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Background: In the United States, suicide is one of the serious public health problems and a major cause of death. Several researchers and clinical settings use the patient health questionnaires (PHQ-9) to gauge depression and psychological distress among adults and to predict suicide and death. This study aimed to assess the sensitivity, specificity, and predictive potential of suicide Q9 of the PHQ-9 compared to the Columbia-suicide severity rating scale (C-SSRS)., Methods: Adults aged 19 or older, identified with a primary mood disorder diagnosis during their initial clinic visit between 2012 and 2020 from the National Network of Depression Centers, were included in the study. The accuracy of the PHQ-9 suicide item was compared with the gold standard, the C-SSRS., Results: Out of 2677 study participants, 31.6 % (n = 846) and 11.65 % (n = 312) had positive responses to the PHQ-9 suicide item and C-SSRS response, respectively. The sensitivity of the PHQ-9 compared to the C-SSR was 74.7 % (95%CI: 69.6 %-79.2 %), specificity 74.1 % (95%CI: 72.3 %-75.8 %), positive predictive value 27.5 % (95%CI: 24.6 %-30.6 %), and negative predictive value 95.7 % (95%CI: 94.7 %-96.5 %). The secondary analysis results showed better validity results of the PHQ-9 suicide item when compared to the suicide ideation item of the C-SSRS., Limitations: This study is among mood disorder patients so additional research would be necessary among populations with different conditions., Conclusion: For initial suicide screening, the PHQ-9 suicide item would over identify patients as at risk for suicide and the C-SSRS should be used mood disorder clinics to identify suicide risk., Competing Interests: Declaration of competing interest Dr. Selvaraj has received speaking honoraria from Global Medical Education and honoraria from British Medical Journal Publishing Group and study or sub-investigator for clinical trials by Flow neuroscience, COMPASS Pathways Limited, Janssen, Relmada, and Liva Nova. J.C·S has received grants/research support from BMS, Forrest, J&J, Merck, Compass pathways, Relmada, Liva Nova, Stanley Medical Research Institute, NIH, and has been a speaker for Pfizer and Abbott. All other authors do not report any financial conflicts of interest., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Importance: People with major psychiatric disorders are more likely to have comorbidities associated with worse outcomes of COVID-19. This fact alone could determine greater vulnerability of people with major psychiatric disorders to COVID-19., Objective: To assess the odds of testing positive for and mortality from COVID-19 among and between patients with schizophrenia, mood disorders, anxiety disorders and a reference group in a large national database., Design, Setting, and Participants: This cross-sectional study used an electronic health record data set aggregated from many national sources in the United States and licensed from Optum with current and historical data on patients tested for COVID-19 in 2020. Three psychiatric cohorts (patients with schizophrenia, mood disorders, or anxiety disorders) were compared with a reference group with no major psychiatric conditions. Statistical analysis was performed from March to April 2021., Exposure: The exposures observed include lab-confirmed positivity for COVID-19 and mortality., Main Outcomes and Measures: The odds of testing positive for COVID-19 in 2020 and the odds of death from COVID-19 were measured., Results: The population studied included 2 535 098 unique persons, 3350 with schizophrenia, 26 610 with mood disorders, and 18 550 with anxiety disorders. The mean (SD) age was 44 (23) years; 233 519 were non-Hispanic African American, 1 583 440 were non-Hispanic Caucasian; and 1 580 703 (62%) were female. The schizophrenia cohort (positivity rate: 9.86%; adjusted OR, 0.90 [95% CI, 0.84-0.97]) and the mood disorder cohort (positivity rate: 9.86%; adjusted OR, 0.93 [95% CI, 0.87-0.99]) had a significantly lower rate of positivity than the anxiety disorder cohort (positivity rate: 11.17%; adjusted OR, 1.05 [95% CI, 0.98-1.12) which was closer to the reference group (11.91%). After fully adjusting for demographic factors and comorbid conditions, patients with schizophrenia were nearly 4 times more likely to die from the disease than the reference group (OR, 3.74; 95% CI, 2.66-5.24). The mood disorders COVID-19 cohort had a 2.76 times greater odds of mortality than the reference group (OR, 2.76; 95% CI, 2.00-3.81), and the anxiety disorders cohort had a 2.39 times greater odds of mortality than the reference group (OR, 2.39; 95% CI, 1.68-3.27)., Conclusions and Relevance: By examining a large database while controlling for multiple confounding factors such as age, race and ethnicity, and comorbid medical conditions, the present study found that patients with schizophrenia had much increased odds of mortality by COVID-19.

Aims: Electroconvulsive Therapy (ECT) is a well-established and effective treatment in mood disorders but the use of ECT in Texas is much lower than the general average among the United States. Our goal is to explore the geographical accessibility of Electroconvulsive Services in Texas., Methods: 22 ECT Centers in Texas listed in State's 2016 annual ECT report were enrolled and georeferenced. We used Esri's StreetMap Premium Network release 1 network dataset to generate 1-hour drive time service areas for these ECTs. We estimated populations within these service areas based on US Census Tract level population-weighted centroids; generated from the 2015, American Community Survey (ACS) estimates at the US Census Block Group level., Results: About 75% (19,851,802 of 26,538,614) of Texas total population is within a 1-hour drive time to any ECT Services location. When focusing on population below the poverty level from 2015 Block Group level ACS data: 68% (3,046,141 of 4,472,451) are within a 1-hour drive time., Conclusions: ECT services are geographically accessible in Texas. Other barriers may contribute to lower use of ECT., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The main objective of this study is to establish potential neuromorphometric differences which might act as markers of genetic risk for bipolar disorder and therefore serve as endophenotypes for discovery of genes that contribute to bipolar disorder. Magnetic resonance imaging (MRI) was used to assess structural brain volumes of 49 subjects. Volumetric analyses were first performed to test possible differences in the volume of brain structures between subjects with bipolar disorder type I (BPI) and control subjects in a new sample, based on regions previously reported in the literature as being either increased or decreased in size in bipolar patients. Subsequently, for those brain regions showing statistical difference between subjects with BPI and control subjects in our new sample, we tested whether unaffected first degree relatives (UFRs) of the BPI subjects also showed similar differences compared with controls. Four specific regions (right prefrontal, right middle prefrontal, right globus pallidus and left globus pallidus) met criteria for being possible endophenotypes for BPI in this sample., (Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.)

This article examines the development of lithium therapy since its dramatic introduction into psychiatry in 1949. Since that time, lithium has been examined in the treatment of a variety of neuropsychiatric conditions, but it is in the treatment of bipolar disorder that it is most effective. This suggests that it has specificity in the treatment of this disorder. These findings are very relevant as they suggest that understanding the mechanism of action of lithium in bipolar disorder may hold keys to elucidating its pathophysiology and to developing newer and more effective treatments. We review the published data on the effectiveness of lithium in bipolar disorder and various neuropsychiatric conditions and also the available data on anticonvulsants and newer therapeutic agents in the treatment of this condition.