于1月12日,2018.
    OBJECTIVE: The aim was to evaluate the effectiveness of a problem-solving intervention with workplace involvement (PSI-WPI) added to care as usual (CAU) in reducing sickness absence days among employees with common mental disorders compared to CAU alone in Swedish primary health care on a monthly basis over 18-months follow-up.
    METHODS: We conducted a cluster-randomised controlled trial including 197 employees blinded to allocation (85 PSI-WPI and 112 CAU). As sickness absence data was skewed and over-dispersed, generalised estimating equations was used to enable a comparison between the intervention and control group for each month of the follow-up period.
    RESULTS: The median number of sickness absence days over the 18-month follow-up was 78 days, inter-quartile range (IQR) 18-196 for employees receiving PSI-WPI and 64 days, IQR 18-161 for employees receiving CAU. The time x group generalised estimating equations analysis showed no statistically significant difference in sickness absence days per month.
    CONCLUSIONS: The addition of a PSI-WPI to CAU was not more effective in reducing sickness absence days. This may be explained by the primary health care context, lack of specialisation in occupational health and the Swedish social insurance system with specific time limits.
    BACKGROUND: The trial was registered at ClinicalTrials.gov, identifier: NCT03346395 on January 12th, 2018.
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  • 文章类型: Journal Article
    人们对同伴基因型如何影响健康(即,同伴社会遗传效应)。作者试图阐明同伴社会遗传对药物使用障碍风险的影响的性质,酒精使用障碍(AUD),严重的抑郁症,和焦虑症。
    Cox模型与来自基于人群的瑞典队列(N=655,327)的数据一起使用。结果是吸毒障碍,AUD,严重的抑郁症,17岁到30岁之间的焦虑症注册,罪犯,和药房登记处。作者将同伴社会遗传效应与同伴家庭遗传风险评分(FGRS)对相同疾病进行索引,这是从一级到五级亲属的诊断推断的遗传风险的个性化测量。
    跨越疾病,同行FGRS预测先证者登记的风险增加(危险比范围,1.01-1.59),对药物使用障碍和AUD的影响比对重度抑郁症和焦虑症的影响更强。同龄人的社会遗传效应对学校同学的影响比对地理上相近的同龄人更强,以及高中(16-19岁)的同龄人与初中(7-16岁)的同龄人。在对社会人口统计学混杂因素进行统计控制后,同伴社会遗传效应仍然显着,同龄人是否受到影响,和同龄人FGRS的教育程度。对于遗传风险较高的先证者,同伴社会遗传效应更为明显。
    青少年同龄人的遗传构成对吸毒障碍的风险具有深远的影响,AUD,严重的抑郁症,和焦虑症。具有高遗传风险的个体对社会遗传效应更敏感。替代假设,如社会人口分层,接触受影响的同龄人,和受教育程度的遗传倾向不能解释物质使用和精神疾病与同伴社会遗传效应相关的风险。
    UNASSIGNED: There is growing interest in how peers\' genotypes may influence health (i.e., peer social genetic effects). The authors sought to clarify the nature of peer social genetic effects on risk for drug use disorder, alcohol use disorder (AUD), major depression, and anxiety disorder.
    UNASSIGNED: Cox models were used with data from a population-based Swedish cohort (N=655,327). Outcomes were drug use disorder, AUD, major depression, and anxiety disorder registrations between ages 17 and 30 from medical, criminal, and pharmacy registries. The authors indexed peer social genetic effects with peers\' family genetic risk scores (FGRSs) for the same disorders, which are personalized measures of genetic risk inferred from diagnoses in first- to fifth-degree relatives.
    UNASSIGNED: Across disorders, peer FGRSs predicted increased risks of proband registration (hazard ratio range, 1.01-1.59), with stronger effects for drug use disorder and AUD than for major depression and anxiety disorder. Peer social genetic effects were stronger for school classmates than for geographically proximal peers, and for peers from upper secondary school (ages 16-19) versus peers from lower secondary school (ages 7-16). Peer social genetic effects remained significant following statistical control for sociodemographic confounders, whether peers were affected, and peers\' FGRS for educational attainment. Peer social genetic effects were more pronounced for probands at higher genetic risk.
    UNASSIGNED: The genetic makeup of adolescents\' peers has long-reaching consequences on risks for drug use disorder, AUD, major depression, and anxiety disorder. Individuals at high genetic risk are more sensitive to social genetic effects. Alternative hypotheses such as sociodemographic stratification, exposure to affected peers, and genetic predispositions for educational attainment did not explain the risk associated with peer social genetic effects for substance use and psychiatric disorders.
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  • 文章类型: Journal Article
    经验性回避(EA)可能是广泛的焦虑相关精神病理学的危险因素。焦虑被认为会引发EA的使用,同时也是EA努力的结果。先前的生态瞬时评估(EMA)研究发现,EA与非临床本科生和社交焦虑症患者的焦虑程度有关。
    本研究考察了瞬间,EA之间的双向关系,感知压力,在广泛诊断为焦虑相关障碍的寻求治疗的患者样本中,焦虑的两个方面(自主唤醒和担忧/痛苦)(N=46)。参与者完成了基线评估,然后是EMA评估期(每天评估三次,共7天)。我们假设EA和焦虑/压力之间存在双向关系。
    结果在很大程度上支持单向关系,使得在一个时间点的较大EA预测在控制先前应力水平和线性时间的较晚时间点的较高应力。讨论了EA和焦虑症状之间的趋势级别关联。
    当前的研究为焦虑相关疾病参与者的临床样本中EA与焦虑症状之间的关系提供了重要的见解。
    UNASSIGNED: Experiential avoidance (EA) may serve as a risk factor for a wide range of anxiety-related psychopathology. Anxiety is thought to trigger the use of EA, while also serving as a consequence of EA efforts. Previous ecological momentary assessment (EMA) studies found that EA was associated with greater anxiety in nonclinical undergraduates and patients with social anxiety disorder.
    UNASSIGNED: The present study examined the in-the-moment, bidirectional relationship between EA, perceived stress, and two facets of anxiety (autonomic arousal and worry/misery) in a sample of treatment-seeking patients broadly diagnosed with an anxiety-related disorder (N = 46). Participants completed a baseline assessment followed by an EMA assessment period (assessments three times daily for seven days). We hypothesized that there would be a bidirectional relationship between EA and anxiety/stress.
    UNASSIGNED: Results largely supported a unidirectional relationship such that greater EA at one time point predicted higher stress at a later time point controlling for previous stress levels and linear time. Trend-level associations between EA and anxiety symptoms are discussed.
    UNASSIGNED: The current study provides important insight into the relationship between EA and anxiety symptoms in a clinical sample of participants with anxiety-related disorders.
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  • 文章类型: Journal Article
    目的:在167名符合焦虑相关障碍诊断标准的自闭症青年样本中,对DSM-IV-自闭症谱系附录(ADIS-ASA)-父母访谈的焦虑症访谈时间表中特定焦虑症部分的并发有效性进行检查(Mage=9.91;男性78.4%;非西班牙裔82%;白人77.67%)。
    方法:通过与(a)父母报告的青年焦虑症状学维度和(b)青年焦虑相关功能障碍的维度测量的关系,检查了诊断和统计手册(DSM)定义的ADIS-ASA焦虑症诊断的并发有效性。分别,使用逻辑回归模型和点双材料相关性。
    结果:发现分离焦虑症和社交焦虑症(但不是广泛性焦虑症或强迫症)之间存在显着关系,分别,和理论上一致的维度青年焦虑症状学方面。ADIS-ASA诊断性与青年功能障碍相关变量之间的关系表明,只有分离焦虑症表现出收敛有效性的有力证据。
    结论:尽管关于ADIS-ASA焦虑症的诊断结果与焦虑严重程度和焦虑相关损害的维度测量之间的关系有不同的发现,本研究结果为ADIS-ASA作为评估自闭症青年焦虑的金标准提供了进一步的支持.这项工作还强调了继续提高自闭症青年焦虑症状学测量精度的重要性,对临床评估有影响。
    OBJECTIVE: Examine the concurrent validity of specific Anxiety Disorders Section of the Anxiety Disorder Interview Schedule for DSM-IV-Autism Spectrum Addendum (ADIS-ASA)-Parent Interview in a sample of 167 autistic youth who met diagnostic criteria for an anxiety-related disorder (Mage = 9.91; 78.4% male; 82% non-Hispanic; 77.67% White).
    METHODS: Concurrent validity of Diagnostic and Statistical Manual (DSM)-defined ADIS-ASA anxiety disorder diagnostic caseness was examined via relations with (a) parent-reported dimensions of youth anxiety symptomology and (b) dimensional measures of youth anxiety-related functional impairment, respectively, using logistic regression models and point-biserial correlations.
    RESULTS: Significant relations were found between separation anxiety disorder and social anxiety disorder (but not generalized anxiety disorder nor obsessive-compulsive disorder) caseness, respectively, and theoretically consistent facets of dimensional youth anxiety symptomology. Relations between ADIS-ASA diagnostic caseness and youth functional impairment-related variables revealed that only separation anxiety disorder demonstrated robust evidence of convergent validity.
    CONCLUSIONS: Despite mixed findings concerning relations between ADIS-ASA anxiety disorder diagnostic caseness and dimensional measures of anxiety severity and anxiety-related impairment, the present findings provide further support for the status of the ADIS-ASA as a gold standard for assessment of anxiety in autistic youth. This work also highlights the importance of continuing to improve precision in measurement of anxiety symptomology in autistic youth, with implications for clinical assessment.
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  • 文章类型: Journal Article
    在日常生活中,人类执行一系列任务。强迫症(OCD)患者可能会中断这些任务。症状,比如强迫,可以被认为是顺序的,并且通常会导致重复任务,从而破坏日常生活(例如,烹饪时检查炉子)。运动序列已用于研究强迫症的行为缺陷。然而,并非所有序列都是运动序列。有些更“抽象”,因为它们由一系列任务组成(例如,切碎和搅拌),而不是依赖于个体的行为或刺激。这些抽象的任务序列需要认知控制机制来执行它们。尽管理论也提出了强迫症中这些序列的缺陷,他们没有被直接调查。我们测试了以下假设:OCD参与者在抽象任务序列和更一般的灵活行为(通过序列内的任务切换来衡量)的控制机制中表现出缺陷,相对于健康对照(HCs)和临床对照(患有焦虑症的参与者[ANX])。共有112名参与者完成了由简单分类任务组成的抽象任务序列。令人惊讶的是,强迫症参与者的表现不比HCs或ANX差.然而,ANX参与者显示出特定于顺序控制的损害,但并未扩展到更一般的灵活控制。因此,我们显示了OCD和ANX之间对抽象任务顺序控制的一种新的行为分离。这些结果还暗示了ANX而不是OCD的特定额叶顺序控制神经回路的缺陷,其中隐性序贯缺陷可能与纹状体回路更紧密相关。
    In everyday life, humans perform sequences of tasks. These tasks may be disrupted in people with obsessive-compulsive disorder (OCD). Symptoms, such as compulsions, can be considered sequential and often cause repetitions of tasks that disrupt daily living (e.g., checking the stove while cooking). Motor sequences have been used to study behavioral deficits in OCD. However, not all sequences are motor sequences. Some are more \"abstract\" in that they are composed of a series of tasks (e.g., chopping and stirring) rather than being dependent on individual actions or stimuli. These abstract task sequences require cognitive control mechanisms for their execution. Although theory has proposed deficits in these sequences in OCD as well, they have not been directly investigated. We tested the hypotheses that OCD participants exhibit deficits in the control mechanisms specific to abstract task sequences and more general flexible behavior (measured with task switching within the sequences), relative to health controls (HCs) and clinical controls (participants with anxiety disorders [ANX]). A total of 112 participants completed abstract task sequences consisting of simple categorization tasks. Surprisingly, participants with OCD did not perform worse than HCs or ANX. However, ANX participants showed impairments specific to sequential control that did not extend to more general flexible control. Thus, we showed a novel behavioral dissociation between OCD and ANX specific to abstract task sequential control. These results also implicate deficits in specific frontal sequential control neural circuitry in ANX and not in OCD, where implicit sequential deficits may more closely align with striatal circuits.
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  • 文章类型: Journal Article
    这项研究旨在评估患者健康问卷(PHQ)在印度尼西亚门诊临床心理学家办公室环境中识别常见精神障碍的诊断准确性。雅加达一家临床心理学办公室共有661名门诊病人,印度尼西亚,参与研究。进行了完整的PHQ,并将其结果与临床心理学家根据ICD-11标准做出的诊断进行比较,包括躯体形式障碍(n=6),抑郁症(n=117),广义焦虑症(GAD,n=50),恐慌症(n=42),神经性贪食症(n=2),暴食症(n=2),以及其他诊断,如OCD和BPD(n=442)。计算接收机工作特性以检查截止点,并根据Youden指数确定了躯体形式障碍(PHQ-15≥13)的最佳临界点,抑郁症(PHQ-9≥13),GAD(GAD-7≥10),和惊恐障碍(PHQ-PD≥7)。由于缺乏样本,无法确定PHQ的酒精滥用和饮食失调模块的截止点,PHQ-9、GAD-7和PHQ-ED的AUC次优。印度尼西亚PHQ在识别躯体形式障碍方面表现出良好的敏感性,但特异性较低。抑郁症,GAD,印度尼西亚临床心理学家办公室门诊患者中基于ICD-11标准的惊恐障碍。在印度尼西亚的门诊精神病背景下,印度尼西亚PHQ的效用似乎最有效地排除了诊断。
    This study aimed to assess the diagnostic accuracy of the Patient Health Questionnaire (PHQ) for identifying common mental disorders in an outpatient clinical psychologist office setting in Indonesia. A total of 661 outpatients from a clinical psychology office in Jakarta, Indonesia, participated in the study. The complete PHQ was administered, and its results were compared with diagnoses made by clinical psychologists based on ICD-11 criteria, including somatoform disorder (n = 6), depression (n = 117), Generalized Anxiety Disorder (GAD, n = 50), panic disorder (n = 42), bulimia nervosa (n = 2), binge eating disorder (n = 2), and other diagnoses such as OCD and BPD (n = 442). Receiver operating characteristics were computed to examine cut-off points, and optimal cut-off points based on the Youden Index were identified for somatoform disorder (PHQ-15 ≥ 13), depression (PHQ-9 ≥ 13), GAD (GAD- 7 ≥ 10), and panic disorder (PHQ-PD ≥ 7). Cut-off points for the alcohol abuse and eating disorder modules of the PHQ could not be determined due to a lack of sample, and AUC was suboptimal for PHQ-9, GAD-7, and PHQ-ED. The Indonesian PHQ demonstrated good sensitivity but low specificity in identifying somatoform disorder, depression, GAD, and panic disorders based on ICD-11 criteria among Indonesian clinical psychologist office outpatients. In the Indonesian outpatient psychiatric context, the utility of the Indonesian PHQ appeared to be most effective in ruling out diagnoses.
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  • 文章类型: Journal Article
    背景:公开演讲是社区和大学样本中最普遍担心的情况之一。尽管广泛的理论模型和实证研究旨在描述公众演讲焦虑(PSA)的潜在因素,导致其发作的特定变量仍未完全表征。
    方法:这项研究涉及来自AmazonTurk调查的297名参与者,参与按受众规模区分的虚拟公共演讲场景,参与度,和房间空间尺寸。参与者的预期焦虑水平在这些场景中进行了定量评估,能够全面探索情境变量和PSA之间的相互作用,从而提供了一个框架来探索受众规模的影响,订婚,和PSA上的空间尺寸。
    结果:混合效应模型揭示了受众规模之间的显着相互作用,观众参与度,和房间空间尺寸。使用主轴因子分解和多元回归的进一步分析确定了三个主要因素:F1(参与大观众),F2(约束或评估焦虑),和F3(观众脱离接触)。这些因素显著预测PSA评分。
    结论:这项研究表明,PSA受到受众规模的复杂相互作用的影响,房间尺寸,和观众参与。该发现强调了将这些情境变量纳入经验调查和治疗干预措施的可行方法。具体来说,它引入了一个新颖的框架,用于相对于房间容量标准化受众规模。
    BACKGROUND: Public speaking is one of the most commonly feared situations reported in both community and university samples. Despite extensive theoretical models and empirical studies aimed at delineating the underlying factors of Public Speaking Anxiety (PSA), the specific variables contributing to its onset remain incompletely characterised.
    METHODS: The research involved 297 participants from an AmazonTurk survey, engaging with virtual public speaking scenarios differentiated by audience size, engagement levels, and room spatial dimensions. Participants\' anticipated anxiety levels were quantitatively assessed across these scenarios, enabling a comprehensive exploration of the interaction between situational variables and PSA, thereby providing a framework to explore the influence of audience size, engagement, and spatial dimensions on PSA.
    RESULTS: The mixed-effect model revealed a significant interaction among audience size, audience engagement, and room spatial dimensions. Further analyses using principal axis factoring and multiple regression identified three main factors: F1 (Engagement in a Large Audience), F2 (Confinement or Evaluation Anxiety), and F3 (Audience Disengagement). These factors significantly predict PSA scores.
    CONCLUSIONS: This study reveals that PSA is influenced by a complex interplay of audience size, room dimensions, and audience engagement. The finding underscores the viable way to incorporate these situational variables in both empirical investigations and therapeutic interventions. Specifically, it introduces a novel framework for standardising audience size relative to room capacity.
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  • 文章类型: Journal Article
    (1)背景:婴儿绞痛(IC)是一种功能性胃肠病,影响约20%的婴儿,产后(PPD)抑郁症是一种常见疾病,影响15%至22%的母亲。在这项研究中,我们的目的是评估产妇产后第一年的心理状态与IC之间的关系,目的是评估喂养类型对婴儿和产妇健康的重要性。(2)方法:对产后第一年的妇女进行了横断面研究。人口统计,medical,收集了母亲和婴儿的产科数据,并确定了喂养的类型。使用爱丁堡产后抑郁量表(EPDS)评估母亲的情绪状态,婴儿绞痛严重程度问卷(ICSQ)用于IC诊断。(3)结果:共对528名女性进行分析,其中170例(32%)被诊断为可能的PPD。三分之二的无抑郁症妇女按需母乳喂养婴儿;因此,我们报道,纯母乳喂养(EBF)可降低可能发生PPD的风险(p<0.001;OR=2.353).39%的婴儿出现IC,大约70%的无绞痛婴儿是按需母乳喂养的。非完全母乳喂养的婴儿患绞痛的风险几乎增加了一倍(p=0.016;OR=1.577)。EPDS和ICSQ评分之间存在显著关联(p<0.001)。超过一半的PPD女性患有绞痛。然而,我们的结果显示,75%的无绞痛婴儿的母亲报告产后情绪健康状况最佳(p<0.001;OR=2.105).(4)结论:本研究结果表明,产后产妇心理幸福感降低了IC的风险。因此,我们报告EBF按需,以及新妈妈健康的情绪状态,可能是防止婴儿绞痛的保护因素。
    (1) Background: Infantile colic (IC) is a functional gastrointestinal disorder that affects around 20% of infants, and postpartum (PPD) depression is a common disorder that affects between 15 and 22% of mothers. In this study, our objective was to evaluate the relationship between the maternal psychological state in the first postpartum year and IC, with the aim of assessing the importance of feeding type in infants and maternal well-being. (2) Methods: A cross-sectional study was conducted in women in their first year postpartum. Demographic, medical, and obstetric data of the mothers and infants were collected, and the type of feeding was identified. The emotional status of the mother was evaluated using the Edinburgh Postnatal Depression Scale (EPDS), and the Infant Colic Severity Questionnaire (ICSQ) was used for IC diagnosis. (3) Results: A total of 528 women were analyzed, of which 170 (32%) were diagnosed with possible PPD. Two-thirds of the women without depression breastfed their babies on demand; therefore, we report that exclusive breastfeeding (EBF) appears to reduce the risk of possible PPD (p < 0.001; OR = 2.353). IC was present in 39% of babies, and around 70% of babies without colic were breastfed on demand. Infants who were not exclusively breastfed showed almost double the risk of developing colic (p = 0.016; OR = 1.577). There was a significant association between the EPDS and ICSQ scores (p < 0.001). More than half of the women with PPD had babies with colic. However, our results show that 75% of babies without colic had mothers who reported optimal postpartum emotional well-being (p < 0.001; OR = 2.105). (4) Conclusions: The results of this study suggest that postpartum maternal psychological well-being reduces the risk of IC. Therefore, we report that EBF on demand, together with a healthy emotional state in new mothers, may be a protective factor against colic in infants.
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  • 文章类型: Journal Article
    环磷酸腺苷(cAMP)是一种细胞内第二信使,它来自腺苷酸环化酶(AC)催化的三磷酸腺苷转化。蛋白激酶A(PKA),cAMP的主要效应,是由两个催化亚基和两个调节亚基组成的二聚蛋白激酶。当cAMP与PKA的调节亚基结合时,它导致PKA的解离和活化,这允许PKA的催化亚基磷酸化靶蛋白,从而调节细胞功能中的各种生理功能和代谢过程。最近的研究还暗示cAMP-PKA信号参与了焦虑症的病理发生。然而,从这一信号通路对焦虑症的预防和治疗仍有争论。综述cAMP-PKA信号在焦虑症中的作用,我们搜索了关键词包括“cAMP”的出版物,“PKA”和“焦虑”来自Pubmed,Embase,WebofScience和CNKI数据库。结果表明,有关焦虑症中cAMP-PKA途径的出版物数量趋于增加。生物信息学结果显示cAMP-PKA通路与焦虑的发生密切相关。机械上,cAMP-PKA信号可影响脑源性神经营养因子和神经肽Y,参与焦虑的调节。cAMP-PKA信号传导还可以对抗γ-氨基丁酸(GABA)的功能障碍,肠道菌群,下丘脑-垂体-肾上腺轴,神经炎症,和信号蛋白(MAPK和AMPK)在焦虑。此外,具有激活cAMP-PKA信号传导能力的化学试剂证明了治疗焦虑症的潜力。这篇综述强调了cAMP-PKA信号传导在焦虑中的核心作用,cAMP-PKA通路的靶标将是治疗焦虑的潜在候选者。然而,更多的实验室调查,以提高治疗效果,减少不良反应,持续的临床研究将保证药物的开发。
    Cyclic adenosine monophosphate (cAMP) is an intracellular second messenger that is derived from the conversion of adenosine triphosphate catalysed by adenylyl cyclase (AC). Protein kinase A (PKA), the main effector of cAMP, is a dimeric protein kinase consisting of two catalytic subunits and two regulatory subunits. When cAMP binds to the regulatory subunits of PKA, it leads to the dissociation and activation of PKA, which allows the catalytic subunit of PKA to phosphorylate target proteins, thereby regulating various physiological functions and metabolic processes in cellular function. Recent researches also implicate the involvement of cAMP-PKA signaling in the pathologenesis of anxiety disorder. However, there are still debates on the prevention and treatment of anxiety disorders from this signaling pathway. To review the function of cAMP-PKA signaling in anxiety disorder, we searched the publications with the keywords including \"cAMP\", \"PKA\" and \"Anxiety\" from Pubmed, Embase, Web of Science and CNKI databases. The results showed that the number of publications on cAMP-PKA pathway in anxiety disorder tended to increase. Bioinformatics results displayed a close association between the cAMP-PKA pathway and the occurrence of anxiety. Mechanistically, cAMP-PKA signaling could influence brain-derived neurotrophic factor and neuropeptide Y and participate in the regulation of anxiety. cAMP-PKA signaling could also oppose the dysfunctions of gamma-aminobutyric acid (GABA), intestinal flora, hypothalamic-pituitary-adrenal axis, neuroinflammation, and signaling proteins (MAPK and AMPK) in anxiety. In addition, chemical agents with the ability to activate cAMP-PKA signaling demonstrated therapy potential against anxiety disorders. This review emphasizes the central roles of cAMP-PKA signaling in anxiety and the targets of the cAMP-PKA pathway would be potential candidates for treatment of anxiety. Nevertheless, more laboratory investigations to improve the therapeutic effect and reduce the adverse effect, and continuous clinical research will warrant the drug development.
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