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Epidemiology and Psychiatry

Coronavirus disease 2019 and its impact on the cognition of older adults: Unraveling the role of inflammation
Mortazavi S, Rashedi V, Cheraghian B, Pourshams F, Saeidimehr S, Dehghan B and Pourshams M
The Coronavirus Disease 2019 (COVID-19) pandemic significantly impacted the older adult population globally. This study aimed to investigate cognitive function and its relationship with inflammation in older COVID-19 survivors over a three-month follow-up to address concerns about cognitive impairment and its risk factors.
Impact of the COVID-19 Pandemic on Swedish Adolescents' Mental Health, Psychosocial Functioning, Risk Behaviours, and Victimisation: Gender Differences and Implications
Johansson C, Hedman Ahlström B, Barac M, Berglund T, Bador K and Kerekes N
The COVID-19 pandemic has shown varying effects on adolescents' mental health, psychosocial functioning, risk behaviours, and victimisation. This study aims to examine the changes reported by a sample of Swedish adolescents ( = 1607) at the end of the first year of the pandemic in relation to these factors. Data were collected with an electronic survey between September 2020 and February 2021, targeting upper-secondary high school students (aged 15-19 years). The results indicate a relatively low overall impact of the pandemic on Swedish upper-secondary school students, with notable gender differences. Compared to adolescent women, a higher percentage of adolescent men reported experiencing elevated levels of anxiety, depression, sleep disturbances, anger, and increased illicit drug use as consequences of the pandemic. In contrast, women demonstrated an increase in several salutogenic behaviours. Victimisation rates generally decreased during this period. These findings underscore the importance of heightened awareness among professionals within schools, social services, and healthcare settings regarding the distinct challenges encountered by a larger portion of adolescent men during the COVID-19 pandemic in Sweden.
Determinants of Weight Status and Body, Health and Life Satisfaction in Young Adults
Suwalska J, Łukasik S, Cymerys M, Suwalska A and Bogdański P
Health behaviors include behavioral patterns and habits that relate to health maintenance, restoration and improvement. They do not only affect the physical condition; they are also associated with life satisfaction. In our study, we focused on young adulthood, a specific lifespan period for establishing long-term health behavior patterns. The aim of the present study was to investigate depressive symptoms, lifestyle and eating behaviors and delineate their associations with overweight/obesity and body, health and life satisfaction in young adults in Poland. We enrolled 800 students (81.4% females and 18.6% males). Diet, physical activity, depressive symptoms, eating behaviors and body, health and life satisfaction were assessed. Multivariate logistic regression models were employed. Almost half of the participants in our study had at least mild symptoms of depression. Symptoms of depression significantly reduced the odds of satisfaction with body, health and life, whereas physical activity increased them. Overweight/obesity significantly reduced the odds of body and health satisfaction. In women, a history of depression and emotional eating increased the odds of being overweight/obese. The results of our study may contribute to the development of educational programs and intervention strategies for young adults.
A Mind-Body Intervention to Improve Physical Activity for Patients with Chronic Hip-Related Pain: Protocol for a Mixed Methods Study
Jochimsen KN, Archer KR, Pollini RA, Parker RA, Enkhtsetseg N, Jacobs CA and Vranceanu AM
Pain and dysfunction persist for most patients following hip-related pain treatment. Additionally, individuals with hip-related pain are typically less physically active than individuals without hip pain, despite evidence that regular physical activity reduces chronic musculoskeletal pain. Poor psychological health is common in patients with hip-related pain and further reinforces low physical activity. Mind-body interventions can improve psychological health and activity levels but have yet to be integrated to provide comprehensive, psychologically informed care for patients with hip-related pain. Thus, we are using the NCCIH intervention development framework to develop Helping Improve PSychological Health (HIPS), a novel, multimodal mind-body intervention to improve physical activity for individuals with hip-related pain and poor psychological health.
Serum Albumin and Post-Stroke Outcomes: Analysis of UK Regional Registry Data, Systematic Review, and Meta-Analysis
Thuemmler RJ, Pana TA, Carter B, Mahmood R, Bettencourt-Silva JH, Metcalf AK, Mamas MA, Potter JF and Myint PK
Hypoalbuminemia associates with poor acute ischemic stroke (AIS) outcomes. We hypothesised a non-linear relationship and aimed to systematically assess this association using prospective stroke data from the Norfolk and Norwich Stroke and TIA Register. Consecutive AIS patients aged ≥40 years admitted December 2003-December 2016 were included. Outcomes: In-hospital mortality, poor discharge, functional outcome (modified Rankin score 3-6), prolonged length of stay (PLoS) > 4 days, and long-term mortality. Restricted cubic spline regressions investigated the albumin-outcome relationship. We updated a systematic review (PubMed, Scopus, and Embase databases, January 2020-June 2023) and undertook a meta-analysis. A total of 9979 patients were included; mean age (standard deviation) = 78.3 (11.2) years; mean serum albumin 36.69 g/L (5.38). Compared to the cohort median, albumin < 37 g/L associated with up to two-fold higher long-term mortality (HR; 95% CI = 2.01; 1.61-2.49) and in-hospital mortality (RR; 95% CI = 1.48; 1.21-1.80). Albumin > 44 g/L associated with up to 12% higher long-term mortality (HR1.12; 1.06-1.19). Nine studies met our inclusion criteria totalling 23,597 patients. Low albumin associated with increased risk of long-term mortality (two studies; relative risk 1.57 (95% CI 1.11-2.22; = 81.28)), as did low-normal albumin (RR 1.10 (95% CI 1.01-1.20; = 0.00)). Strong evidence indicates increased long-term mortality in AIS patients with low or low-normal albumin on admission.
Reproducibility between preschool and school-age Social Responsiveness Scale forms in the Environmental influences on Child Health Outcomes program
Patti MA, Croen LA, Dickerson AS, Joseph RM, Ames JL, Ladd-Acosta C, Ozonoff S, Schmidt RJ, Volk HE, Hipwell AE, Magee KE, Karagas M, McEvoy C, Landa R, Elliott MR, Mitchell DK, D'Sa V, Deoni S, Pievsky M, Wu PC, Barry F, Stanford JB, Bilder DA, Trasande L, Bush NR, Lyall K and
Evidence suggests core autism trait consistency in older children, but development of these traits is variable in early childhood. The Social Responsiveness Scale (SRS) measures autism-related traits and broader autism phenotype, with two age-dependent forms in childhood (preschool, 2.5-4.5 years; school age, 4-18 years). Score consistency has been observed within forms, though reliability across forms has not been evaluated. Using data from the Environmental Influences on Child Health Outcomes (ECHO) program (n = 853), preschool, and school-age SRS scores were collected via maternal report when children were an average of 3.0 and 5.8 years, respectively. We compared reproducibility of SRS total scores (T-scores) and agreement above a clinically meaningful cutoff (T-scores ≥ 60) and examined predictors of discordance in cutoff scores across forms. Participant scores across forms were similar (mean difference: 3.3 points; standard deviation: 7), though preschool scores were on average lower than school-age scores. Most children (88%) were classified below the cutoff on both forms, and overall concordance was high (92%). However, discordance was higher in cohorts following younger siblings of autistic children (16%). Proportions of children with an autism diagnoses were also higher among those with discordant scores (27%) than among those with concordant scores (4%). Our findings indicate SRS scores are broadly reproducible across preschool and school-age forms, particularly for capturing broader, nonclinical traits, but also suggest that greater variability of autism-related traits in preschool-age children may reduce reliability with later school-age scores for those in the clinical range.
Childhood adversity and time-to-pregnancy in a preconception cohort
Lovett SM, Orta OR, Boynton-Jarrett R, Wesselink AK, Ncube CN, Nillni YI, Hatch EE and Wise LA
We examined the association between childhood adversity and fecundability (the per-cycle probability of conception), and the extent to which childhood social support modified this association. We used data from 6,318 female participants aged 21-45 years in Pregnancy Study Online (PRESTO), a North American prospective preconception cohort study (2013-2022). Participants completed a baseline questionnaire, bimonthly follow-up questionnaires (until pregnancy or a censoring event), and a supplemental questionnaire on experiences across the life course including adverse childhood experiences (ACE) and social support (using the modified Berkman-Syme Social Network Index [SNI]). We used proportional probabilities regression models to compute fecundability ratios (FR) and 95% confidence intervals (CI), adjusting for potential confounders and precision variables. Adjusted FRs for ACE scores 1-3 and ≥4 vs. 0 were 0.91 (95% CI: 0.85, 0.97) and 0.84 (95% CI: 0.77, 0.91), respectively. FRs for ACE scores ≥4 vs. 0 were 0.86 (95% CI: 0.78, 0.94) among participants reporting high childhood social support (SNI ≥4) and 0.78 (95% CI: 0.56, 1.07) among participants reporting low childhood social support (SNI <4). Our findings confirm results from two previous studies and indicate that high childhood social support slightly buffered the effects of childhood adversity on fecundability.
Profiling of Tumor-Infiltrating Immune Cells and Their Impact on Survival in Glioblastoma Patients Undergoing Immunotherapy with Dendritic Cells
Peres N, Lepski GA, Fogolin CS, Evangelista GCM, Flatow EA, de Oliveira JV, Pinho MP, Bergami-Santos PC and Barbuto JAM
Glioblastomas (GBM) are the most common primary malignant brain tumors, comprising 2% of all cancers in adults. Their location and cellular and molecular heterogeneity, along with their highly infiltrative nature, make their treatment challenging. Recently, our research group reported promising results from a prospective phase II clinical trial involving allogeneic vaccination with dendritic cells (DCs). To date, six out of the thirty-seven reported cases remain alive without tumor recurrence. In this study, we focused on the characterization of infiltrating immune cells observed at the time of surgical resection. An analytical model employing a neural network-based predictive algorithm was used to ascertain the potential prognostic implications of immunological variables on patients' overall survival. Counterintuitively, immune phenotyping of tumor-associated macrophages (TAMs) has revealed the extracellular marker PD-L1 to be a positive predictor of overall survival. In contrast, the elevated expression of CD86 within this cellular subset emerged as a negative prognostic indicator. Fundamentally, the neural network algorithm outlined here allows a prediction of the responsiveness of patients undergoing dendritic cell vaccination in terms of overall survival based on clinical parameters and the profile of infiltrated TAMs observed at the time of tumor excision.
Time-varying living arrangements and suicide death in the general population sample: 14-year causal survival analysis via pooled logistic regression
Narita Z, Shinozaki T, Goto A, Hori H, Kim Y, Wilcox HC, Inoue M, Tsugane S and Sawada N
While past research suggested that living arrangements are associated with suicide death, no study has examined the impact of sustained living arrangements and the change in living arrangements. Also, previous survival analysis studies only reported a single hazard ratio (HR), whereas the actual HR may change over time. We aimed to address these limitations using causal inference approaches.
Interventions for smoking cessation in hospitalised patients
Streck JM, Rigotti NA, Livingstone-Banks J, Tindle HA, Clair C, Munafò MR, Sterling-Maisel C and Hartmann-Boyce J
In 2020, 32.6% of the world's population used tobacco. Smoking contributes to many illnesses that require hospitalisation. A hospital admission may prompt a quit attempt. Initiating smoking cessation treatment, such as pharmacotherapy and/or counselling, in hospitals may be an effective preventive health strategy. Pharmacotherapies work to reduce withdrawal/craving and counselling provides behavioural skills for quitting smoking. This review updates the evidence on interventions for smoking cessation in hospitalised patients, to understand the most effective smoking cessation treatment methods for hospitalised smokers.
Forecasting the 20-Year Incidence of Dementia by Socioeconomic Status, Race/Ethnicity, and Region Based on Mid-Life Risk Factors in a U.S. Nationally Representative Sample
Churchill N, Barnes DE, Habib M and Nianogo RA
Alzheimer's disease and related dementias (ADRD) incidence varies based on demographics, but mid-life risk factor contribution to this variability requires more research.
The Role of Social Deprivation and Cannabis Use in Explaining Variation in the Incidence of Psychotic Disorders: Findings From the EU-GEI Study
Brink V, Andleeb H, Gayer-Anderson C, Arango C, Arrojo M, Berardi D, Bernardo M, Bobes J, Del-Ben CM, Ferraro L, de Haan L, La Barbera D, La Cascia C, Lasalvia A, Llorca PM, Menezes PR, Pignon B, Sanjuán J, Santos JL, Selten JP, Tarricone I, Tortelli A, Tripoli G, Velthorst E, Rutten BPF, van Os J, Quattrone D, Murray RM, Jones PB, Morgan C, Di Forti M, Jongsma HE and Kirkbride JB
Recent findings suggest the incidence of first-episode psychotic disorders (FEP) varies according to setting-level deprivation and cannabis use, but these factors have not been investigated together. We hypothesized deprivation would be more strongly associated with variation in FEP incidence than the prevalence of daily or high-potency cannabis use between settings.
Association between evacuation and becoming overweight after the Great East Japan Earthquake: a 7-year follow-up of the Fukushima Health Management Survey
Nagao M, Okazaki K, Ohira T, Nakano H, Hayashi F, Shimabukuro M, Sakai A, Hosoya M, Kazama JJ, Takahashi A, Maeda M, Yabe H, Ohto H, Kamiya K and Yasumura S
Disaster evacuation increases the risk of becoming overweight or obese owing to lifestyle changes and psychosocial factors. This study evaluated the effect of evacuation on becoming overweight during a 7-year follow-up among residents of Fukushima Prefecture during the Great East Japan Earthquake.
Prevalence of Mild Cognitive Impairment and Alzheimer's Disease Identified in Veterans in the United States
Aguilar BJ, Jasuja GK, Li X, Shishova E, Palacios N, Berlowitz D, Morin P, O'Connor MK, Nguyen A, Reisman J, Leng Y, Zhang R, Monfared AAT, Zhang Q and Xia W
Diagnostic codes can be instrumental for case identification in Alzheimer's disease (AD) research; however, this method has known limitations and cannot distinguish between disease stages. Clinical notes may offer more detailed information including AD severity and can complement diagnostic codes for case identification.
Kratom addiction per DSM-5 SUD criteria, and kratom physical dependence: Insights from dosing amount versus frequency
Rogers JM, Weiss ST, Epstein DH, Grundmann O, Hill K and Smith KE
Kratom products are widely used in the United States, with inadequate understanding of how dosing amounts/frequencies relate to outcomes.
Associations between fruit and vegetable intakes and incident depression in middle-aged and older adults from 10 diverse international longitudinal cohorts
Matison AP, Flood VM, Lam BCP, Lipnicki DM, Tucker KL, Preux PM, Guerchet M, d'Orsi E, Quialheiro A, Rech CR, Skoog I, Najar J, Sterner TR, Scarmeas N, Kosmidis MH, Yannakoulia M, Gureje O, Ojagbemi A, Bello T, Shahar S, Fakhruddin NNN, Rivan NFM, Anstey KJ, Cherbuin N, Mortby M, Ho R, Brodaty H, Sachdev PS, Reppermund S, Mather KA and
Emerging observational evidence supports a role for higher fruit and vegetable intake in protecting against the development of depression. However, there is a scarcity of research in older adults or in low- to middle-income countries (LMICs).
Neurodevelopmental delay in children exposed to maternal SARS-CoV-2 in-utero
Fajardo-Martinez V, Ferreira F, Fuller T, Cambou MC, Kerin T, Paiola S, Mok T, Rao R, Mohole J, Paravastu R, Zhang D, Marschik P, Iyer S, Kesavan K, Borges Lopes MDC, Britto JAA, Moreira ME, Brasil P and Nielsen-Saines K
It is unclear if SARS CoV-2 infection during pregnancy is associated with adverse neurodevelopmental repercussions to infants. We assessed pediatric neurodevelopmental outcomes in children born to mothers with laboratory-confirmed SARS CoV-2 infection during pregnancy. Neurodevelopmental outcomes of in-utero exposed children were compared to that of pre-pandemic control children in Los Angeles (LA), CA, USA and Rio de Janeiro, Brazil. Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III), the gold standard tool for evaluating neurodevelopment until 36 months of age and Ages and Stages Questionnaires (ASQ-3), a frequently used screening instrument for evaluating neurodevelopment in this same age group were the assessment tools used. Developmental delay (DD) was defined as having a score < - 2 SD below the norm (< 70) in at least one of three Bayley-III domains, (cognitive, motor or language) or a score below the cut-off (dark zone) in at least one of five ASQ-3 domains (communication, gross motor, fine motor, problem solving, personal-social). Exposed children were born between April 2020 and December 2022 while control children were born between January 2016 to December 2019. Neurodevelopmental testing was performed in 300 children total: 172 COVID-19 exposed children between 5-30 months of age and 128 control children between 6-38 months of age. Bayley-III results demonstrated that 12 of 128 exposed children (9.4%) had DD versus 2 of 128 controls (1.6%), p = 0.0007. Eight of 44 additional exposed children had DD on ASQ-3 testing. Fully, 20 of 172 exposed children (11.6%) and 2 of 128 control children (1.6%), p = 0.0006 had DD. In Rio, 12% of exposed children versus 2.6% of controls, p = 0.02 had DD. In LA, 5.7% of exposed children versus 0 controls, p = 0.12 had DD. Severe/critical maternal COVID-19 predicted below average neurodevelopment in the exposed cohort (OR 2.6, 95% CI 1.1-6.4). Children exposed to antenatal COVID-19 have a tenfold higher frequency of DD as compared to controls and should be offered neurodevelopmental follow-up.
Anemia and associated factors among under-five children attending public Hospitals in Harari Regional State, eastern Ethiopia: A cross-sectional study
Gemechu K, Asmerom H, Sileshi B, Belete R, Ayele F, Nigussie K, Bete T, Negash A, Sertsu A, Mekonnen S and Arkew M
Childhood anemia is a significant global public health problem. It influences the physical and cognitive development, as well as immunity of affected children. This in turn leads to poor academic performance, low working potential, and increased morbidity and mortality. There is limited facility-based data on the magnitude and predictors of anemia among under-five children. This study aimed to determine the prevalence and associated factors of anemia among under-five children attending public Hospitals in Harari Regional State, eastern Ethiopia. Institution-based cross-sectional study was conducted at Hiwot Fana Comprehensive Specialized University Hospital and Jugal Hospital from July 1, 2022, to August 31, 2022. A total of 330 under-five children were involved by systematic random sampling technique. Data on sociodemographic characteristics and other possible factors were collected through face-to-face interviews with children's parents/legal guardians. Four milliliters of venous blood samples were collected for a complete blood cell count. Collected data were checked for completeness, entered into Epi-Data Statistical Software Version 4.6, and exported into the Statistical Package for Social Sciences version 25 for analysis. Bivariable and multivariable logistic regression was conducted and P < .05 were considered statistically significant. The overall prevalence of anemia was 33% (95% confidence interval [CI]: 27.9%-37.9%). Age of children 6 to 11 months (adjusted odd ratio [AOR] = 3.94, 95% CI: 1.55-10.01) and 12 to 23 months (AOR = 2.93, 95% CI: 1.15-7.43), no maternal education (AOR = 4.34, 95% CI: 1.53-12.35), not exclusively breastfeeding (AOR = 1.98, 95% CI: 1.11-3.52), being severely stunted (AOR = 3.39, 95 CI: 1.70-6.75), and underweight (AOR = 2.1, 95% CI: 1.12-3.87) were significantly associated with anemia among under-five children. In this study, anemia among under-five children is a moderate public health problem. This study revealed that young child age, maternal education level, early initiation of complementary feeding, and child undernutrition were factors associated with anemia. Thus, efforts should be made to improve the child's nutritional status as well as enhance maternal awareness of nutrition and child-feeding practice through health education. Regular childhood nutritional screening and appropriate intervention for malnutrition are needed. Besides, further studies assessing serum micronutrient levels should be conducted to differentiate the specific cause and type of anemia.
Confidence in providing methadone maintenance treatment of primary care providers in Vietnam
Nguyen BD, Li L, Lin C, Nguyen TT, Shoptaw S and Le MG
Delivering methadone treatment in community health facilities by primary care providers is a task-shifting strategy to expand access to drug use treatment, especially in rural mountainous areas. This study aims to investigate factors related to confidence in providing methadone treatment among primary care providers in Vietnam to inform good practice development.
Is cognitive behavioral therapy for insomnia (CBTI) more cost-effective? New-perspective on economic evaluations: a systematic review and meta-analysis
Fang L, Lyu Z, Ai S, Du S, Zhou W, Zeng S, Luo X, Guo J, Zhao Y, Li S, Hou Y, Lu C and Zhang B
To investigate the cost-effectiveness of cognitive behavioral therapy for insomnia (CBTI), with an additional focus on digital cognitive behavioral therapy for insomnia (dCBTI) in adults with insomnia.
Investigating the association between work family conflict (WFC) and generalized anxiety disorder (GAD) in an Australian community-based cohort study
Wang T, Butterworth P, Cooklin A, Strazdins L and Leach L
Difficulties managing work and family demands are common and have been found to be associated with stress and poor mental health. However, very few studies have examined Work Family Conflict (WFC) in connection with diagnosable anxiety disorders (and none with Australian representative data). The current study investigated whether high WFC was significantly associated with a diagnosis of Generalised Anxiety Disorder (GAD) after controlling for a broad range of socio-demographic contextual factors, related psychosocial job, family and individual characteristics, and prior anxiety symptom history.
A Pilot Study to Evaluate the Use of Automated Nicotine Metabolite Ratio Reporting within Primary Care as an Implementation Strategy to Increase the Use of Tobacco Treatments
Schnoll R, Leone FT, Bauer AM, Wileyto EP, Wollack C, Stevens N, Blumenthal D, Foster C, Koita F, Villasenor J and Jenssen BP
Concerns about safety and effectiveness of tobacco treatments reduce their use. We explored integrating the nicotine metabolite ratio (NMR), and messaging about its potential for improving safety and effectiveness, as a strategy to increase use of tobacco treatments within primary care.
Massively parallel characterization of regulatory elements in the developing human cortex
Deng C, Whalen S, Steyert M, Ziffra R, Przytycki PF, Inoue F, Pereira DA, Capauto D, Norton S, Vaccarino FM, , Pollen AA, Nowakowski TJ, Ahituv N, Pollard KS and
Nucleotide changes in gene regulatory elements are important determinants of neuronal development and diseases. Using massively parallel reporter assays in primary human cells from mid-gestation cortex and cerebral organoids, we interrogated the cis-regulatory activity of 102,767 open chromatin regions, including thousands of sequences with cell type-specific accessibility and variants associated with brain gene regulation. In primary cells, we identified 46,802 active enhancer sequences and 164 variants that alter enhancer activity. Activity was comparable in organoids and primary cells, suggesting that organoids provide an adequate model for the developing cortex. Using deep learning we decoded the sequence basis and upstream regulators of enhancer activity. This work establishes a comprehensive catalog of functional gene regulatory elements and variants in human neuronal development.
Brain cell-type shifts in Alzheimer's disease, autism, and schizophrenia interrogated using methylomics and genetics
Yap CX, Vo DD, Heffel MG, Bhattacharya A, Wen C, Yang Y, Kemper KE, Zeng J, Zheng Z, Zhu Z, Hannon E, Vellame DS, Franklin A, Caggiano C, Wamsley B, Geschwind DH, Zaitlen N, Gusev A, Pasaniuc B, Mill J, Luo C and Gandal MJ
Few neuropsychiatric disorders have replicable biomarkers, prompting high-resolution and large-scale molecular studies. However, we still lack consensus on a more foundational question: whether quantitative shifts in cell types-the functional unit of life-contribute to neuropsychiatric disorders. Leveraging advances in human brain single-cell methylomics, we deconvolve seven major cell types using bulk DNA methylation profiling across 1270 postmortem brains, including from individuals diagnosed with Alzheimer's disease, schizophrenia, and autism. We observe and replicate cell-type compositional shifts for Alzheimer's disease (endothelial cell loss), autism (increased microglia), and schizophrenia (decreased oligodendrocytes), and find age- and sex-related changes. Multiple layers of evidence indicate that endothelial cell loss contributes to Alzheimer's disease, with comparable effect size to genotype among older people. Genome-wide association identified five genetic loci related to cell-type composition, involving plausible genes for the neurovascular unit ( and ) and excitatory neurons ( and ). These results implicate specific cell-type shifts in the pathophysiology of neuropsychiatric disorders.
REM sleep behaviour disorder (RBD): Personal perspectives and research priorities
Schenck CH
The formal identification and naming of rapid eye movement (REM) sleep behaviour disorder (RBD) in 1985-1987 is described; the historical background of RBD from 1966 to 1985 is briefly discussed; and RBD milestones are presented. Current knowledge on RBD is identified with reference to recent comprehensive reviews, allowing for a focus on research priorities for RBD: factors and predictors of neurodegenerative phenoconversion from isolated RBD and patient enrolment in neuroprotective trials; isolated RBD clinical research cohorts; epidemiology of RBD; traumatic brain injury, post-traumatic stress disorder, RBD and neurodegeneration; depression, RBD and synucleinopathy; evolution of prodromal RBD to neurodegeneration; gut microbiome dysbiosis and colonic synuclein histopathology in isolated RBD; other alpha-synuclein research in isolated RBD; narcolepsy-RBD; dreams and nightmares in RBD; phasic REM sleep in isolated RBD; RBD, periodic limb movements, periodic limb movement disorder pseudo-RBD; other neurophysiology research in RBD; cardiac scintigraphy (I-MIBG) in isolated RBD; brain magnetic resonance imaging biomarkers in isolated RBD; microRNAs as biomarkers in isolated RBD; actigraphic, other automated digital monitoring and machine learning research in RBD; prognostic counselling and ethical considerations in isolated RBD; and REM sleep basic science research. RBD research is flourishing, and is strategically situated at an ever-expanding crossroads of clinical (sleep) medicine, neurology, psychiatry and neuroscience.
Algorithmic approach to finding people with multiple sclerosis using routine healthcare data in Wales
Nicholas R, Tallantyre EC, Witts J, Marrie RA, Craig EM, Knowles S, Pearson OR, Harding K, Kreft K, Hawken J, Ingram G, Morgan B, Middleton RM, Robertson N and Research Group UR
Identification of multiple sclerosis (MS) cases in routine healthcare data repositories remains challenging. MS can have a protracted diagnostic process and is rarely identified as a primary reason for admission to the hospital. Difficulties in identification are compounded in systems that do not include insurance or payer information concerning drug treatments or non-notifiable disease.
Understanding Elderly Chinese Cancer Patients in a Multicultural Clinical Setting: Embracing Mortality and Addressing Misperceptions of Vulnerability
Leung YW, Kwong EWY, Wong KLY, So J, Poon F, Cheng T, Chen E, Molasiotis A and Howell D
Chinese patients face higher risks of gastrointestinal (GI) cancers and greater cancer-related deaths than Canadian-born patients. The older population encounters barriers to quality healthcare, impacting their well-being and survival. Previous studies highlighted Chinese immigrant perceptions of not requiring healthcare support. During the COVID-19 pandemic, their underutilization of healthcare services garnered attention. The present study explores the experiences of older Chinese cancer patients to improve culturally sensitive cancer care. A total of twenty interviews carried out in Cantonese and Mandarin were conducted with Chinese immigrants, aged 60 or above, diagnosed with Stage 3 or 4 GI cancer. These interviews were transcribed verbatim, translated, and subjected to qualitative descriptive analysis. Among older Chinese immigrant patients, a phenomenon termed "Premature Acceptance: Normalizing Death and Dying" was observed. This involved four key themes: 1. acceptance and letting go, 2. family first, 3. self-sufficiency, and 4. barriers to supportive care. Participants displayed an early acceptance of their own mortality, prioritizing family prosperity over their own quality of life. Older Chinese patients normalize the reality of facing death amidst cancer. They adopt a pragmatic outlook, acknowledging life-saving treatments while willingly sacrificing their own support needs to ease family burdens. Efforts to enhance health literacy require culturally sensitive programs tailored to address language barriers and differing values among this population. A strengths-based approach emphasizing family support and practical aspects of care may help build resilience and improve symptom management, thereby enhancing their engagement with healthcare services.
The impact of psychopathic traits on anxiety-related behaviors in a mixed reality environment
Voulgaris A, Biedermann SV, Biedermann D, Bründl S, Roth L, Wiessner C, Briken P and Fuss J
There is an ongoing debate about anxiety deficits in psychopathy and their possible impact on individual behavior. Data on actual anxiety- and threat-related behavior associated with psychopathy is still limited. We performed a mixed reality study using the elevated plus-maze (EPM) in a non-clinical sample (N = 160) to test anxiety-related behavior in relation to psychopathic personality traits measured through the Brief Questionnaire of Psychopathic Personality Traits (FPP). The psychopathy sum score correlated significantly with all measures of anxiety-related behavior on the EPM. Sensation seeking, but not general levels of acrophobia was moreover associated with psychopathic traits. Multivariate analyses revealed that the subscales Fearlessness and Lack of Empathy of the FPP predicted anxious behavior. Our findings are the first to demonstrate the relationship between psychopathic traits and actual behavior in an anxiety-inducing environment. This supports the low-anxiety hypothesis in psychopathy research. Implications for potentially harmful or risky behavior are discussed.
Biobank-wide association scan identifies risk factors for late-onset Alzheimer's disease and endophenotypes
Yan D, Hu B, Darst BF, Mukherjee S, Kunkle BW, Deming Y, Dumitrescu L, Wang Y, Naj A, Kuzma A, Zhao Y, Kang H, Johnson SC, Carlos C, Hohman TJ, Crane PK, Engelman CD, and Lu Q
Rich data from large biobanks, coupled with increasingly accessible association statistics from genome-wide association studies (GWAS), provide great opportunities to dissect the complex relationships among human traits and diseases. We introduce BADGERS, a powerful method to perform polygenic score-based biobank-wide association scans. Compared to traditional approaches, BADGERS uses GWAS summary statistics as input and does not require multiple traits to be measured in the same cohort. We applied BADGERS to two independent datasets for late-onset Alzheimer's disease (AD; n=61,212). Among 1738 traits in the UK biobank, we identified 48 significant associations for AD. Family history, high cholesterol, and numerous traits related to intelligence and education showed strong and independent associations with AD. Furthermore, we identified 41 significant associations for a variety of AD endophenotypes. While family history and high cholesterol were strongly associated with AD subgroups and pathologies, only intelligence and education-related traits predicted pre-clinical cognitive phenotypes. These results provide novel insights into the distinct biological processes underlying various risk factors for AD.
Prisoners' Perceptions and Satisfaction with Telepsychiatry Services in Greece and the Effects of Its Use on the Coercion of Mental Healthcare
Karachaliou E, Douzenis P, Chatzinikolaou F, Pantazis N, Martinaki S, Bali P, Tasios K and Douzenis A
Prisoners are often associated with mental health and substance use disorders. Coercive measures are widely used in prison settings. The objective of this study was to compare inmates' perceptions and satisfaction with telepsychiatry versus face-to-face consultation and the effects of telepsychiatry on the use of coercive measures. The sample consisted of 100 male inmates from various backgrounds who had experienced both approaches of services (face to face and telepsychiatry).
A population-based analysis of the management of symptoms of depression among patients with stage IV non-small cell lung cancer (NSCLC) in Ontario, Canada
Tan VS, Tjong MC, Chan WC, Yan M, Delibasic V, Darling G, Davis LE, Doherty M, Hallet J, Kidane B, Mahar A, Mittmann N, Parmar A, Tan H, Wright FC, Coburn NG and Louie AV
Patients with lung cancer can experience significant psychological morbidities including depression. We characterize patterns and factors associated with interventions for symptoms of depression in stage IV non-small cell lung cancer (NSCLC).
Influence of the COVID-19 pandemic on sun habits of patients with melanoma: a cross-sectional study
Trepanowski N, Hathaway CA, Chang MS, Hay JL, Samatham R, Geller AC, Swetter SM, Tworoger SS, Kanetsky PA, Leachman SA and Hartman RI
Implementation Strategies to Promote Short-Course Radiation for Bone Metastases
Gillespie EF, Santos PMG, Curry M, Salz T, Chakraborty N, Caron M, Fuchs HE, Ledesma Vicioso N, Mathis N, Kumar R, O'Brien C, Patel S, Guttmann DM, Ostroff JS, Salner AL, Panoff JE, McIntosh AF, Pfister DG, Vaynrub M, Yang JT and Lipitz-Snyderman A
For patients with nonspine bone metastases, short-course radiotherapy (RT) can reduce patient burden without sacrificing clinical benefit. However, there is great variation in uptake of short-course RT across practice settings.
Mortality risk and mood stabilizers in bipolar disorder: a propensity-score-weighted population-based cohort study in 2002-2018
Chan JKN, Wong CSM, Fang CZ, Hung SC, Lo HKY and Chang WC
Accumulating studies have assessed mortality risk associated with mood-stabilizers, the mainstay treatment for bipolar disorder (BD). However, existing data were mostly restricted to suicide risk, focused on lithium and valproate and rarely adequately adjusted for potential confounders. This study aimed to assess comparative mortality risk with all, natural and unnatural causes between lithium, valproate and three frequently prescribed second-generation antipsychotics (SGA), with adjustment for important confounders.
Irritable Bowel Syndrome in Veterans with Gulf War Illness Evaluated at VA's War-Related Illness and Injury Study Center
Nono Djotsa ABS, Nguyen Wenker TH, Ahmed ST, Ghosh S, Malhotra D, Boyle SH, Gifford EJ, Sims KJ, White DL, Steele L and Helmer DA
Excess rates of Gulf War illness (GWI) and irritable bowel syndrome (IBS), two chronic multisymptom illnesses, have long been documented among nearly 700,000 veterans who served in the 1990-1991 Persian Gulf War. We sought to report the prevalence, characteristics, and association of GWI and IBS decades after the war in a clinical cohort of deployed Gulf War veterans (GWVs) who were evaluated at the Department of Veterans Affairs' War Related Illness and Injury Study Center (WRIISC) for unexplained chronic symptoms.
Individualized prediction models in ADHD: a systematic review and meta-regression
Salazar de Pablo G, Iniesta R, Bellato A, Caye A, Dobrosavljevic M, Parlatini V, Garcia-Argibay M, Li L, Cabras A, Haider Ali M, Archer L, Meehan AJ, Suleiman H, Solmi M, Fusar-Poli P, Chang Z, Faraone SV, Larsson H and Cortese S
There have been increasing efforts to develop prediction models supporting personalised detection, prediction, or treatment of ADHD. We overviewed the current status of prediction science in ADHD by: (1) systematically reviewing and appraising available prediction models; (2) quantitatively assessing factors impacting the performance of published models. We did a PRISMA/CHARMS/TRIPOD-compliant systematic review (PROSPERO: CRD42023387502), searching, until 20/12/2023, studies reporting internally and/or externally validated diagnostic/prognostic/treatment-response prediction models in ADHD. Using meta-regressions, we explored the impact of factors affecting the area under the curve (AUC) of the models. We assessed the study risk of bias with the Prediction Model Risk of Bias Assessment Tool (PROBAST). From 7764 identified records, 100 prediction models were included (88% diagnostic, 5% prognostic, and 7% treatment-response). Of these, 96% and 7% were internally and externally validated, respectively. None was implemented in clinical practice. Only 8% of the models were deemed at low risk of bias; 67% were considered at high risk of bias. Clinical, neuroimaging, and cognitive predictors were used in 35%, 31%, and 27% of the studies, respectively. The performance of ADHD prediction models was increased in those models including, compared to those models not including, clinical predictors (β = 6.54, p = 0.007). Type of validation, age range, type of model, number of predictors, study quality, and other type of predictors did not alter the AUC. Several prediction models have been developed to support the diagnosis of ADHD. However, efforts to predict outcomes or treatment response have been limited, and none of the available models is ready for implementation into clinical practice. The use of clinical predictors, which may be combined with other type of predictors, seems to improve the performance of the models. A new generation of research should address these gaps by conducting high quality, replicable, and externally validated models, followed by implementation research.
Computer-Based Training for Cognitive Behavioural Therapy for Substance Use Disorder: A Randomized Controlled Trial Including Quantitative and Qualitative Health and Economic Outcomes: Formation informatisée pour la thérapie cognitivo-comportementale pour les troubles liés à l'usage de substances : un essai randomisé contrôlé y compris les résultats quantitatifs et qualitatifs en matière de santé et d'économie
Patel A, Corman M, de Oliveira C, Mason J, Somé N, Downie D, Jain E, Patterson M, Cunningham JA, George TP, Le Foll B and Quilty LC
Heavy alcohol and drug use is reported by a substantial number of Canadians; yet, only a minority of those experiencing substance use difficulties access specialized services. Computer-Based Training for Cognitive Behavioural Therapy (CBT4CBT) offers a low-cost method to deliver accessible and high-quality CBT for substance use difficulties. To date, CBT4CBT has primarily been evaluated in terms of quantitative outcomes within substance use disorder (SUD) samples in the United States. A comparison between CBT4CBT versus standard care for SUDs in a Canadian sample is critical to evaluate its potential for health services in Canada. We conducted a randomized controlled trial of CBT4CBT versus standard care for SUD.
The brain structure, inflammatory, and genetic mechanisms mediate the association between physical frailty and depression
Jiang R, Noble S, Rosenblatt M, Dai W, Ye J, Liu S, Qi S, Calhoun VD, Sui J and Scheinost D
Cross-sectional studies have demonstrated strong associations between physical frailty and depression. However, the evidence from prospective studies is limited. Here, we analyze data of 352,277 participants from UK Biobank with 12.25-year follow-up. Compared with non-frail individuals, pre-frail and frail individuals have increased risk for incident depression independent of many putative confounds. Altogether, pre-frail and frail individuals account for 20.58% and 13.16% of depression cases by population attributable fraction analyses. Higher risks are observed in males and individuals younger than 65 years than their counterparts. Mendelian randomization analyses support a potential causal effect of frailty on depression. Associations are also observed between inflammatory markers, brain volumes, and incident depression. Moreover, these regional brain volumes and three inflammatory markers-C-reactive protein, neutrophils, and leukocytes-significantly mediate associations between frailty and depression. Given the scarcity of curative treatment for depression and the high disease burden, identifying potential modifiable risk factors of depression, such as frailty, is needed.
A review of the toxicity of ingredients in e-cigarettes, including those ingredients having the FDA's "Generally Recognized as Safe (GRAS)" regulatory status for use in food
Kassem NOF, Strongin RM, Stroup AM, Brinkman MC, El-Hellani A, Erythropel HC, Etemadi A, Exil V, Goniewicz ML, Kassem NO, Klupinski TP, Liles S, Muthumalage T, Noël A, Peyton DH, Wang Q, Rahman I and Valerio LG
Some firms and marketers of electronic cigarettes (e-cigarettes; a type of electronic nicotine delivery system (ENDS)) and refill liquids (e-liquids) have made claims about the safety of ingredients used in their products based on the term "GRAS or Generally Recognized As Safe" (GRAS). However, GRAS is a provision within the definition of a food additive under section 201(s) (21 U.S.C. 321(s)) of the U.S. Federal Food Drug and Cosmetic Act (FD&C Act). Food additives and GRAS substances are by the FD&C Act definition intended for use in food, thus safety is based on oral consumption; the term GRAS cannot serve as an indicator of the toxicity of e-cigarette ingredients when aerosolized and inhaled (i.e., vaped). There is no legal or scientific support for labeling e-cigarette product ingredients as "GRAS". This review discusses our concerns with the GRAS provision being applied to e-cigarette products and provides examples of chemical compounds that have been used as food ingredients but have been shown to lead to adverse health effects when inhaled. The review provides scientific insight into the toxicological evaluation of e-liquid ingredients and their aerosols to help determine the potential respiratory risks associated with their use in e-cigarettes.
An investigation of neuropsychiatric symptoms, contextual factors, and antidepressant treatment as risk factors for dementia development in people with mild cognitive impairment
Willmott R, Martin West I, Yung P, Giri Shankar V, Perera G, Tsamakis K, Stewart R and Mueller C
While some people with mild cognitive impairment (MCI) progress to dementia, many others show no progression. The aim of this study was to identify factors associated with risk of dementia development in this population.
Quality of health care for patients with coronary heart disease and comorbid mental disorders: a prospective cohort study
Nordmeyer L, Leikert C, Sannemann L, Keller K, Leminski C, Meixner A, Peltzer S, Werner B, Kuntz L, Pfaff H, Schulz-Nieswandt F, Jessen F, Albus C and
Coronary heart disease (CHD) is often associated with mental disorders (MDs). Comorbid MDs reduce the quality of life and increase cardiac morbidity and mortality. Nevertheless, there is little and inconsistent research on the management of MDs in CHD patients. To bridge this gap, this study aims to gain insight into the long-term course of MD-related health care for patients with CHD, in order to identify opportunities for care improvement.
The state of mental health among Ebola virus disease survivors through a cross-sectional study in Sierra Leone
Schindell BG, Fredborg B, Kowalec K, Shaw S, Kangbai JB and Kindrachuk J
The West African Ebola virus disease (EVD) epidemic resulted in >28 000 disease cases and >11 000 fatalities. The unprecedented number of survivors from this epidemic has raised questions about the long-term mental health impacts of EVD survivorship and the capacity to meet these needs.
Prevalence of insulin resistance and its associated factors in drug-naïve patients with bipolar disorder among Han Chinese population
Li K, Li T, Yang T, Lin Y, Liao Y and Gan Z
Metabolic syndrome (Mets) is commonly seen in bipolar disorder (BD). As the key component and early biological index of Mets, insulin resistance (IR) among BD has received more and more attention. However, little is known about the prevalence of IR and its associated factors in drug-naïve patients with (BD), especially among Han Chinese population.
Cross-ancestry atlas of gene, isoform, and splicing regulation in the developing human brain
Wen C, Margolis M, Dai R, Zhang P, Przytycki PF, Vo DD, Bhattacharya A, Matoba N, Tang M, Jiao C, Kim M, Tsai E, Hoh C, Aygün N, Walker RL, Chatzinakos C, Clarke D, Pratt H, , Peters MA, Gerstein M, Daskalakis NP, Weng Z, Jaffe AE, Kleinman JE, Hyde TM, Weinberger DR, Bray NJ, Sestan N, Geschwind DH, Roeder K, Gusev A, Pasaniuc B, Stein JL, Love MI, Pollard KS, Liu C, Gandal MJ and
Neuropsychiatric genome-wide association studies (GWASs), including those for autism spectrum disorder and schizophrenia, show strong enrichment for regulatory elements in the developing brain. However, prioritizing risk genes and mechanisms is challenging without a unified regulatory atlas. Across 672 diverse developing human brains, we identified 15,752 genes harboring gene, isoform, and/or splicing quantitative trait loci, mapping 3739 to cellular contexts. Gene expression heritability drops during development, likely reflecting both increasing cellular heterogeneity and the intrinsic properties of neuronal maturation. Isoform-level regulation, particularly in the second trimester, mediated the largest proportion of GWAS heritability. Through colocalization, we prioritized mechanisms for about 60% of GWAS loci across five disorders, exceeding adult brain findings. Finally, we contextualized results within gene and isoform coexpression networks, revealing the comprehensive landscape of transcriptome regulation in development and disease.
Factors influencing stress and resilience among Egyptian medical students: a multi-centric cross-sectional study
Mohammed HE, Bady Z, Abdelhamid ZG, Elawfi B, AboElfarh HE, Elboraay T and Abdel-Salam DM
Psychological stress is a common psychological comorbidity among medical students and worsens their quality of life. Psychological resilience is thought to have a protective role against stress. However, evidence regarding the prevalence of stress and resilience alongside their associated factors is scarce, especially in the Middle East. This is the first multicenter, cross-sectional study to investigate resilience and stress among Egyptian medical students.
Transcriptomic sex differences in postmortem brain samples from patients with psychiatric disorders
Xia Y, Xia C, Jiang Y, Chen Y, Zhou J, Dai R, Han C, Mao Z, Consortium P, Liu C, Chen C and
Many psychiatric disorders exhibit sex differences, but the underlying mechanisms remain poorly understood. We analyzed transcriptomics data from 2,160 postmortem adult prefrontal cortex brain samples from the PsychENCODE consortium in a sex-stratified study design. We compared transcriptomics data of postmortem brain samples from patients with schizophrenia (SCZ), bipolar disorder (BD), and autism spectrum disorder (ASD) to transcriptomics data of postmortem control brains from individuals without a known history of psychiatric disease. We found that brain samples from females with SCZ, BD and ASD showed a higher burden of transcriptomic dysfunction than did brain samples from males with these disorders. This observation was supported by the larger number of differentially expressed genes (DEGs) and a greater magnitude of gene expression changes observed in female versus male brain specimens. Additionally, female patient brain samples showed greater overall connectivity dysfunction, defined by a higher proportion of gene co-expression modules with connectivity changes and higher connectivity burden, indicating a greater degree of gene co-expression variability. We identified several gene co-expression modules enriched in sex-biased DEGs and identified genes from a genome-wide association study that were involved in immune and synaptic functions across different brain cell types. We found a number of genes as hubs within these modules including those encoding SCN2A, FGF14, and C3. Our results suggest that in the context of psychiatric diseases, males and females exhibit different degrees of transcriptomic dysfunction, and implicate immune and synaptic-related pathways in these sex differences.
Profiles of centenarians' functioning: linking functional and cognitive capacity with depressive symptoms
Uittenhove K, Lampraki C, da Rocha CG, Rott C, von Gunten A and Jopp DS
Despite most centenarians facing age-related declines in functional and cognitive capacities, the severity of these declines varies among individuals, as does the maintenance of good mental health (e.g., depressive symptoms) despite these declines. This study aims to examine this heterogeneity in centenarians from the Second Heidelberg Centenarian Study, which collected data from 112 centenarians living in Germany. In our study, we focus on a subsample of 73 centenarians who provided self-reports for our measures of interest (M age = 100.4, SD age = 0.55).
Extending the PROMIS item bank "ability to participate in social roles and activities": a psychometric evaluation using IRT
Williams GL, Flens G, Terwee CB, de Beurs E, Spinhoven P and Paap MCS
Our objective was to explore whether the extension of the PROMIS item bank Ability to Participate in Social Roles and Activities (APSRA) with new items would result in more effective targeting (i.e., selecting items that are appropriate for each individual's trait level), and more reliable measurements across all latent trait levels.
Machine learning-based health environmental-clinical risk scores in European children
Guimbaud JB, Siskos AP, Sakhi AK, Heude B, Sabidó E, Borràs E, Keun H, Wright J, Julvez J, Urquiza J, Gützkow KB, Chatzi L, Casas M, Bustamante M, Nieuwenhuijsen M, Vrijheid M, López-Vicente M, de Castro Pascual M, Stratakis N, Robinson O, Grazuleviciene R, Slama R, Alemany S, Basagaña X, Plantevit M, Cazabet R and Maitre L
Early life environmental stressors play an important role in the development of multiple chronic disorders. Previous studies that used environmental risk scores (ERS) to assess the cumulative impact of environmental exposures on health are limited by the diversity of exposures included, especially for early life determinants. We used machine learning methods to build early life exposome risk scores for three health outcomes using environmental, molecular, and clinical data.
Parenting styles and psychological effects on children with alopecia areata: exploring family dynamics, anxiety, and depression
Selçukoğlu Kilimci Ö, Yücesoy SN, Turan Ş, Uzunçakmak TK, Kara Esen B, Serdengeçti N, Tarakçıoğlu MC and Serdaroğlu S
Alopecia areata (AA) is an autoimmune disease that develops due to inflammation and causes sudden hair loss. Ithas been observed that family circumstances may contribute to the development of AA. This study aims to assessthe relationship between the development of alopecia areata in children, family functions, and depression andanxiety levels in their parents.Thirty-nine participants diagnosed with AA and 41 healthy controls (HC), agedbetween 8 and 18 years, and their parents participated in the study. The assessment of the children included thecompletion of a socio-demographic data form, the Parenting Style Scale (PSS), and the Revised Children's Anxietyand Depression Scale (RCADS). The parents provided information on a sociodemographic form, the BeckDepression Inventory (BDI), and the Beck Anxiety Inventory (BAI). The children in the control group scoredsignificantly higher on the PSS acceptance/ involvement subscale than those with AA. In the AA group, the numberof authoritative and indulgent (PSS) families was statistically significantly lower than that of the families in the HC,and the number of neglectful families was statistically significantly higher than those of the control group. Totalanxiety and depression t scores (RCADS) were statistically significantly higher in the AA children than in theHC. Our study demonstrates the importance of considering familial factors and parental mental health tounderstand and address alopecia areata in children. Our findings support the psychosomatic component of AA.Implementing comprehensive treatment strategies that target psychological well-being and family dynamics couldprove crucial.
Glucagon-like-peptide 1 receptor agonism and attempted suicide: A Mendelian randomisation study to assess a potential causal association
Nguyen A, Smith E, Hashemy H, Agarwal SM, Hahn MK, Paterson AD and Dash S
Glucagon-like-peptide 1 receptor agonists (GLP-1RA) have transformed type 2 diabetes (T2D) and obesity management. Multiple regulatory agencies are investigating reported associations between GLP1-RA and increased suicide attempts (SA), but observational data may be prone to confounding. Randomised control trials (RCT) of GLP-1RA were largely undertaken in people at lower risk of SA. Real-world data suggest semaglutide use associates with reduced suicidal ideation and depression but was under-powered to statistically assess risk of SA. Mendelian randomisation (MR) leverages genetic instrument(s) to infer potential causal association between an exposure and an outcome. We undertook MR using missense variants in the gene encoding GLP1R that improve glycemia, lower T2D risk and/or lower BMI, to investigate potential causal association between GLP-1RA and SA. In people of European ancestry, MR did not find evidence genetically proxied GLP1RA increased SA in a general population cohort: (rs10305492, exposure: HbA1c, odds ratio [OR] and 95% confidence interval [CI]: 1.38, 0.41-4.62, p = .60), (rs10305492, exposure: FG, OR 1.27, 0.52-3.13, p = .60) and (rs1042044, exposure BMI, OR 0.30, 0.06-1.48) with concordant results in a multi-ancestry SA case-control cohort. In conclusion, we did not find MR evidence that increased GLP-1RA impacts SA. This awaits confirmation with RCT and real-world data.
The risk and protective factors on the mental health of healthcare workers during the lockdown period due to covid-19 pandemic
Liang K, Yang Y, Chen K, Lv F and Du L
This study aimed to analyze the impact of the lockdown period due to COVID-19 pandemic on the mental health status of healthcare workers and identify the related risk factors of psychosomatic distress. We conducted an online questionnaire survey to investigate the general demographic characteristics, perceived stress level, adult attachment style (AAS), family cohesion and adaptability, social support, sleep state, emotional state, and physical health of healthcare workers during the lockdown period due to the pandemic in 2022. We compared the mental health status between doctors and nurses, and further analyzed the factors influencing sleep, emotions, physical symptoms, and severe psychosomatic distress separately. For factors that showed statistical significance in the univariate analysis, forward stepwise regression was used for logistic regression analysis to identify risk factors for the corresponding issues. A total of 622 healthcare workers participated in the survey. Among the participants, 121 (19.5%) reported sleep problems, 209 (33.6%) had negative emotional states, and 147 (23.6%) reported physical health problems. There were 48 (7.7%) healthcare workers with severe psychosomatic distress. Compared to the group of nurses, the group of doctors exhibit a higher prevalence of emotional issues, physical health problems and psychosomatic distress. Perceived stress was identified as a risk factor for sleep disturbance, while living with others during quarantine and family adaptability were identified as protective factors. Higher educational background and perceived stress were identified as risk factors for negative emotion, while subjective support was identified as a protective factor. Perceived stress and coming from a rural area were also identified as risk factors for physical health. Overall, for the comparison between the no psychosomatic distress and severe psychosomatic distress groups, perceived stress was identified as a risk factor for severe psychosomatic distress, while subjective support was identified as a protective factor. Healthcare workers' potential mental and physical health problems are related to their educational background, family cohesion and adaptability, perceived stress and social support. This makes it clearer on how to deal with and prevent adverse consequences when facing stressful situations.
Introducing a machine learning algorithm for delirium prediction-the Supporting SURgery with GEriatric Co-Management and AI project (SURGE-Ahead)
Benovic S, Ajlani AH, Leinert C, Fotteler M, Wolf D, Steger F, Kestler H, Dallmeier D, Denkinger M, Eschweiler GW, Thomas C and Kocar TD
Post-operative delirium (POD) is a common complication in older patients, with an incidence of 14-56%. To implement preventative procedures, it is necessary to identify patients at risk for POD. In the present study, we aimed to develop a machine learning (ML) model for POD prediction in older patients, in close cooperation with the PAWEL (patient safety, cost-effectiveness and quality of life in elective surgery) project.
Trajectories of Gender Identity and Depressive Symptoms in Youths
Gonzales Real A, Lobato MIR and Russell ST
Concerns about the mental health of youths going through gender identity transitions have received increased attention. There is a need for empirical evidence to understand how transitions in self-reported gender identity are associated with mental health.
Using Large Language Models to Understand Suicidality in a Social Media-Based Taxonomy of Mental Health Disorders: Linguistic Analysis of Reddit Posts
Bauer B, Norel R, Leow A, Rached ZA, Wen B and Cecchi G
Rates of suicide have increased by over 35% since 1999. Despite concerted efforts, our ability to predict, explain, or treat suicide risk has not significantly improved over the past 50 years.
Protocol for process evaluation of ARTEMIS cluster randomised controlled trial: an intervention for management of depression and suicide among adolescents living in slums in India
Mukherjee A, Yatirajula SK, Kallakuri S, Paslawar S, Lempp H, Raman U, Kumar A, Essue BM, Sagar R, Singh R, Peiris D, Norton R, Thornicroft G and Maulik PK
There are around 250 million adolescents (10-19 years) in India. The prevalence of mental health-related morbidity among adolescents in India is approximately 7.3%. Vulnerable subpopulations among adolescents such as those living in slum communities are particularly at risk due to poor living conditions, financial difficulty and limited access to support services. Adolescents' Resilience and Treatment nEeds for Mental Health in Indian Slums (ARTEMIS) is a cluster randomised controlled trial of an intervention that intends to improve the mental health of adolescents living in slum communities in India. The aim of this paper is to describe the process evaluation protocol for ARTEMIS trial. The process evaluation will help to explain the intervention outcomes and understand how and why the intervention worked or did not work. It will identify contextual factors, intervention barriers and facilitators and the adaptations required for optimising implementation.
Assessing the Role of Asthma on the Relationship between Neurodevelopmental Disabilities and Adverse Birth Outcomes
Oluwafemi O, Manoharan S, Xie L, Pro G, Patel RS, Delclos GL, Gelfand A, Messiah SE, Lopez DS and Patel J
Investigating asthma as an effect modifier between adverse birth outcomes and neurodevelopmental disabilities (NDDs) across different races is crucial for tailored interventions and understanding variable susceptibility among diverse populations.
Coding of Childhood Psychiatric and Neurodevelopmental Disorders in Electronic Health Records of a Large Integrated Health Care System: Validation Study
Shi JM, Chiu VY, Avila CC, Lewis S, Park D, Peltier MR and Getahun D
Mental, emotional, and behavioral disorders are chronic pediatric conditions, and their prevalence has been on the rise over recent decades. Affected children have long-term health sequelae and a decline in health-related quality of life. Due to the lack of a validated database for pharmacoepidemiological research on selected mental, emotional, and behavioral disorders, there is uncertainty in their reported prevalence in the literature.
Antiseizure medication and early pregnancy loss: should we be worried?
Dreier JW and Christensen J
Mortality and adverse events associated with statin use in primary care patients with depression: a real-world, population-based cohort study
De Giorgi R, De Crescenzo F, Ostinelli EG, Cowen PJ, Harmer CJ, Fazel S and Cipriani A
New National Institute for Health and Care Excellence (NICE) guidance endorses the prescription of statins in larger population groups for the prevention of cardiovascular and cerebrovascular morbidity and mortality, especially in people with severe mental illness. However, the evidence base for their safety and risk/benefit balance in depression is not established.
Medical students' attitudes towards well-being and welfare: a systematic review protocol
Mazzoleni A, Garg S, Bhatia S and Kumar NS
Medical education poses serious stressors on medical students, as they report overall higher rates of psychiatric comorbidities compared with students enrolled in other university-level courses. The high rates of poor well-being reported should be considered a concern, as students represent the future workforce of healthcare professionals. Although there has been an increased interest towards well-being and burn-out in medical students, there is still much to be elucidated. Indeed, there is an overall lack of understanding of which attitudes medical students have towards well-being and welfare, something that could be used to develop targeted practice to improve medics' quality of life and reduce overall burn-out.This review will aim at evaluating and reporting the current research available on medical students' attitudes towards well-being and welfare. We will take into account which countries have published data on the topic, and we will analyse papers written during the COVID-19 period separately, giving this particular time frame a separate outlook.
First-trimester use of antiseizure medications and the risk of miscarriage: a population-based cohort study
Forbes H, Madley-Dowd P, Ahlqvist V, Campbell J, Davies NM, Liebling R, Lyall K, Newschaffer C, Rast J, Tomson T, Zhong C, Magnusson C, Rai D and Lee BK
Antiseizure medications (ASMs) during the first trimester of pregnancy have been associated with an increased risk of miscarriage.
Motivational interviewing from the paediatricians' perspective: assessments after a 2-day training for physicians caring for adolescents with chronic medical conditions (CMCs)
Kammering H, Cruz JA, Platzbecker AL, Reinauer C, Förtsch K, Krassuski L, Viermann R, Domhardt M, Baumeister H, Staab D, Minden K, Mueller-Stierlin AS, Holl RW, Warschburger P and Meissner T
Counselling adolescents with chronic medical conditions (CMCs) can be challenging regarding suitable interviewing skills and clinicians' attitudes toward the patient. Successful communication can be a key element of treatment. Motivational Interviewing (MI) is broadly applicable in managing behavioural problems and diseases by increasing patient motivation for lifestyle changes. However, data concerning the applicability, feasibility and implementation of MI sessions in everyday practice are missing from the physicians' point of view.
Substance Use in Humanitarian Settings: A Case from Yemen
Saleh EA, Wazaify M and Khoshnood K
Autistic adults perceive and experience laughter differently to non-autistic adults
Cai CQ, White SJ, Chen SHY, Mueller MAE and Scott SK
Human interaction is immersed in laughter; though genuine and posed laughter are acoustically distinct, they are both crucial socio-emotional signals. In this novel study, autistic and non-autistic adults explicitly rated the affective properties of genuine and posed laughter. Additionally, we explored whether their self-reported everyday experiences with laughter differ. Both groups could differentiate between these two types of laughter. However, autistic adults rated posed laughter as more authentic and emotionally arousing than non-autistic adults, perceiving it to be similar to genuine laughter. Autistic adults reported laughing less, deriving less enjoyment from laughter, and experiencing difficulty in understanding the social meaning of other people's laughter compared to non-autistic people. Despite these differences, autistic adults reported using laughter socially as often as non-autistic adults, leveraging it to mediate social contexts. Our findings suggest that autistic adults show subtle differences in their perception of laughter, which may be associated with their struggles in comprehending the social meaning of laughter, as well as their diminished frequency and enjoyment of laughter in everyday scenarios. By combining experimental evidence with first-person experiences, this study suggests that autistic adults likely employ different strategies to understand laughter in everyday contexts, potentially leaving them socially vulnerable in communication.
Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation Across Mental Disorders: A Systematic Review and Dose-Response Meta-Analysis
Sabé M, Hyde J, Cramer C, Eberhard A, Crippa A, Brunoni AR, Aleman A, Kaiser S, Baldwin DS, Garner M, Sentissi O, Fiedorowicz JG, Brandt V, Cortese S and Solmi M
Noninvasive brain stimulation (NIBS) interventions have been shown to be efficacious in several mental disorders, but the optimal dose stimulation parameters for each disorder are unknown.
Digital Engagement Strategy and Health Care Worker Mental Health: A Randomized Clinical Trial
Agarwal AK, Southwick L, Gonzales RE, Bellini LM, Asch DA, Shea JA, Mitra N, Yang L, Josephs M, Kopinksy M, Kishton R, Balachandran M, Benjamin Wolk C, Becker-Haimes EM and Merchant RM
The health care workforce continues to experience high rates of depression and anxiety. Finding ways to effectively support the mental health and well-being of health care workers is challenging.
Genetic Complexities of Cerebral Small Vessel Disease, Blood Pressure, and Dementia
Sargurupremraj M, Soumaré A, Bis JC, Surakka I, Jürgenson T, Joly P, Knol MJ, Wang R, Yang Q, Satizabal CL, Gudjonsson A, Mishra A, Bouteloup V, Phuah CL, van Duijn CM, Cruchaga C, Dufouil C, Chêne G, Lopez OL, Psaty BM, Tzourio C, Amouyel P, Adams HH, Jacqmin-Gadda H, Ikram MA, Gudnason V, Milani L, Winsvold BS, Hveem K, Matthews PM, Longstreth WT, Seshadri S, Launer LJ and Debette S
Vascular disease is a treatable contributor to dementia risk, but the role of specific markers remains unclear, making prevention strategies uncertain.
Age-dependent association of cannabis use with risk of psychotic disorder
McDonald AJ, Kurdyak P, Rehm J, Roerecke M and Bondy SJ
Epidemiologic research suggests that youth cannabis use is associated with psychotic disorders. However, current evidence is based heavily on 20th-century data when cannabis was substantially less potent than today.
Association between exposure to antibiotics during pregnancy or early infancy and risk of autism spectrum disorder, intellectual disorder, language disorder, and epilepsy in children: population based cohort study
Choi A, Lee H, Jeong HE, Lee SY, Kwon JS, Han JY, Choe YJ and Shin JY
To evaluate the association between antibiotic use during pregnancy or early infancy and the risk of neurodevelopmental disorders in children.
Factors associated with depression among war-affected population in Northeast, Ethiopia
Anbesaw T, Kassa MA, Yimam W, Kassaw AB, Belete M, Abera A, Abebe G, Yimer N, Melkam M and Ayano G
Depression is the most common mental health outcome of exposure to war-related traumatic stressors. Due to inter-communal conflict, Dessie City residents have experienced prolonged armed conflict in 2021. This conflict leads to widespread violence, negative impact on mental health, and large-scale forced migration. However, the problem is not properly addressed in Ethiopia. Therefore, this study aimed to assess the prevalence and risk factors of depression in the war-affected area in Dessie City, Ethiopia.
U-shaped association between fasting blood glucose and suicide attempts in Chinese patients with first-episode drug-naïve major depressive disorder
Liu J, Zhang G, Jia F, Yuan H, Wang Q, Li C, Yang R, Yue Y, Zhang X, Ye G, Li Z, Du X and Zhang X
Evidence regarding the relationship between fasting blood glucose (FBG) and suicide attempts (SA) in patients with major depressive disorder (MDD) was limited. Therefore, the objective of this research was to investigate whether FBG was independently related to SA in Chinese patients with first-episode drug-naïve (FEDN) MDD after adjusting for other covariates.
Workplace violence and depressive symptoms: the mediating role of fear of future workplace violence and burnout among Chinese nurses
Li C and Fu C
The mechanisms underlying the relationship between workplace violence (WPV) and depressive symptoms in nurses have been less studied. This study aims to examine the mediating role of fear of future workplace violence (FFWV) and burnout in the association between WPV and depressive symptoms.
The prevalence and possible risk factors of gaming disorder among adolescents in China
Zhang L, Han J, Liu M, Yang C and Liao Y
Nowadays, moderate gaming behaviors can be a pleasant and relaxing experiences among adolescents. However, excessive gaming behavior may lead to gaming disorder (GD) that disruption of normal daily life. Understanding the possible risk factors of this emerging problem would help to suggest effective at preventing and intervening. This study aimed to investigate the prevalence of GD and analyze its possible risk factors that adolescents with GD.
Elevated thyroid stimulating hormone and metabolic syndrome risk in patients with first-episode and drug-naïve major depressive disorder: a large-scale cross-sectional study
Zhang Q, Dong G, Zhu X, Cao Y and Zhang X
Metabolic syndrome (MetS) is common in major depressive disorder (MDD), but its relationship with thyroid hormones remains unclear. We aimed to examine the association of thyroid hormones and MetS in first-episode drug-naïve (FEDN) MDD patients.
PTSD, depression, and migration-related experiences among Syrian refugees living in camp vs urban settings
Isik E, Sismanlar SG and Tekeli-Yesil S
Despite the increased heterogeneity of living conditions of refugees in recent years, there is a lack of robust epidemiological data about the relationship between refugees' mental health and their living contexts. The current study aims to compare frequencies of pre-migration traumatic events and post-migration difficulties between refugees living in camps and those living in cities; and to identify the prevalence of post-traumatic stress disorder (PTSD), depression, and factors associated with them. A field survey was conducted among 1,470 refugees living in camps and urban settings of Turkey. The survey instruments included a socio-demographic form, the Harvard Trauma Questionnaire, the Post-migration Living Difficulties Scale, and the PTSD and depression modules of the Mini-International Neuropsychiatric Interview. Both PTSD and depression were more common in urban settings than in camps. Both disorders were associated with living context and migration-related experiences. Pre-migration traumas were more frequent among refugees living in cities than in those living in camps, while post-migration difficulties were more common in the refugees living in camps. The living context is potentially a critical determinant of refugee mental health. Camp and urban refugees may have different experiences and needs. In particular, refugees living in some urban settings may be at higher risk for having psychological problems.
Energy expenditure during nutritional rehabilitation: a scoping review to investigate hypermetabolism in individuals with anorexia nervosa
Reed KK, Silverman AE, Abbaspour A, Burger KS, Bulik CM and Carroll IM
Weight gain and nutritional rehabilitation are essential first steps to achieve medical stabilization in anorexia nervosa, and frequent resistance to weight gain requires patients to consume high kilocalorie loads. Adaptive hypometabolism is common when patients begin treatment, and rebound hypermetabolism is suspected to be a significant barrier to weight gain. The aim of this review was to summarize existing data describing metabolic changes in anorexia nervosa during weight restoration. The reported findings challenge current hypotheses of weight gain resistance and highlight key areas for future research.
Five-year follow-up of the iBerry Study: screening in early adolescence to identify those at risk of psychopathology in emerging adulthood
Bouter DC, Ravensbergen SJ, de Neve-Enthoven NGM, Zarchev M, Mulder CL, Hoogendijk WJG, Roza SJ, and Grootendorst-van Mil NH
The iBerry Study, a Dutch population-based high-risk cohort (n = 1022) examines the transition from subclinical symptoms to psychiatric disorders in adolescents. Here, we present the first follow-up measurement, approximately 3 years after baseline assessment and 5 years after the screening based on self-reported emotional and behavioral problems (SDQ-Y). We give an update on the data collection, details on the (non)response, and the results on psychopathology outcomes. The first follow-up (2019-2022) had a response rate of 79% (n = 807). Our results at baseline (mean age 15.0 years) have shown the effectiveness of using the SDQ-Y to select a cohort oversampled for the risk of psychopathology. At first follow-up (mean age 18.1 years), the previously administered SDQ-Y remains predictive for selecting adolescents at risk. At follow-up, 47% of the high-risk adolescents showed significant mental health problems based on self- and parent reports and 46% of the high-risk adolescents met the criteria for multiple DSM-5 diagnoses. Compared to low-risk adolescents, high-risk adolescents had a sevenfold higher odds of significant emotional and behavioral problems at follow-up. Comprehensive assessment on psychopathology, substance abuse, psychotic symptoms, suicidality, nonsuicidal self-injury, addiction to social media and/or video gaming, and delinquency, as well as social development, and the utilization of healthcare and social services were conducted. This wave, as well as the ones to follow, track these adolescents into their young adulthood to identify risk factors, elucidate causal mechanisms, and discern pathways leading to both common and severe mental disorders. Results from the iBerry Study will provide leads for preventive interventions.
Validation and responsiveness of the English version of the Chemotherapy-Induced Alopecia Distress Scale (CADS) in breast cancer patients
Kraehenbuehl L, Kang D, Bang AS, Ketosugbo KF, Hay J, Patil S, Goldfarb S, Cho J and Lacouture ME
This study aimed to validate the Chemotherapy-Induced Alopecia Distress Scale (CADS) in a diverse English-speaking population and patients with endocrine treatment-induced alopecia (EIA).
Excess mortality among people in homelessness with substance use disorders: a Swedish cohort study
Gaber SN, Franck J, Widing H, Hällgren J, Mattsson E and Westman J
People in homelessness have an increased risk of substance use disorders (SUDs) and poor health outcomes. This cohort study aimed to investigate the association between homelessness and mortality in people with SUDs, adjusting for age, sex, narcotic use, intravenous drug use and inpatient care for SUDs.
Lived experiences of mothers with postnatal anxiety: a qualitative phenomenology study from Pakistan
Saeed Q, Shafique K and Chaudhry N
The prevalence of postnatal anxiety is high among women during the first year of childbirth globally. Rates are higher in low and middle-income countries (LMICs), that is, 24%. Existing literature on maternal mood and its impact on child development has largely focused on postnatal depression. Postnatal anxiety has been recognised to have significant independent effects similar to those of postnatal depression, including negative effects on various aspects of maternal well-being including quality of life, parent-child interaction and child development. The evidence exploring lived experiences of postnatal anxiety is limited from LMICs. This study explored the lived experiences of anxiety in postnatal mothers in Pakistan.
Value-driven attitude surveys: Lessons from the refugee crisis in Greece
Qadir S, Feruni J, Mastora A, Karampoutakis G, Tveit M, Nikopoulos S, Anitsi E, Cleary SD, Dyer AR and Candilis PJ
Community reaction to refugees and asylum-seekers is often gauged by attitude surveys that are not designed to overcome built-in bias. Questionnaires that do not account for context and background consequently yield results that misrepresent community attitudes and offer predictably negative responses to immigrant groups. Such surveys can alter public perception, fuel anti-refugee sentiment, and affect policy simply because of how they are constructed. This model survey among humanitarian aid-workers from nine Greek non-governmental organizations uses specific techniques designed to overcome these challenges by applying sample familiarity, non-inflammatory hypothesis-testing, educational question stems, intentional ordering of questions, and direct questioning rather than surrogate measures like statistical approximation. Respondents working in the refugee crisis in Greece demonstrate how empathy, education, and exposure to refugees serve to overcome the harmful stereotypes of outsiders as contributors to crime, terror, and social burden.
Lost in translation? Deciphering the role of language differences in the excess risk of psychosis among migrant groups
Anderson KK, Khan JA, Edwards J, Le B, Longobardi G, Witt I, Alonso-Sánchez MF and Palaniyappan L
Migration is a well-established risk factor for psychotic disorders, and migrant language has been proposed as a novel factor that may improve our understanding of this relationship. Our objective was to explore the association between indicators of linguistic distance and the risk of psychotic disorders among first-generation migrant groups.
Sex-dependent differences in vulnerability to early risk factors for posttraumatic stress disorder: results from the AURORA study
Haering S, Seligowski AV, Linnstaedt SD, Michopoulos V, House SL, Beaudoin FL, An X, Neylan TC, Clifford GD, Germine LT, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Swor RA, Gentile NT, Hudak LA, Pascual JL, Seamon MJ, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, O'Neil BJ, Sanchez LD, Bruce SE, Harte SE, McLean SA, Kessler RC, Koenen KC, Stevens JS and Powers A
Knowledge of sex differences in risk factors for posttraumatic stress disorder (PTSD) can contribute to the development of refined preventive interventions. Therefore, the aim of this study was to examine if women and men differ in their vulnerability to risk factors for PTSD.
The impact of childhood trauma on Adolescent Depressive Symptoms: the Chain Mediating role of borderline personality traits and self-control
Zhong Y, Hu Q, Chen J, Li Y, Chen R, Li Y, Cong E and Xu Y
The adolescent depression associated with childhood trauma has been confirmed, but the underlying mechanisms remain unclear. This study aims to explore the chain-mediated role of borderline personality traits and self-control in the relationship between childhood trauma and adolescent depression.
Author Correction: Trans-ancestral genome-wide association study of longitudinal pubertal height growth and shared heritability with adult health outcomes
Bradfeld JP, Kember RL, Ulrich A, Balkhiyarova Z, Alyass A, Aris IM, Bell JA, Broadaway KA, Chen Z, Chai JF, Davies NM, Fernandez-Orth D, Bustamante M, Fore R, Ganguli A, Heiskala A, Hottenga JJ, Íñiguez C, Kobes S, Leinonen J, Lowry E, Lyytikainen LP, Mahajan A, Pitkänen N, Schnurr TM, Have CT, Strachan DP, Thiering E, Vogelezang S, Wade KH, Wang CA, Wong A, Holm LA, Chesi A, Choong C, Cruz M, Elliott P, Franks S, Frithiof-Bøjsøe C, Gauderman WJ, Glessner JT, Gilsanz V, Griesman K, Hanson RL, Kaakinen M, Kalkwarf H, Kelly A, Kindler J, Kähönen M, Lanca C, Lappe J, Lee NR, McCormack S, Mentch FD, Mitchell JA, Mononen N, Niinikoski H, Oken E, Pahkala K, Sim X, Teo YY, Baier LJ, van Beijsterveldt T, Adair LS, Boomsma DI, de Geus E, Guxens M, Eriksson JG, Felix JF, Gilliland FD, , Hansen T, Hardy R, Hivert MF, Holm JC, Jaddoe VWV, Järvelin MR, Lehtimäki T, Mackey DA, Meyre D, Mohlke KL, Mykkänen J, Oberfeld S, Pennell CE, Perry JRB, Raitakari O, Rivadeneira F, Saw SM, Sebert S, Shepherd JA, Standl M, Sørensen TIA, Timpson NJ, Torrent M, Willemsen G, Hypponen E, Power C, , McCarthy MI, Freathy RM, Widén E, Hakonarson H, Prokopenko I, Voight BF, Zemel BS, Grant SFA and Cousminer DL
Prevalence and Clinical Profile of Adults with ADHD Attending a Tertiary Care Hospital for Five Years
Bedawi RM, Al-Farsi Y, Mirza H, Al-Huseini S, Al-Mahrouqi T, Al-Kiyumi O, Al-Azri M and Al-Adawi S
(1) Objectives: This study aimed to assess the 5-year prevalence and clinical profile of attention deficit hyperactive disorder (ADHD) among adult patients seeking care in a tertiary care hospital in Oman. (2) Methods: The data were analysed using descriptive and inferential statistics and standardised prevalence estimates were calculated. (3) Results: Of the 39,881 hospital visits, 1.77% were made by adults with ADHD. This is equivalent to 17.8 visits per 1000 outpatients. The year 2021 saw the highest prevalence among the five years considered, while 2020 had the lowest prevalence. Although the age distribution indicated that the age group 'under 20' had the highest prevalence, the gender distribution showed that ADHD was more common among adult men. Among the various subtypes of ADHD, inattention was the most common. (4) Conclusions: This study specifically compared the prevalence and associated factors between an adult cohort with ADHD and those other psychiatric clinic attendees during the same period. The study offers important information on the prevalence and clinical profile of adults with ADHD in the population under consideration.
Emojifying youth mental health research - Leveraging digital expressions in South Asia
Philip S, Datta A, Jamir L, Marri AR and Ransing RS
Examining the Effect of Genes on Depression as Mediated by Smoking and Modified by Sex
Voorhies K, Hecker J, Lee S, Hahn G, Prokopenko D, McDonald ML, Wu AC, Wu A, Hokanson JE, Cho MH, Lange C, Hoth KF and Lutz SM
Depression is heritable, differs by sex, and has environmental risk factors such as cigarette smoking. However, the effect of single nucleotide polymorphisms (SNPs) on depression through cigarette smoking and the role of sex is unclear. In order to examine the association of SNPs with depression and smoking in the UK Biobank with replication in the COPDGene study, we used counterfactual-based mediation analysis to test the indirect or mediated effect of SNPs on broad depression through the log of pack-years of cigarette smoking, adjusting for age, sex, current smoking status, and genetic ancestry (via principal components). In secondary analyses, we adjusted for age, sex, current smoking status, genetic ancestry (via principal components), income, education, and living status (urban vs. rural). In addition, we examined sex-stratified mediation models and sex-moderated mediation models. For both analyses, we adjusted for age, current smoking status, and genetic ancestry (via principal components). In the UK Biobank, rs6424532 [] had a statistically significant indirect effect on broad depression through the log of pack-years of cigarette smoking ( = 4.0 × 10) among all participants and a marginally significant indirect effect among females ( = 0.02) and males ( = 4.0 × 10). Moreover, rs10501696 [] had a marginally significant indirect effect on broad depression through the log of pack-years of cigarette smoking ( = 0.01) among all participants and a significant indirect effect among females ( = 2.2 × 10). In the secondary analyses, the sex-moderated indirect effect was marginally significant for rs10501696 [] on broad depression through the log of pack-years of cigarette smoking ( = 0.01). In the COPDGene study, the effect of an SNP (rs10501696) in on depressive symptoms and medication was mediated by log of pack-years ( = 0.02); however, no SNPs had a sex-moderated mediated effect on depressive symptoms. In the UK Biobank, we found SNPs in two genes [, ] with an indirect effect on broad depression through the log of pack-years of cigarette smoking. In addition, the indirect effect for on broad depression through smoking may be moderated by sex. These results suggest that genetic regions associated with broad depression may be mediated by cigarette smoking and this relationship may be moderated by sex.
Genetic associations with psychosis and affective disturbance in Alzheimer's disease
Antonsdottir IM, Creese B, Klei L, DeMichele-Sweet MAA, Weamer EA, Garcia-Gonzalez P, Marquie M, Boada M, Alarcón-Martín E, Valero S, , Liu Y, Hooli B, Aarsland D, Selbaek G, Bergh S, Rongve A, Saltvedt I, Skjellegrind HK, Engdahl B, Andreassen OA, Borroni B, Mecocci P, Wedatilake Y, Mayeux R, Foroud T, Ruiz A, Lopez OL, Kamboh MI, Ballard C, Devlin B, Lyketsos C and Sweet RA
Individuals with Alzheimer's disease (AD) commonly experience neuropsychiatric symptoms of psychosis (AD+P) and/or affective disturbance (depression, anxiety, and/or irritability, AD+A). This study's goal was to identify the genetic architecture of AD+P and AD+A, as well as their genetically correlated phenotypes.
Effects of speculum lubrication on cervical smears for cervical cancer screening: A double blind randomized clinical trial
Ilika CP, Eleje GU, Chiemeka ME, Ilika FN, Ikechebelu JI, Ilika VC, Ugwu EO, Ofor IJ, Ogelle OM, Umeononihu OS, Mamah JE, Olisa CL, Ezeigwe CO, Nwankwo ME, Ofojebe CJ, Okafor CC, Ekwebene OC, Nnabuchi OK and Okafor CG
Speculum lubrication may help to reduce the pain experienced during Pap-smear collection and hence increase uptake of cervical cancer screening and repeat testing, but there are fears of its interference with cytological results.
An epidemiological study of season of birth, mental health, and neuroimaging in the UK Biobank
Viejo-Romero M, Whalley HC, Shen X, Stolicyn A, Smith DJ and Howard DM
Environmental exposures during the perinatal period are known to have a long-term effect on adult physical and mental health. One such influential environmental exposure is the time of year of birth which affects the amount of daylight, nutrients, and viral load that an individual is exposed to within this key developmental period. Here, we investigate associations between season of birth (seasonality), four mental health traits (n = 137,588) and multi-modal neuroimaging measures (n = 33,212) within the UK Biobank. Summer births were associated with probable recurrent Major Depressive Disorder (β = 0.026, pcorr = 0.028) and greater mean cortical thickness in temporal and occipital lobes (β = 0.013 to 0.014, pcorr<0.05). Winter births were associated with greater white matter integrity globally, in the association fibers, thalamic radiations, and six individual tracts (β = -0.013 to -0.022, pcorr<0.05). Results of sensitivity analyses adjusting for birth weight were similar, with an additional association between winter birth and white matter microstructure in the forceps minor and between summer births, greater cingulate thickness and amygdala volume. Further analyses revealed associations between probable depressive phenotypes and a range of neuroimaging measures but a paucity of interactions with seasonality. Our results suggest that seasonality of birth may affect later-life brain structure and play a role in lifetime recurrent Major Depressive Disorder. Due to the small effect sizes observed, and the lack of associations with other mental health traits, further research is required to validate birth season effects in the context of different latitudes, and by co-examining genetic and epigenetic measures to reveal informative biological pathways.
Changes in substance use, recovery, and quality of life during the initial phase of the COVID-19 pandemic
Lewandowski ME, Delawalla CN, Butcher TJ and Oberlin BG
The COVID-19 pandemic disrupted lives on a massive scale. While the pandemic appeared to worsen mental health outcomes broadly, its effects on alcohol/substance use and recovery are unclear. Many studies convolved the sociopolitical unrest beginning in May 2020 with the pandemic. We assessed pandemic-related changes in substance use, recovery involvement, and quality of life among US adults at two specified time periods that isolated pandemic effects from potentially confounding sociopolitical factors.
Cohort profile: The Social media, smartphone use and Self-harm in Young People (3S-YP) study-A prospective, observational cohort study of young people in contact with mental health services
Bye A, Carter B, Leightley D, Trevillion K, Liakata M, Branthonne-Foster S, Cross S, Zenasni Z, Carr E, Williamson G, Vega Viyuela A and Dutta R
The Social media, Smartphone use and Self-Harm (3S-YP) study is a prospective observational cohort study to investigate the mechanisms underpinning associations between social media and smartphone use and self-harm in a clinical youth sample. We present here a comprehensive description of the cohort from baseline data and an overview of data available from baseline and follow-up assessments.
Intimate partner violence, depression, hazardous alcohol use, and social support among people with HIV initiating HIV care in Cameroon
Grimes KEL, Ebasone PV, Dzudie A, Nash D, Pence BW, Wainberg M, Yotebieng M, Ajeh R and Parcesepe AM
Intimate partner violence (IPV) has been associated with poor mental health among people with HIV (PWH) globally. Social support may be a strategy to foster mental health among PWH. Little is known about whether the relationship between IPV and mental health differs by IPV type or level of social support. Interviews were conducted with 426 PWH initiating HIV care in Cameroon. Log binomial regression analyses were used to estimate the association between four types of IPV (controlling behavior and emotional, physical, and sexual IPV) and symptoms of depression or hazardous alcohol use, separately by IPV type and level of social support. Over half (54.8%) of respondents experienced moderate/high levels of controlling behavior, 42.0% experienced emotional IPV, 28.2% experienced physical IPV and 23.7% experienced sexual IPV. Controlling behavior was associated with greater prevalence of depressive symptoms. This relationship did not vary meaningfully by level of social support (low: aPR 2.4 [95% CI 1.2, 4.9]; high: 1.7 [95% CI 1.0, 2.7]). Emotional and physical IPV were associated with greater prevalence of depressive symptoms among those with low social support (emotional IPV: aPR 1.9 [95% CI 1.0, 3.4]; physical IPV: aPR 1.8 [95% CI 1.2, 2.8]), but not among those with high social support (emotional IPV: aPR 1.0 [95% CI 0.7, 1.6]; physical IPV: aPR 1.0 [95% CI 0.6, 1.6]). Controlling behavior, emotional IPV, and physical IPV were associated with a greater prevalence of hazardous alcohol use, with moderately larger effect estimates among those with high compared to low social support. Sexual IPV was not associated with depressive symptoms or hazardous alcohol use. Services to screen and care for people experiencing IPV are urgently needed among PWH in Cameroon. Future research to identify barriers, feasibility, acceptability, and organizational readiness to integrate IPV and mental health services into HIV care settings is needed.
Eating Disorder Risks Associated with Time Spent Using Social Media at an AMREC Population in the Coal Mining Region of Santa Catarina
Damázio LS, Frutuoso EB, Zilli JPS, Ivanov YA, Cancillier SG, Quevedo J and Zugno AI
Comparing one's appearance to other people's and believing in an ideal body shape can negatively impact an individual. The probability of developing ED in individuals with high body dissatisfaction is higher than in the general population, leading to long-term emotional and metabolic damage. Populational studies on the prevalence of ED in Brazil are scarce in the literature. The research was carried out through the Google Forms website and evaluated risk of eating disorders through the Eating Attitude Test, degree of body dissatisfaction in the sample through the Body Shape Questionnaire and the Internet Addiction Test was used to evaluate time spent on the internet. The results showed that 84.5% of the sample were female and 62.3% of the individuals had eutrophic by the Body Mass Index. About 40.2% of the population studied had abnormal attitudes towards food, indicating a possible risk of developing ED, and 62.5% of the sample did not show body dissatisfaction. Regarding internet use, 10.8% had problematic internet use. The presence of risky eating attitudes was more prevalent in participants dissatisfied with their bodies. In addition, participants with problematic internet use had a higher risk for EDs.
Determinants of burnout in Canadian health care workers during the COVID-19 pandemic
Liu N, Plouffe RA, Liu JJW, Nouri MS, Saha P, Gargala D, Davis BD, Nazarov A and Richardson JD
Health care workers (HCWs) are among the most vulnerable groups to experience burnout during the coronavirus (COVID-19) pandemic. Understanding the risk and protective factors of burnout is crucial in guiding the development of interventions; however, the understanding of burnout determinants in the Canadian HCW population remains limited. Identify risk and protective factors associated with burnout in Canadian HCWs during the COVID-19 pandemic and evaluate organizational factors as moderators in the relationship between COVID-19 contact and burnout. Data were drawn from an online longitudinal survey of Canadian HCWs collected between 26 June 2020 and 31 December 2020. Participants completed questions pertaining to their well-being, burnout, workplace support and concerns relating to the COVID-19 pandemic. Baseline data from 1029 HCWs were included in the analysis. Independent samples t-tests and multiple linear regression were used to evaluate factors associated with burnout scores. HCWs in contact with COVID-19 patients showed significantly higher likelihood of probable burnout than HCWs not directly providing care to COVID-19 patients. Fewer years of work experience was associated with a higher likelihood of probable burnout, whereas stronger workplace support, organizational leadership, supervisory leadership, and a favourable ethical climate were associated with a decreased likelihood of probable burnout. Workplace support, organizational leadership, supervisory leadership, and ethical climate did not moderate the associations between contact with COVID-19 patients and burnout. Our findings suggest that HCWs who worked directly with COVID-19 patients, had fewer years of work experience, and perceived poor workplace support, organizational leadership, supervisory leadership and ethical climate were at higher risk of burnout. Ensuring reasonable work hours, adequate support from management, and fostering an ethical work environment are potential organizational-level strategies to maintain HCWs' well-being.
Innova4Health: an integrated approach for prevention of recurrence and personalized treatment of Major Depressive Disorder
Monaco F, Vignapiano A, Piacente M, Farina F, Pagano C, Marenna A, Leo S, Vecchi C, Mancuso C, Prisco V, Iodice D, Auricchio A, Cavaliere R, D'Agosto A, Fornaro M, Solmi M, Corrivetti G and Fasano A
Major Depressive Disorder (MDD) is a prevalent mental health condition characterized by persistent low mood, cognitive and physical symptoms, anhedonia (loss of interest in activities), and suicidal ideation. The World Health Organization (WHO) predicts depression will become the leading cause of disability by 2030. While biological markers remain essential for understanding MDD's pathophysiology, recent advancements in social signal processing and environmental monitoring hold promise. Wearable technologies, including smartwatches and air purifiers with environmental sensors, can generate valuable digital biomarkers for depression assessment in real-world settings. Integrating these with existing physical, psychopathological, and other indices (autoimmune, inflammatory, neuroradiological) has the potential to improve MDD recurrence prevention strategies.
Does the Dysregulation of Social Rhythms Syndrome (DYMERS) be Considered an Essential Component of Panic Disorders?
Primavera D, Cossu G, Marchegiani S, Preti A and Nardi AE
This editorial explores the role of hyperactivity and social rhythm dysregulation in bipolar disorder (BD) and related syndromes. Social Rhythm Dysregulation Syndrome (DYMERS) is proposed as a common vulnerability across various disorders, including panic disorder (PD), attention deficit hyperactivity disorder, and post-traumatic stress disorder. A study conducted on a sample of elderly individuals participating in an active aging study investigated whether individuals with PD exhibit higher biological rhythm dysregulation compared to those without PD. The sample, consisting of 119 individuals, revealed that those with a lifetime PD diagnosis scored significantly higher on the dysregulation of biological rhythms scale compared to those without panic disorder. A higher prevalence of depressive episodes was found in individuals with PD at the time of the interview. Notably, a small sample of elderly individuals with panic disorder, voluntarily selected for a physical exercise trial, showed a significantly higher level of dysregulation of social rhythms compared to those without panic disorder. This study opens a debate on the accuracy of paper and pencil screening tests for bipolar disorders, especially regarding false positives in individuals with panic disorder. Our hypothesis is that DYMERS could be a shared vulnerability substrate for various disorders, serving as a basis for bipolar onset in the presence of a hyperactivity profile, even with genetic features. The data collected from older adults suggest that social rhythm dysregulation is a typical feature of PD, regardless of the coexistence of a depressive episode. While the study has limitations due to a small sample size, the findings warrant careful analysis and suggest the need for larger-scale replication studies. If confirmed, the dysregulation of rhythms and its association with depressive disorders highlight a significant area of vulnerability for serious psychopathological disorders, emphasizing the importance of extending research to younger populations.
Epidemiological characteristics and behaviors of online broadcast suicidality in China: implications for targeted prevention strategies
Li CY, Xiao Y, Chen TT and Zhu SY
Suicide is a global health concern, exacerbated by stigma around mental illnesses. Online platforms like Twitter and Sina Weibo have seen a rise in "online broadcast suicide," where individuals share suicidal thoughts and actions. However, there is limited understanding of the epidemiological characteristics, particularly in China. This study aims to analyze the demographics and behaviors of individuals engaging in online broadcast suicide in China to inform targeted prevention strategies.
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