Bibliometric and visual study of narcolepsy from 2000 to 2023

BACKGROUND

More studies explored the prevalence, causes, associated conditions, and therapeutic strategies of narcolepsy. With an increasing focus on understanding narcolepsy's prevalence, associated conditions, and therapeutic strategies, there's a notable absence of bibliometric analyses summarizing trends in research and identifying emerging areas of focus within this field.

AIM

To conduct a bibliometric analysis to investigate the current status and frontiers of narcolepsy.

METHODS

The documents related to narcolepsy are obtained from the Web of Science Core Collection database (WoSCC) from January 1, 2000, to December 31, 2023, and VOS viewer 1.6.16, and the WoSCC's literature analysis wire were used to conduct the bibliometric analysis.

RESULTS

A total of 4672 publications related to narcolepsy were included, and 16182 authors across 4397 institutions and 96 countries/regions contributed to these documents in 1131 different journals. The most productive author, institution, country and journal were Yves Dauvilliers, Stanford University, United States, and Sleep Medicine, respectively. The first high-cited document was published in Nature in 2005 by Saper et al, and this research underscores the role of certain neurons in ensuring the stability of sleep-wake transitions, offering insights into narcolepsy's pathophysiology.

CONCLUSION

In conclusion, the main research hotspots and frontiers in the field of narcolepsy are the diagnosis of narcolepsy, pathological mechanism of narcolepsy and the treatment of narcolepsy. More studies are needed to explore effective strategies for the diagnosis and treatment of narcolepsy.

Association between intercellular adhesion molecule-1 to depression and blood-brain barrier penetration in cerebellar vascular disease

BACKGROUND

Cerebral small vessel disease (CSVD) is a prevalent cerebrovascular disease in clinical practice that is often associated with macrovascular disease. A clear understanding of the underlying causes of CSVD remains elusive.

AIM

To explore the association between intercellular adhesion molecule-1 (ICAM-1) and blood-brain barrier (BBB) penetration in CSVD.

METHODS

This study included patients admitted to Fuyang People's Hospital and Fuyang Community (Anhui, China) between December 2021 and March 2022. The study population comprised 142 patients, including 80 in the CSVD group and 62 in the control group. Depression was present in 53 out of 80 patients with CSVD. Multisequence magnetic resonance imaging (MRI) and dynamic contrast-enhanced MRI were applied in patients to determine the brain volume, cortical thickness, and cortical area of each brain region. Moreover, neuropsychological tests including the Hamilton depression scale, mini-mental state examination, and Montreal cognitive assessment basic scores were performed.

RESULTS

The multivariable analysis showed that age [P = 0.011; odds ratio (OR) = 0.930, 95% confidence interval (CI): 0.880-0.983] and ICAM-1 levels (P = 0.023; OR = 1.007, 95%CI: 1.001-1.013) were associated with CSVD. Two regions of interest (ROIs; ROI3 and ROI4) in the white matter showed significant (both P < 0.001; 95%CI: 0.419-0.837 and 0.366-0.878) differences between the two groups, whereas only ROI1 in the gray matter showed significant difference (P = 0.046; 95%CI: 0.007-0.680) between the two groups. ICAM-1 was significantly correlated (all P < 0.05) with cortical thickness in multiple brain regions in the CSVD group.

CONCLUSION

This study revealed that ICAM-1 levels were independently associated with CSVD. ICAM-1 may be associated with cortical thickness in the brain, predominantly in the white matter, and a significant increase in BBB permeability, proposing the involvement of ICAM-1 in BBB destruction.

Enhancing adolescent mental health through cognitive and social support: Insights from study on depression in Chinese adolescents

Adolescent depression is a growing global health concern, affecting 14% of adolescents and leading to severe consequences such as academic failure, substance abuse, and suicidal ideation. The study by Yu et al, investigates the cognitive and social factors influencing depression in 795 Chinese adolescents. Findings reveal that negative life events (NLEs) and dysfunctional attitudes are strongly associated with depressive symptoms, while social support moderates the impact of NLEs but not dysfunctional attitudes. The study highlights the need for cognitive-behavioural interventions targeting perfectionism and autonomy, and the importance of strengthening social support systems in schools and communities. Culturally sensitive, holistic approaches to adolescent mental health are crucial for addressing both the internal vulnerabilities and external pressures contributing to depression. Further research is needed to explore the roles of peer and parental support and the long-term effects of these factors across diverse cultural contexts.

Brain networks in newborns and infants with and without sensorineural hearing loss: A functional near-infrared spectroscopy study

BACKGROUND

Understanding the impact of early sensory deficits on brain development is essential for understanding developmental processes and developing potential interventions. While previous studies have looked into the impact of prenatal experiences on language development, there is a lack of research on how these experiences affect early language and brain function development in individuals with sensorineural hearing loss (SNHL).

AIM

To investigate SNHL effects on early brain development and connectivity in 4-month-olds vs healthy newborns and controls.

METHODS

The research involved analyzing the functional brain networks of 65 infants, categorized into three groups: 28 healthy newborns, 22 4-month-old participants with SNHL, and 15 age-matched healthy participants. The resting-state functional connectivity was measured and compared between the groups using functional near-infrared spectroscopy and graph theory to assess the brain network properties.

RESULTS

Significant differences were found in resting-state functional connectivity between participants with SNHL and age-matched controls, indicating a developmental lag in brain connectivity for those with SNHL. Surprisingly, SNHL participants showed better connectivity development compared to healthy newborns, with connectivity strengths of 0.13 ± 0.04 for SNHL, 0.16 ± 0.08 for controls, and 0.098 ± 0.04 for newborns. Graph theory analysis revealed enhanced global brain network properties for the SNHL group, suggesting higher communication efficiency at 4 months. No significant differences were noted in network properties between 4-month-old SNHL participants and neonates. A unique pattern of central hubs was observed in the SNHL group, with 2 hubs in the left hemisphere compared to 6 in controls.

CONCLUSION

4-month-old infants with SNHL have a distinct brain network pattern with efficient long-distance information transmission but less effective local communication compared to age-matched controls.

Mediating role of health literacy in the relationship between social isolation and psychological distress among pre-frail older adults

BACKGROUND

Frailty has become a significant public health issue. The recent increase in the number of frail older adults has led to increased attention being paid to psychological care services in communities. The social isolation of pre-frail older adults can impact their psychological distress.

AIM

To explore the mediating effect of health literacy between social isolation and psychological distress among communitydwelling older adults with pre-frailty.

METHODS

This descriptive cross-sectional study was conducted with 254 pre-frail older individuals aged 60 years and over. Social isolation, health literacy, and psychological distress were comprehensively measured using the Lubben Social Network Scale-6, 12-item Short-Form Health Literacy Questionnaire, and the Kessler Psychological Distress Scale-10. Data were evaluated using the SPSS 27.0 package program and the PROCESS macro tool. Descriptive statistical analyses, correlation analyses, and bootstrap mediation tests were used to assess associations between the variables.

RESULTS

The results showed that social isolation had an effect on health literacy among pre-frail older adults (β = 0.240, P < 0.001), social isolation impact on psychological distress pre-frail older adults (β = -0.415, P < 0.001); health literacy was identified effect on psychological distress among pre-frail older persons (β = -0.307, P < 0.001). Health literacy partially mediated the relationship between social isolation and psychological distress among community-dwelling older adults with pre-frailty, with a mediation effect of -0.074, accounting for 17.83% of the total effect.

CONCLUSION

Health literacy significantly affects the relationship between social isolation and psychological distress among pre-frail older adults. Apart from fostering social connections, improved health literacy measures should be considered.

Posttraumatic stress symptoms among Chinese university students during the COVID-19 pandemic: Prevalence, correlates, and mental health help-seeking

BACKGROUND

Revisiting the epidemiology of posttraumatic stress symptoms (PTSSs) among university students during the coronavirus disease 2019 (COVID-19) pandemic as well as understanding the mental health help-seeking behavior of individuals with PTSSs has critical implications for public mental health strategies in future medical pandemics.

AIM

To investigate the prevalence and correlates of PTSSs among university students during the first wave of the COVID-19 pandemic in China and to examine mental health help-seeking behaviors among these students.

METHODS

A total of 2507 Chinese university students were recruited via snowball sampling. The students completed the Seven-item Screening Scale for Post-traumatic Stress Disorder during the first wave of the COVID-19 pandemic in China. Sociodemographic characteristics, pandemic-related characteristics, and mental health help-seeking behaviors of students with PTSSs were also collected.

RESULTS

The prevalence of PTSSs among the participants was 28.0%. Seven significant correlates of PTSSs were identified (odds ratio = 1.23-3.65, P ≤ 0.024): Female sex, being 19 years old or older, living with others or alone, a low level of family economic status, fair or poor interpersonal relationships, severe or very severe local pandemic, and having family members diagnosed with COVID-19. However, only 3.28% of the students with PTSSs reported seeking help from mental health specialists. Among the 23 students who sought help from mental health specialists, 13 opted for online or telephone-based psychological consultation.

CONCLUSION

Our data suggest that there was a high risk of PTSSs among university students and a high level of unmet mental health needs during the COVID-19 pandemic. The delivery of mental health services online or via telephone is a promising approach to address these unmet needs.

Mediating role of self-esteem in the relationship between parental disapproval of the child and alexithymic personality

BACKGROUND

Alexithymia is defined as difficulties in identifying, expressing, and understanding emotions. An unapproving environment during childhood is defined as the child not receiving emotional approval from their parents, being punished, or having their emotions devalued. The formation of self-esteem is shaped by the influence of parental behavior during childhood. The communication that the child establishes with their parents contributes to their increased self-esteem and sense of importance. The absence of this may play a role in developmental psychopathology.

AIM

To examine the mediating role of self-esteem in the relationship between a disapproving environment in childhood and alexithymia.

METHODS

The research in the relational screening model was conducted with 404 participants. Demographic Information Form, Disapproving Environment Scale in Childhood, Toronto Alexithymia Scale, and Rosenberg Self-Esteem Scale were used as data collection tools. Hayes' bootstrapping technique was used in the analysis of the data obtained from the research.

RESULTS

As a result of the analyses, parental disapproval positively predicted the level of alexithymia (rmother = 0.51, rfather = 0.52, P < 0.05) and negatively predicted self-esteem (rmother = -0.75, rfather = -0.67, P < 0.05). Additionally, self-esteem negatively predicted alexithymia (r = -0.58, P < 0.05). It was observed that self-esteem had a partial mediating effect on the relationship between parental disapproval and alexithymia. Family types were analyzed separately as chaotic, approving, perfect, and typical. Of these, the chaotic family type positively predicted alexithymia (r = 0.33, P < 0.05) and negatively predicted self-esteem (r = -0.60, P < 0.05). The approving family type negatively predicted alexithymia (r = -0.43, P < 0.05) and positively predicted self-esteem (r = 0.61, P < 0.05). The perfect family type negatively predicted alexithymia (r = -0.27, P < 0.05) and positively predicted self-esteem (r = -0.45, P < 0.05).

CONCLUSION

The type of family in which the child grows up in and parental disapproval during childhood affected the child's self-esteem and caused alexithymic personality traits.

Non-suicidal self-injury risk among left-behind children and adolescents in China: A systematic review and meta-analysis

BACKGROUND

Increasing evidence has shown an increased risk of non-suicidal self-injury (NSSI) in left-behind children and adolescents (LBCAs). However, a systematic summary of studies comparing the risk of NSSI between LBCAs and non-LBCAs in China is lacking.

AIM

To investigate the risk of NSSI among LBCAs in China.

METHODS

We performed a systematic search of Embase, PubMed, and Web of Science from initiation to October 25, 2024, for all relevant studies of NSSI and LBCAs. The effect sizes were reported as odds ratios (ORs) with 95% confidence intervals (CI). Sensitivity analyses were conducted to further confirm the stability of the findings.

RESULTS

A total of 10 studies with 165276 children and adolescents were included in this study. LBCAs had significantly higher rates of NSSI compared with non-LBCAs (OR = 1.33, 95%CI: 1.19-1.49), with high heterogeneity observed (I 2 = 77%, P < 0.001). Further sensitivity analyses were consistent with the primary analysis (OR = 1.29, 95%CI: 1.21-1.39, I 2 = 0%).

CONCLUSION

LBCAs are found to be at an increased risk of NSSI compared with children and adolescents of non-migrants. More attention and intervention are urgently needed for LBCAs, especially those living in developing countries.

Factors influencing vaginal cuff dehiscence after laparoscopic hysterectomy and the psychological state of the patients

BACKGROUND

Despite laparoscopic total hysterectomy provided more benefits to patients and has become one of the most commonly used surgical methods for total hysterectomy. However, vaginal cuff dehiscence is a serious complication after laparoscopic total hysterectomy and so far, there are limited studies on vaginal cuff dehiscence after a total hysterectomy.

AIM

To investigate the factors influencing vaginal cuff dehiscence after laparoscopic hysterectomy and the psychological state of the patients.

METHODS

This study retrospectively, univariately, and multivariately analyzed the clinical data of patients who experienced vaginal cuff dehiscence after laparoscopic hysterectomy in Yuyao People's Hospital from January 2015 to December 2021. Logistic regression was utilized to analyze the high-risk factors of vaginal cuff dehiscence.

RESULTS

Among 1459 cases with laparoscopic hysterectomy, 9 reported vaginal cuff dehiscence postoperatively, with an incidence of 0.617%. Univariate logistic regression analysis revealed that preoperative hemoglobin value [odds ratio (OR) = 5.12, P = 0.016], vaginal cuff suture method (OR = 0.26, P = 0.048), and postoperative first sexual lifetime (OR = 15.86, P = 0.002) were associated with vaginal cuff dehiscence following laparoscopic hysterectomy. Multivariate logistic regression analysis revealed that preoperative hemoglobin value of < 90 g/L (OR = 5.17, P = 0.015) and time interval between postoperative first sexual life and operation of < 3 months (OR = 54.00, P = 0.004) are independent risk factors for vaginal cuff dehiscence after laparoscopic hysterectomy.

CONCLUSION

Postoperative hemoglobin and the time interval between postoperative first sexual life and operation were the independent factors of developing vaginal cuff dehiscence after laparoscopic hysterectomy.

Bibliometric analysis of research in epilepsy and comorbid depression from 2014 to 2023

BACKGROUND

Epilepsy and depression have complicated bidirectional relationships. Our study aimed to explore the field of epilepsy comorbid with depression in a bibliometric perspective from 2014-2023.

AIM

To improve our understanding of epilepsy and depression by evaluating the relationship between epilepsy and depression, bibliometric analyses were performed.

METHODS

Epilepsy and depression-related publications from the last decade were retrieved from the Web of Science Core Collection. We conducted bibliometric and visual analysis using VOSviewer and CiteSpace, examining authorships, countries, institutions, journals of publication, co-citations of references, connections between keywords, clusters of keywords, and keywords with citation bursts.

RESULTS

Over the past ten years, we collected 1045 research papers focusing on the field of epilepsy and comorbid depression. Publications on epilepsy and depression have shown a general upward trend over time, though with some fluctuations. The United States, with 287 articles, and the University of Melbourne, contributing 34 articles, were the top countries and institutions, respectively. In addition, in the field of epilepsy and depression, Professor Lee, who has published 30 articles, was the most contributing author. The hot topics pay attention to the quality of life in patients with epilepsy and depression.

CONCLUSION

We reported that quality of life and stigma in patients with epilepsy comorbid with depression are possible future hot topics and directions in the field of epilepsy and depression research.

Who can benefit more from its twelve-week treatment: A prospective cohort study of blonanserin for patients with schizophrenia

BACKGROUND

Blonanserin (BNS) is a well-tolerated and effective drug for treating schizophrenia.

AIM

To investigate which types of patients would obtain the most benefit from BNS treatment.

METHODS

A total of 3306 participants were evaluated in a 12-week, prospective, multicenter, open-label post-marketing surveillance study of BNS. Brief psychiatric rating scale (BPRS) scores were calculated to evaluate the effectiveness of BNS, and its safety was assessed with the incidence of adverse drug reactions. Linear regression was used to screen the influencing factors for the reduction of BPRS total score, and logistic regression was used to identify patients with a better response to BNS.

RESULTS

The baseline BPRS total score (48.8 ± 15.03) decreased to 27.7 ± 10.08 at 12 weeks (P < 0.001). Extrapyramidal symptoms (14.6%) were found to be the most frequent adverse drug reactions. The acute phase, baseline BPRS total score, current episode duration, number of previous episodes, dose of concomitant antipsychotics, and number of types of sedative-hypnotic agents were found to be independent factors affecting the reduction of BPRS total score after treatment initiation. Specifically, patients in the acute phase with baseline BPRS total score ≥ 45, current episode duration < 3 months, and ≤ 3 previous episodes derived greater benefit from 12-week treatment with BNS.

CONCLUSION

Patients in the acute phase with more severe symptoms, shorter current episode duration, fewer previous episodes, and a lower psychotropic drug load derived the greatest benefit from treatment with BNS.

Investigation and analysis of negative emotion in patients with diabetic retinopathy after vitrectomy

BACKGROUND

As the incidence of diabetes continues to increase, the number of patients with diabetic retinopathy (DR) also increases each year. After undergoing vitrectomy for DR, patients often experience negative emotional problems that negatively affect their recovery.

AIM

To investigate negative feelings in patients with DR after vitrectomy and to explore related influencing factors.

METHODS

A total of 146 individuals with DR who were accepted for treatment at The Third People’s Hospital of Changzhou from May 2021 to April 2023 were recruited to participate in this study. All patients underwent vitrectomy. The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the degree of anxiety and depression 2-3 days after the operation. The participants were divided into a healthy control group and a negative emotion group. The patients’ general demographic characteristics and blood glucose levels were collected. Logistic regression analysis was used to analyze the factors influencing negative feelings post-operation. Pearson’s correlation coefficient was used to analyze the association between SAS scores, SDS scores, and blood glucose levels.

RESULTS

The control group included 85 participants. The negative emotion group comprised 40 participants with anxiety, 13 with depression, and eight with both. Logistic regression showed that being female (OR = 3.090, 95%CI: 1.217-7.847), a family per capita monthly income of < 5000 yuan (OR = 0.337, 95%CI: 0.165-0.668), and a longer duration of diabetes (OR = 2.068, 95%CI: 1.817-3.744) were risk factors for negative emotions in patients with DR after vitrectomy (P < 0.05). The concentrations of fasting plasma glucose (FPG), 2-hour postprandial glucose (2hPG), and glycated hemoglobin (HbA1c) in the negative emotion group exceeded those in the control group (P < 0.05). SAS scores were positively associated with FPG (r = 0.422), 2hPG (r = 0.334), and HbA1c (r = 0.362; P < 0.05). SDS scores were positively correlated with FPG (r = 0.218) and 2hPG (r = 0.218; P < 0.05).

CONCLUSION

Sex, income level, and duration of diabetes were factors that influenced negative emotions post-vitrectomy. Negative emotions were positively correlated with blood glucose levels, which can be used to develop intervention strategies.

Psychological consistency network characteristics and influencing factors in patients after percutaneous coronary intervention treatment

BACKGROUND

A psychological sense of coherence (SOC) in percutaneous coronary intervention (PCI) patients is important for disease prognosis, and there is considerable variation between their symptoms. In contrast, network analysis provides a new approach to gaining insight into the complex nature of symptoms and symptom clusters and identifying core symptoms.

AIM

To explore the psychological coherence of symptoms experienced by PCI patients, we aim to analyze differences in their associated factors and employ network analysis to characterize the symptom networks.

METHODS

A total of 472 patients who underwent PCI were selected for a cross-sectional study. The objective was to investigate the association between general patient demographics, medical coping styles, perceived stress status, and symptoms of psychological coherence. Data analysis was conducted using a linear regression model and a network model to visualize psychological coherence and calculate a centrality index.

RESULTS

Post-PCI patients exhibited low levels of psychological coherence, which correlated with factors such as education, income, age, place of residence, adherence to medical examinations, perceived stress, and medical coping style. Network analysis revealed that symptoms within the sense of psychological coherence were strongly interconnected, particularly with SOC2 and SOC8, demonstrating the strongest correlations. Among these, SOC10 emerged as the symptom with the highest intensity, centrality, and proximity, identifying it as the most central symptom.

CONCLUSION

The network model has strong explanatory power in describing the psychological consistency symptoms of patients after PCI, identifying the central SOC symptoms, among which SOC10 is the key to overall SOC enhancement, and there is a strong positive correlation between SOC2 and SOC8, emphasizing the need to consider the synergistic effect of symptoms in intervention measures.

Effects of suggestion therapy on mood and sleep quality in middle-aged women with depression

BACKGROUND

Depression is one of the most common mental disorders, with high rates of disability, particularly among women.

AIM

To explore the effects of suggestion therapy on anxiety, mood, and sleep-quality in middle-aged women with depression treated with escitalopram.

METHODS

Overall, 102 female patients with depression aged 35-49 years were divided into control and experimental groups. The control group received oral escitalopram therapy, starting at a dose of 5 mg/day, which was gradually increased to 10-20 mg/day after 1 week for a total of 8 weeks. The experimental group received the suggested therapy based on the control group. The Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Profile of Mood States-Short Form, and Pittsburgh Sleep Quality Index (PSQI) were used to assess depression, anxiety, mood status, and sleep quality.

RESULTS

Before treatment, there were no significant differences in the SDS, SAS, Profile of Mood States, and PSQI scores between the two groups (P > 0.05). After treatment, compared to the control group and baseline, the SDS, SAS, tension-anxiety, depression-dejection, and confusion-bewilderment scores in the experimental group significantly decreased (P < 0.05), whereas sleep efficiency, sleep disturbance, hypnotics, and PSQI scores significantly increased (P < 0.05).

CONCLUSION

Suggestion therapy combined with escitalopram treatment can reduce the severity of depression and anxiety, change mood status, and improve sleep quality in middle-aged women with depression.

Can decoding the complex web of non-suicidal self-injury in adolescents pave the way for tailored interventions?

Non-suicidal self-injury (NSSI) is a prevalent and concerning issue in adolescent mental health, often intertwined with depressive symptoms. Despite extensive research on NSSI, a comprehensive understanding of its multifaceted nature and the intricate interplay of risk and resilience factors remains crucial. This Letter to the Editor examines a novel study by Yang et al, which utilized latent profile analysis and network analysis to delineate distinct NSSI subtypes within a Chinese adolescent population and investigate the underlying dynamics of associated factors. The study identifies three distinct NSSI subtypes: NSSI with depression, NSSI without depression, and neither, underscoring bullying as a prominent risk factor. Concurrently, the findings emphasized the pivotal role of emotional regulation and family support as protective factors. The focus of this article is to contextualize these findings within the broader framework of adolescent mental health and to highlight their implications for developing targeted interventions. These insights not only advance our understanding of adolescent NSSI but also provide a foundation for the development of targeted interventions that address the identified risk and protective factors. By focusing on these critical areas, mental health professionals can implement more effective strategies to mitigate NSSI behaviors and cultivate resilience in this vulnerable population.

Influence of preoperative comprehensive education on anxiety, depression, pain, and sleep in elderly patients operated under general anesthesia

BACKGROUND

Owing to the particularities of their physical characteristics, older patients undergoing surgery under general anesthesia experience great surgical traumas. Thus, exploring more refined and individualized nursing approaches is an urgent need to mitigate the negative effects of surgery on such patients.

AIM

To analyze the influence of preoperative comprehensive education on anxiety, depression, pain, and sleep in older patients who underwent surgery under general anesthesia.

METHODS

In total, 163 older adults who underwent surgery under general anesthesia between June 2022 and November 2023 were selected, 77 of them received routine nursing care (control group), and 86 received preoperative comprehensive education (research group). Subsequently, comparative analyses were performed from the following perspectives: Surgical indicators (operation time, time to complete regain of consciousness, and temperature immediately after the procedure and upon recovery from anesthesia) before and after nursing care; negative emotions [self-rating anxiety scale (SAS)/self-rating depression scale (SDS)]; pain severity [visual analog scale (VAS)]; sleep quality [Pittsburgh sleep quality index (PSQI)]; incidence of sleep disturbances (difficulties in falling asleep for the first time, falling asleep again after waking up frequently at night, falling asleep again after waking up early, and falling asleep all night); and incidence of adverse events (airway obstruction, catheter detachment, aspiration, and asphyxia).

RESULTS

The research group had significantly lower operation time and time to complete regain of consciousness than the control group after nursing care and markedly better recovery of postoperative body temperature and body temperature at awakening. In addition, more notable decreases in SAS, SDS, VAS, and PSQI scores were observed in the research group than in the control group. Furthermore, the incidence rate of sleep disturbance (8.14% vs 29.87%) and adverse events (4.65% vs 19.48%) were lower in the research group than in the control group.

CONCLUSION

Preoperative comprehensive education in older patients who underwent surgery under general anesthesia can improve postoperative indicators, effectively reduce the occurrence of anxiety and depression, alleviate postoperative pain, and improve sleep quality.

Challenges in the management of visual and tactile hallucinations in elderly people

This letter provides a concise review of the pertinent literature on visual and tactile hallucinations in elderly patients. The discussion addresses differential diagnoses and potential underlying mechanisms, as well as the psychopathology associated with tactile hallucinations, and emphasizes the necessity for investigation into the possibility of coexisting delusional infestation (parasitosis). These symptoms frequently manifest in patients with primary psychotic disorders, organic mental disorders, and substance use disorders. The proposed pathophysiological mechanisms may involve dopaminergic imbalances and dysfunction of the striatal dopamine transporter.

Catatonia: “Fluctuat nec mergitur”

In the beginning of the 1900s, the prevalence of catatonia in inpatient samples was reported to be between 19.5% and 50%. From the mid-1900s, most clinicians thought that catatonia was disappearing. Advances in medical sciences, particularly in the field of neurology, may have reduced the incidence of neurological diseases that present with catatonic features or mitigated their severity. More active pharmacological and psychosocial treatment methods may have either eliminated or moderated catatonic phenomena. Moreover, the relatively narrow descriptive features in modern classifications compared with classical texts and ascribing catatonic signs and symptoms to antipsychotic-induced motor symptoms may have contributed to an apparent decline in the incidence of catatonia. The application of catatonia rating scales introduced in the 1990s revealed significantly more symptoms than routine clinical interviews, and within a few years, the notion of the disappearance of catatonia gave way to its un-expected resurgence. Several systematic investigations have found that, on average, 10% of acute psychotic patients present with catatonic features. In this editorial, the changes in the incidence of catatonia and the possible underlying causes are reviewed.

Clinical, scientific and stakeholders’ caring about identity perturbations

In this editorial we comment on the article by Zhang et al published in the recent issue of the World Journal of Psychiatry. We focus on identity diffusion, identity perturbations, their origin and developmental pathways. This is an upcoming problem in the society as not only school children are affected. Adolescents and young people suffer from uncertainty in gender identity, in self-image, migration effects due to chronic crises caused by war, pandemic disruptions or climate change. We show how such chronic uncertainty can be cared for, treated, and contained. The key is affective holding, reflection and to provide adequate affective mentalizing in a close concomitant way. These key features also depend on ambient conditions, such as psychotherapeutic care. In a qualitative interview study carried out in a cyclical research design with a comparative analysis on the basis of thematic coding using Grounded Theory Methodology we found institutionalized defenses in health policies. Professionals request better training and adequat academic knowledge as well as research into unresolved areas for improvement of the ambient conditions for adequat development of the self. Practice points for further clinical and scientific development are given and discussed.

Effectiveness and safety of blonanserin monotherapy for first-episode schizophrenia with and without prominent negative symptoms: A prospective study

BACKGROUND

Blonanserin, a novel antipsychotic, has demonstrated efficacy in treating both positive and negative symptoms. However, limited research exists on its dose-dependent effectiveness and safety in patients with and without prominent negative symptoms (PNS).

AIM

To evaluate the effectiveness and safety of blonanserin monotherapy for first-episode schizophrenia in real-world clinical settings and to explore the efficacy and safety of different doses of blonanserin for patients with PNS and without PNS.

METHODS

A 12-week, multicenter, prospective post-marketing surveillance was conducted. In this study, we included patients with first-episode schizophrenia who received blonanserin monotherapy. Patients were divided into those with PNS and without PNS, based on the Brief Psychiatric Rating Scale (BPRS) negative symptoms subscale scores. Additionally, patients were labeled as high-dose and low-dose groups according to the maximum daily dose they received. Effectiveness was assessed using the BPRS, and safety was evaluated through the incidence of adverse drug reactions (ADRs).

RESULTS

A total of 653 patients were included in the analysis, with 613 completing the study. The BPRS total score decreased significantly from 47.94 ± 16.31 at baseline to 26.88 ± 9.47 at 12 weeks (P < 0.001). A significant interaction of PNS × dose × time was observed for BPRS total scores (F = 3.47, P = 0.040) and negative symptom subscale scores (F = 6.76, P = 0.002). In the PNS group, the high-dose group showed greater reductions in BPRS total scores (P = 0.001) and negative symptom subscale scores (P = 0.003) than the low-dose group in week 12. In the without PNS group, no significant difference was observed between the high-dose and low-dose groups at any visit. Most adverse reactions were mild or moderate, with extrapyramidal symptoms (9.3%) being most common; 1.5% of patients gained ≥ 7% body weight at 12 weeks.

CONCLUSION

Blonanserin effectively alleviated the clinical symptoms of first-episode schizophrenia with an acceptable safety profile. High-dose blonanserin is particularly beneficial for patients with PNS in the acute phase of first-episode schizophrenia. However, due to the limitation of ADR reporting the real world, the ADR incidence observed in this study may be underestimated.

Global research trends and mapping knowledge structure of depression in dialysis patients

BACKGROUND

Depression is one of the most common and important psychological issues faced by dialysis patients. It can make it more difficult for them to adhere to their treatment regimen, which, in turn, can worsen their physical symptoms and lead to poorer health outcomes.

AIM

To examine the evolution and growth of publications related to dialysis and depression. The objectives were to identify the number of publications, the top active countries, the contributed institutions, funding agencies and journals, as well as to perform citation and research theme analysis.

METHODS

The search was conducted using the Scopus database for publications related to dialysis and depression between 1970 and 2022. Subsequently, bibliometric analysis was carried out on the data obtained using VOSviewer software, version 1.6.9. This analysis included visualization analysis, co-occurrence analysis and examination of publication trends in dialysis and depression.

RESULTS

We identified 800 publications that met the search criteria. The number of publications related to dialysis and depression has increased significantly in the past two decades. The USA led the way with 144 publications, which is 18% of all publications on this topic. Turkey came second with 88 publications (11%), followed by China with 55 publications (6.88%) and Iran with 52 publications (6.5%). Analysis of the research theme identified three main clusters related to gender differences in prevalence, identification of depression as a risk factor, and effective interventions to relieve depression. Future research direction analysis shows a shift toward effective interventions to relieve depression in dialysis patients.

CONCLUSION

This study provides a comprehensive overview of growth, trends and research themes related to dialysis and depression that could help researchers identify gaps in the literature and develop future research.

Enhancing autism care through remote support: A family-centered approach

Autism spectrum disorder (ASD) poses significant challenges for families, with limited access to specialized care being a critical concern. The coronavirus disease 2019 pandemic has accelerated the adoption of remote support, highlighting its potential to enhance family-centered care for children with ASD. In this editorial, we comment on the article by Lu et al, emphasizing the effectiveness of integrating remote support courses with traditional caregiver-mediated interventions. We further explore the benefits of remote support in delivering family-centered care, summarize the essential components of effective family-centered remote support, outline key considerations for implementation, and discuss potential future research directions. We conclude that family-centered remote support has the potential to significantly improve outcomes and quality of life for individuals with ASD and their families.

Relationship between inflammatory factors, lactic acid levels, acute skin failure, bad mood, and sleep quality

BACKGROUND

The central link between septic shock and acute skin failure (ASF) is the inflammatory response, which occurs throughout disease progression and can lead to systemic inflammatory response syndrome. Patients often experience bad moods, sleep disorders, and other health issues. Despite recognizing these factors, no studies have examined the correlation between inflammatory factors, lactic acid levels, ASF, mood disturbances, and sleep quality in critically ill patients. We hypothesize that higher levels of inflammatory factors and lactic acid are associated with more severe ASF and poorer mood and sleep quality, which may inform clinical treatment for septic shock and ASF.

AIM

To explore the relationship between inflammatory factors, lactic acid levels, the severity of ASF, bad mood, and sleep quality.

METHODS

The retrospective study included 150 patients with septic shock from the Second Hospital of Dalian Medical University, categorized into ASF (n = 35) or non-ASF groups (n = 115). We compared the peripheral blood inflammatory factors, including tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), interleukin-6 (IL-6), lactic acid levels, skin mottling score (SMS), modified early warning score (MEWS), self-rating depression scale (SDS), self-rating anxiety scale (SAS), and Pittsburgh sleep quality index (PSQI) scores. Pearson correlation analysis assessed relationships among these variables.

RESULTS

The ASF group had significantly higher levels of CRP (19.60 ± 4.10 vs 15.30 ± 2.96 mg/mL), IL-6 (298.65 ± 48.65 vs 268.66 ± 33.66 pg/L), procalcitonin, lactic acid (8.42 ± 2.32 vs 5.70 ± 1.27 mmol/L), SMS [0 (0, 1) vs 3 (2, 3)], MEWS (9.34 ± 1.92 vs 6.48 ± 1.96), SAS (61.63 ± 12.03 vs 53.71 ± 12.48), SDS (60.17 ± 12.64 vs 52.27 ± 12.64), and PSQI scores (14.23 ± 3.94 vs 8.69 ± 2.46) compared with the non-ASF group (all P < 0.001). Pearson correlation analysis revealed that IL-6, CRP, TNF-α, and lactic acid were positively correlated with SMS, MEWS, SAS, SDS, and PSQI scores (P < 0.05).

CONCLUSION

Peripheral blood levels of IL-6, CRP, TNF-α, and lactic acid correlate positively with SMS, MEWS, SAS, SDS, and PSQI in critically ill patients with ASF.

Anxiety, depression, and coping styles among cervical cancer patients during radiotherapy and their correlations with uncertainty in illness

BACKGROUND

Currently, there is limited research examining the relationship between anxiety, depression, coping styles, and illness uncertainty in patients with cervical cancer (CC) undergoing radiotherapy. Addressing this gap could provide valuable insights and more reliable evidence for clinical practice targeting this patient population.

AIM

To analyze the anxiety, depression, and coping styles of patients with CC undergoing radiotherapy and explore their correlations with illness uncertainty.

METHODS

A total of 200 patients with CC undergoing radiotherapy at The First Affiliated Hospital of Soochow University between June 2018 and June 2022 were enrolled. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), comprising subscales for anxiety (HADS-A) and depression (HADS-D). Coping styles were evaluated using the Jalowiec Coping Scale (JCS-60), comprising dimensions such as confrontive, evasive, optimistic, fatalistic, emotive, palliative, supportive, and self-reliant. Illness uncertainty was measured using the Mishel Uncertainty in Illness Scale (MUIS), encompassing ambiguity, complexity, information deficit, and unpredictability. Correlations among anxiety, depression, coping styles, and illness uncertainty were analyzed.

RESULTS

During radiotherapy, the mean scores were 7.12 ± 3.39 for HADS-A, 6.68 ± 3.49 for HADS-D, 1.52 ± 0.23 for JCS-60, and 93.40 ± 7.44 for MUIS. Anxiety (HADS-A ≥ 8) was present in 39.5% of patients, depression (HADS-D ≥ 8) in 41.0%, and both in 14.0%. Anxiety was significantly positively correlated with ambiguity, unpredictability, and total MUIS score (P < 0.05). Depression was significantly positively correlated with ambiguity, information deficit, unpredictability, and total MUIS score (P < 0.05). Most patients adopted an optimistic coping style, whereas the emotive style was least utilized. Evasive, fatalistic, and emotive coping styles were significantly positively correlated with illness uncertainty, whereas the self-reliant style was significantly negatively correlated with unpredictability (P < 0.05).

CONCLUSION

Anxiety, depression, and coping styles in patients with CC undergoing radiotherapy correlate significantly with their level of illness uncertainty. Medical staff should address patients' psychological status and coping strategies by providing targeted information to reduce negative emotions, foster adaptive coping styles, and decrease illness uncertainty.

Molecular typing of familial temporal lobe epilepsy

The pathogenesis of temporal lobe epilepsy (TLE) was originally considered to be acquired. However, some reports showed that TLE was clustered in some families, indicating a genetic etiology. With the popularity of genetic testing technology, eleven different types of familial TLE (FTLE), including ETL1-ETL11, have been reported, of which ETL9-ETL11 had not yet been included in the OMIM database. These types of FTLE were caused by different genes/Loci and had distinct characteristics. ETL1, ETL7 and ETL10 were characterized by auditory, visual and aphasia seizures, leading to the diagnosis of familial lateral TLE. ETL2, ETL3 and ETL6 showed prominent autonomic symptom and automatism with or without hippocampal abnormalities, indicating a mesial temporal origin. Febrile seizures were common in FTLEs such as ETL2, ETL5, ETL6 and ETL11. ETL4 was diagnosed as occipitotemporal lobe epilepsy with a high incidence of migraine and visual aura. Considering the diversity and complexity of the symptoms of TLE, neurologists enquiring about the family history of epilepsy should ask whether the relatives of the proband had experienced unnoticeable seizures and whether there is a family history of other neurological diseases carefully. Most FTLE patients had a good prognosis with or without anti-seizure medication treatment, with the exception of patients with heterozygous mutations of the CPA6 gene. The pathogenic mechanism was diverse among these genes and spans disturbances of neuron development, differentiation and synaptic signaling. In this article, we describe the research progress on eleven different types of FTLE. The precise molecular typing of FTLE would facilitate the diagnosis and treatment of FTLE and genetic counseling for this disorder.