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Background: Offspring of parents with affective disorders (OAD) are at risk of developing a wide range of mental disorders. Deficits in the rearing environment and high levels of stress are well‐known risk factors for negative outcomes in OAD. Building on prior research, we aim to examine the longitudinal relationships between family dysfunction, stressful life events, and mental health in OAD and control offspring of parents with no affective disorder. In the present study, we hypothesized that high levels of family dysfunction would be associated with more internalizing and externalizing problems across time in OAD than in controls, and that family dysfunction would mediate the relationship between stressful life events in adolescence and poor mental health in adulthood, particularly in OAD. Methods: As part of the TRacking Adolescents' Lives Survey (TRAILS), 2230 participants (51% female, Mage = 11.1 years, SD = 0.6, at baseline) and their parents completed measures across six time points, spanning 15 years. Mental health, family dysfunction, and stressful life events were assessed with the Youth and Adult Self‐Report, Family Assessment Device, and an in‐house measure, respectively. Results: Multi‐group structured equation modeling revealed that family dysfunction was linked to internalizing and externalizing problems in OAD, but not controls, across time. Risk status did not moderate family dysfunction's mediation of the relationship between stressful life events and negative outcomes in adulthood. Conclusions: OAD show high sensitivity to dysfunction in the rearing environment across childhood and adolescence, which supports the use of family based interventions to prevent the development of mental disorders in high‐risk youth. [ABSTRACT FROM AUTHOR]

Objective: Studies using proton magnetic resonance spectroscopy reveal substantial inconsistencies in the levels of brain glutamate, glutamine and glutamate + glutamine across schizophrenia spectrum disorders. This systematic review employs qualitative and quantitative methods to analyse the patterns and relationships between glutamatergic metabolites, schizophrenia spectrum disorders and brain regions. Methods: A literature search was conducted using various databases with keywords including glutamate, glutamine, schizophrenia, psychosis and proton magnetic resonance spectroscopy. Inclusion criteria were limited to case-control studies that reported glutamatergic metabolite levels in adult patients with a schizophrenia spectrum disorder diagnosis – i.e. first-episode psychosis, schizophrenia, treatment-resistant schizophrenia and/or ultra-treatment-resistant schizophrenia – using proton magnetic resonance spectroscopy at 3 T or above. Pooled study data were synthesized and analysed. Results: A total of 92 studies met the inclusion criteria, including 2721 healthy controls and 2822 schizophrenia spectrum disorder participants. Glu levels were higher in the basal ganglia, frontal cortex and medial prefrontal of first-episode psychosis participants, contrasting overall lower levels in schizophrenia participants. For Gln, strong differences in metabolite levels were evident in the basal ganglia, dorsolateral prefrontal cortex and frontal cortex, with first-episode psychosis showing significantly higher levels in the basal ganglia. In glutamate + glutamine, higher metabolite levels were found across schizophrenia spectrum disorder groups, particularly in the basal ganglia and dorsolateral prefrontal cortex of treatment-resistant schizophrenia participants. Significant relationships were found between metabolite levels and medication status, clinical measures and methodological variables. Conclusion: The review highlights abnormal glutamatergic metabolite levels throughout schizophrenia spectrum disorders and in specific brain regions. The review underscores the importance of standardized future research assessing glutamatergic metabolites using proton magnetic resonance spectroscopy due to considerable literature heterogeneity. [ABSTRACT FROM AUTHOR]

Background: Fluoroquinolones are broad-spectrum antibiotics with significant antimicrobial activity. Despite their therapeutic benefits, they are associated with a range of adverse drug reactions (ADRs), particularly those affecting the central nervous system (CNS). This study aimed to analyze the psychiatric ADRs linked to fluoroquinolones using data from the FDA Adverse Event Reporting System (FAERS) database. Methods: A retrospective pharmacovigilance study was conducted using FAERS data from Q1 2004 to Q4 2023. The data processing phase involved the FDArecommended deduplication method, and ADRs were classified according to Medical Dictionary for Regulatory Activities (MedDRA). Disproportionality analysis was performed using the reporting odds ratio (ROR), and statistical significance was assessed using the Chi-square test or Fisher's exact test. Results: The study identified 84,777 reports associated with fluoroquinolones, with 359,480 Preferred Terms-annotated entries, 27,816 of these reports were psychiatric ADRs. Mood disorders were the most frequently reported, including anxiety, depression, and delirium, with some reports escalating to suicidal ideation and behaviors. The Standardized MedDRA Query classification system was used to categorize these ADRs into Depression, Suicide/self-injury, Psychosis and psychotic disorders, and Non-infectious encephalopathy/delirium. Ciprofloxacin was most frequently linked to depression and suicidal ideation, while moxifloxacin showed a robust correlation with delirium. The risk of psychiatric ADRs varied by age group, with affective disorders more prevalent in adults under 65 and psychosis and delirium in those over 65. Conclusion: Fluoroquinolones are associated with a range of psychiatric ADRs, with notable differences between the drugs in the class. The study highlights the need for caution in prescribing fluoroquinolones, particularly for patients with pre-existing mental health conditions or those in higher risk age groups. The findings also underscore the importance of considering age-specific preventive strategies when administering these antibiotics. [ABSTRACT FROM AUTHOR]

Psychotic and mood disorders are discussed as part of the same continuum. The potential role of immune dysregulation in defining their clinical presentations, however, remains unclear. Differences in TNF-α, IL-6 and TGF-β levels were investigated in 143 patients with schizophrenia (SCH = 63) and bipolar disorder (BD = 80), in remission. Cytokines were evaluated against the dimensional assessment of psychosis and affective symptoms using the schizo-bipolar scale, together with the severity of the same symptom domains measured by the brief psychiatric rating scale (BPRS). Lower TGF-β was associated with more lifetime episodes, family risk for psychosis, and more severe mood and psychotic symptoms in all patients. BPRS Affect symptoms domain correlated with lower TGF-β levels in BD, and higher TGF-β levels in SCH patients. Using moderated mediation analysis, TGF-β was a relevant predictor only in the setting of non-categorical symptom distribution, with familial risk for psychosis confirmed as a significant moderator. Severity of BPRS Affect symptoms domain was an independent predictor of inclination towards the psychosis spectrum. The underlying immune dysregulation may be shared by the disorders, rather than a unique characteristic of each, having significant implications for our understanding of the continuum vs. categorical approach to psychosis and mood disorders. [ABSTRACT FROM AUTHOR]

Objective: This review aims to synthesize and critically evaluate the existing literature on kratom use and its possible association with induction of psychotic and manic symptoms, in order to identify potential areas for future research that would improve our understanding of the risks of kratom consumption. Methods: An electronic search was performed using five major databases: including PubMed, Scopus, Google Scholar, Web of Science, and PsycINFO. keywords such as kratom, Mitragyna speciosa, mania, psychosis, bipolar disorder, schizophrenia, schizoaffective, case report, and case series. The retrieved articles on initial search were screened based on predefined inclusion and exclusion criteria for this study, and then data synthesis was performed to analyze relevant information from the included studies. Results: Six prior papers were found using (1 case series and 5 case reports). These included 10 cases, involving kratom use association with mania and psychosis. The ages of patients ranged from 28 to 55 years mean age was 38, and (SD 13.74), the majority were males (8 out of 11). Patients had durations of kratom use ranging from 2 wk to 15 years. Significant association was found between kratom use and the worsening of psychotic and manic symptoms in individuals with psychiatric conditions. Conclusions: Our research highlights the possibility of worsening preexisting psychiatric conditions in the context of kratom use. This study emphasizes the need for clinical evaluation of patients for kratom use. Additional research is required to gain a deeper understanding of the potential mental health implications of kratom use, especially among vulnerable populations. [ABSTRACT FROM AUTHOR]

The rare psychiatric phenomenon of catatonia has recently been decoupled from schizophrenia in the ICD‐11 and DSM‐V and is now a stand‐alone syndrome. This article explores a complex case of catatonia in intellectual disability, considering a broad array of differential diagnoses for the underlying pathology. The authors also explore evolutionary theories of catatonia and consider the compounding factors resulting in delayed diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Theory of Mind (ToM) is a social-cognitive ability to understand the mental states of others. ToM functions are compromised in the case of mental disorders characterized by cognitive impairments. The Faux Pas Recognition test (FPRT) is considered a good measure of verbal aspects of ToM as it measures social adaptation through the adequate interpretation of potentially sensitive and awkward social situations. However, data on FPRT psychometric properties is somewhat limited. The aim of the present study is the psychometric evaluation of the FPRT in Serbian population. The adapted version in Serbian has been administered to 268 healthy participants, 30 patients with schizophrenia and 31 with bipolar affective disorder. The results show a high internal consistencies of Faux Pas stories (α = .954), Control stories (α = .929) and overall test (α = .936). Both Horn’s parallel analysis and confirmatory factor analysis indicated that a single-factor solution is optimal, supporting the premise of a general ToM ability underlying performance across test. The Faux Pas test showed good discriminative power in differentiation between individuals from healthy and clinical populations making it a useful clinical instrument. [ABSTRACT FROM AUTHOR]

Objectives: The current study uses longitudinal data from the National Alzheimer's Coordinating Center (NACC) to assess the effects of antipsychotic medication use on changes in cognitive functioning among adults in the United States. Methods: Linear mixed models were conducted that included study visits, days between visits, sex, age, education, and medical history (i.e. diabetes, seizures, traumatic brain injury, stroke, and Parkinson's disease). The Neuropsychiatric Inventory Questionnaire (NPI-Q) was used to create variables assessing changes in psychotic symptoms, manic symptoms, and agitation/disinhibition. Results: The results indicated that starting an antipsychotic medication was associated with a greater decline in semantic fluency (Fruit and Vegetable Naming), processing speed (Digit Symbol and Trail Making Test, Part A), and cognitive flexibility (Trail Making Test, Part B). Conversely, stopping an antipsychotic medication was protective against declines in the same cognitive skills. The effect of antipsychotic medications on cognitive functioning did not appear to differ by reported changes in psychiatric symptoms after adjusting for false discovery. Conclusion: The results suggest that prescribers should consider discontinuance of an antipsychotic if the patient is reporting cognitive problems and their symptoms are manageable off the medications. The findings hope to spark future research into the effects of antipsychotic use on biomarkers of progressive dementias (e.g. Alzheimer's disease). [ABSTRACT FROM AUTHOR]

Childhood maltreatment, alexithymia and impulsivity are related to bipolar disorder (BD), but the role of potential underlying mechanisms of this link, such as extreme sensory processing, in BD are unclear. This study compared sensory processing patterns between individuals with BD‐I or BD‐II and between those with and without alexithymia and childhood maltreatment. Additionally, the study aimed to examine the role of extreme sensory processing in the relationship between childhood trauma, alexithymia and impulsivity with both depression and mania in a sample of hospitalized individuals with BD (n = 300). Participants completed self‐report and clinician‐rated scales. Patients with BD‐II exceeded those with BD‐I in low registration, sensory sensitivity and sensation avoidance, whereas patients with BD‐I exhibited a more heightened sensation‐seeking pattern. Patients with BD who had alexithymia and a history of childhood maltreatment exhibited more heightened sensory processing patterns, apart from sensory seeking, compared to those without alexithymia and childhood maltreatment. Additionally, the same pattern was more pronounced in individuals with BD who had both alexithymia and childhood maltreatment compared to those with either condition or neither of these conditions. The pathways from childhood maltreatment and alexithymia to depressive symptoms were mediated by low registration and sensation avoidance. Sensory seeking indirectly affected the link between alexithymia and manic symptoms. Childhood maltreatment and challenges in effectively processing emotional information, along with their related hypo‐ and hypersensitivity, may characterize BD individuals and its manifestation of depressive and manic symptoms. [ABSTRACT FROM AUTHOR]

Catatonia, documented since the 19th century, remains a significant challenge in terms of recognition and treatment. Over the last two decades, ketamine has brought new perspectives to psychiatry, sparking widespread interest. Concurrently, catatonia has attracted heightened scientific attention. Preliminary evidence suggests the therapeutic potential of ketamine for catatonia. We systematically searched Medline/PubMed, Embase, PsycINFO, Lilacs, and Cochrane Library databases, as well as Google Scholar, for studies with ketamine or its enantiomers as intervention for catatonia, with no restrictions to underlying diagnosis, date, language, or study design. Twenty articles were included, encompassing a total of 25 catatonic patients receiving ketamine or esketamine. Predominantly female (61.9 %), with a mean age of 44.4 years, patients mostly exhibited manifestations compatible with the retarded subtype of catatonia. Mood disorders were the most prevalent underlying diagnoses. Ketamine was primarily administered intravenously over a 40-minute period and in multiple-dosing schemes. Mean response and remission rates of catatonic manifestations for the whole sample were 80 % and 44 %, respectively, with no reports of worsening catatonic features or psychotic symptoms. Only one patient discontinued treatment due to intolerable dissociative effects. Challenging the conventional contraindication of ketamine in psychotic disorders, current evidence highlights its potential efficacy, particularly in treating catatonia. Pending further research, we advocate reevaluating this contraindication, as it may offer a promising therapeutic option, especially for challenging cases. Preliminary evidence suggests potentially greater benefits for catatonic patients with underlying mood disorders compared to primary psychotic disorders. [ABSTRACT FROM AUTHOR]

Background: Consumption of stimulant drugs, a heterogeneous group of addictive substances, has significantly increased in recent years with rising numbers of stimulant-associated intoxication and deaths. Objective: To provide an overview of recent scientific evidence of the diagnosis and treatment of stimulant use disorders. Material and methods: A literature review of the neuropathology, clinical presentation, diagnostic criteria and evidence-based treatment for stimulant use disorders. Results: The chronic use of stimulant drugs is associated with significant physical (e.g., hypertension, tachycardia and dyspnoea) and psychological harm (e.g., dependence, psychotic disorders and affective disorders). Despite major advances in the research of the neuropathology of stimulant use disorder and the refinement of diagnostic criteria, the disorder still presents a challenge, not least because of the lack of effective treatments. There are currently no approved pharmacotherapeutic interventions for stimulant use disorder and meta-analyses show that the efficacy of behavioural interventions is low to moderate, similar to cognitive behavioural treatment. Conclusion: Despite growing insights into the neuropathology associated with stimulant use disorder, treatment remains a challenge. The lack of effective interventions makes it difficult to give clear recommendations for the clinical practice. Further scientific research is thus warranted. [ABSTRACT FROM AUTHOR]

The stigma against people with mental illness is a well-worn subject; however, stigma between groups of people with different mental illnesses is rarely discussed. Within the context of a psychiatric hospital, hierarchies form among patients based on symptomatology and diagnosis. In this perspectives piece, I explore, how, in my experiences with being on the bottom of this hierarchy as a person with a schizophrenia-spectrum psychotic illness in a psychiatric hospital. I, and my fellow "psychotics," were stigmatized and outcasted by other groups of individuals who were diagnosed with mental illnesses that are considered less serious than psychosis. I explore how one stigmatized, outcasted group (people with substance use and mood disorders) construct power relationships over an even more highly stigmatized, marginalized group (people with psychotic disorders). Utilizing Goffmanian and Tajfel theories, the perspective explores stigma within a total institution, and the formation of in-groups and out-groups. I explore how people, upon entering the psychiatric hospital unit, know almost immediately whether they belong to the dominant group or the subordinate group, and I conclude with recommendations to reduce the stigma of psychotic disorders within popular culture. [ABSTRACT FROM AUTHOR]

This cohort study examines preceding mental health service use and diagnoses in individuals aged 15 to 29 years with a first diagnosis of a psychotic disorder compared with those with a first diagnosis of a mood disorder. Key Points: Question: Do people who are diagnosed with a psychotic disorder have unique trajectories of preceding mental health service use and diagnoses compared with people diagnosed with a mood disorder? Findings: In this cohort study of 10 501 individuals aged 15 to 29 years with a first diagnosis of psychotic disorder, these individuals used mental health services, particularly acute care services, significantly more in the preceding 3 years compared with matched individuals with a first mood disorder. Meaning: The findings suggest that better understanding of mental health service use before development of a psychotic disorder is needed for more-targeted early identification efforts. Importance: Characterizing mental health service use trajectories preceding diagnosis of a psychotic disorder may help identify individuals at highest risk and in which settings they are at highest risk. Objective: To examine mental health service use and diagnostic trajectories before first diagnosis of psychotic disorder and identify utilization and diagnostic patterns. Design, Setting, and Participants: This population-based, retrospective cohort study used linked provincial health administrative data. The sample included individuals aged 15 to 29 years diagnosed with a psychotic disorder in Ontario, Canada, between April 1, 2012, and March 31, 2018. These individuals were matched to individuals with a diagnosis of a mood disorder. Data were analyzed from November 2018 to November 2019. Main Outcomes and Measures: The main outcomes were rates, timing, and setting of mental health–related service use and associated diagnoses in the 3 years before the index disorder among individuals first diagnosed with a psychotic disorder compared with those first diagnosed with a mood disorder. Results: A total of 10 501 individuals with a first diagnosis of psychotic disorder were identified (mean [SD] age, 21.55 [3.83] years; 72.1% male). A total of 72.2% of individuals had at least 1 mental health service visit during the 3 years before their first psychotic disorder diagnosis, which was significantly more than matched controls with a first mood disorder diagnosis (66.8%) (odds ratio [OR], 1.34; 95% CI, 1.26-1.42). Compared with individuals diagnosed with a mood disorder, individuals diagnosed with a psychotic disorder were significantly more likely to have had mental health–related hospital admissions (OR, 3.98; 95% CI, 3.43-4.62) and emergency department visits (OR, 2.27; 95% CI, 2.12-2.43) in the preceding 3 years. Those with psychotic disorders were more likely to have had prior diagnoses of substance use disorders (OR, 2.57; 95% CI, 2.35-2.81), other disorders (personality disorders, developmental disorders) (OR, 1.75; 95% CI, 1.61-1.90), and self-harm (OR, 1.64; 95% CI, 1.36-1.98) in the past 3 years compared with those diagnosed with mood disorders. Conclusions and Relevance: This study found that in the 3 years prior to an index diagnosis, individuals with a first diagnosis of psychotic disorder had higher rates of mental health service use, particularly emergency department visits and hospitalizations, compared with individuals with a first diagnosis of a mood disorder. Individuals with psychotic disorders also had a greater number of premorbid diagnoses. Differences in health service utilization patterns between those with a first psychotic disorder diagnosis vs a first mood disorder diagnosis suggest distinct premorbid trajectories that could be useful for next steps in prediction and prevention research. [ABSTRACT FROM AUTHOR]

Corticosteroids are frequently prescribed across medical disciplines, yet they are associated with various adverse effects, including neuropsychiatric symptoms, documented since their introduction over 60 years ago. The cellular mechanisms underlying neuropsychiatric symptoms are complex and somewhat obscure, involving multiple pathways. Notably, they include changes in excitability, cellular death of hippocampal and striatal neurons, and increased inflammation and oxidative stress. Clinical presentation varies, encompassing affective disorders (anxiety, euphoria, depression), psychotic episodes, and cognitive deficits. It is crucial to note that these manifestations often go unnoticed by treating physicians, leading to delayed detection of severe symptoms, complications, and underreporting. Discontinuation of corticosteroids constitutes the cornerstone of treatment, resolving symptoms in up to 80% of cases. Although the literature on this topic is scant, isolated cases and limited studies have explored the efficacy of psychotropic medications for symptomatic control and prophylaxis. Pharmacological intervention may be warranted in situations where corticosteroid reduction or withdrawal is not feasible or beneficial for the patient. [ABSTRACT FROM AUTHOR]

Objective: Recreational cannabis legalization (RCL) is expanding rapidly. RCL's effects on mental health issues are of particular concern because cannabis use is more frequent among people receiving psychiatric care and is associated with several psychiatric disorders. The authors conducted a scoping review to examine the evidence and discern gaps in the literature concerning the effects of RCL on mental health and to assess the factors responsible for an observed heterogeneity in research results. Methods: This scoping literature review followed PRISMA guidelines. Five databases—MEDLINE, CINAHL, Embase, APA PsycInfo, and Web of Science—were searched for English- or French-language reports published between January 1, 2012, and April 30, 2023. Results: Twenty-eight studies from the United States and Canada were found. The studies were classified by category of the study's data (patients receiving psychiatric care [k=1], death records [k=4], emergency department or hospital records [k=10], and the general population [k=13]) and by the diagnosis (schizophrenia or psychoses, mood disorders, anxiety disorders and symptoms, suicide or suicidal ideation, or other mental health issues) examined. The review findings revealed a paucity of research and indicated mixed and largely inconclusive results of the studies examined. Research gaps were found in the examination of potential changes in cannabis use patterns among people receiving psychiatric care and in the availability of longitudinal studies. Conclusions: Clinicians, researchers, and policy makers need to collaborate to address the research gaps and to develop evidence-based policies that reflect a thorough understanding of the effects associated with RCL. [ABSTRACT FROM AUTHOR]

Personality dysfunction operationalized as impairment in self- and interpersonal functioning is a characteristic of personality disorders. The metacognitive model suggests that dysfunctional metacognitive beliefs are a common cause of psychological disorders, but the relevance and importance of metacognitions for personality dysfunction is less explored and was the objective for the current study. In a sample of 1278 individuals, we conducted a multiple hierarchical regression analysis to test the predictive role of metacognitive beliefs for personality dysfunction. We found a unique and independent contribution from negative beliefs about the uncontrollability and danger of worry and lower cognitive confidence to personality dysfunction whilst controlling age, gender, maladaptive personality traits, big-5 personality traits, emotional distress symptoms, and general psychosocial functioning. The results bring further support for the metacognitive model of psychological disorders which may be relevant for formulation and treatment of personality dysfunction and disorder. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment is a relevant problem in psychiatry and can be well assessed with a cross-diagnostic test such as the Screen for Cognitive Impairment in Psychiatry (SCIP). The aim of our pilot study is to assess cognitive impairment in acute psychiatric inpatients diagnosed with psychotic disorders, bipolar disorder and depression using the German version of the SCIP (SCIP-G). We also investigate whether cognitive dysfunction improves over the course of the inpatient treatment, where patients are offered a combination of pharmacological treatment and cognitive remediation. Methods: A total of 143 adult inpatients were included in the study. Cognitive testing was performed using two different forms of the SCIP-G. All patients received state-of-the-art pharmacotherapy and cognitive remediation using the COGPACK® software package version 6.06. Results: Based on the ICD-10 Criteria for Research, 54 patients were given an F2 diagnosis (schizophrenia and schizotypal and delusional disorders). Thirty-nine patients met the criteria for bipolar disorder (F30 and F31) and fifty for depression (F32 and F33). At baseline, a significant difference was observed between the SCIP total scores of the F2 and F32/33 patients (p < 0.001) and between the F2 and F30/31 groups (p = 0.022). At the second measurement time point, the SCIP total score showed significant improvement in all three groups (p < 0.001), and there was no statistically significant interaction between SCIP total score and diagnostic groups (p = 0.860). Conclusions: Cognitive dysfunction is present in psychiatric disorders and can be easily assessed during an inpatient hospital stay. In our sample, patients with a psychotic disorder were more cognitively impaired at baseline than patients with an affective disorder. Inpatient treatment, consisting of pharmacotherapy and cognitive remediation, improved cognitive deficits. Patients with psychotic disorders, bipolar disorder and depression showed similar improvements in cognitive performance. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to assess the prevalence of psychiatric disorders among the women between 32-week gestation & two week postpartum. Methods: The study was conducted in the Post Graduate Department of Obstetrics and Gynaecology over a period of one year i.e. November 2016 to October 2017, after approval from the Ethical Committee. Subjects included 150 antenatal women from 32-week period of gestation till delivery and 150 postpartum women from delivery till 2 weeks postpartum. Psychiatric disorder was calculated using Mini Neuropsychiatric Inventory. Other sociodemographic, obstetric, and psychiatric variables were recorded. Results: Overall, 150 antenatal and 150 postnatal women were studied, 28 women (18.7%) in antenatal and 21(14%) women in postnatal group had psychiatric disorder. The overall prevalence of psychiatric disorders in the present study was found to be 16.4%. This prevalence in pregnancy ranges from 15- 29% worldwide. Among 28 antenatal patients diagnosed as having Psychiatric Disorder 13 (8.7%) had Depression. One patient (0.7%) had Dysthymia, 2 (1.3%) had panic disorder. 2 (1.3%) had obsessive compulsive disorder. 10 (6.7%) had Generalized Anxiety Disorder. None of the patients had Depression with Melancholic features, Suicidality, Hypomania, Agoraphobia, Social Phobia, Bipolar Disorder, Alcohol Dependence and abuse, Post-Traumatic Stress Disorder, Psychotic Disorder, Anorexia Nervosa, and Bulimia Nervosa. 21 Postnatal patients were diagnosed as having Psychiatric Disorder, out of which 12 (8.0%) had Depression. None had Dysthymia, 3(2%) had panic disorder. 1 (0.7%) had obsessive compulsive disorder. 1 (0.7%) had Post Traumatic Stress Disorder. 1 (0.7) had Psychotic Disorder and Mood disorder with Psychotic features. 3 (2%) had Generalized Anxiety Disorder. None of the patients had Depression with Melancholic features, Suicidality, Hypomania, Agoraphobia, Social Phobia, Bipolar Disorder, Alcohol Dependence and abuse, Anorexia Nervosa, and Bulimia Nervosa. 21.3% antenatal females had antenatal risk questionnaire score ≥23 with mean score 17.5±8.57 and 26.7% postnatal females had postnatal risk questionnaire score ≥24. Conclusion: Pregnancy-related psychiatric disorders are frequent. The outcomes for pregnant women, infants, and women's health are all improved by proper diagnosis and treatment of psychiatric problems. [ABSTRACT FROM AUTHOR]

Background/Aims: Service users who have spent time in seclusion describe it as a negative experience, viewing it as punishment. Although occupational therapists work within these settings, there is limited research and documentation of interventions aimed at reducing occupational deprivation in seclusion. A service evaluation was conducted at a medium secure adult mental health unit to better understand the current practices of occupational therapists working in seclusion. Methods: A bespoke tool was developed to capture occupational therapy interventions within a 12-month timeline. Results: Data showed that there were 31 interventions provided across 300 days of seclusion for 16 patients. Therapy lasted between 5 and 45 minutes involving a range of adapted interventions and resources appropriate for positive risk taking. Conclusions: Despite creative and adaptive interventions identified, provision of occupational therapy appeared sporadic and restricted by a 5-day service. This illustrates the need for specialist training and guidelines to support an integrated and consistent approach. [ABSTRACT FROM AUTHOR]

Background: Patients with an ultra-high risk of psychosis (UHR) are more likely to transition to psychosis. Attachment style has also been associated with psychosis and other symptoms. Aims: To review attachment styles in UHR patients and to analyze related psychosocial factors. Ours is the first systematic review of attachment in this population. Method: We performed a systematic review of attachment and related psychosocial factors in UHR patients following the PRISMA methodology. Results: We identified five studies. The results revealed high rates of insecure attachment in this population (more than 80%). The UHR sample presented high levels of depression, anxiety, social anxiety, emotional reactivity, trauma, and poor mentalization. Premorbid social adjustment was a predictor of improvement in disorganization and negative symptoms. The rate of transition to psychosis was 10%. Attachment patterns accounted for 16.8% of the variance. This vulnerability for psychosis was also associated with poor mentalization. Conclusion: Early detection of patients with UHR and insecure attachment is crucial, since early intervention to address symptoms, mentalization, and attachment is feasible and may lead to an improvement in the remaining associated psychosocial related factors (secure style: better global functioning and less affective and anxious symptoms). PROSPERO ID440957 [ABSTRACT FROM AUTHOR]

Background: Comprehensive, timely, and integrated primary care services have been proposed as a response to the increased demand for mental health and substance use services especially among young people. However, little is known about the care utilization patterns of young people with mental and substance use disorders. Our aim was to characterize profiles of care use in young Finnish adults with mental or substance use disorders, and the potential factors associated with the service use profiles. Methods: Primary and specialized care visits of young adults (16–29 years) diagnosed with a psychiatric or a substance use disorder (n = 7714) were retrieved from the national health care register from years 2020 and 2021. K-Means clustering was used to detect different profiles based on the utilization of care services. Multinomial logistic regression was used to analyze the factors associated with different profiles of care use. Results: Five different profiles were identified: low care use (75%), and use of principally primary health care (11%), student health services (9%), psychiatric services (5%), or substance use services (1%). Female gender was associated with membership in the primary health care focused profiles (OR 2.58 and OR 1.99), and patients in the primary health care and student health services profiles were associated with a better continuity of care (OR 1.04 and OR 1.05). Substance use disorders were associated with psychiatric service use (OR: 2.51) and substance use services (OR: 58.91). Living in smaller municipalities was associated with lower service use when comparing to the largest city. Conclusions: Young adults diagnosed with a psychiatric or a substance use disorder had remarkably different and heterogeneous care patterns. Most of the participants had low care utilization, indicating potential gaps in service use and care needs. Measures should be taken to ensure equal access to and availability of mental health services. The profiles that utilized the most services highlights the importance of integrated services and patient-oriented improvement of treatment. [ABSTRACT FROM AUTHOR]

Electroconvulsive therapy is a type of therapy frequently used in psychiatric clinical practice. Although it is generally used for the treatment of affective disorders or severe and/or resistant psychotic disorders, it has also demonstrated its usefulness in many other neuropsychiatric conditions. We present the case of a 26-year-old woman, previously diagnosed with a functional neurological disorder--with fixed dystonia phenotype in the right upper limb--, admitted to our hospital for a severe depressive episode. After noting the absence of clinical improvement with psychopharmacological treatment, it was decided to give electroconvulsive therapy, receiving a total of 11 sessions, 9 of which were effective, with bifrontotemporal application, three times a week. The patient experienced a significant improvement, not only at an affective and behavioral level, but also in the dystonia, recovering most of the mobility in the right hand and completely relinquishing the pain. Although scientific evidence is scarce regarding the use of electroconvulsive therapy in functional neurological disorders, this clinical case supports the existing literature and raises this therapy as a possibility in resistant and comorbid conditions with severe affective disorders. [ABSTRACT FROM AUTHOR]

Increased reactivity to daily stressors is associated with mental health difficulties, which are common in autistic individuals. We investigated affective reactivity to daily-life stress, cognitive emotion regulation, and their link with co-occurring mental health symptoms in adolescents and young adults with autism. A 6-day ecological momentary assessment protocol was used to assess perceived daily-life stress (event-related, activity-related, and social stress) as well as negative affects in autistic (n = 39, age = 18.4) and non-autistic (n = 55, age = 18.1) participants. Co-occurring mental health difficulties, social functioning, and cognitive emotion regulation were assessed with questionnaires and clinical evaluations. Youth with autism showed higher levels of perceived stress related to their daily social context and activities, as well as an increased affective reactivity to activity-related stressors compared with non-autistic youth. Moreover, they reported using less adaptive and more non-adaptive emotion regulation, the latter increasing their affective response to daily stressors and possibly contributing to the severity of co-occurring mental health symptoms. Our findings demonstrate high perceived daily-life stress in autistic adolescents and young adults. To minimize the negative effects of stress and the development of mental health symptoms, interventions could focus on effective stress management and strategies that autistic young people use to manage their emotions. Previous research has shown that autistic individuals report high levels of perceived stress and have an increased likelihood of developing mental health difficulties. Increase in individuals' negative emotions in relation to perceived stress (i.e. affective reactivity to stress) is a known risk factor for mental health difficulties. In this study, we investigated perceived daily stress and affective reactivity to stress in autistic (n = 39, age = 18.4) and non-autistic (n = 55, age = 18.1) adolescents and young adults. We used the ecological momentary assessment, a technique that allows to assess individuals repeatedly in their daily life using their smartphone. Moreover, participants filled a questionnaire to evaluate the strategies they use to regulate emotions when faced with difficulties. Finally, a clinical interview and a parent-report questionnaire were used to assess mental health symptoms. Autistic youth reported higher levels of perceived daily stress compared with non-autistic peers. Moreover, they showed increased affective reactivity to stress related to their daily activities. Autistic participants reported more emotion regulation difficulties (e.g. more repetitive thinking of difficulties) compared with non-autistic participants. Difficulties in emotion regulation increased negative emotions in relation to stress and might contribute to the severity of mental health symptoms. We conclude that adolescents and young adults with autism report high perceived stress in their daily lives. To minimize the negative impact of stress and the development of mental health symptoms, people supporting autistic young people could focus on stress management skills and the strategies that the youth use to manage emotions. [ABSTRACT FROM AUTHOR]

Adolescent psychotic mood disorder (MDP) is a specific phenotype that characterized by more severe symptoms and prognosis compared to nonpsychotic mood disorder (MDNP). But the underlying neural mechanisms remain unknown, and graph theory analysis can help to understand possible mechanisms of psychotic symptoms from the perspective of functional networks. A total of 177 adolescent patients with mood disorders were recruited, including 61 MDP and 116 MDNP. Functional networks were constructed, and topological properties were compared between the two groups at baseline and after treatment, and the association between properties changes and symptom improvement was explored. Compared to the MDNP group, the MDP group exhibited higher small-world properties (FDR q = 0.003) and normalized clustering coefficients (FDR q = 0.008) but demonstrated decreased nodal properties in the superior temporal gyrus (STG), Heschl's gyrus, and medial cingulate gyrus (all FDR q < 0.05). These properties were found to be correlated with the severity of psychotic symptoms. Topological properties also changed with improvement of psychotic symptoms after treatment, and changes in degree centrality of STG in the MDP was significantly positive correlated with improvement of psychotic symptoms (r = 0.377, P = 0.031). This study indicated that functional networks are more severely impaired in patients with psychotic symptoms. Topological properties, particularly those associated with the STG, hold promise as emerging metrics for assessing symptoms and treatment efficacy in patients with psychotic symptoms. [ABSTRACT FROM AUTHOR]

Although teen pregnancy and birth rates have declined over the decades, all adolescentpopulations are at risk. Disparities among adolescent pregnancies still exist, including increased risk and rates of unplanned pregnancy among vulnerable adolescents, including those with a mental health diagnosis.Adolescent girls with mental health disorders are notably at higher risk and are three timesmore likely to become pregnant than those without a mental illness. Adolescents who have experienced trauma and have a mental health diagnosis are much more likely to engage in high-risk sexual activity, to not participate in contraceptive use, and to become pregnant than their counterparts.Using Trauma Informed Care (TIC) to assess mental health diagnoses, high-risk sexual behaviors, and risk for unplanned pregnancy among adolescent populations can be an effective approach for primary prevention. There is increased expectation for clinicians to practice TIC and to establish relationships with patients while understanding how mental health diagnoses can impact health behaviors. The focus of this paper is to examine the effects of adolescent unplanned pregnancy, identify the increased risk for adolescents with mental health disorders, and discuss general methods for TIC in clinical practice. [ABSTRACT FROM AUTHOR]

Smooth pursuit eye movements are considered a well-established and quantifiable biomarker of sensorimotor function in psychosis research. Identifying psychotic syndromes on an individual level based on neurobiological markers is limited by heterogeneity and requires comprehensive external validation to avoid overestimation of prediction models. Here, we studied quantifiable sensorimotor measures derived from smooth pursuit eye movements in a large sample of psychosis probands (N = 674) and healthy controls (N = 305) using multivariate pattern analysis. Balanced accuracies of 64% for the prediction of psychosis status are in line with recent results from other large heterogenous psychiatric samples. They are confirmed by external validation in independent large samples including probands with (1) psychosis (N = 727) versus healthy controls (N = 292), (2) psychotic (N = 49) and non-psychotic bipolar disorder (N = 36), and (3) non-psychotic affective disorders (N = 119) and psychosis (N = 51) yielding accuracies of 65%, 66% and 58%, respectively, albeit slightly different psychosis syndromes. Our findings make a significant contribution to the identification of biologically defined profiles of heterogeneous psychosis syndromes on an individual level underlining the impact of sensorimotor dysfunction in psychosis. [ABSTRACT FROM AUTHOR]

Aim: To examine whether polygenic risk scores (PRS) for neuroticism, depression, bipolar disorder and schizophrenia are higher in individuals manifesting trans‐diagnostic risk factors for the development of major mental disorders and whether PRS enhance prediction of early onset full‐threshold disorders. Methods: Using data from the Brisbane Longitudinal Twin Study, we examined individual PRS for neuroticism, depression, bipolar disorder and schizophrenia, recorded evidence of subthreshold syndromes and family history of mood and/or psychotic disorders and noted progression to trans‐diagnostic clinical caseness (onset of major mental disorders) at follow‐up. We undertook multivariate, receiver operating curve and logistic regression analyses that were adjusted for known variables of influence (age, twin status, and so on). Results: Of 1473 eligible participants (female = 866, 59%; mean age 26.3 years), 28% (n = 409) met caseness criteria for a mood and/or psychotic disorder. All PRS were higher in cases versus non‐cases but associations with different levels of risk were inconsistent. The prediction of caseness (reported as area under the curve with 95% confidence intervals [CI]) improved from 0.68 (95% CI: 0.65, 0.71) when estimated using clinical risk factors alone up to 0.71 (95% CI: 0.69, 0.73) when PRS were added to the model. Logistic regression identified five variables that optimally classified individuals according to caseness: age, sex, individual risk characteristics, PRS for depression and mental health case status of cotwins or siblings. Conclusions: The findings need replication. However, this exploratory study suggests that combining PRS with other risk factors has the potential to improve outcome prediction in youth. [ABSTRACT FROM AUTHOR]

Progression to psychosis has been associated with increased cortical thinning in the frontal, temporal and parietal lobes in individuals at clinical high risk for the disorder (CHR-P). The timing and spatial extent of these changes are thought to be influenced by age. However, most evidence so far stems from adult samples. Longitudinal studies are essential to understanding the neuroanatomical changes associated to transition to psychosis during adolescence, and their relationship with age. We conducted a longitudinal, multisite study including adolescents at CHR-P and healthy controls (HC), aged 10–17 years. Structural images were acquired at baseline and at 18-month follow-up. Images were processed with the longitudinal pipeline in FreeSurfer. We used a longitudinal two-stage model to compute the regional cortical thickness (CT) change, and analyze between-group differences controlling for age, sex and scan, and corrected for multiple comparisons. Linear regression was used to study the effect of age at baseline. A total of 103 individuals (49 CHR-P and 54 HC) were included in the analysis. During follow-up, the 13 CHR-P participants who transitioned to psychosis exhibited greater CT decrease over time in the right parietal cortex compared to those who did not transition to psychosis and to HC. Age at baseline correlated with longitudinal changes in CT, with younger individuals showing greater cortical thinning in this region. The emergence of psychosis during early adolescence may have an impact on typical neuromaturational processes. This study provides new insights on the cortical changes taking place prior to illness onset. [ABSTRACT FROM AUTHOR]

Suicide is an important social and medical problem, particularly among children and adolescents. The aim of the study was to determine the association of the psychiatric diagnosis and selected psychosocial factors with the risk of suicide attempts among patients of an adolescent psychiatric unit. A retrospective analysis was performed on a database of consecutive N = 1311 patients aged 13–18 years of the adolescent psychiatric ward. A hierarchical logistic regression analysis was performed to assess the predictive value of the main psychiatric diagnosis, for factors selected from the database to determine their influence on the relative risk of a suicide attempt. Primary diagnoses of mood disorders and emotional and behavioral disorders were associated with an increased risk of a current admission after a suicidal attempt, a history of past suicidal attempts and non-suicidal self-harm (NSSI). History of NSSI was associated with a fourfold increase probability of a suicide attempt. Truancy, sexual abuse, heartbreak and frequent conflicts were related to a rise in suicidal attempt risk. Learning difficulties were found to be linked to increased probability of suicidal attempt, but only among women. The current study confirms that the primary diagnosis, NSSI and well-recognized psychosocial factors (including family- and school-related factors) may prove useful in the assessment of suicidal risk among adolescents admitted to a psychiatric ward. [ABSTRACT FROM AUTHOR]

Recent studies have indicated that clinical high risk for psychosis (CHR-P) is highly specific for psychotic disorders other than pluripotential to various serious mental illnesses. However, not all CHR-P develop psychotic disorder only, and psychosis can occur in non-psychotic disorders as well. Our prospective cohort study aims to investigate the characteristics and clinical outcomes of a pluripotent high-risk group with the potential to develop a diverse range of psychiatric disorders. The SPRIM study is a prospective naturalistic cohort program that focuses on the early detection of those at risk of developing serious mental illness, including psychosis (CHR-P), bipolar (CHR-B), and depressive disorder (CHR-D), as well as undifferentiated risk participants (UCHR). Our study has a longitudinal design with a baseline assessment and eight follow-up evaluations at 6, 12, 18, 24, 30, 36, 42, and 48 months to determine whether participants have transitioned to psychosis or mood disorders. The SPRIM sample consisted of 90 CHR participants. The total cumulative incidence rate of transition was 53.3% (95% CI 32.5–77.2). CHR-P, CHR-B, CHR-D, and UCHR had cumulative incidence rates of 13.7% (95% CI 3.4–46.4), 52.4% (95% CI 28.1–81.1), 66.7% (95% CI 24.6–98.6) and 54.3% (95% CI 20.5–93.1), respectively. The cumulative incidence of psychosis, bipolar, and depressive disorder among all participants was 3.3% (95% CI 0.8–11.5), 45.7% (95% CI 24.4–73.6), and 11.2% (95% CI 3.1–36.2), respectively. Our study suggests that the concept of pluripotent high-risk for a diverse range of psychiatric disorders is an integrative approach to examining transdiagnostic interactions between illnesses with a high transition rate and minimizing stigma. • Characteristics and clinical outcomes of pluripotent high-risk group; potential for diverse psychiatric disorders. • The total cumulative incidence rate of transition was 53.3% (95% CI 32.5–77.2). • The cummulative incidence of psychosis, bipolar, and depressive disorder among all participants was 3.3%, 45.7%, and 11.2%. [ABSTRACT FROM AUTHOR]

In recent years, some models for binary and graded format responses have been proposed to assess unipolar variables or "quasi-traits." These studies have mainly focused on clinical variables that have traditionally been treated as bipolar traits. In the present study, we have made a proposal for unipolar traits measured with continuous response items. The proposed log-logistic continuous unipolar model (LL-C) is remarkably simple and is more similar to the original binary formulation than the graded extensions, which is an advantage. Furthermore, considering that irrational, extreme, or polarizing beliefs could be another domain of unipolar variables, we have applied this proposal to an empirical example of superstitious beliefs. The results suggest that, in certain cases, the standard linear model can be a good approximation to the LL-C model in terms of parameter estimation and goodness of fit, but not trait estimates and their accuracy. The results also show the importance of considering the unipolar nature of this kind of trait when predicting criterion variables, since the validity results were clearly different. [ABSTRACT FROM AUTHOR]

Introduction: The following work aims to compare the types and magnitude of risk events in patients with Schizophrenia and Bipolar Disorder and each of those groups with of a group of healthy siblings, exploring differences and similarities of the two psychotic disorders. Methods: Retrospective interviews were conducted with 20 families to investigate maternal and obstetric health, social support and the presence of early trauma for the affected family members and healthy siblings. Mothers were interviewed with the Prenatal Psychosocial Profile and each family participant was assessed with the Early Trauma Inventory, Screening Questionnaire of the Genomic Psychiatry Cohort and the Diagnostic Interview for Psychosis and Affective Disorders. Results: Obstetric and gestational history, pregnancy weight changes and early trauma were associated with offspring's mental illness, including statistically significant findings for complications of pregnancy, pregnancy weight changes, general trauma, physical punishment and emotional abuse. Conclusion: These findings highlight the different risk factor exposures that occur within a family, which may increase the risk for severe mental illness. [ABSTRACT FROM AUTHOR]

This study examined whether goal‐directed treatment leads to improved treatment outcomes for patients with a primary mood or anxiety disorder and whether beneficial outcomes are achieved sooner compared to treatment as usual. In a quasi‐experimental controlled study with a nested design, 17 therapists received training in goal‐directed treatment and treated 105 patients with anxiety or mood disorders using principles of goal‐directed treatment. Treatment results on a generic self‐report instrument were compared with two control groups: a historical control group consisting of 16 of the 17 participating therapists, who provided treatment as usual to 97 patients before having received training in goal‐directed treatment, and a parallel control group consisting of various therapists, who provided treatment as usual to 105 patients. Symptom reduction on a self‐report measure was compared using multilevel analysis. A survival analysis was performed to assess whether a satisfactory end state had been reached sooner after goal‐directed treatment. The results of this study show that goal‐directed treatment only led to a significantly better overall treatment outcome compared to the parallel treatment as usual group. Furthermore, goal‐directed treatment was significantly shorter than both treatment as usual groups. In conclusion, this research suggest that goal‐directed treatment led to a similar or better treatment outcome in a shorter amount of time. [ABSTRACT FROM AUTHOR]

Refugees are at increased risk of non-affective psychotic disorders, but it is unclear whether this extends to affective psychotic disorders [APD] or non-psychotic bipolar disorder [NPB]. We conducted a nationwide cohort study in Sweden of all refugees, non-refugee migrants and the Swedish-born population, born 1 Jan 1984–31 Dec 2016. We followed participants from age 14 years until first ICD-10 diagnosis of APD or NPB. We fitted Cox proportional hazards models to estimate hazard ratios [HR] and 95 % confidence intervals [95%CI], adjusted for age, sex and family income. Models were additionally stratified by region-of-origin. We followed 1.3 million people for 15.1 million person-years, including 2428 new APD cases (rate: 16.0 per 100,000 person-years; 95%CI: 15.4–16.7) and 9425 NPB cases (rate: 63.8; 95%CI: 62.6–65.1). Rates of APD were higher in refugee (HR adjusted : 2.07; 95%CI: 1.55–2.78) and non-refugee migrants (HR adjusted : 1.40; 95%CI: 1.16–1.68), but lower for NPBs for refugee (HR adjusted : 0.24; 95%CI: 0.16–0.38) and non-refugee migrants (HR adjusted : 0.34; 95%CI: 0.28–0.41), compared with the Swedish-born. APD rates were elevated for both migrant groups from Asia and sub-Saharan Africa, but not other regions. Migrant groups from all regions-of-origin experienced lower rates of NPB. Income may have been on the causal pathway making adjustment inappropriate. Refugees experience elevated rates of APD compared with Swedish-born and non-refugee migrants, but lower rates of NPB. This specificity of excess risk warrants clinical and public health investment in appropriate psychosis care for these vulnerable populations. • Rates of affective psychotic disorders were 1.47 and 2.07 times higher for non-refugee and refugee migrants, respectively, than Swedes • After adjustment for income, rates remained 1.49 times higher amongst refugees • Migrant groups experienced lower rates of non-psychotic bipolar disorder than Swedes • Rates were elevated most in migrants from sub-Saharan Africa and refugees from Asia [ABSTRACT FROM AUTHOR]

Key Clinical Message: Recurrent depression with psychotic features is an atypical presentation of neurosyphilis. This case emphasizes the polymorphic clinical presentation of neurosyphilis and how it mimics affective disorders with psychotic symptoms. [ABSTRACT FROM AUTHOR]

Mental health is a barometer of individual productivity and community wellness. It is important both for the people, as well as general and family physicians to be well informed about symptoms, types, and treatment modalities of mental health conditions, as well as remove misconceptions and stigmas attached to some mental health disorders. Awareness and understanding of mental health conditions can enable timely help, referral, and management, to provide a fulfilled life. [ABSTRACT FROM AUTHOR]

Background and Hypothesis Loneliness, the subjective experience of feeling alone, is associated with physical and psychological impairments. While there is an extensive literature linking loneliness to psychopathology, limited work has examined loneliness in daily life in those with serious mental illness. We hypothesized that trait and momentary loneliness would be transdiagnostic and relate to symptoms and measures of daily functioning. Study Design The current study utilized ecological momentary assessment and passive sensing to examine loneliness in those with schizophrenia (N  = 59), bipolar disorder (N  = 61), unipolar depression (N  = 60), remitted unipolar depression (N  = 51), and nonclinical comparisons (N  = 82) to examine relationships of both trait and momentary loneliness to symptoms and social functioning in daily life. Study Results Findings suggest that both trait and momentary loneliness are higher in those with psychopathology (F (4,284) = 28.00, P  < .001, ηp2 = 0.27), and that loneliness significantly relates to social functioning beyond negative symptoms and depression (β = −0.44, t  = 6.40, P  < .001). Furthermore, passive sensing measures showed that greater movement (β = −0.56, t  = −3.29, P  = .02) and phone calls (β = −0.22, t  = 12.79, P  = .04), but not text messaging, were specifically related to decreased loneliness in daily life. Individuals higher in trait loneliness show stronger relationships between momentary loneliness and social context and emotions in everyday life. Conclusions These findings provide further evidence pointing to the importance of loneliness transdiagnostically and its strong relation to social functioning. Furthermore, we show that passive sensing technology can be used to measure behaviors related to loneliness in daily life that may point to potential treatment implications or early detection markers of loneliness. [ABSTRACT FROM AUTHOR]

Background: Dual disorders (DD) entail the coexistence of a substance use disorder (SUD) and another mental health condition, often within psychotic and affective disorders. This study aims to evaluate lurasidone, an innovative atypical antipsychotic, in individuals diagnosed with schizophrenia spectrum disorder and concurrent comorbidities of alcohol use disorder/substance use disorder (AUD/SUD). Methods: A cohort of 23 subjects diagnosed with schizophrenia spectrum disorder and comorbid AUD/SUD underwent psychometric assessments at baseline (T0) and one-month (T1) post-lurasidone initiation. Results: Lurasidone exhibited significant reductions in psychopathological burden, evidenced by decreased total PANSS scores (Z = 2.574, p = 0.011). Positive symptoms, substance craving (VAS Craving; Z = 3.202, p = 0.001), and aggressivity (MOAS scale; Z = 2.000, p = 0.050) were notably reduced. Clinical Global Impression (CGI) scores significantly improved (Z = 2.934, p = 0.003). Quality of life enhancements were observed in SF-36 subscales (energy, emotional well-being, and social functioning) (p < 0.05) and Q-LES-Q-SF scale (Z = −2.341, p = 0.021). A safety analysis indicated lurasidone's good tolerability, with only 8.7% reporting discontinuation due to side effects. Conclusions: This study offers initial evidence supporting lurasidone's efficacy and safety in dual diagnoses, highlighting positive effects on psychopathology, substance craving, and quality of life. These findings emphasize the need for tailored, comprehensive treatment strategies in managing the complexities of this patient population. [ABSTRACT FROM AUTHOR]

Over the course of the 19th century, the concept of melancholia morphed from a partial insanity defined by disorders of judgment to a disorder characterized primarily by mood disturbances. The francophone Belgian psychiatrist Joseph Guislain, whose work has not been previously translated into English, played an important role in this transition. We translate and comment upon two of his key descriptions of melancholia from 1835 and 1852, emphasizing the following 5 features. First, his concept of melancholia is quite "modern" meeting all DSM-5 criteria for major depression. Second, his clinical descriptions are vivid, often giving voice to his patients. Third, other aspects of his text reflect older concepts, including 17th century melancholic subtypes. Fourth, and of particular historical import, he was, in 1835, likely the first major European alienist to argue that nonpsychotic melancholia was an important form of the disorder and a legitimate mental illness. This represented key step in the transition of melancholia from a psychotic to a mood disorder and also helped expand the 18th century model of insanity which was as restricted solely to disturbances of judgment/imagination. Fifth, beginning with his 1835 writings, but more prominently in his 1852 text, Guislain emphasizes that melancholia is a form of phrenalgia – mental pain. In so doing, he played an important role in helping initiate this influential psychophysiological theory of melancholia that was championed by Wilhelm Griesinger and other important German and English psychiatrists later in the 19th century. • In 1835 and 1852, Joseph Guislain wrote important descriptive accounts of melancholia. • He was the first to recognize that melancholia could occur without psychotic symptoms. • He also contributed to the influential theory that melancholia resulted from mental pain. [ABSTRACT FROM AUTHOR]

Facial emotion expressions play a central role in interpersonal interactions; these displays are used to predict and influence the behavior of others. Despite their importance, quantifying and analyzing the dynamics of brief facial emotion expressions remains an understudied methodological challenge. Here, we present a method that leverages machine learning and network modeling to assess the dynamics of facial expressions. Using video recordings of clinical interviews, we demonstrate the utility of this approach in a sample of 96 people diagnosed with psychotic disorders and 116 never-psychotic adults. Participants diagnosed with schizophrenia tended to move from neutral expressions to uncommon expressions (e.g., fear, surprise), whereas participants diagnosed with other psychoses (e.g., mood disorders with psychosis) moved toward expressions of sadness. This method has broad applications to the study of normal and altered expressions of emotion and can be integrated with telemedicine to improve psychiatric assessment and treatment. [ABSTRACT FROM AUTHOR]

This case report expands the reported range of clinical presentations of CV2/CRMP5 antibody‐related syndromes with two novel findings (manic psychosis and psychogenic polydipsia). A systematic literature review highlights a potentially higher incidence of psychosis than previously reported, clinical features that should prompt antibody testing, and the potential for treatment response. [ABSTRACT FROM AUTHOR]

The psychopathological syndrome of formal thought disorder (FTD) is not only present in schizophrenia (SZ), but also highly prevalent in major depressive disorder and bipolar disorder. It remains unknown how alterations in the structural white matter connectome of the brain correlate with psychopathological FTD dimensions across affective and psychotic disorders. Using FTD items of the Scale for the Assessment of Positive Symptoms and Scale for the Assessment of Negative Symptoms, we performed exploratory and confirmatory factor analyses in 864 patients with major depressive disorder (n = 689), bipolar disorder (n = 108), or SZ (n = 67) to identify psychopathological FTD dimensions. We used T1- and diffusion-weighted magnetic resonance imaging to reconstruct the structural connectome of the brain. To investigate the association of FTD subdimensions and global structural connectome measures, we employed linear regression models. We used network-based statistic to identify subnetworks of white matter fiber tracts associated with FTD symptomatology. Three psychopathological FTD dimensions were delineated, i.e., disorganization, emptiness, and incoherence. Disorganization and incoherence were associated with global dysconnectivity. Network-based statistics identified subnetworks associated with the FTD dimensions disorganization and emptiness but not with the FTD dimension incoherence. Post hoc analyses on subnetworks did not reveal diagnosis × FTD dimension interaction effects. Results remained stable after correcting for medication and disease severity. Confirmatory analyses showed a substantial overlap of nodes from both subnetworks with cortical brain regions previously associated with FTD in SZ. We demonstrated white matter subnetwork dysconnectivity in major depressive disorder, bipolar disorder, and SZ associated with FTD dimensions that predominantly comprise brain regions implicated in speech. Results open an avenue for transdiagnostic, psychopathology-informed, dimensional studies in pathogenetic research. [ABSTRACT FROM AUTHOR]

The COVID-19 medical emergency has ended worldwide, yet the psychological impact of these years of unprecedented changes on students' lives still needs to be deepened. Methods: This study aims to assess and compare COVID-19-related stressors (relationships and academic life; isolation; and fear of contagion) and psychophysical symptoms reported by 637 university students at three times, i.e., April 2020 (n = 197), April 2021 (n = 200), and April 2022 (n = 240). The impact of COVID-19-related stressors on psychophysical symptoms within each time was also tested. Results: In April 2022, perceived isolation and fear of contagion decreased from the peak registered in April 2021, but stress related to relationships and academic life remained high. An ongoing increase in psychophysical symptoms was found. More than 50% of students reported clinical levels of sleep disorders, depression, psychoticism, and interpersonal sensitivity. In April 2022, students still perceiving stress related to relationships and academic life and isolation were at risk for anxiety, somatization, and sleep disorders. Students still perceiving stress related to fear of contagion were also at risk for depression, obsessive–compulsive symptoms, and psychoticism. Conclusion: The findings emphasized the long-lasting effects of COVID-19-related stress on students' psychophysical health. Interventions must aim at supporting students in dealing with the complex post-pandemic adjustment process. [ABSTRACT FROM AUTHOR]

The paper reviews the entire spectrum of Artificial Intelligence (AI) in mental health and its positive role in mental health. AI has a huge number of promises to offer mental health care and this paper looks at multiple facets of the same. The paper first defines AI and its scope in the area of mental health. It then looks at various facets of AI like machine learning, supervised machine learning and unsupervised machine learning and other facets of AI. The role of AI in various psychiatric disorders like neurodegenerative disorders, intellectual disability and seizures are discussed along with the role of AI in awareness, diagnosis and intervention in mental health disorders. The role of AI in positive emotional regulation and its impact in schizophrenia, autism spectrum disorders and mood disorders is also highlighted. The article also discusses the limitations of AI based approaches and the need for AI based approaches in mental health to be culturally aware, with structured flexible algorithms and an awareness of biases that can arise in AI. The ethical issues that may arise with the use of AI in mental health are also visited. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore the relationship between affective disturbances and aberrant salience in the context of childhood trauma, attachment, and mentalization in an analogue study. Methods: Using a cross‐sectional design, an online community sample completed self‐report measures of key variables. Structural equation modelling was used to test childhood trauma's influence on aberrant salience via a set of intermediate risk factors (depression, negative schizotypy, and insecure attachment). These intermediate risk factors were assumed to lead to the proximal risk factors of aberrant salience (i.e., disorganized schizotypy and disorganized attachment) depending on the vulnerability of mentalizing capacity to elevated stress. Results: The sample (N = 1263) was 78% female and aged between 18 and 35 years. The tested models closely fitted the observed data, revealing significant pathways from childhood trauma to aberrant salience via the hypothesized pathways. The direct effect of childhood trauma on aberrant salience was significant. Conclusion: Findings suggest that the pathway to aberrant salience may be characterized by disorganization of self‐state and intersubjectivity as a function of diminishment in mentalizing ability. This may relate to changes in attachment organization and socio‐cognitive capacity, which could constitute possible risk factors signalling development of aberrant salience. [ABSTRACT FROM AUTHOR]

Dis-sociality (DS) reflects the impairment of social experience in people with schizophrenia; it encompasses both negative features (disorder of attunement, inability to grasp the meaning of social contexts, the vanishing of social shared knowledge) and positive features (a peculiar set of values, ruminations not oriented to reality), reflecting the existential arrangement of people with schizophrenia. DS is grounded on the notion of schizophrenic autism as depicted by continental psychopathology. A rating scale has been developed, providing an experiential phenotype. Here we present the Autism Rating Scale for Schizophrenia – Revised English version (ARSS-Rev), developed on the Italian version of the scale. The scale is provided by a structured interview to facilitate the assessment of the phenomena investigated here. ARSS-Rev is composed of 16 distinctive items grouped into 6 categories: hypo-attunement, invasiveness, emotional flooding, algorithmic conception of sociality, antithetical attitude toward sociality, and idionomia. For each item and category, an accurate description is provided. Different intensities of phenomena are assessed through a Likert scale by rating each item according to its quantitative features (frequency, intensity, impairment, and need for coping). The ARSS-Rev has been able to discriminate patients with remitted schizophrenia from euthymic patients with psychotic bipolar disorder. This instrument may be useful in clinical/research settings to demarcate the boundaries of schizophrenia spectrum disorders from affective psychoses. [ABSTRACT FROM AUTHOR]

Aims To address the question of tailored baclofen prescribing in alcohol use disorder (AUD) in relation to dose-dependent efficacy and the potential danger of high doses and to provide suggestions for the use of high doses of baclofen in the treatment of AUD. The context is the approvement in France of baclofen in the treatment of AUD without dose limitation, making French physicians, who usually prescribe baclofen in a tailored manner, often use high or very high doses. Methods A narrative review of the results of randomized controlled trials (RCTs) and observational studies that used tailored baclofen prescribing and of the severe adverse effects of baclofen that have been reported in the literature. Results The results show that RCTs using tailored doses of baclofen in AUD are not completely demonstrative, though they are encouraging according to certain meta-analyses, while observational studies that used tailored doses constantly show a good effectiveness of baclofen treatment. The results suggest that many severe adverse effects of baclofen could be related to a nonrespect by physicians of prescription rules and appropriate treatment monitoring. Conclusions The use of tailored doses shows that the dose required to suppress cravings is highly variable, low or high, depending on each case. Analysis of the circumstances in which severe adverse effects occur suggest that a careful monitoring of baclofen prescribing might prevent a large majority of severe adverse effects. We propose that the education of the patients and the prescription skills, seriousness, and availability of the prescribing physicians are of major importance in the managing of tailored baclofen treatment of AUD. [ABSTRACT FROM AUTHOR]

Background Research suggests that effort-cost decision-making (ECDM), the estimation of work required to obtain reward, may be a relevant framework for understanding motivational impairment in psychotic and mood pathology. Specifically, research has suggested that people with psychotic and mood pathology experience effort as more costly than controls, and thus pursue effortful goals less frequently. This study examined ECDM across psychotic and mood pathology. Hypothesis We hypothesized that patient groups would show reduced willingness to expend effort compared to controls. Study Design People with schizophrenia (N  = 33), schizoaffective disorder (N  = 28), bipolar disorder (N  = 39), major depressive disorder (N  = 40), and controls (N  = 70) completed a physical ECDM task. Participants decided between completing a low-effort or high-effort option for small or larger rewards, respectively. Reward magnitude, reward probability, and effort magnitude varied trial-by-trial. Data were analyzed using standard and hierarchical logistic regression analyses to assess the subject-specific contribution of various factors to choice. Negative symptoms were measured with a clinician-rated interview. Study Results There was a significant effect of group, driven by reduced choice of high-effort options in schizophrenia. Hierarchical logistic regression revealed that reduced choice of high-effort options in schizophrenia was driven by weaker contributions of probability information. Use of reward information was inversely associated with motivational impairment in schizophrenia. Surprisingly, individuals with major depressive disorder and bipolar disorder did not differ from controls. Conclusions Our results provide support for ECDM deficits in schizophrenia. Additionally, differences between groups in ECDM suggest a seemingly similar behavioral phenotype, reduced motivation, could arise from disparate mechanisms. [ABSTRACT FROM AUTHOR]

Background Dynamic functional connectivity (dFC) alterations have been reported in patients with adult-onset and chronic psychosis. We sought to examine whether such abnormalities were also observed in patients with first episode, adolescent-onset psychosis (AOP), in order to rule out potential effects of chronicity and protracted antipsychotic treatment exposure. AOP has been suggested to have less diagnostic specificity compared to psychosis with onset in adulthood and occurs during a period of neurodevelopmental changes in brain functional connections. Study Design Seventy-nine patients with first episode, AOP (36 patients with schizophrenia-spectrum disorder, SSD; and 43 with affective psychotic disorder, AF) and 54 healthy controls (HC), aged 10 to 17 years were included. Participants underwent clinical and cognitive assessments and resting-state functional magnetic resonance imaging. Graph-based measures were used to analyze temporal trajectories of dFC, which were compared between patients with SSD, AF, and HC. Within patients, we also tested associations between dFC parameters and clinical variables. Study Results Patients with SSD temporally visited the different connectivity states in a less efficient way (reduced global efficiency), visiting fewer nodes (larger temporal modularity, and increased immobility), with a reduction in the metabolic expenditure (cost and leap size), relative to AF and HC (effect sizes: Cohen's D, ranging 0.54 to.91). In youth with AF, these parameters did not differ compared to HC. Connectivity measures were not associated with clinical severity, intelligence, cannabis use, or dose of antipsychotic medication. Conclusions dFC measures hold potential towards the development of brain-based biomarkers characterizing adolescent-onset SSD. [ABSTRACT FROM AUTHOR]

Background: The incidence of psychotic disorders varies in different geographic areas. As there has been no report from Turkey, this study aimed to provide the treated incidence rate of first-episode psychosis (FEP) in a defined area. Methods: All individuals, aged 15–64 years, presenting with FEP (ICD-10 F20-29, F30-33) to mental health services in a defined catchment-area in Sinop which is located in the Black Sea region of the northern Turkey were recorded over a 4-year period (2009 to 2012). Incidence rates of psychotic disorders and their 95% confidence intervals (CIs) were estimated. Poisson regression was applied to estimate the differences in incidence rate ratio (IRR) by age, sex, and urbanicity. Results: One hundred and fifteen FEP participants were identified during the 4 years. Crude incidence rates of all psychoses, schizophrenia, other psychotic disorders, and affective psychotic disorders were respectively 38.5 (95% CI 27.1–49.9), 10.7 (95% CI 6.6–14.8), 10.0 (95% CI 5.7–14.3) and 17.7 (95% CI 11.3–24.2) per 100 000 person-years. After age-sex standardisation the rates increased slightly. There were no gender differences in the incidence rates. IRR of any psychotic disorder was highest in the youngest age group (15–24 years) compared to the oldest age group (55–64 years), 7.9 (95% CI 2.8–30.5). In contrast with previous studies, the incidence rate of any psychotic disorder was not significantly increased in urban areas compared with rural areas. Conclusions: The current study, the first of its kind from Turkey, indicates that the risk of schizophrenia and other psychotic disorders in a lowly urbanised area of Turkey is comparable to those reported in Western European cities. [ABSTRACT FROM AUTHOR]