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Purpose of Review: As maternal mortality climbs in the USA with mental health conditions driving these preventable deaths, the field of reproductive psychiatry must shift towards identification of women and other birthing individuals at risk and facilitating access. This review brings together recent studies regarding risk of perinatal depression and highlights important comorbidities that place individuals at higher vulnerability to poor perinatal outcomes., Recent Findings: Recent research suggests that identifying risk for perinatal depression including historical diagnoses of depression, anxiety, trauma, and comorbid substance use and intimate partner violence may move the field to focus on preventive care in peripartum populations. Emerging data shows stark health inequities in racial and ethnic minority populations historically marginalized by the health system and in other vulnerable groups such as LGBTQ+ individuals and those with severe mental illness. Innovative models of care using systems-level approaches can provide opportunities for identification and risk analyses of vulnerable peripartum patients and facilitate access to therapeutic or preventive interventions. Utilizing intergenerational approaches and leveraging multidisciplinary teams that thoughtfully target high-risk women and other birthing individuals could promote significant changes to population-level care in maternal health., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

A growing body of evidence suggests glutamate excess in schizophrenia and that N-methyl-d-aspartate receptor (NMDAR) hypofunction on γ-aminobutyric acid (GABA) interneurons disinhibiting pyramidal cells may be relevant to this hyperglutamatergic state. To better understand how NMDAR hypofunction affects the brain, we used magnetic resonance spectroscopy and resting-state functional magnetic resonance imaging (MRI) to study the effects of ketamine on hippocampal neurometabolite levels and functional connectivity in 15 healthy human subjects. We observed a ketamine-induced increase in hippocampal Glx (glutamate+glutamine; F=3.76; P=0.04), a decrease in fronto-temporal (t=4.92, P FDR <0.05, k E =2198, x=-30, y=52, z=14) and temporo-parietal functional connectivity (t=5.07, P FDR <0.05, k E =6094, x=-28, y=-36, z=-2), and a possible link between connectivity changes and elevated Glx. Our data empirically support that hippocampal glutamatergic elevation and resting-state network alterations may arise from NMDAR hypofunction and establish a proof of principle whereby experimental modelling of a disorder can help mechanistically integrate distinct neuroimaging abnormalities in schizophrenia.

The demand for case managers in the mental health system has increased as helping persons with severe mental disorders to live in community settings of their choice has become a primary outcome goal of intervention. This article reports on an exploratory study that addressed the following questions: What is the case manager's perception of his or her current work satisfaction, and what factors contribute to this perception? How do case managers perceive their overall sense of well-being, use of social support, and role performance? Is there a difference in the intensive case manager's perception of work satisfaction, general well-being, and use of social supports when compared to that of traditional case managers?

There are an estimated 100,000 to 300,000 adolescents living on the streets with no supervision, nurturance or regular assistance from a parent or responsible adult. These young people are not "Huck Finns" seeking adventure but have been forced into this lifestyle and frame of mind. The reasons range from family dysfunctions such as abuse, sexual exploitation, neglect, and abandonment to inaction at the "system" level with regard to the overburdened child protective system, inadequate minimum wage, and lack of affordable housing opportunities. The consequences of this national problem are devastating and must be responded to.

Models which define fitness in terms of per capita rate of increase of phenotypes are used to analyse patterns of individual growth. It is shown that sigmoid growth curves are an optimal strategy (i.e. maximize fitness) if (Assumption 1a) mortality decreases with body size; (2a) mortality is a convex function of specific growth rate, viewed from above; (3) there is a constraint on growth rate, which is attained in the first phase of growth. If the constraint is not attained then size should increase at a progressively reducing rate. These predictions are biologically plausible. Catch-up growth, for retarded individuals, is generally not an optimal strategy though in special cases (e.g. seasonal breeding) it might be. Growth may be advantageous after first breeding if birth rate is a convex function of G (the fraction of production devoted to growth) viewed from above (Assumption 5a), or if mortality rate is a convex function of G, viewed from above (Assumption 6c). If assumptions 5a and 6c are both false, growth should cease at the age of first reproduction. These predictions could be used to evaluate the incidence of indeterminate versus determinate growth in the animal kingdom though the data currently available do not allow quantitative tests. In animals with invariant adult size a method is given which allows one to calculate whether an increase in body size is favoured given that fecundity and developmental time are thereby increased.

The relationship of tests of neuropsychological functioning to clinical ratings of participation in therapeutic activities and predictions of outcome were investigated in two groups of men alcoholics. Factor analysis of the clinical ratings confirmed the existence of three factors: cognitive, clinical improvement and interpersonal. Significant relationships were found in the first group of alcoholics (N = 52) between neuropsychological test scores and scores on each of the three factors. These findings were replicated in the second group of alcoholics (N = 28) drawn from the same population. Patients rated by therapists as having a poor prognosis performed significantly worse on certain neuropsychological tests, especially measures of abstracting and problem solving, than patients rated as having a good prognosis. These data provide evidence that neuropsychological tests are sensitive to many of the same dimensions assessed by clinicians in evaluating therapeutic progress.

It has been proposed that concomitant substances of abuse may have additive or synergistic properties such that alcoholics using other substances of abuse concurrently may have a harder time giving up alcohol than alcoholics abusing only alcohol. The present study surveyed 291 alcoholics in an alcohol treatment program and 86 social drinker controls matched on age, education, SES and gender. Alcohol consumption, smoking, coffee intake, other substances of abuse. Beck depression and Spielberger Anxiety (State) were measured. Alcoholics drank significantly more alcohol than did social drinkers per day (350.19 cc versus 28.08 cc, p less than 0.001), consumed more caffeine/day (486.3 mg versus 339.9 mg, p less than 0.002), smoked more cigarettes/day (27.8 versus 12.8, p less than 0.001), were more depressed (16.8 versus 4.4 (Beck), p less than 0.0001), had lower internal locus of control scores (37.6 versus 39.7, p less than 0.005), had higher scores on control by chance (22.7 versus 20.2, p less than 0.03) and were significantly more anxious (52.5 versus 33.9 on Spielberger's State Inventory p less than 0.0001). Some patients used stimulants, tranquilizers, depressants, narcotics or toluene. Only 3/258 abused alcohol without using other drugs. Results support earlier studies showing strong associations between alcohol and smoking and between alcohol and caffeine consumption. The alcoholic abusing only alcohol is very rare. Treatment programs need to pay attention to concomitant drugs of abuse.

In addition to local allergic skin reactions to the bite of the kissing bug, Triatoma protracta, the systemic reactions can vary from a mild urticarial reaction to a severe anaphylactoid reaction consisting of shock, generalized angioneurotic edema and laryngeal edema. The diagnosis can be established by the clinical history, the finding of an engorged kissing bug, the presence of typical local and systemic signs, and finally, a positive reaction to a skin test with an extract of the bug.