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Media portrayal of mental disorders has a significant impact on awareness and stigma. Given the high prevalence of depression and anxiety as mental disorders, it is crucial to understand how they are represented. This scoping review aimed to map the existing literature on the portrayal of depression and anxiety in mainstream and social media. A comprehensive search was conducted in PubMed and PsychInfo, resulting in the inclusion of 20 records that predominantly examined social media and newspapers. Findings indicate that social media discussions on depression were mostly supportive and non‐stigmatising. Public figures and role models played a significant role in encouraging open communication. Research on newspapers and other media forms yielded mixed results yet leaning towards positive portrayals. Limited studies explored anxiety portrayal. While acknowledging potential limitations in generalisability, this review emphasises the importance of accurately depicting mental health in media, particularly on social media platforms, while highlighting the need for broader investigations into anxiety representation. [ABSTRACT FROM AUTHOR]

Transgender and gender-diverse (TGD) menstruators are individuals assigned female at birth (AFAB)*, who retain the capacity to menstruate and have a gender identity that differs from their natal sex. Reports indicate up to 1.6 million individuals in the US identify as TGD. Until recently, the mainstream menstrual discourse has failed to capture the experience of transmenstruators. However, a better understanding of the menstrual experiences of TGD-AFAB will allow for more individualized patient-centered care. In this review, we provide the relevant data necessary to inform the psychiatric management of menstruation in TGD-AFAB individuals, including experiences of menstruation, preferences for menstrual management, and the impact on mental health. Our review indicates that menstrual care in TGD patients must be tailored to the individual; clinicians should remain open-minded to the unique experience of transmenstruators; gender-affirming menstrual care is necessary to reduce psychological burden. It should not be assumed that TGD-AFAB menstruators are utilizing appropriate contraceptive methods and should receive contraceptive and fertility preservation counseling. We highlight the importance of having these conversations early in the reproductive arch, even before puberty onset. Keeping in mind the gender minority stress model, in the upcoming sections, we discuss the limited body of literature on mood disorders in TGD-AFAB individuals who menstruate, undergo menstrual suppression, or continue to ovulate. The psychological impact of hormonal therapies is also reviewed. [ABSTRACT FROM AUTHOR]

Mood disorders, including major depressive disorder and bipolar disorder, have a profound impact on more than 300 million people worldwide. It has been demonstrated mood disorders were closely associated with deviations in biogenic amine metabolites, which are involved in numerous critical physiological processes. The peripheral and central alteration of biogenic amine metabolites in patients may be one of the potential pathogeneses of mood disorders. This review provides a concise overview of the latest research on biogenic amine metabolites in mood disorders, such as histamine, kynurenine, and creatine. Further studies need larger sample sizes and multi-center collaboration. Investigating the changes of biogenic amine metabolites in mood disorders can provide biological foundation for diagnosis, offer guidance for more potent treatments, and aid in elucidating the biological mechanisms underlying mood disorders. [ABSTRACT FROM AUTHOR]

Introduction: Global mental health issues, particularly anxiety and depression, significantly impact people's everyday activities. While psychotherapies are commonly used, there is a growing interest in problem-solving approaches within mental health. These approaches focus on enabling individuals to develop personalized strategies to address emotional and psychological challenges and enhance their engagement in meaningful activities, known as occupational performance. This paper examines the feasibility of the Cognitive Orientation to daily Occupational Performance (CO-OP) in assisting adults with mood, anxiety, or adjustment disorders. Method: The study employed a mixed methods single-subject design with replication, using an inductive/deductive approach for qualitative analysis. Ethical approval was obtained, and participants were recruited from a Singaporean hospital's occupational therapy service. CO-OP sessions were conducted either in-person or via telehealth. The intervention involved setting goals collaboratively, followed by weekly sessions over 10 weeks. Various data sources, including demographics, field notes, recordings of sessions, assessments and interviews were collected. Data analysis involved comparing pre- and post-intervention scores, thematic analysis of interviews, and triangulation of quantitative and qualitative data for validity. The study results are organized according to five feasibility domains: acceptability, demand, implementation, practicality, and limited efficacy. Results: A total of 10 participants, mostly female, were recruited, with two dropping out during the baseline phase. All remaining participants completed the intervention and 1 month follow-up data collection. CO-OP was perceived as acceptable and beneficial in enhancing occupational performance, satisfaction and managing mood and anxiety symptoms. Participants expressed increased confidence and self-efficacy but desired continued therapist support for strategy application and reinforcement. Discussion: Participants generally embraced CO-OP, favoring its personalized nature over therapist-directed approaches, with high retention rates observed. Building a strong therapeutic relationship was essential. Also using complementary approaches like supportive counseling proved beneficial. CO-OP emerges as a viable intervention alongside existing therapy approaches, offering a promising avenue for addressing the complex needs of individuals with mental health conditions. [ABSTRACT FROM AUTHOR]

Introduction: Bipolar II disorder experiences more frequent episodes of depression and is sometimes comorbid with posttraumatic stress disorder (PTSD). However, there is no clear method to distinguish between depression induced by bipolar disorder and PTSD. Through this case, we aim to examine the features of the patient’s bipolar disorder and PTSD from the depressive episodes. Case: A 23-year-old Indonesian woman came with the chief complaint of unexplainable discomfort that had been experienced almost daily for the past two weeks. The patient also complained that she was often lonely. Patients did not get adequate parenting from her parents, so patients have unfavorable relationships with her family. In addition, patients previously experienced sexual harassment that caused severe trauma. She was diagnosed with a current severe depressive episode in bipolar II disorder with anxious distress and PTSD. Discussion: Bipolar disorder is frequently comorbid with PTSD. She was given Sertraline 25 mg once daily, Aripiprazole 5 mg twice a day, Clobazam 5 mg once a day at night, Folic acid 400 mcg once a day, and psychotherapy. After four weeks of treatment, there was an improvement in symptoms by a decrease in the HDRS and the HARS scores. Conclusion: In the case presented, bipolar patients have major complaints related to somatic symptoms accompanied by a history of experiencing severe traumatic events. Thus, bipolar patients do not always come with the chief complaint of mood swings. Furthermore, these complaints improved with the combination of anti-psychotic, anti-depressant, anti-anxiety, and psychotherapy. [ABSTRACT FROM AUTHOR]

Depression is a heterogenous diagnostic construct; however, dynamic interactions between specific depressive symptoms across their qualitatively different profiles remain largely unknown. The study aimed to recognize the most prevalent profiles of depressive symptoms and assess their dynamics in young adults without a history of psychiatric treatment. Depressive symptoms were recorded using the Patient Health Questionnaire-9 (PHQ-9). The data were assessed for all theoretical and empirical combinations of depressive symptoms in participants with a positive screening for depression. The profiles identified in the majority of participants were analyzed using partial correlation and Bayesian networks. Data from 3583 individuals with a positive screening for depression were analyzed. Out of 382 theoretical profiles, 150 profiles (39.3%) were present in this dataset. The majority of participants (56.8%) showed 4 profiles of depressive symptoms including the profile with all depressive symptoms present, the profile without suicidal ideation, the profile without psychomotor impairment, and the profile without both psychomotor impairment and suicidal ideation. The profiles differed largely in terms of their dynamics and symptoms that are necessary to activate the whole network. The network characteristics within specific profiles did not differ significantly across the level of difficulties attributable to depressive symptoms. Our findings indicate that depression emerging in young adults shows a limited number of symptom profiles. However, dynamics of depressive symptoms differs largely between specific profiles regardless of functional impairment indicating the need to personalize therapeutic approaches. Future studies should further disentangle the heterogeneity of depressive symptoms, e.g., by dissecting the symptoms that are combined together by single PHQ-9 items (i.e., hypersomnia and insomnia; psychomotor agitation and retardation). [ABSTRACT FROM AUTHOR]

Background: Childhood emotional maltreatment, non-suicidal self-injury and depression are prevalent among adolescents with mood disorders. While existing model indicated that childhood emotional maltreatment, functions of non-suicidal self-injury and depression are interrelated, not much is understood about the interplay of functions of non-suicidal self-injury in the relationship between childhood emotional maltreatment and depression. Thus, the goal of this research was to ascertain how functions of non-suicidal self-injury relate to childhood emotional maltreatment and depression. Methods: The participants were adolescents with mood disorders from three hospitals in Sichuan Province, data was collected using self-administered questionnaires, including the Childhood Trauma Questionnaire, Ottawa Self-injury Inventory-Functions, and Childhood Depression Inventory. SPSS26.0 software and PROCESS v3.3 model 4 were used for analysis. Results: In all, 235 adolescents (Mage=14.8, SD = 1.62) participated in the research. The functions of non-suicidal self-injury (r = 0.289, P < 0.01) and depression (r = 0.475, P < 0.01) were considerably positively connected with childhood emotional maltreatment, and the functions of non-suicidal self-injury were strongly positively correlated with depression (r = 0.364, P < 0.01). The direct impact of childhood emotional maltreatment on depression in adolescents was found to be significant (95% CI 0.434, 0.828) in the mediated effects model. Additionally, the indirect effect of childhood emotional maltreatment on depression through functions of non-suicidal self-injury was found to be significant (95% CI 0.055, 0.236), with a mediating effect value of 17.58%. Conclusion: Childhood emotional maltreatment has a direct impact on depression, but it also has an indirect influence through mediation roles of functions of non-suicidal self-injury. Medical staff should take care of the mental health of adolescents hospitalized for mood disorders so that they can clarify the role of functions of NSSI in lowering depressive symptoms and improving quality of life and create more targeted and effective intervention plans. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Symptoms related to mood and anxiety disorders (emotional disorders) often present in childhood and adolescence. Some of the genetic liability for mental disorders, and emotional and behavioral difficulties seems to be shared. Yet, it is unclear how genetic liability for emotional disorders and related traits influence trajectories of childhood behavioral and emotional difficulties, and if specific developmental patterns are associated with higher genetic liability for these disorders.This study uses data from a genotyped sample of children (n = 54,839) from the Norwegian Mother, Father, and Child Cohort Study (MoBa). We use latent growth models (1.5–5 years) and latent profile analyses (1.5–8 years) to quantify childhood trajectories and profiles of emotional and behavioral difficulties and diagnoses. We examine associations between these trajectories and profiles with polygenic scores for bipolar disorder (PGSBD), anxiety (PGSANX), depression (PGSDEP), and neuroticism (PGSNEUR).Associations between PGSDEP, PGSANX, and PGSNEUR, and emotional and behavioral difficulties in childhood were more persistent than age‐specific across early childhood (1.5–5 years). Higher PGSANX and PGSDEP were associated with steeper increases in behavioral difficulties across early childhood. Latent profile analyses identified five profiles with different associations with emotional disorder diagnosis. All PGS were associated with the probability of classification into profiles characterized by some form of difficulties (vs. a normative reference profile), but only PGSBD was uniquely associated with a single developmental profile.Genetic risk for mood disorders and related traits contribute to both a higher baseline level of, and a more rapid increase in, emotional and behavioral difficulties across early and middle childhood, with some indications for disorder‐specific profiles. Our findings may inform research on developmental pathways to emotional disorders and the improvement of initiatives for early identification and targeted intervention. [ABSTRACT FROM AUTHOR]

Mood disorders, including major depressive disorder and bipolar disorder, have a profound impact on more than 300 million people worldwide. It has been demonstrated mood disorders were closely associated with deviations in biogenic amine metabolites, which are involved in numerous critical physiological processes. The peripheral and central alteration of biogenic amine metabolites in patients may be one of the potential pathogeneses of mood disorders. This review provides a concise overview of the latest research on biogenic amine metabolites in mood disorders, such as histamine, kynurenine, and creatine. Further studies need larger sample sizes and multicenter collaboration. Investigating the changes of biogenic amine metabolites in mood disorders can provide biological foundation for diagnosis, offer guidance for more potent treatments, and aid in elucidating the biological mechanisms underlying mood disorders. [ABSTRACT FROM AUTHOR]

Introduction: Global mental health issues, particularly anxiety and depression, significantly impact people's everyday activities. While psychotherapies are commonly used, there is a growing interest in problem-solving approaches within mental health. These approaches focus on enabling individuals to develop personalized strategies to address emotional and psychological challenges and enhance their engagement in meaningful activities, known as occupational performance. This paper examines the feasibility of the Cognitive Orientation to daily Occupational Performance (CO-OP) in assisting adults with mood, anxiety, or adjustment disorders. Method: The study employed a mixed methods single-subject design with replication, using an inductive/deductive approach for qualitative analysis. Ethical approval was obtained, and participants were recruited from a Singaporean hospital's occupational therapy service. CO-OP sessions were conducted either in-person or via telehealth. The intervention involved setting goals collaboratively, followed by weekly sessions over 10 weeks. Various data sources, including demographics, field notes, recordings of sessions, assessments and interviews were collected. Data analysis involved comparing pre- and post-intervention scores, thematic analysis of interviews, and triangulation of quantitative and qualitative data for validity. The study results are organized according to five feasibility domains: acceptability, demand, implementation, practicality, and limited efficacy. Results: A total of 10 participants, mostly female, were recruited, with two dropping out during the baseline phase. All remaining participants completed the intervention and 1 month follow-up data collection. CO-OP was perceived as acceptable and beneficial in enhancing occupational performance, satisfaction and managing mood and anxiety symptoms. Participants expressed increased confidence and self-efficacy but desired continued therapist support for strategy application and reinforcement. Discussion: Participants generally embraced CO-OP, favoring its personalized nature over therapist-directed approaches, with high retention rates observed. Building a strong therapeutic relationship was essential. Also using complementary approaches like supportive counseling proved beneficial. COOP emerges as a viable intervention alongside existing therapy approaches, offering a promising avenue for addressing the complex needs of individuals with mental health conditions. [ABSTRACT FROM AUTHOR]

Objective: Knowing the prevalence of mental health difficulties in young children is critical for early identification and intervention. In the current study, we examine the agreement among three different data sources estimating the prevalence of diagnoses for attention deficit hyperactivity disorder (ADHD) and emotional disorders (i.e., anxiety or mood disorder) for children between birth and 9 years of age. Methods: Data from a prospective pregnancy cohort was linked with provincial administrative health data for children in Alberta, Canada. We report the positive agreement, negative agreement, and Cohen's Kappa of parent-reported child diagnoses provided by a health professional ("parent report"), exceeding a clinical cut-off on a standardized questionnaire completed by parents (the Behavior Assessment System for Children, 3rd edition ["BASC-3"]), and cumulative inpatient, outpatient, or physician claims diagnoses ("administrative data"). Results: Positive and negative agreement for administrative data and parent-reported ADHD diagnoses were 70.8% and 95.6%, respectively, and 30.5% and 94.9% for administrative data and the BASC-3, respectively. For emotional disorders, administrative data and parent-reported diagnoses had a positive agreement of 35.7% and negative agreement of 96.30%. Positive and negative agreement for emotional disorders using administrative data and the BASC-3 were 20.0% and 87.4%, respectively. Kappa coefficients were generally low, indicating poor chance-corrected agreement between these data sources. Conclusions: The data sources highlighted in this study provide disparate agreement for the prevalence of ADHD and emotional disorder diagnoses in young children. Low Kappa coefficients suggest that parent-reported diagnoses, clinically elevated symptoms using a standardized questionnaire, and diagnoses from administrative data serve different purposes and provide discrete estimates of mental health difficulties in early childhood. Plain Language Title: Prevalence of child mental health disorders according to different data sources in Canada Plain Language Summary: Knowing the prevalence of mental health difficulties in young children is critical for informing mental health policy and decision-making. Yet, different sources yield different estimates and we do not know how these estimates compare. In the current study, we examine the agreement among three different information sources estimating the prevalence of diagnoses for attention deficit hyperactivity disorder (ADHD) and emotional disorders (i.e., anxiety or mood disorder) for children between birth and 9 years of age. To estimate the prevalence of mental disorders, we asked parents if their child had ever been diagnosed, we asked parents to complete a questionnaire using clinical symptom cut-offs for diagnosis, and we looked at data collected in the health care system to see if a child was ever diagnosed by a healthcare provider. We found that for ADHD, parent report that their child had received a diagnosis and their child having received a diagnosis in the healthcare system were similar. There were larger differences between a parent report of elevated symptoms on a questionnaire and whether they had been diagnosed by a healthcare provider. For emotion disorders, there were larger differences between parent report that their child had received a diagnosis and whether one was documented in the health record. Overall, there was somewhat low agreement between these three sources of data. We conclude that the different sources of data used in this study provide different estimates of ADHD and emotional disorder diagnoses in children. Therefore, when trying to understand the burden of child mental health disorders in young children, it is important to consider multiple sources to obtain a comprehensive picture of the issue. [ABSTRACT FROM AUTHOR]

Reward processing impairments are a key factor associated with negative symptoms in those with severe mental illnesses. However, past findings are inconsistent regarding which reward processing components are impaired and most strongly linked to negative symptoms. The current study examined the hypothesis that these mixed findings may be the result of multiple reward processing pathways (i.e., equifinality) to negative symptoms that cut across diagnostic boundaries and phases of illness. Participants included healthy controls (n = 100) who served as a reference sample and a severe mental illness-spectrum sample (n = 92) that included psychotic-like experiences, clinical high-risk for psychosis, bipolar disorder, and schizophrenia participants. All participants completed tasks measuring four RDoC Positive Valence System constructs: value representation, reinforcement learning, effort–cost computation, and hedonic reactivity. A k-means cluster analysis of the severe mental illness-spectrum samples identified three clusters with differential reward processing profiles that were characterized by: (1) global reward processing deficits (22.8%), (2) selective impairments in hedonic reactivity alone (40.2%), and (3) preserved reward processing (37%). Elevated negative symptoms were only observed in the global reward processing cluster. All clusters contained participants from each clinical group, and the distribution of these groups did not significantly differ among the clusters. Findings identified one pathway contributing to negative symptoms that was transdiagnostic and transphasic. Future work further characterizing divergent pathways to negative symptoms may help to improve symptom trajectories and personalized treatments. [ABSTRACT FROM AUTHOR]

To study the prevalence of fatigue and factors associated with fatigue in patients with major depressive disorder (MDD) or bipolar disorder (BD). Two hundred fifty-three outpatients with MDD or BD at the initial assessment were used to study the prevalence of fatigue and relationship between fatigue and other clinical correlates. The severity of fatigue was measured with Iowa Fatigue Scale (IFS), and depression and anxiety symptom-severity were measured with the QIDS-16-SR (the 16-item Quick Inventory of Depressive Symptomatology – Self-Report) and Zung-SAS (Zung Self-Rating Anxiety Scale). Correlation between IFS and QIDS-16-SR total scores, QIDS-16-SR item scores or Zung-SAS total scores, and independent factors associated with fatigue was assessed with simple or multiple linear regression analysis. Overall, 28.4 % of MDD and 29.8 % of BD patients did not have fatigue, but 41.2 % of MDD and 45.0 % of BD patients had fatigue, and 30.4 % of MDD and 25.2 % of BD patients had severe fatigue. Depression/anxiety severity was significantly correlated with fatigue. However, after controlling current psychiatric comorbidities, demographics, some social factors, and psychotropic use, only QIDS-16-SR scores were still significantly and positively correlated with IFS scores in both MDD and BD. Differential correlations between IFS scores and item scores of QIDS-16-SR in MDD and BD were observed. Cross-sectional. In this outpatient sample, fatigue was highly prevalent in patients with MDD or BD. The independent association of depressive severity with the severity of fatigue highlights the importance of complete resolution of depressive symptoms in treating MDD and BD. • Fatigue is highly prevalent in patients with major depressive disorder (MDD) or bipolar disorder (BD); • Complete resolution of depressive symptoms may be a key factor to decrease the severity of fatigue in patients with MDD or BD; • Independent factors associated with the severity of fatigue in MDD and BD might be different. • Depression symptom domains associated with the severity of fatigue in MDD and BD suggest that different measures of fatigue may be necessary to study fatigue in MDD and BD. [ABSTRACT FROM AUTHOR]

Background and aim: The COVID-19 pandemic has led to a significant adverse effect on the mental health of healthcare professionals. This study aims to assess the effects of the prolonged pandemic on burnout and mood disorders and to evaluate the influence of positive vaccination beliefs on these factors at a medical center during the extended COVID-19 pandemic. Methods: This retrospective study analyzed the results of an online questionnaire survey including burnout status and mood disorders from 2020 to 2022. The factors related to mood moderate/severe disorders and the impact of the positive vaccine belief were also explored. Results: The initial analysis revealed that healthcare professionals continued to experience significant levels of personal and work-related burnout, along with mood disorders. However, the scores and the percentage of moderate to severe burnout gradually decreased. Notably, the percentage of individuals with moderate to severe mood disorders also gradually declined (2020: 13.4%, 2021: 12.3%, 2022: 11.1%). The number of participants who need professional interventions decreased from 56.2% in 2020 to 45.9% in 2021, and 46% in 2022. Multivariate analysis revealed a positive vaccine belief was associated with a lower risk of moderate/severe mood disorders, with odd ratios (OR) and 95% confidence intervals (95% CI) of 0.38 (0.28 -- 0.52) and 0.41 (0.30 -- 0.52) in the 2021 and 2022 cohorts, respectively. Further investigation revealed that age over 50 was linked to a positive vaccine belief in 2021 and 2022. Within the 2022 cohort, working as nurses was identified as the independent factor associated with a less positive belief, with the OR and 95% CI of 0.49 (0.27 -- 0.90). Conclusion: The findings of the present study suggest burnout and mood disorders are still significant during the pandemic. A positive vaccine belief may mitigate pandemic-related mental distress. Further interventions to enhance the belief combined with other supporting measures are important in a long fight against the pandemic. [ABSTRACT FROM AUTHOR]

Abstract Background Childhood emotional maltreatment, non-suicidal self-injury and depression are prevalent among adolescents with mood disorders. While existing model indicated that childhood emotional maltreatment, functions of non-suicidal self-injury and depression are interrelated, not much is understood about the interplay of functions of non-suicidal self-injury in the relationship between childhood emotional maltreatment and depression. Thus, the goal of this research was to ascertain how functions of non-suicidal self-injury relate to childhood emotional maltreatment and depression. Methods The participants were adolescents with mood disorders from three hospitals in Sichuan Province, data was collected using self-administered questionnaires, including the Childhood Trauma Questionnaire, Ottawa Self-injury Inventory-Functions, and Childhood Depression Inventory. SPSS26.0 software and PROCESS v3.3 model 4 were used for analysis. Results In all, 235 adolescents (M age=14.8, SD = 1.62) participated in the research. The functions of non-suicidal self-injury (r = 0.289, P

Background: Suicide is a primary health concern worldwide, and has a negative impact on the individual, family, and society. The literature suggests that females are more prone to attempt suicide and have more suicidal inclinations; however, males are more serious suicide attempters compared to females. Objective: The objective of this study was to assess the sociodemographic and clinical profile of patients admitted to acute care with the current suicide attempt. Materials and Methods: One hundred consecutive patients, aged between 18 and 60 years, who were medically stable and presented to the emergency or medical wards at the hospital with suicidal attempt, were included in this study. Beck’s Suicide Intent Scale (SIS), Beck Scale for Suicidal Ideation, Beck Hopelessness Scale, and Beck Depression Inventory–II were administered to assess the current suicidal intent and ideation, depression, and hopelessness. Results: The diagnostic breakup was – 69% mood (affective) disorders, 21% adjustment disorders, 4% schizophrenia, and 6% other disorders. Most suicide attempters were female (66% vs. 34%) and belonged to a younger age group (28.30 ± 10.08 years vs. 34.73 ± 13.97 years) compared to males (P < 0.05). Although both genders displayed high suicide intent, a significant difference in the SIS score was noted between females and males (36.53 ± 7.68 vs. 41.47 ± 8.82; P < 0.05). Conclusion: There is a difference in the clinical and demographic profile among male and female suicide attempters. Hence, appropriate interventions can be devised to prevent the future suicide attempts as per the demographic and clinical characteristics specific to the study population.

The discovery of intrinsically photosensitive retinal ganglion cells (ipRGCs) has opened up a new field of research: the non-image forming visual (NIFV) of light. Light in the environment can have extensive effects on specific brain functions. As an important physical modality treatment method, light therapy is a novel intervention that has several strengths: non-invasive, safe, effective, low-cost, few adverse effects, and high compliance. It has clear advantages in terms of tolerance and safety. Light therapy has significant clinical values in the rehabilitation field of brain function modulation. This study systematically reviews the application of light therapy in the rehabilitation of mood disorders, cognitive dysfunction, sleep disorders, and pain. The results support that light therapy exerts a positive regulatory effect on various diseases related to brain function. However, the application of light therapy in brain function modulation is still in its early stage and there are several limitations. For example, the specific mechanisms of light therapy need to be further clarified, there is a lack of research on the combined use of light therapy with other treatments, and the long-term clinical effects remain to be observed. Future research should focus on analyzing the neural mechanisms of light therapy, establishing new intervention paradigms that target specific neural circuits and efficiently modulate brain function, and exploring whether light therapy can produce additional rehabilitative outcomes when combined with traditional treatments. Additionally, long-term follow-up studies are needed to observe the lasting effects of light therapy and to provide valuable insights for its application in brain function modulation.

Abstract Objectives Electroconvulsive therapy (ECT) is one of the most effective treatments in mood disorders, mainly in major depressive episode (MDE) in the context of either unipolar (MDD) or bipolar disorder (BD). However, ECT remains a neglected and underused treatment. Older people are at high risk patients for the development of adverse drug reactions. In this context, we sought to determine the duration of MDEs and the number of lines of treatment before the initiation of ECT in patients aged 65 years or over according to the presence or absence of first-line indications for using ECT from international guidelines. Methods In this multicenter, retrospective study including patients aged 65 years or over with MDEs in MDD or BD who have been treated with ECT for MDEs, data on the duration of MDEs and the number of lines of treatment received before ECT were collected. The reasons for using ECT, specifically first-line indications (suicidality, urgency, presence of catatonic and psychotic features, previous ECT response, patient preference) were recorded. Statistical comparisons between groups used standard statistical tests. Results We identified 335 patients. The mean duration of MDEs before ECT was about 9 months. It was significantly shorter in BD than in MDD- about 7 and 10 months, respectively. The co-occurrence of chronic medical disease increased the duration before ECT in the MDD group. The presence of first-line indications for using ECT from guidelines did not reduce the duration of MDEs before ECT, except where there was a previous response to ECT. The first-line indications reduced the number of lines of treatment before starting ECT. Conclusion Even if ECT seems to be a key treatment in the elderly population due to its efficacity and safety for MDEs, the delay before this treatment is still too long.

Aims Methods Results Conclusion Lithium is Food and Drug Administration‐approved for bipolar disorder (BD) and is also used in depressive disorders but is underutilized due to concerns about chronic kidney disease (CKD). We explored clinical and demographic profiles of patients on long‐term lithium therapy (LTLT) and assessed kidney function. Our aims were to identify the predictors for CKD stage ≥3 and the impact of lithium discontinuation post‐CKD diagnosis.We conducted a population‐based historical cohort study of adult patients with mood disorders on LTLT at the Marshfield Clinical Health System from 1990 to 2019. Data on lithium therapy and kidney‐related information (estimated glomerular filtration rate and CKD) were extracted from electronic medical records.Among 1603 patients with mood disorders (mean age 42.1 years, 60% females), 15.3% (n = 246) developed CKD stage ≥3. Patients without CKD were on lithium for 4.5 years, compared to 6.6 years for those with CKD. Hypertension, age, and BD were significant CKD risk factors. Kidney function declined linearly with lithium duration, returning to pre‐treatment trajectory in patients without CKD but showed no improvement in those with CKD after lithium discontinuation.The findings suggest that CKD occurs in 15% of patients with mood disorder receiving LTLT, with its progression potentially influenced by existing comorbidities rather than lithium alone. These results underscore the importance of monitoring kidney function in patients on LTLT and considering individual risk factors for CKD development. In patients who developed CKD, Li discontinuation did not impact change in kidney function. [ABSTRACT FROM AUTHOR]

Bipolar disorder (BD) has a high disease burden and the highest mortality risk in BD comes from suicide. Bipolar disorder type II (BD-II) has been described as a milder form of bipolar disorder; however, extant literature is inconsistent with this description and instead describe illness burden and notably suicidality comparable to persons with bipolar I disorder (BD-I). Towards quantifying the hazard of BD-II, herein we aim via systematic review and meta-analysis to evaluate the rates of completed suicide in BD-I and BD-II. We conducted a literature search on PubMed, OVID (Embase, Medline) and PsychINFO databases from inception to June 30th, 2023, according to PRISMA guidelines. Articles were selected based on the predetermined eligibility criteria. A meta-analysis was performed, comparing the risk of completed suicide between individuals diagnosed with BD-I to BD-II. Four out of eight studies reported higher suicide completion rates in persons living with BD-II when compared to persons living with BD-I; however, two of the studies reported non-significance. Two studies reported significantly higher suicide completion rates for BD-I than BD-II. The pooled odds ratio of BD-II suicide rates to BD-I was 1.00 [95 % CI = 0.75, 1.34]. The overarching limitation is the small number of studies and heterogeneity of studies that report on suicide completion in BD-I and BD-II. Our study underscores the severity of BD-II, with a risk for suicide not dissimilar from BD-I. The greater propensity to depression, comorbidity and rapid-cycling course reported in BD-II are contributing factors to the significant mortality hazard in BD-II. • Data on risk for completed suicide in bipolar disorders type I and-II are limited. • Therefore, we conducted a systematic review and meta-analysis on the topic. • We found similar risk of completed suicide in bipolar disorder type I and -II. • Bipolar disorder type II should be considered as severe as bipolar disorder type I. • Large high-quality studies on suicide risk in bipolar disorder types are warranted. [ABSTRACT FROM AUTHOR]

Childhood maltreatment (CM) is prevalent among patients with mood disorders and considered an important risk factor for suicide in the general population. Despite mood disorders being implicated in up to 60 % of completed suicides, the predictive role of CM on suicide attempt (SA) among early mood disorder patients remains poorly understood. We enrolled 480 participants diagnosed with early-onset major depressive disorder (MDD), bipolar I disorder (BD I), and bipolar II disorder (BD II). Over an average of 60 weeks, participants underwent follow-up assessments at 12-week intervals. Using multivariate logistic regression, we examined the association between CM and SA history at baseline. Further, the Cox proportional hazard model assessed the predictive role of childhood maltreatment in SA during follow-up. At baseline, 38 % of the total participants reported SA history, with a follow-up prevalence of 10 %. Childhood maltreatment was significantly associated with past SAs and was a robust predictor of future SA, adjusting for relevant clinical risk factors. Emotional abuse and sexual abuse related to SA history, and physical abuse increased future SA risk. Potential biases in reporting SA and childhood maltreatment, along with unexplored factors such as additional environmental and familial risks, may affect the study's findings. Childhood maltreatment emerged as a robust predictor of SA among early-onset mood disorder patients. Systematic evaluation of CM early in the clinical process may be crucial for effective risk management. Additionally, our findings highlight the importance of implementing proactive interventions for CM to prevent the onset of adverse psychological trajectories. • Childhood maltreatment is a key predictor of suicide attempts over 60 weeks of follow-up in early-onset mood disorders. • Childhood maltreatment remains a significant risk factor for suicide, even when accounting for relevant clinical risk factors. • Findings highlight the need for early detection and interventions to mitigate childhood maltreatment's impact on mood disorders. [ABSTRACT FROM AUTHOR]

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

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

Introduction Sleep-related disorders are associated with pain, fatigue, and deficits in cognitive performance, which may interfere with successful rehabilitation. The study objectives were to (1) quantify outpatient prescriptions for insomnia medications during the first year following combat-related amputations, (2) examine longitudinal changes in prescriptions for insomnia medications, and (3) analyze patient characteristics associated with prescriptions for insomnia medications. Material and Methods This was a retrospective study of DoD casualty records from the Expeditionary Medical Encounter Dataset and prescriptions for outpatient medications from the Pharmacy Data Transaction Service. Patients were a total of 1,651 U.S. service members who sustained major limb amputations in Operations Iraqi and Enduring Freedom from 2001 through 2017 and had outpatient prescriptions for any medication during the first year postinjury. Prescriptions for medications recommended for insomnia were low-dose antidepressants, anxiolytic sedatives, benzodiazepines, melatonin receptor agonist, and low-dose quetiapine. These prescription medications were analyzed by medication type, postinjury time, and patient characteristics during the first year postinjury. Results During the first year postinjury, 78% of patients (1,291 of 1,651) had outpatient prescriptions for insomnia medications, primarily anxiolytic sedative drugs (e.g. zolpidem), averaging a total of 86 prescription days (median = 66). The prevalence of these prescriptions declined substantially during the first year, from 57% of patients during the first quarter to 28% during the fourth quarter postinjury. In univariate analyses, multiple patient characteristics, including high Injury Severity Score, continued opioid and non-opioid analgesic prescriptions, and diagnoses of chronic pain, mood disorder, and posttraumatic stress disorder, were significantly associated with higher prevalence and duration of outpatient prescriptions for insomnia medications. Conclusions The present results indicate a high prevalence of outpatient prescriptions for insomnia medications following combat-related amputations, a prevalence that is substantially higher than previously reported among active duty personnel. These findings can inform DVA/DoD guidelines for amputation care and insomnia among military subpopulations. The results highlight the need for more research on the treatment of insomnia during early postinjury rehabilitation among patients who sustained serious combat injuries. [ABSTRACT FROM AUTHOR]

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

This study aimed to compare the effects of High-Intensity Interval Training (HIIT) performed in a single session(1xHIIT) versus three daily sessions (3xHIIT) on fitness level and behavior of aged rats. Eighteen-month-old Wistar rats were assigned to Untrained (UN), 1xHIIT, or 3xHIIT (n = 12/group). Both groups, 1xHIIT and 3xHIIT, performed 15 min of a treadmill running HIIT protocol during 8 weeks. 1xHIIT protocol consisted of a single daily session of 15 min, while the 3xHIIT performed three daily sessions of 5 min with a 4 h interval between the sessions. Morris Water Maze (MWM) task was used to evaluate spatial learning and memory. Splash test, Forced Swim test, and Elevated Plus Maze task (EPM) were used to evaluate anhedonic, depressive-like, and anxious behaviors, respectively. Rats were euthanized, and the hippocampus was harvested for western blot analyses (CaMKII and BDNF). Both HIIT protocols improved VO2max and spatial memory. Notably, only the 3xHIIT protocol attenuated anxious and depressive-like behaviors. Western blot analyses of the hippocampus revealed that both HIIT protocols increased BDNF levels. BDNF levels were higher in the 3xHIIT when compared with 1xHIIT group, and we observed increasement of the CamKII levels just in the 3x HIIT group. Therefore, this study provides evidence indicating that accumulated HIIT sessions is more effective than traditional daily HIIT sessions in improving fitness level, cognitive function, memory, inhibiting the development of mood disorders, and enhancing BDNF and CaMKII levels in the hippocampus of aged rats. [ABSTRACT FROM AUTHOR]

Background: This study aims to verify the accuracy of item 10 on the energy level of the Short-Form Health Survey (SF-12) in an item screening according to Mood Disorder Questionnaire (MDQ) results, providing a measure of hyper-energy. Methods: Regression techniques were employed in a dataset comprising 4093 records of respondents to test both linear and nonlinear relationships between predictor and outcome variables (energy level and symptoms considered in the MDQ). We examined the relationship of energy level with cases identified using MDQ with a cut-off of 7. Results: Levels of energy, as rated on item 10 of the SF-12, were related to the MDQ score with sensitivity = 0.72 and specificity = 0.70. In linear regression, the associations were stronger with MDQ items on excessive energy or activity, showing a medium effect size and an explained variance of 10% or higher. A greater association was observed for items on excessive energy and activity, as expected, as well as for items concerning self-confidence, sociability, and talkativeness. Conclusions: This result may have implications for the research on risk factors and the pathogenesis of the dysregulation of mood, energy, and social rhythms syndrome (DYMERS), a syndrome that is hypothesized to occur in stressful conditions like those shown under the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea (OSA) is characterized by repeated airway obstructions during sleep, causing hypopnea, apnea, intermittent hypoxia, and sleep fragmentation. The severity of OSA is measured using the apnea–hypopnea index (AHI), with AHI ≥ 5 indicating OSA. This study aims to assess the frequency and type of depressive disorder characteristics of OSA patients and to evaluate the impact on quality of life, also considering the presence of hyperactivity. Methods: A case-control study using OSA patients referred to Cagliari's sleep disorder center. Controls were matched by age and sex from community databases. OSA diagnoses were made with AHI > 15. Depressive episodes were identified using BDI-SF, and H-QoL (Health related Quality of Life) was measured with the SF-12, focusing on item 10 for hyper-energy. Results: The clinical sample (n = 25) had a higher frequency of depressive episodes (36%) compared to controls (7% and 4%). Depressed OSA patients had worse H-QoL and higher hyper-energy scores, but the additional burden from depression was relatively low. Conclusions: The OSA sample has a higher frequency of depressive episodes compared to the general population. Depressive episodes in OSA patients are linked to higher scores on item 10 of the SF-12, indicating hyper-energy despite lower overall quality of life scores. While OSA significantly impacts quality of life, the additional burden from depression is less severe than in other chronic diseases. These findings suggest that depressive episodes in OSA may be related to rhythm dysregulation and hyperactivity (DYMERS). [ABSTRACT FROM AUTHOR]

As screens have become ubiquitous in modern-day society, investigating the effects of high screen time on mental health is highly warranted. In the past decade, many studies have determined that higher levels of screen time engagement are associated with adverse mental health outcomes like anxiety and depression. However, the nature of the relationship between screen time and mental health requires further investigation to gain a better understanding of its mechanisms and properties. The purpose of this study is to utilize a nationally representative data set to (1) examine how factors like sex, age, and socioeconomic status moderate the relationship between screen time and mental health in Canadian youth and (2) determine whether this relationship supports the Goldilocks hypothesis or an exposure-response curve. It was hypothesized that (1) young, female, lower socioeconomic status individuals will be more strongly associated with poor mental health, and that (2) mental health will peak at low screen time usage, therefore, supporting an exposure-response curve. A series of moderation analyses concluded that young, male, lower socioeconomic status individuals strongly moderated the relationship between screen time and poor mental health compared to their counterparts. Furthermore, three out of the four mental health (presence of mood disorder, presence of anxiety disorder, and depression severity) measures peaked at an average of 12 hours and 19 minutes of screen time per week, hence, supporting the exposure-response curve. [ABSTRACT FROM AUTHOR]

Background: Available evidence points to a possible role of Short Chain Fatty Acids (SCFAs) in mood disorders. This is the first systematic review to map the associations between SCFA levels and mood disorder symptoms. Methods: Following the PRISMA guidelines, the databases PubMed, Embase, and PsycINFO were searched for studies that assessed SCFA levels in human populations with mood disorder symptoms, or animal models of mood disorder. Risk of bias was assessed by the Strengthening of Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results: 19 studies were included and could be divided into animal (n=8) and human studies (n=11), with the animal studies including 166 animals and 100 controls, and the human studies including 662 participants and 330 controls. The studies were characterized by heterogeneity and methodological challenges on multiple parameters, limiting the validity and transferability of findings. Notably, only two of the clinical studies assessed the presence of mood disorder with diagnostic criteria, and no studies of mania or bipolar disorder met the inclusion criteria. Discussion: Despite significant methodological limitations, associations between SCFA levels and depressive symptoms were reported in most of the studies. However, the direction of these associations and the specific SCFAs identified varied. The quantification of SCFA levels in mood disorders is an emerging yet sparsely studied research field. Although there is some evidence suggesting a link between SCFAs and depressive symptoms, the directionality of effects and mechanisms are unclear and the relation to manic symptoms is uninvestigated. [ABSTRACT FROM AUTHOR]

Objectives: Electroconvulsive therapy (ECT) is one of the most effective treatments in mood disorders, mainly in major depressive episode (MDE) in the context of either unipolar (MDD) or bipolar disorder (BD). However, ECT remains a neglected and underused treatment. Older people are at high risk patients for the development of adverse drug reactions. In this context, we sought to determine the duration of MDEs and the number of lines of treatment before the initiation of ECT in patients aged 65 years or over according to the presence or absence of first-line indications for using ECT from international guidelines. Methods: In this multicenter, retrospective study including patients aged 65 years or over with MDEs in MDD or BD who have been treated with ECT for MDEs, data on the duration of MDEs and the number of lines of treatment received before ECT were collected. The reasons for using ECT, specifically first-line indications (suicidality, urgency, presence of catatonic and psychotic features, previous ECT response, patient preference) were recorded. Statistical comparisons between groups used standard statistical tests. Results: We identified 335 patients. The mean duration of MDEs before ECT was about 9 months. It was significantly shorter in BD than in MDD- about 7 and 10 months, respectively. The co-occurrence of chronic medical disease increased the duration before ECT in the MDD group. The presence of first-line indications for using ECT from guidelines did not reduce the duration of MDEs before ECT, except where there was a previous response to ECT. The first-line indications reduced the number of lines of treatment before starting ECT. Conclusion: Even if ECT seems to be a key treatment in the elderly population due to its efficacity and safety for MDEs, the delay before this treatment is still too long. Key points: • The mean duration of depression before ECT was 8.8 months. • The duration before ECT for Bipolar Disorder (vs Major Depressive Disorder) is shorter. • The co-occurrence of chronic medical disease increased the duration before ECT in the MDD group. • Focusing on the first-line indications for using ECT, only a previous response reduces the duration of depression before ECT. [ABSTRACT FROM AUTHOR]

Aim: Mood disorders are significantly connected with sexual functioning impairment among women. The aim of this study was to assess and describe specifics of sexual expression and its dysfunction in groups of women diagnosed with bipolar disorders (F31), major depressive disorder (F32 and F33) and persistent mood disorders (F34). Material and Methods: The sample comprised 129 female patients aged 19-65. Subjects were recruited in the Polish psychiatry hospital wards. Patients were interviewed using the sexological questionnaire Mell-Krat (Kromierzyńska's version) for women (SFK/K) for clinical assessment of patients' mood Montgomery-Åsberg Depression Rating Scale (MADRS), and Young Mania Rating Scale (YMRS) were used. Alcohol Use Disorder Identification Test (AUDIT) was also used to control alcohol addiction's influence on sexual functions. Results: The mean final score in SFK/K for the whole sample was 35.3 points (SD=15.65), clearly below the cut-off point for the average level of sexual reaction for the Polish population. More than 88.4% of patients achieved scores lower than optimal. Discussion: The prevalence of sexual dysfunctions among women suffering from mood disorders is increased. However, the image of the sexual expression of those patients is not homogenous. Conclusion: The paper put light on the sexual functioning of women with mood disorders. However, further research using more specific methods and bigger samples is needed. [ABSTRACT FROM AUTHOR]

Introduction. International studies on emergency medical patients have identified an association between mental health problems and the number of patients' readmissions and their length of stay. Objective. We evaluated the relationship between patients' mental health (including anxiety and depression levels and suicide risk) and the number of readmissions and length of stay at the emergency department (ED) of a Mexico City hospital emergency department (ED). Method. This cross-sectional study was conducted between 2017 and 2020 at a general hospital in Mexico City. The sample comprised 236 patients in the ED. The study administered three instruments with psychometric properties to evaluate the sample. In addition, patient records were reviewed to identify the number of readmissions and length of stay in the emergency department. Results. The mean length of stay was 69.6 hours (standard deviation [SD] = 65.68) and the mean number of readmissions was .4 (SD = .88). In regard to mental health variables, it was found that 50% of the study population displayed anxiety symptoms, 54% showed depression symptoms and 8.30% of the patients presented a moderate/high risk of suicide according to the International Neuropsychiatric Interview (MINI). No statistically significant associations were found between study variables. Discussion and conclusion. There appears to be no relationship between mental health and length of stay. The percentages and implications of the data obtained are discussed. [ABSTRACT FROM AUTHOR]

Adolescent psychotic mood disorder (MDP) is a specific phenotype that characterized by more severe symptoms and prognosis compared to nonpsychotic mood disorder (MDNP). But the underlying neural mechanisms remain unknown, and graph theory analysis can help to understand possible mechanisms of psychotic symptoms from the perspective of functional networks. A total of 177 adolescent patients with mood disorders were recruited, including 61 MDP and 116 MDNP. Functional networks were constructed, and topological properties were compared between the two groups at baseline and after treatment, and the association between properties changes and symptom improvement was explored. Compared to the MDNP group, the MDP group exhibited higher small-world properties (FDR q = 0.003) and normalized clustering coefficients (FDR q = 0.008) but demonstrated decreased nodal properties in the superior temporal gyrus (STG), Heschl's gyrus, and medial cingulate gyrus (all FDR q < 0.05). These properties were found to be correlated with the severity of psychotic symptoms. Topological properties also changed with improvement of psychotic symptoms after treatment, and changes in degree centrality of STG in the MDP was significantly positive correlated with improvement of psychotic symptoms (r = 0.377, P = 0.031). This study indicated that functional networks are more severely impaired in patients with psychotic symptoms. Topological properties, particularly those associated with the STG, hold promise as emerging metrics for assessing symptoms and treatment efficacy in patients with psychotic symptoms. [ABSTRACT FROM AUTHOR]

About 16 million adults present with chronic back pain, the sixth most costly condition in the United States (US). Estimates suggest that about 60% of initial back surgeries have a successful outcome; however, many don't, leaving over 80,000 failed back surgeries per year. Failed Back Surgery Syndrome (FBSS) is defined by the International Association for the Study of Pain as back pain, with or without radiating pain, located in the lower limbs, of unknown origin, which persists or begins after surgical procedures are performed to treat lumbar disc herniations. Psychiatric comorbidities and psychosocial factors have been associated with patients presenting with this syndrome. A retrospective cross-sectional study was performed to identify the prevalence of FBSS in a population of patients during the period of January 2019-December 2020 across Hospital Corporation of America (HCA) Healthcare in the US. With a sample of 28,426 patients who underwent back surgery only 8% had FBSS. Those with FBSS (N = 2434) were mainly females (54.27%) with a mood disorder (61.18%), P -value <.0001. Among those with FBSS, there was a statistically significant relationship between mood disorder and smoking (57.37%) and obesity (54.61%) compared to non-smokers and non-obese. Lifestyle interventions may ameliorate disabling symptoms and improve the well-being of this population. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Producing relevant knowledge on the prevalence of mood disorders (MDs) requires a clear identification of people living with the condition. Analyzing this multifaceted disease from the perspective of health administrative data and population‐based surveys could contribute to document inconsistencies between these data sources and highlight the strengths and limitations of each methodological approaches. Objectives The aim of this study was to estimate the prevalence of MD disease, assess concordance of MD patterns in population‐based surveys versus health administrative data, and investigate statistical differences in characteristics between individuals presenting the disease in each data sources. Methods This study used the Care Trajectories—Enriched Data (TorSaDE) cohort. The TorSaDE cohort is built by merging five waves of the Canadian Community Health Survey (CCHS) with health administrative data of the province of Quebec, Canada. The sample includes individuals who participated in at least one round of CCHS and for whom evidence of use of health services in the year of CCHS completion and the year before were present in health administrative data. The cohort was split into four groups based on the presence and absence of MD in self‐reported versus health administrative data. Groups' characteristics were compared using chi‐square tests and ANOVA. Results The study cohort was composed of 96,079 individuals, of which 10,418 (10.8%) had MD, regardless of the data sources. Self‐reported prevalence of MD was 6.03%, while the prevalence from health administrative data was about 7.79%. Estimates showed a low level of concordance between the two measures, as only 27.4% of people presenting this medical condition were identified in both data sources. Furthermore, individuals identified with MD only in survey data had poorer socioeconomic outcomes but better health outcomes than those from the concordant group (i.e., identified in both data sources). In addition, people presenting MD in health administrative data only had better socioeconomic and health outcomes than those who reported MD diagnosis only in survey data. Conclusion Findings suggest that each measure capture different specific subpopulations. Estimates obtained from each source should thus be contextualized and interpreted with caution.

Transgender and gender-diverse (TGD) menstruators are individuals assigned female at birth (AFAB)*, who retain the capacity to menstruate and have a gender identity that differs from their natal sex. Reports indicate up to 1.6 million individuals in the US identify as TGD. Until recently, the mainstream menstrual discourse has failed to capture the experience of transmenstruators. However, a better understanding of the menstrual experiences of TGD-AFAB will allow for more individualized patient-centered care. In this review, we provide the relevant data necessary to inform the psychiatric management of menstruation in TGD-AFAB individuals, including experiences of menstruation, preferences for menstrual management, and the impact on mental health. Our review indicates that menstrual care in TGD patients must be tailored to the individual; clinicians should remain open-minded to the unique experience of transmenstruators; gender-affirming menstrual care is necessary to reduce psychological burden. It should not be assumed that TGD-AFAB menstruators are utilizing appropriate contraceptive methods and should receive contraceptive and fertility preservation counseling. We highlight the importance of having these conversations early in the reproductive arch, even before puberty onset. Keeping in mind the gender minority stress model, in the upcoming sections, we discuss the limited body of literature on mood disorders in TGD-AFAB individuals who menstruate, undergo menstrual suppression, or continue to ovulate. The psychological impact of hormonal therapies is also reviewed.

Abstract Background Red onion husk, a readily available agricultural waste material, contains diverse bioactive compounds with potential health benefits. This study aimed to assess the safety and therapeutic potential of red onion husk extract in managing manic-like symptoms and associated neurochemical dysfunctions. Methods Acute and repeated oral dose studies were conducted in mice and rats to evaluate the safety profile of the extract. FT-IR analysis identified functional groups in the extract, while GC-MS analysis identified specific bioactive compounds in the flavonoid-rich fraction. A ketamine-induced manic behaviour model in Wistar rats was employed to assess the extract’s efficacy in attenuating manic-like symptoms. Behavioural and neurochemical analyses were performed to further investigate the extract’s effects. Results The extract demonstrated a favourable safety profile in both acute and repeated dose studies. FT-IR analysis revealed a complex mixture of organic compounds, including hydroxyl groups, alkynes/nitriles, aromatic and non-aromatic C = C bonds, amines, and polysaccharides. GC-MS analysis identified 17 bioactive compounds, including five-methyl-2-phenylindolizine, methadone N-oxide, and 3-phenylthiane, S-oxide. Ketamine administration significantly increased oxidative stress markers, TBARS, and suppressed antioxidant enzyme activities (SOD, GPx, CAT) in both the cerebral cortex and hippocampus, alongside elevated acetylcholinesterase (AchE) activity, indicating enhanced neuronal excitability. Pre-treatment with FRF (25 mg/kg) effectively mitigated ketamine-induced oxidative stress, as evidenced by reduced TBARS levels and partially restored SOD and GPx activities. Interestingly, FRF significantly increased CAT activity (p

Valproate is a widely used mood stabiliser in neurology and psychiatric practice. It can cause rare but serious adverse effects, including hyperammonaemia. Hereby, the authors present a case report of 40-year-old married male diagnosed with bipolar affective disorder, who presented with manic symptoms and subsequently developed hyperammonaemia after the initiation of Sodium Valproate. Despite normal liver function and no history of substance use, the patient exhibited excessive drowsiness and constipation five days after increasing the valproate dosage to 1500 mg/day. Serum ammonia levels were significantly elevated, prompting the cessation of all psychiatric medications and the initiation of lactulose treatment. Over six days, ammonia levels normalised, revealing the underlying manic symptoms. The patient was transitioned to Lithium for mood stabilisation while Valproate was not reintroduced. The case highlights the potential for hyperammonaemia in patients receiving valproate, even in the absence of liver dysfunction. The mechanisms behind this adverse effect may include Carnitine depletion and toxic metabolite accumulation from valproate metabolism. The report underscores the importance of vigilance in monitoring for hyperammonaemia, particularly in patients receiving rapid dose escalations of valproate. Limitations of the report include the absence of serum Valproate levels at the time of hyperammonaemia, which would have aided in understanding the dose-response relationship. It also highlights the need for early detection of hyperammonaemia and appropriate management.

Patients with major depression often suffer from excessive interpersonal sensitivity, although it is not typically measured in antidepressant clinical trials. Preliminary evidence suggests selective serotonin reuptake inhibitors have the capacity to reduce interpersonal sensitivity. This was a pooled analysis of data from 1709 patients in three randomized, double-blind, placebo-controlled trials of fluoxetine and paroxetine for acute major depressive disorder. Depressive symptoms were assessed with the Hamilton Depression Rating Scale. A factor from the Symptom Checklist was used to assess interpersonal sensitivity. Our outcome of interest was change from baseline scores at the last assessment (up to 8 or 12 weeks, depending on the trial). Both medications produced significantly greater reductions in interpersonal sensitivity relative to placebo. The effect of medication remained significant after controlling for depression improvement, which explained 18.5% of the variation in interpersonal sensitivity improvement among those treated with active medication. The effect of medication on depressive symptoms, relative to placebo, was not influenced by baseline interpersonal sensitivity. The outcome measured interpersonal sensitivity over the last week, and the results do not necessarily reflect changes in long-standing, trait-like patterns of interpersonal sensitivity. Only two medications were studied. Selective serotonin reuptake inhibitors are effective at treating interpersonal sensitivity in acutely depressed patients. This appears to be a unique drug effect that is not only the result of depression improvement. Future clinical trials might benefit from assessing interpersonal sensitivity more routinely. • Paroxetine and fluoxetine reduced interpersonal sensitivity more than placebo. • This effect could not be fully explained by concurrent depression improvement. • Baseline interpersonal sensitivity did not moderate the depression treatment effect. [ABSTRACT FROM AUTHOR]

La symptomatologie cognitive est un enjeu majeur en santé mentale, elle reste pourtant trop peu prise en compte dans la pratique clinique. Cet article vise à fournir une vision globale de la littérature actuelle sur le fonctionnement cognitif des personnes vivant avec un trouble bipolaire. Il a également pour objectif de mettre en lumière les interventions possibles, notamment au sein des Centres Experts du réseau FondaMental. Nous avons réalisé une revue de la littérature pour explorer différents aspects liés aux troubles cognitifs dans les troubles bipolaires, tels que les troubles cognitifs traits, les variations au cours de la maladie, et l'évaluation et le traitement de ces troubles. Des troubles cognitifs au sein de différentes sphères sont présents dans les troubles bipolaires. Ils sont retrouvés dans toutes les phases et sous-types de la pathologie, avec une augmentation de l'intensité des troubles en phase aiguë. On observe cependant une hétérogénéité interindividuelle. La société internationale pour les troubles bipolaires a élaboré des recommandations, telles que la systématisation d'un bilan de dépistage permettant d'orienter vers des consultations spécialisées en neuropsychologie, ou encore des évaluations régulières facilitant la détection précoce des processus neurodégénératifs. Les Centres Experts dans les troubles bipolaires peuvent proposer ces évaluations, des actions de prévention, de la psychoéducation ou des interventions adaptées aux troubles cognitifs, telles que la remédiation cognitive. Nous présentons enfin le programme de remédiation cognitive écologique ECo, qui se base sur des exercices créés spécifiquement pour permettre le transfert des stratégies en vie quotidienne pour les personnes vivant avec un trouble de l'humeur. L'association d'évaluations régulières, de mesures préventives et curatives permettrait de prendre en charge la symptomatologie cognitive et d'accompagner les personnes vivant avec un trouble bipolaire dans leur parcours de rétablissement. Cognitive impairments represent a major issue in mental health that remains understudied in clinical practice. This article aims to provide an overview of the literature on cognitive functioning in bipolar disorders. Additionally, its purpose is to highlight potential interventions that promote recovery, particularly within the bipolar "Centers of Expertise" of the Fondation FondaMental network. We conducted a literature review to explore various aspects related to cognitive issues in bipolar disorders, such as trait-related cognitive impairments, variations throughout the course of the illness, and the assessment and treatment of these cognitive deficits. In bipolar disorders, many cognitive disorders may present themselves in different ways; the literature identifies disorders of attention, psychomotor speed, executive functions, memory, emotional and social cognition, and metacognition. These cognitive disorders are present in all phases of the disease with heterogeneity between patients. This heterogeneity does not depend on whether patients have type I or type II bipolar disorders; nor does it depend on depressive, manic, or euthymic phases, although cognitive symptomatology is more intense in the acute phases. Bipolar disorders require treatment, although some treatments can have an influence on cognition, notably antipsychotics, lithium, or more general polypharmacy. The International Society for Bipolar Disorders (ISBD) Targeting Cognition Task Force developed consensual recommendations for clinicians regarding cognitive interventions in bipolar disorders. The recommendations include an objective and subjective assessment of cognition for all patients, regardless of whether partial or complete remission is achieved. Caregivers who are not neuropsychology specialists may, after a short training period, use screening tools such as the "Screen for Cognitive Impairment in Psychiatry" (SCIP) and "Cognitive Complaints in Bipolar Disorders Rating Assessment" (COBRA), and must refer patients for a more complete evaluation if any difficulties emerge. There is also an interest in regularly assessing cognition, in connection with the possibility of neurodegeneration. Indeed, there are several theories about the development of cognitive impairments in bipolar disorders in the literature. One theory suggests that neurodevelopmental factors could influence the occurrence of these disorders. On the contrary, the "neuroprogression model" postulates that allostatic load may disrupt cognitive functioning as part of a longer term degenerative process. The FondaMental network Centers of Expertise provide educational programs as well as interventions adapted to several aspects of psychiatric diseases, notably cognitive impairment. Patients can be provided with a complete cognitive assessment, and then directed towards appropriate therapies. The centers offer, for example, cognitive remediation for bipolar patients, with the goal of personal recovery. Cognitive remediation is a psychosocial rehabilitation treatment which consists of training cognitive functions via exercises aimed at developing problem-solving strategies that can be transferred to daily life. This treatment should lead to an improvement in patients' quality of life and autonomy. Worldwide, there is a lack of recognized programs for people with mood disorders, including bipolar disorders. However, some studies report that cognitive remediation therapy leads to cognitive and functional improvement, despite heterogeneity in the results of these studies. Some authors of these studies recommend developing individualized and integrative treatments centered around the patients' personal and professional projects, and targeting different psychological processes that mediate functional improvement. An ecological cognitive remediation program, called "Eco", was recently created in France for patients with mood disorders, including bipolar disorders. This program uses paper and manipulable tools for cognitive remediation exercises that have been created specifically to support the transfer of cognitive skills into people's daily lives. It is composed of a psychoeducational module that: develops the patient's metacognitive knowledge; reduces self-stigmatization; and increases intrinsic motivation towards therapy. The program includes three cognitive training modules (on attention, memory, and executive functions), with sub-modules for specific functions, with exercises to be done in a guided session as well as occasionally at home. The order of presentation of the modules, as well as the number of sessions per sub-module, are adapted to each patient. Exercises are composed of ten levels of difficulty, and they allow patients to discover, develop, and then generalize new cognitive strategies. A final functional training module is used in conjunction with cognitive training, in order to help the transfer of the cognitive strategies developed to complex situations in daily life. The combination of frequent assessments, preventive measures, and treatments should make it possible to manage cognitive symptoms and to support people living with a bipolar disorder in their recovery journey. [ABSTRACT FROM AUTHOR]

Adolescent anhedonia is a multidimensional construct defined as the loss of enjoyment or pleasure across multiple domains of life. Anhedonia is concurrently associated with substantial impairment and distress, and it prospectively predicts the onset, severity, and treatment of depression. Despite its demonstrated importance, a limited number of anhedonia measures are validated for adolescents. The current study assessed the psychometric properties of the Dimensional Anhedonia Rating Scale (DARS) in 400 English-speaking, 12- to 19-year-old adolescents. Overall, the DARS demonstrated good convergent and discriminant validity, but sub-optimal concurrent validity. The strengths and limitations of the DARS and its utility as a measure of adolescent anhedonia are discussed. Furthermore, future directions for the construction of measures of adolescent anhedonia are outlined. [ABSTRACT FROM AUTHOR]

Intolerance of uncertainty (IU) is a risk factor for poor mental health. Acquired brain injury (ABI; for example, stroke, traumatic brain injury) often brings considerable uncertainty and increased mood disorder vulnerability. The Intolerance of Uncertainty Scale–Short Form (IUS-12) is a brief, well-validated IU measure in non-ABI samples, comprising two subscales, namely, Prospective Anxiety and Inhibitory Anxiety. Here, for the first time, we investigated its reliability and validity (N = 118), and factor structure (N = 176), in ABI. Both subscales had high test–retest reliability (intraclass correlation coefficients [ICCs] of.75 and.86) and were significantly associated with mood disorder symptoms. The two-factor model was superior to a one-factor IU model fit. Some fit statistics were less than optimal (standardized root mean square residual [SRMR] = 0.06, root mean square error of approximation [RMSEA] = 0.09); hence, exploration of other factor structures in other ABI samples may be warranted. Nonetheless, the IUS-12 appears suitable in ABI. [ABSTRACT FROM AUTHOR]

Depression, migraine, insomnia, and fibromyalgia are reportedly comorbidities. Nevertheless, no study has evaluated the comorbidity of all four of these disorders. This study aimed to investigate the comorbidity of these four disorders. Cross-sectional analyses were performed using data of the Circannual Change in Headache and Sleep study, an online nationwide population-based survey. Validated questionnaires were used to diagnose the disorders and measure quality of life. The change of clinical characteristics by addition of any comorbidity was analyzed using the Jonckheere–Terpstra trend test. The prevalence rates of depression, migraine, insomnia, and fibromyalgia were 7.2 %, 5.6 %, 13.3 %, and 5.8 %, respectively. Among the 3030 included participants, 494 (16.3 %), 164 (5.4 %), 40 (1.3 %), and 6 (0.2 %) had one, two, three, and four of these conditions, respectively. The number of headache days per 30 days (Jonckheere–Terpstra trend test, p = 0.011) and migraine-related disability (migraine disability assessment score, p = 0.021) increased with an increase in the number of comorbidities but not with the intensity of headache (visual analog scale, p = 0.225) among participants with migraine. The severity of insomnia (Insomnia Severity Index, p < 0.001) and fibromyalgia (fibromyalgia severity score, p = 0.002) increased with additional comorbidities; however, depression (Patient Health Questionnaire-9, p = 0.384) did not show such an increase. The diagnoses of conditions were based on self-reported questionnaires. The findings confirmed significant comorbidity between depression, migraine, insomnia, and fibromyalgia. Health professionals should be aware of the probable comorbidity of depression, migraine, insomnia, and fibromyalgia when caring for individuals with any of these four disorders. • Depression, migraine, insomnia, and fibromyalgia overlap and are highly comorbid. • Addition of depression, migraine, insomnia, or fibromyalgia increases headache days. • More depression, migraine, insomnia, or fibromyalgia; the more migraine disability. • Insomnia and fibromyalgia severity increase with comorbidities. [ABSTRACT FROM AUTHOR]

Introduction: Lithium has an irreplaceable role in the treatment of severe mood disorders, but declining renal function associated with its use leads to clinical dilemmas. Although not often applied, and requiring close monitoring and multidisciplinary actions, concurrent lithium and haemodialysis treatment (CLHT) is a feasible option. To our knowledge, however, there are no detailed consensus‐ or evidence‐based treatment guidelines or directives on its delivery. Methods: To fill this gap, we reviewed the literature and surveyed psychiatrists and nephrologists with experience in CLHT using a self‐designed questionnaire. Our goal was to form an integrated picture of the current knowledge and clinical practices of CLHT and formulate practical recommendations for colleagues being confronted with patients with renal dysfunction requiring lithium to help manage their mood disorder. Results: We identified 14 case reports and case series describing CLHT and one systematic review concluding CLHT to be effective. Ten nephrologists and six psychiatrists practising in the Netherlands completed our questionnaire, providing details on collaboration, lithium dosing regimens, serum level evaluations and additional amenities and services they deemed necessary during CLHT delivery. Discussion: We found that CLHT appears to be safe and effective and argue that delivery is a shared responsibility and needs continuous multidisciplinary finetuning. To facilitate delivery, we provide a flowchart for the initiation or reinstatement of lithium therapy in haemodialysis patients and a practical guide for CLHT, including an easy‐to‐use rule of thumb for calculating the lithium target dose. [ABSTRACT FROM AUTHOR]

Introduction: Non-adherence to treatment recommendations is a significant problem, as it contributes to the progression of the disease and to the exacerbation of distressing symptoms. Failure to cope with the disease and elevated levels of stress, in turn, influence the choice of strategy for coping with a difficult situation, and thus adherence to recommendations. Objectives: The purpose of our study was to evaluate the impact of the subjects' stress coping styles on therapeutic adherence, life satisfaction, disease acceptance and quality of life (QoL) in people with mood disorders. Methods: This survey-based study included 102 respondents diagnosed with mood disorders, living in the West Pomeranian Voivodeship. It was performed using the sociodemographic questionnaire and standardized tools: The Coping Inventory for Stressful Situations (CISS), The Satisfaction with Life Scale (SWLS), The Short Form-36 (SF-36) Health Survey, The Adherence to Refills and Medication Scale (ARMS), and The Acceptance of Illness Scale (AIS). Results: Some 47.06% of the respondents suffered from depressive disorders, while 34.31% had depression or mixed anxiety disorder. Patients who made greater use of an emotion-focused style were found to have significantly lower life satisfaction than other patients. Moreover, this style was related to such SF-36 domains as general health, social functioning, role emotional, vitality, and mental health, as well as to physical component summary (PCS) and mental component summary (MCS). Conclusion: Treatment non-adherence is a serious challenge in the treatment of patients with mood disorders. Individuals who do not adequately follow treatment recommendations often resort to alternative activities as a mechanism for coping with difficult situations. Patients who predominantly adopt an emotion-oriented coping style tend to experience lower life satisfaction and greater difficulty accepting their condition compared to their peers. Conversely, patients who adopt a task-oriented coping style report better quality of life than those who rely on emotion-oriented coping or alternative activities. [ABSTRACT FROM AUTHOR]