Tag: Mood and emotional regulation

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<![CDATA[Why sleep checks matter in ADHD: spot apnea, executive dysfunction, and hidden ADHD behind treatment-resistant depression.]]>
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Latent profile analysis and associated factors of alexithymia among patients with chronic obstructive pulmonary disease

BackgroundAlexithymia is one of the most common psychological characteristics observed in patients with chronic obstructive pulmonary disease (COPD) and is associated with poorer health outcomes. The negative impact of alexithymia on physical illness is reflected in more severe clinical symptoms and poorer quality of life, which adversely affect clinical outcomes and further increase disease burden, potentially contributing to a cycle of worsening health status. Therefore, timely identification of the psychological characteristics of patients with COPD, along with early psychological support, may help improve the quality of life of patients with COPD.ObjectivesTo explore the latent profiles of alexithymia among patients with COPD and to analyze their associated factors.MethodsThis cross-sectional study recruited 312 patients with COPD using convenience sampling between October 2024 and March 2025. Sociodemographic characteristics, physiological and disease-related information, psychospiritual information, environmental factors, and alexithymia scores were collected. Latent profile analysis, univariate analysis, and multinomial logistic regression were conducted to identify alexithymia profiles and examine factors associated with profile membership.ResultsThe results of this study showed that patients with COPD were categorized into three alexithymia profiles: high (28.85%), moderate (63.46%), and low (7.69%). COPD duration, depression, activity intensity, self-perceived social support, psychological resilience, and anxiety were associated with different alexithymia profiles among patients with COPD.ConclusionThis single-center cross-sectional study identified three preliminary alexithymia profiles (high, moderate, and low) among patients with COPD. Due to potential selection bias resulting from convenience sampling, these findings require validation in multicenter studies before generalization. The observed associations among COPD duration, depression, activity intensity, social support, resilience, and anxiety provide empirical evidence to inform the development of tailored patient classification and targeted support strategies for early identification, with the goal of improving quality of life in this population.
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Cannabidiol Oil for Treatment-Resistant Major Depression

Conditions: Major Depressive Disorder (MDD); Treatment-resistant Depression (TRD)

Interventions: Drug: Full-spectrum CBD oil 100 mg/mL; Drug: Placebo oil (MCT oil)

Sponsors: Universidade do Sul de Santa Catarina; Federal University of Latin American Integration; Associação Cannabis Sem Fronteiras – ACSF

Recruiting
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<![CDATA[New Delphi consensus guides off-label IV ketamine for depression, detailing protocols and rapid antisuicidal mechanisms via neuroplasticity and BDNF.]]>
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<![CDATA[Consensus guidance clarifies IV ketamine dosing, monitoring, staffing and consent to support safer, evidence-based depression treatment.]]>
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Autistic- and attention-deficit/hyperactivity disorder-like traits: differential associations with burnout, depression and anxiety, and empathy among Japanese junior residents

IntroductionBurnout, depression, and anxiety are major concerns among physicians because they affect individual well-being, patient care, and healthcare systems. Neurodevelopmental traits, including autistic-like traits (ALTs) and attention-deficit/hyperactivity disorder (ADHD)-like traits (ADHLTs), may increase vulnerability to psychological distress. However, little is known about how these traits relate to burnout, depression and anxiety, and empathy among junior residents.MethodsIn this cross-sectional study, 148 junior residents from two teaching hospitals in Japan completed validated measures of ALTs (21-item Japanese version of the Autism-Spectrum Quotient), ADHLTs (Adult ADHD Self-Report Scale Screener), burnout (Maslach Burnout Inventory), depression and anxiety (Hospital Anxiety and Depression Scale), physician–patient empathy (Jefferson Scale of Physician Empathy), and psychological flexibility and inflexibility processes (Valuing Questionnaire, Cognitive Fusion Questionnaire-7, and Work-related Acceptance and Action Questionnaire). Associations were examined using multivariable logistic and linear regression analyses. Exploratory statistical mediation analyses using structural equation modeling examined indirect associations through psychological flexibility and inflexibility processes.ResultsThe prevalence of ALTs and ADHLTs was 23.6% for each trait. ALTs were associated with lower personal accomplishment, a burnout dimension; higher depression and anxiety; and lower physician–patient empathy. ADHLTs were associated with greater emotional exhaustion, another burnout dimension. In exploratory statistical mediation analyses, progress toward values, a core process of psychological flexibility, showed a significant indirect association between ALTs and personal accomplishment, and the direct association was attenuated and no longer statistically significant after including the process variables. Significant indirect associations through progress toward values were also observed for the associations of ALT with depression and anxiety and empathy. Cognitive fusion, a core process of psychological inflexibility, showed a significant indirect association between ADHLTs and emotional exhaustion. Overall, neurodevelopmental traits were associated with distinct patterns of psychological functioning, suggesting variability in both vulnerability and adaptive processes.DiscussionNeurodevelopmental traits such as ALTs and ADHLTs were significantly associated with burnout dimensions, depression and anxiety, and physician–patient empathy among junior residents. Psychological flexibility and inflexibility processes, particularly progress toward values and cognitive fusion, may be relevant to these associations. Process-based support strategies may warrant further investigation for residents with elevated neurodevelopmental traits.Clinical trial registrationhttps://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R00005, identifier UMIN000046897.
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Treating addiction with an addictive drug: the ketamine paradox revisited

BackgroundSubstance use disorders (SUDs) and treatment-resistant depression (TRD) remain a major global health challenge, marked by high relapse rates and limited long-term effectiveness of existing treatments. Ketamine, a glutamatergic modulator with rapid neuroplastic effects, has emerged as a novel intervention for TRD and is increasingly investigated as an adjunctive treatment for addiction, yet concerns about its abuse liability persist.ObjectiveThis review critically evaluates ketamine’s therapeutic potential for SUDs while examining its neurobiological mechanisms, clinical efficacy, and risk of misuse within a unified risk–benefit framework.MethodsA structured narrative review conducted in accordance with the SANRA framework using the PubMed, Scopus, PsycINFO, and Web of Science databases, covering literature published until March 2026. Eligible studies included clinical trials, experimental studies, and mechanistic investigations relevant to ketamine use in addiction and depression. Evidence was synthesized thematically across the domains of efficacy, mechanisms, and safety.ResultsAcross alcohol and cocaine use disorders, ketamine combined with psychotherapy has demonstrated promising reductions in craving and increases in abstinent days in small-to moderate-sized Phase 2 trials. However, findings remain difficult to generalize due to considerable variability in dosing strategies, comparator conditions, and follow-up periods. Effects on relapse prevention have been more inconsistent and less reliably positive. Mechanistically, ketamine promotes synaptic plasticity via NMDA receptor antagonism and downstream glutamatergic signaling, potentially disrupting maladaptive reward-related memories and reversing maladaptive neurocircuitry involved in both depression and addiction. While acute adverse effects are generally transient under clinical supervision, ketamine carries a well-established risk of misuse, particularly in unsupervised or high-dose settings.ConclusionsKetamine represents a promising but still experimental intervention for both refractory depression and selected SUDs. Its clinical use depends on careful patient selection, structured delivery, and integration with psychotherapy. Although ketamine may redefine treatment paradigms for TRD and addiction, larger-scale trials and long-term safety data are essential to define its role within psychiatric and addiction treatment frameworks.