Journal of Surface Investigation

Background Depression is prevalent among individuals with chronic kidney disease (CKD) and those undergoing dialysis, with significant impacts on morbidity and mortality. This systematic review and meta-analysis was done to evaluate the efficacy of psychosocial interventions in managing depressive symptoms in patients with CKD. Methods This systematic review and meta-analysis adhered to PRISMA guidelines. A literature search was conducted across PubMed, Embase, Google Scholar, and Cochrane Library databases from January 2007 to July 2024. Randomized controlled trials (RCTs) investigating psychosocial interventions in CKD patients (Stage 4 or 5 or on hemodialysis) were included. The primary outcome was the change in depressive symptoms, measured by standardized clinical tools. Quality of life was a secondary outcome. Data extraction and bias assessment were conducted using ROB-2 and GRADEpro GDT tools. Results Twelve studies with a total of 792 participants (420 in the intervention group and 372 in the control group) were included. Cognitive-behavioral therapy (CBT) was the most common intervention. Psychosocial interventions significantly reduced depressive symptoms compared to routine care (mean difference [MD]: −4.22; 95% CI: −6.67, −1.76; P = 0.0008). High heterogeneity (I2 = 89%) was noted. Sensitivity analysis confirmed the robustness of the results. The impact on quality of life was not statistically significant (MD: 0.94; 95% CI: −0.61, 2.49; P = 0.24). Conclusions Moderate-quality evidence suggests that psychosocial interventions effectively reduce depressive symptoms in CKD patients. While no significant improvement in quality of life was observed, these interventions provide an alternative to pharmacological treatments, potentially minimizing drug-related side effects.

Objective Tramadol is a synthetic opioid widely used in clinical practice to treat moderate to severe pain. While it is considered safer than traditional opioids, growing concerns have emerged regarding its adverse psychological effects. This systematic review examined tramadol-induced psychological side effects, identified risk factors, and evaluated possible underlying mechanisms that might help to guide safer clinical use. Methods A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar using the related keywords of tramadol and psychological effects. This review primarily focused on case reports, which were included if they provided detailed accounts of tramadol-induced mental health side-effects. Two independent reviewers screened the studies, and data was extracted on patient demographics, details of tramadol usage, psychological outcomes, and risk factors. The quality of the case reports was assessed using the Joanna Briggs Institute (JBI) scale. Results The review found that tramadol is associated with a range of psychological symptoms, including manic episodes, hypomania, serotonin syndrome, psychosis, and cognitive impairment. Risk factors included age, pre-existing psychiatric conditions, polydrug use, and prolonged tramadol use. Elderly individuals and those with psychiatric histories were particularly vulnerable. Conclusion Tramadol has the potential to cause serious psychological side effects, prompting cautious prescription, especially in vulnerable populations. Clinicians should closely monitor patients for these adverse effects, and further research is needed to understand the mechanisms involved and to reduce the psychological site-effects resulting from tramadol use.

Objective Alcohol withdrawal syndrome poses a significant health burden worldwide, with its prevalence steadily rising in countries like India due to high rates of alcohol use disorders. The treatment landscape for alcohol withdrawal syndrome is evolving with the introduction of bromocriptine offering a promising adjunctive treatment for patients resistant to standard benzodiazepine therapy. Methods We report two cases from India of severe alcohol withdrawal syndrome successfully treated with bromocriptine. Results There were clinically significant improvements in both patients with regard to Alcohol Withdrawal Symptoms in a relatively short time span. Conclusions Bromocriptine represents an addition to the therapeutic options for alcohol withdrawal syndrome management, offering symptom relief, improving clinical outcomes, and addressing the neuropsychiatric burden associated with the condition.

Objective There is only limited research on suicidal thoughts and behaviors of oncologists. This study examined the prevalence and correlates of suicidal thoughts among oncologists in Serbia. Method A cross-sectional study was conducted in January 2024 involving 159 oncologists from Serbia and the Republic of Srpska. Respondents completed an online questionnaire which assessed socio-demographic and work characteristics and included the Risk Assessment Suicidality Scale, Depression Anxiety Stress Scale-21, Maslach Burnout Inventory, and Brief Resilience Scale. Results Results indicated that 21.4% of oncologists reported elevated suicidality scores. Medical oncologists had the highest average suicidality scores compared to surgical and radiation oncologists, although these differences were not statistically significant. Key associated factors with suicidality included seeing a psychiatrist, undergoing psychiatric therapy, having family history of depression, and family history of suicide attempts and/or suicide. Resilience and sense of personal accomplishment were inversely associated with suicidality. Conclusions The finding that 1 out of 5 oncologists had elevated suicidality scores underscores the urgent need for mental health support for members of this profession, particularly those showing signs of distress. Interventions should promote resilience, enhance personal accomplishment, and ensure easy access to psychiatric care. While these results contribute to the limited data on suicidality among oncologists, they also identify gaps that future studies should address, such as the need for larger sample sizes and the exploration of other potential risk factors. Addressing oncologists’ mental health challenges is critical to reducing suicide risk and fostering well-being in this high-risk profession.

Objectives To assess the efficacy of escitalopram combined with quetiapine vs quetiapine alone in the treatment of depressive episodes of bipolar disorder (BPD). Methods 88 hospitalized patients with a BPD depressive episode were recruited into the study. All patients were randomized to a control group (n = 44) or the intervention group (n = 44). Members of the control group received quetiapine fumarate alone, with an initial dose 50 mg/time twice/day; the dose was increased by 50-100 mg daily until 300-600 mg/d was reached. The treatment group received quetiapine at the same doses plus escitalopram, with the initial dose of escitalopram 10 mg/d, adjusting the dose to 20 mg/d after 1 week. Both groups were treated for 8 weeks. The scores on the Hamilton Depression Scale (HAMD) and Young Mania Rating Scale (YMRS), along with levels of IL-6, IL-1β, MIF, SOD, CAT, MDA and GSH-Px, were compared between groups. Results Among those in the intervention group, 88.6% of participants experienced a 50% or greater reduction in HAMD score compared to 70.5% in the control group ( P < .05). Participants in the intervention group also experienced a significantly greater reduction in IL-6, IL-1β, MIF and MDA levels ( P < .05), and a significant increase in SOD, CAT and GSH-Px levels compared to the control group ( P < .05). Conclusion Escitalopram oxalate combined with quetiapine is more effective than quetiapine alone in the treatment of patients with bipolar depressive episodes, which can effectively improve the symptoms of depression, inhibit the body’s inflammatory response, regulate the state of oxidative stress, and does not increase the risk of mania.

Objective Despite the well-established increased risk of cardiovascular mortality in individuals with bipolar disorder (BD), prevention and treatment of cardiovascular risk factors and diseases have been largely overlooked in this population. This manuscript reviews the pathophysiological basis of the connection between BD and cardiovascular diseases, highlighting their shared mechanisms, reciprocal interactions, and relevant prevention and treatment strategies. Methods For this narrative review, a search was carried out on PubMed using the keywords bipolar disorder, cardiovascular diseases, and cardiovascular risk factors. Results The increased frequency of cardiovascular morbidity in BD can be attributed to overlapping biological and psychosocial mechanisms. These mechanisms are complex and involve both direct effects of BD and indirect effects mediated by lifestyle and pharmacological factors. Cardiovascular diseases also significantly exacerbate the clinical course of BD and increase morbidity and healthcare costs; thus, their effective management can improve psychiatric outcomes and vice versa. However, patients with BD frequently encounter healthcare barriers. Conclusion Awareness initiatives and research on integrated care are needed to determine the best strategies for improving cardiovascular and psychiatric outcomes in individuals with BD.

Objective Although religious leaders play an important role in providing informal mental health care to individuals struggling to seek religious and spiritual care, existing studies have not explored the magnitude of psychiatric symptoms and motivators to seek mental health services from religious leaders in religious listening centers and mental hospitals. This paper presents preliminary data from a survey aimed at assessing psychiatric symptoms and factors associated with access to spiritual services among 151 individuals at a religious listening center, as well as to determine the pathways of care among 150 patients attending a mental health clinic in conflict zones of the Eastern Democratic Republic of the Congo. Method Three hundred and one participants were screened for psychiatric symptoms and factors motivating access to religious leaders using a semi-structured questionnaire. Descriptive analyses were performed to determine information on psychiatric symptoms and factors affecting access to spiritual and mental health services. Results Nearly 6 in 10 individuals seeking spiritual help in the religious center had psychiatric symptoms. Furthermore, 7 in 10 patients seek help for mental health needs from religious leaders and healers before seeking conventional mental health services; among such individuals, there was a high prevalence of bipolar disorder and schizophrenia spectrum disorder, recurrent admissions, and poor adherence to psychotropic medication. Conclusion These results highlight the need for greater integration of mental health services with care provided by religious organizations within conflict zones such as the Congo. They also emphasize the need for greater promotion of person-centered care that considers and integrates patients’ religious beliefs in their treatment.

Objective Functional seizures (FS) are a highly debilitating symptom of functional neurological disorder (FND). FS requires a multi-disciplinary approach to treatment because the patient’s initial presentation is to neurology, emergency medicine, or primary care and treatment consists of psychotherapy. People with FS commonly experience severe childhood trauma, particularly sexual trauma. The authors aimed to investigate associations between reported trauma and maladaptive coping mechanisms in the FS population. Methods This retrospective, observational study reports on 137 patients enrolled in the FS Clinic at the University of Colorado between March 2020 - March 2021. Multiple linear regression was used to reveal associations between self-reported childhood sexual and violent trauma and maladaptive coping mechanisms of self-blame and disengagement on the Brief COPE. A quantile regression was generated for each of these outcomes. Results Results showed that violent and sexual trauma were experienced by 47.5% and 61.6% of the population sample, respectively. Of those exposed to violent trauma, 27.2% perceived it as extremely severe while 43.4% of those exposed to sexual trauma perceived it as extremely severe. Quantile regressions for self-blame and disengagement showed significance for the 25th percentile of those who experienced violent trauma. Self-blame was significantly associated with the 50th and 75th percentile of those exposed to sexual trauma. Conclusions This evidence supports the value of identifying trauma experienced by individuals with FS as it is associated with specific coping mechanisms that may affect treatment. Identifying prior trauma and resulting coping mechanisms can potentially assist in individualizing care for people with FS.

Objective The purpose of this systematic review is to provide a detailed summary of the long-acting injectable antipsychotic medications approved by the Food and Drug Administration (FDA) between 2008 to October 2024. We aim to provide an overview of the mechanism of action, indications for both labeled and off-label uses, evidence for efficacy, dosing, and the adverse effects of each drug. Methods Studies published from 2008 to October 1, 2024, were identified from the PubMed database, using the keywords: ‘long-acting injectables’ OR ‘LAI*’AND ‘psychopharm*” OR ‘schizophrenia’ The authors conducted a focused analysis independently and reached a consensus on the recently approved long-acting injectable antipsychotic medications to be included in this systematic review. Key findings were derived from the full text in order to create the tables from selected studies. Results A total of 13 long-acting injectable antipsychotic medications for the treatment of schizophrenia were FDA-approved between 2008 and October 1, 2024. One long-acting injectable antipsychotic is currently being investigated in a Phase 3 clinical trial. The indications, evidence, practical implementation issues, and adverse effects of each drug are discussed in this review. Conclusion Improved understanding of newly approved long-acting injectables is critical in the management of patients with schizophrenia. The FDA approval of long-acting injectables in the past 15 years creates hopeful options for clinicians to improve clinical outcomes and quality of life for their patients.

Background Existing studies on the effects of physical activity on cognitive function have predominantly focused on pre- or post-exercise effects, leaving a gap in understanding the immediate cognitive impacts during physical exertion. Understanding cognitive performance during activity could have significant implications for improving productivity and therapeutic strategies. Methods This study examined the relationship between heart rate and cognitive performance, specifically attention, using the D2 attention test among 32 adolescents aged 12-18 years. Participants underwent attention assessments at rest and while moving at target heart rates of 100 bpm, 120 bpm, and 140 bpm. The influence of body mass index (BMI) and sleep quality on attention has been analysed too. Results A significant positive correlation between heart rate and attention was observed (r = 0.39, P < .005), indicating enhanced cognitive performance with increased heart rate. Furthermore, a significant negative correlation was found between BMI and attention (r = −0.37, P = .039) and a significant positive correlation was found between sleep quality and attention (r = 0.66, P = .014). Conclusion These findings suggest that moderate physical activity can enhance attention, which could inform the design of educational, therapeutic, and occupational strategies. Future research should explore the generalizability of these effects across different cognitive domains, age groups, and settings.

Objective This study aimed to evaluate the effects of the Bushen Yinao Pill, combined with standard therapy, on gut flora imbalances, inflammatory markers, and cognitive function in older patients with Alzheimer’s disease (AD). Methods A total of 136 AD patients treated at the Department of Neurology from August 2022 to September 2023 were randomly assigned to two groups: 68 patients received standard treatment (control group, CTG), and 68 patients received the Bushen Yinao Pill plus standard treatment (intervention group, ITG). Outcomes included TCM syndrome scores, gut microbiota composition, inflammatory markers, cognitive function, overall efficacy, and safety. Results ITG showed significant reductions in syndrome scores as compared to CTG after treatment ( P < 0.05). The ITG also showed significant increases in beneficial bacteria and decreases in harmful bacteria compared to the CTG ( P < 0.05). Inflammatory markers (Aβ, IL-6, TNF-α) were reduced, and cognitive function improved more significantly in the ITG ( P < 0.05). The effective rate was higher in the ITG, with no significant difference in adverse reactions between the groups ( P > 0.05). Conclusion The Bushen Yinao Pill, when combined with standard therapy, effectively regulates gut microbiota, reduces inflammatory markers, and enhances cognitive function in AD patients, showing a favorable safety profile. Further research is recommended to validate these findings in diverse populations.