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Diagnostic Psychiatry

Predictors of cocaine use disorder treatment outcomes: a systematic review
Palazón-Llecha A, Caparrós B, Trujols J, Duran-Sindreu S, Batlle F, Madre M and Mallorquí-Bagué N
Psychosocial approaches are the first-line treatments for cocaine dependence, although they still present high dropout and relapse rates. Thus, there is a pressing need to understand which variables influence treatment outcomes to improve current treatments and prevent dropout and relapse rates. The aim of this study is to explore predictors of treatment retention and abstinence in CUD.
Functional Neurological Disorder Presenting After Concussion: A Retrospective Case Series
Polich G, Baslet G, O'Neal MA, Gupta R and Raynor LCG
Although a majority of individuals recover from a concussion within weeks of the index injury, a substantial minority of patients report persistent postconcussion symptoms. Some of these symptoms may reflect a diagnosis of functional neurological disorder (FND). The authors evaluated the relationship between persistent postconcussion symptoms and FND symptoms.
Association between colchicine use and the risk of dementia among patients with gout: A nationwide retrospective cohort study
Chen PY, Tseng CC, Lee YT, Yip HT, Chang R and Wei JC
Recent findings suggest a link between gout and the development of dementia. Early treatment with colchicine is recommended as a first-line therapy for gout flares. Animal studies demonstrate that colchicine could induce cognitive impairment. This cohort study aimed to investigate the association between colchicine use and the risk of developing dementia.
Neuromyelitis optica spectrum disorder co-existing with antiphospholipid syndrome: A case report
Edwin G, Msagati F, Komanya F, Alphonce B, Meda J and Nyundo A
Neuromyelitis optica spectrum disorder is an autoimmune disease, rarely presents with antiphospholipid syndrome. Diagnosis and management of NMOSD are challenging in the background of diverse presentations, especially in resource-limited settings.
Generalized Periodic Discharges Associated With Catatonia and Delirium: A Case Series
Luccarelli J, Smith JR, Fricchione G and Westover MB
Generalized periodic discharges are a repeated and generalized electroencephalography (EEG) pattern that can be seen in the context of altered mental status. This article describes a series of five individuals with generalized periodic discharges who demonstrated signs and symptoms of catatonia, a treatable neuropsychiatric condition.
The contribution of cannabis use to the increased psychosis risk among minority ethnic groups in Europe
Selten JP, Di Forti M, Quattrone D, Jones PB, Jongsma HE, Gayer-Anderson C, Szöke A, Llorca PM, Arango C, Bernardo M, Sanjuan J, Santos JL, Arrojo M, Tarricone I, Berardi D, Lasalvia A, Tosato S, la Cascia C, Velthorst E, van der Ven EMA, de Haan L, Rutten BP, van Os J, Kirkbride JB, Morgan CM, Murray RM and Termorshuizen F
We examined whether cannabis use contributes to the increased risk of psychotic disorder for non-western minorities in Europe.
Mental health and use of psychotropic prescription drugs in adult patients with primary immune thrombocytopenia: a nationwide population-based cohort study
Mannering N, Hansen DL, Pottegård A, Andersen K and Frederiksen H
Patients with primary immune thrombocytopenia (ITP) suffer from reduced survival and quality of life, but the underlying reasons for this are largely undescribed. Mental health and the use of psychotropic drugs in ITP is unknown. We investigated the risk of hospital registered mental health events including fatigue and the use of psychotropic drugs in adult patients with ITP compared with the general population, using nationwide registry-data. We identified 3,749 patients with ITP and 149,849 age-sex matched general population comparators in the Danish Health Registries in the period 1997-2016. The median age was 60 years (IQR 40-73) and 53% were women. We followed the individuals for incident mental health events and estimated the use of psychotropic drugs over calendar-years and in temporal relation to diagnosis of ITP. The first year cumulative incidence of any mental health event was 2.3% (95% confidence interval, 1.9-2.9) in patients and 0.7% (0.6-0.7) in comparators, yielding an adjusted cause-specific hazard ratio (csHR) of 3.57 (2.84-4.50). The corresponding estimates for depression were 1.2% (0.9-1.6) and 0.3% (0.3-0.4) respectively, with an adjusted csHR of 3.53 (2.56-4.85). We found similar findings for anxiety and fatigue, but risks generally diminished after 1-5 years. The use of opioids, antidepressants, and benzodiazepines increased in temporal relation to diagnosis of ITP. The risk of mental health events and the use of psychotropic drugs is higher in adult patients with ITP compared with the general population, and has a temporal relation to diagnosis of ITP emphasizing that mental health in ITP is a concern.
Alcohol milestones and internalizing, externalizing, and executive function: longitudinal and polygenic score associations
Paul SE, Baranger DAA, Johnson EC, Jackson JJ, Gorelik AJ, Miller AP, Hatoum AS, Thompson WK, Strube M, Dick DM, Kamarajan C, Kramer JR, Plawecki MH, Chan G, Anokhin AP, Chorlian DB, Kinreich S, Meyers JL, Porjesz B, Edenberg HJ, Agrawal A, Bucholz KK and Bogdan R
Although the link between alcohol involvement and behavioral phenotypes (e.g. impulsivity, negative affect, executive function [EF]) is well-established, the directionality of these associations, specificity to stages of alcohol involvement, and extent of shared genetic liability remain unclear. We estimate longitudinal associations between transitions among alcohol milestones, behavioral phenotypes, and indices of genetic risk.
Factors contributing to readmission in patients with psychotic disorders, with a special reference to first follow-up visit in outpatient care
Suokas K, Lindgren M, Gissler M, Liukko E, Schildt L, Salokangas RKR, Rissanen P, Gauffin T, Näätänen P, Holm M and Suvisaari J
Timely outpatient follow-up and readmission after discharge are common quality indicators in psychiatric care, but their association varies in previous research. We aimed to examine whether the impact of outpatient follow-up and other factors on readmission risk evolves over time in people with non-affective psychotic disorder (NAP).
Bridging personality dimensions and eating symptoms: A transdiagnostic network approach
Ruiz-Gutiérrez J, Miras-Aguilar MDM, Rodríguez-Pérez N, Ventura L, González Gómez J, Del Barrio AG and Gónzalez-Blanch C
Eating disorders (ED) have recently been studied from a network approach, conceptualising them as a complex system of interconnected variables, while highlighting the role of non-ED symptoms and personality dimensions. This study aims to explore the connections between personality and ED symptoms, identify central nodes, and compare the EDs network to a healthy control network.
Reduced lateralization of multiple functional brain networks in autistic males
Peterson M, Prigge MBD, Floris DL, Bigler ED, Zielinski BA, King JB, Lange N, Alexander AL, Lainhart JE and Nielsen JA
Autism spectrum disorder has been linked to a variety of organizational and developmental deviations in the brain. One such organizational difference involves hemispheric lateralization, which may be localized to language-relevant regions of the brain or distributed more broadly.
Rapid and sustained antidepressant effects of intravenous ketamine in treatment-resistant major depressive disorder and suicidal ideation: a randomized clinical trial
Zolghadriha A, Anjomshoaa A, Jamshidi MR and Taherkhani F
Major depressive disorder (MDD) is the most disabling and burdensome mental disorder, negatively affecting an individual's quality of life and daily functioning. the current study was conducted with the aim of investigating the clinical effects of intravenous ketamine on symptoms of MDD and suicidal ideation.
In Vivo Reactive Astrocyte Imaging in Patients With Schizophrenia Using Fluorine 18-Labeled THK5351
Kim M, Choi W, Choi S, Oh H, Kim J, Lee J, An SJ, Hwang JS, Lee YS, Song IC, Moon SY, Lho SK, Cho SS and Kwon JS
In vivo imaging studies of reactive astrocytes are crucial for understanding the pathophysiology of schizophrenia because astrocytes play a critical role in glutamate imbalance and neuroinflammation.
Dimensional Neuroimaging Endophenotypes: Neurobiological Representations of Disease Heterogeneity Through Machine Learning
Wen J, Antoniades M, Yang Z, Hwang G, Skampardoni I, Wang R and Davatzikos C
Machine learning has been increasingly used to obtain individualized neuroimaging signatures for disease diagnosis, prognosis, and response to treatment in neuropsychiatric and neurodegenerative disorders. Therefore, it has contributed to a better understanding of disease heterogeneity by identifying disease subtypes with different brain phenotypic measures. In this Review, we first present a systematic literature overview of studies using machine learning and multimodal MRI to unravel disease heterogeneity in various neuropsychiatric and neurodegenerative disorders, including Alzheimer's disease, schizophrenia, major depressive disorder, autism spectrum disorder, multiple sclerosis, as well as their potential in a transdiagnostic framework, where neuroanatomical and neurobiological commonalities were assessed across diagnostic boundaries. Subsequently, we summarize relevant machine learning methodologies and their clinical interpretability. We discuss the potential clinical implications of the current findings and envision future research avenues. Finally, we discuss an emerging paradigm called dimensional neuroimaging endophenotypes (DNE). DNE dissects the neurobiological heterogeneity of neuropsychiatric and neurodegenerative disorders into low-dimensional yet informative, quantitative brain phenotypic representations, serving as robust intermediate phenotypes (i.e., endophenotypes) presumably reflecting the interplay of underlying genetic, lifestyle, and environmental processes associated with the disease etiology.
Capgras syndrome in children and adolescents: A systematic review
Walfisch R, Danieli PP, Mosheva M, Hochberg Y, Shilton T and Gothelf D
To improve understanding of Capgras syndrome (CS) in the pediatric population, this study investigates its clinical features and discerns similarities and differences compared to CS in adults.
Prospective Two-Year Course and Predictors of Outcome in Avoidant/Restrictive Food Intake Disorder
Kambanis PE, Tabri N, McPherson I, Gydus JE, Kuhnle M, Stern CM, Asanza E, Becker KR, Breithaupt L, Freizinger M, Shrier LA, Bern EM, Eddy KT, Misra M, Micali N, Lawson EA and Thomas JJ
To evaluate the 2-year course and outcomes of full and subthreshold avoidant/restrictive food intake disorder (ARFID) in youth ages 9-23 at baseline using a prospective longitudinal design to characterize the remission and persistence of ARFID, evaluate diagnostic crossover, and identify predictors of outcome. We hypothesized that greater severity in each ARFID profile - sensory sensitivity, fear of aversive consequences, and lack of interest - would predict greater likelihood of illness persistence, controlling for age, sex, BMI percentile, ARFID treatment status, and baseline diagnosis.
Mechanistic studies in pathological health anxiety: A systematic review and emerging conceptual framework
Guthrie AJ, Paredes-Echeverri S, Bleier C, Adams C, Millstein DJ, Ranford J and Perez DL
Pathological health anxiety (PHA) (e.g., hypochondriasis and illness anxiety disorder) is common in medical settings and associated with increased healthcare costs. However, the psychological and neurobiological mechanisms contributing to the development and maintenance of PHA are incompletely understood.
The Neuropsychological Assessment Battery Driving Scenes Test in a Dementia Clinic
Ashendorf L, Withrow S and Gavett BE
In dementia research, the Driving Scenes test from the Neuropsychological Assessment Battery has been shown to relate to memory, dementia diagnosis, and functional impairment. The aim of the current study was to examine Driving Scenes and its component scores, and their relationships with cognition and daily functioning, in a mixed dementia clinic sample.
Adverse Childhood Experiences Moderate the Relationship between Pain and Later Suicidality Severity Among Youth: A Longitudinal High-Risk Cohort Study
Tutelman PR, Noel M, Bernier E, Schulte FSM and Kopala-Sibley DC
Pain in adolescence can lead to the development of serious mental health issues, including suicidality. This risk may be strengthened among youth exposed to more adverse childhood experiences (ACEs; abuse, neglect, household challenges). This longitudinal study examined the role of ACEs in the relationship between pain and later suicidality onset and severity among a cohort of adolescents at risk for developing mental health problems. Participants were 139 healthy youth (M=13.74 years, SD=1.56, 64% female) between the ages of 11-17 years, recruited based on parental history of depression or anxiety. Youth completed validated measures of internalizing symptoms, ACEs, and pain characteristics at baseline and follow-up diagnostic interviews 9- and/or 18-months later to assess for onset and severity of suicidality. After controlling for demographics, baseline internalizing symptoms, and ACEs, worse pain interference and increased ACEs at baseline predicted increased suicidality severity at follow-up. Moderation analyses revealed that there was a significant interaction between ACEs and pain interference and pain intensity. Increased pain interference (b = 7.65, p <.0001) or intensity (b = 6.96, p =.0003) was only associated with increased suicidality severity at follow-up in youth with high levels of ACEs. This study demonstrates that ACEs strengthen the relationship between pain and later suicidality severity among youth at risk of developing mental health problems. Findings underscore the critical need to adopt a trauma informed lens to pediatric pain prevention and treatment (e.g., screening for ACEs), and for pain to be on the child mental health agenda. PERSPECTIVE: This article provides evidence that while pain is a risk factor for future increased suicidality severity, it is a particularly strong risk factor in youth who experienced increased childhood adversity. These results may help identify youth at greatest risk for suicidality.
Eight-year nationwide study of the bidirectional association between type 2 diabetes and depression in nearly 8 million German outpatients
Chae WR, Kohring C, Rohde C, Köhler-Forsberg O, Otte C and Holstiege J
Research linking type 2 diabetes and depression mostly relied on hospital-based diagnoses or prescription data, overlooking many outpatient diagnoses. We aimed to quantify the risks of depression in individuals newly diagnosed with type 2 diabetes, and type 2 diabetes in those newly diagnosed with depression, while exploring potential risk differences depending on age, sex, and follow-up time.
Practitioner Review: Assessment and treatment of body dysmorphic disorder in young people
Krebs G, Rautio D, Fernández de la Cruz L, Hartmann AS, Jassi A, Martin A, Stringaris A and Mataix-Cols D
Body dysmorphic disorder (BDD) is a relatively common and highly impairing mental disorder that is strikingly underdiagnosed and undertreated in Child and Adolescent Mental Health Services (CAMHS). The only clinical guidelines for the management of BDD in youth were published nearly 20 years ago, when empirical knowledge was sparse. Fortunately, there has been a surge in research into BDD over the last 10 years, shedding important insights into the phenomenology, epidemiology, assessment and treatment of the disorder in young people. This review aimed to provide an overview of recent research developments of relevance to clinicians and healthcare policymakers. We summarise key findings regarding the epidemiology of BDD in youth, which indicate that the disorder usually develops during teenage years and affects approximately 2% of adolescents at any one point in time. We provide an overview of aetiological research, highlighting that BDD arises from an interplay between genetic and environmental influences. We then focus on screening and assessment strategies, arguing that these are crucial to promote detection and diagnosis of this under-recognised condition. Additionally, we summarise the recommended treatment approaches for BDD in youth, namely cognitive behaviour therapy with or without selective serotonin reuptake inhibitors. The review concludes by highlighting key knowledge gaps and priorities for future research including, but not limited to, better understanding aetiological factors, long-term consequences and treatment.
Spontaneous persistent activity and inactivity in vivo reveals differential cortico-entorhinal functional connectivity
Choudhary K, Berberich S, Hahn TTG, McFarland JM and Mehta MR
Understanding the functional connectivity between brain regions and its emergent dynamics is a central challenge. Here we present a theory-experiment hybrid approach involving iteration between a minimal computational model and in vivo electrophysiological measurements. Our model not only predicted spontaneous persistent activity (SPA) during Up-Down-State oscillations, but also inactivity (SPI), which has never been reported. These were confirmed in vivo in the membrane potential of neurons, especially from layer 3 of the medial and lateral entorhinal cortices. The data was then used to constrain two free parameters, yielding a unique, experimentally determined model for each neuron. Analytic and computational analysis of the model generated a dozen quantitative predictions about network dynamics, which were all confirmed in vivo to high accuracy. Our technique predicted functional connectivity; e. g. the recurrent excitation is stronger in the medial than lateral entorhinal cortex. This too was confirmed with connectomics data. This technique uncovers how differential cortico-entorhinal dialogue generates SPA and SPI, which could form an energetically efficient working-memory substrate and influence the consolidation of memories during sleep. More broadly, our procedure can reveal the functional connectivity of large networks and a theory of their emergent dynamics.
The landscape of inequalities in dementia across Europe: First insights from the INTERDEM taskforce
Giebel C, Harding E, Volkmer A, Chirico I, Hopper L, Szczesniak D, Talbot CV, Diaz-Ponce A, Gove D, Knapp M, Robinson L, Rahman-Amin M, Thyrian R, Hanna K and
Getting a diagnosis of dementia does not equate to equitable access to care. People with dementia and unpaid carers face many barriers to care, which can vary within, and across, different countries and cultures. With little evidence across different countries, the aim of this scoping exercise was to identify the different and similar types of inequalities in dementia across Europe, and provide recommendations for addressing these.
The nonverbal expression of guilt in healthy adults
Stewart CA, Mitchell DGV, MacDonald PA, Pasternak SH, Tremblay PF and Finger EC
Guilt is a negative emotion elicited by realizing one has caused actual or perceived harm to another person. One of guilt's primary functions is to signal that one is aware of the harm that was caused and regrets it, an indication that the harm will not be repeated. Verbal expressions of guilt are often deemed insufficient by observers when not accompanied by nonverbal signals such as facial expression, gesture, posture, or gaze. Some research has investigated isolated nonverbal expressions in guilt, however none to date has explored multiple nonverbal channels simultaneously. This study explored facial expression, gesture, posture, and gaze during the real-time experience of guilt when response demands are minimal. Healthy adults completed a novel task involving watching videos designed to elicit guilt, as well as comparison emotions. During the video task, participants were continuously recorded to capture nonverbal behaviour, which was then analyzed via automated facial expression software. We found that while feeling guilt, individuals engaged less in several nonverbal behaviours than they did while experiencing the comparison emotions. This may reflect the highly social aspect of guilt, suggesting that an audience is required to prompt a guilt display, or may suggest that guilt does not have clear nonverbal correlates.
Differentiating Prodromal Dementia with Lewy Bodies from Prodromal Alzheimer's Disease: A Pragmatic Review for Clinicians
Wyman-Chick KA, Chaudhury P, Bayram E, Abdelnour C, Matar E, Chiu SY, Ferreira D, Hamilton CA, Donaghy PC, Rodriguez-Porcel F, Toledo JB, Habich A, Barrett MJ, Patel B, Jaramillo-Jimenez A, Scott GD and Kane JPM
This pragmatic review synthesises the current understanding of prodromal dementia with Lewy bodies (pDLB) and prodromal Alzheimer's disease (pAD), including clinical presentations, neuropsychological profiles, neuropsychiatric symptoms, biomarkers, and indications for disease management. The core clinical features of dementia with Lewy bodies (DLB)-parkinsonism, complex visual hallucinations, cognitive fluctuations, and REM sleep behaviour disorder are common prodromal symptoms. Supportive clinical features of pDLB include severe neuroleptic sensitivity, as well as autonomic and neuropsychiatric symptoms. The neuropsychological profile in mild cognitive impairment attributable to Lewy body pathology (MCI-LB) tends to include impairment in visuospatial skills and executive functioning, distinguishing it from MCI due to AD, which typically presents with impairment in memory. pDLB may present with cognitive impairment, psychiatric symptoms, and/or recurrent episodes of delirium, indicating that it is not necessarily synonymous with MCI-LB. Imaging, fluid and other biomarkers may play a crucial role in differentiating pDLB from pAD. The current MCI-LB criteria recognise low dopamine transporter uptake using positron emission tomography or single photon emission computed tomography (SPECT), loss of REM atonia on polysomnography, and sympathetic cardiac denervation using meta-iodobenzylguanidine SPECT as indicative biomarkers with slowing of dominant frequency on EEG among others as supportive biomarkers. This review also highlights the emergence of fluid and skin-based biomarkers. There is little research evidence for the treatment of pDLB, but pharmacological and non-pharmacological treatments for DLB may be discussed with patients. Non-pharmacological interventions such as diet, exercise, and cognitive stimulation may provide benefit, while evaluation and management of contributing factors like medications and sleep disturbances are vital. There is a need to expand research across diverse patient populations to address existing disparities in clinical trial participation. In conclusion, an early and accurate diagnosis of pDLB or pAD presents an opportunity for tailored interventions, improved healthcare outcomes, and enhanced quality of life for patients and care partners.
Distinct palmitoylation of Foxp3 regulates the function of regulatory T cells via palmitoyltransferases
Zhou B, Zhang M, Ma H, Wang Y, Qiu J, Liu Y, Lu L, Li T, Zhang L, Huang R, Gu Y, Kong E and Liang Y
Association of categorical diagnoses and psychopathologies with quality of life in patients with depression, anxiety, and somatic symptoms: A cross-sectional study
Tu CY, Liao SC, Wu CS, Chiu YT and Huang WL
Major depressive disorder (MDD), anxiety disorders, and somatic symptom disorder (SSD) are associated with quality of life (QoL) reduction. This cross-sectional study investigated the relationship between these conditions as categorical diagnoses and related psychopathologies with QoL, recognizing their frequent overlap.
Contrasting neurofunctional correlates of face- and visuospatial-processing in children and adolescents with Williams syndrome: convergent results from four fMRI paradigms
Garvey MH, Nash T, Kippenhan JS, Kohn P, Mervis CB, Eisenberg DP, Ye J, Gregory MD and Berman KF
Understanding neurogenetic mechanisms underlying neuropsychiatric disorders such as schizophrenia and autism is complicated by their inherent clinical and genetic heterogeneity. Williams syndrome (WS), a rare neurodevelopmental condition in which both the genetic alteration (hemideletion of ~ twenty-six 7q11.23 genes) and the cognitive/behavioral profile are well-defined, offers an invaluable opportunity to delineate gene-brain-behavior relationships. People with WS are characterized by increased social drive, including particular interest in faces, together with hallmark difficulty in visuospatial processing. Prior work, primarily in adults with WS, has searched for neural correlates of these characteristics, with reports of altered fusiform gyrus function while viewing socioemotional stimuli such as faces, along with hypoactivation of the intraparietal sulcus during visuospatial processing. Here, we investigated neural function in children and adolescents with WS by using four separate fMRI paradigms, two that probe each of these two cognitive/behavioral domains. During the two visuospatial tasks, but not during the two face processing tasks, we found bilateral intraparietal sulcus hypoactivation in WS. In contrast, during both face processing tasks, but not during the visuospatial tasks, we found fusiform hyperactivation. These data not only demonstrate that previous findings in adults with WS are also present in childhood and adolescence, but also provide a clear example that genetic mechanisms can bias neural circuit function, thereby affecting behavioral traits.
The risk of cannabis use disorder is mediated by altered brain connectivity: A chronnectome study
Fazio G, Olivo D, Wolf ND, Hirjak D, Schmitgen MM, Werler F, Witteman M, Kubera KM, Calhoun VD, Reith W, Wolf RC and Sambataro F
The brain mechanisms underlying the risk of cannabis use disorder (CUD) are poorly understood. Several studies have reported changes in functional connectivity (FC) in CUD, although none have focused on the study of time-varying patterns of FC. To fill this important gap of knowledge, 39 individuals at risk for CUD and 55 controls, stratified by their score on a self-screening questionnaire for cannabis-related problems (CUDIT-R), underwent resting-state functional magnetic resonance imaging. Dynamic functional connectivity (dFNC) was estimated using independent component analysis, sliding-time window correlations, cluster states and meta-state indices of global dynamics and were compared among groups. At-risk individuals stayed longer in a cluster state with higher within and reduced between network dFNC for the subcortical, sensory-motor, visual, cognitive-control and default-mode networks, relative to controls. More globally, at-risk individuals had a greater number of meta-states and transitions between them and a longer state span and total distance between meta-states in the state space. Our findings suggest that the risk of CUD is associated with an increased dynamic fluidity and dynamic range of FC. This may result in altered stability and engagement of the brain networks, which can ultimately translate into altered cortical and subcortical function conveying CUD risk. Identifying these changes in brain function can pave the way for early pharmacological and neurostimulation treatment of CUD, as much as they could facilitate the stratification of high-risk individuals.
A review of published studies on virtual reality in sexuality research
Marques JM, Figueiredo CPM and Scanavino MDT
Virtual reality (VR) technology contributes to greater approach of methodological safety to make ecological validity more feasible and a growing interest in sexuality behaviors.
Structural neuroimaging of skin-picking disorder
Schienle A and Wabnegger A
Skin-picking disorder (SPD) is conceptualized as an obsessive-compulsive and related disorder (OCRD). Patients with SPD excessively manipulate their skin, which leads to skin lesions, psychological distress, and functional impairment. The neuroanatomical facets of this disorder are still poorly understood.
Prognostic implications of delirium after Left Ventricular Assist Device (LVAD) implantation: A retrospective study
Noufi P, Anderson KM, Crowell N, White Y, Molina E, Rao SD and Groninger H
In critically ill patients, delirium is a prognostic indicator of morbidity and mortality. This study investigates the impact of a delirium diagnosis on outcomes after Left Ventricular Assist Device (LVAD) implantation.
Minimum spanning tree analysis of EEG resting-state functional networks in schizophrenia
Becske M, Marosi C, Molnár H, Fodor Z, Farkas K, Rácz FS, Baradits M and Csukly G
Schizophrenia is a serious and complex mental disease, known to be associated with various subtle structural and functional deviations in the brain. Recently, increased attention is given to the analysis of brain-wide, global mechanisms, strongly altering the communication of long-distance brain areas in schizophrenia. Data of 32 patients with schizophrenia and 28 matched healthy control subjects were analyzed. Two minutes long 64-channel EEG recordings were registered during resting, eyes closed condition. Average connectivity strength was estimated with Weighted Phase Lag Index (wPLI) in lower frequencies: delta and theta, and Amplitude Envelope Correlation with leakage correction (AEC-c) in higher frequencies: alpha, beta, lower gamma and higher gamma. To analyze functional network topology Minimum Spanning Tree (MST) algorithms were applied. Results show that patients have weaker functional connectivity in delta and alpha frequency bands. Concerning network differences, the result of lower diameter, higher leaf number, and also higher maximum degree and maximum betweenness centrality in patients suggest a star-like, and more random network topology in patients with schizophrenia. Our findings are in accordance with some previous findings based on resting-state EEG (and fMRI) data, suggesting that MST network structure in schizophrenia is biased towards a less optimal, more centralized organization.
Structured clinical interview for diagnosing obsessive-compulsive spectrum disorders
Lochner C, Maré KT and Stein DJ
There are several established structured diagnostic interviews that cover common mental disorders seen in general psychiatry clinics. The administration of more focused diagnostic interviews may be useful in specialty clinics, such as OCD clinics. A semi-structured clinician-administered interview for obsessive-compulsive spectrum disorders (SCID-OCSD) was developed and adapted for DSM-5/ICD-11 obsessive-compulsive and related disorders as well as other putative obsessive-compulsive spectrum conditions.
Towards the DSM-6: Results of a Survey of Experts on the Reintroduction of First-Rank Symptoms as Core Criteria of Schizophrenia and on Redefining Hallucinations
Moritz S, Borgmann L, Heinz A, Fuchs T and Gallinat J
Diagnostic criteria for mental disorders are subject to change. This is particularly true for schizophrenia, whose diagnostic criteria in the current DSM-5 bear little resemblance to what Kraepelin once named "dementia praecox" and Bleuler termed "the schizophrenias." The present study reports results from a survey of experts on two core topics of schizophrenia: (a) whether subsequent editions of the DSM should once again give the Schneiderian first-rank symptoms (FRS; eg, thought broadcasting) the prominent role they had in the DSM-IV and (b) whether the currently quite narrow definition of hallucinations in the DSM-5 requiring them to be vivid and clear and have the full force and impact of normal perceptions should be broadened to incorporate perceptual-like phenomena that the individual can differentiate from proper perceptions but still perceives as real and externally generated.
Antipsychotic-Related DRESS Syndrome: Analysis of Individual Case Safety Reports of the WHO Pharmacovigilance Database
de Filippis R, Kane JM, Arzenton E, Moretti U, Raschi E, Trifirò G, Barbui C, De Fazio P, Gastaldon C and Schoretsanitis G
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is gaining attention in pharmacovigilance, but its association with antipsychotics, other than clozapine, is still unclear.
Outer Retinal Thickness Is Associated With Cognitive Function in Normal Aging to Intermediate Age-Related Macular Degeneration
Owsley C, McGwin G, Swain TA, Clark ME, Thomas TN, Goerdt L, Sloan KR, Trittschuh EH, Jiang Y, Owen JP, Lee CS and Curcio CA
Research on Alzheimer's disease (AD) and precursor states demonstrates a thinner retinal nerve fiber layer (NFL) compared to age-similar controls. Because AD and age-related macular degeneration (AMD) both impact older adults and share risk factors, we asked if retinal layer thicknesses, including NFL, are associated with cognition in AMD.
Gliomatosis cerebri in children: A poor prognostic phenotype of diffuse gliomas with a distinct molecular profile
Nussbaumer G, Benesch M, Grabovska Y, Mackay A, Castel D, Grill J, Alonso MM, Antonelli M, Bailey S, Baugh JN, Biassoni V, Blattner Johnson M, Broniscer A, Carai A, Colafati GS, Colditz N, Corbacioglu S, Crampsie S, Entz-Werle N, Eyrich M, Friker LL, Frühwald MC, Garrè ML, Gerber NU, Giangaspero F, Gil-da-Costa MJ, Graf N, Hargrave D, Hauser P, Herrlinger U, Hoffmann M, Hulleman E, Izquierdo E, Jacobs S, Karremann M, Kattamis A, Kebudi R, Kortmann RD, Kwiecien R, Massimino M, Mastronuzzi A, Miele E, Morana G, Noack CM, Pentikainen V, Perwein T, Pfister SM, Pietsch T, Roka K, Rossi S, Rutkowski S, Schiavello E, Seidel C, Štěrba J, Sturm D, Sumerauer D, Tacke A, Temelso S, Valentini C, van Vuurden D, Varlet P, Veldhuijzen van Zanten SEM, Vinci M, von Bueren AO, Warmuth-Metz M, Wesseling P, Wiese M, Wolff JEA, Zamecnik J, Morales La Madrid A, Bison B, Gielen GH, Jones DTW, Jones C and Kramm CM
The term Gliomatosis cerebri (GC), a radiology-defined highly infiltrating diffuse glioma, has been abandoned since molecular GC-associated features have not been established yet.
Foster Care and Health in Medicaid-Enrolled Children Experiencing Parental Opioid Use Disorder
Meinhofer A, Chandra N, Byanova D and Keyes KM
The burden of the US opioid crisis has fallen heavily on children, a vulnerable population increasingly exposed to parental opioid use disorder (POUD) in utero or during childhood. A paucity of studies have investigated foster care involvement among those experiencing parental opioid use during childhood and the associated health and health care outcomes.
History of traumatic brain injury is associated with increased grey-matter loss in patients with mild cognitive impairment
Khoury MA, Churchill NW, Di Battista A, Graham SJ, Symons S, Troyer AK, Roberts A, Kumar S, Tan B, Arnott SR, Ramirez J, Tartaglia MC, Borrie M, Pollock B, Rajji TK, Pasternak SH, Frank A, Tang-Wai DF, Scott CJM, Haddad SMH, Nanayakkara N, Orange JB, Peltsch A, Fischer CE, Munoz DG and Schweizer TA
To investigate whether a history of traumatic brain injury (TBI) is associated with greater long-term grey-matter loss in patients with mild cognitive impairment (MCI).
Rapid Initiation of Injection Naltrexone for Opioid Use Disorder: A Stepped-Wedge Cluster Randomized Clinical Trial
Shulman M, Greiner MG, Tafessu HM, Opara O, Ohrtman K, Potter K, Hefner K, Jelstrom E, Rosenthal RN, Wenzel K, Fishman M, Rotrosen J, Ghitza UE, Nunes EV and Bisaga A
Injectable extended-release (XR)-naltrexone is an effective treatment option for opioid use disorder (OUD), but the need to withdraw patients from opioid treatment prior to initiation is a barrier to implementation.
"": A qualitative exploration of the experiences of young people with Long COVID
Newlands F, Lewis C, d'Oelsnitz A, Pinto Pereira SM, Stephenson T, Chalder T, Coughtrey A, Dalrymple E, Heyman I, Harnden A, Ford T, Ladhani SN, Powell C, McOwat K, Bhopal R, Dudley J, Kolasinska P, Muhid MZ, Nugawela M, Rojas NK, Shittu A, Simmons R and Shafran R
Young people living with Long COVID are learning to navigate life with a constellation of poorly understood symptoms. Most qualitative studies on experiences living with Long COVID focus on adult populations. This study aimed to understand the experiences of young people living with Long COVID. Qualitative, semi-structured interviews were conducted ( = 16); 11 young people (aged 13-19) and five parents were recruited from the Children and Young People with Long COVID (CLoCk) study ( = 11) or its patient and public involvement and engagement (PPIE) group ( = 5). Thematic analysis generated four themes: (i) Unravelling Long COVID: Exploring Symptom Journeys and Diagnostic Dilemmas; (ii) Identity Disruption and Adjustment; (iii) Long COVID's Ripple Effect: the impact on Mental Health, Connections, and Education; and (iv) Navigating Long COVID: barriers to support and accessing services. Treatment options were perceived as not widely available or ineffective, emphasising the need for viable and accessible interventions for young people living with Long COVID.
Aberrant salience mediates the interplay between emotional abuse and positive symptoms in schizophrenia
de Filippis R, Aloi M, Liuzza MT, Pugliese V, Carbone EA, Rania M, Segura-Garcia C and De Fazio P
Childhood trauma and adversities (CTA) and aberrant salience (AS) have a pivotal role in schizophrenia development, but their interplay with psychotic symptoms remains vague. We explored the mediation performed by AS between CTA and psychotic symptomatology in schizophrenia.
Exploring heterogeneity in PTSD symptoms and associated predictors and outcomes in Afghanistan veterans: A latent profile analysis
Rønning L, Anyan F, Hjemdal O, Bøe HJ, Espetvedt Nordstrand A, Herberman Mash HB and Naifeh JA
Research on posttraumatic stress symptoms (PTSS) typically focuses on diagnosis or symptom severity, however, this overlooks the variety of symptom patterns that exist. Latent profile analysis was used to explore PTSS profiles in a sample of Norwegian Afghanistan veterans ( = 4052, 91.7% males). Multinomial logistic regression analyses were conducted to examine predictors and outcomes associated with PTSS profile membership. Three profiles emerged: profile (85%); profile (13%); and profile (2%). Being female, lower number of deployments, barriers to disclose war-related experiences, and higher number of potentially morally injurious events (PMIEs) were associated with belonging to the profile compared to the (Male gender: OR = 0.37,  < .05; Number of deployments: OR = 0.68,  < .05; Barriers to disclose: OR = 1.39,  < .001; PMIEs: OR = 1.15.  < .05), or profile (Male gender: OR = 0.36,  < .05; Number of deployments: OR = 0.67, < .01; Barriers to disclose: OR = 1.80,  < .001; PMIEs: OR = 1.32.  < .001). Participants in the profile had the highest probability of mental health service use (0.37) and endorsing suicidal ideation (0.38), compared to the two other profiles ( < .01). Participants in the profile had a higher probability of seeking professional mental health care (0.17), endorsing suicidal ideation (0.16), and reporting more suicide attempts compared to the profile (0.02 vs. 0.00,  < .001). These findings highlight the importance of considering the heterogeneity of PTSS profiles and understanding the predictors and responses of individuals who exhibit elevated PTSS symptoms.
Promoting Growth in Behavioral Neurology: A Path Forward
Bateman JR, Josephy-Hernandez S, Apostolova LG, Benjamin S, Barrett AM, Boeve BF, Budson AE, Chemali Z, Lin CR, Daffner KR, Geschwind MD, Heilman KM, Hillis AE, Holden SK, Jaffee MS, Kletenik I, Love MN, Moo LR, Pelak VS, Press DZ, Ramirez-Gomez L, Rosen HJ, Schmahmann JD, Vaishnavi SN, Windon CC, Hamilton RH and Perez DL
Behavioral neurology & neuropsychiatry (BNNP) is a field that seeks to understand brain-behavior relationships, including fundamental brain organization principles and the many ways that brain structures and connectivity can be disrupted, leading to abnormalities of behavior, cognition, emotion, perception, and social cognition. In North America, BNNP has existed as an integrated subspecialty through the United Council for Neurologic Subspecialties since 2006. Nonetheless, the number of behavioral neurologists across academic medical centers and community settings is not keeping pace with increasing clinical and research demand. In this commentary, we provide a brief history of BNNP followed by an outline of the current challenges and opportunities for BNNP from the behavioral neurologist's perspective across clinical, research, and educational spheres. We provide a practical guide for promoting BNNP and addressing the shortage of behavioral neurologists to facilitate the continued growth and development of the subspecialty. We also urge a greater commitment to recruit trainees from diverse backgrounds so as to dismantle persistent obstacles that hinder inclusivity in BNNP-efforts that will further enhance the growth and impact of the subspecialty. With rapidly expanding diagnostic and therapeutic approaches across a range of conditions at the intersection of neurology and psychiatry, BNNP is well positioned to attract new trainees and expand its reach across clinical, research, and educational activities.
Role of the prefrontal cortical protease TACE/ADAM17 in neurobehavioral responses to chronic stress during adolescence
Sharafeddin F, Sierra J, Ghaly M, Simon TB, Ontiveros-Ángel P, Edelbach B, Febo M, Labus J and Figueroa JD
Chronic adolescent stress profoundly affects prefrontal cortical networks regulating top-down behavior control. However, the neurobiological pathways contributing to stress-induced alterations in the brain and behavior remain largely unknown. Chronic stress influences brain growth factors and immune responses, which may, in turn, disrupt the maturation and function of prefrontal cortical networks. The tumor necrosis factor alpha-converting enzyme/a disintegrin and metalloproteinase 17 (TACE/ADAM17) is a sheddase with essential functions in brain maturation, behavior, and inflammatory responses. This study aimed to determine the impact of stress on the prefrontal cortex and whether TACE/ADAM17 plays a role in these responses.
Antidepressant exposure and long-term dementia risk in a nationwide retrospective study on US veterans with midlife major depressive disorder
Ramos-Cejudo J, Corrigan JK, Zheng C, Swinnerton KN, Jacobson SR, La J, Betensky RA, Osorio RS, Madanes S, Pomara N, Iosifescu D, Brophy M, Do NV and Fillmore NR
The use of antidepressants in major depressive disorder (MDD) has been reported to influence long-term risk of Alzheimer's disease (AD) and AD-related dementias (AD/ADRD), but studies are conflicting.
An association study of m6A methylation with major depressive disorder
Li Y, Miao P, Li F, Huang J, Fan L, Chen Q, Zhang Y, Yan F and Gao Y
To find the relationship between N6-methyladenosine (m6A) genes and Major Depressive Disorder (MDD).
Default mode network shows distinct emotional and contextual responses yet common effects of retrieval demands across tasks
Souter NE, de Freitas A, Zhang M, Shao X, Del Jesus Gonzalez Alam TR, Engen H, Smallwood J, Krieger-Redwood K and Jefferies E
The default mode network (DMN) lies towards the heteromodal end of the principal gradient of intrinsic connectivity, maximally separated from the sensory-motor cortex. It supports memory-based cognition, including the capacity to retrieve conceptual and evaluative information from sensory inputs, and to generate meaningful states internally; however, the functional organisation of DMN that can support these distinct modes of retrieval remains unclear. We used fMRI to examine whether activation within subsystems of DMN differed as a function of retrieval demands, or the type of association to be retrieved, or both. In a picture association task, participants retrieved semantic associations that were either contextual or emotional in nature. Participants were asked to avoid generating episodic associations. In the generate phase, these associations were retrieved from a novel picture, while in the switch phase, participants retrieved a new association for the same image. Semantic context and emotion trials were associated with dissociable DMN subnetworks, indicating that a key dimension of DMN organisation relates to the type of association being accessed. The frontotemporal and medial temporal DMN showed a preference for emotional and semantic contextual associations, respectively. Relative to the generate phase, the switch phase recruited clusters closer to the heteromodal apex of the principal gradient-a cortical hierarchy separating unimodal and heteromodal regions. There were no differences in this effect between association types. Instead, memory switching was associated with a distinct subnetwork associated with controlled internal cognition. These findings delineate distinct patterns of DMN recruitment for different kinds of associations yet common responses across tasks that reflect retrieval demands.
Risk of traumatic brain injury among patients with ADHD and their unaffected siblings
Wu PC, Tsai SJ, Hsu JW, Huang KL, Chen TJ, Pan TL and Chen MH
As the relationship between attention deficit hyperactivity disorder (ADHD) and traumatic brain injury (TBI) is gaining increasing attention, the TBI risk in patients with ADHD, unaffected siblings of ADHD probands, and non-ADHD controls remains unclear.
Quercetin Ameliorates Myocardial Injury in Diabetic Rats by Regulating Autophagy and Apoptosis through AMPK/mTOR Signaling Pathway
Chen YF, Qiu Q, Wang L, Li XR, Zhou S, Wang H, Jiang WD, Geng JY, Qin-Gao , Tang B, Wang HJ and Kang PF
A high-glucose environment is involved in the progression of diabetes mellitus (DM). This study aims to explore the regulatory effects of quercetin (QUE) on autophagy and apoptosis after myocardial injury in rats with DM. The type 2 DM rat models were constructed using low-dose streptozotocin (STZ) treatment combined with a high-carbohydrate (HC) diet . Compared with the control group, the body weight was decreased, whereas blood pressure, blood glucose, and the LVW/BW ratio were increased in the diabetic group. The results showed that the myocardial fibers were disordered in the diabetic group. Moreover, we found that the myocardial collagen fibers, PAS-positive cells, and apoptosis were increased, whereas the mitochondrial structure was destroyed and autophagic vacuoles were significantly reduced in the diabetic group compared with the control group. The expression levels of autophagy-related proteins LC3 and Beclin1 were decreased, whereas the expression levels of P62, Caspae-3, and Bax/Bcl-2 were increased in the diabetic group and . Moreover, QUE treatment alleviated the cellular oxidative stress reaction under high-glucose environments. The results of immunoprecipitation (IP) showed that the autophagy protein Beclin1 was bound to Bcl-2, and the binding capacity increased in the HG group, whereas it decreased after QUE treatment, suggesting that QUE inhibited the binding capacity between Beclin1 and Bcl-2, thus leading to the preservation of Beclin1-induced autophagy. In addition, the blood pressure, blood glucose, and cardiac function of rats were improved following QUE treatment. In conclusion, QUE suppressed diabetic myocardial injury and ameliorated cardiac function by regulating myocardial autophagy and inhibition of apoptosis in diabetes through the AMPK/mTOR signaling pathway.
Effects of ebselen addition on emotional processing and brain neurochemistry in depressed patients unresponsive to antidepressant medication
Ramli FF, Singh N, Emir UE, Villa LM, Waters S, Harmer CJ, Cowen PJ and Godlewska BR
Lithium is an effective augmenting agent for depressed patients with inadequate response to standard antidepressant therapy, but numerous adverse effects limit its use. We previously reported that a lithium-mimetic agent, ebselen, promoted a positive emotional bias-an indicator of potential antidepressant activity in healthy participants. We therefore aimed to investigate the effects of short-term ebselen treatment on emotional processing and brain neurochemistry in depressed patients with inadequate response to standard antidepressants. We conducted a double-blind, placebo-controlled 7-day experimental medicine study in 51 patients with major depressive disorder who were currently taking antidepressants but had an inadequate response to treatment. Participants received either ebselen 600 mg twice daily for seven days or identical matching placebo. An emotional testing battery, magnetic resonance spectroscopy and depression and anxiety rating scales were conducted at baseline and after seven days of treatment. Ebselen did not increase the recognition of positive facial expressions in the depressed patient group. However, ebselen increased the response bias towards fear emotion in the signal detection measurement. In the anterior cingulate cortex, ebselen significantly reduced the concentrations of inositol and Glx (glutamate+glutamine). We found no significant differences in depression and anxiety rating scales between visits. Our study did not find any positive shift in emotional bias in depressed patients with an inadequate response to antidepressant medication. We confirmed the ability of ebselen to lower inositol and Glx in the anterior cingulate cortex. These latter effects are probably mediated through inhibition of inositol monophosphatase and glutaminase respectively.
Neural mechanism of non-adaptive cognitive emotion regulation in patients with non-suicidal self-injury
Lang AN, Zhong Y, Lei W, Xiao Y, Hang Y, Xie Y, Lv Z, Zhang Y, Liu X, Liang M, Zhang C, Zhang P, Yang H, Wu Y, Wang Q, Yang K, Long J, Liu Y, Wang S, Tang Y, Lei M, Zhang D, Ouyang L, Zhang L and Wang C
The incidence of non-suicidal self-injury (NSSI) has been on the rise in recent years. Studies have shown that people with NSSI have difficulties in emotion regulation and cognitive control. In addition, some studies have investigated the cognitive emotion regulation of people with NSSI which found that they have difficulties in cognitive emotion regulation, but there was a lack of research on cognitive emotion regulation strategies and related neural mechanisms.
The association of symptomatic vitreous floaters with depression and anxiety
Gouliopoulos N, Oikonomou D, Karygianni F, Rouvas A, Kympouropoulos S and Moschos MM
To evaluate the levels of anxiety and depression in patients with symptomatic vitreous floaters and to determine the possible correlations of psychological implications with the symptoms duration and possible improvement, the degree of posterior vitreous detachment, and the discomfort severity.
Longitudinal Trajectories of Premorbid Social and Academic Adjustment in Youth at Clinical High Risk for Psychosis: Implications for Conversion
Cowan HR, Mittal VA, Addington J, Bearden CE, Cadenhead KS, Cornblatt BA, Keshavan M, Mathalon DH, Perkins DO, Stone W, Tsuang MT, Woods SW, Cannon TD and Walker EF
Social and academic adjustment deteriorate in the years preceding a psychotic disorder diagnosis. Analyses of premorbid adjustment have recently been extended into the clinical high risk for psychosis (CHR) syndrome to identify risk factors and developmental pathways toward psychotic disorders. Work so far has been at the between-person level, which has constrained analyses of premorbid adjustment, clinical covariates, and conversion to psychosis.
SAN: Mitigating spatial covariance heterogeneity in cortical thickness data collected from multiple scanners or sites
Zhang R, Chen L, Oliver LD, Voineskos AN and Park JY
In neuroimaging studies, combining data collected from multiple study sites or scanners is becoming common to increase the reproducibility of scientific discoveries. At the same time, unwanted variations arise by using different scanners (inter-scanner biases), which need to be corrected before downstream analyses to facilitate replicable research and prevent spurious findings. While statistical harmonization methods such as ComBat have become popular in mitigating inter-scanner biases in neuroimaging, recent methodological advances have shown that harmonizing heterogeneous covariances results in higher data quality. In vertex-level cortical thickness data, heterogeneity in spatial autocorrelation is a critical factor that affects covariance heterogeneity. Our work proposes a new statistical harmonization method called spatial autocorrelation normalization (SAN) that preserves homogeneous covariance vertex-level cortical thickness data across different scanners. We use an explicit Gaussian process to characterize scanner-invariant and scanner-specific variations to reconstruct spatially homogeneous data across scanners. SAN is computationally feasible, and it easily allows the integration of existing harmonization methods. We demonstrate the utility of the proposed method using cortical thickness data from the Social Processes Initiative in the Neurobiology of the Schizophrenia(s) (SPINS) study. SAN is publicly available as an R package.
Asynchronous Versus Synchronous Screening for Depression and Suicidality in a Primary Health Care System: Quality Improvement Study
Sattler A, Dunn J, Albarran M, Berger C, Calugar A, Carper J, Chirravuri L, Jawad N, Zein M and McGovern M
Despite being a debilitating, costly, and potentially life-threatening condition, depression is often underdiagnosed and undertreated. Previsit Patient Health Questionnaire-9 (PHQ-9) may help primary care health systems identify symptoms of severe depression and prevent suicide through early intervention. Little is known about the impact of previsit web-based PHQ-9 on patient care and safety.
Psychiatric diagnoses are common after liver transplantation and associated with increased healthcare utilization and patient financial burden
Lieber SR, Jones AR, Jiang Y, Gowda P, Patel M, Lippe B, Shenoy A, Evon DM, Gurley T, Ngo V, Olumesi M, Trudeau RE, Noriega Ramirez A, Jordan-Genco L, Mufti A, Lee SC, Singal AG and VanWagner LB
Psychiatric disorders after liver transplantation (LT) are associated with worse patient and graft outcomes, which may be amplified by inadequate treatment. We aimed to characterize the burden of psychiatric disorders, treatment patterns, and associated financial burden among LT recipients (LTRs).
Multi-level prediction of substance use: Interaction of white matter integrity, resting-state connectivity and inhibitory control measured repeatedly in every-day life
Chirokoff V, Pohl KM, Berthoz S, Fatseas M, Misdrahi D, Serre F, Auriacombe M, Pfefferbaum A, Sullivan EV and Chanraud S
Substance use disorders are characterized by inhibition deficits related to disrupted connectivity in white matter pathways, leading via interaction to difficulties in resisting substance use. By combining neuroimaging with smartphone-based ecological momentary assessment (EMA), we questioned how biomarkers moderate inhibition deficits to predict use. Thus, we aimed to assess white matter integrity interaction with everyday inhibition deficits and related resting-state network connectivity to identify multi-dimensional predictors of substance use. Thirty-eight patients treated for alcohol, cannabis or tobacco use disorder completed 1 week of EMA to report substance use five times and complete Stroop inhibition testing twice daily. Before EMA tracking, participants underwent resting state functional MRI and diffusion tensor imaging (DTI) scanning. Regression analyses were conducted between mean Stroop performances and whole-brain fractional anisotropy (FA) in white matter. Moderation testing was conducted between mean FA within significant clusters as moderator and the link between momentary Stroop performance and use as outcome. Predictions between FA and resting-state connectivity strength in known inhibition-related networks were assessed using mixed modelling. Higher FA values in the anterior corpus callosum and bilateral anterior corona radiata predicted higher mean Stroop performance during the EMA week and stronger functional connectivity in occipital-frontal-cerebellar regions. Integrity in these regions moderated the link between inhibitory control and substance use, whereby stronger inhibition was predictive of the lowest probability of use for the highest FA values. In conclusion, compromised white matter structural integrity in anterior brain systems appears to underlie impairment in inhibitory control functional networks and compromised ability to refrain from substance use.
Social communication and restricted, repetitive behavior as assessed with a diagnostic tool for autism (ADOS-2) in women with anorexia nervosa
Saure E, Laasonen M, Kylliäinen A, Hämäläinen S, Lepistö-Paisley T and Raevuori A
In anorexia nervosa (AN), the traits of autism spectrum disorder (ASD) are associated with poor outcomes. However, the subtle nature of these characteristics remains poorly understood. We investigated the in-depth patterns of ASD traits using Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) in women with AN.
Neural Correlates of Stress and Alcohol Cue-Induced Alcohol Craving and of Future Heavy Drinking: Evidence of Sex Differences
Radoman M, Fogelman N, Lacadie C, Seo D and Sinha R
Stress and alcohol cue reactivity are associated with poor treatment outcomes in alcohol use disorder (AUD), but sex-specific neural correlates of stress and alcohol cue-induced craving compared with neutral cue-induced craving and of heavy drinking outcomes in AUD have not been examined. Thus, this study prospectively examined these associations and assessed sex differences.
Detection of Language Lateralization Using Spectral Analysis of EEG
Nix KC, Oh A, Goad BS, Wu W, Lucas MV and Baumer FM
Language lateralization relies on expensive equipment and can be difficult to tolerate. We assessed if lateralized brain responses to a language task can be detected with spectral analysis of electroencephalography (EEG).
Associations between trauma exposure and irritability within the family unit: a network approach
Cotter G, Morreale K, Valdegas A, Fish M, Beebe R, Grasso D, Stover C and Tseng WL
Pediatric irritability is a pervasive psychiatric symptom, yet its etiology remains elusive. While trauma exposure may contribute to the development of irritability, empirical research is limited. This study examined the prevalence of irritability among trauma-exposed children, identified factors that differentiate trauma-exposed children with and without irritability, and employed a network analysis to uncover associations between irritability and trauma exposure in the family unit.
Advancing Research on and Treatment of Dissociative Identity Disorder With People With Lived Experience
Robinson MA, Purcell JB, Ward L, Winternitz S, Kaufman ML, Baranowski KA, Lebois LAM and
Dissociative identity disorder is a posttraumatic, psychobiological syndrome that develops over time during childhood. Despite empirical evidence supporting the validity of this diagnosis and its relation to trauma, the disorder remains a misunderstood and stigmatized condition. This article highlights expert consensus guidelines and current empirical research on the treatment of dissociative identity disorder. In addition, the authors describe the Lived Experience Advisory Panel (LEAP), which was designed to leverage the expertise of individuals with dissociative identity disorder to combat stigma and improve research, clinical programming, professional education, and public outreach related to the disorder. This article also describes how LEAP members have partnered with other researchers to create new knowledge through participatory action research in order to advance equitable service provision and effect positive change.
Genetic influence on within-person longitudinal change in anthropometric traits in the UK Biobank
Kemper KE, Sidorenko J, Wang H, Hayes BJ, Wray NR, Yengo L, Keller MC, Goddard M and Visscher PM
The causes of temporal fluctuations in adult traits are poorly understood. Here, we investigate the genetic determinants of within-person trait variability of 8 repeatedly measured anthropometric traits in 50,117 individuals from the UK Biobank. We found that within-person (non-directional) variability had a SNP-based heritability of 2-5% for height, sitting height, body mass index (BMI) and weight (P 2.4 × 10). We also analysed longitudinal trait change and show a loss of both average height and weight beyond about 70 years of age. A variant tracking the Alzheimer's risk APOE- allele (rs429358) was significantly associated with weight loss (  = -0.047 kg per yr, s.e. 0.007, P = 2.2 × 10), and using 2-sample Mendelian Randomisation we detected a relationship consistent with causality between decreased lumbar spine bone mineral density and height loss (b = 0.011, s.e. 0.003, P = 3.5 × 10). Finally, population-level variance quantitative trait loci (vQTL) were consistent with within-person variability for several traits, indicating an overlap between trait variability assessed at the population or individual level. Our findings help elucidate the genetic influence on trait-change within an individual and highlight disease risks associated with these changes.
Care trajectories around a first dementia diagnosis in patients with serious mental illness
Dufour I, Brodeur S, Courteau J, Roy MA, Vanasse A, Quesnel-Vallee A and Vedel I
To develop a typology of care trajectories (CTs) 1 year before and after a first dementia diagnosis in individuals aged ≥65 years, with prevalent schizophrenia or bipolar disorder.
Family screening for neurodevelopmental problems and its associations with child cognitive function enable tailored treatment for childhood obesity
Dellenmark-Blom M, Järvholm K, Sjögren L, Levinsson A and Dahlgren J
To identify neurodevelopmental disorders in children with obesity, and investigate associations to cognitive functions as well as parents' self-reported neurodevelopmental problems.
The dynamics of functional brain network segregation in feedback-driven learning
Wang X, Zwosta K, Hennig J, Böhm I, Ehrlich S, Wolfensteller U and Ruge H
Prior evidence suggests that increasingly efficient task performance in human learning is associated with large scale brain network dynamics. However, the specific nature of this general relationship has remained unclear. Here, we characterize performance improvement during feedback-driven stimulus-response (S-R) learning by learning rate as well as S-R habit strength and test whether and how these two behavioral measures are associated with a functional brain state transition from a more integrated to a more segregated brain state across learning. Capitalizing on two separate fMRI studies using similar but not identical experimental designs, we demonstrate for both studies that a higher learning rate is associated with a more rapid brain network segregation. By contrast, S-R habit strength is not reliably related to changes in brain network segregation. Overall, our current study results highlight the utility of dynamic functional brain state analysis. From a broader perspective taking into account previous study results, our findings align with a framework that conceptualizes brain network segregation as a general feature of processing efficiency not only in feedback-driven learning as in the present study but also in other types of learning and in other task domains.
The relationship between gamma-band neural oscillations and language skills in youth with Autism Spectrum Disorder and their first-degree relatives
Arutiunian V, Santhosh M, Neuhaus E, Borland H, Tompkins C, Bernier RA, Bookheimer SY, Dapretto M, Gupta AR, Jack A, Jeste S, McPartland JC, Naples A, Van Horn JD, Pelphrey KA and Webb SJ
Most children with Autism Spectrum Disorder (ASD) have co-occurring language impairments and some of these autism-specific language difficulties are also present in their non-autistic first-degree relatives. One of the possible neural mechanisms associated with variability in language functioning is alterations in cortical gamma-band oscillations, hypothesized to be related to neural excitation and inhibition balance.
Elucidating the association of obstructive sleep apnea with brain structure and cognitive performance
Bao J, Zhao Z, Qin S, Cheng M, Wang Y, Li M, Jia P, Li J and Yu H
Obstructive sleep apnea (OSA) is a pervasive, chronic sleep-related respiratory condition that causes brain structural alterations and cognitive impairments. However, the causal association of OSA with brain morphology and cognitive performance has not been determined.
ICD-11 and -5-TR prolonged grief symptoms and quality of life: A criterion validity test
Eisma MC and Schmitt LO
Two similar but distinct versions of prolonged grief disorder (PGD) have recently been included in the International Classification of Diseases eleventh edition (ICD-11) and the - fifth edition, Text-Revision (-5-TR). This study provides a criterion validity test of both new criteria sets of PGD, by examining concurrent and longitudinal associations of ICD-11 and -5-TR prolonged grief symptoms with quality of life (QOL).
Downregulation of miR-29a as a possible diagnostic biomarker for schizophrenia
Khosroshahi PA, Ashayeri H, Ghanbari M, Malek A, Farhang S and Haghi M
MicroRNAs (miRNAs) are epigenetic factors regulating many genes involved in brain development. Dysregulation of miRNA could result in dysregulation of genes which may contribute to diseases affecting the brain and behavior (e.g., schizophrenia). miR-29 family is a miRNA family contributing to brain maturation. miR-29 knockout in animal studies is reported to correlate with psychiatric disorders very similar to those seen in schizophrenia. In this study, we aimed to evaluate the miR-29a level in patients with schizophrenia and its potential value in the diagnosis of schizophrenia.
Topiramate Versus Naltrexone for Alcohol Use Disorder: A Genotype-Stratified Double-Blind Randomized Controlled Trial
Morley KC, Kranzler HR, Luquin N, Jamshidi N, Adams C, Montebello M, Tremonti C, Dali G, Logge W, Baillie A, Teesson M, Trent R and Haber PS
There have been no well-controlled and well-powered comparative trials of topiramate with other pharmacotherapies for alcohol use disorder (AUD), such as naltrexone. Moreover, the literature is mixed on the effects of two polymorphisms-rs2832407 (in ) and rs1799971 (in )-on response to topiramate and naltrexone, respectively. The authors sought to examine the comparative effectiveness of topiramate and naltrexone in improving outcomes in AUD and to examine the role of the rs2832407 and rs1799971 polymorphisms, respectively, on response to these medications.
Associations Between a Primary Care-Delivered Alcohol-Related Brief Intervention and Subsequent Opioid-Related Outcomes
Blalock DV, Berlin SA, Berkowitz T, Smith VA, Wright C, Bachrach RL and Grubber JM
The co-occurrence of unhealthy alcohol use and opioid misuse is high and associated with increased rates of overdose, emergency health care utilization, and death. The current study examined whether receipt of an alcohol-related brief intervention is associated with reduced risk of negative downstream opioid-related outcomes.
Cost-effectiveness of surgery for degenerative cervical myelopathy in the United Kingdom
Goacher E, Yardanov S, Phillips R, Budu A, Dyson E, Ivanov M, Barton G, Hutton M, Gardner A, Quraishi NA, Grahovac G, Jung J, Demetriades AK, Vergara P, Pereira E, Arzoglou V, Francis J, Trivedi R, Davies BM and Kotter MRN
Degenerative cervical myelopathy (DCM) is the commonest cause of adult spinal cord dysfunction worldwide, for which surgery is the mainstay of treatment. At present, there is limited literature on the costs associated with the surgical management of DCM, and none from the United Kingdom (UK). This study aimed to evaluate the cost-effectiveness of DCM surgery within the National Health Service, UK.
Extended Phenotyping of Migraine in Children: A Cross-Sectional Study in a Specialist Children's Headache Clinic
Karsan N, Prabhakar P and Goadsby PJ
The pediatric migraine phenotype may exhibit differences to adults, leading to diagnostic challenges. We aimed to perform a cross-sectional systematic study to characterize the extended phenotype of pediatric migraine.
The relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder: A systematic review and Meta-analysis
Clarke AT, Fineberg NA, Pellegrini L and Laws KR
This systematic review and meta-analysis explored the relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder (OCD).
The Role of Anxiety and Depression in the Relationship Among Emotional Eating, Sleep Quality, and Impulsivity
Akkuş M, Gelirgün ÖG, Karataş KS, Telatar TG, Gökçen O and Dönmez F
The aim of this study was to investigate the relationship among sleep quality, impulsivity, anxiety, and depression in individuals with emotional eating behavior. The study was designed as a cross-sectional study. The study included 92 individuals (age 31.29 ± 9.17; female, 67.4% [n = 62]; male, 32.6% [n = 30]) with symptoms of emotional eating but no previous psychiatric diagnosis or treatment. Participants were administered a Structured Clinical Interview for DSM-5 Disorders interview form, a sociodemographic data form, the Emotional Eating Scale, the Beck Depression Scale, the Barratt Impulsivity Scale, the Beck Anxiety Scale, and the Pittsburgh Sleep Quality Index Scale. Emotional eating is positively correlated with anxiety (r = 0.377, p = 0.001), depression (r = 0.375, p = 0.001), impulsivity (r = 0.250, p = 0.016), and poor sleep quality (r = 0.478, p = 0.001). Obese individuals (defined as having a body mass index of 30 or higher) showed higher emotional eating (z = -2.552, p = 0.016) and poorer sleep quality (z = -2.089, p = 0.044) than nonobese individuals, and women showed higher emotional eating (t = 2116, p = 0.037) and poorer sleep quality (z = -2537, p = 0.010) than men. Poor sleep quality was associated with emotional eating. In this relationship, poor sleep quality influenced emotional eating through all mediators, including anxiety and depression (B = 3.491; standardized effect, 0.485; p = 0.001). Poor sleep quality directly influenced emotional eating (B = 2.806; standardized effect, 0.390; p = 0.001). The findings of the study suggest that emotional eating is associated with higher levels of anxiety, depression, impulsivity, and sleep problems, especially in women. It suggests that the interrelationships of psychological factors associated with emotional eating should be investigated.
A Bird's-Eye Perspective: An Unusual Case of Very Late-Onset Schizophrenia-Like Psychosis With Visual Hallucinations Included in Its Manifestations Versus the Dementia Prodrome
Bezalwar A, Patil PS, Gautam I and Sahu N
Very late-onset schizophrenia-like psychosis (VLOSLP) is still a paradox; certain characteristics such as episodic progression of psychosis including delusions and hallucinations involving various modalities, as well as the absence of negative symptoms, are strongly predictive of VLOSLP. We describe an interesting case of a 61-year-old male who presented with a second episode of psychosis along with mild to moderate cognitive impairment like having difficulty in buttoning for over eight months at our tertiary care hospital. Previously, during the first episode, he was treated by a private practitioner; adequate doses for an adequate duration of two atypical antipsychotics were given; and up to 25% global improvement was reported by the caregiver. During the current episode, he experienced delusions, in which he had a conviction that a "WIFI" was capable of "thought-making" functions. During the past four months, his delusions exacerbated and were accompanied by hallucinations of other modalities, like visual and kinesthetic hallucinations, which profoundly impacted his daily life. He used to hear voices. While listening to the voices, he also experienced voices coming out of his mouth. All these were experienced by him in clear consciousness daily for a few hours. All plausible medical causes of late-onset psychosis, such as neuroinflammatory/immunological disorders, were ruled out. Neuroimaging revealed T2-weighted image (T2WI)/fluid-attenuated inversion recovery (FLAIR) hyperintensity in bilateral subcortical and periventricular deep white matter, suggestive of small vessel ischemic changes in the brain. The diagnosis of VLOSLP is completely rationalized by evidence-based medicine. Hence, the role of cerebrovascular risk factors, as well as age-related neurobiological processes, in the pathogenesis of VLOSLP is discussed. Future research ought to emphasize identifying a particular biomarker that would be highly predictive for accurately diagnosing VLOSLP and giving it an identity to separate it from various overlapping clinical conditions such as dementia with Lewy bodies (DLB) and other types of dementia with psychosis so that the patient can be given specific treatment.
Diagnosis and treatment of Wernicke's encephalopathy: A systematic literature review
Sato I, Yoshioka A, Uchida N, Onishi H and Ishida M
Pathway from attention-deficit/hyperactivity disorder to suicide/self-harm
Lin PI, Wu WT, Azasu EK and Wong TY
To evaluate the effect of ADHD diagnosis by the age of 10 on the suicide/self-harm risk at age 14 and examine factors that may modify/mediate the association, a longitudinal study based on the nationwide survey consisting of 5,107 children in Australia was used. Self-harm and suicidal risks in children with ADHD at age 14 were the main outcomes; ADHD medication, history of bullied or depression, and other sociodemographic disadvantages, were treated as covariates. The diagnosis of ADHD at age 10 is associated with elevated risks of self-harm, suicidal thoughts, planning, or attempts by age 14, with greater susceptibility in males. The pathway from ADHD symptoms to suicide/self-harm could also be mediated by depression and exposure to bullying assessed at age 12. Note that depression and exposure to bullying might at best contribute to less than 10 % of the total effect of ADHD diagnosis on either the risk of suicide or self-harm. Early gender-tailored intervention and prevention strategies are crucial in clinical practice and health policy.
Ensemble Learning for Higher Diagnostic Precision in Schizophrenia Using Peripheral Blood Gene Expression Profile
Wagh VV, Kottat T, Agrawal S, Purohit S, Pachpor TA, Narlikar L, Paralikar V and Khare SP
Stigma contributes to a significant part of the burden of schizophrenia (SCZ), therefore reducing false positives from the diagnosis would be liberating for the individuals with SCZ and desirable for the clinicians. The stigmatization associated with schizophrenia advocates the need for high-precision diagnosis. In this study, we present an ensemble learning-based approach for high-precision diagnosis of SCZ using peripheral blood gene expression profiles.
A retrospective multicenter study on clinical and serological parameters in patients with MuSK myasthenia gravis with and without general immunosuppression
Koneczny I, Mané-Damas M, Zong S, De Haas S, Huda S, van Kruining D, Damoiseaux J, De Rosa A, Maestri M, Guida M, Molenaar P, Van Damme P, Fichtenbaum A, Perkmann T, De Baets M, Lazaridis K, Zouvelou V, Tzartos S, Ricciardi R, Losen M and Martinez-Martinez P
Muscle-specific kinase (MuSK)- myasthenia gravis (MG) is caused by pathogenic autoantibodies against MuSK that correlate with disease severity and are predominantly of the IgG4 subclass. The first-line treatment for MuSK-MG is general immunosuppression with corticosteroids, but the effect of treatment on IgG4 and MuSK IgG4 levels has not been studied.
Researching COVID to enhance recovery (RECOVER) pediatric study protocol: Rationale, objectives and design
Gross RS, Thaweethai T, Rosenzweig EB, Chan J, Chibnik LB, Cicek MS, Elliott AJ, Flaherman VJ, Foulkes AS, Gage Witvliet M, Gallagher R, Gennaro ML, Jernigan TL, Karlson EW, Katz SD, Kinser PA, Kleinman LC, Lamendola-Essel MF, Milner JD, Mohandas S, Mudumbi PC, Newburger JW, Rhee KE, Salisbury AL, Snowden JN, Stein CR, Stockwell MS, Tantisira KG, Thomason ME, Truong DT, Warburton D, Wood JC, Ahmed S, Akerlundh A, Alshawabkeh AN, Anderson BR, Aschner JL, Atz AM, Aupperle RL, Baker FC, Balaraman V, Banerjee D, Barch DM, Baskin-Sommers A, Bhuiyan S, Bind MC, Bogie AL, Bradford T, Buchbinder NC, Bueler E, Bükülmez H, Casey BJ, Chang L, Chrisant M, Clark DB, Clifton RG, Clouser KN, Cottrell L, Cowan K, D'Sa V, Dapretto M, Dasgupta S, Dehority W, Dionne A, Dummer KB, Elias MD, Esquenazi-Karonika S, Evans DN, Faustino EVS, Fiks AG, Forsha D, Foxe JJ, Friedman NP, Fry G, Gaur S, Gee DG, Gray KM, Handler S, Harahsheh AS, Hasbani K, Heath AC, Hebson C, Heitzeg MM, Hester CM, Hill S, Hobart-Porter L, Hong TKF, Horowitz CR, Hsia DS, Huentelman M, Hummel KD, Irby K, Jacobus J, Jacoby VL, Jone PN, Kaelber DC, Kasmarcak TJ, Kluko MJ, Kosut JS, Laird AR, Landeo-Gutierrez J, Lang SM, Larson CL, Lim PPC, Lisdahl KM, McCrindle BW, McCulloh RJ, McHugh K, Mendelsohn AL, Metz TD, Miller J, Mitchell EC, Morgan LM, Müller-Oehring EM, Nahin ER, Neale MC, Ness-Cochinwala M, Nolan SM, Oliveira CR, Osakwe O, Oster ME, Payne RM, Portman MA, Raissy H, Randall IG, Rao S, Reeder HT, Rosas JM, Russell MW, Sabati AA, Sanil Y, Sato AI, Schechter MS, Selvarangan R, Sexson Tejtel SK, Shakti D, Sharma K, Squeglia LM, Srivastava S, Stevenson MD, Szmuszkovicz J, Talavera-Barber MM, Teufel RJ, Thacker D, Trachtenberg F, Udosen MM, Warner MR, Watson SE, Werzberger A, Weyer JC, Wood MJ, Yin HS, Zempsky WT, Zimmerman E, Dreyer BP and
The prevalence, pathophysiology, and long-term outcomes of COVID-19 (post-acute sequelae of SARS-CoV-2 [PASC] or "Long COVID") in children and young adults remain unknown. Studies must address the urgent need to define PASC, its mechanisms, and potential treatment targets in children and young adults.
Epidemiology of social phobia in Andalusia
González-Domenech P, Gutiérrez B, Muñoz-Negro JE, Molina E, Rivera M and Cervilla JA
Population studies on social anxiety disorder (SAD) are relatively scarce and there is no previous reported evidence on prevalence or correlates of SAD in an Andalusian general population sample.
CSF neurofilament light chain profiling and quantitation in neurological diseases
Leckey CA, Coulton JB, Giovannucci TA, He Y, Aslanyan A, Laban R, Heslegrave A, Doykov I, Ammoscato F, Chataway J, De Angelis F, Gnanapavan S, Byrne LM, Schott JM, Wild EJ, Barthelémy NR, Zetterberg H, Wray S, Bateman RJ, Mills K and Paterson RW
Neurofilament light chain is an established marker of neuroaxonal injury that is elevated in CSF and blood across various neurological diseases. It is increasingly used in clinical practice to aid diagnosis and monitor progression and as an outcome measure to assess safety and efficacy of disease-modifying therapies across the clinical translational neuroscience field. Quantitative methods for neurofilament light chain in human biofluids have relied on immunoassays, which have limited capacity to describe the structure of the protein in CSF and how this might vary in different neurodegenerative diseases. In this study, we characterized and quantified neurofilament light chain species in CSF across neurodegenerative and neuroinflammatory diseases and healthy controls using targeted mass spectrometry. We show that the quantitative immunoprecipitation-tandem mass spectrometry method developed in this study strongly correlates to single-molecule array measurements in CSF across the broad spectrum of neurodegenerative diseases and was replicable across mass spectrometry methods and centres. In summary, we have created an accurate and cost-effective assay for measuring a key biomarker in translational neuroscience research and clinical practice, which can be easily multiplexed and translated into clinical laboratories for the screening and monitoring of neurodegenerative disease or acute brain injury.
[Clinical reflexes in the face of an atypical neuropsychiatric picture]
Marotta F and Point C
A 59-year-old man who had been presenting with a variety of neuropsychiatric symptoms for several weeks. Despite repeated visits to somatic emergencies, as well as a thorough work-up including complementary examinations and specialist opinions, no organic diagnosis was established. The patient was treated symptomatically with neuroleptics and benzodiazepines, which led to a significant improvement in symptoms.
Case report: Recurring and treatment-resistant depression in acquired hepatocerebral degeneration due to a congenital portosystemic shunt
Tamura T, Takagi S, Hayakawa A, Oyama J, Fujino J, Shiwaku H, Takahashi H and Sugihara G
Acquired hepatocerebral degeneration (AHD) is a neurological condition associated with cerebral manganese (Mn) accumulation caused by portosystemic shunts (PSS), usually because of advanced liver disease. AHD is diagnosed by the identification of T1-weighted brain magnetic resonance imaging (MRI) hyperintensities coupled with the presence of PSS and neurological symptoms. Clinical presentations primarily involve motor dysfunction and cognitive impairment. As a result of the frequently concurrent hepatic encephalopathy, the psychiatric symptoms of AHD alone remain unclear. This report is the first documentation of unique psychiatric symptoms of AHD due to a congenital PSS (CPSS) and suggests the efficacy of shunt embolization in achieving sustained remission of psychiatric symptoms in such cases.
Non-use and inadequate use of cervical cancer screening among a representative sample of women in the United States
Narcisse MR, McElfish PA, Hallgren E, Pierre-Joseph N and Felix HC
Women's adherence to the United States (U.S.) Preventive Services Task Force guidelines for cervical cancer screening was determined by examining predisposing, enabling, and needs factors from Andersen's Behavioral Model of Health Services Use conceptual framework.
Associations of Nightmares and Sleep Disturbance With Neurobehavioral Symptoms Postconcussion
Faerman A, Nabasny A, Wright B and Juengst SB
This study investigates the association of nightmares beyond general sleep disturbance on neurobehavioral symptoms in adults with mild traumatic brain injury (mTBI).
Three Prospective Case Studies Examining Mifepristone's Efficacy in Patients with Treatment-Resistant PTSD
van Minnen A, Vos L, Bet PM, de Jongh A, Linsen F, van Marle HJF, Meijer OC, Otte WM, Russcher M and Vinkers CH
Despite the availability of various treatment approaches for patients with posttraumatic stress disorder (PTSD), some patients do not respond to these therapies, and novel treatment approaches are needed. This study investigated the efficacy of mifepristone, a glucocorticoid receptor antagonist, in treatment-resistant PTSD patients. Three patients with PTSD who were resistant to standard psychological and pharmacological treatments were prescribed mifepristone (600-1,200 mg/day) for 1 week. A baseline-controlled single-case design was used, involving a 2-week baseline phase (no intervention), a 1-week intervention phase (mifepristone), and a 2-week postintervention phase. The primary outcome measure, self-reported PTSD symptom severity (PCL-5), was assessed daily, with participants providing their own control condition. Two of the three patients experienced a significant reduction in PTSD symptom severity after the intervention phase and no longer met the diagnostic criteria for PTSD. These positive results were maintained during long-term follow-up. These findings support the potential effectiveness of mifepristone in the treatment of patients with treatment-resistant PTSD. However, our findings must be interpreted with caution, and further studies with larger sample sizes and more rigorous designs are necessary to confirm the promising results.
Approach to the diagnosis and management of dysbiosis
Alagiakrishnan K, Morgadinho J and Halverson T
All microorganisms like bacteria, viruses and fungi that reside within a host environment are considered a microbiome. The number of bacteria almost equal that of human cells, however, the genome of these bacteria may be almost 100 times larger than the human genome. Every aspect of the physiology and health can be influenced by the microbiome living in various parts of our body. Any imbalance in the microbiome composition or function is seen as dysbiosis. Different types of dysbiosis are seen and the corresponding symptoms depend on the site of microbial imbalance. The contribution of the intestinal and extra-intestinal microbiota to influence systemic activities is through interplay between different axes. Whole body dysbiosis is a complex process involving gut microbiome and non-gut related microbiome. It is still at the stage of infancy and has not yet been fully understood. Dysbiosis can be influenced by genetic factors, lifestyle habits, diet including ultra-processed foods and food additives, as well as medications. Dysbiosis has been associated with many systemic diseases and cannot be diagnosed through standard blood tests or investigations. Microbiota derived metabolites can be analyzed and can be useful in the management of dysbiosis. Whole body dysbiosis can be addressed by altering lifestyle factors, proper diet and microbial modulation. The effect of these interventions in humans depends on the beneficial microbiome alteration mostly based on animal studies with evolving evidence from human studies. There is tremendous potential for the human microbiome in the diagnosis, treatment, and prognosis of diseases, as well as, for the monitoring of health and disease in humans. Whole body system-based approach to the diagnosis of dysbiosis is better than a pure taxonomic approach. Whole body dysbiosis could be a new therapeutic target in the management of various health conditions.
Depression among refugee youth in an outpatient healthcare center-prevalence and associated factors
Schumacher L, Echterhoff J, Zindler A and Barthel D
Due to armed conflict and other crises, many children worldwide have to flee their home country and are, consequently, at a high risk for mental health problems.
Insights into the structure and function of the hippocampus: implications for the pathophysiology and treatment of autism spectrum disorder
Long J, Li H, Liu Y, Liao X, Tang Z, Han K, Chen J and Zhang H
The hippocampus is one of the brain areas affected by autism spectrum disorder (ASD). Individuals with ASD typically have impairments in hippocampus-dependent learning, memory, language ability, emotional regulation, and cognitive map creation. However, the pathological changes in the hippocampus that result in these cognitive deficits in ASD are not yet fully understood. In the present review, we will first summarize the hippocampal involvement in individuals with ASD. We will then provide an overview of hippocampal structural and functional abnormalities in genetic, environment-induced, and idiopathic animal models of ASD. Finally, we will discuss some pharmacological and non-pharmacological interventions that show positive impacts on the structure and function of the hippocampus in animal models of ASD. A further comprehension of hippocampal aberrations in ASD might elucidate their influence on the manifestation of this developmental disorder and provide clues for forthcoming diagnostic and therapeutic innovation.
The utility of PET imaging in depression
Singh SB, Tiwari A, Katta MR, Kafle R, Ayubcha C, Patel KH, Bhattarai Y, Werner TJ, Alavi A and Revheim ME
This educational review article aims to discuss growing evidence from PET studies in the diagnosis and treatment of depression. PET has been used in depression to explore the neurotransmitters involved, the alterations in neuroreceptors, non-neuroreceptor targets (e.g., microglia and astrocytes), the severity and duration of the disease, the pharmacodynamics of various antidepressants, and neurobiological mechanisms of non-pharmacological therapies like psychotherapy, electroconvulsive therapy, and deep brain stimulation therapy, by showing changes in brain metabolism and receptor and non-receptor targets. Studies have revealed alterations in neurotransmitter systems such as serotonin, dopamine, GABA, and glutamate, which are linked to the pathophysiology of depression. Overall, PET imaging has furthered the neurobiological understanding of depression. Despite these advancements, PET findings have not yet led to significant changes in evidence-based practices. Addressing the reasons behind inconsistencies in PET imaging results, conducting large sample size studies with a more standardized methodological approach, and investigating further the genetic and neurobiological aspects of depression may better leverage PET imaging in future studies.
The Effects of Patient Preference on Clinical Outcome, Satisfaction and Adherence Within the Treatment of Anxiety and Depression: A Meta-Analysis
Eigenhuis E, van Buuren VEM, Boeschoten RE, Muntingh ADT, Batelaan NM and van Oppen P
Taking patient preference into consideration has received increased attention in the last decades. We conducted a meta-analysis to estimate the effects of patient preference on clinical outcome, satisfaction and adherence regarding treatment of depression and anxiety.
The association of blood biomarkers with cerebral white matter and myelin content in bipolar disorder: a systematic review
Ali M, Husnudinov R, Wollenhaupt-Aguiar B and Frey BN
Evidence from diffusion tensor imaging (DTI) and postmortem studies has demonstrated white-matter (WM) deficits in bipolar disorder (BD). Changes in peripheral blood biomarkers have also been observed; however, studies evaluating the potential relationship between brain alterations and the periphery are scarce. The objective of this systematic review is to investigate the relationship between blood-based biomarkers and WM in BD.
Socioeconomic and gender inequalities in mental disorders among adolescents and young adults
Mar J, Larrañaga I, Ibarrondo O, González-Pinto A, Hayas CL, Fullaondo A, Izco-Basurko I, Alonso J, Mateo-Abad M, de Manuel E and
Socioeconomic status (SES) and gender play a key role in mental health. The objective of this study was to assess socioeconomic and gender mental health inequalities in adolescents and young adults using a population-based registry.
Self-reported symptom burden among patients attending public health care facilities in India: Looking through ICPC-3 lens
Gupta P, Bharati B, Sundar Sahu K, Mahapatra P and Pati S
The objectives of this study were: 1) to describe the socio-demographics and classify the chief complaints and reasons to encounter facilities of patients presenting to public healthcare facilities; 2) to explore differences in these complaints and: International Classification of Primary Care-3 (ICPC-3) groups across socio-demographic and health system levels.
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