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Introduction: Monoamine oxidase (MAO) is an enzymatic complex comprised of two isoforms: MAO-A and MAO-B. In the brain, it catalyzes the breakdown of monoamine neurotransmitters including dopamine, serotonin, and epinephrine. The inhibition of MAO has shown antidepressant effects. Mirtazapine is an antidepressant drug that antagonizes the adrenergic alpha2-autoreceptors and alpha2-heteroreceptors and blocks the serotoninergic 5-HT2 and 5-HT3 receptors. Although it is widely accepted that mirtazapine has no interactions with MAO, evidence is not conclusive on the matter. Objectives: To provide a review of experimental studies reporting any effect derived from the interaction between mirtazapine monotherapy and MAO. Methods: Articles were identified independently by two reviewers through a systematic search of MEDLINE and Web of Science. Key words were 'mirtazapine AND ("monoamine oxidase" OR MAO)'. Additional articles were identified through non-systematic search of SCOPUS and manual search of reference lists. As the heterogeneity of articles did not permit a formal meta-analysis, a qualitative synthesis is presented. Results: 6 published articles were identified from an initial search of 377 studies. Mirtazapine exhibited a non-competitive inhibitory effect on MAO-A and MAO-B; however, in opposition to most antidepressants, this inhibition was not complete. Although mirtazapine's mechanism of action is not apparently related to MAO, several studies found altered responses to mirtazapine in depressive patients who presented polymorphisms in MAO-A and MAO-B genes. Mirtazapine also affected MAO by reducing intracellular pH in neurons, but did not show anti-apoptotic properties. Conclusions: Current evidence suggests an interaction between mirtazapine and MAO that might reinforce its antidepressant action. [ABSTRACT FROM AUTHOR]

Introduction: Online streaming series 'Thirteen reasons why' (13RW) depicts the suicide of an adolescent who, prior to death, records thirteen audiotapes blaming several people for her decision. Following the show's release in March 2017, 13RW raised concerns about the glamorized portrayal of the main character's suicide and led some people to fear a global contagion of self-harm behaviors. Objectives: To provide a review of original studies analyzing the role of 13RW as an influencing factor for suicide. Methods: Articles were identified through a systematic search of MEDLINE, SCOPUS and Web of Science, and a manual search of reference lists. Key words were '("thirteen reasons why" OR "13 reasons why") AND (suicide OR suicidal OR suicidality)'. As the heterogeneity of articles did not permit a formal meta-analysis, a qualitative synthesis is presented. Results: 15 published articles were identified from an initial search of 64 studies. Positive effects of watching 13RW included a reduction in suicide stigma and a greater likelihood to discuss mental health concerns and seek for help. On the other hand, most studies reported negative outcomes including significant increases in (1) the rate of suicide deaths in adolescents; (2) the number of pediatric admissions for suicidal reasons; and (3) the prevalence and severity of depressive symptoms, suicidal ideation and selfharm behaviors in vulnerable viewers. Conclusions: Due to methodological limitations, no causal relation can be established; however, results are highly suggestive of so. Prevention measures are required to alert of the risk and should be particularly addressed to susceptible subjects. [ABSTRACT FROM AUTHOR]

Introduction: Evidence in literature suggests a positive correlation between clinical response to electroconvulsive therapy (ECT) and electroencephalographic (EEG) quality. Several authors have identified elements from the EEG that could be associated to greater ECT efficacy. Still, we lack a practical scale to monitor EEG response in daily clinical practice. Objectives: (1) to design a simple scale, easy to administer, using the EEG parameters with greater evidence in literature; (2) to prove the correlation between this scale and clinical response in a real sample of patients. Methods: The design of the scale was based on a bibliographical review and a consensus between the authors. Two raters analyzed the EEG registers (sessions 2 to 6, 275 treatments) from 55 patients from 3 different hospitals. Raters were blinded to subject ID and ECT treatment number and, afterwards, EEG scores were correlated with the scores obtained in MADRS (Montgomery-Asberg Depression Rating Scale), which had been administered at baseline and at the end of the ECT course. Results: None of the EEG parameters contemplated in the scale were statistically significant in predicting change in MADRS. However, models contemplating loss of EEG quality (rather than the ones that only considered mean quality) tended to predict more of the variance in MADRS change. Conclusions: The lack of statistical significance is likely to be attributed to methodological limitations (insufficient sample, failure to control for other confounding variables...), but it could also be due to an excessive simplification of the scale. The validation of the scale should be examined in a larger sample. [ABSTRACT FROM AUTHOR]

Introduction: A growing number of studies support that subjects who have experienced Childhood Trauma (CT) show deficits in general cognitive performance. However, this correlation has been scarcely studied in patients with bipolar disorder. Objectives: Our aim is to examine the potential association of CT on cognitive performance in euthymic patients diagnosed with bipolar disorder. Methods: We conducted a cross-sectional study on a sample of 64 bipolar outpatients recruited from the Bipolar Disorder Program of the Parc Taulí University Hospital in Sabadell (Spain). Participants underwent a comprehensive clinical interview, which specifically included the Child Trauma Questionnaire (CTQ) and a cognitive evaluation with a battery of neuropsychological tests. Inclusion criteriawere as follows: (a) bipolar I or II (DSM5) diagnosis, (b) age >18, (c) fulfilling euthymia criteria for at least 3 months, (d) the capacity to provide written informed consent. Exclusion criteria were: (a) IQ < than 80 (b) a course of electronvulsive therapy within the past year, (c) substance abuse, (d) medical condition affecting neuropshychological performance. No restrictions were made regarding pharmacological treatment. A two-step cluster analysis will be applied to delimit different groups of bipolar patients based on the presence of CT and their clinical features and cognitive performance. Results: Our preliminary results suggest that the history of child abuse measured by CTQ is associated with a worse performance in different cognitive domains. Conclusions: Exposure to CT has lasting consequences in the clinical presentation of bipolar disorder; fact that reinforces the need to establish specific prevention and treatment strategies. [ABSTRACT FROM AUTHOR]

Background: Suicide is one of the main external causes of death worldwide. People who have already attempted suicide are at high risk of new suicidal behavior. However, there is a lack of information on the risk factors that facilitate the appearance of reattempts. The aim of this study was to calculate the risk of suicide reattempt in the presence of suicidal history and psychosocial risk factors and to estimate the effect of each individual risk factor., Methods: This systematic review and meta-analysis were conducted following the PRISMA-2020 guidelines. Studies on suicide reattempt that measured risk factors were searched from inception to 2022. The risk factors studied were those directly related to suicide history: history of suicide prior to the index attempt, and those that mediate the transition from suicidal ideation to attempt (alcohol or drug misuse, impulsivity, trauma, and non-suicidal self-injury)., Results: The initial search resulted in 11 905 articles. Of these, 34 articles were selected for this meta-analysis, jointly presenting 52 different effect sizes. The pooled effect size across the risk factors was significant (OR 2.16). Reattempt risk may be increased in presence of any of the following risk factors: previous history, active suicidal ideation, trauma, alcohol misuse, and drug misuse. However, impulsivity, and non-suicidal self-injury did not show a significant effect on reattempt., Conclusion: Most of the risk factors traditionally associated with suicide are also relevant when talking about suicide reattempts. Knowing the traits that define reattempters can help develop better preventive and intervention plans.

Online streaming series 'Thirteen Reasons Why' (13RW), released in March 2017, was criticized for its sensationalist portrayal of the main character's suicide, leading some people to voice fears of a global contagion of self-harm behaviors. The current investigation provides a systematic review of original studies analyzing the role of 13RW as an influencing factor for suicide. Articles were identified through a systematic search of Medline, Web of Science, Scopus, PsycInfo, and a manual search of reference lists from inception until the 16 January 2023. Twenty-seven published articles were identified from an initial search of 496 studies. The positive effects of watching 13RW included a reduction in suicide stigma and a greater likelihood to discuss mental health concerns and seek for help. However, several studies reported negative outcomes, including significant increases in the rate of deaths by suicide in adolescents, the number of admissions for suicidal reasons, and the prevalence and severity of suicidal ideation and self-harm behaviors in vulnerable viewers. Still, due to methodological limitations, no causal relationship could be established. Preventive measures are required to alert of the risk and should be particularly addressed to susceptible subjects. Psychoeducational programs should be focused on this kind of phenomena in vulnerable populations.

Objectives: To estimate the risk of suicide attempt repetition among individuals with an index attempt. It also aims to study the role of risk factors and prevention programme in repetition., Methods: This systematic review and meta-analysis was conducted in keeping with the PRISMA 2020 guidelines. Studies on attempt repetition (both cohort studies and intervention studies) were searched from inception to 2022., Results: A total of 110 studies comprising 248,829 attempters was reviewed. The overall repetition rate was 0.20 (0.17, 0.22). Repetition risk linearly increased over time. A higher risk of attempt repetition was associated with female sex and index attempts in which self-cutting methods were used. Moreover, a mental disorder diagnosis was associated with an increasing repetition risk (OR = 2.02, p < .01). The delivery of a preventive programme reduced the repetition risk, OR = 0.76, p < .05; however, this effect was significant for psychotherapy interventions, OR = 0.38, p < .01., Conclusion: One in five suicide attempters will engage in a new suicide attempt. An elevated repetition risk is associated with being female, more severe index methods and psychiatric disorder diagnosis. Preventive programmes, particularly psychotherapy, may contribute to reducing repetition risk and eventually save lives., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Prader-Willi syndrome is a genetic disorder caused by chromosomal changes in segment 15q11-q13 including cognitive, mental, and behavioral symptoms, as well as a specific physical phenotype. Both the most common psychopathological changes (intellectual disability, obsessions, impulsivity, autism spectrum disorders, self-injuries) and the main psychiatric comorbidities (affective disorders, psychosis, obsessive-compulsive disorder, autism spectrum disorder) are characterized by a great heterogeneity, which warrants the need for better identification of their frequency and clinical signs. In addition to its effects on body compositionand hypotony, growth hormone has been shown to be useful for regulating patient behavior, and psychoactive drugs are also an option. Other alternatives have shown promising results in experimental trials. Adequate understanding of the psychopathology associated to Prader-Willi syndrome would allow for improving clinical approach, symptom identification, detection of comorbidities, and administration of more effective treatments, leading to better clinical outcomes., (Copyright © 2019 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)

A case of congenital diverticulum of the left ventricle associated with probable mitral and tricuspid prolapses is presented. The authors comment on the absence of symptomatology in patients affected with this disease and point out the electrocardiographic, radiologic, and phonomechanocardiographic data. The importance of the left ventriculography in the diagnosis and classification of this disease stands out, as does the value of echocardiography (mode-M) in the diagnosis of mitral and tricuspid valvular prolapses which were associated in the present case. The classifications given by various authors in connection with this anomaly are reviewed and lastly the appropriate therapeutic approach is discussed. There is a surgical possibility for young asymptomatic patients, taking into account the little experience we have at present on the natural history of this disease.

The reported case consists in a 45-year-old patient with a mitral disease, who presented a bacterial endocarditis after a dental extraction, in the course of which he developed a mycotic aneurysm of the right superficial femoral artery; surgical treatment of this lesion was successful. One year later he was reoperated in relation with the progression of his previous mitral disease, and a Bjork-Shilley prosthesis was implanted. At the present time, 2 years and a half after the last operation the patient is free of symptoms. The clinical data, exploratory studies, the results which were obtained, and the surgical procedure applied are discussed. The rarity of this complication, the localization of the mycotic aneurysm, the surgical valve heart replacement, the pathologic findings of the resected valve and the satisfactory evolution of the patient are also pointed out.