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Yale Psychiatry

The predictive value of supervised machine learning models for insomnia symptoms through smartphone usage behavior
Simon L, Terhorst Y, Cohrdes C, Pryss R, Steinmetz L, Elhai JD and Baumeister H
Digital phenotyping can be an innovative and unobtrusive way to improve the detection of insomnia. This study explores the correlations between smartphone usage features (SUF) and insomnia symptoms and their predictive value for detecting insomnia symptoms.
Erratum
[This corrects the article DOI: 10.1016/j.bpsgos.2023.100283.].
Obituary Dr Marina Vamos
PODCAST-June 2024
Trainee matters
PODCAST-July 2024
Upcoming RANZCP conferences
From the President
Winners of the 2023 PIF annual essay competition
Essay topic 'A psychiatrist's role in advocacy?'
Aksoy BDY
The child psychiatry pioneer who approached ADHD in a new way
Metcalf A
Suicide on the Toronto Transit Commission subway system in Canada (1998-2021): a time-series analysis
Chow S, Men VY, Zaheer R, Schaffer A, Triggs C, Spittal MJ, Elliott M, Schaffer D, Vije M, Jayakumar N and Sinyor M
The Toronto Transit Commission (TTC) operates the public transit system in Toronto, Canada. From 1954 to 1980, there were 430 suicide deaths/attempts on the TTC subway system. In 2011, TTC implemented Crisis Link, a suicide helpline to connect subway passengers with counsellors. Upstream factors such as media reporting about suicide incidents may also influence suicidal behaviour. Our objectives were to investigate how Crisis Link and media reports about TTC suicide incidents influenced suicide rates.
The way forward is collaborative: Climate change and mental wellbeing
George BR
Psychometric properties of the Spanish version of the measure of insight into cognition-self-report in psychosis-risk and non-clinical Mexican young adults
Fresán A, Domínguez T, Flores Y, Nieto L, Sheinbaum T, Robles R and Medalia A
Cognitive disturbances typically precede the onset of overt psychotic symptoms and represent a neurobiological marker for psychosis risk that is also associated with poor functional outcomes. The Measure of Insight into Cognition-Self Report (MIC-SR) is a widely used 12-item questionnaire that assesses the perceived frequency of cognitive impairment in the domains of executing functioning, attention, and memory. However, the MIC-SR is not available in Spanish, one of the most widely spoken languages worldwide. The present study aimed to provide a Spanish version of the MIC-SR and examine its psychometric properties in psychosis-risk and non-clinical Mexican young adults.
Non-peer professionals' understanding of recovery and attitudes towards peer support workers joining existing community mental health teams in the North Denmark Region: A qualitative study
Lerbæk B, Johansen K, Burholt AK, Gregersen LM, Terp MØ, Slade M, Castelein S and Jørgensen R
Peer support is a collaborative practice where people with lived experience of mental health conditions engage in supporting like-minded. Peer support impacts on personal recovery and empowerment and creates value at an organisational level. However, the implementation of peer support into existing mental health services is often impeded by barriers embedded in organisational culture and support in role expectations. Non-peer professionals' recovery orientation and attitudes towards peer support workers (PSWs) are essential factors in the implementation of peer support, and this study explored non-peer professionals' understanding of recovery and their attitudes towards PSWs joining existing community mental health teams in one region of Denmark. In total, 17 non-peer professionals participated in three focus groups. Thematic analysis led to three themes: (1) Recovery is a process of "getting better" and balancing personal and clinical perspectives; (2) Realising recovery-oriented practice: a challenging task with conflicting values; and (3) Expectations and concerns about peer support workers joining the team. Recovery-oriented practice faces challenging conditions in contemporary mental health services due to a dominant focus on biomedical aspects in care and treatment. Implementation facilitators and barriers in the employment of PSWs point towards fundamental aspects that must be present when employing PSWs in an organisation. The issues described leading up to the employment of PSWs reflected in this study underpin the importance of preparing an organisation for the employment of PSWs based on the available knowledge.
Sustained Treatment Response and Global Improvements With Long-term Valbenazine in Patients With Tardive Dyskinesia
Correll CU, Citrome L, Singer C, Lindenmayer JP, Zinger C, Liang G, Dunayevich E and Marder SR
Using data from KINECT® 4, a phase 3, 48-week study of valbenazine, post hoc analyses were conducted to assess long-term outcomes that are relevant to the real-world management of tardive dyskinesia (TD).
Assessing the joint effects of mitochondrial genes and physical activity on the psychiatric phenotype of subjective well-being based on the UK Biobank data
Shi P, Wang B, Shi S, Chu X, Liu C, Kang M, Hui J, Gou Y, Zhou R, Liu Y, Jia Y, Zhang F and Wen Y
Subjective well-being (SWB) is an important measure for mental health status. Previous research has shown that physical activity can affect an individual's well-being, yet the underlying molecular mechanism remains to be clarified. In this study, we aim to evaluate the potential interactions between mitochondrial genes and physical activity (PA) as well as their combined effects on individual well-being. SWB phenotype data in UK Biobank were enrolled for this study including nine aspects such as work/job satisfaction, health satisfaction, family relationship satisfaction, friendships satisfaction, financial situation satisfaction, ever depressed for a whole week, general happiness, general happiness with own health and belief that own life is meaningful. We made analysis for each aspects separately. Firstly, mitochondria-wide association studies (MiWAS) was conducted to assess the association of mitochondrial Single Nucleotide Polymorphisms SNP with each aspect of SWB. Then an interaction analysis of mitochondrial DNA (mtDNA) mutation and PA was performed to evaluate their joint effect on SWB status. Meanwhile, these two analysis were made for female and male group separately as well as the total samples, all under the control of possible confounding factors including gender, age, Townsend Deprivation Index (TDI), education, alcohol consumption, smoking habits, and 10 principal components. MiWAS analysis identified 45 mtSNPs associated with 9 phenotypes of SWB. For example, m.15218A > G on MT-CYB in the health satisfaction phenotype of the total subjects. Gender-specific analyses found 30 mtSNPs in females and 58 in males, involving 13 mtGenes. In mtDNA-PA interaction analysis, we also identified 10 significant mtDNA-PA interaction sets for SWB. For instance, m.13020 T > C (MT-ND5) was associated with the SWB financial situation satisfaction phenotype in all subjects (P = 0.00577). In addition, MiWAS analysis identified 12 mtGene variants associated with SWB, as MT-ND1 and MT-ND2. However, in mtDNA-PA interactions we detected 7 mtDNA affecting psychiatric disorders occurring, as in the friendships satisfaction phenotype (m.3394 T > C on MT-ND1). Our study results suggest an implication of the interaction between mitochondrial function and physical activity in the risk of psychiatric disorder development.
Comparing outcomes of psychiatric rehabilitation between ethnic-religious groups in Israel
Gal G, Lourie J, Roe D, Gelkopf M, Khatib A and Shadmi E
Psychiatric rehabilitation for people with severe mental illness (SMI) has many documented benefits, but less is known about cultural related aspects. To date, no comparison of psychiatric rehabilitation outcomes between Israeli Jews and Israeli Arabs has been carried out. Thus, the purpose of the present study was to compare the outcome measures of Israeli Arabs and Israeli Jews consuming psychiatric rehabilitation services. As part of the Israeli Psychiatric Rehabilitation Reported Outcome Measurement project (PR-ROM), a cross-sectional study comparing different ethnic-religious groups was performed. Data is based on 6,751 pairs of psychiatric rehabilitation consumers and their service providers. The consumers filled questionnaires on quality of life (QoL) and functioning, and their providers completed mirroring instruments. The findings revealed that QoL and functioning ratings were lower among Muslim Arabs compared to Jews on both consumers' and providers' ratings. Among Muslim Arabs, differences in outcomes according to the service's location were indicated. The observed differences between Israeli Arabs and Israeli Jews with SMI in the PR-ROM point to the need for culturally adapted rehabilitation services that take into account how cultural differences may affect the benefits of such services.
What variables predict stigmatizing attitudes toward people with mental disorders and their treatment in Filipinos and Americans?
Ramos N and McNally RJ
In the United States, Asian Americans express greater stigma toward those with mental disorders and report lower rates of seeking mental health treatment than do White Americans. However, research on these topics in Filipino cultural groups, especially Filipinos living in the Philippines (i.e., Filipino nationals), is sparse. To support the design of interventions to decrease stigma and improve rates of seeking treatment, we assessed attitudes toward mental disorders and help-seeking in Filipinos. U.S. national (i.e., American) and Filipino national participants completed an online survey containing the Mental Illness Stigma Scale, a Theory of Planned Behavior questionnaire measuring attitudes toward seeking treatment, and queries regarding demographic and psychosocial factors. Filipinos expressed significantly more stigma regarding relationship disruption, interpersonal anxiety, and poor hygiene, alongside increased perceived subjective norms opposing seeking treatment and decreased perceived behavioral control over getting treatment if necessary. We ran a linear mixed effects regression on each nationality separately to identify relationships between stigma and psychosocial factors. For Filipinos, increased parental education predicted decreased perceived relationship disruption and interpersonal anxiety; urbanization was associated with greater trust in mental health professionals, and having a close relative with a disorder led to decreased belief in patient recoverability. For Americans, increased participant education predicted decreased interpersonal anxiety, increased perceived recoverability, and improved perceived behavioral control over getting treatment if necessary, and having a close relative with a disorder predicted improved perceived treatability. The results guide programs for decreasing stigma and increasing treatment-seeking behavior. Limitations, future research directions, and possible interventions are discussed.
"They Ask Questions, But They Don't Want the Answers"-Perceptions of Clinical Communication Among Veterans Discontinuing Buprenorphine for the Treatment of Opioid Use Disorder
Eckhardt A, Waller DE, Shull S, Lovejoy TI, Morasco BJ, Gordon AJ and Wyse JJ
Many patients with opioid use disorder (OUD) discontinue treatment prematurely, increasing their risk of opioid-related overdose and death. While patient-centered care is considered the gold standard in treating chronic illness, it may be practiced less frequently in the context of OUD care. Patient-provider communication can influence patients' care experiences, potentially having an impact on treatment retention and care decision-making.
Cognitive flexibility and resilience measured through a residual approach
Notebaert L, Clarke PJF, Meeten F, Todd J and Van Bockstaele B
Resilience refers to the process through which individuals show better outcomes than what would be expected based on the adversity they experienced. Several theories have proposed that variation in resilience is underpinned by cognitive flexibility, however, no study has investigated this using an outcome-based measure of resilience.
Letter to the Editor: Robust clinician relationships must be the bedrock for future innovations in integrated Alcohol- Associated Liver Disease care
Winder GS and Mellinger JL
Neurocognitive training enhances the outcomes of children with attention deficit hyperactivity disorder: A preliminary study
Buker N, Karagoz E, Sengul YS, Guney SA and Ozbek A
Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by diverse clinical manifestations including inattention, hyperactivity and impulsivity.
Systematic review and meta-analysis: relative age in attention-deficit/ hyperactivity disorder and autism spectrum disorder
Frisira E, Holland J and Sayal K
Youngest students in their class, with birthdates just before the school entry cut-off date, are overrepresented among children receiving an Attention-Deficit/Hyperactivity Disorder (ADHD) diagnosis or medication for this. This is known as the relative age effect. This systematic review and meta-analysis summarises the evidence on the influence of relative age on ADHD symptoms, diagnosis and medication prescribing. As no review to date has investigated the association with autism spectrum disorder (ASD) diagnosis, this is also examined. Following prospective registration with PROSPERO, we conducted a systematic review according to the PRISMA guidelines. We searched seven databases: Medline, Embase, PsycInfo, Web of Science Core Collection, ERIC, Psychology and Behavioural Sciences Collection, and Cochrane Library. Additional references were identified from manual search of retrieved reviews. We performed a meta-analysis of quantitative data. Thirty-two studies were included, thirty-one investigated ADHD and two ASD. Younger relative age was associated with ADHD diagnosis and medication, with relative risks of 1.38 (1.36-1.52 95% CI) and 1.28 (1.21-1.36 95% CI) respectively. However, risk estimates exhibited high heterogeneity. A relative age effect was observed for teacher ratings of ADHD symptoms but not for parent ratings. With regard to ASD, the youngest children in their school year were more likely to be diagnosed with ASD. This review confirms a relative age effect for ADHD diagnosis and prescribed ADHD medication and suggests that differences in teacher and parent ratings might contribute to this. Further research is needed on the possible association with ASD.
Correction to: Psychosocial experiences in youth with Tourette syndrome: a systematic review and meta-synthesis
Lee MY, Wang HS and Chen CJ
Association Between Clozapine Exposure and Risk of Hematologic Malignancies in Veterans With Schizophrenia
Brainerd DR, Alexander B, Tague MJ and Lund BC
The objective of this study was to examine the relationship between clozapine use and hematologic malignancies, using national administrative data from the United States Veterans Health Administration (VHA). This case-control study of veterans with schizophrenia matched cases with incident hematologic malignancy to 10 controls without hematologic malignancy by gender, age, and time since first schizophrenia diagnosis from October 1999, the beginning of VHA data archives, to June 2022. Schizophrenia diagnoses were identified using , code 295.x and codes F20.x and F25.x from inpatient hospitalization and outpatient encounter data. Additional inclusion criteria were age 18-85 years, no prior history of malignancy, and at least 1 year of antipsychotic exposure. Clozapine exposure was assessed using 3 metrics: any exposure, years of exposure, and cumulative defined daily doses (DDD). Conditional multivariable logistic regression was used to adjust for nonmatched confounding variables. A total of 2,306 veterans with schizophrenia were identified with an incident diagnosis of hematologic malignancy and matched to 23,043 controls. Any prior clozapine exposure was more commonly observed among cases (5.3%) than controls (4.1%) and was significantly different after adjustment (odds ratio [OR], 1.31; 95% CI, 1.08-1.60). Risk was dose-dependent, where cumulative clozapine exposures from 3,000 to 4,999 DDD (OR, 1.78; 95% CI, 1.13-2.79) and ≥5,000 DDD (OR, 1.81; 95% CI, 1.24-2.64) were significantly associated with malignancy risk. Similarly, clozapine exposure of 5 or more years was associated with malignancy risk (OR, 1.88; 95% CI, 1.43-2.47). Consistent with prior report, this study observed an increased risk of hematologic malignancy associated with clozapine exposure. These findings suggest patients receiving clozapine use, particularly those with long-term use, should be closely monitored for hematologic malignancy.
Psychotic-like experiences and associated factors in resident physicians: A Canadian cross-sectional study
Paquin V, Guay E, Moderie C, Paradis C, Nahiddi N, Philippe FL and Geoffroy MC
Medical residency training is associated with a range of sociodemographic, lifestyle and mental health factors that may confer higher risk for psychotic-like experiences (PLEs) in residents, yet little research has examined this question. Thus, we aimed to document the prevalence and associated factors of PLEs among resident physicians.
Time estimates in prognostic discussions: A conversation analytic study of hospice multidisciplinary team meetings
Bruun A, White N, Oostendorp L, Stone P and Bloch S
Recommendations state that multidisciplinary team expertise should be utilised for more accurate survival predictions. How the multidisciplinary team discusses prognoses during meetings and how they reference time, is yet to be explored.
Self-reported problems and functional difficulties in anxious pregnant women in Pakistan: The use of a patient-generated mental health outcome measure
Rauf N, Park S, Zaidi A, Malik A, Atif N and Surkan PJ
Anxiety during pregnancy affects women worldwide and is highly prevalent in Pakistan. The Psychological Outcome Profiles (PSYCHLOPS) questionnaire is an instrument used in therapy to assess patient-generated problems and the consequent functional difficulties. Using the PSYCHLOPS, we aimed to describe the type of problems and the consequent functional difficulties faced by anxious pregnant women in Pakistan. Secondarily, we sought to explore if a cognitive behavioral therapy (CBT)-based intervention brought about changes in the severity score for certain problems or functional difficulties. Anxious pregnant women were recruited from the Obstetrics/Gynecology Department of a tertiary hospital in Rawalpindi, Pakistan. Of 600 pregnant women randomized to receive a psychosocial intervention for prenatal anxiety delivered by non-specialist providers, 450 received ≥1 intervention session and were administered the PSYCHLOPS. Eight types of problems were identified; worries about the unborn baby's health and development (23%), concerns about family members (13%), and financial constraints (12%) were the most frequently reported primary problems. Severity scores between baseline and the last available therapy session indicated the largest decrease for relationship problems (mean = 2.4) and for concerns about family members (mean = 2.2). For functional difficulties, 45% of the participants reported difficulties in performing household chores, but the intervention showed the greatest decrease in severity scores for mental or emotional functional difficulties. Focus on certain types of patient-generated problems, e.g., relationship problems, could anchor therapy delivery in order to have the greatest impact. Tailored CBT-based intervention sessions have the potential to address important but neglected problems and functional difficulties in anxious pregnant women.
Intersectional HIV- and Depression-Related Stigma Among People with HIV Entering HIV Care in Cameroon
Filiatreau LM, Ebasone PV, Dzudie A, Wainberg M, Yotebieng M, Anastos K and Parcesepe AM
Mental health-related stigma is a prominent barrier to improved mental health outcomes globally and may be particularly harmful to populations with other stigmatized identities. We aimed to understand intersectional depression- and HIV-related stigma among people with HIV (PWH) entering HIV care in Cameroon. Using baseline data from a cohort of PWH entering HIV care in Cameroon between 2019 and 2020, we characterized depression- and HIV-related stigma in the population overall and by sociodemographic sub-group. We also explored substantively meaningful variation in stigma endorsement by depressive symptom severity (Patient Health Questionnaire-9 [PHQ-9]) and causal attribution of depression. Among those with elevated depressive symptoms (PHQ-9 scores > 4), we estimated the association between stigma type and depressive symptom severity using binomial regression. Among 398 participants, 49% endorsed low HIV- and depression-related stigma (N = 195), 10% endorsed high HIV- and depression-related stigma (N = 38), 29% endorsed high depression-related stigma only (N = 116), and 12% endorsed high HIV-related stigma only (N = 49). Respondents with and without heightened depressive symptoms commonly believed depressive symptoms were caused by HIV (N = 140; 32.9%). Among those with elevated depressive symptoms, the prevalence of moderate to severe symptoms was higher among those endorsing high HIV-related stigma only (prevalence ratio 1.55; 95% confidence interval: 1.01, 2.37) compared to those reporting low HIV- and depression-related stigma. HIV- and depression-related stigma are both common among PWH entering HIV care in Cameroon. The consistent association between HIV-related stigma and poor psychosocial well-being among people with HIV necessitates the urgent scale-up of evidence-based HIV-related stigma interventions specifically.
Is Antipsychotic Drug Use During Pregnancy Associated with Increased Malformation Rates and Worsening of Maternal and Infant Outcomes? A Systematic Review
Sani G, Callovini T, Ferrara OM, Segatori D, Margoni S, Simonetti A, Lisci FM, Marano G, Fischetti A, Kotzalidis GD, Segni FD, Fiaschè F, Janiri D, Moccia L, Manfredi G, Alcibiade A, Brisi C, Grisoni F, Stella G, Bernardi E, Brugnami A, Ciliberto M, Spera MC, Caso R, Rossi S, Boggio G, Mastroeni G, Abate F, Conte E, Quintano A, Chiara L, Monti L, Camardese G, Rinaldi L, Koukopoulos AE, Chieffo DPR, Angeletti G and Mazza M
There is much debate about continuing antipsychotic medication in patients who need it when they become pregnant because benefits must be weighed against potential teratogenic and malformation effects related to antipsychotics themselves. To address this, we conducted a systematic review on the PubMed, PsycINFO and CINHAL databases and the ClinicalTrials.gov register using the following strategy: (toxicity OR teratogenicity OR malformation* OR "birth defect*" OR "congenital abnormality" OR "congenital abnormalities" OR "brain changes" OR "behavioral abnormalities" OR "behavioral abnormalities") AND antipsychotic* AND (pregnancy OR pregnant OR lactation OR delivery OR prenatal OR perinatal OR post-natal OR puerperium) on September 27, 2023. We found 38 studies to be eligible. The oldest was published in 1976, while most articles were recent. Most studies concluded that the antipsychotics, especially the second-generation antipsychotics, were devoid of teratogenic potential, while few studies were inconclusive and recommended replication. Most authoritative articles were from the Boston area, where large databases were implemented to study the malformation potential of psychiatric drugs. Other reliable databases are from Northern European registers. Overall conclusions are that antipsychotics are no more related to malformations than the disorders themselves; most studies recommend that there are no reasons to discontinue antipsychotic medications in pregnancy.
Maternal caffeine intake during pregnancy and the risk of delivering a small for gestational age baby: Kuopio Birth Cohort
Kukkonen A, Hantunen S, Voutilainen A, Ruusunen A, Backman K, Kirjavainen PV, Ylilauri M, Voutilainen R, Pasanen M and Keski-Nisula L
High caffeine intake during pregnancy is associated with restricted fetal growth. We aimed to evaluate the association between maternal caffeine intake during early and late pregnancy and the risk of delivering a small for gestational age (SGA) baby.
Towards an Active Role of Financial Institutions in Preventing Problem Gambling: A Proposed Conceptual Framework and Taxonomy of Financial Wellbeing Indicators
Lakew N, Jonsson J and Lindner P
The transformation of gambling into a largely digital commodity has created a need for online payment technologies to facilitate online gambling, thereby also raising the question of what role these actors can play in the promotion of Responsible Gambling (RG). With the means and access they maintain, financial institutions are in a unique position to alleviate financial pitfalls, yet their role in the gambling context has thus far received little scrutiny. The objective of this study was to conduct an extant literature review to develop an initial set of financial indicators tailored for financial institutions, enabling them to engage in the RG initiatives. We conducted a two-step narrative literature review to identify both general Financial Well-Being (FWB) indicators across financial research disciplines, and one specific to gambling. A literature search over the past 20 years was performed across the following academic databases: Medline (Ovid), Sociological Abstracts (ProQuest), Web of Science (Clarivate), and PsycInfo (EBSCO). Manifest content analysis was used in step one to review general financial well-being, yielding a general FWB conceptual framework. In step two, we applied latent content analysis to the gambling-specific literature, linking essential concepts of gambling-related financial harms to the broader FWB literature. This resulted in a tentative taxonomy of indicators applicable to financial institutions with gambling customers. In tandem with the FWB conceptual framework, the preliminary taxonomy could provide a foundation for financial institutions catering to gambling customers to engage in the duty of care agenda, potentially broadening player protection beyond the current operator-focused RG measures.
Child Ability and Parental Attributions: Development and Validation of the Reasons for Children's Behavior Scale
Kautz-Turnbull C, Rogge RD and Petrenko CLM
Parent attributions for children's behavior affect parenting practices and emotional reactions. The current study aimed to create a new measure of parental attributions, called the Reasons for Children's Behavior (RCB), to capture how parents take developmental ability into account when making attributions for specific behaviors. A 224-item survey was completed by 836 participants, including original items and established parent attribution and parenting construct scales. Exploratory factor analyses and item-response theory analyses were utilized to develop the RCB, which includes 30 items comprising seven subscales. The RCB demonstrated an extremely stable factor structure, high levels of internal consistency across 25 demographic groups, reasonable test-retest correlations across 2 weeks, appropriate convergent and discriminant validity, and unique predictive validity (i.e., incremental validity). The RCB offers researchers and clinicians a novel tool to better understand how parent attributions for child behavior impact parenting and larger family dynamics.
Evaluation of Galectin-1 and Galectin-3 levels in patients with bipolar disorder: Is Galectin-3 associated with treatment response?
Aytekin MY, Kahve AC, Ekinci RN, Nural AS, Çakmak IB, Naycı NA and Göka E
Galectins (Gal) were linked with inflammatory responses in the central nervous system, may play an important role in the pathogenesis of BD.In this study,we aimed to investigate whether serum Gal-1 and Gal-3 levels are related to BD.
The Impact of Chronic Diseases on Mental Health: An Overview and Recommendations for Care Programs
Akif A, Qusar MMAS and Islam MR
The current achievement of medical advancement is noteworthy; however, the occurrence of chronic diseases is increasing day by day, with a significant percentage of affected people are suffering from a mental health crisis. This article aims to present a thorough yet brief review of methods that can be employed to build the emotional wellness of chronic patients.
Longitudinal Associations of Family Relationship Quality with Chronic Pain Incidence and Persistence Among Aging African Americans
Woods SB, Roberson PNE, Booker Q, Wood B and Booker S
This study examines how family relationships convey risk or resilience for pain outcomes for aging African Americans, and to replicate and extend analyses across two nationally representative studies of aging health.
Effect of Sleep Restriction on Adolescent Cognition by Adiposity: A Randomized Crossover Trial
Stager LM, Watson CS, Cook EW and Fobian AD
Pediatric obesity is associated with impaired cognitive function; however, the mechanisms underlying this association demand assessment. Sleep may be a relevant moderator, as poor sleep predicts both increased adiposity and impaired cognitive function.
A candidate projective neuron type of the cerebellar cortex: the synarmotic neuron
Flace P, Galletta D, Bizzoca A, Gennarini G and Livrea P
Previous studies on the granular layer of the cerebellar cortex have revealed a wide distribution of different subpopulations of less-known large neuron types, called "non-traditional large neurons", which are distributed in three different zones of the granular layer. These neuron types are mainly involved in the formation of intrinsiccircuits inside the cerebellar cortex. A subpopulation of these neuron types is represented by the synarmotic neuron, which could play a projective role within the cerebellar circuitry. The synarmotic neuron cell body map within the internal zone of the granular layer or in the subjacent white substance. Furthermore, the axon crosses the granular layer and runs in the subcortical white substance, to reenter in an adjacent granular layer, associating two cortico-cerebellar regions of the same folium or of different folia, or could project to the intrinsic cerebellar nuclei. Therefore, along with the Purkinje neuron, the traditional projective neuron type of the cerebellar cortex, the synarmotic neuron is candidate to represent the second projective neuron type of the cerebellar cortex. Studies of chemical neuroanatomy evidenced a predominant inhibitory GABAergic nature of the synarmotic neuron, suggesting that it may mediate an inhibitory GABAergic output of cerebellar cortex within cortico-cortical interconnections or in projections towards intrinsic cerebellar nuclei. On this basis, the present minireview mainly focuses on the morphofunctional and neurochemical data of the synarmotic neuron, and explores its potential involvement in some forms of cerebellar ataxias.
Benson relaxation technique to address sleep quality and aggression among patients with bipolar type I disorder: A randomized clinical trial study
Gharehbaghi M, Mirhosseini S, Minaei-Moghadam S, Salari M, Grimwood S and Vaghee S
The present research was conducted to assess the effect of the Benson relaxation technique on sleep quality and aggression among patients with bipolar type I disorder.
Early pharmacological interventions for prevention of post-traumatic stress disorder (PTSD) in individuals experiencing acute traumatic stress symptoms
Bertolini F, Robertson L, Bisson JI, Meader N, Churchill R, Ostuzzi G, Stein DJ, Williams T and Barbui C
Acute traumatic stress symptoms may develop in people who have been exposed to a traumatic event. Although they are usually self-limiting in time, some people develop post-traumatic stress disorder (PTSD), a severe and debilitating condition. Pharmacological interventions have been proposed for acute symptoms to act as an indicated prevention measure for PTSD development. As many individuals will spontaneously remit, these interventions should balance efficacy and tolerability.
Antipsychotic Medication Continuation vs Taper and Discontinuation in Patients With Schizophrenia and Other Nonaffective Psychotic Disorders
Andrade C
Schizophrenia is a major mental illness that is managed with long-term antipsychotic medication as a standard of care. Antipsychotic medications, however, are associated with many subjective and objective adverse effects. These adverse effects have driven the study of risk-mitigation strategies such as targeted intermittent therapy and dose reduction and drug discontinuation. Randomized controlled trials (RCTs) of these strategies have been synthesized in meta-analysis; both strategies have been associated with no functional benefits and with an increased risk of relapse. The RCTs, however, have been criticized because, in many, patients were abruptly switched to the target dose or too rapidly tapered, thereby predisposing the RCT to failure of the intervention. Two important RCTs examined gradual individualized dose reduction and discontinuation. One, conducted in first-episode psychosis patients who were free from positive symptoms for 6 months, found that, at 18-month follow-up, dose reduction was associated with a higher risk of relapse (number needed to harm [NNH] = 5) and with no functional benefits. However, after return to routine clinical care, at a 7-year follow-up, the dose reduction group had better functional outcomes and similar clinical outcomes relative to the maintenance treatment group. The other RCT, conducted in patients with relapsing psychosis, found that, at a 2-year follow-up, dose reduction was associated with a higher risk of relapse (NNH = 5) and with no improvements in social, cognitive, quality of life, satisfaction, and other domains. Many large nationwide observational studies have found that antipsychotic discontinuation by patients with first-episode psychosis and schizophrenia is associated with increased relapse, rehospitalization, suicide mortality, cardiovascular mortality, and all-cause mortality. There is also the ethical matter that attempts to identify the few who may benefit from antipsychotic dose reduction and discontinuation may compromise the health and stability of the many who require long-term maintenance treatment.
Integrating family caregivers in older adults' hospital stays: a needed cultural shift
Muntefering C, Kastrinos A, McAndrew NS, Ahrens M, Applebaum AJ, Bangerter L and Fields B
This study aimed to examine perceived barriers and facilitators to caregiver inclusion in the hospital care of older adult family members or friends through the perspectives of (1) hospitalized older adults, (2) caregivers of a hospitalized older adult, (3) healthcare clinicians, and (4) policymakers.
Dietary Caffeine and Brain Dopaminergic Function in Parkinson Disease
Saarinen EK, Kuusimäki T, Lindholm K, Niemi K, Honkanen EA, Noponen T, Seppänen M, Ihalainen T, Murtomäki K, Mertsalmi T, Jaakkola E, Myller E, Eklund M, Nuuttila S, Levo R, Chaudhuri KR, Antonini A, Vahlberg T, Lehtonen M, Joutsa J, Scheperjans F and Kaasinen V
This study was undertaken to investigate the effects of dietary caffeine intake on striatal dopamine function and clinical symptoms in Parkinson disease in a cross-sectional and longitudinal setting.
Effect of Time From Onset of Major Depressive Disorder on the Therapeutic Response to Esmethadone (REL-1017)
Guidetti C, De Martin S, Serra G, Apicella M, Pani L, Pappagallo M, Mattarei A, Folli F, Manfredi P and Fava M
The relationship between the duration of major depressive disorder (MDD) and therapeutic response to standard antidepressant treatment (SAT) is unknown. -methyl-D-aspartate receptor uncompetitive antagonists are emerging drugs for MDD. We investigated whether the antidepressant effect of esmethadone (REL-1017) could be related to the duration of depression. We analyzed data from a Phase 2a study of adjunctive treatment with esmethadone in MDD patients () with inadequate response to ongoing SAT (May 2018-August 2019). Patients were randomized to treatment with esmethadone 25 mg, esmethadone 50 mg, or placebo for 7 days, followed by an observation period (Days 7-14). Duration of depression was derived from 2 measures: (1) time from onset (TFO), calculated as the difference in years between age at trial enrollment and age at the onset of the first major depressive episode (MDE), and (2) TFO index, calculated by computing the years of illness duration (number of years from the beginning of MDD), divided by age and multiplied by 100. First, bivariate correlations between TFO and change from baseline (CFB) were calculated by Spearman ρ. Linear mixed-model analyses were also conducted. A total of 62 patients participated in the trial. The median values of time from MDD onset for the 62 patients were 11 years (absolute value) and 22% (percentage of life-years). Duration of depression was significantly correlated with Montgomery-Asberg Depression Rating Scale (MADRS) CFB on Day 14, even when controlling for the effect of current depression severity (MADRS baseline). In the linear mixed-model analyses, we found a significant effect of duration on reduction in MADRS score from T0 to subsequent assessments ( < .05). Number of previous MDEs and effect of esmethadone 50 mg when compared to 25 mg were not significant. Esmethadone 25 and 50 mg were more effective in reducing MADRS scores in patients with shorter time from first MDE onset. ClinicalTrials.gov identifier: NCT03051256.
Effects of a Multicomponent Intervention With Cognitive Training and Lifestyle Guidance for Older Adults at Risk of Dementia: A Randomized Controlled Trial
Wang P, Yang T, Peng W, Wang M, Chen X, Yang Y, Huang Y, Jiang Y, Wang F, Sun S, Ruan Y, Ding Y, Yao Y and Wang Y
This study examined the effects of a multicomponent intervention program on cognitive function in community-dwelling older adults with mild cognitive impairment (MCI) and subjective cognitive decline (SCD). This was a 2-arm, randomized controlled trial in which a multicomponent intervention was applied. Participants were recruited from June 2020 to August 2020, randomization and intervention began in August 2020, and the entire program ended in January 2021. It included cognitive training (mnemonic strategy training) and lifestyle guidance (diet, sleep, and exercise guidance) for 7 weeks. A total of 123 Chinese community-dwelling older adults experiencing MCI or SCD were randomly divided into a multicomponent intervention group (n = 62) and a health education group (n = 61). The global cognitive function was measured using the Mini-Mental State Examination (MMSE). The cognitive domains outcomes included memory functions measured using the immediate and delayed tests of the Auditory Verbal Learning Test (AVLT) and Logical Memory Test (LMT), and executive function and attention measured using the Digital Symbol Substitution Test (DSST) and Digit Span Test (DST). Data were collected at baseline and postintervention. For cognitive outcome, the results of linear mixed-effect model showed significant time × group effects in the MMSE (Cohen =0.63 [95% CI, 0.27 to 1.00], = 10.25, = .002). This study found significant time × group effects in AVLT-immediate (Cohen = 0.47 [95% CI, 0.11 to 0.83], = 8.18, = .005), AVLT delayed (Cohen = 0.45 [95% CI, 0.10 to 0.81], = 4.59, = .034), LMT-delayed (Cohen = 0.71 [95% CI, 0.34 to 1.07], = 4.59, = .034), DSST (Cohen = 0.27 [95% CI, -0.08 to 0.63], = 4.83, = .030), and DST (Cohen =0.69 [95% CI, 0.33 to 1.05], = 8.58, = .004). The results support the feasibility and effectiveness of the multicomponent intervention program in improving cognitive function in community dwelling older adults at risk of dementia. The high adherence of this program shows its potential for promotion in the community and supports a larger and longer trial. Chinese Clinical Trial Registry (ChiCTR2200061420).
A common computational and neural anomaly across mouse models of autism
Noel JP, Balzani E, Acerbi L, Benson J, , Savin C and Angelaki DE
Computational psychiatry has suggested that humans within the autism spectrum disorder (ASD) inflexibly update their expectations (i.e., Bayesian priors). Here, we leveraged high-yield rodent psychophysics (n = 75 mice), extensive behavioral modeling (including principled and heuristics), and (near) brain-wide single cell extracellular recordings (over 53k units in 150 brain areas) to ask (1) whether mice with different genetic perturbations associated with ASD show this same computational anomaly, and if so, (2) what neurophysiological features are shared across genotypes in subserving this deficit. We demonstrate that mice harboring mutations in , , and show a blunted update of priors during decision-making. Neurally, the differentiating factor between animals flexibly and inflexibly updating their priors was a shift in the weighting of prior encoding from sensory to frontal cortices. Further, in mouse models of ASD frontal areas showed a preponderance of units coding for deviations from the animals' long-run prior, and sensory responses did not differentiate between expected and unexpected observations. These findings demonstrate that distinct genetic instantiations of ASD may yield common neurophysiological and behavioral phenotypes.
Psychometric properties of persian version of the cardiff fertility knowledge scale (CFKS-P)
Mirghafourvand M, Asghari Jafarabadi M, Gharacheh M, Maeda E, Haghani S and Ranjbar F
The level of fertility knowledge of reproductive-age people is low to moderate, and the inadequate knowledge of infertility-related factors may cause some people to unconsciously engage in activities that reduce their fertility. Given the significance of fertility knowledge, and the lack of standard instruments to evaluate it in Iran, the present study aimed at determining psychometric properties of the Persian version of the Cardiff Fertility Knowledge Scale (CFKS-P) in Iranian population.
Summary Document Research on RDS Anti-addiction Modeling: Annotated Bibliography
Blum K, Baron D, McLaughlin T, Thanos PK, Dennen C, Ceccanti M, Braverman ER, Sharafshah A, Lewandrowski KU, Giordano J and Badgaiyan RD
Annotated bibliography of genetic addiction risk severity (GARS) publications, pro-dopamine regulation in nutraceuticals (KB220 nutraceutical variants), and policy documents. Further research is required to encourage the field to consider "Reward Deficiency Syndrome (RDS) Anti-addiction Modeling" which involves early risk identification by means of genetic assessment similar to GARS, followed by induction of dopamine homeostasis by means of genetically guided pro-dopamine regulation similar to KB220. These results suggest that genetically based treatments may be a missing piece in the treatment of substance use disorder (SUD).
Nutritional Calorie Labeling and Menu Ordering Practices Among US Adults With Chronic Illnesses
Ibecheozor C, Morales J, Ross J, Ezeofor A, McKie C, Scott VF, Kibreab A, Howell C, Aduli F, Brim H, Ashktorab H, Oyawusi M, McDonald-Pinkett S and Laiyemo AO
The relationship between diet and the management of chronic illnesses is well established. However, it is unknown the extent to which people with chronic illnesses pay attention to nutritional information and act upon the information obtained. We evaluated the menu ordering practices of adults with chronic illnesses.
Getting to Fidelity: Consensus Development Process to Identify Core Activities of Implementation Facilitation
Smith JL, Ritchie MJ, Kim B, Miller CJ, Chinman MJ, Kelly PA, Landes SJ and Kirchner JE
Transferring successful implementation strategies from research to practice requires approaches for assessing fidelity to the strategy's core components. Implementation facilitation (IF) is a strategy involving an interactive process of problem-solving, enabling, and supporting individuals in efforts to implement clinical innovations that occurs in the context of a recognized need for improvement and supportive interpersonal relationships. Because IF is a dynamic strategy involving numerous activities, our objective was to conduct a rigorous consensus development process to identify core activities for monitoring fidelity to IF when applied in clinical settings. We first conducted a scoping literature review to identify the range of activities used when IF has been applied in clinical settings, searching multiple citation databases for English-language articles including "facilitation" or other commonly-used terms for the strategy published from 1996-2015. Through multi-stage screening, 135 articles (from 94 studies) were identified for data extraction on IF activities, frequency with which IF activities were identified as 'core' by study authors, and study outcomes. From the literature review, we identified 32 distinct IF activities and developed definitions/examples for each. Next, we conducted a 3-stage, modified-Delphi expert panel consensus development process to identify core IF activities across three implementation phases (i.e., Pre-Implementation, Implementation, Sustainment). The expert panel identified 8 core activities for the Pre-Implementation Phase, 8 core activities for the Implementation Phase, and 4 core activities for the Sustainment Phase. This work provides an important foundation for developing measures/tools to assess use of core IF activities to ensure the strategy is delivered with fidelity.
A Case of Risperidone-Induced Urinary Incontinence
Eierman AC, Reischman AE and Gouthro RV
Schizophrenia spectrum disorders are psychiatric conditions associated with an increased risk of all-cause mortality; patients with these conditions have a shortened average lifespan compared to the general population. First-line treatment for schizophrenia spectrum illness consists of atypical antipsychotics, which are associated with well-understood side effects, including metabolic syndrome, anticholinergic effects, and extrapyramidal symptoms. We are presenting a case of a 36-year-old patient treated with the atypical antipsychotic risperidone who experienced treatment-associated urinary incontinence. In the current literature, atypical antipsychotic-induced urinary incontinence is not well-documented in patients with schizophrenia spectrum disorder. Incontinence is often a topic of societal shame for many patients, and as a side effect, it may influence medication compliance. In the treatment of schizophrenia spectrum disorders, compliance is essential to prevent psychosis relapse in patients, so prescribers must be aware of this potential side effect and how to manage it. Upon a patient presenting with incontinence suspected to be due to atypical antipsychotics, other more common causes of incontinence must first be ruled out. Then, further management can consist of stopping the offending medication or adding a medication to address the incontinence. In this case, our patient had an extended history of suboptimal treated schizoaffective disorder, and risperidone was providing significant improvement; therefore, to ensure continued improvement, we initiated oxybutynin to manage urinary incontinence.
Addressing cortex dysregulation in youth through brain health check coaching and prophylactic brain development
Blum K, Braverman ER, Gold MS, Dennen CA, Baron D, Thanos PK, Hanna C, Elman I, Gondre-Lewis MC, Ashford JW, Newberg A, Madigan MA, Jafari N, Zeine F, Sunder K, Giordano J, Barh D, Gupta A, Carney P, Bowirrat A and Badgaiyan RD
The Carter Center has estimated that the addiction crisis in the United States (US), if continues to worsen at the same rate, may cost the country approximately 16 trillion dollars by 2030. In recent years, the well-being of youth has been compromised by not only the coronavirus disease 2019 pandemic but also the alarming global opioid crisis, particularly in the US. Each year, deadly opioid drugs claim hundreds of thousands of lives, contributing to an ever-rising death toll. In addition, maternal usage of opioids and other drugs during pregnancy could compromise the neurodevelopment of children. A high rate of DNA polymorphic antecedents compounds the occurrence of epigenetic insults involving methylation of specific essential genes related to normal brain function. These genetic antecedent insults affect healthy DNA and mRNA transcription, leading to a loss of proteins required for normal brain development and function in youth. Myelination in the frontal cortex, a process known to extend until the late 20s, delays the development of proficient executive function and decision-making abilities. Understanding this delay in brain development, along with the presence of potential high-risk antecedent polymorphic variants or alleles and generational epigenetics, provides a clear rationale for embracing the Brain Research Commission's suggestion to mimic fitness programs with an adaptable brain health check (BHC). Implementing the BHC within the educational systems in the US and other countries could serve as an effective initiative for proactive therapies aimed at reducing juvenile mental health problems and eventually criminal activities, addiction, and other behaviors associated with reward deficiency syndrome.
Identification of stress-induced epigenetic methylation onto dopamine D2 gene and neurological and behavioral consequences
Blum K, Bowirrat A, Baron D, Elman I, Makale MT, Cadet JL, Thanos PK, Hanna C, Ahmed R, Gondre-Lewis MC, Dennen CA, Braverman ER, Soni D, Carney P, Khalsa J, Modestino EJ, Barh D, Bagchi D, Badgaiyan RD, McLaughlin T, Cortese R, Ceccanti M, Murphy KT, Gupta A, Makale MT, Sunder K and Gold MS
The D2 dopamine receptor () gene has garnered substantial attention as one of the most extensively studied genes across various neuropsychiatric disorders. Since its initial association with severe alcoholism in 1990, particularly through the identification of the allele, numerous international investigations have been conducted to elucidate its role in different conditions. As of February 22, 2024, there are 5485 articles focusing on the gene listed in PUBMED. There have been 120 meta-analyses with mixed results. In our opinion, the primary cause of negative reports regarding the association of various gene polymorphisms is the inadequate screening of controls, not adequately eliminating many hidden reward deficiency syndrome behaviors. Moreover, pleiotropic effects of variants have been identified in neuropsychologic, neurophysiologic, stress response, social stress defeat, maternal deprivation, and gambling disorder, with epigenetic DNA methylation and histone post-translational negative methylation identified as discussed in this article. There are 70 articles listed in PUBMED for DNA methylation and 20 articles listed for histone methylation as of October 19, 2022. For this commentary, we did not denote DNA and/or histone methylation; instead, we provided a brief summary based on behavioral effects. Based on the fact that Blum and Noble characterized the allele as a generalized reward gene and not necessarily specific alcoholism, it now behooves the field to find ways to either use effector moieties to edit the neuroepigenetic insults or possibly harness the idea of potentially removing negative mRNA-reduced expression by inducing "dopamine homeostasis."
Comparison of Apathy and Cognitive Symptoms in Pre- and Postoperative Period in Deep Brain Stimulation Surgery
Polat S, Erdem M and Çekinmez M
The aim of the study was to investigatie apathy and cognitive functions in Parkinson's disease patients who underwent deep brain stimulation surgery on bilateral subthalamic nuclei.
Emotion Regulation, Theory of Mind, and Attachment to Parents and Peers Among Turkish Adolescent Offenders and Victims: A Single-Center, Cross-Sectional, Case-Control Study
İmrek Y, Öztürk Y, Balta Kesikbaş B, Taşkan M, Göl Özcan G and Tufan AE
There may be many risk factors for both youth offending and victimization. In our study, we aimed to compare youth offenders and victims in terms of attachment characteristics, emotion regulation, and mind-reading skills.
Functional Impairment, Attachment, and Affective Temperaments in Euthymic Patients with Bipolar Disorder
Kartal C and Fahri Aydın E
Functional impairment in euthymic patients with bipolar disorder is a compelling issue, and revealing unknown related factors with functional impairment is a substantial topic. We aimed to assess the effects of clinical factors, affective temperaments, and attachment on overall functioning in euthymic patients with bipolar disorder.
Psychological Attitudes of Physicians in Seeking Help and Associated Factors
Göksel P, Ay R and Kılınçel O
Physician suicides have been increasing in recent years, and this shows that the psychological state of physicians is a subject that needs research and intervention. We think that the factors affecting the behavior of physicians to seek medical help due to their psychiatric disorders should be addressed. Therefore, we conducted a study examining the relationship between the anxiety, depression and stress levels of physicians, their attitudes toward seeking psychological help, and the degree of self-stigma related to seeking help.
Optical Coherence Tomography Findings in Bipolar Disorder Patients and the Related Factors
Kurt A, Zor KR, Yıldırım Biçer G, Küçük E and Erşan EE
This study's purpose is to determine the effects of current episode and the mood stabilizers on chorioretinal layer thicknesses of bipolar disorder (BD) patients using spectral-domain optical coherence tomography (SD-OCT).
Effects of Transcranial Direct Current Stimulation on Cognitive Deficits in Depression: A Systematic Review
Jin J, Al-Shamali HF, McWeeny R, Sawalha J, Shalaby R, Marshall T, Greenshaw AJ, Cao B, Zhang Y, Demas M, Dursun SM, Dennett L and Suleman R
Major depressive disorder is the leading cause of mental health-related burden globally and up to one-third of major depressive disorder patients never achieve remission. Transcranial Direct Current Stimulation is a non-invasive intervention used to treat individuals diagnosed with major depressive disorder and bipolar disorder. Since the last transcranial direct current stimulation review specifically focusing on cognitive symptoms in major depressive disorder, twice as many papers have been published.
Identification and Analyses of Crucial Genes Associated with Pathogenesis of Major Depressive Disorder
Li J, Ma Q and Ai M
Major depressive disorder is a debilitating mental condition that causes severe disability leading to a high fatality rate. No valid blood-based biomarkers for major depressive disorder are currently available. The purpose of this research is to investigate gene biomarkers and pathways that may be linked to major depressive disorder pathogenesis.
Why Do Adolescents Relapse? A Multicenter, Cross-sectional Study
Kardaş Ö, Şimşek M and Ögel K
Adolescents use drugs once, then use them regularly, then start and stop many times. In addiction treatment, relapse is a major barrier to recovery. Relapse is more common among adolescents and is a major problem. Thus, this study aimed to identify the factors impacting the duration of relapse in adolescents.
Electrocardiographic Changes During and After Alcohol Withdrawal
İzci F, Ünübol B and İzci S
Our study aimed to examine the possible risk of ventricular arrhythmia and sudden cardiac death by calculating the electrocardiographic changes and indicators of ventricular repolarization during and after alcohol withdrawal.
Effects of Beliefs, Conspiracy Theories, and Vaccine Hesitancy on the Vaccination Status of Patients with Severe Mental Illness in a Tertiary Psychiatric Care Hospital in Türkiye
Kucukparlak İ, Fikret Giynas F and Gica S
The aim of the study was to investigate the relationship between the vaccination rates and vaccine hesitancy and the adoption of conspiracy theories by patients with severe mental illness in Türkiye.
Development and Psychometric Properties of the Social Network Site Use Motives Scale-Revised
Lim YJ
Social network site use motives have been reported to be important in understanding the causes of Social Network Site addiction. The purpose of this study was to supplement the weaknesses of the Social Network Site Use Motives Scale with a 6-factor structure and to examine the psychometric properties of the Social Network Site Use Motives Scale-Revised with an 8-factor structure.
Comparison of Attitude and Insight Toward Illness Between in Patients with Bipolar I Disorder Manic Episode and Major Depressive Disorder
Chang MJ and Huang SS
Studies comparing insight toward illness in patients with bipolar I disorder manic episode and in patients with major depressive disorder are scarce. The aim of this study was to investigate the attitudes and insight of patients with bipolar I disorder in manic episode and in patients with major depressive disorder.
Use of Clonidine in Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder Comorbidity: Report of 3 Cases
Temeltürk RD, İlçioğlu Ekici G, Yağmur Efendi G and Kılıç BG
Clonidine has been widely used in child and adolescent psychiatry, especially in attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), which are recently categorized under neurodevelopmental disorders. However, it is not recommended as a first-line medication for treatment, and current data on the use of clonidine are limited. Herein, we present 3 cases with ADHD and ASD comorbidity, if any, as well as other neurodevelopmental disorders, including intellectual disability and Tourette's disorder, treated with clonidine. At the second-month follow-up, substantial improvements were observed in subscale scores of Conners's Parent Rating Scale-Revised Long Form, and Autism Behavior Checklist. Our case report indicated that clonidine is well tolerated, safe, and effective in improving both ADHD- and ASD-related symptoms as well as disruptive, aggressive behaviors and tics in children with multiple neurodevelopmental disorders.
Sertraline-Induced Leukocytoclastic Vasculitis with Definite Causal Association: A Case Report
Selçuk M
Antidepressants like sertraline are frequently used to treat psychiatric diseases like depression, panic disorder, and obsessive-compulsive disorder. Small-vessel vasculitis called leukocytoclastic vasculitis is defined histopathologically by immune complex-mediated vasculitis of the dermal capillaries and venules. Typically, it shows up as purpura on the lower extremities, either with or without systemic involvement. Leukocytoclastic vasculitis can be idiopathic but it can also happen in conjunction with several medications. Here, we present data on sertraline-induced leukocytoclastic vasculitis in a patient with major depressive disorder. To our knowledge, sertraline and other selective serotonin reuptake inhibitors have not previously been definitively linked to leukocytoclastic vasculitis, which is rare with antidepressants.
Perceived Social Support and Parental Emotional Temperament Among Children with Attention Deficit and Hyperactivity Disorder
Özbek MM, Sevinçok D and Aksu H
This research examined how the emotional temperaments of parents of children with attention deficit and hyperactivity disorder correlated with their perceptions of their children's social support from friends, teachers, and families. Additionally, the parents' emotional temperaments in terms of their association with children's low and high perceptions of family support were examined.
The Psychotherapy of Schizophrenia: A Review of the Evidence for Psychodynamic and Nonpsychodynamic Treatments
Ruffalo ML
Following the discovery of chlorpromazine's effectiveness as a treatment for schizophrenia in the 1950s, a gradual shift away from psychotherapeutic and toward biological methods of investigation has ensued. Nevertheless, psychological approaches to schizophrenia have a long history and continue to represent an important component of schizophrenia treatment. In the past 2 decades, there has been renewed interest in psychotherapy for schizophrenia among some clinicians and researchers. This article examines the current evidence for both psychodynamic and nonpsychodynamic (cognitive-behavioral, cognitive enhancement, and psychoeducational) therapies for schizophrenic illness. There is evidence to support the use of both types of therapies though these orientations generally differ in their views on the role of psychological factors in the etiology of schizophrenia. It is argued that a pluralistic or biopsychosocial model of schizophrenia is necessary to account for the complexity of the disease and to provide the most effective treatment.
Erythrocytic Reduced/Oxidized Glutathione and Serum Thiol/Disulfide Homeostasis in Patients with Opioid Use Disorder
Kabadayı Şahin E, Şenat A, Söğüt İ, Duymaz T and Erel Ö
This study aimed to evaluate oxidative damage by measuring erythrocytic reduced/oxidized glutathione as an intracellular thiol pool and serum thiol/disulfide homeostasis as an extracellular thiol pool in patients with opioid use disorder.
Adaptation of the Attitudes Toward Motherhood Scale to Turkish: Reliability and Validity Study
Şenyasar Meterelliyoz K, Yazar MS, Çobanoğlu Saf P and Saf C
The aim of this study is to investigate the validity and reliability of the Turkish version of the Attitudes Toward Motherhood Scale. Attitudes Toward Motherhood Scale was developed by Sockol et al to evaluate cognitive distortions and attitudes toward motherhood during pregnancy and the postpartum period.
Functional Impairments and Related Factors in Adolescents with Attention Deficit Hyperactivity Disorder During the COVID-19 Normalization Stage
Yıldırım Demirdöğen E, Akif Akıncı M, Bozkurt A, Çakır A and Tanrıverdi Ç
Attention deficit hyperactivity disorder is a disorder associated with significant functional impairments that can have important consequences for the individual and the society. Those with attention deficit hyperactivity disorder were reported to be more vulnerable in the face of difficulties and experience more psychological problems during the coronavirus disease 2019 pandemic. It was shown that the psychological problems experienced during the pandemic could persist during the normalization stage. We aimed to assess functional impairment in adolescents with attention deficit hyperactivity disorder and the related factors during the normalization stage which involved the initiation of fully face-to-face schooling practices.
Serum Zonulin and Claudin-5 but not Interferon-Gamma and Interleukin-17A Levels Increased in Children with Specific Learning Disorder: A Case-Control Study
Tanır Y, Cahid Örengül A, Esad Özdemir Y, Karayağmurlu A, Bilbay Kaynar T, Merve Baki A, Vural P and Coşkun M
Gut-blood and blood-brain barrier permeabilty (gut-brain axis) has been attracting increased attention in the etiology of neurodevelopmental disorders. In this study, we aimed to investigate serum levels of zonulin (a biomarker of intestinal permeability), claudin-5 (a biomarker of blood-brain barrier permeability), and interferon-gamma and interleukin-17A in children with specific learning disorder.
The Potential Use of Monocyte-to-High-Density Lipoprotein Ratio as a Chronic Inflammatory Marker in Major Depressive Disorder
Öztürk O, Doğru Balakbabalar AP, Okuyucu M and Göktepe ME
Monocytes secrete pro-inflammatory and pro-oxidant cytokines as part of inflammatory reactions. High-density lipoproteins have anti-inflammatory and antioxidant effects. This study investigated the potential use of the monocyte-to-high-density lipoprotein ratio in the follow-up of major depressive disorder.
Risk of Relapse Assessment Scale for Metamphetamine Abusers: Reliability and Validity Study of the Turkish Version
Turan Ç, Budak E, Şenormancı G, Evren C, Ünal S, Açıkgöz Yalçınkaya E and Senormanci Ö
This study aims to investigate the validity and reliability of the Turkish adaptation of the 16-item Risk of Relapse Assessment Scale (RRAS) for methamphetamine abusers.
Gray Matter Alterations in Panic Disorder: A Voxel-Wise Meta-Analysis
Pan A, Liu S, Hu S, Dai J and Yi J
Gray matter alterations play a role in the panic disorder's pathophysiology origin. However, the current literature seemed inadequate to reach a consistent conclusion. Therefore, we conducted this gray matter meta-analysis on panic disorder.
Satisfaction of Patients and Their Relatives Who Are Reminded of Their Appointments and Treatments with ""
Teksin MG, Karslıoğlu EH, Arıkoğlu Y and Çayköylü A
Community Mental Health Centers have been established in Turkey for patients with chronic psychiatric disorders actively engaged in treatment. The Treatment Collaboration Portal is a web-based voice response platform offered to Community Mental Health Centres to support the treatment compliance processes of patients. The Treatment Collaboration Portal automatically reminds patients or their families of injection treatments and psychiatry appointments at regular intervals. The purpose of this study is to determine the satisfaction of patients or their relatives enrolled in the Treatment Collaboration Portal and the reasons why.
The Development of Psychosis in Patients with Substance Use Disorder and Its Association with Cavum Septum Pellucidum and Adhesio Interthalamica
Ergül C, Aydın C, Shukurov B, Şalçini C, Tabak NA and Dilbaz N
It is known that there is a relationship between psychotic disorders and the presence of cerebral midline defects, such as the cavum septum pellucidum and the absence of adhesio interthalamica. This study aims to investigate whether these defects in people with alcohol/substance use disorders are associated with the occurrence and persistence of psychotic symptoms.
Life Chart of Substance Use Career: A Clinical Profile Study from Turkey
Guliyev C, Simsek M, Bezek-Dino S and Ogel K
The "career approach," developed to understand substance use and treatment, is important because it can broadly encompass the complexity of addiction patterns and help to better illustrate the chronic and recurrent nature, correlations, and consequences of addiction. The current study aimed to examine the substance use career and patterns of patients diagnosed with substance use disorder.
Turkish Adaptation, Validity, and Reliability Study of Shitsu-Taikan-Sho (Alexisomia) Scale
Aksu MH, Baltacı NN, Ekmekçi Ertek İ and Coşar B
The Shitsu-Taikan-Sho (Alexisomia) Scale is a self-report scale for measuring alexisomia, defined as the difficulty in awareness and expression of somatic emotions or feelings. The scale is available in Japanese and Finnish versions. This research aims to examine the psychometric properties of the Turkish version of the Shitsu-Taikan-Sho (Alexisomia) Scale.
Mechanisms in Emotional Information Processing in Individuals with Major Depressive Disorder: An Event-Related Potential Study of an Information Processing Model
Ahorsu DK, Chung KHM, Wong HH, Yiu MGC, Mok YF, Lei KS and Tsang HWH
Individuals with major depressive disorder have a cognitive bias toward emotional stimuli, which influences the quality and speed of emotional information processing. This study aimed to understand the factors underlying this bias by identifying when it occurs during information processing using an information processing model.
The Association Between Clozapine Plasma Concentration, CYP2D6 (*10, *2) Polymorphisms and Risk of Adverse Reactions
Qu K, Zhou Q, Zhu H, Zhou Z, Shen Y, Tian L and Su X
The aim of this article was to study the relationships between the risk of adverse reactions, plasma concentration, and cytochrome P450 2D6 rs1065852 (*10) and rs16947 (*2) polymorphisms for clozapine.
The Relationship Between Depression, Anxiety and Stress Levels on Suicidal Behavior in Patients with Schizophrenia
Taktak Ş and Seki Öz H
Suicide is a major public health problem, and most people, who attempt suicide, have a psychiatric disorder. The preventable nature of suicide has further warranted the conduct of studies on suicide.
Evaluation of Serum Complement Levels and Factors Affecting Treatment Resistance in Patients with Schizophrenia
Goker M, Aytac HM and Guclu O
There are increasing investigations about the potential role of the complement system in disorders affecting the central nervous system, including schizophrenia. Therefore, we aim to evaluate the levels of complement 3 and complement 4 and the factors affecting treatment resistance in schizophrenia patients.
The Relationship Between Suicidal Behavior, Neurocognitive Functions, and Insight in Patients with Schizophrenia
Calli SY, Fidan YS, Bestepe EE and Izci F
In schizophrenia, the relationship between suicide and cognition is unclear. We aimed to assess cognitive functions and insight in schizophrenia patients with and without suicide attempts.
Safe and Effective Use of Low-Dose Clozapine for Tardive Dyskinesia in a Patient with Schizophrenia and Comorbid Epilepsy: A Case Report
Selçuk M
Atypical antipsychotic clozapine has a special therapeutic impact on tardive dyskinesia and treatment-resistant schizophrenia. Clozapine also has important adverse effects such as epileptic seizures. For this reason, most clinicians avoid using clozapine in patients with schizophrenia and epilepsy. Therefore, treating patients with schizophrenia, tardive dyskinesia, and epilepsy is challenging. Here, we describe the case of a 32-year-old woman who was already suffering from epilepsy, schizophrenia, and tardive dyskinesia. She experienced clozapine-related seizures. But at the same time, clozapine dose adjustments successfully improved her psychosis and tardive dyskinesia and also stabilized her epilepsy. This case study indicates that epilepsy does not preclude the use of this important agent whenever it is clinically appropriate.
Resveratrol in Neurodegeneration, in Neurodegenerative Diseases, and in the Redox Biology of the Mitochondria
Danışman B, Ercan Kelek S and Aslan M
Neurodegeneration is a process leading to the progressive loss of structure and functions of neurons. Many neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and Huntington's disease have shown many common points at the subcellular level. Neurons are metabolically active cells and need a high amount of energy. Mitochondria are known as the energy synthesis center for cells, involved in the synthesis of adenosine triphosphate by oxidative phosphorylation. Rather than just being an energy synthesis center, it has critical importance for many cellular functions such as calcium homeostasis, cell proliferation, cell growth, and apoptosis. In the process of mitochondrial dysfunction, cellular functions are disrupted and cells enter the apoptotic or necrotic pathway. Resveratrol (trans-3,5,4-trihydoxystilbene), a plant-derived polyphenol found in the seed of grapes, berries, peanuts, and wine, has many biological effects such as inhibition of lipid peroxidation, scavenging of free radicals, changes in eicosanoid synthesis, inhibition of platelet aggregation, anti-inflammatory and anticancer activity, and regulation of lipid metabolism. Through the reviewed literature, the current study investigated the protective role of resveratrol in neurodegenerative diseases. Studies show that resveratrol moderates mitochondrial function, redox status, and cellular dynamics in both and experimental models of neurodegeneration. Resveratrol suppresses reactive oxygen species production by reducing the activity of complex III due to its competition effect with coenzyme Q. In the present work, we discussed the protective effects of resveratrol on neurodegeneration, neurodegenerative diseases, and the redox biology of the mitochondria.
Acute neuroendocrine changes after traumatic brain injury
Magyar-Sumegi ZD, Stankovics L, Lendvai-Emmert D, Czigler A, Hegedus E, Csendes M, Toth L, Ungvari Z, Buki A and Toth P
Post-traumatic hypopituitarism (PTHP) is a significant, but often neglected consequence of traumatic brain injury (TBI).
Eating Behaviors and Adiposity Indicators - Observations from the 2016/17 Examination of the Population Study of Women in Gothenburg
Mehlig K, Sliwa P, Blomstrand A, Farhan L, Hällström T and Hange D
To determine the cross-sectional association between eating behavior in terms of the three-factor eating questionnaire (TFEQ) and adiposity measures.
Artificial intelligence and future perspectives in Forensic Medicine: a systematic review
Volonnino G, De Paola L, Spadazzi F, Serri F, Ottaviani M, Zamponi MV, Arcangeli M and La Russa R
Artificial intelligence (AI) is the ability of a computer machine to display human capabilities such as reasoning, learning, planning, and creativity. Such processing technology receives the data (already prepared or collected), processes them, using models and algorithms, and answers questions about forecasting and decision-making. AI systems are also able to adapt their behavior by analyzing the effects of previous actions and working then autonomously. Artificial intelligence is already present in our lives, even if it often goes unnoticed (shopping networked, home automation, vehicles). Even in the medical field, artificial intelligence can be used to analyze large amounts of medical data and discover matches and patterns to improve diagnosis and prevention. In forensic medicine, the applications of AI are numerous and are becoming more and more valuable.
Evaluation of Genetic Variant and Its Lack of Association with Valproic Acid Plasma Concentrations Among Zhuang and Han Schizophrenia Patients in Guangxi
Teng JM, Qin S, Lu D, Gu Y, Tang SJ, Yan Q, Yao J and Zhang C
To investigate the genotype distribution and allelic frequency among the Zhuang and Han schizophrenic populations in Guangxi, examine the correlation between genetic variants and standardized blood levels of Valproic Acid (VPA) in schizophrenic patients, and evaluate the effects of age, gender, and Body Mass Index (BMI) on standardized VPA blood concentrations.
Real-time personalized feedback in mHealth for adolescents
Dietvorst E, Hillegers MH, Legerstee JS, Vries LP, Vreeker A and Keijsers L
Mobile Health (mHealth) interventions have the potential to improve early identification, prevention, and treatment of mental health problems. Grow It! is a multiplayer smartphone app designed for youth aged 12-25, allowing them to monitor their emotions and engage in daily challenges based on Cognitive Behavioral Therapy (CBT) principles. Recently, a personalized mood profile was added to improve the app. We investigated whether real-time personalized feedback on mood enhances app engagement, user experience, and the effects on affective and cognitive well-being. Sample A ( = 1269, age = 18.60 SD = 3.39, 80.6% girls, 95.4% Dutch) played the original app without feedback on their mood, and an independent Sample B ( = 386, age = 16.04 SD = 3.21, 67.6% girls, 82.9% Dutch) received the renewed version with personalized real-time feedback on their mood. Participants who received personal feedback did not have higher app engagement ((1750,400) = 1.39, = .206,  = 0.07; (692,905) = 0.36, = .971,  = 0.0) nor higher user experience ((177,596) = 0.21, = .831,  = 0.02; ((794) = 1.28, = .202,  = 0.12; χ (659,141) = 2.83, = .091). Players of the renewed version (Sample B) experienced significant improvements in affective ((175) = 3.01, .003,  = 0.23) and cognitive well-being ((175) = 3.48, = <.001,  = 0.26) over the course of three weeks. The renewed version Grow It! has the potential to enhance youths' affective and cognitive well-being. However, adding real-time insights did not seem to affect app engagement nor user experience.
Acupuncture therapy on myofascial pain syndrome: a systematic review and meta-analysis
Xiong J, Zhou X, Luo X, Gong X, Jiang L, Luo Q, Zhang S, Jiang C, Pu T, Liu J, Zhang J, Li B and Chi H
Traditional Chinese medicine (TCM) therapies, especially acupuncture, have received increasing attention in the field of pain management. This meta-analysis evaluated the effectiveness of acupuncture in the treatment of myofascial pain syndrome.
Trust performance in managing inflammatory arthritis over time in England and Wales: a latent class analysis approach
Yang Z, Arumalla N, Alveyn E, Gallagher S, Price E, Russell MD, Bechman K, Norton S and Galloway J
To evaluate trust-level performance in time to initiation of DMARD therapy in patients with early inflammatory arthritis (EIA), with identification of the change in performance trajectories over time and investigation of trust characteristics associated with this change.
Defining the Effects of PKC Modulator HIV Latency-Reversing Agents on Natural Killer Cells
Dimapasoc M, Moran JA, Cole SW, Ranjan A, Hourani R, Kim JT, Wender PA, Marsden MD and Zack JA
Latency reversing agents (LRAs) such as protein kinase C (PKC) modulators can reduce rebound-competent HIV reservoirs in small animal models. Furthermore, administration of natural killer (NK) cells following LRA treatment improves this reservoir reduction. It is currently unknown why the combination of a PKC modulator and NK cells is so potent and whether exposure to PKC modulators may augment NK cell function in some way.
Data leakage in deep learning studies of translational EEG
Brookshire G, Kasper J, Blauch NM, Wu YC, Glatt R, Merrill DA, Gerrol S, Yoder KJ, Quirk C and Lucero C
A growing number of studies apply deep neural networks (DNNs) to recordings of human electroencephalography (EEG) to identify a range of disorders. In many studies, EEG recordings are split into segments, and each segment is randomly assigned to the training or test set. As a consequence, data from individual subjects appears in both the training and the test set. Could high test-set accuracy reflect data leakage from subject-specific patterns in the data, rather than patterns that identify a disease? We address this question by testing the performance of DNN classifiers using segment-based holdout (in which segments from one subject can appear in both the training and test set), and comparing this to their performance using subject-based holdout (where all segments from one subject appear exclusively in either the training set or the test set). In two datasets (one classifying Alzheimer's disease, and the other classifying epileptic seizures), we find that performance on previously-unseen subjects is strongly overestimated when models are trained using segment-based holdout. Finally, we survey the literature and find that the majority of translational DNN-EEG studies use segment-based holdout. Most published DNN-EEG studies may dramatically overestimate their classification performance on new subjects.
An observational study to evaluate the awareness of drug treatment, prescription pattern, adverse drug reactions, and adherence in patients of major depressive disorder
Parmar UI, Puradkar P, Kadam K, Tadavi F, Gajbhiye S, Joshi S and Sohal A
Due to the paucity of studies in and out of India that dealt with treatment awareness of major depressive disorder (MDD), we decided to assess the awareness of MDD patients, and since adherence and awareness are linked to each other, we assessed adherence too. Prescription pattern studies identify changes in prescriptions due to poor initial response or adverse drug reactions (ADRs), which may result in dose reduction or switching medications and delay remission. Therefore, the study assessed the ADR pattern.
Frailty and poor physical functioning as risk factors for driving cessation
Mielenz TJ, Jia H, DiGuiseppi CG, Strogatz D, Andrews HF, Molnar LJ, Eby DW, Hill LL and Li G
Frailty and low physical performance are modifiable factors and, therefore, targets for interventions aimed at delaying driving cessation (DC). The objective was to determine the impact of frailty and physical performance on DC.
Health service providers experience of psycho-emotional violence and associated factors among urban hospitals in Eastern Ethiopia
Tolera A, Weldesenbet AB, Regassa LD, Tusa BS, Merga BT, Tariku M, Cheru A, Enyew DB and Gemeda AT
Psycho-emotional violence, a type of workplace violence targeting healthcare workers, varies across countries, occasions, and professions in the healthcare sector. Unfortunately, there is a scarcity of comprehensive studies focusing on violence against healthcare workers in Ethiopia, which may also encompass psycho-gender-based emotional violence against healthcare workers. Therefore, there is a compelling need for in-depth research to address this gap and develop effective strategies to mitigate psycho-emotional violence in the healthcare sector in Ethiopia, especially in the eastern region. Hence, we aimed to identify the prevalence of and factors associated with workplace psycho-emotional violence against healthcare providers in eastern Ethiopia.
yale psychiatry/wpbmb]

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