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The biological mechanisms underlying the onset of major depressive disorder (MDD) have predominantly been studied in adult populations from high-income countries, despite the onset of depression typically occurring in adolescence and the majority of the world's adolescents living in low- and middle-income countries (LMIC). Taking advantage of a unique adolescent sample in an LMIC (Brazil), this study aimed to identify biological pathways characterizing the presence and increased risk of depression in adolescence, and sex-specific differences in such biological signatures. We collected blood samples from a risk-stratified cohort of 150 Brazilian adolescents (aged 14-16 years old) comprising 50 adolescents with MDD, 50 adolescents at high risk of developing MDD but without current MDD, and 50 adolescents at low risk of developing MDD and without MDD (25 females and 25 males in each group). We conducted RNA-Seq and pathway analysis on whole blood. Inflammatory-related biological pathways, such as role of hypercytokinemia/hyperchemokinemia in the pathogenesis of influenza (z-score = 3.464, p

Background: Adverse childhood experiences (ACEs) are well‐established risk factors for self‐harm and depression. However, despite their high comorbidity, there has been little focus on the impact of developmental timing and the duration of exposure to ACEs on co‐occurring self‐harm and depression. Methods: Data were utilised from over 22,000 children and adolescents participating in three UK cohorts, followed up longitudinally for 14–18 years: the Avon Longitudinal Study of Parents and Children (ALSPAC), the Millennium Cohort Study (MCS) and the Environmental Risk (E‐Risk) Longitudinal Twin Study. Multinomial logistic regression models estimated associations between each ACE type and a four‐category outcome: no self‐harm or depression, self‐harm alone, depression alone and self‐harm with co‐occurring depression. A structured life course modelling approach was used to examine whether the accumulation (duration) of exposure to each ACE, or a critical period (timing of ACEs) had the strongest effects on self‐harm and depression in adolescence. Results: The majority of ACEs were associated with co‐occurring self‐harm and depression, with consistent findings across cohorts. The importance of timing and duration of ACEs differed across ACEs and across cohorts. For parental mental health problems, longer duration of exposure was strongly associated with co‐occurring self‐harm and depression in both ALSPAC (adjusted OR: 1.18, 95% CI: 1.10–1.25) and MCS (1.18, 1.11–1.26) cohorts. For other ACEs in ALSPAC, exposure in middle childhood was most strongly associated with co‐occurring self‐harm and depression, and ACE occurrence in early childhood and adolescence was more important in the MCS. Conclusions: Efforts to mitigate the impact of ACEs should start in early life with continued support throughout childhood, to prevent long‐term exposure to ACEs contributing to risk of self‐harm and depression in adolescence. [ABSTRACT FROM AUTHOR]

Objectives: Research indicates psychologists typically lack subjective understanding of voice hearing. Voice hearing simulation training has potential to improve understanding, empathy and confidence among clinicians, but psychologists have had limited input into its development. This study investigated psychologists' and a psychotherapist's clinical experience of working with people who hear voices and their views and recommendations for voice hearing simulation training. Design: This was a qualitative study. Methods: Clinical psychologists and one psychotherapist (N = 17) participated in semi‐structured interviews. Thematic analysis was used to analyse transcribed data. Results: The Clinical Experience theme comprised of subthemes Barriers to engagement, Diversity of voice hearing experiences, Lack of subjective understanding, Curiosity about voice hearing, Empathy for voice hearers, Using personal experiences to relate to voices, Clinical experience increases knowledge, Importance of supervision and colleague's support, Benefits of experiential training, Limited training in non‐psychosis settings and Clinical experience increases confidence. The Views on Voice Hearing Simulation Training theme comprised of subthemes Improves subjective understanding, Concern about distress, Discomfort as a strength of voice hearing simulations, Artificiality of simulation, Increases empathy and Over‐estimation of understanding. The Recommendations theme comprised of subthemes Discuss artificiality, Co‐production, Promote voice diversity, Support staff and Maximise inclusivity. Conclusions: Findings indicate that clinical experience improves psychologists' confidence and knowledge, yet participants reported a lack of subjective understanding of voice hearing. Co‐produced simulation training between individuals who hear voices and clinicians was anticipated to improve subjective understanding, empathy and therapeutic relationships, which could support a range of staff and improve quality of care delivered. [ABSTRACT FROM AUTHOR]

Background During the last decades, an abundance of studies has investigated childhood adversity in relation to psychosis. This systematic review critically examines the methodologies employed to investigate childhood adversity in psychosis over the past decade, including operational definitions, measurement tools and characteristics, and psychometric properties of instruments used in these studies. Study Design This systematic review followed the PRISMA guidelines (registration number CRD42022307096), and the search used the following electronic databases: PsychINFO, SCOPUS, Web of Science, African Index Medicus (AIM), LILACS, CINAHL, EMBASE, and MEDLINE. The search included variations and combinations of the terms targeting childhood adversity and psychosis. Study Results Out of 585 identified studies published between 2010 and 2023, 341 employed a validated instrument to investigate childhood adversity. Our findings show "childhood trauma" being the most frequently examined construct, followed by "child maltreatment" or "child abuse." The short version of the Childhood Trauma Questionnaire was the dominant instrument. Physical abuse, emotional abuse, and sexual abuse were most frequently investigated, and indeed the field appears generally to focus on child abuse and neglect over other adversities. Significant psychometric heterogeneity was observed in the selection and summarization of instrument items, with only 59% of studies documenting original psychometric validation and 22% reporting reliability in their datasets. Conclusion This review highlights substantial methodological heterogeneity in the field, pointing out biases in the research on childhood adversity and psychosis. These findings underline the need for standardized definitions and high-quality measurement tools to enhance the validity of future research in this area. [ABSTRACT FROM AUTHOR]

COVID-19 presented significant challenges to psychiatric staff, while social distancing and remote working necessitated digital communications. NHS England prioritised staff wellbeing. Arts-based creativity interventions appear to improve psychological wellbeing, so this study evaluated online Creativity Workshops as a staff support response for COVID-19-related stress. Participants were staff from a South London NHS psychiatric hospital. Group Creativity Workshops were facilitated via Microsoft Teams. Acceptability data on pre- and post-workshop mood and attitudes were self-reported by participants. Feasibility data were gathered from adherence to number of workshop components delivered. Eight workshops were delivered in May-September 2020 (N = 55) with high adherence to components. Participants reported significantly increased positive mood and attitudes towards themselves and others; and decreased stress and anxiety. Online Creativity Workshops appear feasible and acceptable in reducing stress in psychiatric staff. Integrating a programme of Creativity Workshops within healthcare staff support may benefit staff wellbeing. [ABSTRACT FROM AUTHOR]

Research into clinical applications of speech-based emotion recognition (SER) technologies has been steadily increasing over the past few years. One such potential application is the automatic recognition of expressed emotion (EE) components within family environments. The identification of EE is highly important as they have been linked with a range of adverse life events. Manual coding of these events requires time-consuming specialist training, amplifying the need for automated approaches. Herein we describe an automated machine learning approach for determining the degree of warmth, a key component of EE, from acoustic and text natural language features. Our dataset of 52 recorded interviews is taken from recordings, collected over 20 years ago, from a nationally representative birth cohort of British twin children, and was manually coded for EE by two researchers (inter-rater reliability 0.84–0.90). We demonstrate that the degree of warmth can be predicted with an F1-score of 64.7% despite working with audio recordings of highly variable quality. Our highly promising results suggest that machine learning may be able to assist in the coding of EE in the near future. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Adverse childhood experiences (ACEs) are associated with mental health problems, but many children who experience ACEs do not develop such difficulties. A warm and supportive adult presence in childhood is associated with a lower likelihood of developing mental health problems after exposure to ACEs. However, it is unclear whether this association is causal, as previous research has not accounted for genetic and environmental confounding.We used the twin‐difference design to strengthen causal inference about whether a warm and supportive adult presence protects children exposed to ACEs from mental health problems. Participants were from the Environmental Risk (E‐Risk) Longitudinal Twin Study, a UK population‐representative birth cohort of 2,232 same‐sex twins. ACEs were measured prospectively from ages 5 to 12. Maternal warmth was assessed at ages 5 and 10 through maternal speech samples. Adult support was assessed through child reports at age 12. Mental health problems were assessed through interviews at age 12 with parents and teachers and participants at age 18.Among children exposed to ACEs, those who experienced greater maternal warmth and adult support had lower levels of mental health problems at ages 12 and 18. In monozygotic twin‐difference analyses, the protective effects of maternal warmth and adult support on mental health were attenuated by 70% for maternal warmth and 81% for adult support, compared to phenotypic analyses. Twins who experienced greater maternal warmth and adult support had minimal or no difference in mental health compared to their co‐twins, concordant for ACE exposure.The apparent protective effect of a warm, supportive adult against mental health problems following ACEs is largely explained by genetic and environmental confounding. This suggests that interventions which boost maternal warmth and adult support should be supplemented by components addressing wider family environments and heritable vulnerabilities in children exposed to adversity, to improve mental health. [ABSTRACT FROM AUTHOR]

Objective: Although there is a general perception that adolescent social media use is a global phenomenon, there is a scarcity of data on patterns and preferences of social media use among youth in low- and middle-income countries (LMICs). We here describe self-reported prevalence and perceived effects of social media use in a school-based sample of Brazilian adolescents., Methods: We analyzed cross-sectional data on 7,113 adolescents aged 14 to 16 years enrolled at 101 public state schools between 2018 and 2019 in Porto Alegre, state of Rio Grande do Sul, Brazil., Results: Of the 7,113 adolescents with complete data for analyses, 54.9% were female, and 60.6% reported their skin color as white. At least one social media platform was used by 97.7% of adolescents every day, and 64.7% reported being online "almost constantly." YouTube and WhatsApp were the most popular platforms. Most participants perceived the effect on their lives of social media use as neutral., Conclusion: The pattern of social media use by adolescents in Porto Alegre, Brazil, is similar to that reported for samples from high income countries. Also, we found that those who reported being constantly online were also more likely to report socializing with their friends offline., Competing Interests: No conflicts of interest declared concerning the publication of this article.