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Aims and method We aimed to describe the clinical characteristics of female patients presenting with premenstrual disorders to a tertiary service in the UK. We conducted a retrospective case-note review of referrals to the National Female Hormone Clinic from April 2014 to August 2020. Based on clinical assessment, we determined whether the patient met criteria for premenstrual dysphoric disorder or premenstrual exacerbation of an underlying psychiatric disorder. Results Of 146 patients seen in clinic for premenstrual disorders, an ICD-10 psychiatric diagnosis was made in 130 (89.0%); a minority 16 (11.0%) did not have a psychiatric diagnosis. Following assessment, 94 patients (64.4%) met criteria for premenstrual dysphoric disorder and 67 (45.6%) had exacerbation of a psychiatric disorder. Clinical implications Patients presenting to this specialist service had complex psychiatric comorbidity; almost half presented with exacerbation of a psychiatric disorder. [ABSTRACT FROM AUTHOR]

The article discusses the potential benefits of menopausal hormone therapy for women with schizophrenia. It highlights the increased risk of relapse in women with schizophrenia during the menopause transition and suggests that hormone therapy may help reduce this risk. The article presents findings from a nationwide cohort study that showed a 16% decreased risk of psychosis relapse in women who used menopausal hormone therapy. However, the article also acknowledges that further research is needed to fully establish the effectiveness and safety of hormone therapy as an adjunctive treatment for schizophrenia. [Extracted from the article]

Cognitive performance is affected by an individual's characteristics and the environment, as well as by the nature of the task and the amount of practice at it. Mental performance tests range in complexity and include subjective estimates of mood, simple objective tests (reaction time), and measures of complex performance that require decisions to be made and priorities set. Mental performance tasks show 2 components, a circadian rhythm and the effects of time awake. The circadian rhythm is in phase with the rhythm of core temperature and there is evidence for a causal link. Increasing time awake results in performance deterioration and is attributed to fatigue. The relative contribution of these 2 components depends upon the task under consideration; simple tasks generally show smaller effects due to increasing time awake. These contributions have been assessed by constant routines and forced desynchronization protocols and have formed the basis of several mathematical models that attempt to predict performance in a variety of field conditions. Mental performance is negatively affected by sleep loss; although short naps are beneficial, sleep inertia limits their value immediately after waking. The processes involved in cognition include attention (tonic and phasic alertness, and selective and sustained attention), working memory (phonological, used for speech, reading, and writing; and visuospatial, used for spatial processing, drawing, and mathematics), and executive function (initiative, decision making, and problem solving). These processes are illuminated by analysis of the regions of the brain involved, the presence of circadian rhythmicity, and the effects of sleep loss. The results from such laboratory- and field-based observations are relevant to the issue of learning in schoolchildren and lead to suggestions for improving their performance.

The current experiment investigated the effect of differential training histories on responses to a 5-term linear chain of nonsense syllables (described here with sequential, alphabetical characters; A [is less than] B [is less than] C [is less than] D [is less than] E) across unreinforced probe trials. Participants' responses to nonarbitrary stimulus relations of More-than and Less-than were first brought under contextual control. Participants were then exposed to 1 of 3 training structures, in which each training structure was defined by the trial types that were presented: Less-More (A [is less than] B | B [is less than] C | D>C | E>D), All-Less (A [is less than] B | B [is less than] C | C [is less than] D | D [is less than] E) and All-More (B>A | C>B | D>C | E>D. The contextual cues served as sample stimuli, and 2 nonsense words as comparison stimuli. Twenty unreinforced probe trials were subsequently administered on all possible derived relations: directly trained, mutually entailed, and 1-, 2- and 3-node combinatorially entailed relation types. Comparisons of response latencies among 1-, 2-, and 3-node combinatorially entailed relations, for accurate performances on all 20 test trials, indicated that the former produced significantly longer latencies than the latter 2 relations. Comparisons of response latencies across the 3 training structures indicated that latencies were significantly lower in the All-More condition relative to both the Less-More and the All-Less conditions. The effects of nodal distance are readily predicted by both associative accounts and Relational Frame Theory, but the effect of training structure is readily predicted only by the latter theory. The reported findings are also broadly in accordance with previous studies on relational inferences reported in the literature from mainstream cognitive psychology.

Background: Intermittent (luteal phase) dosing of selective serotonin reuptake inhibitors is one treatment strategy for premenstrual syndromes such as premenstrual dysphoric disorder. This avoids the risk of the antidepressant withdrawal syndrome associated with long-term continuous dosing. Aims: To compare intermittent dosing to continuous dosing in terms of efficacy and acceptability. Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO, PubMed and CINAHL for randomised trials of intermittent compared with continuous dosing of selective serotonin reuptake inhibitors in premenstrual syndromes. We extracted response rates, dropout rates and changes in symptom scores. We used random effects meta-analyses to pool study-level data and calculated odds ratio for dichotomous data and standardised mean difference for continuous data. Risk of bias was assessed using the Cochrane risk-of-bias tool. The study was registered with PROSPERO (CRD42020224176). Results: A total of 1841 references were identified, with eight studies being eligible for analysis, consisting of a total of 460 participants. All included studies provided response rates, six provided dropout rates and five provided symptom scores. There was no statistically significant differences between intermittent and continuous dosing in terms of response rate (odds ratio: 1.0, 95% confidence interval (CI): 0.23–4.31, I 2 = 71%), dropout rate (odds ratio 1.26, 95% CI: 0.39–4.09, I 2 = 33%) or symptom change (standardised mean difference: 0.04, 95% CI: −0.27 to 0.35, I 2 = 39%). All studies had a moderate or high risk of bias. Conclusion: Since intermittent dosing avoids the potential for withdrawal symptoms, it should be considered more commonly in this patient population. [ABSTRACT FROM AUTHOR]

The parent of a murdered daughter (who is also an educator) examines student potential for violence and suicide and stresses the importance of early intervention for violence prevention. Teachers are urged to establish meaningful connections with students to identify students who fit the profile of alienation that typifies those who actually commit murder or suicide. (Contains references.) (DB)

Describes one parent's account of the death of his daughter by a youth suffering from depression. Suggests three levels of prevention (primary, secondary, tertiary) that can be useful in classifying the range of intervention strategies appropriate for preventing or surviving problems of violence. Stresses the importance of connecting with quiet youth. (Author/JDM)