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Purpose: Examine the reliability of field-based fitness assessments in school-aged children with emotional or behavioral difficulties (EBD). Understanding the impact of fitness on physical activity participation for children with EBD is limited by our ability to reliably measure it. Methods: Fifteen children aged 7–12 years with EBD completed 7 assessments—standing broad jump, overhead throw, grip strength, isometric plank hold, isometric wall squat, unilateral heel raise, and modified 6-minute walk test—in a random order on 2 separate occasions. Intraclass correlation coefficients (ICCs) were computed to evaluate reliability. Results: ICCs ranged from.65 to.99 representing moderate to excellent reliability for all assessments. Shorter assessments requiring less attention and behavior regulation tended to demonstrate higher ICC values while assessments with greater attention or behavioral regulation demands tended to have lower ICC values. Conclusion: Results demonstrate varied reliability for fitness tests in children with EBD. Practitioners can use grip strength and standing broad jump assessments with confidence. Other assessments have good reliability but greater variability indicating they may be a challenge for some children with EBD. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionsWe aimed to test the performance of the short version of the Temperamental Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire (Short-TEMPS-A) as a tool for bipolar disorder (BD) status detection in an outpatient sample with affective disorders, using Cyclothymic-Hyperthymic High Temperamental Load (HTL-CH) as the criterion for a positive test.We enrolled 201 euthymic female and male adult outpatients (73.1% female; mean age 47.3 ± 16 years), with BD (42.79%), and other affective disorders (major depressive disorder (20.9%), or anxiety disorders (36.32%)) in a public general hospital in South-Central Chile. Diagnosis was made using the Structured Clinical Interview for axis I. All subjects completed the Short-TEMPS-A. HTL-CH was defined using a cutoff of ≥75% in the hyperthymic or cyclothymic subscales of the Short-TEMPS-A. We estimated the HTL-CH likelihood of BD versus non-BD using multiple logistic regression modeling to control for possible confounders. The performance of HTL-CH as a tool for BD status evaluation was assessed using area under receiver operating characteristic curve (AUC ROC) analysis.Patients with HTL-CH had an OR = 7.55 (CI95% = 2.11–26.96) of having a BD status. HTL-CH showed good psychometric properties for BD status detection, correctly classifying 74.13% of patients. AUC ROC was 0.74 (CI95%=0.68–0.81).HTL-CH, as assessed by the Short-TEMPS-A, was able to detect BD status accurately and reliably in affective outpatients. The Short-TEMPS-A might be a useful tool in aiding clinicians to detect BD, particularly during initial assessment of affective patients in low-resource settings. [ABSTRACT FROM AUTHOR]

Background: Mood disorders involve a complex interplay between multifaceted internal emotional states, and complex external inputs. Dynamical systems theory suggests that this interplay between aspects of moods and environmental stimuli may hence determine key psychopathological features of mood disorders, including the stability of mood states, the response to external inputs, how controllable mood states are, and what interventions are most likely to be effective. However, a comprehensive computational approach to all these aspects has not yet been undertaken. Methods: Here, we argue that the combination of ecological momentary assessments (EMA) with a well-established dynamical systems framework—the humble Kalman filter—enables a comprehensive account of all these aspects. We first introduce the key features of the Kalman filter and optimal control theory and their relationship to aspects of psychopathology. We then examine the psychometric and inferential properties of combining EMA data with Kalman filtering across realistic scenarios. Finally, we apply the Kalman filter to a series of EMA datasets comprising over 700 participants with and without symptoms of depression. Results: The results show a naive Kalman filter approach performs favourably compared to the standard vector autoregressive approach frequently employed, capturing key aspects of the data better. Furthermore, it suggests that the depressed state involves alterations to interactions between moods; alterations to how moods responds to external inputs; and as a result an alteration in how controllable mood states are. We replicate these findings qualitatively across datasets and explore an extension to optimal control theory to guide therapeutic interventions. Conclusions: Mood dynamics are richly and profoundly altered in depressed states. The humble Kalman filter is a well-established, rich framework to characterise mood dynamics. Its application to EMA data is valid; straightforward; and likely to result in substantial novel insights both into mechanisms and treatments. Author summary: In this study, we aimed to understand the dynamics of mood in the context of depression, utilizing experience sampling data and well-established mathematical techniques. Our approach sought to overcome limitations of traditional methods and accurately capture the dynamics of moods in real-life situations. Through the application of a Kalman filter to examine mood trajectories in experience sampling data from various datasets, including both patients with depression and healthy controls, we were able to capture the evolution of mood, interaction among different mood items, and responsiveness to environmental inputs. The study revealed distinct dynamical features characteristic of depression, highlighted the potential of using external factors to influence mood and potentially shift between stable emotional states. The findings offer valuable insights into the impact of depression on mood dynamics and potential intervention strategies, contributing to a better understanding of depression mechanisms. The study also acknowledges the challenges of employing complex models to depict sparse and noisy data, emphasizing the need for further research to address these complexities. [ABSTRACT FROM AUTHOR]

Growing evidence suggests the tendency to act rashly under positive and negative emotions and affect-related drinking motives connect symptoms of mood disorders with alcohol-related problems. However, studies examining this sequence are scarce in Latin-American samples. The present study evaluated, in Argentinian college students (n = 403; 68.2% women; Mage = 21.03 ± 4.90), a sequential model of symptoms of depression, urgency traits, internal drinking motives, and problematic alcohol use. Path analysis was conducted to examine the direct and indirect associations between symptoms of depression and problematic alcohol use (heavy episodic drinking and alcohol-related negative consequences) via positive and negative urgency traits and internal drinking motives. Findings revealed indirect associations from depressive symptoms to problematic alcohol use via urgency traits and drinking motives (e.g. depression symptoms→positive [negative] urgency→enhancement [coping]→drinking problems). This suggests that students who experience more symptoms of depression may be more likely to react to these experiences of negative affect by engaging in heavy drinking episodes and encounter more alcohol-related problems. This seems to stem from a higher propensity to act rashly during intense emotional experiences and a greater motivation to drink as a means of regulating their mood. Future interventions aimed at preventing or reducing problematic alcohol use (especially among Argentinian young adults) might consider targeting these specific impulsivity traits as well as affect-related drinking motivations. [ABSTRACT FROM AUTHOR]

Background: Findings from the Global Burden of Disease (GBD) study have shown that the burden of mental and substance use disorders is considerable, and unevenly distributed across demographic groups in the population. However, there is a lack of knowledge on how this burden differs by socioeconomic position. The aim of this study was to examine educational differences in years lived with disability (YLDs) from mental and substance use disorders among males and females in two high-income countries, taking comorbidity with other diseases into account. Methods: The study included all registered residents in Denmark and Norway from 2011 to 2021. Diagnostic information was retrieved from records in the Norwegian National Patient Registry (NPR) and the Danish Psychiatric Central Research Register (PCRR) and used as proxy measures for disorder prevalence. Demographical and educational information was taken from administrative registries. The YLD is a measure of the non-fatal health loss in the population and was calculated by multiplying the duration of a disorder with a disability weight (DW), scaled between 0 and 1. Information on remission and DWs were retrieved from the GBD study and other sources, and disorder specific DWs were averaged by severity levels and adjusted for comorbidity. Results: Educational gradients in YLD rates were found for mental and substance disorders overall, and for most of the specific disorders. The educational gradient was more pronounced for schizophrenia, intellectual disability and substance use disorders than for eating, anxiety, and affective disorders. Both higher YLD rates, and a larger attributed proportion of the total YLDs, were found for schizophrenia, intellectual disability, and substance use disorders in the groups with low versus high education. YLD rates for eating, anxiety, and affective disorders were more equal across educational levels, but constituted a smaller proportion of the total YLDs among the groups with low versus the groups with high educational level. Conclusion: Most of the disease burden related to mental and substance use disorders falls on those with the fewest years of education. This should be taken into consideration when public health targets aimed at improving mental health and reducing social inequalities in health are developed and implemented. Key message: • The disease burden of mental and substance use disorder is unequally distributed by educational levels in both Denmark and Norway. • The educational gradient in disease burden from mental and substance use disorders is more pronounced for schizophrenia, intellectual disability and substance use disorders, than for eating, anxiety, and affective disorders. • Use of disease burden methodology on individually linked registry data extends the knowledge on the distribution of important causes of non-fatal health loss in different groups of the population. [ABSTRACT FROM AUTHOR]

Introduction: Bipolar disorder (BD), a mood disorder with recurrent affective episodes and a strong genetic basis is frequently associated with significant comorbidities, both physical and psychiatric, yet its neurobiology remains unclear. Recent evidence underscores oxidative stress as a pivotal factor linking BD to its comorbidities, prompting an investigation into whether this is a sign of a genetic vulnerability or a consequence of the disease. In this study, we systematically reviewed oxidative stress studies conducted on individuals at risk for BD. We performed a meta-analysis on studies examining oxidative DNA damage in these individuals. Methods: The literature was searched across the databases PubMed, Web of Science, Scopus, Ovid MEDLINE, and Cochrane to locate studies of oxidative stress markers in relatives of patients with BD compared with healthy controls (from 1946 to March 2024). Studies were considered for inclusion based on the following criteria: (i) involvement of first- or second-degree relatives of individuals diagnosed with BD, (ii) presence of a healthy control group, (iii) reporting of oxidative stress parameters for relatives, including mean and standard deviation or median and interquartile range (25–75%) values, and (iv) publication in the English language. Studies comparing the levels of 8-hydroxy-2′-deoxyguanosine (8-OH-dG) or its tautomer 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxo-dG) in individuals at risk for BD with healthy controls were evaluated using a meta-analysis with the random-effects method. The risk of bias was evaluated using the Risk of Bias in Non-Randomized Studies of Exposure (ROBINS-E) tool. Results: Eleven studies were included in the systematic review and four studies for the meta-analysis. The meta-analysis included 543 individuals (first-degree relatives of individuals with BD = 238, control = 305). 8-OH-dG levels were found to be increased in first-degree relatives of individuals with BD compared to healthy controls (random effects: Hedges’s g = 0.53, 95% CI = 0.36–0.71, p < 0.001). Findings of oxidative stress markers other than oxidative DNA damage in relatives of individuals with BD are limited and scarce. Conclusion: In this meta-analysis, which consists of a limited number of studies, oxidative DNA damage seems to be a trait marker for BD. This finding could be associated with increased comorbidity and a higher risk of premature aging in individuals at risk for BD. However, further studies with larger sample sizes and longitudinal designs are warranted to confirm findings. Clarifying the changes in these markers from individuals at risk for the disorder throughout the course of the illness would help bridge the gap in understanding the role of oxidative pathways in the risk of BD. [ABSTRACT FROM AUTHOR]

Cerebral microvascular dysfunction is a promising area for research into the pathogenesis of major depressive disorder (MDD) and bipolar disorder (BD). Despite the scientific and clinical potential of studying microvascular dysfunction, progress in this area has long been hampered by the lack of methods to study microvessels intravitally. The aim of the present study was to search for potential optical coherence tomography (OCT) and OCT-angiography (OCTA) biomarkers of BD and MDD. One hundred and five consecutive patients with a current depressive episode were enrolled in the study (39 – BD and 66 – MDD). In addition, forty-one generally healthy subjects were enrolled as a control group. Only the right eye was examined in all subjects. Structural OCT and OCTA scans with signal strength ≥7 were included. Structural OCT measurements showed no significant differences between the groups. OCTA measurements of foveal avascular zone (FAZ), area and skeleton density showed a decrease in the retinal capillary bed in BD patients, whereas OCTA values in MDD patients did not differ from the control group. Several significant differences were found between the BD and control groups. In the BD group, the FAZ of the deep capillary plexus was increased, reflecting a reduction in capillary perfusion in the central subfield of this plexus. OCTA measurements of FAZ, area and skeleton density showed a decrease in the retinal capillary bed in BD patients, whereas OCTA values in MDD patients did not differ from the control group. • Characteristics of the retina may be potential biomarkers for mood disorders • Optical coherence tomography angiography (OCTA) provides in vivo imaging of the retinal vasculature • Bipolar disorder is associated with reduced foveal avascular zone area and skeletal density in the retinal capillary bed [ABSTRACT FROM AUTHOR]

Social support is a robust predictor of post-traumatic stress disorder (PTSD). Although the inverse relationship between perceived social support and PTSD (social causation model) is supported, less is understood about the antecedents of the social causation model. Further, there is limited research in non-Western psychiatric populations that experience elevated rates of trauma and PTSD (e.g., mood disorders). The present study evaluated whether cumulative traumatic life events influenced current PTSD symptoms through maladaptive personality traits and perceptions of social support among Asian patients with mood disorders. A total of 200 Asian patients (77.5 % Chinese) with mood disorders were assessed for maladaptive personality traits, perceptions of social support, cumulative traumatic life events, PTSD, and depressive symptoms. Structural equation modelling was conducted to evaluate the extended social causation model. The extended social causation model demonstrated acceptable fit to the data (Comparative Fit Index [CFI] = 0.90; absolute Root Mean Square Error of Approximation [RMSEA] = 0.08). There were significant indirect effects of cumulative traumatic life events on current PTSD symptoms (β = 0.29, p <.001; 85 % variance explained) and depressive symptoms (β = 0.28, p <.001; 69 % variance explained). Results may not be generalizable beyond the Singapore population due to the socio-cultural and environmental context. The present findings provide conceptual support for a maladaptive personality-informed model of social support and PTSD, which could better inform trauma-focused interventions in preventing and treating the debilitating effects of PTSD in psychiatric populations. • Less is known about the antecedents of the social causation model of PTSD. • Cumulative trauma and maladaptive personality traits are important antecedents. • Preliminary conceptual support for a maladaptive personality-informed model of PTSD. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Family history of Parkinson's disease (PD) is a common finding in PD patients. However, a few studies have systematically examined this aspect.We investigated the family history of PD patients, comparing demographic and clinical features between familial PD (fPD) and sporadic PD (sPD).A cross‐sectional study enrolling 2035 PD patients was conducted in 28 Italian centers. Clinical data and family history up to the third degree of kinship were collected.Family history of PD was determined in 21.9% of patients. fPD patients had earlier age at onset than sporadic patients. No relevant differences in the prevalence of motor and nonmotor symptoms were detected. Family history of mood disorders resulted more prevalently in the fPD group.fPD was found to recur more frequently than previously reported. Family history collection beyond the core family is essential to discover disease clusters and identify novel risk factors for PD. [ABSTRACT FROM AUTHOR]

• Higher free-water index in bipolar group suggests neuroinflammation links. • ALPS index and disease duration are inversely related suggesting glymphatic issues. • FW-corrected measures linked with DRS indicate severe bipolar impacts myelin. The glymphatic system, an expansive cerebral waste-disposal network, harbors myriad enigmatic facets necessitating elucidation of their nexus with diverse pathologies. Murine investigations have revealed a relationship between the glymphatic system and affective disorders. This study aimed to illuminate the interplay between bipolar disorder and the glymphatic system. Fifty-eight individuals afflicted with bipolar disorder were identified through meticulous psychiatric assessment. These individuals were juxtaposed with a cohort of 66 comparably aged and sex-matched, mentally stable subjects. Subsequent analysis entailed the application of covariance analysis to evaluate along with the perivascular space (ALPS) index, a novel magnetic resonance imaging method for assessing brain interstitial fluid dynamics via diffusion tensor imaging within the bipolar and control cohorts. We also evaluated the correlation between the ALPS index and clinical parameters, which included the Hamilton Depression scale scores, disease duration, and other clinical assessments. Moreover, partial correlation analyses, incorporating age and sex as covariates, were performed to investigate the relationships between the ALPS index and clinical measures within the two cohorts. A noteworthy adverse correlation was observed between the ALPS index and illness duration. A free-water imaging analysis revealed a substantial elevation in the free-water index within the white-matter tracts, prominently centered on the corpus callosum, within the bipolar cohort relative to that in the control group. In analogous cerebral regions, a conspicuous affirmative correlation was observed between the free-water–corrected radial diffusivity and depression rating scales. Our results showed that the protracted course of bipolar disorder concomitantly exacerbated glymphatic system dysregulation. [ABSTRACT FROM AUTHOR]

Background: Depression and anxiety are prevalent after stroke and associated with poor outcomes. We previously co-developed a stroke-specific self-management intervention, HEADS: UP (Helping Ease Anxiety and Depression after Stroke). The two studies reported here aimed to test the feasibility and acceptability of the HEADS: UP course and supporting materials, and research processes ahead of a definitive trial. Methods: We recruited community-dwelling stroke survivors (SS) ≥ 3 months post-stroke, with symptoms of mood disorder (Hospital Anxiety and Depression Scale ≥ 8). Participants could 'enrol' a family member/ 'other' to take part with them, if desired. Study 1 tested HEADS: UP delivered in-person, and informed optimisation of research processes and intervention delivery and materials. In a pragmatic response to Covid-related socialising restrictions, HEADS: UP was then adapted for online delivery, tested in Study 2. The primary outcome (both studies) was the feasibility (acceptability, fidelity) of the intervention and of research processes. Quantitative data (including patient-reported outcome measures (PROMs) assessing mood and quality of life) and qualitative data were collected pre-/post-intervention. Descriptive statistics were used to analyse quantitative data; a thematic framework approach was used to analyse qualitative data. Both studies received ethical approval prior to commencement. Results: Study 1 Feasibility: 13 (59.1%) of 22 potentially eligible stroke survivors consented; aged 66 (median, interquartile range (IQR) 14); male (n = 9; 69%); 28 (IQR 34) months post-stroke. Of these, n = 10 (76.9%) completed PROMS pre-intervention; n = 6 (46.2%) post-intervention. Acceptability: Nine (69.2%) of the 13 participants attended ≥ 4 core intervention sessions. Aspects of screening and data collection were found to be burdensome. Study 2 Feasibility: SS n = 9 (41%) of 22 potentially eligible stroke survivors consented; aged 58 years (median; IQR 12); male (n = 4; 44.4%); 23 (IQR 34) months post-stroke. Of these, n = 5 (55.6%) completed PROMS pre-intervention; n = 5 (55.6%) post-intervention. Acceptability: Five (55.6%) of the 9 participants attended ≥ 4 core sessions. They found online screening and data collection processes straightforward. [ABSTRACT FROM AUTHOR]

Background: Diabetes and poor glycaemic control have been shown to negatively impact cognitive abilities, while also raising risk of both mood disorders and brain structural atrophy. Sites of atrophy include the hippocampus, which has been implicated in both memory performance and depression. The current study set out to better characterise the associations between poor glycaemic control, memory performance, and depression symptoms, and investigate whether loss of hippocampal volume could represent a neuropathological mechanism underlying these. Methods: 1331 participants (60.9% female, age range 18–88 (Mean = 44.02), 6.5% with likely diabetes) provided HbA1c data (as an index of glycaemic control), completed a word list learning task, and a validated depression scale. A subsample of 392 participants underwent structural MRI; hippocampal volumes were extracted using FreeSurfer. Results: Partial correlation analyses (controlling for age, gender, and education) showed that, in the full sample, poorer glycaemic control was related to lower word list memory performance. In the MRI sub-sample, poorer glycaemic control was related to higher depressive symptoms, and lower hippocampal volumes. Total hippocampus volume partially mediated the association between HbA1c levels and depressive symptoms. Conclusions: Results emphasise the impact of glycaemic control on memory, depression and hippocampal volume and suggest hippocampal volume loss could be a pathophysiological mechanism underlying the link between HbA1c and depression risk; inflammatory and stress-hormone related processes might have a role in this. [ABSTRACT FROM AUTHOR]

Background: Five-guaranteed elderly individuals are a special group of the elderly Chinese population faced with unique challenges; these individuals lack any financial resources (including support by relatives), and are solely reliant on the government to provide food, clothing, medical care, and housing as well as burials. In this article, we aim to investigate mood problems (depression, anxiety) and cognitive functioning in Five-guaranteed elderly individuals, and to validate the effectiveness of two promising interventions, graphene far-infrared intervention (GFII; an exploratory and noninvasive technique) and social network intervention (SNI), for elderly people to lay the foundation for future social service work. Methods: To address the emotional and cognitive difficulties experienced by this special group, we designed this study, which is the first to apply GFII in this population. We also administered SNI given the social isolation of these individuals, in addition to a corresponding control group. 108 elderly individuals in 3 elder care facilities were screened to evaluate eligibility to participate in the current study, including 44 from Facility A (allocated to the GFII group), 43 from Facility B (allocated to the SNI group), and 21 from Facility C (allocated to the control group). GFII lasts for four weeks, with professionally trained carers putting on and removing intervention caps for half an hour each day. SNI lasts for three weeks, three times a week, and consists of a total of nine themed activities. The length of an activity is 90 min. We also did pre- and post-test comparisons of depression, anxiety and cognition in each group of older adults. Results: The results showed that GFII led to immediate improvements in anxiety and cognitive impairment in the five-guaranteed elderly individuals, and the improvement in cognitive function was sustained over time. Moreover, SNI group showed significant improvements in cognitive function after the intervention period. Conclusions: The GFII is a promising intervention that can be applied to intervene in cognitive and mood disorders in older adults. The GFII has short-term interventions for anxiety in older adults, but long-term effects for cognitive impairment. SNI also had an interventional effect on cognition. [ABSTRACT FROM AUTHOR]

Anomalies in mood, thinking, work, bodily functions, emotions, social interactions, and general behavior are frequently related to mental disorders. A strong correlation has been found between affective disorders, mental illnesses, and physiological reactions from the brain, muscles, heart, eyes, and skin. Understanding multidisciplinary open research challenges, including the combination of behavioral sciences, computer science, machine learning, psychology, and sociology, could potentially reveal new interdisciplinary research domains. In the purview of previously stated arguments, this study intends to investigate the physiological and behavioral signals could be used for machine learning-based detection of mental disorders. Subsequently, identification of machine learning algorithms to exploit these modalities for detecting mental disorders were studied. This study presents a systematic literature review to promulgate state-of-the-art computational methods and technologies facilitating the automated detection of affective disorders. The relevant literature between 2010 and 2022 has been studied for this survey. Recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model were adopted for the identification, screening, validating, and inclusion of research literature. The study concluded the fact that self-diagnosis tools for detecting mental disorders, like questionnaires and rating scales, produce inconsistent results. Further, there are no standard baselines for mental disorders. This situation mandates a multi-faceted approach that may utilize physiological signals, behavioral patterns, and even data obtained from various online portals like social media to efficiently and effectively detect mental disorders' prevalence, type, and severity. [ABSTRACT FROM AUTHOR]

The neuropathology of mood disorders, including the diagnostic transition from major depressive disorder (MDD) to bipolar disorder (BD), is poorly understood. This study investigated resting-state electroencephalography (EEG) activity in patients with MDD and those whose diagnosis changed from MDD to BD. Among sixty-eight enrolled patients with MDD, the diagnosis of 17 patients converted to BD during the study period. We applied machine learning techniques to differentiate the two groups using sensor- and source-level EEG features. At the sensor level, patients with BD showed higher theta band power at the AF3 channel and low-alpha band power at the FC5 channel compared to patients with MDD. At the source level, patients with BD showed higher theta band activity in the right anterior cingulate and low-alpha band activity in the left parahippocampal gyrus. These four EEG features were selected for discriminating between BD and MDD with the best classification performance showing an accuracy of 80.88%, a sensitivity of 76.47%, and a specificity of 82.35%. Our findings revealed distinct theta and low-alpha band activities in patients with BD and MDD. These differences could potentially serve as candidate neuromarkers for the diagnosis and diagnostic transition between the two distinct mood disorders. [ABSTRACT FROM AUTHOR]

Over the years, the use of Electroconvulsive therapy (ECT) has gained increasing acceptance as a viable treatment for managing treatment-resistant mental health conditions, and it is known to deliver more rapid therapeutic benefits than most treatment modalities in psychiatry. However, the practice of ECT exhibits significant variability both within and between countries. This review aimed to shed light on the status of ECT in the African context and its implications for mental health care in the region. In July 2023, databases (Ovid, PubMed, Web of Science, etc.) were searched for articles about ECT in Africa, following the PRISMA guidelines. Eligible studies reporting ECT practices in Africa and those about knowledge, attitudes, and perceptions were excluded. A total of 25 articles met the study criteria. The reviewed studies revealed that unmodified ECT continues to be used in some African countries due to resource limitations, while bilateral ECT is widely practiced across the continent. The primary diagnostic indications for ECT in Africa included severe depression and affective disorders. ECT usage and regulation vary significantly throughout Africa. The studies, primarily observational, detailed numerous challenges in employing the method, particularly concerning resource utilization in healthcare facilities. The review highlights the necessity for adaptable standards and local protocols to enhance ECT practices throughout Africa. It emphasizes the importance of conducting more evidence-based research to develop region-specific guidelines that ensure the safe and effective use of ECT. Policymakers and healthcare practitioners should prioritize resource allocation, training, and standardization to improve ECT delivery and outcomes on the continent. [ABSTRACT FROM AUTHOR]

Introduction: Discriminating bipolar disorder (BD) from major depressive disorder (MDD) remains a challenging clinical task. Identifying specific peripheral biosignatures that can differentiate between BD and MDD would significantly increase diagnostic accuracy. Dysregulated neuroplasticity is implicated in BD and MDD, and psychotropic medications restore specific disrupted processes by increasing neurotrophic signalling. The nerve growth factor inducible vgf gene (non-acronymic) encodes a precursor protein named proVGF, which undergoes proteolytic processing to produce several VGF peptides, some of which were suggested to be implicated in mood disorders and have antidepressant effects. Since the presence of VGF peptides in humans has been exclusively investigated in brain and cerebrospinal fluid, we aimed to identify which VGF peptides are present in the plasma and to investigate whether their levels could differentiate BD from MDD as well as responders from non-responders to pharmacological interventions. Methods: VGF peptides were investigated in plasma from patients diagnosed with MDD (n = 37) or BD (n = 40 under lithium plus n = 29 never exposed to lithium), as well as healthy controls (HC; n = 36). Results: Three VGF peptides (TLQP-11, AQEE-14, and NAPP-19) were identified using spectrometry analysis of plasma from HC. These peptides were then measured in the entire sample using ELISA, which showed significantly lower levels of AQEE and NAPP in BD than in HC and MDD (p = 5.0 × 10−5, p = 0.001, respectively). Conclusion: Our findings suggest that lower plasma levels of NAPP and AQEE are specifically associated with BD, thus possibly representing a diagnostic biomarker in mood disorders. [ABSTRACT FROM AUTHOR]

Depression, a mood disorder characterized by a persistent low mood and lack of enjoyment, is considered the leading cause of non-fatal health losses worldwide. Neuroplasticity refers to the brain's ability to adapt to external or internal stimuli, resulting in functional and structural changes. This process plays a crucial role in the development of depression. Traditional Chinese Medicine (TCM) shows significant potential as a complementary and alternative therapy for neurological diseases, including depression. However, there has been no systematic summary of the role of neuroplasticity in the pathological development of depression and TCM Interventions currently. This review systematically summarized recent literature on changes in neuroplasticity in depression and analyzed the regulatory mechanisms of active metabolites in TCM and TCM formulas on neuroplasticity in antidepressant treatment. Additionally, this review discussed the limitations of current research and the application prospects of TCM in regulating neuroplasticity in antidepressant research. [ABSTRACT FROM AUTHOR]

Background: Electroencephalography (EEG) is a promising tool for identifying the physiological biomarkers of fibromyalgia (FM). Evidence suggests differences in power band and density between individuals with FM and healthy controls. EEG changes appear to be associated with pain intensity; however, their relationship with the quality of pain has not been examined. We aimed to investigate whether abnormal EEG in the frontal and central points of the 10–20 EEG system in individuals with FM is associated with pain's sensory-discriminative and affective-motivational dimensions. The association between EEG and the two dimensions of emotional disorders (depression and anxiety) was also investigated. Methods: In this cross-sectional pilot study, pain experience (pain rating index [PRI]) and two dimensions of emotional disorders (depression and anxiety) were assessed using the McGill Pain Questionnaire (PRI-sensory and PRI-affective) and Hospital Anxiety and Depression Scale (HADS), respectively. In quantitative EEG analysis, the relative spectral power of each frequency band (delta, theta, alpha, and beta) was identified in the frontal and central points during rest. Results: A negative correlation was found between the relative spectral power for the delta bands in the frontal (r= -0.656; p = 0.028) and central points (r= -0.624; p = 0.040) and the PRI-affective scores. A positive correlation was found between the alpha bands in the frontal (r = 0.642; p = 0.033) and central points (r = 0.642; p = 0.033) and the PRI-affective scores. A negative correlation between the delta bands in the central points and the anxiety subscale of the HADS (r = -0.648; p = 0.031) was detected. Conclusion: The affective-motivational dimension of pain and mood disorders may be related to abnormal patterns of electrical activity in patients with FM. Trial registration: Retrospectively registered on ClinicalTrials.gov (NCT05962658). [ABSTRACT FROM AUTHOR]

As meaningful measure of cognitive impairment (CI), cognitive phenotypes provide an avenue for symptom management and individualized rehabilitation. Since CI is highly variable in severity and progression, monitoring cognitive phenotypes over time may be useful to identify trajectory of cognitive decline in Multiple Sclerosis (MS). Based on cognitive and mood information from patient-reported outcomes (PROs) and clinician-assessed outcomes (CAOs), four cognitive subgroups of people with MS (PwMS) were identified: phenotype 1 (44.5%) showed a preserved cognitive profile; phenotype 2 (22.8%) had a mild-cognitive impairment profile with attention difficulties; phenotype 3 (24.3%) included people with marked difficulties in visuo-executive, attention, language, memory and information processing speed; lastly, phenotype 4 (8.4%) grouped individuals with a multi-domain impairment profile (visuo-executive, attention, language, memory, orientation, information processing speed and mood disorders). Although some fluctuations occurred considering the rate of impairment, cognitive phenotypes did not substantially vary at follow up in terms of type and number of impairments, suggesting that 1 year is a relatively brief temporal window to observe considerable changes. Our results corroborate that investigating cognitive phenotypes and their stability over time would provide valuable information regarding CI and, in addition, increase clinical importance of PROs and CAOs and their uptake in decision-making and individualized treatment planning for PwMS. [ABSTRACT FROM AUTHOR]

The massive use of herbicides, particularly glyphosate‐based herbicides (GBHs), raises several worries, notably their neurotoxic effects. Several studies have explored the consequences of developmental exposure. Our work aims to determine the impact of maternal exposure to GBH on behavioral disorders and memory deficits, as well as the involvement of oxidative stress in the hippocampus and prefrontal cortex. In addition, our study explores the neuroprotective properties of melatonin in male and female offspring. Pregnant Wistar rats were injected with GBH 75 mg/kg during gestation and lactation. After weaning, the offspring were treated with melatonin (4 mg/kg) from postnatal days 30–58. Our results show that GBH increases anxiety‐like behavior levels in offspring, as well as depression‐like behavior. GBH also impairs working memory in progeny. While markers of oxidative stress show a disturbance in lipid peroxidation and catalase activity, with a more pronounced effect in females, on the other hand, melatonin considerably attenuated the neurotoxic impact observed in the offspring, with higher efficacy in females. The oxidative stress results confirm the antioxidant power of melatonin to counteract the damaging effects of exposure to environmental contaminants such as glyphosate‐based pesticides. It will then be interesting to further our work to fully understand the sex‐dependent effect of melatonin. [ABSTRACT FROM AUTHOR]

Understanding the factors that are associated with individual differences in emotion regulation (ER) difficulties, which is one of the common transdiagnostic factors underlying many psychological disorders, is crucial for understanding and treating psychological disorders. The aim of the two investigations was to examine the mediator role of looming cognitive style (LCS) in the relationship of harm avoidance (HA) with both state and trait forms of ER difficulty. A total of 362 adults participated in Study 1 and 236 adults in Study 2. They completed measurements of HA, LCS, and ER. In Study 2, participants were induced into an anxious mood state and filled out a scale measuring ER in that process. Path analysis demonstrated that social looming between HA and trait ER and physical looming between HA and state ER had mediator roles. Finally, the alternative models which included HA and ER as the outcomes yielded poor fit. The results revealed that LCS significantly mediated the relationship of HA with both trait and state forms of ER difficulty, providing support for the model that aimed to explain how LCS contributes to the development and maintenance of psychological disorders. [ABSTRACT FROM AUTHOR]

Juvenile ankylosing spondylitis (JAS) is a systemic inflammatory arthritis that can negatively impact quality of life and mood. While psychological interventions, such as cognitive behavioral therapy (CBT), are recommended for addressing mood and adjustment in juvenile rheumatic diseases, there is currently no literature describing the application of CBT in adolescents with JAS. This case study presents the first use of a CBT framework in an adolescent with JAS. A 15-year-old male participated in 17 CBT sessions targeting pain management, anxiety, and functional impairments related to his JAS. Therapy focused on the acquisition of coping and self-regulation skills to improve functioning, reduce mood concerns, and manage pain. CBT led to significant improvements in depression, anxiety, and quality of life measures. The patient reported subjective enhancements in health behaviors, pain, and general functioning. This study discusses areas in which CBT may benefit adolescents with JAS and suggests avenues for future research. [ABSTRACT FROM AUTHOR]

The research in neuroimmunomodulation aims to shed light on the complex relationships that exist between the immune and neurological systems and how they affect the human body. This multidisciplinary field focuses on the way immune responses are influenced by brain activity and how neural function is impacted by immunological signaling. This provides important insights into a range of medical disorders. Targeting both brain and immunological pathways, neuroimmunomodulatory approaches are used in clinical pain management to address chronic pain. Pharmacological therapies aim to modulate neuroimmune interactions and reduce inflammation. Furthermore, bioelectronic techniques like vagus nerve stimulation offer non-invasive control of these systems, while neuromodulation techniques like transcranial magnetic stimulation modify immunological and neuronal responses to reduce pain. Within the context of aging, neuroimmunomodulation analyzes the ways in which immunological and neurological alterations brought on by aging contribute to cognitive decline and neurodegenerative illnesses. Restoring neuroimmune homeostasis through strategies shows promise in reducing age-related cognitive decline. Research into mood disorders focuses on how immunological dysregulation relates to illnesses including anxiety and depression. Immune system fluctuations are increasingly recognized for their impact on brain function, leading to novel treatments that target these interactions. This review emphasizes how interdisciplinary cooperation and continuous research are necessary to better understand the complex relationship between the neurological and immune systems. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Disorders of gut-brain interaction (DGBIs) may originate in childhood. There are currently limited data on persistence of DGBI into adulthood and risk factors for persistence. Furthermore, there are no data on this question from general practice, where the majority of DGBIs are diagnosed and managed. This study documents the proportion of childhood-diagnosed DGBIs that persisted into adulthood and what factors were associated with persistence. METHODS: General practice records were obtained for more than 60,000 patients whose medical record spanned both childhood and adulthood years. Patients with diagnosed organic gastrointestinal disorder were excluded. Medical records were also interrogated for potential risk factors. RESULTS: Eleven percent of patients with irritable bowel syndrome (IBS) and 20% of patients with functional dyspepsia (FD) diagnosed in childhood had repeat diagnoses of the same condition in adulthood. Female sex (odds ratio [OR] 2.02) was associated with persistence for IBS, while a childhood diagnosis of gastritis (OR 0.46) was risk-protective. Childhood non-steroidal anti-inflammatory drug use (OR 1.31, 95% confidence interval [CI] 1.09-1.56) was a risk factor for persistence in IBS. For FD, a childhood diagnosis of asthma (OR 1.30, 95% CI 1.00-1.70) was a risk factor, as was anxiety for both IBS (OR 1.24, 95% CI 1.00-1.54) and FD (OR 1.48 95% CI 1.11-1.97) with a similar finding for depression for IBS (OR 1.34, 95% CI 1.11-1.62) and FD (OR 1.88 95% CI 1.47-2.42). DISCUSSION: Childhood DGBIs persist into adulthood in 10%-20% of patients, suggesting that management monitoring should continue into adulthood. Those diagnosed with anxiety or mood disorders in childhood should receive particular attention, and prescription of non-steroidal anti-inflammatory drugs in children should be made judiciously. [ABSTRACT FROM AUTHOR]

Introduction: Suicide is a widespread problem, with risk factors still a challenge. The aim was to assess correlations among insomnia, circadian rhythm, and inflammatory markers in individuals who attempted suicide. Materials and Methods: Consecutive patients hospitalised following an attempted suicide, were assessed. Psychiatric diagnosis (DSM-5-TR Criteria), lethality of the suicide attempt (Suicide Intent Scale-SIS), and inflammatory parameters NLR (neutrophil-lymphocyte ratio) PLR (platelet-lymphocyte ratio), and SII (systemic inflammation index/neutrophil-to-platelet ratio on lymphocytes), were computed. Depressive and manic symptoms (Beck Depression Inventory-BDI-II, Young Mania Rating Scale- YMRS), circadian rhythms disturbances (Biological Rhythms Interview of Assessment in Neuropsychiatry-BRIAN), insomnia symptoms (Insomnia Severity Index-ISI) were assessed together with socio-demographic, clinical and pharmacological data. Results: The final sample included 52 individuals. Patients who experienced insomnia during the preceding two weeks utilised high lethality methods, reported heightened dysregulation of chronobiological rhythms, heightened severity of depression, and elevated levels of inflammatory markers. High lethality was best predicted by insomnia symptoms (OR = 20.1, CI-95% 4.66-87.25, p = 0.001), by disturbances of circadian rhythms (OR = 6.97, CI-95% 1.82-26.66, p = 0.005), and by NLR indices (OR 4.00, CI-95% 1.14-13.99, p = 0.030). Conclusions: Sleep disturbances may be a risk factor for suicidal lethality, along with markers of inflammation. It is plausible that insomnia and circadian sleep dysregulation may contribute to inflammation, thereby promoting suicidal risk. [ABSTRACT FROM AUTHOR]

The regulation of emotions is a crucial facet of well‐being and social adaptability, with explicit strategies receiving primary attention in prior research. Recent studies, however, emphasize the role of implicit emotion regulation, particularly implicating the ventromedial prefrontal cortex (VMPFC) in association with its implementation. This study delves into the nuanced role of the VMPFC through focality‐optimized multichannel transcranial direct current stimulation (tDCS), shedding light on its causal involvement in implicit reappraisal. The primary goal was to evaluate the effectiveness of VMFPC‐targeted tDCS and elucidate its role in individuals with high trait anxiety. Participants engaged in implicit and explicit emotion regulation tasks during multichannel tDCS targeting the VMPFC. The outcome measures encompassed negative emotion ratings, pupillary diameter, and saccade count, providing a comprehensive evaluation of emotion regulation efficiency. The intervention exhibited a notable impact, resulting in significant reductions in negative emotion ratings and pupillary reactions during implicit reappraisal, highlighting the indispensable role of the VMPFC in modulating emotional responses. Notably, these effects demonstrated sustained efficacy up to 1 day postintervention. This study underscores the potency of VMPFC‐targeted multichannel tDCS in augmenting implicit emotion regulation. This not only contributes insights into the neural mechanisms of emotion regulation but also suggests innovative therapeutic avenues for anxiety disorders. The findings present a promising trajectory for future mood disorder interventions, bridging the gap between implicit emotion regulation and neural stimulation techniques. [ABSTRACT FROM AUTHOR]

Background In the healthcare domain, the indispensable role of caregivers in patient support is utmost. The family plays a crucial role in the care of a mentally and chronically ill patient. As these conditions can significantly impact the lives of patients, they also exert a profound influence on those who provide care, affecting their burden and quality of life. Aim This study aimed to evaluate the burden and Quality of Life among caregivers of Bipolar Disorder and Tuberculosis Patients. Methods This cross-sectional study involved primary caregivers of patients diagnosed with Bipolar Affective Disorder according to ICD-10 guidelines and of chronic medical conditions such as Refractory tuberculosis, and Drug-Resistant Tuberculosis. The study took place at the Department of Psychiatry, Rama Medical College, Hospital, and Research Centre, Kanpur. The sample was calculated using scientific statistical tools. The patient's caregivers were recruited from the Department of Psychiatry and the Department of TB & Chest till the required sample size was met and were categorized into two groups: Group 1 comprised 40 caregivers of bipolar patients, and Group 2 included caregivers of tuberculosis. Sociodemographic information was obtained through a semi-structured questionnaire. The Montgomery Borgatta Caregiver Burden Scale and Quality of Life WHOQOL-BREF were administered to both groups to assess the burden and their Quality of life. Results and discussion According to the burden scale caregivers of Group 1 face more burden compared to Group 2 caregivers and their Quality of Life is also more affected in all the four domains. The result is statistically significant in all the dimensions. Conclusion Our study concluded that caregivers in both groups experience significant burden that adversely affect their quality of life. Therefore, strategies should be developed to support and psychoeducating caregivers to help them cope better and enhance their Quality of life. [ABSTRACT FROM AUTHOR]

We aimed to use real-world data to characterize the burden of psychiatric comorbidities in young people with eating disorders (EDs) relative to peers without EDs. This retrospective cohort study used a large federated multi-national network of real-time electronic health records. Our cohort consisted of 124,575 people (14,524 people receiving their index, first-ever, ED diagnosis, compared to 110,051 peers without EDs initiating antidepressants). After 1:1 propensity score matching of the two cohorts by pre-existing demographic and clinical characteristics, we used multivariable logistic regression to compute the adjusted odds ratio (aOR) of psychiatric diagnoses arising in the year following the index event (either first ED diagnosis or first antidepressant script). Over 50% of people with EDs had prior psychiatric diagnoses in the year preceding the index EDs diagnosis, with mood disorders, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), specific phobia (SP), attention-deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD) being the most common. Adjusted analyses showed higher odds for mood disorders (aOR = 1.20 [95% CI = 1.14–1.26]), GAD (aOR = 1.28 [1.21–1.35]), PTSD (aOR = 1.29 [1.18–1.40]), and SP (aOR = 1.45 [1.31–1.60]) in the EDs cohort compared to antidepressant-initiating peers without EDs, although rates of ADHD and ASD were similar in both cohorts. This large-scale real-time analysis of administrative data illustrates a high burden of co-occurring psychiatric disorders in people with EDs. [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]

Schizophrenia is a serious mental disorder that affects millions of people worldwide. This disorder slowly disintegrates thinking ability and changes behaviours of patients. These patients will show some psychotic symptoms such as hallucinations, delusions, thought disorder and movement disorder. These symptoms are in common with some other psychiatric disorders such as bipolar disorder, major depressive disorder and mood spectrum disorder. As patients would require immediate treatment, an on-time diagnosis is critical. This study explores the use of omics data in diagnosis of schizophrenia. Transcriptome, miRNA and epigenome data are used in diagnosis of patients with schizophrenia with the aid of machine learning algorithms. As the data is in high dimension, mutual information and feature importance are independently used for selecting relevant features for the study. Selected sets of features (biomarkers) are individually used with different machine learning algorithms and their performances are compared to select the best-performing model. This study shows that the top 140 miRNA features selected using mutual information along with support vector machines give the highest accuracy (0.86 ± 0.07) in the diagnosis of schizophrenia. All reported accuracies are validated using 5-fold cross validation. They are further validated using leave one out cross validation and the accuracies are reported in the supplementary material. [ABSTRACT FROM AUTHOR]

Vasopressin or arginine‐vasopressin (AVP) is a neuropeptide molecule known for its antidiuretic effects and serves to regulate plasma osmolality and blood pressure. The existing literature suggests that AVP plays a multifaceted—though less well‐known—role in the central nervous system (CNS), particularly in relation to the pathophysiology and treatment of mood disorders. Animal models have demonstrated that AVP is implicated in regulating social cognition, affiliative and prosocial behaviors, and aggression, often in conjunction with oxytocin. In humans, AVP is implicated in mood disorders through its effects on the hypothalamic–pituitary–adrenal (HPA) axis as well as on the serotoninergic and glutamatergic systems. Measuring plasma AVP has yielded interesting but mixed results in mood and stress‐related disorders. Recent advances have led to the development of copeptin as a stable and reliable surrogate biomarker for AVP. Another interesting but relatively unexplored issue is the interaction between the osmoregulatory system and mood disorder pathophysiology, given that psychotropic medications often cause dysregulation of AVP receptor expression or signaling that can subsequently lead to clinical syndromes like syndrome of inappropriate diuresis and diabetes insipidus. Finally, pharmaceutical trials of agents that act on V1a and V1b receptor antagonists are still underway. This narrative review summarizes: (1) the neurobiology of the vasopressinergic system in the CNS; (2) the interaction between AVP and the monoaminergic and glutamatergic pathways in the pathophysiology and treatment of mood disorders; (3) the iatrogenic AVP dysregulation caused by psychotropic medications; and (4) the pharmaceutical development of AVP receptor antagonists for the treatment of mood 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]

Background: Generalized anxiety disorder (GAD)–characterised by excessive and uncontrollable worry–is the most frequently diagnosed anxiety disorder during pregnancy and the postpartum period. Identification of GAD often relies on assessment of its cardinal feature, pathological worry. The Penn State Worry Questionnaire (PSWQ) is the most robust measure of pathological worry to date but has not been extensively evaluated for use during pregnancy and the postpartum period. This study evaluated the internal consistency, construct validity, and diagnostic accuracy of the PSWQ in a sample of pregnant and postpartum women with and without a principal GAD diagnosis. Methods: One hundred forty-two pregnant and 209 postpartum women participated in this study. Sixty-nine pregnant and 129 postpartum participants met criteria for a principal diagnosis of GAD. Results: The PSWQ demonstrated good internal consistency and converged with measures assessing similar constructs. Pregnant participants with principal GAD scored significantly higher on the PSWQ than those with no psychopathology and postpartum participants with principal GAD scored significantly higher than those with principal mood disorders, other anxiety and related disorders, and no psychopathology. A cut-off score of 55 and 61 or greater was determined for detecting probable GAD during pregnancy and the postpartum period, respectively. Screening accuracy of the PSWQ was also demonstrated. Conclusions: This study underscores the robustness of the PSWQ as a measure of pathological worry and probable GAD and supports its use in the detection and monitoring of clinically significant worry symptoms during pregnancy and postpartum period. [ABSTRACT FROM AUTHOR]

Prior research has observed reciprocal associations between sleep and mood. However, these findings are primarily based on the examination of one or two aspects of sleep behaviors (e.g., duration, quality), neglecting how multiple dimensions of sleep (particularly indicators pertinent to adolescence, e.g., sleep variability) are linked to adolescent mood both daily and longitudinally. Drawing on a multidimensional framework for sleep, this study addressed the knowledge gap by examining the directionality of and differential effects for associations between multiple dimensions of sleep and mood during early adolescence. Participants were 273 Chinese early adolescents (34.39% girls; Mage = 11.57, SD = 1.31), who filled out a pre-survey on demographics (T1) and 7-day diaries on sleep (i.e., duration, quality, disturbance, and latency) and mood (i.e., positive and negative mood). Adolescents completed another wave of diary reports 1 year later (T2). Findings revealed both bidirectional and unidirectional, within-person effects depending on specific sleep parameters, suggesting differential associations between multiple dimensions of sleep and mood. Specifically, on days when adolescents had longer sleep latency and greater disturbance than usual, they reported higher negative mood the next day, whereas higher negative mood was linked to poorer sleep quality the next day. The longitudinal investigation found that greater variability in sleep quality at T1 was associated with higher negative mood at T2. These findings underscore the importance of understanding the complex interplay between sleep and mood by examining the directionality of and differential effects for the daily and longer-term associations between multiple dimensions of sleep and mood among early adolescents. [ABSTRACT FROM AUTHOR]

The article describes the case of a 59-year old Japanese man diagnosed with cerebellar cognitive affective syndrome (CCAS) caused by cerebellar atrophy associated with Wallerian degeneration after pontine haemorrhage. The patient demonstrated psychiatric symptoms, slow gait, configuration apraxia, cognitive and motor decline, decline in intelligence quotient and function. Symptoms of CCAS include motor deficits, decreased blood flow in the posterior cerebellar lobes and functional impairment.

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]

Accurately predicting the probability of aggressive behavior is crucial for guiding early intervention in patients with mood disorders. Cox stepwise regression was conducted to identify potential influencing factors. Nomogram prediction models were constructed to predict the probabilities of aggressive behavior in patients with mood disorders, and their performance was assessed using consistency index (C-index) and calibration plots. Research findings on 321 patients with mood disorders indicated that being older (HR = 0.92, 95% CI: 0.86–0.98), single (HR = 0.11, 95% CI: 0.02–0.68), having children (one child, HR = 0.07, 95%CI: 0.01–0.87; more than one child, HR = 0.33, 95%CI: 0.04–2.48), living in dormitory (HR = 0.25, 95%CI: 0.08–0.77), non-student (employee, HR = 0.24, 95% CI: 0.07–0.88; non-employee, HR = 0.09, 95% CI: 0.02–0.35), and higher scores in subjective support (HR = 0.90, 95% CI: 0.82–0.99) were protective factors. On the contrary, minorities (HR = 5.26, 95% CI: 1.23–22.48), living alone (HR = 4.37, 95% CI: 1.60–11.94), having suicide history (HR = 2.51, 95% CI: 1.06–5.95), and having higher scores in EPQ-E (HR = 1.04, 95% CI: 1.00–1.08) and EPQ-P (HR = 1.03, 95% CI: 1.00–1.07) were identified as independent risk factors for aggressive behavior in patients with mood disorders. The nomogram prediction model demonstrated high discrimination and goodness-of-fit. A novel nomogram prediction model for the probability of aggressive behavior in patients with mood disorders was developed, effective in identifying at-risk populations and offering valuable insights for early intervention and proactive measures. [ABSTRACT FROM AUTHOR]

Purpose: Suicide attempts (SA) during perinatal period have the potential to adversely affect a woman's health and her developing infant. To date, little is known about perinatal SA and their risk factors. This study aimed to synthetize the evidence on risk factors of SA in pregnant and postpartum women. Methods: We systematically reviewed studies retrieved from PubMed/Medline, PsycINFO, and CINAHL, following the PRISMA guidelines for reporting. A meta-analysis was conducted only for risk factors examined in at least three distinct samples. Results: A total of ten studies were eligible for inclusion. All the studies found significant associations in regression models between perinatal SA and other variables (sociodemographic, clinical factors obstetric, neonatal, and psychosocial). The meta-analysis showed that unmarried women (pooled OR = 1.87, 95% CI = 1.26–2.78), with no higher education (pooled OR = 1.89, 95% CI = 1.31–2.74) and affected by a mood disorder (pooled OR = 11.43, 95% CI = 1.56–83.87) have a higher risk of postpartum SA; women who smoke during pregnancy (pooled OR = 3.87, 95% CI = 1.35–11.11) have a higher risk of SA in pregnancy; and women with previous suicidal behavior(pooled OR = 38.04, 95% CI = 3.36–431.17) have a higher risk of perinatal SA, whether during pregnancy or in the postpartum period. The type of sample, whether community or clinical, is a relevant moderating factor. Conclusion: Our study extends prior reviews about suicidal behaviors in women by studying perinatal suicide attempts independently, as well as it synthesized data on some sociodemographic, clinical, and obstetric/neonatal risk factors. Further studies about specific risk factors for perinatal SA are needed in order to improve early detection and intervention of women at risk. [ABSTRACT FROM AUTHOR]

Emotion dysregulation (ED) is a vulnerability factor for affective disorders that may originate from deficits in cognitive control (CC). Although measures of ED are often designed to assess trait-like tendencies, the extent to which such measures capture a time-varying (TV) or state-like construct versus a time-invariant (TI) or trait-like personality characteristic is unclear. The link between the TV and TI components of ED and CC is also unclear. In a 6-wave, 5-month longitudinal study, community participants (n = 1281) completed the Difficulties in Emotion Regulation Scale (DERS-16), a commonly used measure of ED and measures of CC. A latent variable (trait-state-occasion) model showed that the proportion of TI factor variance (.80) was greater than the TV factor variance (.19). Although TV factor stability was significant, the coefficients were small in magnitude. Furthermore, regression weights for the ED TI factor (average $\beta$ β = −.62) were significant and larger than those for the TV factor (average $\beta$ β = −.10) in predicting latent CC at each of the six-time points. These findings suggest that ED, as assessed by the DERS-16, is largely TI and this TI component is more strongly linked to CC than the TV component. [ABSTRACT FROM AUTHOR]

Despite intensified warnings from regulators about fetal risk associated with the use of valproic acid during pregnancy, pregnancy incidence rates in women receiving valproic acid have remained largely unchanged, results of a cohort study suggest. Use of contraception in this population has also remained low overall, the investigators reported. Study results were published May 22, 2024, in JAMA Network Open. [ABSTRACT FROM AUTHOR]

Objective: Negative urgency (i.e., acting rashly when experiencing negative affect; NU), is a theorised maintenance factor in binge‐eating type eating disorders. This study examined the association between trait NU and eating disorder severity, momentary changes in state NU surrounding episodes of binge eating, and the momentary mechanistic link between affect, rash action, and binge‐eating risk. Methods: Participants were 112 individuals with binge‐eating disorder (BED). Baseline measures included the UPPS‐P Impulsive Behaviour Scale to assess trait NU and the Eating Disorders Examination to assess binge‐eating frequency and global eating disorder severity. Ecological momentary assessment captured real‐time data on binge eating, negative affect, and state NU. Results: Multiple regression analysis revealed a strong association between trait NU and eating disorder severity. Generalised estimating equations showed that state NU increased before and decreased after binge‐eating episodes, and that this pattern was not moderated by trait‐level NU. Finally, a multilevel structural equation model indicated that increases in rash action mediated the momentary relationship between states of high negative affect and episodes of binge eating. Conclusion: These findings underscore the importance of both trait and state NU in binge‐eating type eating disorders, and suggest NU as a potential key target for intervention. Highlights: Trait negative urgency (tNU) appears to be a marker of disorder severity, potentially above and beyond binge frequencyState urgency significantly increased prior to binge eating and decreased following binge eating, regardless of tNUMoments of high negative affect predict increases in subsequent rash action, and that this impulsivity is predictive of a greater likelihood of a binge‐eating episode [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]

Key Points: Question: What is the overlap between accelerometry-assessed sleep, physical activity, and circadian rhythms, and do they distinguish state and trait in major depressive disorder (MDD)? Findings: This cross-sectional study of 2317 adults used a multimodal data-reduction technique and found that joint components outweighed individual variation in the 3 domains. MDD was characterized by reduced and more fragmented physical activity, lower amplitude of circadian rhythm, and later timing of both sleep and the peak of physical activity. Meaning: These findings highlight the importance of characterizing 24-hour rhythms with accelerometry for future research and to define targets for interventions for MDD. This cross-sectional study examines joint and individual components of the accelerometry-derived domains of sleep, physical activity, and circadian rhythms and assesses associations with major depressive disorder (MDD) among adults from Lausanne, Switzerland. Importance: Accelerometry has been increasingly used as an objective index of sleep, physical activity, and circadian rhythms in people with mood disorders. However, most prior research has focused on sleep or physical activity alone without consideration of the strong within- and cross-domain intercorrelations; and few studies have distinguished between trait and state profiles of accelerometry domains in major depressive disorder (MDD). Objectives: To identify joint and individual components of the domains derived from accelerometry, including sleep, physical activity, and circadian rhythmicity using the Joint and Individual Variation Explained method (JIVE), a novel multimodal integrative dimension-reduction technique; and to examine associations between joint and individual components with current and remitted MDD. Design, Setting, and Participants: This cross-sectional study examined data from the second wave of a population cohort study from Lausanne, Switzerland. Participants included 2317 adults (1164 without MDD, 185 with current MDD, and 968 with remitted MDD) with accelerometry for at least 7 days. Statistical analysis was conducted from January 2021 to June 2023. Main Outcomes and Measures: Features derived from accelerometry for 14 days; current and remitted MDD. Logistic regression adjusted for age, sex, body mass index, and anxiety and substance use disorders. Results: Among 2317 adults included in the study, 1261 (54.42%) were female, and mean (SD) age was 61.79 (9.97) years. JIVE reduced 28 accelerometry features to 3 joint and 6 individual components (1 sleep, 2 physical activity, 3 circadian rhythms). Joint components explained 58.5%, 79.5%, 54.5% of the total variation in sleep, physical activity, and circadian rhythm domains, respectively. Both current and remitted depression were associated with the first 2 joint components that were distinguished by the salience of high-intensity physical activity and amplitude of circadian rhythm and timing of both sleep and physical activity, respectively. MDD had significantly weaker circadian rhythmicity. Conclusions and Relevance: Application of a novel multimodal dimension-reduction technique demonstrates the importance of joint influences of physical activity, circadian rhythms, and timing of both sleep and physical activity with MDD; dampened circadian rhythmicity may constitute a trait marker for MDD. This work illustrates the value of accelerometry as a potential biomarker for subtypes of depression and highlights the importance of consideration of the full 24-hour sleep-wake cycle in future studies. [ABSTRACT FROM AUTHOR]

Purpose: This study identifies potential predictors of unemployment and describes specific work difficulties and their determinants in a subgroup of employed people with multiple sclerosis (PwMS). The specific work difficulties were evaluated using a validated tool that measures the impact of respondents' symptoms and of workplace features. Methods: A cross-sectional study was carried out in Italy during 2021–2022. The subjects included were adults (18–65 years) with a diagnosis of MS, currently employed or unemployed. Logistic regression models were used to determine the association between each potential determinant and employment status, while linear regression models were used to determine the association between determinants and specific work difficulties. Results: The main risk factors associated with a higher risk of being unemployed were being older, living in the South of Italy/islands, and having a higher disability level, while protective factors against unemployment were having a high level of education and 'stable' employment (an open-ended contract). Fatigue was found to be associated with all work difficulties analyzed; mood disorders emerged as the main predictors of mental health-related work difficulties; level of disability and comorbidity significantly impacted physical health-related ones, and a good quality of life was found to improve both workplace-related and mental health-related difficulties at work. Conclusion: Identifying the most significant difficulties is a crucial step in the development of vocational rehabilitation interventions tailored to maximize the ability of PwMS to handle their job-related duties and demands. [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]

Experiencing erotic feelings towards a patient is a fairly common occurrence, not pathological per se, during phases of psychotherapy. This study aims to analyze associations between, on the one hand, the presence in therapists of romantic attraction (RA), sexual attraction (SA), or flirting behavior (FB) toward patients and, on the other hand, a series of characteristics of therapist, patient, and treatment. Between April and June 2022, 547 psychotherapists completed an online survey investigating their affective and behavioral responses toward their most recently treated patient. Compared to female therapists, males showed significantly higher prevalence of SA alone (p <.001) or in combination with RA (p <.01), FB (p <.01), or both (p <.05). Multivariate adjusted regression models showed that RA was associated with patient age ≤40 years (OR:39.49 for age 18–29; OR:28.44 for age 30–39), male sex (OR:10.40), and diagnosis of mood disorder (OR:14.08). Furthermore, RA was associated with intense countertransference feelings of tenderness towards the patient (OR:79.77) and hostility towards significant figures in their life (OR: 77.93). SA was associated with the therapist's male sex/gender (OR: 16.14), psychoanalytic orientation (OR:13.34), post-license experience ≤20 years (OR:6.12 for 1–9 years; OR:6.08 for 10–19 years). Lastly, FB was associated with the therapist's male sex/gender (OR:16.94). [ABSTRACT FROM AUTHOR]

Emotion dysregulation is a transdiagnostic phenomenon. In evidence-based treatments for disorders involving emotion dysregulation, there are still many who do not achieve clinically significant gains. The primary goal of the present study was to examine the effect of personality on treatment outcomes in individuals experiencing symptoms of emotion dysregulation. Participants were involved in a randomized control trial, where they participated in one of two group therapy programs, dialectical behavioural therapy or positive psychotherapy (PPT). Hierarchical regressions were performed to examine the main effects and interactive effects predicting change in emotion dysregulation, depression, and anxiety across the course of treatment. Split group analyses were conducted to examine the main effects of personality on treatment outcomes, differentiated by treatment group. None of the individual personality traits reached a level of significance to predict treatment outcomes after controlling for baseline symptom severity. However, large effect sizes were observed suggesting personality may have moderated specific treatment effects within the individual types of treatment. For participants undergoing dialectical behaviour therapy, higher conscientiousness and higher neuroticism predicted improved depressive symptoms. Conversely, for participants undergoing PPT, lower neuroticism and lower conscientiousness predicted improved emotion dysregulation. Extraversion predicted better outcomes across both groups. Results suggest that certain treatment types could be more beneficial for people with certain personality profiles. [ABSTRACT FROM AUTHOR]

Case formulation is at the heart of personalised care in psychotherapy. Scientific research into case formulations can provide new insights in the heterogeneity of psychopathology which are relevant for advances in personalised psychopathology research and practice. This mixed-methods study examined the content of 483 fully personalised network-based case formulations in psychotherapy in terms of uniqueness (i.e., frequencies of concepts) and commonality (i.e., the presence of common themes over the different case formulations). In a real-world clinical care setting, patients co-created network-based case formulations with their therapist as part of their routine diagnostic process. These case formulations feature concepts that are relevant to individual patients and their current situation. We assessed how often concepts were used by different patients to quantify uniqueness. We applied a bottom-up thematic analysis to identify patient-relevant themes from the concepts. The case formulations of 483 patients diagnosed with mood and/or anxiety disorders contained a total of 4908 interpretable concepts of which 4272 (87%) were completely unique. Through thematic analysis, we identified seven overarching themes in the concepts: autonomy, connectedness, emotions, self-care, identity, self-efficacy, and bodily sensations. Case formulations were highly unique, thereby illustrating the importance of personalised diagnostics. The unique concepts could be grouped under seven overarching themes which seem to encompass basic human needs. Current advancements in personalised diagnostics and assessment should have a broader scope than symptoms alone, and could use the themes identified here as part of a topic list in the generation of (network-based) case formulations. [ABSTRACT FROM AUTHOR]

The term 'Common Emotional Disorders' refers to a range of clinical conditions such as anxiety disorders, panic atacs, mild and moderate depressive states, sleep disorders, somatoform disorders and post-traumatic stress disorder. The aim of the present article is to investigate the effectiveness of a specific group psychotherapy protocol for common emotional disorders. The outcome was evaluated in terms of reduction of anxiety-depressive symptoms. The aim is for this protocol to represent a first and valid intervention tool in the public context, in compliance with national indications in terms of cost-effectiveness. The protocol is structured in seven modules, each of which deals with the pivotal points of a psychotherapeutic pathway. It has a total duration of 6 months, and was applied to 61 adult patients afferent to a Mental Health Centre (45 F and 16 M). Results show a significant reduction in overall symptom severity and an extensive improvement in both depressive and anxious symptoms, as well as a self-perceived degree of improvement in subjective well-being. This protocol has the advantage of being able to group together patients with comorbid clinical conditions and symptom heterogeneity and offers them proven cognitive-behavioral treatment. [ABSTRACT FROM AUTHOR]