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While tobacco products (such as combustible cigarettes and nicotine vaping products) and cannabis use rates remain high in the general United States (U.S.) population, veterans from the conflicts in Iraq and Afghanistan (i.e., OEF/OIF veterans) are at high risk of high rates of cannabis and tobacco use. Co-use of tobacco and cannabis (i.e., using both substances within a specified period of time or combining the drugs within the same device for use) is of growing prevalence in the U.S. However, little is understood about the prevalence rates of tobacco and cannabis co-use among U.S. veterans and its associations with mental health symptomology. The current study conducted a preliminary analysis of co-use patterns of tobacco and cannabis and associated mental health outcomes among a sample of Iraq/Afghanistan (i.e. OEF/OIF) veterans (N= 1,230). Results indicated high rates of lifetime and past 30-day use of both substances. Past 30-day co-users endorsed significantly higher levels of stress, PTSD, depression, and anxiety compared to singular product users. Results suggest that the addition of cannabis use in conjunction with tobacco use may be associated with greater mental health symptoms among veterans. Findings indicate veteran tobacco and cannabis co-users may benefit from mental health care to help mitigate poor mental health symptoms.

Introduction: Clinical trials remain the gold standard for evaluating efficacy, but there is increasing interest in using real-world evidence (RWE) to inform health care decision making. The aims of this observational study were to describe patterns of medical cannabis use, associated changes in symptom severity over time, and to evaluate change in cannabis dose over time for pain-related symptoms. Methods: Data were collected by Strainprint™, an application that is HIPAA, PIPEDA, and PHIPA compliant. A total of 629 participants recorded data between May 2017 and August 2019. A total of 65 symptoms were grouped as Pain, Mental Health, Physical Symptoms, Seizures, Headaches/Migraines, and Other. Descriptive statistics and mixed-effects modeling were applied. Results: THC-dominant products were more frequently consumed for symptoms of pain and sleep, while CBD-dominant products were more frequently consumed for anxiety and depression. Male and female participants demonstrated significant differences in the type of cannabis they consumed. Females more frequently consumed CBD-dominant products, and males more frequently consumed balanced (THC:CBD) products. Oil use was more prominent among females, while vaping was more common among males. Product use also varied by age tertiles ( 40 years). CBD-dominant products were more common among younger participants, 41 years. Dosages of CBD-dominant and balanced (THC:CBD) products increased over time irrespective of symptom response. THC-dominant products demonstrated a significant relationship between dose and symptom reduction over time. Conclusions: Recognizing that RWE has important methodological limitations, we observed cannabis product preferences based on demographic characteristics, such as gender and age and the primary symptom treated such as pain and anxiety. Our study offers real-world insights into how participants use and respond to cannabis products and suggests important avenues and methodologies for future research.

Introduction: Among adolescents and young adults, cannabis use is prevalent. Prior studies characterizing withdrawal effects in this age range have primarily included treatment seeking or comorbid ...

Cardiovascular complications from drugs of abuse are becoming more apparent because of increased usage worldwide. Substance abuse can cause acute and chronic cardiovascular complications and is increasing in prevalence especially in young adults. These substances contribute to the development of acute coronary syndrome, type 2 myocardial injury, arrhythmias, and cardiomyopathies, and have numerous other cardiovascular complications. Although no screening guidelines exist, clinical awareness of these potential complications and their prevention, clinical presentation, diagnosis, and treatment are critically important. Management of cardiovascular disease should be coupled with appropriate social and mental health interventions to provide sustained clinical benefit. The higher the number of substances used recreationally, the greater the risk of premature heart disease. Epidemiological studies showed that 1 in 5 young adults misuse several substances and often start using at younger ages with a greater risk for adverse health outcomes over the long term. The aim of this review is to highlight the basic epidemiology, cardiac complications, and disease-specific treatment options of commonly abused substances including methamphetamine, cocaine, alcohol, anabolic-androgenic steroids, cannabis, and tobacco.

Objectives: To characterize attitudes and perceptions regarding risks and benefits of cannabis before Canadian legalization for recreational use, both in general and between cannabis users and nonusers. Methods: A cross-sectional sample of community adults assessed in the month before legalization (September 17 to October 17, 2018). Overall, 1,480 individuals (60% female) of an average age of 34.5 years (±13.92) were included in the analysis; 48% reported cannabis use in the past 6 months. Attitudes and perceptions were assessed using a subset of items from the Canadian Cannabis Survey, the National Survey on Drug Use and Health, and the Risks and Benefits of Cannabis Use. Results: Most commonly identified risks of cannabis were impaired memory (67%) and legal problems (54%). Most also identified addiction as a risk (52%), although 25% reported that cannabis was not addictive. The most commonly identified benefits were for pain relief (94%) and management of stress, anxiety, or depression (80%). Active cannabis users systematically reported lower endorsement of risks and higher endorsement of benefits. Only 6% of respondents anticipated increasing cannabis use postlegalization. Among other legal substances, medical cannabis was considered the most socially acceptable, followed by alcohol, recreational cannabis, electronic cigarettes, and then combustible cigarettes. Conclusion: Before legalization, attitudes toward cannabis in this sample of Canadian adults were generally favorable, particularly for medical cannabis. Perceptions of risk were often compatible with existing evidence, but notable proportions underendorsed risk of cannabis use disorder and overendorsed benefits for mental health. These results suggest priorities for public health messaging and provide benchmarks for understanding attitudinal changes postlegalization.

OBJECTIVE: The current study examined daily associations between mental health symptoms (i.e., depression and anxiety symptoms) and simultaneous alcohol and marijuana (SAM) use and use-related negative consequences among young adults. METHOD: Participants were a community sample of 409 young adults between the ages of 18–25 who drank alcohol at least three times in the past month and reported SAM use in the past month (M(age) = 21.6, 50.9% female). A baseline assessment included a measure of SAM use motives, after which participants completed five 14-day bursts reporting daily mental health symptoms, and alcohol/marijuana use. RESULTS: Daily mental health symptoms were not associated with SAM use likelihood. However, baseline SAM coping motives moderated the association between mental health symptoms and use such that young adults with stronger coping motives showed a stronger positive association between mental health symptoms and SAM use. Further, on SAM use days, reporting more mental health symptoms relative to one’s average was associated with experiencing more use-related negative consequences, even after controlling for daily levels of alcohol and marijuana use (RR = 1.03, 95% CI = 1.01–1.05, p = .002). CONCLUSIONS: The association between daily mental health symptoms and SAM use depended on whether the young adults had coping motives for use. Daily fluctuations in mental health were associated with negative use-related consequences experienced on SAM use days regardless of motives. These findings highlight the potential importance of prevention and intervention strategies particularly on days when young adults are experiencing increased mental health symptoms. IMPACT STATEMENT: This study documented that mental health symptoms (i.e., symptoms of depression and anxiety) on a given day were associated with simultaneous alcohol and marijuana (SAM) use that day only for young adults with stronger baseline SAM coping motives. On SAM use days, greater mental health symptoms were associated with more negative consequences, regardless of motives for use. Elevated mental health symptoms on a given day are an indicator of substance use related risk.

Background Subcortical brain structures play a key role in pathological processes of age-related neurodegenerative disorders. Mounting evidence also suggests that early-life factors may have an impact on the development of common late-life neurological diseases, including genetic factors that can influence both brain maturation and neurodegeneration. Methods Using large population-based brain imaging datasets across the lifespan (N 40,628) we aimed to: (i) estimate the heritability of subcortical volumes in young ( 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ), middle (35-65), and older age (65+), and their genetic correlation across age groups; (ii) identify whether genetic loci associated with subcortical volumes in older persons also show associations in early adulthood, and explore underlying genes using transcriptome-wide association studies; (iii) explore their association with neurological phenotypes. Results Heritability of subcortical volumes consistently decreased with increasing age. Genetic risk scores for smaller caudate nucleus, putamen and hippocampus volume in older adults were associated with smaller volumes in young adults. Individually, ten loci associated with subcortical volumes in older adults also showed associations in young adults. Within these loci, transcriptome-wide association studies showed that expression of several genes in brain tissues (especially MYLK2 and TUFM) was associated with subcortical volumes in both age-groups. One risk variant for smaller caudate nucleus volume (TUFM locus) was associated with lower cognitive performance. Genetically-predicted Alzheimer’s disease was associated with smaller subcortical volumes in middle and older age. Conclusions Our findings provide novel insights into the genetic determinants of subcortical volumes across the lifespan. More studies are needed to decipher the underlying biology and clinical impact.

Objectives To assess the burden of hospitalizations due to cannabis harms in Ontario, Canada before Canada's legalization of nonmedical cannabis. Methods We conducted a retrospective population-level study that included all individuals living in Ontario between 2003 and 2017. We described patterns of hospitalizations due to cannabis harms in men and women by demographics, socioeconomic factors, and mental health comorbidities. We calculated annual crude rates of hospitalizations due to cannabis harms and assessed time trends using Poisson regression models. Results There were 39,092 hospitalizations due to cannabis harms among 32,811 unique individuals. Annual hospitalizations due to a cannabis harm increased by 280% between 2003 and 2017 (1712 vs 4730), with increases noted for all age groups and sexes. Rates of hospitalizations due to cannabis harms were greater in young adults, low-income individuals, and those with mental health comorbidities. Overall, the rate of hospitalizations due to cannabis harms increased on average by 7.8% per year (95% CI 7.5-8.0). Women aged 15 to 24 experienced the largest average annual increase (12.2% per year, 95% CI 11.5 to 12.8). Conclusions There are distinct patterns of hospitalizations due to cannabis harms in different priority populations. Young women aged 15 to 24 are a key demographic that is disproportionately burdened with a rapid increase in hospitalizations due to cannabis harms. Jurisdictions considering new approaches to cannabis control policy and addiction services should consider the rising burden of harms faced by youth and young adults when planning interventions.

Insomnia is a common, impairing, and difficult-to-treat comorbidity in children with neurodevelopmental disorders (NDDs). Behavioral interventions can be challenging because of developmental and behavioral features that interfere with treatment. Medication management also can be difficult due to a high burden of side effects, a high rate of paradoxical responses, and frequent treatment resistance. Therefore, new treatment options for insomnia in children with NDDs are needed. Dual orexin receptor antagonists (DORAs) are a relatively new class of pharmacotherapeutics that induce sleep by inhibiting the orexin signaling pathway. To date, there is little safety or efficacy data on the use of DORAs in children with NDDs. We present four patients with NDDs and insomnia that we treated with the DORA, suvorexant. We found that patients had a wide range of responses, with one patient displaying a robust improvement in sleep onset and maintenance, while another had significant improvement in insomnia symptoms on combination therapy with trazodone. Our final two patients had mild or no benefit from suvorexant therapy. Further research is necessary to establish the safety and efficacy of DORAs in this population and to identify predictive factors, such as specific neurogenetic diagnoses or clinical features, of a positive treatment response.

Author(s): Srivastava, Akanksha; Miller, Alexandria N; Coles, Mandy S; Brigham, Rebecca; Peterson, Erin R; Kreida, Ellen; Mueser, Kim T; Ng, Lauren C

The role of central estrogen in cognitive, metabolic, and reproductive health has long fascinated the lay public and scientists alike. In the last two decades, insight into estrogen signaling in the brain and its impact on female physiology is beginning to catch up with the vast information already established for its actions on peripheral tissues. Using newer methods to manipulate estrogen signaling in hormone-sensitive brain regions, neuroscientists are now identifying the molecular pathways and neuronal subtypes required to establish crucial sex differences in energy allocation. However, the immense cellular complexity of these hormone-sensitive brain regions makes it clear that more research is needed to fully appreciate how estrogen modulates neural circuits to regulate physiological and behavioral end points. Such insight is essential for understanding how natural or drug-induced hormone fluctuations across lifespan affect women's health. Expected final online publication date for the Annual Review of Physiology, Volume 84 is February 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Left–right asymmetry of the human brain is one of its cardinal features, and also a complex, multivariate trait. Decades of research have suggested that brain asymmetry may be altered in psychiatric disorders. However, findings have been inconsistent and often based on small sample sizes. There are also open questions surrounding which structures are asymmetrical on average in the healthy population, and how variability in brain asymmetry relates to basic biological variables such as age and sex. Over the last 4 years, the ENIGMA‐Laterality Working Group has published six studies of gray matter morphological asymmetry based on total sample sizes from roughly 3,500 to 17,000 individuals, which were between one and two orders of magnitude larger than those published in previous decades. A population‐level mapping of average asymmetry was achieved, including an intriguing fronto‐occipital gradient of cortical thickness asymmetry in healthy brains. ENIGMA's multi‐dataset approach also supported an empirical illustration of reproducibility of hemispheric differences across datasets. Effect sizes were estimated for gray matter asymmetry based on large, international, samples in relation to age, sex, handedness, and brain volume, as well as for three psychiatric disorders: autism spectrum disorder was associated with subtly reduced asymmetry of cortical thickness at regions spread widely over the cortex; pediatric obsessive–compulsive disorder was associated with altered subcortical asymmetry; major depressive disorder was not significantly associated with changes of asymmetry. Ongoing studies are examining brain asymmetry in other disorders. Moreover, a groundwork has been laid for possibly identifying shared genetic contributions to brain asymmetry and disorders., Left–right asymmetry of the human brain is one of its cardinal features, and also a complex, multivariate trait. Over the last four years, the ENIGMA‐Laterality Working Group has published six studies of grey matter morphological asymmetry in health and disease, based on total sample sizes from roughly 3,500 to 17,000 individuals, which were between one and two orders of magnitude larger than those published in previous decades. Here we review the findings from these six studies.

Non-human primate (NHP) models are essential for developing and translating new treatments that target neural circuit dysfunction underlying human psychopathology. As a proof-of-concept for treating neuropsychiatric disorders, we used a NHP model of pathological anxiety to investigate the feasibility of decreasing anxiety by chemogenetically (DREADDs [designer receptors exclusively activated by designer drugs]) reducing amygdala neuronal activity. Intraoperative MRI surgery was used to infect dorsal amygdala neurons with AAV5-hSyn-HA-hM4Di in young rhesus monkeys. Invivo microPET studies with [11C]-deschloroclozapine and postmortem autoradiography with [3H]-clozapine demonstrated selective hM4Di binding in the amygdala, and neuronal expression of hM4Di was confirmed with immunohistochemistry. Additionally, because of its high affinity for DREADDs, and its approved use in humans, we developed an individualized, low-dose clozapine administration strategy to induce DREADD-mediated amygdala inhibition. Compared to controls, clozapine selectively decreased anxiety-related freezing behavior in the human intruder paradigm in hM4Di-expressing monkeys, while coo vocalizations and locomotion were unaffected. These results are an important step in establishing chemogenetic strategies for patients with refractory neuropsychiatric disorders in which amygdala alterations are central to disease pathophysiology.

The declaration of coronavirus disease 2019 (COVID-19) as a pandemic led to the closures of schools worldwide to contain disease spread. In the present study, we examine the effects of this mandated homeschooling on parents’ mental health and substance use. In a study of 758 couples, 211 of whom were homeschooling, we contrasted homeschooling effects on general mental health (anxiety and depression) and on COVID-specific mental health (socioeconomic and traumatic stress), and on optimism. We also examined effects on coping-related use of alcohol and cannabis. Actor–partner interdependence model results demonstrated negative impacts of mandatory homeschooling;there were significantly lower levels of optimism and greater use of cannabis to cope and marginally higher use of alcohol to cope in couples who were versus were not homeschooling. These levels were higher than prepandemic norms. We then explored the parenting dynamic through actor and partner effects. Among homeschooling families, more time spent homeschooling was associated with increased anxiety, depression, and COVID-19-specific socioeconomic and traumatic stress in the homeschooling parent;for the homeschooler’s partner, there was significantly increased alcohol use to cope and marginally increased traumatic stress. These findings highlight the need for the design and delivery of educational and mental health supports for parents during mandatory homeschooling required for COVID-19 and other pandemics—so that parents can best support their families through these uncertain times. (PsycInfo Database Record (c) 2021 APA, all rights reserved) © 2021 American Psychological Association

Adolescent cannabis use is associated with adverse health outcomes. The impact of cannabis legalization on adolescent cannabis-related hospitalizations remains unknown. We sought to assess whether state cannabis legalization is associated with adolescent cannabis-related hospitalizations.We conducted a retrospective cohort study of adolescent (11-17 years) hospitalizations at children's hospitals between January 1, 2008 and December 31, 2019 using the Inpatient Essentials database. We investigated differences in adolescent cannabis-related diagnosis during a hospitalization by state cannabis legalization status, including states with no legal use to medical cannabis laws (MCLs) and states with MCLs to nonmedical (21 years old) cannabis laws (NMCLs).Of 1,898,432 adolescent hospitalizations in 18 states and Washington, DC, there were 37,562 (2%) hospitalizations with a cannabis-related diagnosis, with 8,457 (23%) in states with no legal use, 20,444 (54%) in MCL states, and 8,661 (23%) in NMCL states. There was an increase in adjusted odds of a cannabis-related hospitalization in MCL (odds ratio 1.05, 95% confidence interval 1.04-1.06) and NMCL states (odds ratio 1.03, 95% confidence interval 1.02-1.03) between 2008 and 2019. Characteristics associated with the greatest increase in adjusted odds of a cannabis-related hospitalization postpolicy change included adolescents without an underlying mental health or other substance use disorder in MCL and NMCL states (p.001) and younger age in NMCL states (13 vs. 16 and 17 years old, p = .02 and p = .02).Cannabis-related adolescent hospitalizations at children's hospitals are increasing, with a disproportionate increase postlegalization in states with NMCLs. Interventions are warranted to increase cannabis use identification and treatment among at-risk adolescents in the hospital-based setting.

Objective Burnout is experienced by up to two thirds of neurosurgery residents. Team sport participation as an adolescent protects against adverse mental health outcomes in adulthood. The objective of this study was to determine whether high school or collegiate team sport participation is associated with improved psychological well-being during neurosurgery residency. Methods A cross-sectional survey study of U.S. neurosurgery residents was conducted between June 2020 and February 2021. Outcomes included self-ratings of sadness, anxiety, stress, burnout, optimism, and fulfillment, on 100-point scales, which were averaged into a “Burnout Composite Score” (BCS). Respondents were grouped and compared according to their prior self-reported participation in team sports (participants vs. nonparticipants). A 3-way analysis of variance tested the effects of resident level, exercise days, and team sport participation on BCS. Results Of 229 submitted responses, 228 (99.5%) provided complete data and 185 (81.1%) residents participated in team sports. Days/week of exercise was similar across groups (2.5 ± 1.8 vs. 2.1 ± 1.8, P = 0.20). The team sport group reported lower mean BCS (37.1 vs. 43.6 P = 0.030, Cohen d = 0.369). There was a significant interaction between prior team sport participation and exercise regimen on BCS (F [3, 211] = 3.39, P = 0.019, n2 = 0.046), such that more exercise days per week was associated with decreased BCS for prior team sport athletes (F [3, 211] = 11.10, P Conclusions Prior team sport participation was associated with lower BCS among neurosurgery residents, an effect more pronounced during senior residency. Lessons imparted during early team sport experience may have profound impacts on reducing burnout throughout a 7-year neurosurgery residency.

Researchers have raised concerns about mental health in elite athletes, including problem gambling, where research hitherto is scarce. While gambling has been assessed in the younger student-athlete population, neither gambling nor the recently recognized behavioral addiction of gaming disorder has been sufficiently addressed in the elite athlete population. The present systematic literature review aimed to summarize research knowledge on the prevalence and correlates of problem gambling and problem gaming in elite athletes. Research papers were searched systematically using the Scopus, PsycINFO, and PubMed/MEDLINE databases and evaluated following a PRISMA paradigm. For the elite athlete population, eight reports on problem gambling and one report on problem gaming were found. While at least five papers indicated an increased risk of problem gambling in elite athletes compared to the general population, one study from Australia indicated the opposite. Problem gambling was generally more common in male athletes. Knowledge of problem gaming prevalence is thus far limited. It is concluded that increased research in problem gambling and problem gaming in elite athletes is warranted.

Changes in exercise behavior and negative emotional states (i.e., depression, anxiety, and stress) in combat sport (e.g., boxing, wrestling, martial arts) athletes were examined the month prior to gym closures related to the COVID-19 pandemic (February 2020), and approximately 1 month following gym closures (May 2020). A total of 312 combat sport athletes from 33 different countries responded to the study solicitation. Results indicated a significant decrease in combat sport training following gym closures; however, participation in other exercise activities did not significantly change. Significant mean increases in depression, anxiety, and stress were found following combat gym closures. Regression analyses revealed that number of hours of participants participated in combat sport training added significant incremental variance explained in depressive and stress symptoms above and beyond that accounted for by sex differences, preexisting conditions, and training level. Practical implications regarding losses to preferred exercise activities are discussed.

The mechanistic underpinnings of autism remain a subject of debate and controversy. Why do individuals with autism share an overlapping set of atypical behaviors and symptoms, despite having different genetic and environmental risk factors? A major challenge in developing new therapies for autism has been the inability to identify convergent neural phenotypes that could explain the common set of symptoms that result in the diagnosis. Although no striking macroscopic neuropathological changes have been identified in autism, there is growing evidence that inhibitory interneurons (INs) play an important role in its neural basis. In this Review, we evaluate and interpret this evidence, focusing on recent findings showing reduced density and activity of the parvalbumin class of INs. We discuss the need for additional studies that investigate how genes and the environment interact to change the developmental trajectory of INs, permanently altering their numbers, connectivity and circuit engagement.

Session 2 of the National Cancer Institute’s Cannabis, Cannabinoids, and Cancer Research Workshop opened with testimony from a lymphoma survivor who detailed medicinal cannabis-related improvements in nausea, low appetite, insomnia, and mental health and the limited clinical counsel she received regarding cannabis use. Discussion next turned to the evolution of the legal landscape of cannabis in the United States, one in which state and federal laws frequently conflict and the Controlled Substance Act renders cannabis Schedule I. This legal climate creates conundrums for US medicinal cannabis researchers who contend with limited funding opportunities, avenues to source trial drug, and procedural red tape and for oncology clinicians who recommend medicinal cannabis to patients with some frequency while perceiving themselves as ill equipped to make such clinical recommendations. Ultimately, it creates challenges for cancer patients who find themselves turning to nonmedical and anecdotal information sources. The risks of cannabis use by the cancer patient were discussed next. These include infection, pharmacodynamic and pharmacokinetic drug-botanical interactions, cyclic nausea and vomiting, e-cigarette or vaping product use–associated illness, legal issues, and high cost. The session concluded with a broad survey of the research supporting oncologic cannabinoid use, conclusive evidence for chemotherapy-induced nausea and vomiting, and suggestive evidence for cancer-related pain.

Objective: To examine the relationship between self-reported concussion history and stress, depression, anxiety and quality of life among Icelandic female athletes. Method: Participants in the study were 508 Icelandic female athletes, aged 18-45 (M = 26.99, SD = 7.14), that had or were currently training and competing in the two top leagues in basketball, soccer and handball, in the top league in ice-hockey and in national tournaments in mixed martial arts, taekwondo, karate and boxing. Participants completed an online questionnaire regarding their age, sport and concussion history before answering standard mental health scales concerning stress (PSS), depression (PHQ-9), anxiety (GAD-7) and quality of life (QOLS). Results: Female athletes with a history of one or more concussions scored significantly higher on PHQ-9 and with two or more on PSS and GAD-7 than those reporting no concussion history. Scores on the QOLS were not significantly different between the groups. Female athletes having sustained a concussion were 3.9 times more likely to score above clinical cut-off on PHQ-9 and 2.3 times more likely to score above clinical cut-off on GAD-7 than those with no history of concussion. Number of concussions sustained significantly predicted scores on PSS, PHQ-9, GAD-7 and QOLS. Conclusion: Results indicate that Icelandic female athletes with a history of concussion feel worse than those with no history of concussion and the higher number of concussions sustained, the worse they feel. Keywords: Concussion, athletes, stress, depression, anxiety, quality of life

BACKGROUND Potential links between a history of sport-related concussions and later-life neurobiological and psychological brain health have been studied in former collision-sport athletes. However, empirical studies of how former athletes perceive the future of their brain health as a result of these injuries are missing. OBJECTIVES We aimed to (1) identify the extent to which former National Football League players currently have concerns about their long-term psychological and cognitive functioning as a result of concussions sustained while playing football; (2) examine whether current concerns are different than concerns they had while playing football; (3) examine the relationship between current brain health concerns and self-reported concussion history (SR-CHx); and (4) explore other important factors associated with these concerns. METHODS In this cross-sectional study, former National Football League players with a SR-CHx of one or more concussions (n = 1514; aged mean [standard deviation] = 52.3 [15.7] years) completed a general health questionnaire. Participants reported their lifetime concussion history, as well as both their current concerns and concerns while playing football (i.e., retrospective concerns) regarding the long-term effects of concussions on their memory, thinking skills, and risk of developing chronic traumatic encephalopathy. Current and retrospective concerns were self-reported on a five-point Likert scale. Four concussion history categories were created based on SR-CHx: 1-2 (n = 309); 3-5 (n = 413); 6-9 (n = 356); and 10 + (n = 436) lifetime concussions. Proportions of participants reporting each level of current and retrospective concerns were examined to identify whether concerns presently exist in these former players, and whether their current concerns are different than retrospective concerns. Next, we explored associations between current concerns and SR-CHx. RESULTS More than one-third of participants reported being currently "extremely concerned" about memory problems (36.9%), thinking skills (37.8%), and developing chronic traumatic encephalopathy (39.5%). In contrast, when asked about concerns while playing, most reported being "not at all concerned" regarding memory = 61.2%, thinking skills = 56.1%, and developing chronic traumatic encephalopathy = 71.2%. Of those who retrospectively endorsed being "not at all" or "slightly" concerned regarding memory (n = 1159/1514), thinking skills (n = 1080/1514), and developing chronic traumatic encephalopathy (n = 1219/1514), approximately half reported being currently "moderately" or "extremely" concerned about those same issues (n = 586/1159; n = 534/1080; n = 619/1219, respectively). Current concerns regarding memory (χ216 = 316.61; p

Adolescent bullying victimization can have long-term mental health and well-being outcomes. This study focused on the potential mediating role of the perceived long-term negative and positive impact of adolescent bullying victimization to understand its relations with mental health and well-being problems during emerging adulthood. A retrospective study consisting of closed and open-ended questions was conducted among 1010 Flemish and 650 Dutch emerging adults aged 18-26. Path analyses among early victims (N-Flemish = 644; N-Dutch = 217) demonstrated that the relations between bullying victimization intensity and current self-esteem, social interaction anxiety, and life satisfaction were all mediated by the perceived negative long-term impact of adolescent bullying victimization. Additionally, the open-ended questions provided a better understanding of the perceived negative and positive impact of adolescent bullying victimization. The present study offers insights into the importance of considering subjective perceptions of the overall impact of being bullied to understand long-term bullying victimization outcomes. Implications and limitations are discussed, including the need for longitudinal data-for instance, a three-wave panel study-to establish the temporal order of effects.

Introduction: Exercise can invigorate the body's metabolism. There are very few people who know how sports promote people's physical and mental health. How to lead people to participate in physical exercise through sports is a question worth considering. Objective: We explore the effects of sports on human metabolism. Methods: The article analyzes athletes’ physical and chemical indicators before and after exercise and during the recovery period. The indicators cover blood routine, urine routine, and blood testosterone content. Results: The blood and urine routines of athletes before and after training are different (P

Background There is growing recognition that bidirectional signaling between the digestive tract and the brain contributes to irritable bowel syndrome (IBS). We recently showed in a large randomized controlled trial that cognitive behavioral therapy (CBT) reduces IBS symptom severity. This study investigated whether baseline brain and gut microbiome parameters predict CBT response and whether response is associated with changes in the brain-gut-microbiome (BGM) axis. Methods Eighty-four Rome III-diagnosed IBS patients receiving CBT were drawn from the Irritable Bowel Syndrome Outcome Study (IBSOS; ClinicalTrials.gov NCT00738920) for multimodal brain imaging and psychological assessments at baseline and after study completion. Fecal samples were collected at baseline and post-treatment from 34 CBT recipients for 16S rRNA gene sequencing, untargeted metabolomics, and measurement of short-chain fatty acids. Clinical measures, brain functional connectivity and microstructure, and microbiome features associated with CBT response were identified by multivariate linear and negative binomial models. Results At baseline, CBT responders had increased fecal serotonin levels, and increased Clostridiales and decreased Bacteroides compared to non-responders. A random forests classifier containing 11 microbial genera predicted CBT response with high accuracy (AUROC 0.96). Following treatment, CBT responders demonstrated reduced functional connectivity in regions of the sensorimotor, brainstem, salience, and default mode networks and changes in white matter in the basal ganglia and other structures. Brain changes correlated with microbiome shifts including Bacteroides expansion in responders. Conclusions Pre-treatment intestinal microbiota and serotonin levels were associated with CBT response, suggesting that peripheral signals from the microbiota can modulate central processes affected by CBT that generate abdominal symptoms in IBS. CBT response is characterized by co-correlated shifts in brain networks and gut microbiome that may reflect top-down effects of the brain on the microbiome during CBT.

Increased alcohol and cannabis consumption and related harms have been reported since the beginning of the COVID-19 pandemic. Existing evidence shows that substance use and related harms differ by gender. Yet, no Canadian study has applied a gendered lens to alcohol and cannabis consumption use during this time. Our objectives were to (1) provide gender-specific prevalence estimates of self-reported increased alcohol and cannabis use; and (2) examine gender-specific associations between sociodemographic and mental health variables and alcohol and cannabis use.Using data from the Survey on COVID-19 and Mental Health, we calculated nationally representative, gender-specific prevalence estimates and disaggregated them by sociodemographic and mental health variables. Four logistic regression models were used to assess the likelihood of self-reported increased alcohol and cannabis use.The prevalence of self-reported increase in alcohol use (16.2% women; 15.2% men) and cannabis use (4.9% women; 5.8% men) did not differ by gender. For both genders, income, racialized group membership, working in the past week, being a parent/legal guardian of a child aged under 18 and screening positive for depression and anxiety were associated with increased alcohol use. Men and women who were between the ages of 18 to 44, screened positive for depression, or both, were more likely to report increased cannabis use. For women, education was significantly associated with increased alcohol use. For men, being a parent/legal guardian was significantly associated with lower odds of increased cannabis use.Sociodemographic factors, as well as depression and anxiety, were similarly associated with increased alcohol and cannabis use for both men and women in the second wave of the pandemic.On a fait état d’une augmentation de la consommation d’alcool et de cannabis, ainsi que les méfaits qui en découlent depuis le début la pandémie de COVID 19. Les données disponibles montrent que la consommation de substances psychoactives et les dommages qui y sont associés diffèrent selon le genre. Pourtant, aucune étude canadienne n’a adopté de perspective axée sur le genre relativement à la consommation d’alcool et de cannabis pendant cette période. Nos objectifs étaient 1) de fournir des estimations de la prévalence selon le genre d’une consommation autodéclarée accrue d’alcool et de cannabis et 2) d’analyser les associations stratifiées selon le genre entre les variables sociodémographiques et de santé mentale et la consommation d’alcool et de cannabis.À l’aide des données de l’enquête sur la COVID 19 et la santé mentale, nous avons calculé des estimations de prévalence représentatives à l’échelle nationale, spécifique à chaque genre, et les avons ventilées par variables sociodémographiques et de santé mentale. Quatre modèles de régression logistique ont été utilisés pour évaluer la probabilité d’une consommation autodéclarée accrue d’alcool et de cannabis.La prévalence d’une consommation autodéclarée accrue d’alcool (16,2 % chez les femmes, 15,2 % chez les hommes) et de cannabis (4,9 % chez les femmes, 5,8 % chez les hommes) ne diffère pas selon le genre. Pour les deux genres, le revenu, l’appartenance à un groupe dit « racialisé », le fait d’avoir travaillé au cours de la semaine précédente, le fait d’être parent ou tuteur légal d’un enfant de moins de 18 ans et le fait d’avoir reçu un résultat positif au dépistage de la dépression et de l’anxiété sont associés à une consommation accrue d’alcool. Les hommes et les femmes âgés de 18 à 44 ans ou ayant obtenu un résultat positif au dépistage de la dépression étaient plus susceptibles de déclarer une consommation accrue de cannabis. Chez les femmes, le niveau d’éducation est significativement associé à une consommation accrue d’alcool. Chez les hommes, le fait d’être parent ou tuteur légal est associé de manière significative à une probabilité moindre d’augmentation de la consommation de cannabis.Lors de la deuxième vague de la pandémie, les facteurs sociodémographiques ainsi que la dépression et l’anxiété ont été associés de manière similaire à une augmentation de la consommation d’alcool et de cannabis, tant chez les hommes que chez les femmes.Between September and December 2020, 16.2% of women and 15.2% of men self-reported an increase in their alcohol consumption. During the same period, 4.9% of women and 5.8% of men self-reported an increase in their cannabis consumption. Overall, the factors associated with alcohol and cannabis use in gender-specific regression models were similar. For women, higher education was significantly associated with self-reported increased alcohol use. Men who were parents/legal guardians were significantly less likely to report increased cannabis use. For men and women, screening positive for symptoms of depression was significantly associated with higher odds of increased alcohol and cannabis use.Entre septembre et décembre 2020, 16,2 % des femmes et 15,2 % des hommes ont déclaré avoir augmenté leur consommation d’alcool. Au cours de la même période, 4,9 % des femmes et 5,8 % des hommes ont déclaré avoir augmenté leur consommation de cannabis. Dans l’ensemble, les facteurs associés à la consommation d’alcool et de cannabis dans les modèles de régression stratifiés par genre étaient similaires. Chez les femmes, des niveaux de scolarité plus élevés étaient significativement associés à une consommation accrue d’alcool. Les hommes qui étaient parents ou tuteurs légaux étaient significativement moins susceptibles d’avoir déclaré une consommation accrue de cannabis. Chez les hommes comme chez les femmes, le dépistage des symptômes de la dépression était significativement associé à une probabilité plus élevée de consommation accrue d’alcool et de cannabis.

This study presents nationally representative estimates of self-reported changes in alcohol and cannabis consumption since the onset of COVID-19 in Canada. We used data from the Survey on COVID-19 and Mental Health (collected from September to December 2020) to calculate the prevalence of self-reported change in alcohol and cannabis consumption. We found that 15.7% of respondents self-reported an increase in alcohol consumption and 5.4% in cannabis consumption since the start of the pandemic. Sociodemographic disparities were also observed, indicating that increased alcohol and cannabis consumption may be more prevalent among certain populations.Cette étude présente des estimations représentatives à l’échelle nationale portant sur les changements autodéclarés relatifs à la consommation d’alcool et de cannabis depuis le début de la pandémie de COVID 19 au Canada. Nous nous sommes servi de données de l’Enquête sur la COVID 19 et la santé mentale (qui a eu lieu de septembre à décembre 2020) pour calculer la prévalence de ces changements. Les résultats révèlent que 15,7 % des répondants ont déclaré avoir augmenté leur consommation d’alcool et 5,4 % leur consommation de cannabis depuis le début de la pandémie. Des disparités sociodémographiques ont été observées, laissant supposer que l’augmentation de la consommation d’alcool et de cannabis serait plus répandue au sein de certaines populations.From 11 September to 4 December 2020, 15.7% and 5.4% of individuals self-reported an increase in alcohol and cannabis consumption, respectively, compared to before the pandemic. Individuals who reported that their mental health was worse now, compared to before the pandemic, had the highest prevalence of self-reported increase in alcohol and cannabis consumption. Understanding the social determinants of health is critical to the development of harm reduction and mitigation strategies.Entre le 11 septembre et le 4 décembre 2020, 15,7 % des répondants ont déclaré avoir augmenté leur consommation d’alcool et 5,4 % leur consommation de cannabis par rapport à avant la pandémie. Les personnes ayant déclaré que leur santé mentale était pire au moment de l’Enquête qu’avant la pandémie offraient la prévalence la plus forte en matière d’augmentation de la consommation d’alcool et de cannabis. Il est primordial de comprendre les déterminants sociaux de la santé pour élaborer des stratégies de réduction des méfaits et d’atténuation.

Vocal learning, the ability to imitate sounds from conspecifics and the environment, is a key component of human spoken language and learned song in three independently evolved avian groups—oscine songbirds, parrots, and hummingbirds. Humans and each of these three bird clades exhibit specialized behavioral, neuroanatomical, and brain gene expression convergence related to vocal learning, speech, and song. To understand the evolutionary basis of vocal learning gene specializations and convergence, we searched for and identified accelerated genomic regions (ARs), a marker of positive selection, specific to vocal learning birds. We found avian vocal learner-specific ARs, and they were enriched in noncoding regions near genes with known speech functions or brain gene expression specializations in humans and vocal learning birds, including FOXP2, NEUROD6, ZEB2, and MEF2C, and near genes with major neurodevelopmental functions, including NR2F1, NRP2, and BCL11B. We also found enrichment near the SFARI class S genes associated with syndromic vocal communication forms of autism spectrum disorders. These findings reveal strong candidate noncoding regions near genes for the evolutionary adaptations that distinguish vocal learning species from their close vocal nonlearning relatives and provide further evidence of molecular convergence between birdsong and human spoken language.

OBJECTIVE Evaluating the impact of coenzyme Q10 (CoQ10) supplementation on hormonal indices, mental health, and biomarkers of inflammatory responses and oxidative stress among female patients suffering from polycystic ovary syndrome (PCOS). METHODS The present double-blinded, placebo-controlled randomized clinical trial consisted of 55 PCOS women (aged 18-40 years old), who were randomized into groups receiving 100 mg/day of CoQ10 (28 cases) or placebo (27 cases) for 12 weeks. RESULTS The supplementation of CoQ10 decreased significantly the scores of Beck Depression Inventory (BDI) (p = .03) and Beck Anxiety Inventory (BAI) (p = .01) and high-sensitivity C-reactive protein (hs-CRP) level (p = .005) when comparing with the placebo group. Moreover, CoQ10 group exhibited a significant drop in total testosterone (p = .004), dehydroepiandrosterone sulfate (DHEAS) (p

Graphical abstract COVID-19 epidemic has resulted in devastating mortality and morbidity consisting of socioeconomic and health effects that have included respiratory/pulmonary, cardiovascular, mental health and neurological consequences such as anxiety, depression, and substance use. Several effective vaccines have been developed and extensive efforts are underway to develop therapeutics to treat COVID-19. Cannabis and/or its product-cannabidiol (CBD) are being advertised for the treatment of COVID-19 associated mental/neurological complications and substance use disorders. However, research reviewed shows that there is insufficient data from clinical studies to support the use of cannabis or CBD for the treatment of COVID-19 associated mental health and neurological complications. Additional basic and clinical research is suggested to develop cannabis or cannabidiol for the treatment of mental health problems associated with coronavirus infection and or substance use disorders. In the meantime, it is important that the addiction physician/psychiatrist must caution while prescribing or recommending cannabis or CBD for treating such clinical indications. Research shows that currently there is no clinical evidence to support the use of cannabis or any of its compounds including CBD for treating any of the neuropsychiatric complications of COVID-19. Thus, it is important that the addiction physicians/psychiatrists caution their patients from using cannabis or cannabis products for treating any such complications.

OBJECTIVE Emerging evidence points toward a connection between mental health and the gut microbiota and its metabolites (e.g., short-chain fatty acids - SCFAs). It is unknown whether gut microbiota levels are associated with the development of mental health problems (e.g., internalizing or externalizing behaviors) in preschool children. The objective of this study was to evaluate associations between the gut microbiota and internalizing and externalizing behaviors in preschool-aged children. METHODS A community sample of 248 typically developing children (3-5 years) provided a stool sample for gut microbiota and SCFA analysis. Parents reported child internalizing and externalizing behaviors using the Child Behavior Checklist. Associations between child behaviors and gut microbiota measures were analyzed using Spearman correlations followed by an adjustment for multiple testing, with subanalysis conducted in children clinically "at risk" for behavioral problems compared to those who were not using Mann-Whitney U tests. RESULTS There was a correlation between Shannon alpha diversity with internalizing behaviors (rs = -0.134, p = 0.035), and its subscale somatic complaints (rs = -0.144, p = 0.023), while children clinically "at risk" for internalizing problems had decreased alpha diversity (U = 551, p = 0.017). Internalizing behaviors correlated with valerate and isobutyrate (rs = -0.147, p = 0.021; rs = -0.140, p = 0.028, respectively), while the somatic complaints subscale additionally correlated with acetate and butyrate (rs = -0.219, p = 0.001; rs = -0.241, p < 0.001, respectively). These findings were also present in children "at risk" for internalizing problems (U = 569, p = 0.026; U = 571, p = 0.028), and somatic complaints (U = 164, p = 0.004; U = 145, p = 0.001). CONCLUSIONS These analyses reveal novel associations between internalizing behaviors and the gut microbiota in preschool children. Furthermore, a relationship between somatic complaints and acetate and butyrate was identified, indicating that interventions that increase SCFA production warrant future investigation.

Athletes are vulnerable to sexual violence. Perpetrators of sexual violence may be a trusted coach, a member of the health care team, or a peer. The consequences of sexual violence are wide ranging, resulting in immediate and long-term physical and mental health outcomes that require recognition and comprehensive, multidisciplinary care. Sports medicine providers need to have specific knowledge and skill to care for athletes who experience sexual violence. Several sports organizations (e.g., International Olympic Committee, United States Olympic and Paralympic Committee, the National Collegiate Athletic Association, and the National Athletic Trainers' Association) have developed policies and procedures to prevent sexual violence and help sports medicine specialists provide care and services for athletes affected by sexual violence. Nevertheless, there remains a need for clinical guidelines, screening tools, and education, as well as clinical best practices to address sexual violence in sports medicine.

Polybrominated diphenyl ethers (PBDEs) are ubiquitous persistent organic pollutants (POPs) that are known neuroendocrine disrupting chemicals with adverse neurodevelopmental effects. PBDEs may act as risk factors for autism spectrum disorders (ASD), characterized by abnormal psychosocial functioning, although direct evidence is currently lacking. Using a translational exposure model, we tested the hypothesis that maternal transfer of a commercial mixture of PBDEs, DE-71, produces ASD-relevant behavioral and neurochemical deficits in female offspring. C57Bl6/N mouse dams (F0) were exposed to DE-71 via oral administration of 0 (VEH/CON), 0.1 (L-DE-71) or 0.4 (H-DE-71) mg/kg bw/d from 3 wk prior to gestation through end of lactation. Mass spectrometry analysis indicated in utero and lactational transfer of PBDEs (in ppb) to F1 female offspring brain tissue at postnatal day (PND) 15 which was reduced by PND 110. Neurobehavioral testing of social novelty preference (SNP) and social recognition memory (SRM) revealed that adult L-DE-71 F1 offspring display deficient short- and long-term SRM, in the absence of reduced sociability, and increased repetitive behavior. These effects were concomitant with reduced olfactory discrimination of social odors. Additionally, L-DE-71 exposure also altered short-term novel object recognition memory but not anxiety or depressive-like behavior. Moreover, F1 L-DE-71 displayed downregulated mRNA transcripts for oxytocin (Oxt) in the bed nucleus of the stria terminalis (BNST) and supraoptic nucleus, and vasopressin (Avp) in the BNST and upregulated Avp1ar in BNST, and Oxtr in the paraventricular nucleus. Our work demonstrates that developmental PBDE exposure produces ASD-relevant neurochemical, olfactory processing and behavioral phenotypes that may result from early neurodevelopmental reprogramming within central social and memory networks.

Medical and recreational cannabis are becoming more accessible and socially accepted across the United States. Emerging adults (EAs; 18 to 29) are the largest group of cannabis users. Studies have found that veterans are more likely to report cannabis use compared to nonveterans. While research exists on the use levels of cannabis, limited knowledge is available on the perceived risks and benefits of using cannabis among EA military and veteran populations. Helping professionals encounter veterans who use cannabis and must consider military cultural factors and attitudes towards cannabis that may influence or exacerbate cannabis use. We conducted a qualitative study with 23 EA veteran and military members with high-risk substance use and asked about their thoughts on the acceptability, risks, and perceived benefits associated with cannabis. Two qualitative coders used NVivo to find themes following the six steps of thematic analysis. Results provide in-depth understanding of EA military members and veterans’ perceptions of cannabis. Overall, we found participants were receptive to using cannabis for pain ailments, mental health issues, and as an alternative to benzodiazepines, opioids, and alcohol. However, they acknowledged restrictions are needed to moderate cannabis use and mitigate negative outcomes. Lastly, participants recognized the incongruence of cannabis use with military job responsibilities and expectations. These findings shed light on potential risk and protective factors related to using cannabis for recreational or medical reasons and should be considered when consulting EA military members and veterans.

College students have experienced significant disruptions related to COVID-19, and limited international data suggest they may be at elevated risk for mental health symptom increases related to COVID. Given their potentially elevated risk, our aim was to evaluate differences from pre-college closures to post-closure in mental health symptoms, alcohol, and cannabis use. Participants (N = 4749) were from seven U.S. public universities/colleges. They were 70.1 % female and 48.5 % white, non-Hispanic/Latino, with 48.1 % in their first college/university year. 30-day retrospective assessments of alcohol and cannabis use, and past 2-week retrospective assessments of anxiety, depression, anger, and insomnia were captured at the time of the survey. We examined differences between those providing data pre- and post-university closure via linear and negative binomial regressions. Alcohol and cannabis use days were 13 % and 24 % higher, respectively, from pre-to post-university closure; also, prevalence of any 30-day alcohol use and alcohol use consequences were both higher in the post-closure sample (odds ratios = 1.34 and 1.31, respectively). In contrast, days of binge alcohol use were 4 % lower in the post-closing sample. Depressive symptoms and anger were both modestly higher in post-closing participants (d

Introduction: Researches had shown that Men who have sex with men (MSM) have higher chances of having psychiatric disorder as compared to heterosexual men. Ongoing homophobia, stigma and discrimination have negative effects on mental health of MSM. Many MSM do not seek care from mental health provider because of fear of discrimination Objectives: This study was carried out to assess psychiatric health problem among MSM and also assess their health seeking behavior. Method: The Snowball sampling technique was used. First participants were recruited through a non-profit peer group. Further participants were subsequently referred by participants from their peer circles. Data obtained from total 52 MSM using pretested questionnaire and General health questionnaire (GHQ-28) was analyzed using MS Excel. Results: Two-fifth (40.38%) of MSM had self-reported psychiatric health problem. While on GHQ, 57.69% of MSM were found to have psychiatric health problem with GHQ score of ≥24. MSM who were completely homosexual and who were victims/doer of violence with sex partners had significantly higher chances of having psychiatric health problem.57.15% MSM sought treatment for their psychiatric problem from an Allopathic doctor. Rest of them either went for a self treatment (28.57%) or not taken any treatment (14.28%). 75% MSM reportedly sought treatment from private health facility. Better facility, cost effectiveness, someone known recommended were most commonly cited reason for preferring a mental health provider. Conclusion: High prevalence of psychiatric health problems was found among MSM who engage in higher-risk sexual behavior. MSM require access to mental health screening services.

The rules leading to the emergence of a social organization and the role of social hierarchy on normal and pathological behaviours remain elusive. Here we show that groups of four isogenic male mice rapidly form enduring social ranks in a dominance hierarchy. Highest ranked individuals display enhanced anxiety and working memory, are more social and more susceptible to stress-related maladaptive behaviours. Are these differences causes or consequences to social life? We show that anxiety emerges from life in colony whereas sociability is a pre-existing trait. Strikingly, highest ranked individuals exhibit lower bursting activity of VTA dopamine neurons. Both pharmacogenetic inhibition of this neuronal population and the genetic inactivation of glucocorticoid receptor signalling in dopamine-sensing brain areas promote the accession to higher social ranks. Altogether, these results indicate that the shaping of social fate relies upon the interplay of dopamine system and stress response, impacting individual behaviour and potentially mental health.

During adolescence, frequent and heavy cannabis use can lead to serious adverse health effects and cannabis use disorder (CUD). Rodent models of adolescent exposure to the main psychoactive component of cannabis, delta-9-tetrahydrocannabinol (THC), mimic the behavioral alterations observed in adolescent users. However, the underlying molecular mechanisms remain largely unknown. Here, we treated female and male C57BL6/N mice with high doses of THC during early adolescence and assessed their memory and social behaviors in late adolescence. We then profiled the transcriptome of five brain regions involved in cognitive and addiction-related processes. We applied gene coexpression network analysis and identified gene coexpression modules, termed cognitive modules, that simultaneously correlated with THC treatment and memory traits reduced by THC. The cognitive modules were related to endocannabinoid signaling in the female dorsal medial striatum, inflammation in the female ventral tegmental area, and synaptic transmission in the male nucleus accumbens. Moreover, cross-brain region module-module interaction networks uncovered intra- and inter-region molecular circuitries influenced by THC. Lastly, we identified key driver genes of gene networks associated with THC in mice and genetic susceptibility to CUD in humans. This analysis revealed a common regulatory mechanism linked to CUD vulnerability in the nucleus accumbens of females and males, which shared four key drivers (Hapln4, Kcnc1, Elavl2, Zcchc12). These genes regulate transcriptional subnetworks implicated in addiction processes, synaptic transmission, brain development, and lipid metabolism. Our study provides novel insights into disease mechanisms regulated by adolescent exposure to THC in a sex- and brain region-specific manner.

Spontaneous neuronal activity strongly impacts stimulus encoding and behavioral responses. We sought to determine the effects of neocortical prestimulus activity on stimulus detection. We trained mice in a selective whisker detection task, in which they learned to respond (lick) to target stimuli in one whisker field and ignore distractor stimuli in the contralateral whisker field. During expert task performance, we used widefield Ca2+ imaging to assess prestimulus and post-stimulus neuronal activity broadly across frontal and parietal cortices. We found that lower prestimulus activity correlated with enhanced stimulus detection: lower prestimulus activity predicted response versus no response outcomes and faster reaction times. The activity predictive of trial outcome was distributed through dorsal neocortex, rather than being restricted to whisker or licking regions. Using principal component analysis, we demonstrate that response trials are associated with a distinct and less variable prestimulus neuronal subspace. For single units, prestimulus choice probability was weak yet distributed broadly, with lower than chance choice probability correlating with stronger sensory and motor encoding. These findings support low amplitude and low variability as an optimal prestimulus cortical state for stimulus detection that presents globally and predicts response outcomes for both target and distractor stimuli.

Millions of Americans use cannabis for medical purposes including but not limited to pain, nausea, mood changes and appetite stimulation. The use of cannabinoid in the palliative care setting is a relatively new trend. Given the fact that a patient receiving palliative care is not necessarily approaching death, the increasing need for palliative care as the American population ages, this literature review was compiled in order to examine the potential efficacy of cannabis in treating the mental health comorbidities of palliative care patients. We attempted to create the most comprehensive report on cannabinoid use in palliative psychiatry. It summarizes the most recently published science on cannabinoid use in palliative care patients and its impact on mood and anxiety symptoms. The mechanism of action of cannabinoids on their associated receptors was elucidated, as were the pharmacological roles that specific molecules in cannabinoids, like cannabidiolic acid and terpenes, play in cannabinoids’ overall efficacy. The legal impediments to widespread cannabis use were also explored. While the potential efficacy of cannabinoids has proven to be mixed, more research is necessary to ensure that a potentially vital resource in treating palliative care patients does not go underutilized.

The environment and events that we are exposed to in utero, during birth and in early childhood influence our future physical and mental health. The underlying mechanisms that lead to these outcomes are unclear, but long-term changes in epigenetic marks, such as DNA methylation, could act as a mediating factor or biomarker. DNA methylation data were assayed at 713 522 CpG sites from 9537 participants of the Generation Scotland: Scottish Family Health Study, a family-based cohort with extensive genetic, medical, family history and lifestyle information. Methylome-wide association studies of eight early life environment phenotypes and two adult mental health phenotypes (major depressive disorder and brief resilience scale) were conducted using DNA methylation data collected from adult whole blood samples. Two genes involved with different developmental pathways (PRICKLE2, Prickle Planar Cell Polarity Protein 2 and ABI1, Abl-Interactor-1) were annotated to CpG sites associated with preterm birth (P

Nepal is a geographically, ecologically, bio-culturally and ethnically diverse country. Cannabis has been a flora, used in various forms and ways and its effect has been variably a matter of concern in Nepal. Perception to its use has also been changing with time with the dynamics of various factors and trends around and in the world. The views of its proponents at times appear with relatively more powerful influence among people though the views of the opponents seem less, and relatively less influential. Proponents advocate for its legalization with highlights of its different uses and benefits whereas opponents, mainly mental health professionals point out sporadically its adverse consequences, mainly in psychological health. The purpose of this review is to explore the existing literature regarding cannabis use and abuse in Nepal. Search for articles for this review was performed in PubMed, Google Scholar, and Nepal Journal Online. We summarize and discuss about cannabis in various aspects in the Nepalese context. The overarching objective is to reflect upon the ongoing debate regarding its harm and benefits, thereby upon the issue of its legalization in Nepal.

OBJECTIVE To assess the mental health and experience of sport-related harassment and abuse of elite aquatic athletes and to analyze it in relation to gender and discipline. DESIGN Cross-sectional study using an anonymous survey. SETTING The FINA World Championships 2019. PARTICIPANTS Registered athletes in the disciplines of swimming, diving, high diving, water polo, artistic swimming, and open water swimming. INTERVENTIONS Athletes completed an online or paper-based questionnaire. MAIN OUTCOME MEASURES The main outcome measures included screening for depression (10-item version of the Center for Epidemiological Studies Depression Scale revised), eating disorders (Brief Eating Disorders in Athletes Questionnaire), the subjective need for psychotherapeutic support, and the experience of sport-related harassment and/or abuse. RESULTS A quarter (24.6%) of the 377 responding athletes were classified as depressed and 2.5% as having an eating disorder. More than 40% of the athletes stated that they wanted or needed psychotherapeutic support. Fifty-one athletes (14.9%) had experienced harassment/abuse in sport themselves, and 31 (9%) had witnessed it in another athlete. The experiences of harassment and abuse ranged from unwanted comments about body or appearance (40.2%) to rewards in sport for sexual favors (2.5%) and rape (0.3%). Athletes who had experienced harassment/abuse in sport themselves had higher average scores for depression and eating disorders, and more of them felt they needed psychotherapeutic support. Up to a third would not talk or report to anybody if they saw or experienced harassment/abuse, and less than 20% would talk to an official for help. CONCLUSION Targeted initiatives are required to address mental health issues and harassment and abuse in sport in the FINA aquatic disciplines.

The objectives of this study were to explore perceived social support, negative social interactions, and psychological distress in Canadian adults who experience lifetime abuse, or dependence on cannabis (ADC), and to determine whether, and the extent to which variables of interest predict psychological distress. Data were extracted from a cross-sectional, national datafile representing a sample of 1503 individuals who met the criteria for a lifetime prevalence of ADC. Levels of perceived overall social support, and several subtypes were measured using the Social Provisions Scale (SPS), negative social interactions were assessed using the Negative Social Interaction (NSI) scale, and psychological distress was examined using the Kessler Psychological Distress Scale (K10). It was observed that Canadians with ADC had significantly lower SPS scores (overall, and by subtype) and significantly higher NSI and K10 scores compared with the overall Canadian adult sample. An exploratory stepwise regression revealed that NCI scores were the most significant, positive predictor of psychological distress, which alone accounted for 20 percent of the variance, followed by reassurance of worth, attachment, and social integration which were inversely related to psychological distress. With the recent legalization of cannabis in Canada, the results of this study suggest that abuse may strongly link with negative social consequences that might serve to exacerbate psychological distress. As such, it might be beneficial to clearly understand one's social context when considering medicinal purposes of cannabis for mental health symptom management. Further, the findings also suggest that patients with cannabis addiction will likely benefit from receiving particular forms of social support. Limitations of this study and future research are considered.

Healthy sleep behaviors are a cornerstone to mental wellness and sports performance among athletes. Disturbances in sleep timing, quantity, and quality may impact an athlete's performance in the short and long term. Sleep disturbances may contribute to overall health, risk of injury, and career duration. This review discusses the prevalence of sleep disorders among athletes and its impact on mental health problems. A strategic approach is provided and highlights the importance of proactively identifying sleep disorders versus waiting for the problem to express itself. A summary of available therapeutic interventions to improve sleep in the athlete population is presented.

Major depressive disorder and other related disturbances in mood account for the highest proportion of psychiatric illnesses in the general population and are a leading cause of disability around the world. Despite belief to the contrary, athletes are vulnerable to the same mental illnesses as the general population. Unique circumstances experienced by athletes create challenges that are exclusive to that population, which can place them at greater risk for depression and other mental illnesses. This chapter explores the incidence of depression and related mood disturbances in athletes, risk factors for illness, obstacles to assessment and management, and treatment strategies.

The majority of mental health disorders have their onset during adolescence and early adulthood, with roughly half of these disorders emerging in mid-adolescence. While sport offers a range of critically important benefits, competitive demands on young athletes may increase susceptibility to mental health symptoms and disorders during an already challenging developmental period, especially in the context of elite sport, which is characterized by increasing professionalization and specialization. This clinical review examines key literature regarding risk factors for mental health symptoms and disorders in youth athletes, as well as providing informed practical guidance for clinicians working with this cohort.

Summary Background The purpose of this study was to bring the impact of the COVID-19 pandemic on competitive sports of german para-athletes into focus. We aimed to identify special aspects of disabled athletes during the pandemic, and their mental health. Material and Methods All german candidate athletes preparing for the Tokyo Summer Paralympic Games were asked to complete a questionnaire, which consisted of questions about sports participation, physical and mental health, and the occupational and personal impact of the COVID-19 pandemic. Results A total of 109 athletes (52 men, 57 women, mean age 29.2 (±10.4) years) completed the questionnaire between May 17th and August 30th 2020. 70% of the athletes felt that organizing their training was difficult, two-thirds of the athletes trained less than before. Half of the participants worried about their own well-being, 25% about their career, only 8% about their finances. Conclusions The COVID-19 pandemic has a huge impact on sports of elite para athletes. Many athletes worried about the social impact and half of the respondents were of the opinion that people with disabilities were specially affected by the COVID-19 pandemic. Level of evidence: IV