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Comparative physiological effects of antipsychotic drugs in children and young people: a network meta-analysis
Rogdaki M, McCutcheon RA, D'Ambrosio E, Mancini V, Watson CJ, Fanshawe JB, Carr R, Telesia L, Martini MG, Philip A, Gilbert BJ, Salazar-de-Pablo G, Kyriakopoulos M, Siskind D, Correll CU, Cipriani A, Efthimiou O, Howes OD and Pillinger T
The degree of physiological responses to individual antipsychotic drugs is unclear in children and adolescents. With network meta-analysis, we aimed to investigate the effects of various antipsychotic medications on physiological variables in children and adolescents with neuropsychiatric and neurodevelopmental conditions.
Reduced nicotine in cigarettes in a marketplace with alternative nicotine systems: randomized clinical trial
Hatsukami DK, Jensen JA, Carroll DM, Luo X, Strayer LG, Cao Q, Hecht SS, Murphy SE, Carmella SG, Denlinger-Apte RL, Colby S, Strasser AA, McClernon FJ, Tidey J, Benowitz NL and Donny EC
Reducing cigarette addictiveness has the potential to avert millions of yearly tobacco-related deaths worldwide. Substantially reducing nicotine in cigarettes decreases cigarette consumption, but no large clinical trial has determined the effects of reduced-nicotine cigarettes when other nicotine-containing products are available. The aim of this study was to examine the effects of reduced-nicotine cigarettes in the context of the availability of alternative nicotine delivery systems.
Effects of the ActiveHip+ mHealth intervention on the recovery of older adults with hip fracture and their family caregivers: a multicentre open-label randomised controlled trial
Prieto-Moreno R, Mora-Traverso M, Estévez-López F, Molina-Garcia P, Ortiz-Piña M, Salazar-Graván S, Cruz-Guisado V, Gago ML, Martín-Matillas M and Ariza-Vega P
Mobile health (mHealth) systems are a promising alternative for rehabilitation of hip fracture, addressing constrained healthcare resources. Half of older adults fails to recover their pre-fracture routines, which imposes a burden on caregivers. We aimed to test the effectiveness of the 3-month ActiveHip + mHealth intervention on physical and psychological outcomes of older adults with hip fracture and their family caregivers.
Outcomes of Six Specific Types of Post-Hospital Brain Injury Rehabilitation Programs
Salisbury DB, Parrott D, Walters GJ, McGrath C, Logan DM, Altman IM and Malec JF
Evaluate outcomes of intensive posthospital brain injury rehabilitation programs compared to supported living (SL) programs; explore variations in outcome by diagnostic category (traumatic brain injury, stroke, and other acquired brain injury [ABI]) and specific program type.
Attenuated neural activity in processing decision-making feedback in uncertain conditions in patients with mild cognitive impairment
Zhang Y, Zhang M, Wang L, Zheng Y, Li H, Xie Y, Lv X, Yu X and Wang H
The present study aimed to explore the potential neural correlates during feedback evaluation during decision-making under risk and ambiguity in MCI. Nineteen individuals with MCI and twenty age-matched HCs were enrolled. Decision-making performance under risk and ambiguity was examined with the modified game of dice task (GDT) and an Iowa gambling task (IGT). Using task-related EEG data, reward positivity (RewP) and feedback P3 (fb-P3) were used to characterize participants' motivation and allocation of cognitive resources. Also, response time and event-related oscillation (ERO) were used to evaluate information processing speed, and the potent of post-feedback information integration and behavioral modulation. MCI patients had lower RewP (p = 0.022) and fb-P3 (p = 0.045) amplitudes in the GDT than HCs. Moreover, the amount and valence of feedback modulated the RewP (p = 0.008; p = 0.017) and fb-P3 (p < 0.001; p < 0.001). In the IGT, in addition to the significantly reduced fb-P3 observed in MCI patients (p = 0.010), the amount and valence of feedback modulated the RewP (p = 0.002; p = 0.020). Furthermore, MCI patients took longer to make decisions (t = 2.15, p = 0.041). The ERO analysis revealed that delta power was reduced in MCI (GDT: p = 0.045; p = 0.011). The findings suggest that, during feedback evaluation when making risky and ambiguous decisions, motivation, allocation of cognitive resources, information processing and neuronal excitability were attenuated in MCI. It implies that neural activity related to decision making was compromised in MCI.
Post-traumatic stress disorder in children after discharge from the pediatric intensive care unit: a scoping review
Tang M, Chui PL, Chong MC and Liu X
As the prevalence of post-traumatic stress disorder (PTSD) among children discharged from pediatric intensive care unit (PICU) continues to rise, corresponding research efforts have also increased. This scoping review aimed to review the PTSD prevalence, influencing factors, and tools used for PTSD measurements in children discharged from the PICU. This review employed the five-stage framework proposed by Arksey and O'Malley. The data sources included PubMed, Web of Science, Ovid, ScienceDirect, Springer, Scopus, CNKI, and WANFANG. Studies in English or Chinese published up to September 2023 were eligible for inclusion. The search yielded a total of 3536 results, with 31 articles meeting the inclusion criteria. The included studies reported that the prevalence of PTSD ranged from a minimum of 13% to a maximum of 84.6%. Risk factors for PTSD included medical interventions, child-related factors, and family environment. A total of 17 assessment tools for PTSD in PICU patients were reported. Given the significance of PTSD in this pediatric population, further attention, research, and intervention are warranted to help alleviate the burden of PTSD.
Extended-Release Injection vs Sublingual Buprenorphine for Opioid Use Disorder With Fentanyl Use: A Post Hoc Analysis of a Randomized Clinical Trial
Nunes EV, Comer SD, Lofwall MR, Walsh SL, Peterson S, Tiberg F, Hjelmstrom P and Budilovsky-Kelley NR
Fentanyl has exacerbated the opioid use disorder (OUD) and opioid overdose epidemic. Data on the effectiveness of medications for OUD among patients using fentanyl are limited.
Wearable Technologies for Detecting Burnout and Well-Being in Health Care Professionals: Scoping Review
Barac M, Scaletty S, Hassett LC, Stillwell A, Croarkin PE, Chauhan M, Chesak S, Bobo WV, Athreya AP and Dyrbye LN
The occupational burnout epidemic is a growing issue, and in the United States, up to 60% of medical students, residents, physicians, and registered nurses experience symptoms. Wearable technologies may provide an opportunity to predict the onset of burnout and other forms of distress using physiological markers.
Attitudes toward and training in medications for opioid use disorders: a descriptive analysis among employees in the youth legal system and community mental health centers
O'Reilly LM, Schwartz K, Brown SA, Dir A, Gillenwater L, Adams Z, Zapolski T, Hulvershorn LA and Aalsma M
Research demonstrates gaps in medications for opioid use disorder uptake (MOUDs; methadone, buprenorphine, and naltrexone) especially among adolescents. These gaps may be partly attributable to attitudes about and training in MOUDs among youth-serving professionals. We extended prior research by conducting descriptive analyses of attitudes regarding effectiveness and acceptability of MOUDs, as well as training in MOUDs, among youth legal system (YLS) employees and community mental health center (CMHC) personnel who interface professionally with youth.
Genome-wide analyses reveal a potential role for the MAPT, MOBP, and APOE loci in sporadic frontotemporal dementia
Manzoni C, Kia DA, Ferrari R, Leonenko G, Costa B, Saba V, Jabbari E, Tan MM, Albani D, Alvarez V, Alvarez I, Andreassen OA, Angiolillo A, Arighi A, Baker M, Benussi L, Bessi V, Binetti G, Blackburn DJ, Boada M, Boeve BF, Borrego-Ecija S, Borroni B, Bråthen G, Brooks WS, Bruni AC, Caroppo P, Bandres-Ciga S, Clarimon J, Colao R, Cruchaga C, Danek A, de Boer SC, de Rojas I, di Costanzo A, Dickson DW, Diehl-Schmid J, Dobson-Stone C, Dols-Icardo O, Donizetti A, Dopper E, Durante E, Ferrari C, Forloni G, Frangipane F, Fratiglioni L, Kramberger MG, Galimberti D, Gallucci M, García-González P, Ghidoni R, Giaccone G, Graff C, Graff-Radford NR, Grafman J, Halliday GM, Hernandez DG, Hjermind LE, Hodges JR, Holloway G, Huey ED, Illán-Gala I, Josephs KA, Knopman DS, Kristiansen M, Kwok JB, Leber I, Leonard HL, Libri I, Lleo A, Mackenzie IR, Madhan GK, Maletta R, Marquié M, Maver A, Menendez-Gonzalez M, Milan G, Miller BL, Morris CM, Morris HR, Nacmias B, Newton J, Nielsen JE, Nilsson C, Novelli V, Padovani A, Pal S, Pasquier F, Pastor P, Perneczky R, Peterlin B, Petersen RC, Piguet O, Pijnenburg YA, Puca AA, Rademakers R, Rainero I, Reus LM, Richardson AM, Riemenschneider M, Rogaeva E, Rogelj B, Rollinson S, Rosen H, Rossi G, Rowe JB, Rubino E, Ruiz A, Salvi E, Sanchez-Valle R, Sando SB, Santillo AF, Saxon JA, Schlachetzki JC, Scholz SW, Seelaar H, Seeley WW, Serpente M, Sorbi S, Sordon S, St George-Hyslop P, Thompson JC, Van Broeckhoven C, Van Deerlin VM, Van der Lee SJ, Van Swieten J, Tagliavini F, van der Zee J, Veronesi A, Vitale E, Waldo ML, Yokoyama JS, Nalls MA, Momeni P, Singleton AB, Hardy J and Escott-Price V
Frontotemporal dementia (FTD) is the second most common cause of early-onset dementia after Alzheimer disease (AD). Efforts in the field mainly focus on familial forms of disease (fFTDs), while studies of the genetic etiology of sporadic FTD (sFTD) have been less common. In the current work, we analyzed 4,685 sFTD cases and 15,308 controls looking for common genetic determinants for sFTD. We found a cluster of variants at the MAPT (rs199443; p = 2.5 × 10, OR = 1.27) and APOE (rs6857; p = 1.31 × 10, OR = 1.27) loci and a candidate locus on chromosome 3 (rs1009966; p = 2.41 × 10, OR = 1.16) in the intergenic region between RPSA and MOBP, contributing to increased risk for sFTD through effects on expression and/or splicing in brain cortex of functionally relevant in-cis genes at the MAPT and RPSA-MOBP loci. The association with the MAPT (H1c clade) and RPSA-MOBP loci may suggest common genetic pleiotropy across FTD and progressive supranuclear palsy (PSP) (MAPT and RPSA-MOBP loci) and across FTD, AD, Parkinson disease (PD), and cortico-basal degeneration (CBD) (MAPT locus). Our data also suggest population specificity of the risk signals, with MAPT and APOE loci associations mainly driven by Central/Nordic and Mediterranean Europeans, respectively. This study lays the foundations for future work aimed at further characterizing population-specific features of potential FTD-discriminant APOE haplotype(s) and the functional involvement and contribution of the MAPT H1c haplotype and RPSA-MOBP loci to pathogenesis of sporadic forms of FTD in brain cortex.
Effect of Saffron Versus Selective Serotonin Reuptake Inhibitors (SSRIs) in Treatment of Depression and Anxiety: A Meta-analysis of Randomized Controlled Trials
Shafiee A, Jafarabady K, Seighali N, Mohammadi I, Rajai Firouz Abadi S, Abhari FS and Bakhtiyari M
Saffron, a natural remedy with potential antidepressant and anxiolytic properties, has gained attention as a potential therapeutic option.
Social Media Use and Internalizing Symptoms in Clinical and Community Adolescent Samples: A Systematic Review and Meta-Analysis
Fassi L, Thomas K, Parry DA, Leyland-Craggs A, Ford TJ and Orben A
In response to widespread concerns about social media's influence on adolescent mental health, most research has studied adolescents from the general population, overlooking clinical groups.
Examining U.S. disparities in smoking among rural versus urban women of reproductive age: 2002-2019
Higgins ST, Erath T and Chen FF
This study is part of a programmatic investigation of rural disparities in cigarette smoking examining disparities in smoking prevalence and for the first-time quit ratios among adult women of reproductive age (18-44 years), a highly vulnerable population due to risk for multigenerational adverse effects.
An interim exploratory proteomics biomarker analysis of a phase 2 clinical trial to assess the impact of CT1812 in Alzheimer's disease
Lizama BN, North HA, Pandey K, Williams C, Duong D, Cho E, Di Caro V, Ping L, Blennow K, Zetterberg H, Lah J, Levey AI, Grundman M, Caggiano AO, Seyfried NT and Hamby ME
CT1812 is a novel, brain penetrant small molecule modulator of the sigma-2 receptor (S2R) that is currently in clinical development for the treatment of Alzheimer's disease (AD). Preclinical and early clinical data show that, through S2R, CT1812 selectively prevents and displaces binding of amyloid beta (Aβ) oligomers from neuronal synapses and improves cognitive function in animal models of AD. SHINE is an ongoing Phase 2 randomized, double-blind, placebo-controlled clinical trial (COG0201) in participants with mild to moderate AD, designed to assess the safety and efficacy of 6 months of CT1812 treatment. To elucidate the mechanism of action in AD patients and pharmacodynamic biomarkers of CT1812, the present study reports exploratory cerebrospinal fluid (CSF) biomarker data from 18 participants in an interim analysis of the first set of patients in SHINE (part A). Untargeted mass spectrometry-based discovery proteomics detects >2000 proteins in patient CSF and has documented utility in accelerating the identification of novel AD biomarkers reflective of diverse pathophysiologies beyond amyloid and tau, and enabling identification of pharmacodynamic biomarkers in longitudinal interventional trials. We leveraged this technique to analyze CSF samples taken at baseline and after 6 months of CT1812 treatment. Proteome-wide protein levels were detected using tandem mass tag-mass spectrometry (TMT-MS), change from baseline was calculated for each participant, and differential abundance analysis by treatment group was performed. This analysis revealed a set of proteins significantly impacted by CT1812, including pathway engagement biomarkers (i.e., biomarkers tied to S2R biology) and disease modification biomarkers (i.e., biomarkers with altered levels in AD vs. healthy control CSF but normalized by CT1812, and biomarkers correlated with favorable trends in ADAS-Cog11 scores). Brain network mapping, Gene Ontology, and pathway analyses revealed an impact of CT1812 on synapses, lipoprotein and amyloid beta biology, and neuroinflammation. Collectively, the findings highlight the utility of this method in pharmacodynamic biomarker identification and providing mechanistic insights for CT1812, which may facilitate the clinical development of CT1812 and enable appropriate pre-specification of biomarkers in upcoming clinical trials of CT1812.
Association between negative life events through mental health and non-suicidal self-injury with young adults: evidence for sex moderate correlation
Zhang Y, Gong L, Feng Q, Hu K, Liu C, Jiang T and Zhang Q
Non-suicidal self-injury (NSSI) has exhibited an increasing trend in recent years and is now globally recognized as a major public health problem among adolescents and young adults. Negative life events (NLEs) are positively associated with NSSI. We sought to explore (1) whether sex plays a role in the risk of NLEs leading to NSSI and (2) the role played by mental health (MH).
Natural language processing analysis of the theories of people with multiple sclerosis about causes of their disease
Haag C, Steinemann N, Ajdacic-Gross V, Schlomberg JTT, Ineichen BV, Stanikić M, Dressel H, Daniore P, Roth P, Ammann S, Calabrese P, Kamm CP, Kesselring J, Kuhle J, Zecca C, Puhan MA and von Wyl V
While potential risk factors for multiple sclerosis (MS) have been extensively researched, it remains unclear how persons with MS theorize about their MS. Such theories may affect mental health and treatment adherence. Using natural language processing techniques, we investigated large-scale text data about theories that persons with MS have about the causes of their disease. We examined the topics into which their theories could be grouped and the prevalence of each theory topic.
Strategies, processes, outcomes, and costs of implementing experience sampling-based monitoring in routine mental health care in four European countries: study protocol for the IMMERSE effectiveness-implementation study
Reininghaus U, Schwannauer M, Barne I, Beames JR, Bonnier RA, Brenner M, Breznoščáková D, Dančík D, De Allegri M, Di Folco S, Durstewitz D, Gugel J, Hajdúk M, Heretik A, Izáková Ľ, Katreniakova Z, Kiekens G, Koppe G, Kurilla A, Marelli L, Nagyova I, Nguyen H, Pečeňák J, Schulte-Strathaus JCC, Sotomayor-Enriquez K, Uyttebroek L, Weermeijer J, Wolters M, Wensing M, Boehnke JR, Myin-Germeys I and Schick A
Recent years have seen a growing interest in the use of digital tools for delivering person-centred mental health care. Experience Sampling Methodology (ESM), a structured diary technique for capturing moment-to-moment variation in experience and behaviour in service users' daily life, reflects a particularly promising avenue for implementing a person-centred approach. While there is evidence on the effectiveness of ESM-based monitoring, uptake in routine mental health care remains limited. The overarching aim of this hybrid effectiveness-implementation study is to investigate, in detail, reach, effectiveness, adoption, implementation, and maintenance as well as contextual factors, processes, and costs of implementing ESM-based monitoring, reporting, and feedback into routine mental health care in four European countries (i.e., Belgium, Germany, Scotland, Slovakia).
Parenting stress, anxiety, and sources of acquiring knowledge in Taiwanese caregivers of children with attention-deficit/hyperactivity disorder
Liu TL, Hsiao RC, Chou WJ and Yen CF
This survey study investigated the types of sources other than medical professionals (e.g., social media) that the caregivers of children with attention-deficit/hyperactivity disorder (ADHD) use to acquire knowledge about ADHD and investigated the association between the use of such information sources and caregiver parenting stress and anxiety in Taiwan.
A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022
Ashcraft LE, Goodrich DE, Hero J, Phares A, Bachrach RL, Quinn DA, Qureshi N, Ernecoff NC, Lederer LG, Scheunemann LP, Rogal SS and Chinman MJ
Studies of implementation strategies range in rigor, design, and evaluated outcomes, presenting interpretation challenges for practitioners and researchers. This systematic review aimed to describe the body of research evidence testing implementation strategies across diverse settings and domains, using the Expert Recommendations for Implementing Change (ERIC) taxonomy to classify strategies and the Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) framework to classify outcomes.
Non-invasive brain stimulation for treatment-resistant schizophrenia: protocol of a systematic review and network meta-analysis
Siafis S, Lorenz C, Wu H, Zhu Y, Schneider-Thoma J, Bighelli I, Li C, Hansen WP, Padberg F, Salanti G and Leucht S
Non-invasive brain stimulation (NIBS) is a promising intervention for treatment-resistant schizophrenia. However, there are multiple available techniques and a comprehensive synthesis of evidence is lacking. Thus, we will conduct a systematic review and network meta-analysis to investigate the comparative efficacy and safety of NIBS techniques as an add-on to antipsychotics for treatment-resistant schizophrenia.
Association of prenatal substance exposure and the development of the amygdala, hippocampus, and parahippocampus
Hartwell M, Bloom M, Elenwo C, Gooch T, Dunn K, Breslin F and Croff JM
Prenatal substance exposure (PSE) can lead to various harmful outcomes for the developing fetus and is linked to many emotional, behavioral, and cognitive difficulties later in life. Therefore, examination of the relationship between the development of associated brain structures and PSE is important for the development of more specific or new preventative methods.
Examining the Impact of the Innovative Opioid Court Model on Treatment Access and Court Outcomes for Court Participants
Elkington KS, Ryan ME, Basaraba C, Dambreville R, Alschuler D, Wall MM, Garcia A, Christofferson M, Andrews HF and Nunes EV
The opioid intervention court (OIC) is an innovative, pre-plea treatment court to facilitate rapid linkage to medications for opioid use disorder (MOUD) for people at risk of overdose. This study compares participants in OIC and participants with opioid use problems in a traditional drug treatment court model on (i) initiation for any substance use (SU) treatment, (ii) initiation of MOUD, (iii) number of days to MOUD initiation, and (iv) retention in the OIC program/retention on MOUD.
Why Do People Watch Pornography? Cross-Cultural Validation of the Pornography Use Motivations Scale (PUMS) and Its Short Form (PUMS-8)
Koós M, Nagy L, Kraus SW, Demetrovics Z, Potenza MN, Gaudet É, Ballester-Arnal R, Batthyány D, Bergeron S, Billieux J, Briken P, Burkauskas J, Cárdenas-López G, Carvalho J, Castro-Calvo J, Chang YH, Chen L, Ciocca G, Corazza O, Csako RI, Fernandez DP, Fujiwara H, Fernandez EF, Fuss J, Gabrhelík R, Gewirtz-Meydan A, Gjoneska B, Gola M, Grubbs JB, Hashim HT, Hsieh YP, Islam MS, Ismail M, Jiménez-Martínez MC, Jurin T, Kalina O, Klein V, Költő A, Lee SK, Lewczuk K, Lochner C, López-Alvarado S, Lukavská K, Mayta-Tristán P, Miller DJ, Orosová O, Orosz G, Ponce FP, Quintana GR, Quintero Garzola GC, Ramos-Diaz J, Rigaud K, Rousseau A, Scanavino MT, Schulmeyer MK, Sharan P, Shibata M, Shoib S, Sigre-Leirós V, Sniewski L, Spasovski O, Steibliene V, Stein DJ, Strizek J, Štulhofer A, , Ünsal BC, Vaillancourt-Morel MP, Van Hout MC and Bőthe B
Motivations for pornography use may vary across gender identities, sexual orientations, and geographical regions, warranting examination to promote individual and public health. The aims of this study were to validate the Pornography Use Motivations Scale (PUMS) in a diverse, multicultural sample, and develop a short form (PUMS-8) that can assess a wide range of pornography use motivations. Using data from 42 countries ( = 75,117; M = 32.07; SD = 12.37), enabled us to thoroughly evaluate the dimensionality, validity, and reliability of the Pornography Use Motivations Scale (PUMS), leading to the development of the more concise PUMS-8 short scale. Additionally, language-, nationality-, gender-, and sexual-orientation-based measurement invariance tests were conducted to test the comparability across groups. Both the PUMS and the PUMS-8 assess eight pornography use motivations, and both demonstrated excellent psychometric properties. Sexual Pleasure emerged as the most frequent motivation for pornography use across countries, genders, and sexual orientations, while differences were observed concerning other motivations (e.g. self-exploration was more prevalent among gender-diverse individuals than men or women). The motivational background of pornography use showed high similarity in the examined countries. Both the PUMS and the PUMS-8 are reliable and valid measurement tools to assess different types of motivations for pornography use across countries, genders, and sexual orientations. Both scales are recommended for use in research and clinical settings.
Depression, Rumination, and Suicide Attempts in Adolescents With Mood Disorders: Sex Differences in This Relationship
Liu D, Lei G, Li D, Deng H, Zhang XY and Dang Y
. Sex differences in suicide attempts have been widely recognized across domains such as depression and rumination. The relationship between depression, rumination, and suicide attempts in mood disorders has been studied before; however, how they interact across sexes remains unclear. This study aimed to examine the sex differences in the relationship between depression, rumination, and suicide attempts in Chinese adolescents with mood disorders. We recruited 681 adolescents with mood disorders who met ICD-10 criteria for having unipolar or bipolar depression with a current depressive episode at the time of the study and collected demographic and clinical data. The prevalence of suicide attempts in female adolescents with mood disorders (64.36%) was significantly higher than that in male adolescents with mood disorders (49.47%), with an odds ratio of 1.84 (95% CI, 1.31-2.59). Regression analysis showed that PHQ-9 was independently associated with suicide attempts among male adolescents with mood disorders, while in female adolescents with mood disorders, total scores of PHQ-9 and RRS-10 were independently associated with suicide attempts. Importantly, in female adolescents with mood disorders, the mediating effect of RRS-10 total score on the relationship between PHQ-9 and suicide attempts was significant (standardized β = 0.005, = 0.003, 95% CI, 0.002-0.008), the mediating effect accounted for 31.25% of the total effect of depressive symptoms on suicide attempts. Our study suggests that there are sex differences in depression, rumination, and suicide attempts and in the interaction between them in adolescents with mood disorders. These sex differences may have important clinical implications, both for improving strategies to detect suicidal behaviors and for developing better early intervention programs for this population.
Universal Credit receipt among working-age patients who are accessing specialist mental health services: results from a novel data linkage study
Stevelink SAM, Bakolis I, Dorrington S, Downs J, Leal R, Madan I, Phillips A, Geiger B, Hotopf M and Fear NT
In 2013, Universal Credit (UC) was introduced by the UK Government. Understanding of how UC provision is allocated among people with mental disorders, and its intersection with protected characteristics is limited. This study aimed to explore (1) how UC receipt, including UC conditionality regime, varied among users of specialist mental health services between 2013 and 2019 and (2) associations between sociodemographic and diagnostic patient characteristics and UC receipt.
The quality of qualitative research
van IJzendoorn MH and Miedema S
In this contribution, we discuss criteria for the quality of qualitative research. We consider reliability and validity as specifications of the comprehensive requirement for 'intersubjective replicability', with which qualitative research should comply. In the data collection phase, 'argumentative' reliability generally must suffice; in the data analysis phase, attention must also be given to 'technical' reliability. Validation of qualitative research has to take place via three approaches: 'communicative', 'critical' or 'empirical' validation. This clarifies the relative validity or 'authenticity' of qualitative research.
A systematic review and meta-analysis of psychosocial interventions for persons with comorbid anxiety and substance use disorders
Nardi WR, Kelly P, Roy A, Becker S, Brewer J and Sun S
Anxiety and substance use disorders are highly comorbid and represent two of the leading causes of disease burden globally. Psychosocial interventions are important treatment options for people with co-occurring anxiety and substance use disorders (A-SUD). To date, few reviews have assessed the efficacy of psychosocial treatments for patients with A-SUD. This systematic review and meta-analysis aims to synthesize this literature and assess the efficacy of psychosocial interventions among patients with A-SUD.
Plasma extracellular vesicle tau and TDP-43 as diagnostic biomarkers in FTD and ALS
Chatterjee M, Özdemir S, Fritz C, Möbius W, Kleineidam L, Mandelkow E, Biernat J, Doğdu C, Peters O, Cosma NC, Wang X, Schneider LS, Priller J, Spruth E, Kühn AA, Krause P, Klockgether T, Vogt IR, Kimmich O, Spottke A, Hoffmann DC, Fliessbach K, Miklitz C, McCormick C, Weydt P, Falkenburger B, Brandt M, Guenther R, Dinter E, Wiltfang J, Hansen N, Bähr M, Zerr I, Flöel A, Nestor PJ, Düzel E, Glanz W, Incesoy E, Bürger K, Janowitz D, Perneczky R, Rauchmann BS, Hopfner F, Wagemann O, Levin J, Teipel S, Kilimann I, Goerss D, Prudlo J, Gasser T, Brockmann K, Mengel D, Zimmermann M, Synofzik M, Wilke C, Selma-González J, Turon-Sans J, Santos-Santos MA, Alcolea D, Rubio-Guerra S, Fortea J, Carbayo Á, Lleó A, Rojas-García R, Illán-Gala I, Wagner M, Frommann I, Roeske S, Bertram L, Heneka MT, Brosseron F, Ramirez A, Schmid M, Beschorner R, Halle A, Herms J, Neumann M, Barthélemy NR, Bateman RJ, Rizzu P, Heutink P, Dols-Icardo O, Höglinger G, Hermann A and Schneider A
Minimally invasive biomarkers are urgently needed to detect molecular pathology in frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS). Here, we show that plasma extracellular vesicles (EVs) contain quantifiable amounts of TDP-43 and full-length tau, which allow the quantification of 3-repeat (3R) and 4-repeat (4R) tau isoforms. Plasma EV TDP-43 levels and EV 3R/4R tau ratios were determined in a cohort of 704 patients, including 37 genetically and 31 neuropathologically proven cases. Diagnostic groups comprised patients with TDP-43 proteinopathy ALS, 4R tauopathy progressive supranuclear palsy, behavior variant FTD (bvFTD) as a group with either tau or TDP-43 pathology, and healthy controls. EV tau ratios were low in progressive supranuclear palsy and high in bvFTD with tau pathology. EV TDP-43 levels were high in ALS and in bvFTD with TDP-43 pathology. Both markers discriminated between the diagnostic groups with area under the curve values >0.9, and between TDP-43 and tau pathology in bvFTD. Both markers strongly correlated with neurodegeneration, and clinical and neuropsychological markers of disease severity. Findings were replicated in an independent validation cohort of 292 patients including 34 genetically confirmed cases. Taken together, the combination of EV TDP-43 levels and EV 3R/4R tau ratios may aid the molecular diagnosis of FTD, FTD spectrum disorders and ALS, providing a potential biomarker to monitor disease progression and target engagement in clinical trials.
Social connection and self-neglect: A case for broader exploration
Burnett J, Hoyumpa GM, Beauchamp JES, Hernandez-Tejada MA, Acierno R and Perissinotto C
Self-neglect (SN) is the most common report to Adult Protective Services (APS) and is associated with significant morbidity and mortality risks for older adults. Lack of instrumental support is a well-evidenced etiologic factor in the development and continuation of SN, but little is known about other modifiable social connection characteristics. The social connection framework, provides a host of evidence-based characteristics across structure, function, quality missing from SN studies that could be identified if explored. These factors could provide prevention and intervention targets related to poor health. We present a narrative case study using quantitative and qualitative data to explore social connection across structure, function, and quality in the context of SN. The findings highlight the complexity of social connection that may be frequently observed in SN cases reported to APS. Strategic utilization of direct and indirect social interventions to support social connection in this case is presented and provides general considerations that may be generalizable to other SN cases. Thoughts for future research on social connection in this population are provided.
Effects of Herbal Tea (Non-Camellia sinensis) on Glucose Homeostasis and Serum Lipids in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Alasvand Zarasvand S, Ogawa S, Nestor B, Bridges W and Haley-Zitlin V
Hyperglycemia and hyperlipidemia increase the risk for diabetes and its complications, atherosclerosis, heart failure, and stroke. Identification of safe and cost-effective means to reduce risk factors is needed. Herbal teas may be a vehicle to deliver antioxidants and polyphenols for prevention of complications.
Mapping the landscape of sleep medicine training across Asia
BaHammam AS, Al-Abri MA, Rashid RA, Amra B, Al Oweidat K, Chan JWY, Chen NH, Chirakalwasan N, Dizon RV, Gupta R, Duong-Quy S, Han F, Hong SB, Jihui Z, Jahrami H, Jamil MG, Jung KY, Kadotani H, Leow LC, Lee PL, Shin W, Xu L, Wing YK, Inoue Y and
This study assessed the current state of sleep medicine accreditation and training in Asia by conducting a comprehensive survey across 29 Asian countries and regions facilitated by the Asian Society of Sleep Medicine (ASSM) to identify existing gaps and provide recommendations for future enhancements.
MDDOmics: multi-omics resource of major depressive disorder
Zhao Y, Xiang J, Shi X, Jia P, Zhang Y and Li M
Major depressive disorder (MDD) is a pressing global health issue. Its pathogenesis remains elusive, but numerous studies have revealed its intricate associations with various biological factors. Consequently, there is an urgent need for a comprehensive multi-omics resource to help researchers in conducting multi-omics data analysis for MDD. To address this issue, we constructed the MDDOmics database (Major Depressive Disorder Omics, (https://www.csuligroup.com/MDDOmics/), which integrates an extensive collection of published multi-omics data related to MDD. The database contains 41 222 entries of MDD research results and several original datasets, including Single Nucleotide Polymorphisms, genes, non-coding RNAs, DNA methylations, metabolites and proteins, and offers various interfaces for searching and visualization. We also provide extensive downstream analyses of the collected MDD data, including differential analysis, enrichment analysis and disease-gene prediction. Moreover, the database also incorporates multi-omics data for bipolar disorder, schizophrenia and anxiety disorder, due to the challenge in differentiating MDD from similar psychiatric disorders. In conclusion, by leveraging the rich content and online interfaces from MDDOmics, researchers can conduct more comprehensive analyses of MDD and its similar disorders from various perspectives, thereby gaining a deeper understanding of potential MDD biomarkers and intricate disease pathogenesis. Database URL: https://www.csuligroup.com/MDDOmics/.
Panel stacking is a threat to consensus statement validity
Kepp KP, Aavitsland P, Ballin M, Balloux F, Baral S, Bardosh K, Bauchner H, Bendavid E, Bhopal R, Blumstein DT, Boffetta P, Bourgeois F, Brufsky A, Collignon PJ, Cripps S, Cristea IA, Curtis N, Djulbegovic B, Faude O, Flacco ME, Guyatt GH, Hajishengallis G, Hemkens LG, Hoffmann T, Joffe AR, Klassen TP, Koletsi D, Kontoyiannis DP, Kuhl E, La Vecchia C, Lallukka T, Lambris J, Levitt M, Makridakis S, Maltezou HC, Manzoli L, Marusic A, Mavragani C, Moher D, Mol BW, Muka T, Naudet F, Noble PW, Nordström A, Nordström P, Pandis N, Papatheodorou S, Patel CJ, Petersen I, Pilz S, Plesnila N, Ponsonby AL, Rivas MA, Saltelli A, Schabus M, Schippers MC, Schünemann H, Solmi M, Stang A, Streeck H, Sturmberg JP, Thabane L, Thombs BD, Tsakris A, Wood SN and Ioannidis JPA
Consensus statements can be very influential in medicine and public health. Some of these statements use systematic evidence synthesis but others fail on this front. Many consensus statements use panels of experts to deduce perceived consensus through Delphi processes. We argue that stacking of panel members towards one particular position or narrative is a major threat, especially in absence of systematic evidence review. Stacking may involve financial conflicts of interest, but non-financial conflicts of strong advocacy can also cause major bias. Given their emerging importance, we describe here how such consensus statements may be misleading, by analysing in depth a recent high-impact Delphi consensus statement on COVID-19 recommendations as a case example. We demonstrate that many of the selected panel members and at least 35% of the core panel members had advocated towards COVID-19 elimination (zero-COVID) during the pandemic and were leading members of aggressive advocacy groups. These advocacy conflicts were not declared in the Delphi consensus publication, with rare exceptions. Therefore, we propose that consensus statements should always require rigorous evidence synthesis and maximal transparency on potential biases towards advocacy or lobbyist groups to be valid. While advocacy can have many important functions, its biased impact on consensus panels should be carefully avoided.
Stress-Relieving Properties of a Polyherbal Blend with L. and Pierre ex A. Froehner: A Review and Bibliometric Analysis
Zakaria N, Fadhlina A, Sheikh H, Hairani M, MohdFauzi M and AbdulMajid F
and are acknowledged for their outstanding antioxidant, anti-inflammatory, and nerve-stimulant properties, showcasing potential in brain protection. Therefore, this study aims to quantitatively review existing literature and assess the potential of using it to formulate a herbal tea blend for managing stress and anxiety. Data was retrieved from the Scopus database, and a bibliometric analysis was performed using VOSviewer software. Following a screening process, a total of 121 articles were identified, with yielding a higher number compared to . A detailed exploration of each plant revealed active components such as eugenol, β-caryophyllene, α-humulene, caffeine, mangiferin, and chlorogenic acids, each exhibiting stimulatory effects alongside antioxidant and anti-inflammatory properties. The neuroprotective effects were attributed to the reduction of oxidative stress and inflammation, coupled with the stimulation of neurotransmitters and hormones like dopamine, serotonin, cortisol, and adrenaline. The review showed that these plants positively affect mood and cognition by influencing the brain's pleasure system. This suggests the need for further research to combine these plant extracts for developing "Tenang tea," a potential herbal blend for managing stress and anxiety.
Structural white matter abnormalities in Schizophrenia and associations with neurocognitive performance and symptom severity
Male AG, Goudzwaard E, Nakahara S, Turner JA, Calhoun VD, Mueller BA, Lim KO, Bustillo JR, Belger A, Voyvodic J, O'Leary D, Mathalon DH, Ford JM, Potkin SG, Preda A and van Erp TGM
Schizophrenia is associated with robust white matter (WM) abnormalities but influences of potentially confounding variables and relationships with cognitive performance and symptom severity remain to be fully determined. This study was designed to evaluate WM abnormalities based on diffusion tensor imaging (DTI) in individuals with schizophrenia, and their relationships with cognitive performance and symptom severity. Data from individuals with schizophrenia (SZ; n=138, mean age±SD=39.02±11.82; 105 males) and healthy controls (HC; n=143, mean age±SD=37.07±10.84; 102 males) were collected as part of the Function Biomedical Informatics Research Network Phase 3 study. Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) were compared between individuals with schizophrenia and healthy controls, and their relationships with neurocognitive performance and symptomatology assessed. Individuals with SZ had significantly lower FA in forceps minor and the left inferior fronto-occipital fasciculus compared to HC. FA in several tracts were associated with speed of processing and attention/vigilance and the severity of the negative symptom alogia. This study suggests that regional WM abnormalities are fundamentally involved in the pathophysiology of schizophrenia and may contribute to cognitive performance deficits and symptom expression observed in schizophrenia.
Abnormal Scanning Patterns Based on Eye Movement Entropy in Early Psychosis
Zhang D, Ma C, Xu L, Liu X, Cui H, Wei Y, Zheng W, Hong Y, Xie Y, Qian Z, Hu Y, Tang Y, Li C, Liu Z, Chen T, Liu H, Zhang T and Wang J
Restricted scan path mode is hypothesized to explain abnormal scanning patterns in patients with schizophrenia. Here, we calculated entropy scores (drawing upon gaze data to measure the statistical randomness of eye movements) to quantify how strategical and random participants were to process image stimuli.
Large language models in psychiatry: Opportunities and challenges
Volkmer S, Meyer-Lindenberg A and Schwarz E
The ability of Large Language Models (LLMs) to analyze and respond to freely written text is causing increasing excitement in the field of psychiatry; the application of such models presents unique opportunities and challenges for psychiatric applications. This review article seeks to offer a comprehensive overview of LLMs in psychiatry, their model architecture, potential use cases, and clinical considerations. LLM frameworks such as ChatGPT/GPT-4 are trained on huge amounts of text data that are sometimes fine-tuned for specific tasks. This opens up a wide range of possible psychiatric applications, such as accurately predicting individual patient risk factors for specific disorders, engaging in therapeutic intervention, and analyzing therapeutic material, to name a few. However, adoption in the psychiatric setting presents many challenges, including inherent limitations and biases in LLMs, concerns about explainability and privacy, and the potential damage resulting from produced misinformation. This review covers potential opportunities and limitations and highlights potential considerations when these models are applied in a real-world psychiatric context.
Physical activity during COVID-19 in people with systemic sclerosis: A Scleroderma Patient-centred Intervention Network COVID-19 Cohort longitudinal study
Wurz A, Henry RS, Kwakkenbos L, Carrier ME, Patten SB, Bartlett SJ, Mouthon L, Varga J, Benedetti A, Culos-Reed SN and Thombs BD
People with systemic sclerosis (SSc) face barriers to physical activity. Few studies have described physical activity in SSc, and none have explored physical activity longitudinally during COVID-19. We evaluated physical activity from April 2020 to March 2022 among people with SSc.
Impact of COVID-19-Induced Academic Stress on Insomnia and Suicidal Ideation among Taiwanese Health Trainees and Junior Doctors
Huang PC, Lin CY, Huang RY, Chen JS, Potenza MN, Strong C, Wang HW, Griffiths MD, Chen CY, Ko NY and Shieh SJ
BACKGROUND Clinical training for allied health trainees (AHTs) and postgraduate-year (PGY) doctors needed to go online during the outbreak of coronavirus disease 2019 (COVID-19), which may have caused academic stress and consequent outcomes among this cohort. MATERIAL AND METHODS To evaluate academic-related stress, clinical confidence, psychological distress, and insomnia, an online survey-based study was conducted among Taiwanese AHTs and PGY doctors between July and December, 2022, during the COVID-19 pandemic. The survey included the 21-item Depression, Anxiety, and Stress Scale (DASS-21), the Insomnia Severity Index (ISI), and self-designed questions. It was distributed using convenience sampling and snowball sampling and was completed by 522 participants. RESULTS Structural equational modelling showed that academic stress was negatively associated with clinical confidence (standardized coefficient [ß]=-0.382, p<0.001). Clinical confidence was negatively associated with psychological distress (ß=-0.397, p<0.001), which was associated with insomnia (ß=0.648, p<0.001). Additionally, clinical confidence and psychological distress were the significant mediators. Results indicated that higher academic stress was associated with higher level of insomnia via the mediation of clinical confidence and psychological distress. CONCLUSIONS Academic stress related to changes in clinical training may have led to insomnia among AHTs and PGY doctors during the pandemic. Factors to reduce academic stress should be investigated to promote good mental health while providing sufficient clinical training, especially during events that can cause increased stress (eg, epidemics, pandemics).
A Comprehensive Study of Positive Body Image as a Predictor of Psychological Well-Being in Anorexia Nervosa
Torres S, Vieira AI, Vieira FM, Miller KM, Guerra MP, Lencastre L, Reis AC, Timóteo S, Nunes P and Barbosa MR
Recent data suggest a close association between positive body image (PBI) and eating disorder recovery. Nevertheless, the specific mechanisms through which PBI may facilitate recovery from anorexia nervosa (AN) remain unknown. To advance understanding of these mechanisms, this study examined core indices of PBI within AN, exploring its association with emotion regulation and well-being outcomes. Data were collected from 159 female participants, 64 with AN diagnosis and 95 healthy controls (HCs), who completed measures of PBI (body appreciation, functionality appreciation, and body responsiveness), emotion regulation, and psychological well-being (depression, anxiety, stress, and psychological quality of life). The AN group reported lower levels of PBI and psychological well-being, along with greater difficulties in regulating emotions, relative to HCs. PBI variables significantly predicted emotion regulation and psychological well-being in AN, accounting for 36% to 72% of the variance, with body appreciation emerging as the strongest predictor. These findings lend credence to the view that PBI can serve as a catalyst for psychological health. We hypothesize that enhancing PBI can improve interoceptive awareness, which is crucial for emotion regulation and reducing maladaptive food-related coping. Emphasizing a mind-body connection in lifestyle could be a relevant element to consider for both treating and preventing AN.
Prenatal Iodine Intake and Maternal Pregnancy and Postpartum Depressive and Anhedonia Symptoms: Findings from a Multiethnic US Cohort
Akinkugbe AA, Chiu YM, Kannan S, Bergink V and Wright RJ
: Emerging evidence suggests that essential trace elements, including iodine, play a vital role in depressive disorders. This study investigated whether prenatal dietary iodine intake alone and in combination with supplemental iodine intake during pregnancy were associated with antepartum and postpartum depressive and anhedonia symptoms. : The study population included 837 mothers in the PRogramming of Intergenerational Stress Mechanisms (PRISM) study. The modified BLOCK food frequency questionnaire was used to estimate prenatal dietary and supplemental iodine intake, while the 10-item Edinburg Postpartum Depression Scale (EPDS) ascertained depressive symptoms. Analyses considered the global EPDS score and the anhedonia and depressive symptom subscale scores using dichotomized cutoffs. Logistic regression estimating odds ratios and 95% confidence intervals (CIs) assessed associations of iodine intake in the second trimester of pregnancy and 6-month postpartum depressive and anhedonia symptoms considering dietary intake alone and combined dietary and supplementary intake in separate models. : Most women were Black/Hispanic Black (43%) and non-Black Hispanics (35%), with 39% reporting a high school education or less. The median (interquartile range, IQR) dietary and supplemental iodine intake among Black/Hispanic Black (198 (115, 337) µg/day) and non-Black Hispanic women (195 (126, 323) µg/day) was higher than the overall median intake level of 187 (116, 315) µg/day. Relative to the Institute of Medicine recommended iodine intake level of 160-220 µg/day, women with intake levels < 100 µg/day, 100-<160 µg/day, >220-<400 µg/day and ≥400 µg/day had increased adjusted odds of 6-month postpartum anhedonia symptoms (aOR = 1.74 (95% CI: 1.08, 2.79), 1.25 (95% CI: 0.80, 1.99), 1.31 (95% CI: 0.82, 2.10), and 1.47 (95% CI: 0.86, 2.51), respectively). The corresponding estimates for postpartum global depressive symptoms were similar but of smaller magnitude. Prenatal iodine intake, whether below or above the recommended levels for pregnant women, was most strongly associated with greater anhedonia symptoms, particularly in the 6-month postpartum period. Further studies are warranted to corroborate these findings, as dietary and supplemental iodine intake are amenable to intervention.
Treatment strategies for insomnia in Japanese primary care physicians' practice: A Web-based questionnaire survey
Takeshima M, Sakurai H, Inada K, Aoki Y, Ie K, Kise M, Yoshida E, Matsui K, Utsumi T, Shimura A, Okajima I, Kotorii N, Yamashita H, Suzuki M, Kuriyama K, Shimizu E, Mishima K, Watanabe K and Takaesu Y
It is unclear how primary care physicians manage insomnia after the introduction of novel hypnotics such as orexin receptor antagonists and melatonin receptor agonists. This Web-based questionnaire survey aimed to examine treatment strategies for insomnia in Japanese primary care practice.
Impact of the 2008 economic crisis on the burden of hepatitis B and C diseases in Southern European countries
Palladino C, Ramis R, Ezeonwumelu IJ, Biondi A, Carreras G, Fischer F, Gallus S, Golinelli D, Gorini G, Hassan S, Kabir Z, Koyanagi A, Lazarus JV, Mentis AA, Meretoja TJ, Mokdad AH, Monasta L, Mulita F, Postma MJ, Tabarés-Seisdedos R, Thiyagarajan A, Taveira N, Briz V and
The economic crisis that began in 2008 has severely affected Southern (Greece, Italy, Portugal, Spain) Western European (SWE) countries of Western Europe (WE) and may have affected ongoing efforts to eliminate viral hepatitis. This study was conducted to investigate the impact of the economic crisis on the burden of HBV and HCV disease.
Risk of major mental disorders in the offspring of parents with migraine
Li DJ, Tsai SJ, Chen TJ, Liang CS and Chen MH
Migraine has been associated with mental disorders, however whether parental migraine is associated with an increased risk of major mental disorders (MMDs) in offspring has not been investigated. We aimed to examine the risk of the development of MMDs in the offspring of parents with migraine compared with those of parents without migraine.
Pre-COVID life expectancy, mortality, and burden of diseases for adults 70 years and older in Australia: a systematic analysis for the Global Burden of Disease 2019 Study
The Australian population aged 70 and above is increasing and imposing new challenges for policy makers and providers to deliver accessible, appropriate and affordable health care. We examine pre-COVID patterns of health loss between 1990 and 2019 to inform policies and practices.
Effects of time of the day at sampling on CSF and plasma levels of Alzheimer' disease biomarkers
Orduña Dolado A, Stomrud E, Ashton NJ, Nilsson J, Quijano-Rubio C, Jethwa A, Brum WS, Brinkmalm Westman A, Zetterberg H, Blennow K, Janelidze S and Hansson O
Studies suggest that cerebrospinal fluid (CSF) levels of amyloid-β (Aβ)42 and Aβ40 present a circadian rhythm. However sustained sampling of large volumes of CSF with indwelling intrathecal catheters used in most of these studies might have affected CSF dynamics and thereby confounded the observed fluctuations in the biomarker levels.
Disproportionate Increases in Numbers and Rates of Homelessness Among Women in the United States, 2018-2022
Tsai J and Lampros A
Information about homelessness among women is conflicting. We examined changes in the number and rate of various types of homelessness among females in multiple population groups from 2018 through 2022.
Protocol for a double-blind placebo-controlled randomised controlled trial assessing the impact of oral semaglutide in amyloid positivity (ISAP) in community dwelling UK adults
Koychev I, Adler AI, Edison P, Tom B, Milton JE, Butchart J, Hampshire A, Marshall C, Coulthard E, Zetterberg H, Hellyer P, Cormack F, Underwood BR, Mummery CJ and Holman RR
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), currently marketed for type 2 diabetes and obesity, may offer novel mechanisms to delay or prevent neurotoxicity associated with Alzheimer's disease (AD). The impact of semaglutide in amyloid positivity (ISAP) trial is investigating whether the GLP-1 RA semaglutide reduces accumulation in the brain of cortical tau protein and neuroinflammation in individuals with preclinical/prodromal AD.
Protocol for the development of a tool to map systemic sclerosis pain sources, patterns, and management experiences: a Scleroderma Patient-centered Intervention Network patient-researcher partnership
Dal Santo T, Golberg M, Nassar EL, Carrier ME, Hu S, Kwakkenbos L, Bartlett SJ, Fox RS, Lee YC, Varga J, Benedetti A, Thombs BD and
Systemic sclerosis (SSc) is a rare, complex autoimmune rheumatic disease with multiple factors that contribute to pain. People with SSc emphasize the effect pain has on their quality of life, but no studies have systematically examined the frequency and relative importance of different SSc pain sources, patterns of pain from different sources, and pain management experiences. Our objectives are to (1) develop a tool, jointly with researchers, health care providers, and patients, to map sources of pain in SSc, determine patterns of pain from different sources, and understand pain management experiences; and (2) administer the final tool version to participants in the large multinational Scleroderma Patient-centered Intervention Network (SPIN) Cohort.
Decoding Early Psychoses: Unraveling Stable Microstructural Features Associated with Psychopathology Across Independent Cohorts
Wang HR, Liu ZQ, Nakua H, Hegarty CE, Thies MB, Patel PK, Schleifer CH, Boeck TP, McKinney RA, Currin D, Leathem L, DeRosse P, Bearden CE, Misic B and Karlsgodt KH
Early Psychosis patients (EP, within 3 years after psychosis onset) show significant variability, making outcome predictions challenging. Currently, little evidence exists for stable relationships between neural microstructural properties and symptom profiles across EP diagnoses, limiting the development of early interventions.
Correlation of altered intrinsic functional connectivity with impaired self-regulation in children and adolescents with ADHD
Tsai CJ, Lin HY and Gau SS
Attention-deficit hyperactivity disorder (ADHD) has a high prevalence of co-occurring impaired self-regulation (dysregulation), exacerbating adverse outcomes. Neural correlates underlying impaired self-regulation in ADHD remain inconclusive. We aimed to investigate the impact of dysregulation on intrinsic functional connectivity (iFC) in children with ADHD and the correlation of iFC with dysregulation among children with ADHD relative to typically developing controls (TDC).
Machine learning applied to prediction of relapse, hospitalization, and suicide in bipolar disorder using neuroimaging and clinical data: A systematic review
Amanollahi M, Jameie M, Looha MA, Basti FA, Cattarinussi G, Moghaddam HS, Di Camillo F, Akhondzadeh S, Pigoni A, Sambataro F, Brambilla P and Delvecchio G
Bipolar disorder (BD) is a mental disorder associated with increased morbidity/mortality. Adverse outcome prediction helps with the management of patients with BD.
Prenatal exposure to air pollution and maternal depression: Combined effects on brain aging and mental health in young adulthood
Jáni M, Mikeš O, Marecek R, Brazdil M and Mareckova K
Both maternal depression problems during pregnancy and prenatal exposure to air pollution have been associated with changes in the brain as well as worse mood and anxiety in the offspring in adulthood. However, it is not clear whether these effects are independent or whether and how they might interact and impact the brain age and mental health of the young adult offspring.
Comparison of scores on Patient Health Questionnaire-9, Edinburgh Postnatal Depression Scale and Hospital Anxiety and Depression - Depression subscale scores by administration mode: An individual participant data differential item functioning meta-analysis
Harel D, Wu Y, Levis B, Fan S, Sun Y, Xu M, Rice DB, Boruff J, Markham S, Ioannidis JPA, Takwoingi Y, Patten SB, Ziegelstein RC, Cuijpers P, Gilbody S, Vigod S, Akena D, Benedetti A, Thombs BD and
Administration mode of patient-reported outcome measures (PROMs) may influence responses. We assessed if Patient Health Questionnaire-9 (PHQ-9), Edinburgh Postnatal Depression Scale (EPDS) and Hospital Anxiety and Depression Scale - Depression subscale (HADS-D) item responses and scores were associated with administration mode. We compared (1) self-administration versus interview-administration; within self-administration (2) research or medical setting versus private; and (3) pen-and-paper versus electronic; and within interview-administration (4) in-person versus phone. We analysed individual participant data meta-analysis datasets with item-level data for the PHQ-9 (N = 34,529), EPDS (N = 16,813), and HADS-D (N = 16,768). We used multiple indicator multiple cause models to assess differential item functioning (DIF) by administration mode. We found statistically significant DIF for most items on all measures due to large samples, but influence on total scores was negligible. In 10 comparisons conducted across the PHQ-9, EPDS, and HADS-D, Pearson's correlations and intraclass correlation coefficients between latent depression symptom scores from models that did or did not account for DIF were between 0.995 and 1.000. Total PHQ-9, EPDS, and HADS-D scores did not differ materially across administration modes. Researcher and clinicians who evaluate depression symptoms with these questionnaires can select administration methods based on patient preferences, feasibility, or cost.
Chemical signatures delineate heterogeneous amyloid plaque populations across the Alzheimer's disease spectrum
Koutarapu S, Ge J, Dulewicz M, Srikrishna M, Szadziewska A, Wood J, Blennow K, Zetterberg H, Michno W, Ryan NS, Lashley T, Savas J, Schöll M and Hanrieder J
Amyloid plaque deposition is recognized as the primary pathological hallmark of Alzheimer's disease(AD) that precedes other pathological events and cognitive symptoms. Plaque pathology represents itself with an immense polymorphic variety comprising plaques with different stages of amyloid fibrillization ranging from diffuse to fibrillar, mature plaques. The association of polymorphic Aβ plaque pathology with AD pathogenesis, clinical symptoms and disease progression remains unclear. Advanced chemical imaging tools, such as functional amyloid microscopy combined with MALDI mass spectrometry imaging (MSI), are now enhanced by deep learning algorithms. This integration allows for precise delineation of polymorphic plaque structures and detailed identification of their associated Aβ compositions. We here set out to make use of these tools to interrogate heterogenic plaque types and their associated biochemical architecture. Our findings reveal distinct Aβ signatures that differentiate diffuse plaques from fibrilized ones, with the latter showing substantially higher levels of Aβx-40. Notably, within the fibrilized category, we identified a distinct subtype known as coarse-grain plaques. Both in sAD and fAD brain tissue, coarse grain plaques contained more Aβx-40 and less Aβx-42 compared with cored plaques. The coarse grain plaques in both sAD and fAD also showed higher levels of neuritic content including paired helical filaments (PHF-1)/phosphorylated phospho Tau-immunopositive neurites. Finally, the Aβ peptide content in coarse grain plaques resembled that of vascular Aβ deposits (CAA) though with relatively higher levels of Aβ1-42 and pyroglutamated Aβx-40 and Aβx-42 species in coarse grain plaques. This is the first of its kind study on spatial biochemical characterization of different plaque morphotypes demonstrating the potential of the correlative imaging techniques used that further increase the understanding of heterogeneous AD pathology. Linking the biochemical characteristics of amyloid plaque polymorphisms with various AD etiologies and toxicity mechanisms is crucial. Understanding the connection between plaque structure and disease pathogenesis can enhance our insights. This knowledge is particularly valuable for developing and advancing novel, amyloid-targeting therapeutics.
Primitive macrophages enable long-term vascularization of human heart-on-a-chip platforms
Landau S, Zhao Y, Hamidzada H, Kent GM, Okhovatian S, Lu RXZ, Liu C, Wagner KT, Cheung K, Shawky SA, Vosoughi D, Beroncal EL, Fernandes I, Cummins CL, Andreazza AC, Keller GM, Epelman S and Radisic M
The intricate anatomical structure and high cellular density of the myocardium complicate the bioengineering of perfusable vascular networks within cardiac tissues. In vivo neonatal studies highlight the key role of resident cardiac macrophages in post-injury regeneration and angiogenesis. Here, we integrate human pluripotent stem-cell-derived primitive yolk-sac-like macrophages within vascularized heart-on-chip platforms. Macrophage incorporation profoundly impacted the functionality and perfusability of microvascularized cardiac tissues up to 2 weeks of culture. Macrophages mitigated tissue cytotoxicity and the release of cell-free mitochondrial DNA (mtDNA), while upregulating the secretion of pro-angiogenic, matrix remodeling, and cardioprotective cytokines. Bulk RNA sequencing (RNA-seq) revealed an upregulation of cardiac maturation and angiogenesis genes. Further, single-nuclei RNA sequencing (snRNA-seq) and secretome data suggest that macrophages may prime stromal cells for vascular development by inducing insulin like growth factor binding protein 7 (IGFBP7) and hepatocyte growth factor (HGF) expression. Our results underscore the vital role of primitive macrophages in the long-term vascularization of cardiac tissues, offering insights for therapy and advancing heart-on-a-chip technologies.
Child developmental outcomes associated with postpartum depression and anxiety in low and middle-income countries: a systematic review
Sridhar H, Kishore MT and Chandra PS
This systematic review aims to summarize the findings of empirical studies conducted in low- and middle-income countries (LMICs) examining the relationship between postpartum depression and anxiety, and child developmental outcomes measured at 24 months of child's age.
Evaluation of polygenic scoring methods in five biobanks shows larger variation between biobanks than methods and finds benefits of ensemble learning
Monti R, Eick L, Hudjashov G, Läll K, Kanoni S, Wolford BN, Wingfield B, Pain O, Wharrie S, Jermy B, McMahon A, Hartonen T, Heyne H, Mars N, Lambert S, , Hveem K, Inouye M, van Heel DA, Mägi R, Marttinen P, Ripatti S, Ganna A and Lippert C
Methods of estimating polygenic scores (PGSs) from genome-wide association studies are increasingly utilized. However, independent method evaluation is lacking, and method comparisons are often limited. Here, we evaluate polygenic scores derived via seven methods in five biobank studies (totaling about 1.2 million participants) across 16 diseases and quantitative traits, building on a reference-standardized framework. We conducted meta-analyses to quantify the effects of method choice, hyperparameter tuning, method ensembling, and the target biobank on PGS performance. We found that no single method consistently outperformed all others. PGS effect sizes were more variable between biobanks than between methods within biobanks when methods were well tuned. Differences between methods were largest for the two investigated autoimmune diseases, seropositive rheumatoid arthritis and type 1 diabetes. For most methods, cross-validation was more reliable for tuning hyperparameters than automatic tuning (without the use of target data). For a given target phenotype, elastic net models combining PGS across methods (ensemble PGS) tuned in the UK Biobank provided consistent, high, and cross-biobank transferable performance, increasing PGS effect sizes (β coefficients) by a median of 5.0% relative to LDpred2 and MegaPRS (the two best-performing single methods when tuned with cross-validation). Our interactively browsable online-results and open-source workflow prspipe provide a rich resource and reference for the analysis of polygenic scoring methods across biobanks.
Psychoeducational group interventions for adults diagnosed with attention-deficit/ hyperactivity disorder: a scoping review of feasibility, acceptability, and outcome measures
Skliarova T, Pedersen H, Holsbrekken Å, Pedersen SA, Mandal A, De Las Cuevas C, Havnen A, Gråwe R and Lara-Cabrera ML
Although psychoeducational group interventions are increasingly used for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD), a comprehensive review focused on the feasibility and acceptability indicators of these interventions remains lacking. Furthermore, although previous research has explored various aspects of psychoeducation for ADHD, such as its definition and approaches, limited research has focused on the synthesis for outcome measures and patients' experiences related to these interventions. Therefore, this scoping review aims to map the existing evidence reported on psychoeducational group interventions for adults diagnosed with ADHD. The objective is to provide a comprehensive overview of feasibility indicators, acceptability, and outcome measures used in psychoeducational group interventions.
Cortical responses to looming sources are explained away by the auditory periphery
Benghanem S, Guha R, Pruvost-Robieux E, Lévi-Strauss J, Joucla C, Cariou A, Gavaret M and Aucouturier JJ
A wealth of behavioral evidence indicate that sounds with increasing intensity (i.e. appear to be looming towards the listener) are processed with increased attentional and physiological resources compared to receding sounds. However, the neurophysiological mechanism responsible for such cognitive amplification remains elusive. Here, we show that the large differences seen between cortical responses to looming and receding sounds are in fact almost entirely explained away by nonlinear encoding at the level of the auditory periphery. We collected electroencephalography (EEG) data during an oddball paradigm to elicit mismatch negativity (MMN) and others Event Related Potentials (EPRs), in response to deviant stimuli with both dynamic (looming and receding) and constant level (flat) differences to the standard in the same participants. We then combined a computational model of the auditory periphery with generative EEG methods (temporal response functions, TRFs) to model the single-participant ERPs responses to flat deviants, and used them to predict the effect of the same mechanism on looming and receding stimuli. The flat model explained 45% variance of the looming response, and 33% of the receding response. This provide striking evidence that difference wave responses to looming and receding sounds result from the same cortical mechanism that generate responses to constant-level deviants: all such differences are the sole consequence of their particular physical morphology getting amplified and integrated by peripheral auditory mechanisms. Thus, not all effects seen cortically proceed from top-down modulations by high-level decision variables, but can rather be performed early and efficiently by feed-forward peripheral mechanisms that evolved precisely to sparing subsequent networks with the necessity to implement such mechanisms.
Genetic influences on brain and cognitive health and their interactions with cardiovascular conditions and depression
Zhukovsky P, Tio ES, Coughlan G, Bennett DA, Wang Y, Hohman TJ, Pizzagalli DA, Mulsant BH, Voineskos AN and Felsky D
Approximately 40% of dementia cases could be prevented or delayed by modifiable risk factors related to lifestyle and environment. These risk factors, such as depression and vascular disease, do not affect all individuals in the same way, likely due to inter-individual differences in genetics. However, the precise nature of how genetic risk profiles interact with modifiable risk factors to affect brain health is poorly understood. Here we combine multiple data resources, including genotyping and postmortem gene expression, to map the genetic landscape of brain structure and identify 367 loci associated with cortical thickness and 13 loci associated with white matter hyperintensities (P < 5×10), with several loci also showing a significant association with cognitive function. We show that among 220 unique genetic loci associated with cortical thickness in our genome-wide association studies (GWAS), 95 also showed evidence of interaction with depression or cardiovascular conditions. Polygenic risk scores based on our GWAS of inferior frontal thickness also interacted with hypertension in predicting executive function in the Canadian Longitudinal Study on Aging. These findings advance our understanding of the genetic underpinning of brain structure and show that genetic risk for brain and cognitive health is in part moderated by treatable mid-life factors.
Quality of life during usual epilepsy care for anxiety or depression symptoms: Secondary patient-reported outcomes in a randomized trial of remote assessment methods
Munger Clary HM, Snively BM, Kumi-Ansu Y, Alexander HB, Kimball J, Duncan P, Conner K, Christopher J, Lohana P and Brenes GA
Anxiety and depression are highly prevalent and impactful in epilepsy. American Academy of Neurology quality measures emphasize anxiety and depression screening and quality of life (QOL) measurement, yet usual epilepsy care QOL and anxiety/depression outcomes are poorly characterized. The main objective was to assess 6-month QOL, anxiety and depression during routine care among adults with epilepsy and baseline anxiety or depression symptoms; these were prespecified secondary outcomes within a pragmatic randomized trial of remote assessment methods.
Female sex and age-based advantage of simulated electric field in TMS to the prefrontal cortex in schizophrenia and mood disorders
Tamaki A, Uenishi S, Yamada S, Yasuda K, Ikeda N, Tabata M, Kita A, Mizutani-Tiebel Y, Keeser D, Padberg F, Tsuji T, Kimoto S and Takahashi S
This study investigates computational models of electric field strength for transcranial magnetic stimulation (TMS) of the left dorsolateral prefrontal cortex (DLPFC) based on individual MRI data of patients with schizophrenia (SZ), major depressive disorder (MDD), bipolar disorder (BP), and healthy controls (HC). In addition, it explores the association of electric field intensities with age, gender and intracranial volume. The subjects were 23 SZ (12 male, mean age = 45.30), 24 MDD (16 male, mean age = 43.57), 23 BP (16 male, mean age = 39.29), 23 HC (13 male, mean age = 40.91). Based on individual MRI sequences, electric fields were computationally modeled by two independent investigators using SimNIBS ver. 2.1.1. There was no significant difference in electric field strength between the groups (HC vs SZ, HC vs MDD, HC vs BP, SCZ vs MDD, SCZ vs BP, MDD vs BP). Female subjects showed higher electric field intensities in widespread areas than males, and age was positively significantly associated with electric field strength in the left parahippocampal area as observed. Our results suggest differences in electric field strength of left DLPFC TMS for gender and age. It may open future avenues for individually modeling TMS based on structural MRI data.
Efficacy and acceptability of interventions to reduce antipsychotic polypharmacy: A systematic review and meta-analysis of randomized clinical trials
Köhler-Forsberg O, Højlund M, Rohde C, Kemp AF, Gregersen AT, Mellentin AI and Correll CU
Antipsychotic polypharmacy (APP) is frequent but evidence-based guidelines on reducing APP to antipsychotic monotherapy (APM) are sparse. We aimed to systematically review clinical interventions randomizing patients to reducing APP to APM versus continuing APP.
Mapping Brain Synergy Dysfunction in Schizophrenia: Understanding Individual Differences and Underlying Molecular Mechanisms
Ding C, Li A, Xie S, Tian X, Li K, Fan L, Yan H, Chen J, Chen Y, Wang H, Guo H, Yang Y, Lv L, Wang H, Zhang H, Lu L, Zhang D, Zhang Z, Wang M, Jiang T and Liu B
To elucidate the brain-wide information interactions that vary and contribute to individual differences in schizophrenia (SCZ), an information-resolved method is employed to construct individual synergistic and redundant interaction matrices based on regional pairwise BOLD time-series from 538 SCZ and 540 normal controls (NC). This analysis reveals a stable pattern of regionally-specific synergy dysfunction in SCZ. Furthermore, a hierarchical Bayesian model is applied to deconstruct the patterns of whole-brain synergy dysfunction into three latent factors that explain symptom heterogeneity in SCZ. Factor 1 exhibits a significant positive correlation with Positive and Negative Syndrome Scale (PANSS) positive scores, while factor 3 demonstrates significant negative correlations with PANSS negative and general scores. By integrating the neuroimaging data with normative gene expression information, this study identifies that each of these three factors corresponded to a subset of the SCZ risk gene set. Finally, by combining data from NeuroSynth and open molecular imaging sources, along with a spatially heterogeneous mean-field model, this study delineates three SCZ synergy factors corresponding to distinct symptom profiles and implicating unique cognitive, neurodynamic, and neurobiological mechanisms.
Near real-time patient experience feedback with data relay to providers: a systematic review of its effectiveness
Jesus TS, Struhar J, Zhang M, Lee D, Stern BZ, Heinemann AW, Jordan N and Deutsch A
Near Real-Time Feedback (NRTF) on the patient's experience with care, coupled with data relay to providers, can inform quality-of-care improvements, including at the point of care. The objective is to systematically review contemporary literature on the impact of the use of NRTF and data relay to providers on standardized patient experience measures. Six scientific databases and five specialty journals were searched supplemented by snowballing search strategies, according to the registered study protocol. Eligibility included studies in English (2015-2023) assessing the impact of NRTF and data relay on standardized patient-reported experience measures as a primary outcome. Eligibility and quality appraisals were performed by two independent reviewers. An expert former patient (Patient and Family Advisory Council and communication sciences background) helped interpret the results. Eight papers met review eligibility criteria, including three randomized controlled trials (RCTs) and one non-randomized study. Three of these studies involved in-person NRTF prior to data relay (patient-level data for immediate corrective action or aggregated and peer-compared) and led to significantly better results in all or some of the experience measures. In turn, a kiosk-based NRTF achieved no better experience results. The remaining studies were pre-post designs with mixed or neutral results and greater risks of bias. In-person NRTF on the patient experience followed by rapid data relay to their providers, either patient-level or provider-level as peer-compared, can improve the patient experience of care. Reviewed kiosk-based or self-reported approaches combined with data relay were not effective. Further research should determine which approach (e.g. who conducts the in-person NRTF) will provide better, more efficient improvements and under which circumstances.
Validation of the German version of the 25-item hikikomori questionnaire 25
Hajek A, Teo AR, Zwar L and König HH
The 25-item Hikikomori Questionnaire (HQ-25) is an instrument developed to measure a condition characterized by extreme social withdrawal that was first described in Japan. This study aimed to translate the HQ-25 into German and validate the German version (HQ-25-G).
Comparing the effects of CETP in East Asian and European ancestries: a Mendelian randomization study
Dunca D, Chopade S, Gordillo-Marañón M, Hingorani AD, Kuchenbaecker K, Finan C and Schmidt AF
CETP inhibitors are a class of lipid-lowering drugs in development for treatment of coronary heart disease (CHD). Genetic studies in East Asian ancestry have interpreted the lack of CETP signal with low-density lipoprotein cholesterol (LDL-C) and lack of drug target Mendelian randomization (MR) effect on CHD as evidence that CETP inhibitors might not be effective in East Asian participants. Capitalizing on recent increases in sample size of East Asian genetic studies, we conducted a drug target MR analysis, scaled to a standard deviation increase in high-density lipoprotein cholesterol. Despite finding evidence for possible neutral effects of lower CETP levels on LDL-C, systolic blood pressure and pulse pressure in East Asians (interaction p-values < 1.6 × 10), effects on cardiovascular outcomes were similarly protective in both ancestry groups. In conclusion, on-target inhibition of CETP is anticipated to decrease cardiovascular disease in individuals of both European and East Asian ancestries.
Living Alone With Mild-to-Moderate Dementia Over a Two-Year Period: Longitudinal Findings From the IDEAL Cohort
Clare L, Gamble LD, Martyr A, Henderson C, Knapp M, Matthews FE and
To compare the experiences of people with dementia living alone or with others and how these may change over two years.
Dopamine D2 receptor antagonism of antipsychotics and the risk of death due to choking
Luykx JJ, Tanskanen A, Lähteenvuo M, Manu P, Correll CU, Hasan A, Lieslehto J, Taipale H and Tiihonen J
The risk of fatal choking for people with schizophrenia and associations with antipsychotic medication are largely unknown. Therefore, we calculated the choking-related standardized mortality ratio for schizophrenia relative to the general population (SMR). We also computed adjusted hazard ratios (aHR) of choking-related mortality for antipsychotics in a nationwide cohort of patients with schizophrenia (N = 59,916). SMR was 20.5 (95 % confidence interval (CI)=17.1-23.9). The aHR was 1.74 (95 %CI=1.19-2.55) for strong dopamine 2-antagonists. For other antipsychotics, CIs included 1. Importantly, aHRs were particularly high for high dose categories of strong dopamine D2 receptor (D2R) antagonists. In conclusion, a schizophrenia diagnosis is associated with a 20-fold risk of death due to choking. This risk is elevated during use of strong D2R antagonist antipsychotics, particularly when prescribed in high dosages.
The efficacy and safety of autologous epidermal cell suspensions for re-epithelialization of skin lesions: A systematic review and meta-analysis of randomized trials
Lou J, Xiang Z, Fan Y, Song J, Huang N, Li J, Jin G and Cui S
Successful usage of autologous skin cell suspension (ASCS) has been demonstrated in some clinical trials. However, its efficacy and safety have not been verified. This latest systematic review and meta-analysis aim to examine the effects of autologous epidermal cell suspensions in re-epithelialization of skin lesions.
Racial and ethnic disparities in receipt of specialty treatment across risk profiles of adults with heavy alcohol use
Palzes VA, Chi FW, Weisner C, Kline-Simon AH, Satre DD and Sterling S
Variation in specialty treatment utilization for alcohol use disorder (AUD) by patient subgroups is poorly understood. This study examined whether and how patient risk profiles predict receipt of specialty treatment and whether there are disparities by race and ethnicity.
Working mechanisms of the use and acceptability of ecological momentary interventions: a realist evaluation of a guided self-help ecological momentary intervention targeting self-esteem
Postma MR, Vrancken S, Daemen M, Meulen IH, Volbragt N, Delespaul P, Haan L, Pluijm MV, Breedvelt JJF, Gaag MV, Lindauer R, Berg DVD, Bockting C, Amelsvoort TV, Schwannauer M, Doi L and Reininghaus U
Technology improves accessibility of psychological interventions for youth. An ecological momentary intervention (EMI) is a digital intervention geared toward intervening in daily life to enhance the generalizability and ecological validity, and to be able to intervene in moments most needed. Identifying working mechanisms of the use of ecological momentary interventions might generate insights to improve interventions.
Translation, cultural adaptation and validation of Patient Health Questionnaire and generalized anxiety disorder among adolescents in Nepal
Luitel NP, Rimal D, Eleftheriou G, Rose-Clarke K, Nayaju S, Gautam K, Pant SB, Devkota N, Rana S, Chaudhary JM, Gurung BS, Åhs JW, Carvajal-Velez L and Kohrt BA
Depression and anxiety are significant contributors to the global burden of disease among young people. Accurate data on the prevalence of these conditions are crucial for the equitable distribution of resources for planning and implementing effective programs. This study aimed to culturally adapt and validate data collection tools for measuring depression and anxiety at the population level.
Transcutaneous auricular vagus nerve stimulation to acutely reduce emotional vulnerability and improve emotional regulation in borderline personality disorder (tVNS-BPD): study protocol for a randomized, single-blind, sham-controlled trial
Guerriero G, Liljedahl SI, Carlsen HK, López Muñoz M, Daros AR, Ruocco AC and Steingrimsson S
Borderline personality disorder (BPD) is considered a disorder of emotion regulation resulting from the expression of a biologically determined emotional vulnerability (that is, heightened sensitivity to emotion, increased emotional intensity/reactivity, and a slow return to emotional baseline) combined with exposure to invalidating environments. Vagal tone has been associated with activity in cortical regions involved in emotion regulation and a lower resting state of vagal tone has been observed in BPD patients relative to healthy controls. Non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) has been shown to reduce temper outbursts in adults with Prader-Willi Syndrome, to enhance recognition of emotions in healthy students, and to improve depressive and anxiety symptoms. Furthermore, a single session of taVNS has been shown to acutely alter the recognition of facial expressions of negative valence in adolescents with MDD and increase emotion recognition in controls. However, the effect of taVNS on emotional vulnerability and regulation in individuals diagnosed with BPD has not been investigated. Our aims are to determine if taVNS is effective in acutely reducing emotional vulnerability and improve emotional regulation in BPD patients.
Trajectories of Hearing From Childhood to Adulthood
Leung JH, Thorne PR, Purdy SC, Cheyne K, Steptoe B, Ambler A, Hogan S, Ramrakha S, Caspi A, Moffitt TE and Poulton R
The Dunedin Multidisciplinary Health and Development Study provides a unique opportunity to document the progression of ear health and hearing ability within the same cohort of individuals from birth. This investigation draws on hearing data from 5 to 13 years and again at 45 years of age, to explore the associations between childhood hearing variables and hearing and listening ability at age 45.
Translating motivational interviewing for the HPV vaccine into a computable ontology model for automated AI conversational interaction
Moore N, Amith M, Neumann AC, Hamilton J, Tang L, Savas LS and Tao C
Human papillomavirus (HPV) vaccinations are lower than expected. To protect the onset of head and neck cancers, innovative strategies to improve the rates are needed. Artificial intelligence may offer some solutions, specifically conversational agents to perform counseling methods. We present our efforts in developing a dialogue model for automating motivational interviewing (MI) to encourage HPV vaccination. We developed a formalized dialogue model for MI using an existing ontology-based framework to manifest a computable representation using OWL2. New utterance classifications were identified along with the ontology that encodes the dialogue model. Our work is available on GitHub under the GPL v.3. We discuss how an ontology-based model of MI can help standardize/formalize MI counseling for HPV vaccine uptake. Our future steps will involve assessing MI fidelity of the ontology model, operationalization, and testing the dialogue model in a simulation with live participants.
Procrastination as a Marker of Anxiety Disorder Among College Students: An Institution-Based Cross-Sectional Study From Puducherry, India
Govindan S, Kaliaperumal M, Arulmozhi M and Priya P
Background and objective Procrastination, which refers to the act of unnecessarily delaying the beginning or completion of an assigned task, is a widespread but often neglected problem among college students. Postponing a task can impair academic performance or lead to stress and poor mental well-being. A knowledge gap exists in understanding the cyclical nature of the relationship between anxiety and procrastination, wherein anxiety leads to procrastination, which in turn exacerbates anxiety. In light of this, we aimed to assess the level of procrastination and anxiety among college students and to correlate the relationship between their procrastination and anxiety status. Methodology A cross-sectional analytical study was conducted among 347 graduate students from various disciplines at a tertiary care hospital in Puducherry, India. A convenient sampling technique was employed to recruit the participants, and data were collected using the validated Procrastination Assessment Scale for Students (PASS) and the Hamilton Anxiety Rating Scale (HAM-A). Results Our findings showed that about 124 (35.7%) participants reported weekly reading assignments as the most frequently procrastinated task, with a mean score of 3.15 ± 1.02, followed by studying for exams and writing term papers. The most commonly reported reason for procrastination was evaluation anxiety, followed by low self-esteem and perfectionism. A significant number of students (157, 45.2%) had mild anxiety, and 58 (16.7%) students were found to have severe anxiety. A Spearman correlation coefficient of 0.26 (95% CI: 0.16 - 0.36) was observed between the overall procrastination score and HAM-A score, which indicated a weak positive correlation and was statistically significant (p<0.05). Similarly, a weak positive correlation was found between task aversiveness, fear of failure, and anxiety levels. Conclusions Procrastination is positively related to anxiety but the relationship is weak. Understanding and addressing the underlying anxiety or stress can be a key to managing procrastination among college students.
Out-Patient versus In-Patient Arteriovenous Fistula Creation for Dialysis: Assessing Cost-Effectiveness Alongside Clinical Implications
Russu E, Munteanu AC, Arbănași EM, Szanto LA, Bartus R, Florea E, Bandici BC, Arbănași EM, Ion AP, Cordoș BA, Serac G, Ujlaki-Nagi AA, Ciucanu CC and Mureșan AV
(1) Background: The surgical procedure to create an arteriovenous fistula (AVF) can be performed in either an ambulatory or in-patient hospital setting, depending on the case's complexity, the anesthesia type used, and the patient's comorbidities. The main scope of this study is to assess the cost-effectiveness and clinical implications of surgically creating an AVF in both ambulatory and in-hospital settings. (2) Methods: We conducted a retrospective observational study, in which we initially enrolled all patients with end-stage kidney disease (ESKD) admitted to the Vascular Surgery Department, Emergency County Hospital of Targu Mures, Romania, to surgically create an AVF for dialysis, between January 2020 and December 2022. The primary endpoint of this study is to assess the cost-effectiveness of surgically creating an AVF in an ambulatory vs. in-hospital setting by comparing the costs required for the two types of admissions. Further, the 116 patients enrolled in this study were divided into two groups based on their preference for hospitalization: and . (3) Results: Regarding in-patient comorbidities, there was a higher prevalence of peripheral artery disease (PAD) ( = 0.006), malignancy ( = 0.020), and previous myocardial infarction ( = 0.012). In addition, active smoking ( = 0.006) and obesity ( = 0.018) were more frequent among these patients. Regarding the laboratory data, the in-patients had lower levels of white blood cells (WBC) ( = 0.004), neutrophils count ( = 0.025), lymphocytes ( = 0.034), and monocytes ( = 0.032), but there were no differences between the two groups regarding the systemic inflammatory biomarkers or the AVF type. Additionally, we did not register any difference regarding the outcomes: local complications ( = 0.588), maturation failure ( = 0.267), and primary patency ( = 0.834). In our subsequent analysis, we discovered no significant difference between the hospitalization type chosen by patients regarding AVF primary patency failure ( = 0.195). We found no significant association between the hospitalization type and the recorded outcomes (all > 0.05) in both multivariate linear regression and Cox proportional hazard analysis. (4) Conclusions: In conclusion, there are no significant differences in the clinical implications, short-term and long-term complications of AVF for out-patient and in-patient admissions. Additionally, we found no variation in the costs associated with laboratory tests and surgical supplies for an AVF creation. Therefore, it is safe to perform ambulatory AVFs, which can reduce the risk of hospital-acquired infections and provide greater comfort to the patient.
The Potential Effects of the Ketogenic Diet in the Prevention and Co-Treatment of Stress, Anxiety, Depression, Schizophrenia, and Bipolar Disorder: From the Basic Research to the Clinical Practice
Chrysafi M, Jacovides C, Papadopoulou SK, Psara E, Vorvolakos T, Antonopoulou M, Dakanalis A, Martin M, Voulgaridou G, Pritsa A, Mentzelou M and Giaginis C
The ketogenic diet (KD) has been highly developed in the past for the treatment of epileptic pathological states in children and adults. Recently, the current re-emergence in its popularity mainly focuses on the therapy of cardiometabolic diseases. The KD can also have anti-inflammatory and neuroprotective activities which may be applied to the prevention and/or co-treatment of a diverse range of psychiatric disorders.
Glial Markers of Suicidal Behavior in the Human Brain-A Systematic Review of Postmortem Studies
Yamamoto M, Sakai M, Yu Z, Nakanishi M and Yoshii H
Suicide is a major public health priority, and its molecular mechanisms appear to be related to glial abnormalities and specific transcriptional changes. This study aimed to identify and synthesize evidence of the relationship between glial dysfunction and suicidal behavior to understand the neurobiology of suicide. As of 26 January 2024, 46 articles that met the inclusion criteria were identified by searching PubMed and ISI Web of Science. Most postmortem studies, including 30 brain regions, have determined no density or number of total Nissl-glial cell changes in suicidal patients with major psychiatric disorders. There were 17 astrocytic, 14 microglial, and 9 oligodendroglial studies using specific markers of each glial cell and further on their specific gene expression. Those studies suggest that astrocytic and oligodendroglial cells lost but activated microglia in suicides with affective disorder, bipolar disorders, major depression disorders, or schizophrenia in comparison with non-suicided patients and non-psychiatric controls. Although the data from previous studies remain complex and cannot fully explain the effects of glial cell dysfunction related to suicidal behaviors, they provide risk directions potentially leading to suicide prevention.
Iranian Traditional Medicine for Treatment of Attention Deficit Disorder with Hyperactivity in Children: A Systematic Review of Randomized Controlled Trials
Noorazar SG, Mirzaei M and Kalejahi P
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with a complex etiology. Stimulants as a first-line treatment are not effective in some cases. In this study, we conducted a systematic review to evaluate the efficacy of traditional Persian Iranian medicine (TIM) for children and adolescents with ADHD.
Finding the Right Setting for the Right Treatment During the Acute Treatment of Individuals with Schizophrenia: A Narrative Review and Clinical Practice Guideline
Correll CU, Arango C, Fagiolini A, Giordano GM, Leucht S and Salazar de Pablo G
Schizophrenia is most times a chronic and often debilitating illness associated with poor mental health outcomes. Early and effective treatment of schizophrenia in the most appropriate setting can make a significant difference in the long-term recovery. The aim of this narrative review was to provide suggestions and recommendations for effectively managing patients with schizophrenia during acute exacerbations and to enhance awareness and skills related to personalized medicine.
Automated Scoring of Alzheimer's Disease Atrophy Scale with Subtype Classification Using Deep Learning-Based T1-Weighted Magnetic Resonance Image Segmentation
Choe YS, Kim REY, Kim HW, Kim J, Lee H, Lee MK, Lee M, Kim KY, Kim SH, Kim JH, Lee JY, Kim E, Kim D and Lim HK
Application of visual scoring scales for regional atrophy in Alzheimer's disease (AD) in clinical settings is limited by their high time cost and low intra/inter-rater agreement.
A machine learning approach for differentiating bipolar disorder type II and borderline personality disorder using electroencephalography and cognitive abnormalities
Nazari MJ, Shalbafan M, Eissazade N, Khalilian E, Vahabi Z, Masjedi N, Ghidary SS, Saadat M and Sadegh-Zadeh SA
This study addresses the challenge of differentiating between bipolar disorder II (BD II) and borderline personality disorder (BPD), which is complicated by overlapping symptoms. To overcome this, a multimodal machine learning approach was employed, incorporating both electroencephalography (EEG) patterns and cognitive abnormalities for enhanced classification. Data were collected from 45 participants, including 20 with BD II and 25 with BPD. Analysis involved utilizing EEG signals and cognitive tests, specifically the Wisconsin Card Sorting Test and Integrated Cognitive Assessment. The k-nearest neighbors (KNN) algorithm achieved a balanced accuracy of 93%, with EEG features proving to be crucial, while cognitive features had a lesser impact. Despite the strengths, such as diverse model usage, it's important to note limitations, including a small sample size and reliance on DSM diagnoses. The study suggests that future research should explore multimodal data integration and employ advanced techniques to improve classification accuracy and gain a better understanding of the neurobiological distinctions between BD II and BPD.
Distinct biological signature and modifiable risk factors underlie the comorbidity between major depressive disorder and cardiovascular disease
Bergstedt J, Pasman JA, Ma Z, Harder A, Yao S, Parker N, Treur JL, Smit DJA, Frei O, Shadrin AA, Meijsen JJ, Shen Q, Hägg S, Tornvall P, Buil A, Werge T, Hjerling-Leffler J, Als TD, Børglum AD, Lewis CM, McIntosh AM, Valdimarsdóttir UA, Andreassen OA, Sullivan PF, Lu Y and Fang F
Major depressive disorder (MDD) and cardiovascular disease (CVD) are often comorbid, resulting in excess morbidity and mortality. Here we show that CVDs share most of their genetic risk factors with MDD. Multivariate genome-wide association analysis of shared genetic liability between MDD and atherosclerotic CVD revealed seven loci and distinct patterns of tissue and brain cell-type enrichments, suggesting the involvement of the thalamus. Part of the genetic overlap was explained by shared inflammatory, metabolic and psychosocial or lifestyle risk factors. Our data indicated causal effects of genetic liability to MDD on CVD risk, but not from most CVDs to MDD, and showed that the causal effects were partly explained by metabolic and psychosocial or lifestyle factors. The distinct signature of MDD-atherosclerotic CVD comorbidity suggests an immunometabolic subtype of MDD that is more strongly associated with CVD than overall MDD. In summary, we identified biological mechanisms underlying MDD-CVD comorbidity and modifiable risk factors for prevention of CVD in individuals with MDD.
Meta-analysis of experimental factors influencing single-pulse TMS effects on the early visual cortex
Zhang Y, Song B, Zhao X, Jin Z, Zhang J and Li L
Single-pulse transcranial magnetic stimulation (spTMS) applied to the Early Visual Cortex (EVC) has demonstrated the ability to suppress the perception on visual targets, akin to the effect of visual masking. However, the reported spTMS suppression effects across various studies have displayed inconsistency.
Cardiovascular disease risk: it is complicated, but race and ethnicity are key, a Bayesian network analysis
Bowles NP, He Y, Huang YH, Stecker EC, Seixas A and Thosar SS
Cardiovascular diseases are the leading cause of morbidity and mortality in the United States. Despite the complexity of cardiovascular disease etiology, we do not fully comprehend the interactions between non-modifiable factors (e.g., age, sex, and race) and modifiable risk factors (e.g., health behaviors and occupational exposures).
Burden of irregular menstrual cycle and its predictors among reproductive-age women in Ethiopia: Systematic review and meta-analysis
Mussa I, Jibro U, Sertu A, Deressa A, Mohammed F, Regassa LD, Cheru A, Mohammed E, Abdurahman D and Balis B
Irregular menstrual cycle has negative health and psychosocial repercussions for women of reproductive age worldwide. However, there is no national data for policymakers and health planners in Ethiopia. Therefore, this review aimed to determine the overall burden of irregular menstrual cycle and predictors among reproductive-age women in Ethiopia.
Potential Link Between Exercise and N-Methyl-D-Aspartate Glutamate Receptors in Alcohol Use Disorder: Implications for Therapeutic Strategies
Sedhom S, Hammond N, Thanos KZ, Blum K, Elman I, Bowirrat A, Dennen CA and Thanos PK
Alcohol use disorder (AUD) is a significant risk factor, accounting for approximately 13% of all deaths in the US. AUD not only destroys families but also causes economic losses due to reduced productivity, absenteeism, and healthcare expenses. Statistics revealing the sustained number of individuals affected by AUD over the years underscore the need for further understanding of the underlying pathophysiology to advance novel therapeutic strategies. Previous research has implicated the limbic brain regions N-methyl-D-aspartate glutamate receptors (NMDAR) in the emotional and behavioral effects of AUD. Given that aerobic exercise can modulate NMDAR activity and sensitivity to alcohol, this review presents a summary of clinical and basic science studies on NMDAR levels induced by alcohol consumption, as well as acute and protracted withdrawal, highlighting the potential role of aerobic exercise as an adjunctive therapy for AUD. Based on our findings, the utility of exercise in the modulation of reward-linked receptors and AUD may be mediated by its effects on NMDA signaling. These data support further consideration of the potential of aerobic exercise as a promising adjunctive therapy for AUD.
Resting-state networks and anosognosia in Alzheimer's disease
Tondelli M, Ballotta D, Maramotti R, Carbone C, Gallingani C, MacKay C, Pagnoni G, Chiari A and Zamboni G
Recent evidence suggests that anosognosia or unawareness of cognitive impairment in Alzheimer's Disease (AD) may be explained by a disconnection between brain regions involved in accessing and monitoring information regarding self and others. It has been demonstrated that AD patients with anosognosia have reduced connectivity within the default mode network (DMN) and that anosognosia in people with prodromal AD is positively associated with bilateral anterior cingulate cortex (ACC), suggesting a possible role of this region in mechanisms of awareness in the early phase of disease. We hypothesized that anosognosia in AD is associated with an imbalance between the activity of large-scale resting-state functional magnetic resonance imaging (fMRI) networks, in particular the DMN, the salience network (SN), and the frontoparietal network (FPN).
Post-traumatic stress disorder: the role of the amygdala and potential therapeutic interventions - a review
Davis LL and Hamner MB
Post-traumatic stress disorder (PTSD) is a psychiatric disorder triggered by exposure to a life-threatening or sexually violent traumatic event, and is characterized by symptoms involving intrusive re-experiencing, persistent avoidance of associated stimuli, emotional and cognitive disturbances, and hyperarousal for long periods after the trauma has occurred. These debilitating symptoms induce occupational and social impairments that contribute to a significant clinical burden for PTSD patients, and substantial socioeconomic costs, reaching approximately $20,000 dollars per individual with PTSD each year in the US. Despite increased translational research focus in the field of PTSD, the development of novel, effective pharmacotherapies for its treatment remains an important unmet clinical need.
Mental health literacy and associated factors among traditional healers of Jimma town, southwest, Ethiopia 2020: a community based, cross-sectional study
Mideksa G, Tesfaye E, Yitayih Y, Sime Y, Aliye K and Gizaw AT
Traditional healers are in the front line to give the mental healthcare service in developing countries like Ethiopia. In Ethiopia, different studies were done focusing on the role of traditional medicine and perception of the community toward traditional medicine. However, there is paucity of studies, which shows the level of mental health literacy among traditional healers. Therefore, this study intended to mental health literacy level of traditional healers in Jimma town, Ethiopia.
A Bayesian multilevel model for populations of networks using exponential-family random graphs
Lehmann B and White S
The collection of data on populations of networks is becoming increasingly common, where each data point can be seen as a realisation of a network-valued random variable. Moreover, each data point may be accompanied by some additional covariate information and one may be interested in assessing the effect of these covariates on network structure within the population. A canonical example is that of brain networks: a typical neuroimaging study collects one or more brain scans across multiple individuals, each of which can be modelled as a network with nodes corresponding to distinct brain regions and edges corresponding to structural or functional connections between these regions. Most statistical network models, however, were originally proposed to describe a single underlying relational structure, although recent years have seen a drive to extend these models to populations of networks. Here, we describe a model for when the outcome of interest is a network-valued random variable whose distribution is given by an exponential random graph model. To perform inference, we implement an exchange-within-Gibbs MCMC algorithm that generates samples from the doubly-intractable posterior. To illustrate this approach, we use it to assess population-level variations in networks derived from fMRI scans, enabling the inference of age- and intelligence-related differences in the topological structure of the brain's functional connectivity.
Mapping intracellular NAD content in entire human brain using phosphorus-31 MR spectroscopic imaging at 7 Tesla
Guo R, Yang S, Wiesner HM, Li Y, Zhao Y, Liang ZP, Chen W and Zhu XH
Nicotinamide adenine dinucleotide (NAD) is a crucial molecule in cellular metabolism and signaling. Mapping intracellular NAD content of human brain has long been of interest. However, the sub-millimolar level of cerebral NAD concentration poses significant challenges for measurement and imaging.
The Reddit cannabis subjective highness rating scale: Applying computational social science to explore psychological and environmental correlates of naturalistic cannabis use
Meacham MC, Nobles AL, Bone C', Gilbert M and Thrul J
Social media data provide unprecedented access to discussions of active, naturalistic, and often real-time cannabis use in an era of cannabis policy liberalization. The aim of this study was to explore psychological and environmental correlates of cannabis effects by applying computational social science approaches to a large dataset of unprompted reports of naturalistic cannabis use with corresponding self-reported numerical ratings of subjective highness. Post title text was extracted via the Pushshift dataset from N = 328,865 posts to the r/trees Reddit community, where posters self-assess and disclose how high they feel on a scale from 1 to 10 (M = 6.9, SD = 1.8). Structural topic modelling and Linguistic Inquiry and Word Count (LIWC) dictionary-based approaches were applied to identify (1) frequently discussed topics and (2) text indicative of 5 psychological processes (affective, social, cognitive, perceptual, biological), respectively, as well as to examine relationships between subjective highness and (1) topic prevalence and (2) psychological process word counts. A 40-topic model was selected for interpretation based on semantic coherence and exclusivity. The most discussed topics in a 40-topic model were characterized by references to smoking places, social contexts, positive affect, cognitive states, as well as food and media consumed. In LIWC dictionary analyses, words mentioning affective, social, and cognitive processes were referenced more often than perceptual or body processes. Posters reported greater subjective highness when using language that referred to in-person social environments and lower subjective highness when using language that referred to online social environments and positive affect psychological states. This examination of unprompted online reports of naturalistic cannabis use identified textual content referring to affect and to other people as being associated with perceived effects of cannabis. These affective and social aspects of the cannabis use experience were salient to active posters in this online community and should be integrated into experience sampling methods and behavioral pharmacology research, as well as public health messaging.
Clinical decision-making before discharge in hospitalized persons with schizophrenia: a Spanish Delphi expert consensus
Montes JM, Agüera-Ortiz L, Mané A, Martinez-Raga J and Gutiérrez-Rojas L
The care of people with schizophrenia (PWS) is usually provided in an outpatient setting by community mental health teams. However, PWS frequently require inpatient treatment because of a wide array of clinical, personal and/or social situations. Unfortunately, to our knowledge, there are no guidelines available to help psychiatrists in the decision-making process on hospital discharge for PWS. The aim of this project was to develop an expert consensus on discharge criteria for PWS after their stay in an acute inpatient psychiatric unit.
Demultiplexing of single-cell RNA-sequencing data using interindividual variation in gene expression
Nassiri I, Kwok AJ, Bhandari A, Bull KR, Garner LC, Klenerman P, Webber C, Parkkinen L, Lee AW, Wu Y, Fairfax B, Knight JC, Buck D and Piazza P
Pooled designs for single-cell RNA sequencing, where many cells from distinct samples are processed jointly, offer increased throughput and reduced batch variation. This study describes expression-aware demultiplexing (EAD), a computational method that employs differential co-expression patterns between individuals to demultiplex pooled samples without any extra experimental steps.
Sex, gender, sexual orientation, and more: Sexual diversity in Alzheimer's research needs a new lens to achieve inclusive research and generalizable results
Stites SD and Velocci B
Diversity, Equity, and Inclusion (DEI) efforts in Alzheimer's disease and related dementia (ADRD) research are guiding the adoption of two-step self-report questions that capture research participants' identity based on categories of sex, sexual orientation, and gender identity. The intent is to facilitate inclusion and representation of sexual and gender minoritized (SGM) communities in ADRD research. The data from using these questions are on a collision course with another National Institute of Aging initiative, which is aimed at understanding sex differences in ADRD mechanisms. Here, we critically analyze the goals and methods of the two initiatives. We propose that, in addition to being SGM focused, DEI efforts are needed to expand how scientists consider and measure sexual diversity itself.
Childhood maltreatment, genetic risk, and subsequent risk of arrhythmias: a prospective cohort study
Chen Y, Xue H, Zhou J, Shu X, He Z, Ai S, Feng H, Zhang J, Liang YY, Lv Y and Zhou Y
Emerging evidence has linked childhood maltreatment with cardiovascular disease risk; however, the association between childhood maltreatment and cardiac arrhythmias remains unclear. Moreover, any genetic predispositions to atrial fibrillation (AF), a common cardiac arrhythmia associated with an elevated risk of stroke, heart failure, and mortality, that modify such associations have been undocumented. To examine the associations between childhood maltreatment and incident arrhythmias, and whether a genetic predisposition to arrhythmias modifies these associations. This prospective analysis included 151,741 participants from the UK Biobank (mean age 55.8 years, 43.4% male). Childhood maltreatment, including five types, was measured using the Childhood Trauma Screener (CTS). Incident arrhythmias (AF, ventricular arrhythmias [VA], and bradyarrhythmia [BA]) were documented through linked hospital admission and death registry. Weighted AF genetic risk score was calculated. Cox proportional hazard models were conducted to test for associations between childhood maltreatment and incident arrhythmias. During a median follow-up of 12.21 years (interquartile range, 11.49-12.90 years), 6,588 AF, 2,093 BA, and 742 VA events occurred. Compared with the absence of childhood maltreatment, having 3-5 types of childhood maltreatment was associated with an increased risk of incident AF (HR, 1.23; 95%CI 1.09-1.37), VA (HR, 1.39; 95%CI 1.03-1.89), and BA (HR, 1.32; 95%CI 1.09-1.61) after adjusting demographic, socioeconomic and lifestyle factors. The associations between cumulative type of childhood maltreatment and the risk of AF (< .001; = .674) and BA (= .007; = .377) demonstrated a linear pattern. There was a gradient association between childhood maltreatment and AF risks across the intermediate and high genetic risk groups (both < .05) but not within the low genetic risk group (= .378), irrespective of non-significant interaction effect (= .204). Childhood maltreatment was associated with higher risks of incident arrhythmias, especially AF and BA. Genetic risk of AF did not modify these associations.
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