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T Muhammad,1 Milan Das,2 Arup Jana,2 Soomi Lee1 1Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA; 2Department of Population & Development, International Institute for Population Sciences, Mumbai, Maharashtra, IndiaCorrespondence: Arup Jana; T Muhammad, Email arupjana0000@gmail.com; mkt5742@psu.eduBackground: Sleep problems are a critical issue in the aging population, affecting quality of life, cognitive efficiency, and contributing to adverse health outcomes. The coexistence of multiple diseases is common among older adults, particularly women. This study examines the associations between specific chronic diseases, multimorbidity, and insomnia symptoms among older Indian men and women, with a focus on the interaction of sex in these associations.Methods: Data were drawn from 31,464 individuals aged 60 and older in the Longitudinal Ageing Study in India, Wave-1 (2017– 18). Insomnia symptoms were assessed using four questions adapted from the Jenkins Sleep Scale (JSS-4), covering difficulty falling asleep, waking up, waking too early, and feeling unrested during the day. Multivariable logistic regression models, stratified by sex, were used to analyze the associations between chronic diseases and insomnia symptoms.Results: Older women had a higher prevalence of insomnia symptoms than men (44.73% vs 37.15%). Hypertension was associated with higher odds of insomnia in both men (AOR: 1.20) and women (AOR: 1.36). Women with diabetes had lower odds of insomnia (AOR: 0.80), while this association was not significant in men. Neurological or psychiatric disorders, stroke, and bone and joint diseases were linked to higher odds of insomnia in both sexes. Chronic lung disease was associated with insomnia in men (AOR: 1.65), but not in women. Additionally, having three or more chronic diseases significantly increased the odds of insomnia in both men (AOR: 2.43) and women (AOR: 2.01).Conclusion: Hypertension, bone and joint diseases, lung diseases, stroke, neurological or psychiatric disorders, and multimorbidity are linked to insomnia symptoms in older Indian adults. Disease-specific management and routine insomnia screening are crucial for promoting healthy aging in this vulnerable population.Keywords: chronic conditions, India, insomnia symptoms, multimorbidity

Abstract Research into the risk of anorexia nervosa (AN) has examined twin pairs to further the understanding of the contributions of genetics, trait inheritance, and environmental factors to eating disorder (ED) development. Investigations of twin experiences of EDs have been biologically-based and have not considered the qualitative, phenomenological aspects of twin experiences. A gap in the literature exists regarding understanding of discordant twins with EDs. This research was developed in response, with the aim to deepen understanding of AN in discordant twins and to create novel ideas for further research and testing. The case studies presented in this article provide lived experience insights of two identical discordant twin pairs: one twin pair discordant for longstanding AN and one twin pair discordant for ‘atypical’ AN (the twin with AN has recovered). The perspectives and experiences of each co-twin (one with AN and one without) explore a number of factors that may have contributed to twin discordance in these cases, and how each twin has responded to the impact of AN in their lives. Through use of first-person accounts in case study presentation, this article centres social justice values of lived experience leadership and involvement in research. This article aims to extend current knowledge and understanding of EDs in discordant twins, particularly regarding risk for ED development, ED duration, diagnosis and treatment, and recovery processes.

Abstract Background Obsessive-compulsive disorder (OCD) and eating disorders (ED) share common features, including the presence of obsessions and compulsions, and they often co-occur. Additionally, there is a significant comorbidity between ED and childhood traumatic experiences (CTE), as well as between CTE and OCD. Various biological and environmental factors have been proposed to explain the connection between ED, OCD, and CTE. This study explores the link between CTE and the comorbidity of ED and OCD, with the hypothesis that specific types of CTE may increase the risk of developing OCD in individuals with ED. Methods Participants (N = 562) were enrolled at an eating disorder unit in Montpellier, France, between March 2013 and January 2020. The Childhood Trauma Questionnaire (CTQ), Eating Disorder Examination Questionnaire (EDE-Q), and Mini International Neuropsychiatric Interview (MINI) were used to evaluate childhood maltreatment, assess clinical characteristics associated with ED, and categorize participants into two groups: patients with and without OCD. Results Bivariate analysis revealed that patients with comorbid ED and OCD had higher EDE-Q scores (p

Abstract Background Stigma is a complex construct and its association with help-seeking among those experiencing eating disorders is not well understood. Rates of help-seeking are low for those with eating disorder symptoms and, therefore, determining the role of stigma and shame in this relationship is needed to help inform effective awareness campaigns aimed at improving prognostic outcomes. The current study examined the associations between perceived stigma, self-stigma, shame, and help-seeking behaviour in a community sample of individuals with elevated eating disorder symptoms. Methods Participants completed an online survey that included measures of stigma and shame as perceived barriers to help-seeking for individuals with eating disorders. Those with elevated eating disorder symptoms and high clinical impairment were included in the study (N = 333). Results Using binary logistic regression models controlling for age and gender, results showed that perceived stigma, self-stigma, and shame predicted 64% of help-seeking behaviour (p = .005). The only significant unique predictor of formal help-seeking was “Being concerned that other people believe eating disorders are not real illnesses”. No other stigma or shame items were found to significantly predict help-seeking. Conclusions The present findings suggest that while stigma plays an important role in help-seeking, it might not be the primary reason preventing individuals with eating disorders from accessing care. The field is encouraged to investigate these factors to promote help-seeking effectively.

Abstract We assessed the bi-directional relationships between upward appearance comparisons on social media with body dissatisfaction (BD) and disordered eating (DE) in women’s daily lives and the potential moderating effect of trait self-objectification on these relationships. Women (N = 315) completed a baseline measure of trait self-objectification, then reported momentary experiences of social media-based appearance comparisons (upward, lateral, downward), body satisfaction, and DE urges (restrict food intake, exercise, overeat) for seven days. We hypothesized that upward (relative to no) comparisons would predict lower body satisfaction and higher DE urges, while lateral and downward (relative to no) comparisons would predict higher body satisfaction and lower DE urges. We expected these relationships to be bi-directional and moderated by trait self-objectification. Multilevel modelling results revealed complex bi-directional relationships. Upward comparisons predicted lower body satisfaction and increased urges to restrict food intake, which in turn predicted increased upward comparisons. Unexpectedly, urges to restrict food intake predicted all comparison types. We observed somewhat unanticipated bi-directional relationships between lateral comparisons and exercise urges, and between downward comparisons and body satisfaction. Uni-directional relationships emerged between upward comparisons and the urge to overeat. Trait self-objectification moderated very few of these relationships. These findings support the non-uniform impact of appearance comparisons on body image and eating concerns and highlight the complexity of daily social media-body image dynamics. Future research using refined measures over extended periods is needed to elucidate these relationships further and inform targeted interventions.

Abstract Background Anorexia nervosa (AN) is a severe psychiatric disorder, from which recovery is often protracted. The role of prior specialized inpatient treatment on subsequent treatment attempts for adults with chronic AN and predictors of treatment response for severe and enduring AN (SE-AN) are needed to improve outcomes. Method Participants (N = 135) with chronic AN (ill ≥7 years) admitted to an integrated inpatient-partial hospitalization eating disorders (ED) unit with prior ED hospitalization(s) (+ PH; n = 100) were compared to those without prior ED hospitalizations (-PH; n = 35) on admission characteristics (BMI, length of illness, outpatient ED treatment history, symptomatology (ED, anxiety, and depressive), history of suicide attempts or non-suicidal self-injury (NSSI)), treatment motivation and recovery self-efficacy, and discharge outcomes (discharge BMI, rate of weight gain, length of stay, clinical improvement). Results Groups were similar with regard to age, years ill, and admission BMI. The + PH group had lower desired weight, lifetime nadir BMI and self-efficacy for normative eating, and higher state and trait anxiety than the -PH group. +PH were also more likely to endorse history of NSSI and suicide attempt. Regarding discharge outcomes, most patients achieved weight restoration at program discharge (mean discharge BMI = 19.8 kg/m2). Groups did not differ on rate of weight gain, likelihood of attending partial hospital, partial hospital length of stay, program discharge BMI, or likelihood of clinical improvement (p’s > 0.05) although inpatient length of stay was longer for the + PH group. Conclusions Participants with chronic AN + PH exhibited more severe psychiatric comorbidity and lower self-efficacy for normative eating than AN -PH, however short-term discharge outcomes were similar. Future research should determine whether weight restoration and targeting comorbidities impacts relapse risk or need for rehospitalization among chronic and severe + PH. Despite similar illness durations, those with chronic AN -PH may be able to transition to partial hospital earlier. Conversely there is risk of undertreatment of chronic AN + PH given the recent shift promoting briefer self-directed admissions for adults with SE-AN. Research comparing + PH and -PH adults with chronic AN may facilitate efforts to individualize care and characterize relapse risk following intensive treatment.

Abstract Background Binge eating (BE) is associated with a range of cognitive control deficits related to impulsivity, including lower response inhibition, preference for immediate gratification, and maladaptive decision-making. The aim was to investigate whether impulsivity and BE may interact with the decision process and underlying brain activity in outpatients with overweight or obesity who are starting a treatment to achieve weight loss. Methods A sample of 26 treatment-seeking outpatients with overweight or obesity was evaluated for impulsivity, BE, and temporal discounting rates. Impulsivity was measured with the Barratt Impulsiveness Scale (BIS-11), according to which two groups were composed: high BIS and low BIS; BE was assessed with the eating disorders module of the Structured Clinical Interview for DSM5—Research Version, according to which two groups were composed: with (BE group) or without BE (NBE group). Changes in subjective value of rewards were measured with the Temporal Discounting Task (TDt) where participants had to choice between sooner but smaller vs. later but larger monetary rewards. These choices were made in two differently delayed conditions (“Now” and “Not-now”). Brain rhythms were recorded through high-density electroencephalogram (hd-EEG) during the TDt. Results Patients with BE reported more impulsive tendencies and perceived sooner rewards as more gratifying when both options were delayed (Not-now condition, p = 0.02). The reward choice in the TDt was accompanied by a general EEG alpha band desynchronization in parietal areas observed without differences between experimental conditions and patients groups. No effects were observed within the Now condition or in the other EEG bands. Conclusions The tendency to favor immediate rewards may constitute an obstacle to adhering to treatment plans and achieving weight loss goals for outpatients with overweight or obesity. Clinicians are therefore encouraged to include psychological factors, such as impulsivity and dysfunctional eating behaviors, when designing weight loss programs. By addressing these psychological aspects, clinicians can better support patients in overcoming barriers to adherence and achieving sustainable weight loss. Trial registration This study was approved by the Ethics Committee of the Department of Psychological, Health, and Territorial Sciences of the University G. d’Annunzio of Chieti-Pescara (Prot. n. 254 of 03/14/2017).

Abstract Background Anorexia nervosa is a serious and potentially lethal psychiatric disorder. Furthermore, there is significant evidence that some individuals develop a very long-standing form of the illness that requires a variety of different treatment interventions over time. Objective The primary goal of this paper was to provide a review of treatment strategies for severe and enduring anorexia nervosa (SE-AN) with the particular focus on treatments involving hospital care. Additionally, we wish to highlight a contemporary approach to such care and provide qualitative reactions to this model from both staff and patients. Methods A selective and strategic review of the treatment literature for SE-AN was conducted for the current paper. Emphasis was placed on clinical or scientific papers related to hospital-based care. Additionally, staff who work on a specific inpatient eating disorder unit with a substantial treatment program for SE-AN, along with a number of SE-AN patients were surveyed regarding their experiences working on, or receiving treatment on the unit. Importantly, the staff of this unit created a specific treatment protocol for individuals receiving hospital care. The results of the highlight both advantages and challenges of a hospital-based protocol oriented toward emphasizing quality of life, medical stability, and a health-promoting meal plan. Discussion While there is general inconsistency with the type of treatment that is best suited to individuals with SE-AN, this is particularly true for higher levels of care that rely on inpatient hospital units or residential treatment settings. This is a highly significant clinical topic in need of further clinical and scientific examination.

Abstract Evidence for the value of peer support for eating disorders (EDs) is growing. Peer support is not a replacement for treatment, but can provide hope for recovery, enhance motivation for treatment, and increase feelings of connectedness and belonging for those experiencing EDs. In this study, we explored peer mentees’ experiences of peer support for EDs to better understand the impact of peer support and its role in the Canadian treatment and support continuum. We conducted semi-structured interviews with 20 people who had received peer support (group, one-on-one, or chat) and conducted a reflexive thematic analysis through a critical realist lens. We developed four themes. Participants described the importance of connecting with others who had “been there,” which helped generate a sense of belonging and connectedness. They also highlighted aspects of the peer support “container” that needed to be in place, such as guidelines for groups and agreements for one-on-one mentoring. When peer support was delivered well, participants described how it helped them help themselves through increasing motivation, communication skills, and other coping skills. Finally, participants described the unique role of peer support within the treatment continuum, as a modality that was accessible, free, and delivered in a way that focused on the whole person. Together, our findings illustrate the value of peer support and considerations for enabling effective and safe peer support delivery.

Abstract Background Weight stigma refers to the social rejection, discrimination, and ideological devaluation of individuals because of body size and is a direct result of weight bias and anti-fat attitudes. Individuals with higher weight may be less likely to seek healthcare due to weight stigma, and if or when they do present for care, medical providers with weight bias may fail to provide high quality care. Little, however, is known about the intersectionality of weight stigma and perceptions of healthcare interactions as experienced by individuals who also binge eat. Methods Community-based adults completed online self-report questionnaires regarding generalized weight stigma (Attitudes Towards Obese Persons1), healthcare interaction quality (Patient Perceptions of Healthcare Provider Interaction Quality; PPH), and disordered eating (Eating Disorder Examination-Questionnaire) via Amazon’s Mechanical Turk platform. For this cross-sectional study, participants were categorized by the presence and absence of regular binge episodes. Pearson’s correlations, T-tests, ANOVA/ANCOVA, and a multivariate regression were used to examine relationships among demographic variables, weight stigma, disordered eating, and the PPH. Results Participants (N = 648) primarily identified as female (65.4%) and White, non-Hispanic (72.7%). Participants’ average age and body mass index (BMI) were 37.5 (SD = 12.3) years old and 27.3 (SD = 6.9) kg/m2, respectively. Higher healthcare provider interaction quality ratings (PPH) were significantly related to lower BMI (r(648)=-0.098,p = 0.012), less weight stigma (r(648) = 0.149,p

Abstract Decisions about the treatment of eating disorders do not occur in a socio-political vacuum. They are shaped by power relations that produce categories of risk and determine who is worthy of care. This impacts who gets access to care and recognition of rights in mental health services. Globally, there are calls for more human rights-based approaches in mental health services to reduce coercion, improve collaborative decision making and enhance community care. Treating individuals with longstanding, Severe and Enduring Eating Disorders (SEED) or Severe and Enduring Anorexia Nervosa (SE-AN) can be particularly problematic when it involves highly controversial issues such as treatment withdrawal and end-of-life decisions and, where legally permissible, medically assisted dying. In this article, we argue that the socio-political context in which clinical decision making occurs must be accounted for in these ethical considerations. This encompasses considerations of how power and resources are distributed, who controls these decisions, who benefits and who is harmed by these decisions, who is excluded from services, and who is marginalised in decision making processes. The article also presents tools for critically reflective practice and collaborative decision-making that can support clinicians in considering power factors in their practice and assisting individuals with longstanding eating disorders, SEED and SE-AN to attain their rights in mental health services.

Abstract Background Job burnout is defined as physical, emotional, and mental exhaustion due to persistent work stress, and it includes emotional exhaustion (EE), cynicism (CY), and reduced personal accomplishment (PA) and usually leads to symptoms of depression, lack of motivation, and decreased enthusiasm. Previous studies from different countries have suggested that job burnout, depression, and anxiety are a common work-related problems. This study aims to assess for job burnout, depression, and anxiety among radiation workers in order to investigate the effects of radiation exposure during work on the mental health. This comparative cross-sectional study was performed on 208 workers in the Egyptian Atomic Energy Authority (EAEA) and the Egyptian Nuclear and Radiological Regulatory Authority (ENRRA) at Cairo Governorate, Egypt. Study participants were divided into 2 groups: 1st group which included 104 workers among radiation field and 2nd group which included 104 workers and employees who do not often work among radiation field. Maslach Burnout Inventory Scale (MBI), Hamilton Rating Scale for Depression (HAM-D), and Hamilton Rating Scale for Anxiety (HAM-A) were used to assess for burnout, depression, and anxiety among study participants. Results The prevalence and severity of depression, anxiety, burnout, and among workers inside radiation field group were statistically significantly higher than those working outside radiation field group. Work type (WIRF) and number of working hours per week (> 40 h) were the significant risk factors for all the burnout, depression, and anxiety, while age (> 40–60 years old) was a significant predictor for depression, female gender was a significant predictor for anxiety, and both age (20–40 years old) and years of experience (≤ 10 years) were significant predictors for burnout among workers inside radiation field. Conclusions Burnout, depression, and anxiety are common among workers inside radiation field with higher prevalence and severity than those working outside radiation field. Younger age, fewer years of experience, and more working hours per week are significantly associated risk factors for burnout among workers inside radiation field.

Abstract Background The emergence of the COVID-19 pandemic in 2019 imposed significant shifts in global health, particularly in understanding and addressing anxiety disorders precipitated by pandemic-related stressors. The current study aimed to adapt and validate the COVID-19 Anxiety Questionnaire (C-19 A) for Arabic-speaking populations (C-19 A-A), assessing its structural integrity, concurrent validity, factorial validity, and reliability. Methods The data of 571 individuals, including age range, educational history, gender, and marital status, were collected through online platforms. The translation process of C-19 A-A underwent rigorous verification by linguistic and subject matter experts. Several advanced statistical procedures were used to examine the C-19 A-A’s reliability, validity, and measurement invariances across demographic subsets. Results The results indicated robust internal consistency, with a Cronbach’s alpha coefficient of 0.889, confirming the questionnaire’s reliability. Concurrent validity showed significant and positive correlations between C-19-A and FCV-19S (r = 0.77, p

Abstract Background Child maltreatment (CM) can have devastating and potentially lifelong effects for those affected and is a major contributor to mental health problems. To tackle public health problems it is crucial to have reliable data on CM. The aim of this study is to assess the prevalence and predictors of CM in a nationwide sample of the German population of young adults. Methods The study population (young adults aged 18 to 31 years) stems from the KiGGS Cohort study, the longitudinal branch of the German Health Interview and Examination Survey for children and adolescents. This sample meets the criteria of the United Nations Sustainable Development Goals (SDG) indicator 16.2.3. The data was collected between 2014 and 2017. CM were assessed with the Childhood Trauma Questionnaire (CTQ) in. In addition, socio-demographic variables and other known risk factors for CM were assessed. A total of 6433 (47.8% female) participants were included in the analyses. Binary logistic regression analyses were used to investigate predictors of maltreatment subtypes. Ordinal regression was used to examine their association with experience of multiple forms of CM. Results Overall, 18.4% (f: 20.9%, m: 16.1%) of the participants reported having experienced at least one type of CM; 6.7% (f: 8.8%, m: 4.8%) reported experiences of emotional abuse, 3.7% (f: 3.9%, m: 3.5%) physical abuse, 3.5% (f: 5.3%, m: 1.7%) sexual abuse, 9.0% (f: 9.9%, m: 8.2%) emotional neglect and 8.6% (f: 8.5%, m: 8.7%) physical neglect. Gender, subjective social status, education and household dysfunction (e.g. living with an individual who is using substances) emerged as significant predictors for different types of CM. Additionally, all these factors were significant risk factors for experiencing cumulative CM. Conclusions CM is common in the German population, with almost one in five people experiencing at least one type of CM. The results reveal important risk factors for the occurrence of CM. In particular, people with lower social status and those who grew up in dysfunctional households are at higher risk of CM. Greater support for this vulnerable population may reduce the prevalence of CM.

Abstract Adolescents with callous unemotional (CU) traits are at risk for poor quality-of-life outcomes such as incarceration, suicide, and psychopathy. It is currently unknown which treatments are implemented with CU adolescents specifically and which elements make up these interventions. A narrative systematic review was used to identify the treatments and common elements used with CU adolescents (12–18 years). Eligible studies were randomized controlled trials and quasi-experimental studies evaluating psychosocial interventions, delivered within a clinical context, and directed towards the adolescent or their family. Eight studies with 1291 participants were included. Significant decreases in CU traits were demonstrated only in a minority of studies. The most utilized practice elements were set goals for treatment, practice interpersonal/communication skills, prepare for termination, and teach parents skills and strategies; the most utilized process elements were formal therapy, practice exercises, important others, and flexible/adaptive. A majority of the studies did not report an implementation element. While theoretical frameworks for CU children are employed with CU adolescents, there is still uncertainty regarding their suitability for this age group. Given the limited empirical evidence, there is a critical need for further exploration.

Abstract Background Sexual offenses encompass a diverse array of behaviors across various contexts, affecting numerous individuals. Despite the prevalence of sexual offending among adolescents, there is still a limited understanding of this population. To contribute further to the literature in this field, the present study was conducted to compare a group of male adolescents convicted of sexual offenses with a control group in terms of reflective functioning (RF), emotion regulation (ER) strategies, and emotion dysregulation (ED). Methods 60 male adolescents aged 12 to 18 years (M = 16.90; SD = 0.97) who had been convicted of at least one serious sexual offense were recruited from male adolescents referred by juvenile courts to the Legal Medicine Organization in Mashhad, Iran, and compared with a control group of non-offending adolescents consisting of 60 male adolescents aged 12 to 18 years (M = 16.97; SD = 0.82) who were attending school. The groups were matched on age and education level. Results A comparison between these two groups revealed that adolescents with a history of sexual offending exhibited poorer RF capacity, greater use of suppression as an ER strategy, and higher scores in all ED domains (p’s

Abstract Background Mindfulness skills training is a core component of Dialectical Behavior Therapy and aims to improve emotion dysregulation (ED) in people with Borderline Personality Disorder (BPD). However, the underlying mechanisms of change are not fully understood. Methods A total of 75 BPD outpatients participated in a 10-week mindfulness skills training. Multilevel models with a time-lagged approach were conducted to examine the temporal dynamics between the proposed mechanisms and ED. Decentering, nonjudgment, body awareness and attention awareness as putative mechanisms and ED as outcome were assessed on a session-by-session basis. Results Greater nonjudgment and body awareness showed within-person effects; participants who reported higher nonjudgement of inner experience and body awareness than their own personal average at a given week showed improvement in ED at the following week. Notably, decentering moderated these associations, such that increased nonjudgment and body awareness predicted improvements in ED more strongly in those participants with high decentering ability. Lastly, a bidirectional relationship between the mechanisms and ED was found; when participants were more emotionally dysregulated than their usual state, they showed less gain in the mechanisms at the following week. Conclusions Knowing how mindfulness training works is relevant to optimize treatments. Clinicians may use strategies to increase these mechanisms when the goal is to improve emotion regulation difficulties in BPD.

Abstract Growing evidence suggests a potential link between the gut microbiome and schizophrenia. However, it is unclear whether the gut microbiome is causally associated with schizophrenia. We performed two-sample bidirectional Mendelian randomization to detect bidirectional causal relationships between gut microbiome and schizophrenia. Summary genome-wide association study (GWAS) datasets of the gut microbiome from the MiBioGen consortium (n = 18,340) and schizophrenia (n = 130,644) were utilized in our study. Then a cohort of sensitive analyses was followed to validate the robustness of MR results. We identified nine taxa that exerted positive causal effects on schizophrenia (OR: 1.08–1.16) and six taxa that conferred negative causal effects on schizophrenia (OR: 0.88–0.94). On the other hand, the reverse MR analysis showed that schizophrenia may increase the abundance of nine taxa (OR: 1.03–1.08) and reduce the abundance of two taxa (OR: 0.94). Our study unveiled mutual causal relationships between gut microbiome and schizophrenia. The findings may provide evidence for the treatment potential of gut microbiomes in schizophrenia.

Abstract How early in life stress-immune related environmental factors increase risk predisposition to schizophrenia remains unknown. We examined if pro-inflammatory changes perturb the brain epidermal growth factor (EGF) system, a system critical for neurodevelopment and mature CNS functions including synaptic plasticity. We quantified genes from key EGF and immune system pathways for mRNA levels and eight immune proteins in post-mortem dorsolateral prefrontal (DLPFC; Brodmann’s Area (BA) 46) and orbitofrontal (OFC; BA11) cortices from people with schizophrenia, mood disorders and neurotypical controls. In BA46, 64 genes were differentially expressed, predominantly in schizophrenia, where attenuated expression of the MAPK-ERK, NRG1-PI3K-AKT and mTOR cascades indicated reduced EGF system signalling, and similarly diminished immune molecular expression, notably in TLR, TNF and complement pathways, along with low NF-κB1 and elevated IL12RB2 protein levels were noted. There was nominal evidence for altered convergence between ErbB-PI3K-AKT-mTOR and TLR pathways in BA46 in schizophrenia. Comparatively minimal changes were noted in BA11. Overall, distinct pathway gene expression changes may reflect variant pathological processes involving immune and EGF system signalling between schizophrenia and mood disorder, particularly in DLPFC. Further, the abnormal convergence between innate immune signalling and candidate EGF signalling pathways may indicate a pathologically important interaction in the developing brain in response to environmental stressors.

Abstract Depersonalization/derealization disorder (DPD) is a prevalent yet inadequately understood clinical condition characterized by a recurrent or persistent sense of unreality. This study aims to provide insight into DPD through descriptive and comparative analyses involving a large group of Chinese participants. The socio-demographic details (age, gender proportion, education, occupational status, marital status), depersonalized and dissociative symptom characteristics (symptomatic factors or subscales of the Cambridge Depersonalization Scale and the Dissociative Experiences Scale), development trajectory (age of onset, potential precipitating factors, course characteristics), treatment history (duration of delayed healthcare attendance, duration of delayed diagnosis, previous diagnoses), and adverse childhood experiences of the DPD patients are presented. Comparisons of anxiety and depressive symptoms, alongside psychosocial functioning, between DPD participants and those diagnosed with generalized anxiety disorder, bipolar disorders, and major depressive disorder were conducted. The analysis highlights a higher male preponderance and early onset of DPD, symptomatology marked by derealization, notable impairment in psychosocial functioning, and prolonged periods of delayed healthcare attendance and diagnosis associated with symptom severity. Furthermore, noteworthy relationships between adverse childhood experiences and symptom levels were identified. The findings substantiate the view that DPD is a serious but neglected mental disorder, urging initiatives to improve the current condition of DPD patients.

Abstract Objective Major depressive disorder (MDD) is often accompanied by psychotic symptoms. However, few studies have examined the relationship between psychotic symptoms and endocrine factors in adolescent patients with MDD. Therefore, this study aimed to investigate the prevalence and related endocrine clinical factors of psychotic symptoms in Chinese adolescent patients with MDD. Methods In total, 601 patients (aged 12–18) with MDD were recruited. The Patient Health Questionnaire – 9 items (PHQ – 9) was utilized for assessing depressive symptoms. Psychotic symptoms were assessed through clinical interviews. Prolactin (PRL), thyroid-stimulating hormone (TSH), triiodothyronine (T3), free triiodothyronine (FT3), thyroxine (T4), and free thyroxine (FT4) were also measured. Results The incidence of psychotic symptoms in adolescent patients with MDD was 22.6%. The findings demonstrated that age, self-harming behavior, PHQ-9 score, FT4, and normalized PRL were independently associated with psychotic symptoms in patients with MDD (All p

Abstract Aim Functional Management and Recovery is a standardized Psychoeducational Intervention, derived from “Integro”, an effective salutogenic-psychoeducational intervention for people in recovery journey, designed to improve recovery and functioning of individuals with psychotic disorders in Psychiatric Residential Facilities (PRFs). The aim of this study is to evaluate the primary and secondary outcomes of this intervention elaborated specifically for PRFs where evidence based structured interventions seem rare and desirable. Methods 66 individuals with psychotic disorders were recruited in 9 PRFs dislocated in the North, Center and South Italy and 63 underwent a multicenter follow-up study with a two time-point evaluation (t0, pre-treatment and t1, 6 months; ). At each time point, social functioning was assessed as primary outcome by the Personal and Social Performance scale (PSP); furthermore, psychopathological status was assessed by Brief Psychiatric Rating Scale (BPRS), Recovery by Recovery Assessment Scale (RAS), Cognitive Functioning by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Stress management by Stress-Scale, Cognitive Flexibility by Modified Five-Point Test (M-FPT), Emotional Intelligence by Emotional Intelligence Index (EI-I), the PRF Atmosphere and the Opinion of users about the PFR by an ad hoc questionnaire. The Abilities Knowledge, the Utility and Pleasantness of sessions were measured by an ad hoc list of items. Results 63 individuals out of 66, 52 (82,5%) affected by schizophrenia and 11 (17,5%) by bipolar I disorder with psychotic symptoms according to DSM-5-TR completed the study. At the end of the study, 43 (68,3%) were male, 57 (90.5%) were single, 5 (7.9%) engaged, 1 (1.6%) married; 45 (71.4%) unemployed. The total scores of PSP, RAS, BPRS, BANS, Stress management, Abilities Knowledge, Utility and Pleasantness of sessions showed a statistically significant improvement at t1 vs. t0. Two sub-scales out of 5 of M-FPT showed a statistically significant improvement. The Emotional Intelligence, the Unit Atmosphere and the Opinion of Users about PFR improved without statistical significance. Six months after the end of the follow-up study 22 individuals of the sample were dismissed with a very high turnover. Conclusions After a six-month follow-up (a short period of time), these results showed improvement in functioning, the primary outcome, as well as in the following secondary outcome variables: RAS, BPRS, BANS, Stress management, Abilities Knowledge, two sub-scales out of 5 of M-FPT, Utility and Pleasantness of sessions. Overall, a remarkable impact of psychoeducational structured intervention on the key Recovery variables is observed. Further studies are needed to address extent and duration of these improvements.

Abstract Background The main objective of this study was to examine the burden of schizophrenia, depression, Alzheimer’s disease/dementia, and stroke on caregivers and non-caregivers in Japan. This study also aimed to provide a comparative landscape on the burden of caregiving for each disorder. Methods The Japan National Health and Wellness Survey database, 2016 and 2018 was used in this study. Health-related quality of life (HRQoL), work productivity, and health care utilization were assessed using a self-administered, Internet-based questionnaire. The burden of caregiving experienced by each group of caregivers was compared with background-matched non-caregivers (controls) as well as with caregivers of patients with each disorder. Results Caregivers of patients with schizophrenia, depression, Alzheimer’s disease/dementia, or stroke had lower HRQoL, higher healthcare costs and work productivity impairment than non-caregivers. Furthermore, caregivers of patients with psychiatric disorders such as schizophrenia and depression had lower HRQoL and work productivity than caregivers of patients with Alzheimer’s disease/dementia and stroke. In addition, according to the Caregiver Reaction Assessment (CRA), caregivers of patients with schizophrenia and depression were more inclined to perceive a loss in physical strength and financial burden to the same extent as their self-esteem. Conclusions This study indicated a substantial caregiving burden among caregivers of patients with psychiatric and neurological diseases in Japan. The caregiver burden of psychiatric disorders (schizophrenia and depression) was greater than that of neurological disorders (Alzheimer’s disease/dementia and stroke), suggesting a need to provide support to caregivers of patients with psychiatric disorders to be better able to care for their patients. Trial Registration None.

Abstract Background Non-suicidal self-injury (NSSI) is a significant public health concern among adolescents with major depressive disorders (MDD). Although previous research has linked child maltreatment (CM) to NSSI, the precise mechanisms remain unclear. This study aims to investigate the association between CM, cognitive reappraisal (CR), negative coping styles (NC) and NSSI in adolescents with MDD, from the perspectives of both Latent Variable Theory and the Network Theory of Mental Disorder. Methods A sample of 651 adolescents with MDD was recruited from January to December 2023. Data on CM, CR, NC, and NSSI were collected through paper-based self-reported questionnaires. Data analysis primarily involved structural equation modeling and network analysis. Results The reporting rate of NSSI among adolescents with MDD was 48.2%. CM showed a significant positive correlation with NSSI. NSSI was affected by CM through three paths: the mediating role of CR, the mediating role of NC, and the chain mediating role of both CR and NC. Emotional abuse (EA) was the central node, while NSSI, EA, and “The urge to cry quietly when faced with troubles“(NC10) were the key bridge nodes. Conclusions This study is the first to use both structural equation modeling and network analysis to explore the explore the relationship between CM, CR, NC, and NSSI in adolescents with MDD, providing a theoretical basis for future early prevention and targeted interventions for adolescents with MDD.

Abstract Background Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory rheumatic disease in children, and adalimumab is one of the primary treatment options. Although it is widely used for inflammatory diseases, there is limited research on its safety and efficacy in patients with psychiatric disorders or in those with inflammatory diseases who also have comorbid psychiatric conditions. Case report We report a 12-year-old adolescent boy who presented with emotional instability for 1 year, exacerbated leading to hospital admission in the past month. Upon detailed evaluation after admission, it was found that the patient’s emotional fluctuations may be related to the use of Adalimumab. Follow-up after psychiatric inpatient treatment revealed that the patient did not experience emotional excitement again after discontinuing Adalimumab. Conclusions Although tumor necrosis factor-α inhibitors have positive effects on the emotional, cognitive, and physical functions of patients with inflammatory diseases, their use may induce mood swings in patients with comorbid mood disorders. This is particularly important for adolescents with rapid mood changes, where greater caution is required. Further research is necessary to clarify the correlation between the adverse effects of these drugs and their impact on patients with bipolar disorder.

Abstract Background Individuals’ concealment of negative information and privacy may lead to impaired social interactions and threatened health conditions. This study aimed to investigate the effectiveness of the Self-Concealment Scale (SCS) in the middle-aged Chinese population and to examine the equivalence of the SCS among different age groups. Methods The current research adopted the SCS, Distress Disclosure Index (DDI), Revised Cheek and Buss Shyness Scale (RCBS), Social Interaction Anxiety Scale (SIAS), Social Phobia Scale (SPS), UCLA Loneliness Scale (ULS-8), and Kessler Psychological Distress Scale (K10) to survey 1124 middle-aged people. To explore the factor structure of the SCS, the study employed exploratory factor analysis and confirmatory factor analysis. The reliability of the SCS was measured based on Cronbach’s α coefficients, McDonald’s Omega coefficients, and split-half reliability. Correlation analysis was applied to examine the relationship between SCS and RCBS, SIAS, SPS, ULS-8, and K10. Moreover, this study recruited 1458 emerging adults and 1104 older adults to identify the cross-age invariance of the SCS. Results Exploratory factor analysis of the middle aged adults’ data supported a single factor model. The factor loadings of SCS items ranged from 0.62 to 0.73, the commonality ranged from 0.39 to 0.53, and the single-factor model fitted well. The scale showed a Cronbach’s α coefficient value of 0.895, McDonald’s Omega coefficient of 0.893, and a split-half reliability coefficient value of 0.861. In addition, the SCS demonstrated invariance in emerging adults, middle-aged adults, and older adults. Further analysis showed that the scores of the SCS (F = 3.55, p = 0.029) among emerging adults (M = 26.43, SD = 7.96) were significantly higher than among middle-aged (M = 25.77, SD = 7.79), and older cohort (M = 25.69, SD = 7.91). Conclusion The SCS revealed favorable psychometric characteristics among the middle-aged Chinese population. The degree of self-concealment among emerging adults was higher than that of middle-aged and older people.

Abstract Alterations in the reward and cognitive control systems are commonly observed among adolescents with internet dependence (ID), and this impairment is often accompanied by social dysfunctions, such as academic burnout. However, the intercorrelations among ID, reward, cognitive control processing, and learning burnout remain unclear. We recruited 1074 Chinese adolescents to investigate the complex interrelationships among these variables using network analysis. The resulting network revealed patterns that connected ID to the behavioral inhibition/activation system (BIS/BAS), self-control, and learning burnout; these results exhibited reasonable stability and test–retest consistency. Throughout the network, the node of BAS-drive was the critical influencing factor, and the node of self-control was the protection factor. In addition, several symptoms of learning burnout and ID were positively associated with sensitivity to punishment. As revealed by the network comparison test, the network constructed among internet dependent (ID) group differed from the network constructed among internet nondependent (IND) group not only in the edges between BIS and learning burnout but also in terms of the edges associated with learning burnout. In conclusion, this study provides insights into the complex mechanisms underlying ID among adolescents from the perspective of the network relationships between core influencing factors and negative consequences. It validates the dual-system model of risky behavior among adolescents and offers a foundation for early warning and interventions for ID in this context.

Abstract Objective To assess the effectiveness of Internet-based self-help interventions in treating depression in adolescents and young adults. Methods A systematic search was conducted across six databases, including PubMed, to identify randomized controlled trials (RCTs) that satisfied the specified inclusion and exclusion criteria. The intervention measure consisted of Internet-based self-help interventions. Results A total of 23 randomized controlled trials (RCTs) were included in this analysis. Meta-analysis indicated that Internet-based self-help therapies significantly reduced depression scores in adolescents and young adults. (OR = -0.68, 95%CI [-0.88, -0.47], P

Abstract Background We report the final results of treatment with aripiprazole, blonanserin, and paliperidone from the Japan Useful Medication Program for Schizophrenia (JUMPs), a 104-week naturalistic study. Methods JUMPs was an open-label, three-arm, randomized, parallel-group, 104-week study. Patients aged ≥ 20 years with schizophrenia requiring antipsychotic treatment or a switch from previous therapy were enrolled. The primary endpoint was treatment discontinuation rate over 104 weeks. Secondary endpoints included remission rate, Personal and Social Performance (PSP), safety, Positive and Negative Syndrome Scale (PANSS), and quality of life (QOL; EuroQol-5 dimension). Results In total, 251 patients received aripiprazole (n = 82), blonanserin (n = 85), or paliperidone (n = 84). Treatment discontinuation rates (aripiprazole, 80.5%; blonanserin, 81.2%; paliperidone, 71.4%) were not significantly different (p = 0.2385) among the treatment groups at 104 weeks; comparable outcomes were observed for endpoints, including remission (42.9%, 46.7%, and 45.8%), PANSS, and safety. In the overall cohort, while the improvement in the PSP total score at Week 104 was not significantly different from baseline, a significant improvement (p

Abstract Background Sex differences in the symptomatology of adults with attention-deficit/hyperactivity disorder (ADHD) have often been overlooked when studying behavioral abnormalities. However, it is known that women exhibit considerably more stronger symptoms related to emotional competence than men. Since affective functions significantly influence the processing of risky decision-making and risk-engagement, we assume that risky behavior in ADHD is affected by sex differences. Therefore, we specifically investigated sex-specific effects on the interaction between emotionally induced changes in physiology and behavioral performance on a decision-making task. Methods Skin conductance responses of twenty-nine adults with ADHD (n = 16 male; n = 13 female) and thirty-three adults in the control group (n = 14 male; n = 19 female) were recorded during the performance in a modified version of the Balloon Analogue Risk Task (BART). Additional questionnaires were used to reveal insights in the self-assessment of emotional competence, risk perception, and feedback sensitivity. Emotional arousal and decision-making behavior were analyzed using linear mixed-effects models. Results Results showed different effects of sex on risk behaviors in controls and ADHD. In contrast to healthy controls, female adults with ADHD showed a significantly greater risk engagement in the BART compared to males with ADHD. This contrary sex relation was not observed in skin conductance responses and revealed a significantly different sex-dependent correlation of body response and behavioral task performance in ADHD. Comparisons with results from self-assessments furthermore indicate a reduced behavioral self-perception in women with ADHD, but not in men. Conclusion In summary, we found an altered interaction between physiological activity and risky behavior in women with ADHD. Thus, the present study indicates a reduced sensitivity towards the own bodily responses in women with ADHD, which could consequently cause increased risky DM behavior in daily life. The current results suggest that more consideration needs to be given to sex-specific effects on physiological processes and behavior in adults with ADHD.

Abstract Background Cognitive impairment is a core symptom of schizophrenia. Metabolic abnormalities impact cognition, and although the influence of blood lipids on cognition has been documented, it remains unclear. We conducted a small cross-sectional study to investigate the relationship between blood lipids and cognition in patients with stable-phase schizophrenia. Using Olink proteomics, we explored the potential mechanisms through which blood lipids might affect cognition from an inflammatory perspective. Methods A total of 107 patients with stable-phase schizophrenia and cognitive impairment were strictly included. Comprehensive data collection included basic patient information, blood glucose, blood lipids, and body mass index. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and the MATRICS Consensus Cognitive Battery (MCCB). After controlling for confounding factors, we identified differential metabolic indicators between patients with mild and severe cognitive impairment and conducted correlation and regression analyses. Furthermore, we matched two small sample groups of patients with lipid metabolism abnormalities and used Olink proteomics to analyze inflammation-related differential proteins, aiming to further explore the association between lipid metabolism abnormalities and cognition. Results The proportion of patients with severe cognitive impairment (SCI) was 34.58%. Compared to patients with mild cognitive impairment (MCI), those with SCI performed worse in the Attention/Alertness (t = 2.668, p = 0.009) and Working Memory (t = 2.496, p = 0.014) cognitive dimensions. Blood lipid metabolism indicators were correlated with cognitive function, specifically showing that higher levels of TG (r = -0.447, p

Abstract Background Depression is a highly prevalent and often recurrent condition; however, treatment is not always accessible or effective in addressing abnormalities in emotional processing. Given the high prevalence of depression worldwide, identifying and mapping out effective and sustainable interventions is crucial. Emotion dysregulation in depression is not readily amenable to improvement due to the complex, time-dynamic nature of emotion; however, systematic planning frameworks for programs addressing behavioral changes can provide guidelines for the development of a rational intervention that tackles these difficulties. This study proposes an empirical and theoretical art-based emotion regulation (ER) intervention using an integrated approach that combines intervention mapping (IM) with participatory action research (PAR). Methods We used the IM protocol to identify strategies and develop an intervention for patients with major depressive disorder (MDD). As applied in this study, IM comprises six steps: (a) determining the need for new treatments and determinants of risk; (b) identifying changeable determinants and assigning specific intervention targets; (c) selecting strategies to improve ER across relevant theories and research disciplines; (d) creating a treatment program and refining it based on consultations with an advisory group; (e) developing the implementation plan and conducting a PAR study to pilot-test it; and (f) planning evaluation strategies and conducting a PAR study for feedback on the initial testing. Results Following the steps of IM, we developed two frameworks for an art-based ER intervention: an individual and an integrative framework. The programs include four theory- and evidence-based ER strategies aimed mainly at decreasing depressive symptoms and improving ER in patients with MDD. We also developed a plan for evaluating the proposed intervention. Based on our preliminary PAR studies, the intervention was feasible and acceptable for adoption and implementation in primary care settings. Conclusion The application of IM incorporated with PAR has resulted in an intervention for improving ER in depression. While changing behavior is perceived as a challenging and elaborate task, this method can be useful in offering a clear structure for developing rational interventions. Further refinement is necessary through rigorous research.

Abstract Background For Attention Deficit/Hyperactivity Disorder (ADHD) youth transitioning from child to adult services, protocols that guide the transition process are essential. While some guidelines are available, they do not always consider the effective workload and scarce resources. In Italy, very few guidelines are currently available, and they do not adhere to common standards, possibly leading to non-uniform use. Methods The present study analyzes 6 protocols collected from the 21 Italian services for ADHD patients that took part in the TransiDEA (Transitioning in Diabetes, Epilepsy, and ADHD patients) Project. The protocols’ content is described, and a comparison with the National Institute for Clinical Health and Excellence (NICE) guidelines is carried out to determine whether the eight NICE fundamental dimensions were present. Results In line with the NICE guidelines, the dimensions addresses in the 6 analyzed documents are: early transition planning (although with variability in age criteria) (6/6), individualized planning (5/6), and the evaluation of transfer needs (5/6). All protocols also foresee joint meetings between child and adult services. The need to include the families is considered by 4 out of 6 protocols, while monitoring (2/6), and training programs (1/6) are less encompassed. In general, a highly heterogeneous picture emerges in terms of quality and quantity of regulations provided. Conclusions While some solid points and core elements are in common with international guidelines, the content’s variability highlights the need to standardize practices. Finally, future protocols should adhere more to the patients’ needs and the resources available to clinicians.

João Guerreiro,1 Laura Schulze,1 Albert Garcia i Tormo,1 Amanda J Henwood,1 Luc Schneider,1,2 Elise Krob,1 Sarah Salvilla,3 Kelly MY Chan,3 Sarah Deedat,3 Aleksandar Matic1 1R&D, Koa Health, Barcelona, Spain; 2Department of Management, LSE, London, UK; 3FWD Group, FWD Group, Hong Kong, People’s Republic of ChinaCorrespondence: João Guerreiro, R&D, Koa Health, Carrer de la Ciutat de Granada 121, Barcelona, 08018, Spain, Email joao.leitaoguerreiro@koahealth.comAbstract: Sleep, an intrinsic aspect of human life, is experienced by individuals differently which may be influenced by personality traits and characteristics. Exploring how these traits influence behaviors and sleep routines could be used to inform more personalized and effective interventions to promote better sleep. Our objective was to summarize the existing literature on the relationship between personality traits and sleep patterns through a systematic review. An abstract and keyword search was conducted in PsycINFO, Cochrane and PubMed, collecting relevant literature, published between January 1980 and June 2024. A total of 1713 records were found, of which 18 studies were analyzed in the descriptive synthesis. Relevant studies covered populations in 11 different countries, Australia, China, Estonia, Finland, Germany, Italy, Japan, Poland, Turkey, the United Kingdom, and the United States, comprising a total of 58,812 subjects. All studies reported an association between a sleep pattern with at least one of the Big Five personality traits (agreeableness, conscientiousness, extraversion, neuroticism, openness to experience). Ten studies found associations between personality and sleep quality, all of which reported a link between neuroticism and sleep quality (effect sizes 0.183-0.40). Five studies found an association between conscientiousness and morningness (effect sizes 0.16-0.35). Other sleep patterns linked to personality traits included sleep duration, nightmare frequency and distress, sleep deficiency, sleep continuity, insomnia severity and sleep problems, sleep hygiene, sleep latency and daytime sleepiness. This novel systematic review confirms that sleep and personality traits are related, suggesting that those traits should be considered when trying to understand or change one’s sleep behavior.Keywords: personality traits, sleep patterns, big five, sleep quality, chronotype

Catatonia was first described by Kahlbaum in 1874. Subsequently, in 1908, Kraepelin delineated a cyclical pattern of catatonia in a group of patients with Schizophrenia. Further ahead, in 1938, Gjessing demonstrated the role of nitrogen phasic change in synchronous syntonic cases of periodic catatonia. However, Stokes et al., in 1941, demonstrated it to be a result of steady accumulation rather than a phasic change in nitrogen balance. There are no reliable prevalence figures for periodic catatonia. Prominent diagnostic manuals have not given this diagnostic entity a separate nosological status, despite evidence of a discrete metabolic profile. This case series elucidates periodic catatonia in different psychiatric disorders and how a separate diagnostic criterion could help in early detection and management. We narrate three case reports of catatonic manifestations in two young adolescents and one young adult male, with no underlying medical condition. The first case report highlights intermittent brief periods of catatonic excitement beginning with acute anxiety and followed by fainting spells. The second case report narrates an acute onset manic episode which alternates with the catatonic episode. The third case report shows seasonal advents of catatonia. The pharmacological intervention itself was adequate enough to resolve the catatonic symptoms. The three cases give a purview of catatonic manifestations with differential phenomenology. The treatment of catatonia bears challenges owing to a lack of awareness and differential response to available pharmacotherapy.

Introduction: The substance use among the elderly is a growing enormity and an accurate understanding of the patterns of substances of the elderly is missing in the literature. Therefore, this study explored the sociodemographic and clinical profile of the elderly population-seeking treatment at a tertiary care center in North India. Methods: The present study reviewed the case notes of the elderly registered in the de-addiction center of North India. The cohort for this study consisted of all outpatients aged more than 60 years registered in the study setting from January 2017 to December 2021. The profile of the study subjects including sociodemographic and clinical data was reviewed based on the existing structured pro forma used in the department. Results: The data for a total of 508 treatment-seeking elderly aged more than 60 years were analyzed in which the mean age at the presentation was 65 ± 3.8 years. We identified that tobacco (57.5%), alcohol (52.6%), and opioids (36.2%) were the leading substances used in this setting. We noted a statistically significant association among the study subjects with alcohol, opioid, and tobacco dependence based on the presence or absence of a co-occurring medical illness. Conclusion: The present retrospective chart review identified that tobacco, alcohol, and opioids were the leading substances used among treatment-seeking elderly in this setting. Estimating the magnitude of substance use among the elderly is crucial to predict the imposed burden of the illness and ascertain the treatment and prevention strategies for controlling the magnitude of the problem.

Background: Comorbidity in obsessive–compulsive disorder (OCD) is known, especially alcohol use disorders (AUDs) in OCD. Data are lacking regarding the prevalence, the obsessions and compulsions in people with OCD with comorbid alcohol use. Aims and Objectives: The aim was to study the prevalence of AUDs in people with OCD. The primary objective was to study the prevalence of AUDs in 100 people with OCD. Secondary objective was to study the clinical characteristics, obsessions, and compulsions of people with OCD and comorbid alcohol use. Settings and Designs: The study design was a cross-sectional study. Materials and Methods: 100 patients of Asha Hospital diagnosed with OCD were screened and included in the study after a written informed consent. YBOCS checklist and scoring were done. People satisfying the criteria for AUD were further assessed with SADQ questionnaire. SPSS software was used for statistical analysis. Results and Conclusions: The lifetime prevalence of substance use disorders was found 18%. Point prevalence of any substance use was 13%, out of which 7% had AUDs. 2% had a dependence pattern and 5% had an abuse pattern. When comparing people with alcohol versus non-alcohol use, there was a significant difference in the proportion of males in the alcohol group (P = 0.0011). Nicotine was used in higher proportion in the alcohol group (P = 0.0001). Alcohol users were not regular with medications (P = 0.01). Miscellaneous obsessions are more common in them (P = 0.002). Alcohol users had a higher proportion of nil compulsions (P = 0.057) implying that obsessions were more prominent than compulsions in them. Mean scores of OCD in both groups were around moderate severity, with no significant difference between the two.

Background: Mindfulness-based interventions are increasing in clinical and nonclinical populations. It is important to have a culturally validated instrument to measure the construct. Aims: We intended to evaluate the Mindful Attention Awareness Scale (MAAS) in an Indian sample, for its reliability and dimensionality along with any differences among the sociodemographic strata. Settings and Design: The design of the study was an online-based survey. Materials and Methods: An anonymous survey was conducted involving adult participants with a convenience and snowball sampling method. Mindfulness based on MAAS responses and demographic details were collected. Statistical Analysis: Cronbach’s alpha, t-test, analysis of variance, Tukey’s honestly significant difference test, and factor analysis were used for analysis. Results: The average mindfulness score was 4.3 ± 0.78, and skewness was − 0.39. The score was normally distributed. The reliability for the MAAS (Cronbach’s α =0.830) was acceptable. The split-half reliability correlation was 0.66. The mean of item scores varied from 3.52 to 4.85, and the standard deviation varied from 1.2 to 1.6. The factor analysis explained 53% variance and identified four factors named as “inattention to the present,” “lost in thought,” “lack of circumstantial awareness,” and “late realization of feelings.” MAAS scores were significantly different across age, marital status, and occupation but did not differ by gender, education, or economic status. Conclusions: It appears that MAAS can be used in the Indian population; however, there is a need for further validation studies, in different specific populations.

Neurodevelopmental disabilities in children, affecting personal, social, academic, or occupational functioning, present a global challenge. Neurodevelopmental issues contribute significantly to learning disabilities, emphasizing the need for early intervention. The Rashtriya Bal Swasthya Karyakram (RBSK), a government program launched in 2013, is a multidisciplinary initiative addressing child health. This article compares three distinct approaches – multidisciplinary, interdisciplinary, and transdisciplinary – in the context of early intervention. Multidisciplinarity utilizes knowledge from various disciplines, while interdisciplinarity synthesizes links between disciplines, and transdisciplinarity integrates sciences beyond traditional boundaries. Challenges in early intervention, particularly with RBSK, include limited awareness and accessibility, necessitating ongoing efforts and innovations. This study concludes by emphasizing the transformative potential of embracing innovative solutions to create a more inclusive and equitable future for children with neurodevelopmental difficulties and their families.

Background: Opioid substitution therapy (OST) is one of the most effective treatment options for opioid dependence. However, there are not enough credible studies available on the health-care problems of clients undergoing OST. Materials and Methods: The study recruited 100 patients undergoing OST on an outpatient basis using a consecutive sampling technique. The mental and physical health problems were evaluated using the Patient Health Questionnaire-9, General Anxiety Disorder Scale 7, and a self-reported physical symptom checklist. Results: The estimates of depression and anxiety were 52% and 39%, respectively. The general physical ailments were more often reported by the subjects followed by musculoskeletal problems and neurological problems. A significant correlation was observed between physical health problems with anxiety (r = 0.40, P < 0.01) and depression (r = 0.37, P < 0.01). Conclusion: The clients undergoing OST have a high degree of self-reported health problems and psychological distress in this setting.

Introduction: Burnout is a concerning clinical syndrome comprising excessive stress, lack of satisfaction, and a feeling of being overworked. In India, postgraduate residents who shoulder the entire burden of patient care, are prone to suffer from burnout. Only a few Indian studies have been carried out to estimate the prevalence of burnout among postgraduate resident doctors. Our study, the first of its kind from eastern India, aims to address this lacuna. Materials and Methods: This was a single-institution cross-sectional observational study carried out using an online semi-structured form comprising demographic data and the Maslach Burnout Inventory. Appropriate statistical tests were carried out to analyze the data obtained. Results: The study received a response rate of 79.2%. Of the participants, 44.1% were females, 54.9% were males, and 1% identified as other gender. The mean age (standard deviation) of the participants was 28.02 (3.67) years. Overall, 75% of the participants experienced burnout. Younger participants, females, clinical residents, those in a relationship, and 2nd year of residency reported higher emotional exhaustion. Depersonalization was associated with lower age, being in a relationship, metropolitan upbringing, and 2nd year of residency. The lower personal accomplishment was seen in those coming from metropolitan and rural backgrounds. Conclusion: Burnout has serious implications on psychological and physical health of the residents. Interventions for effective management will greatly improve the overall mental health and work performance of the junior doctors.

Introduction: There are three independent variables used in clinical practice to evaluate patients suffering from alcohol use disorder (AUD); these are Alcohol Use Disorders Identification Test (AUDIT), liver function tests (LFTs), and imaging findings on ultrasound of the abdomen. There is limited literature about the association of imaging findings with LFT and AUDIT scores in cases of AUD. Objective: The study was conducted to determine the association of ultrasound abdomen findings with LFTs and AUDIT scores in patients with AUD. Methods: This study was conducted using data from 439 patients of AUD (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) treated in the psychiatry department of a tertiary care hospital. The data hence obtained were subjected to statistical analysis. The ordinal data sets were compared using the Chi-square test, and P < 0.05 was taken as statistically significant. Results: The ultrasonography (USG) findings of hepatic/portal system changes in patients of AUD show a significant association with the corresponding changes in AUDIT scores, serum bilirubin, and aspartate transaminase (AST) levels. The ultrasound findings were also significantly associated with total years of drinking and average drinking (in g) per day in the last 3 years. The USG findings did not show a significant statistical association between ALT (alanine transaminase) and serum gamma-glutamyl transferase levels. Conclusion: In patients with alcohol use disorder, USG abdomen findings correlate with the severity of dependence as indicated by years of drinking, average alcohol consumption per day for the last 3 years, AUDIT score (last 1 year), and markers of liver injury (serum bilirubin and AST). Combined use of clinical severity indicators (e.g., AUDIT), lab parameters, and USG abdomen can help in the early diagnosis of ALD.

Context: Both personality and gender influence academic performance, coping skills, and resilience. Studying these factors together could help identify methods to improve academic achievement, coping mechanisms, and ego resilience. Aim: The aim of the study was to analyze the correlation of personality factors and gender with academic achievement, coping mechanisms, and ego resilience. Materials and Methods: Online forms were filled out by 112 interns in a government medical college. Sociodemographic details and academic scores were asked. Appropriate questionnaires for personality factors, coping mechanisms, and ego resilience were used. Data were analyzed using descriptive and analytic statistics using the Statistical Package for the Social Sciences software version 26. Results: Emotional stability had a statistically significant negative correlation with female gender, academic achievement, emotion focused, and avoidant coping. Openness to experiences and emotional stability showed a positive correlation with ego resilience. Gender did not show significant correlations with academics, coping, or resilience, although men were statistically more emotionally stable than women. Conclusion: Emotional stability having majority of the significant correlations may emphasize the relative importance of particular personality dimensions at different times across the lifespan. Males being more emotionally stable may indicate how they are using healthier coping styles and are more resilient compared to their female counterparts.

Background: Alcohol use disorders (AUDs) are emerging as a substance use disorder having various psychological and physical ill effects leading to hampering of individual’s productivity and functioning. Aims: The aim of this study was to evaluate the efficacy of ketamine in enhancing confidence levels to abstain from alcohol. Methods: Eighteen patients were administered ketamine intravenously after detoxification; a total of three doses, with a 3-day gap between each. The Alcohol Abstinence Self-Efficacy Scale was used to measure their confidence in abstaining from alcohol. Results: The study revealed a significant increase in mean confidence scores after three ketamine sessions, with a final assessment showing a 51.98% increase in confidence from baseline. Conclusions: The study found that ketamine therapy significantly increased confidence levels in individuals with AUD to abstain from alcohol, with P = 0.05 threshold. However, the impact may wane over time, suggesting the need for additional support or maintenance treatments.

Background: School-going adolescents are found to be on the leading edge when it comes to social media usage. Aim and Objectives: The study was designed to see the behavioral issues related to excessive usage of social media among school-going adolescents from the Sonitpur district of Assam, India. Materials and Methods: Cross-sectional descriptive research design and simple random sampling were used to collect data. At the onset, 1045 respondents were recruited, but finally, n = 943 respondents were kept for the final study. Tools administered were sociodemographic data sheet, a semi-structured questionnaire, strength and difficulty questionnaire, and social media addiction scale. Statistical analysis was done using SPSS version 23.0. Results: The level of social media addiction was very high in 30.5% of the respondents. In Pearson’s coefficient correlation, social media addiction score was found to be significantly positively correlated with the emotional problem (r = 0.509, P = 0.01), conduct problem (r = 0.398, P = 0.01), hyperactivity problem (r = 0.489, P = 0.01), and peer problem (r = 0.359, P = 0.01). Conclusion: The present study highlighted the high prevalence of social media addiction among school-going adolescents. Hence, based on the findings, precautionary measures are the need of the hour. Intervention can be planned at the school level in collaboration with mental health-care personnel such as psychologists, school counselors, and social workers, etc.

Introduction: Alcohol dependence syndrome (ADS) is a significant health problem all over the world. Alcohol-dependent individuals have a high prevalence of psychiatric comorbidities and nonadaptive personality traits that may influence the pathogenesis, treatment outcome, clinical course, and relapse of ADS. Aim: The aim of this study was to assess the personality traits and psychiatric comorbidities of alcohol-dependent patients and to determine the association of personality traits with psychiatric comorbidities in ADS. Methodology: An observational study was conducted on 100 patients of ADS from Acharya Vinoba Bhave Rural Hospital, Sawangi Wardha, Maharashtra. They were assessed through semi-structured sociodemographic pro forma, Mini-International Neuropsychiatric Interview PLUS, and 16 Personality Factor Inventory. Results: Most of the patients scored high on personality traits such as dominance (67%), warmth (56%), sensitivity (70%), social boldness (56%), openness to change (65%), vigilance (77%), and perfectionism (52%) while they scored low on factors privateness (50%) and liveliness (35%). The prevalence of psychiatric comorbidity was found to be 49%, with mood disorders (21%) being the most common diagnosis. Personality factors dominance (0.0001) and social boldness (0.042) were significantly associated with psychiatric comorbidities with P < 0.05. Conclusion: The personality traits and psychiatric comorbidity need to be addressed at the time of management to improve outcome.

Background: Spirituality and religious resources support and enhance both overall and emotional well-being during adversity such as diagnosis of breast cancer. Breast cancer patients are at higher risk of developing severe anxiety, depression, and potential mood disorders. Aim: The aim is to assess, compare, and correlate spiritual well-being and religious coping in patients with breast cancer with and without psychiatric disorders (anxiety and depression). Materials and Methodology: Recently diagnosed 90 treatment-naïve breast cancer patients were selected in adherence to the inclusion and exclusion criteria. Hospital Anxiety and Depression Scale (HADS), Spiritual Assessment Scale, and Brief Religious Coping Scale were applied to the sample population. The study population was divided into two groups depending on scores of HADS, those having psychiatric disorders, and those who did not have. The data were analyzed using Mann‒Whitney test and Pearson’s correlation coefficient in the SPSS version 21. Results: More than half (61.1%) of the females suffered from psychiatric disorders after diagnosis of breast cancer. About 50% and 38.9% of the study population developed significant emotional distress, leading to the diagnosis of cases of anxiety and depression, respectively. Females suffering from psychiatric disorders have significantly lower spirituality, positive religious coping, and significantly higher negative religious coping than females without any psychiatric disorder. Total spirituality score (P = 0.034) is making a significant contribution toward predicting depression. Negative religious coping is making a significant contribution toward predicting both anxiety (P = 0.008) and depression (P = 0.045). Conclusion: The study suggests that spirituality and religion-based coping facilitates adaptive psychological adjustment to cancer and decreases the prevalence of anxiety and depression.

Background: There is a high community prevalence of mental health problems in India. Psychiatric patients often consult nonspecialist or unqualified health providers which results in significant treatment delays and poor mental health outcomes. Knowledge of existing treatment-seeking practices may be useful to design specific and effective awareness programs. Objectives: The objectives were to study the types of health-care providers contacted by patients suffering from different mental illnesses as well as assess the treatment delays and associated factors. Methodology: A cross-sectional observational descriptive study was done in a psychiatry clinic of a tertiary health care center and teaching hospital in Central India. The information was collected from consecutive newly visiting patients on two predefined weekdays through face-to-face interviews. A predesigned sociodemographic format and World Health Organization pathways interview schedule were used to assess pathways of care. Results: Data were collected from 157 participants. Majority of participants were males (58%). Mood disorders were the most common diagnostic category (28%), followed by substance-related disorders (23%) and anxiety disorders (21%). Eighty (51%) among the total participants consulted psychiatrist in the first visit. Allopathic practitioners were the second commonly consulted health provider category. The median delay in treatment was maximum in substance-related disorders (7 years). Conclusion: Significant delay in treatment was observed across all diagnostic categories. Training general practitioners in the diagnosis and treatment of mental illnesses and a structured health-care referral system to enhance appropriate psychiatry consultations may be desirable to improve mental health outcomes in India.