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Affective disorders profoundly affect individuals' emotional well-being and quality of life. This study investigates the epidemiology of affective disorders in Germany from 2011 to 2021, focusing on incidence rates, age- and sex-standardized rates, and developmental trends. Using nationwide data of ICD-10 diagnosis codes from 2011 to 2021, this cross-sectional study analyzed inpatient cases of affective disorders in individuals aged 20 years or older. Age- and sex-standardized incidence rates were calculated based on the population size of each birth cohort in the 16 German federal states. Incidence rate ratios (IRRs) for 2011 to 2021 and 2019 to 2021 were compared with a two-sample z-test. Between 2011 and 2021, F30 (manic episode) showed a decline of 42.8 % to an incidence of 4.9 per 100,000 inhabitants, even though not statistically significant (p = 0.322). F31 (bipolar affective disorder) remained relatively stable with a reduction of 15.3 % to an incidence of 13.6 per 100,000 inhabitants in 2021 (p = 0.653). F32 (depressive episode) decreased statistically significant by 25.7 % to an incidence of 64.1 per 100,000 inhabitants (p = 0.072). F33 (recurrent depressive disorder) slightly increased by 18.3 % to an incidence of 94.6 per 100,000 inhabitants (p = 0.267). No statistically significant differences were found when comparing the COVID-19 pandemic year 2021 to 2019 incidences (p ≥ 0.529). The study provides valuable insights into the changing landscape of affective disorders in Germany over the past decade. The observed decline in incidence rates underscores the importance of continued efforts to promote mental health awareness and access to care. • This studies utilized nationwide inpatient data from all clinics in Germany from 2011 to 2021 • 267,067 patients were hospitalized for affective disorders, (1.73% of the general population) in 2021 • Bipolar affective disorder remained relatively stable with an incidence of 13.6/100,000 inhabitants • Depressive episodes decreased by 25.7% to an incidence of 64.1/ 100,000 inhabitants • There were no statistically significant differences when comparing the COVID-19 pandemic year 2021 to 2019 incidences [ABSTRACT FROM AUTHOR]

This research is to explore the impacts of irisin on hyperalgesia and behavioral deficits caused by chronic constriction injury (CCI) and the underlying mechanisms. The CCI mice model was used in this study. The experimental mice were assigned into sham, sham + irisin (3 μg/kg), CCI, CCI + irisin (0.1, 1, and 3 μg/kg), and CCI + irisin (3 μg/kg) + ML385 (30 mg/kg) groups. The results showed that after CCI injury, the mice exhibited hyperalgesia, depression, and anxiety. In addition, the levels of inflammatory cytokines NF-κB, IL-1β, IL-6, TNF-α, and iNOS increased in the mice hippocampus, frontal cortex, and spinal cord. Moreover, oxidative stress relevant factor MDA increased, while GSH and SOD decreased in the mice hippocampus, frontal cortex, and spinal cord. However, irisin treatment ameliorated CCI-induced mechanical allodynia, thermal hyperalgesia, depressive, and anxiety behaviors, and reversed the abnormal expressions of inflammatory and oxidative stress relevant cytokines. Interestingly, these therapeutic effects of irisin were partly abolished by ML385, a specific Nrf2 antagonist. Taken together, irisin may be an effective therapeutic agent for CCI-induced neuralgia and the affective disorders, and the mechanisms may be associated with the anti-neuroinflammation mediated by NF-κB and the anti- oxidative stress function regulated by Nrf2.

Huan Wang,1,* Xing Xie,2,* Zuowei Li,3 Lian Xue,4 Qiaoling Liao5 1The First Department of Psychosomatic Diseases, the Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, 621000, People’s Republic of China; 2Mental Health Center of West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China; 3Nursing Department, the Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, 621000, People’s Republic of China; 4The Second Department of Psychosomatic Diseases, the Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, 621000, People’s Republic of China; 5The Second Department of Severe Psychiatric, the Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, 621000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qiaoling Liao, The second department of severe Psychiatric, the Third Hospital of Mianyang, Sichuan Mental Health Center, No. 190, Jiannan Road, Youxian District, Mianyang, Sichuan Province, 621000, People’s Republic of China, Email qqliao2009@163.comPurpose: This study aims to investigate the status of family functioning and dissatisfaction of family function from the perception of adolescents with affective disorders and explore associated factors.Methods: This was a multicentric cross-sectional study conducted from April 2022 to February 2023. Adolescents with affective disorders were surveyed in representative samples drawn from three hospitals in Sichuan province, China. Data were obtained from 235 participants regarding their demographic characteristics, family characteristics, disease-related characteristics, and family functioning.Results: The study found family functioning and its’ dissatisfaction both lower than national norms from the perspectives of adolescents. Younger age, single-parent family, and reconstituted family were predictors of not close of cohesion. Younger age, lower educational level of father, and reconstituted family were associated with less change of flexibility. Less times of hospitalizations, higher educational level of father, stem family were more satisfy with cohesion. Higher educational level of father, and stem family were also associated with greater satisfaction with flexibility.Conclusion: The study demonstrated that the family function of adolescents of affective disorders was poor, more attention should be paid to it. Age, family structure, number of hospitalizations and the educational level of father were influencing factors of family functioning. Therefore, it is important for medical worker to assess demographic and family characteristics of adolescents with affective disorders. Younger children, children of reconstituted family and single-parent family, children with repeated hospitalizations and fathers of lower level of education should be given emphasized in implementation of interventions. Based on the evaluation results, personalized family therapy has been proved to be an affective measure and could be used in clinical work.Keywords: affective disorders, adolescent, family functioning

This article, published in the American Journal of Psychiatry, explores the topics of affective disorders, pharmacogenomics, and psychiatric illness-related cardiometabolic problems. It discusses the use of pharmacogenomic tools in treating depression and examines the genetics of affective disorders and bipolar disorder. The article also investigates the connection between antidepressant use and the induction of hypomania/mania in bipolar depression, as well as the relationship between alterations in stress responsivity and the pathophysiology of depression. Additionally, it assesses the risk of developing cardiometabolic problems in various psychiatric illnesses. The findings provide valuable insights into the genetics, pathophysiology, and treatment of affective disorders, as well as the associations between different psychiatric disorders and the development of cardiometabolic problems. The article discusses the results of a study on patients with major depression, which revealed abnormal brain activity in mood regulation networks and blunted stress-related cortisol levels. The study also found decreased GABA levels in a specific brain region and a negative correlation between cortisol reactivity and brain activity in depressed patients. The authors suggest that these findings indicate faulty regulation and abnormal associations between brain activity and stress response in depressed individuals. Another study examined the relationship between psychiatric disorders and cardiometabolic problems, finding that individuals with psychiatric diagnoses had an increased risk of developing cardiovascular disorders and metabolic syndrome. The authors concluded that a general psychopathology factor contributes to this increased risk. [Extracted from the article]

The closure of schools, social hubs, and extracurricular activities due to lockdown measures imposed to curb the spread of SARS-CoV-2, has increased the risk factors for students' mental health. This cross-sectional study, conducted from March 2020 to March 2021, aimed to estimate socio-emotional, cognitive, and affective disorders and substance use in a sample of first- and second-grade high school students in Northern Italy. This study compared data from 284 Italian students' self-perceptions along with the perceptions of their parents and teachers through a web-based survey. The differences in the perceptions of the three groups (students, parents, and teachers) were analyzed using an analysis of variance test, applying a Bonferroni correction. The X[superscript 2] test was used to assess the comparison between students, parents, and teachers in the substance use questions. The results showed statistically significant differences among the three groups. The most important outcomes were sociality, scholastic performance, extracurricular activity, emotional symptoms, affective disorders (depression and anxiety), and substance use. These findings could be interesting for the promotion of mental health and prevention of psychopathological risks in students.

Parkinson's disease is a progressive neurodegenerative disorder characterized by damage to dopaminergic neurons in the substantia nigra, pars compacta and nigrostriatal pathways. This translates into a low level of dopamine which is responsible for the appearance of specific motor manifestations such as tremors, rigidity, bradykinesia, akinesia and postural instability. The clinical picture of Parkinson's disease is complemented by non-motor symptoms such as affective disorders, psychotic manifestations, neurocognitive disorders, hypnic disorders or autonomic dysfunction. This paper represents a critical assessment of the symptomatology, risk factors and treatment of affective disorders in Parkinson's disease, making a comparative analysis between the most common clinical manifestations and the pharmacological treatments used. Studies show an extremely variable rate (2.7%-90%) regarding the presence of depression in patients diagnosed with Parkinson's disease. In general, all antidepressants are effective and safe in treating depression in Parkinson's disease. The most commonly used in practice are SSRIs and mirtazapine, and the best results have been obtained with tricyclic antidepressants (such as desipramine, nortriptyline), SNRIs (venlafaxine) and SSRIs (citalopram, sertraline, paroxetine). Using the UPDRS scale, pramipexole (dopaminergic agonist) has been shown to have the best antidepressant effect results (both in major depressive disorder and in bipolar affective disorder) among antiparkinsonians. The number of studies evaluating bipolar affective disorder in Parkinson's disease is much smaller than those addressing unipolar depressive disorder. However, it has been shown that the presence of bipolar affective disorder ((hypo)manic, mixed and depressive episodes) predisposes to the appearance of this neurodegenerative disease (having a much higher incidence compared to the general population). The treatment of this condition is carried out with mood stabilizers, but lithium (the first line in bipolar affective disorder) is not recommended in patients with Parkinson's disease due to adverse effects (it can worsen tremors). Thus, valproic acid (especially for rapid-cycling bipolar affective disorder) and antipsychotics with a thymostabilizing effect such as clozapine, quetiapine and pimavanserin are preferred. [ABSTRACT FROM AUTHOR]

Continuous challenges have been imposed on mental health science by Anxiety and Depression disorders as the most prevalent and debilitating psychiatric conditions worldwide. Pharmacologic and cognitive behavioral therapies, either alone or in combination, have been considered as the first-line therapies, however, resistant symptomatology is prevalent in comorbid conditions with symptoms remaining after interventions. The demand for new therapeutic solutions has given space to the development of non-invasive brain stimulation techniques (NIBS), and the transmagnetic direct current stimulation (tDCS) has been reported as a safe and well-tolerated technique for the treatment of several mental health conditions, including Anxiety and Depression disorders. Relying on quantitative electroencephalography(qEEG)- tDCS approach, the current study aims to inspect the effect of tDCS intervention on patients who suffer from anxiety-depression comorbidity, in particular, the impact of tDCS intervention on qEEG spectral power activity and resting-state connectivity organization during eyes closed and eyes open protocols. QEEG data were acquired from eight patients suffering from moderate to severe anxiety-depression comorbid symptoms along with poor coping skills to manage stress and negative affect. Twelve control subjects allocated in the control group exhibiting low to moderate symptoms in both anxiety and depression conditions went also through the qEEG data acquisition. In addition, a sham-controlled study was conducted, and the patient group went through resting-state qEEG-tDCS neuromodulation once a week for ten weeks. Various-stage qEEG recordings were performed to inspect the efficacy of tDCS treatment during the modulation of brain regions involved in the regulation of affective responses. Our results demonstrated that after tDCS neuromodulation, the patients' groups exhibited decreased absolute power abnormalities over the left anterior cingulate cortex and reduced abnormal activity in the alpha band over posterior regions; improved functional connectivity indexes; decreased anxiety and depressive scores while positive affect score was improved. Besides the promising improvements, our study did not find a significant tDCS effect on perceived stress and negative affect scores. Consistently, significant differences in absolute spectral power over the left anterior cingulate cortex were detected among the patient group, as compared to the controls, as expected. Therefore, our study offers preliminary data to understand the neuroplasticity changes that potentially result from the manipulation of cortical excitability during affective regulation protocols followed by the consequent decrease of comorbid anxiety and depressive symptomatology. The pilot study was followed by prospective registration with ChiCTR2200062142.

Comprehensive knowledge of factors causing and sustaining functional impairment in patients with affective disorders is warranted. The aim is to investigate associations between clinical factors (such as affective symptoms) and personal factors (such as personality traits, coping strategies, and childhood trauma experiences) on functioning and improvement of functioning in patients with affective disorders. This exploratory study includes data from 103 patients with bipolar disorder and unipolar depressive disorder. Clinician-rated functioning was assessed at baseline using the Functioning Assessment Short Test (FAST), and performance-based functioning was assessed at baseline and 6-month follow-up using the Assessment of Motor and Process Skills (AMPS). Data on clinical and personal factors were collected at baseline. Personal factors were measured by the Eysenck Personality Inventory (EPQ), Coping Inventory for Stressful Situations (CISS) and Childhood Trauma Questionnaire (CTQ). Pearson correlations and multiple linear regression models were used to analyse the association of clinical and personal factors with baseline functioning (FAST) and to identify predictors of improvement in functioning (AMPS) from baseline to follow-up. At baseline, greater depressive symptom severity, the personality trait neuroticism, emotional coping, and childhood trauma all correlated with poorer functioning (higher FAST scores). In multiple linear regression models, depression severity, emotional coping and childhood trauma were significant predictors of poorer functioning. More childhood trauma was a predictor of less functional improvement measured by AMPS at 6-month follow-up. In conclusion, maladaptive coping styles and depressive symptoms contribute to functional impairment in patients with affective disorders, while childhood trauma has a negative impact on long-term functional outcomes. [ABSTRACT FROM AUTHOR]

Two of the most common and incapacitating mental health disorders around the world are major depressive disorder (MDD) and post-stroke depression (PSD). MDD is thought to result from abnormal connectivity between the monoaminergic, glutamatergic, GABAergic, and/or cholinergic pathways. Additional factors include the roles of hormonal, immune, ageing, as well as the influence of cellular, molecular, and epigenetics in the development of mood disorders. This complexity of factors has been anticipated by the Swiss psychiatrists Paul Kielholz and Jules Angst who introduced a multimodal treatment of MDD. Depression is the predominant mood disorder, impacting around one-third of individuals who have experienced a stroke. MDD and PSD share common underlying biological mechanisms related to the disruption of monoaminergic pathways. The major contributor to PSD is the stroke lesion location, which can involve the disruption of the serotoninergic, dopaminergic, glutamatergic, GABAergic, or cholinergic pathways. Additionally, various other disorders such as mania, bipolar disorder, anxiety disorder, and apathy might occur post-stroke, although their prevalence is considerably lower. However, there are differences in the onset of MDD among mood disorders. Some mood disorders develop gradually and can persist for a lifetime, potentially culminating in suicide. In contrast, PSD has a rapid onset because of the severe disruption of neural pathways essential for mood behavior caused by the lesion. However, PSD might also spontaneously resolve several months after a stroke, though it is associated with higher mortality. This review also provides a brief overview of the treatments currently available in medical practice. • The interplay between genes and the environment in the development of mood disorders • The influence of immune, hormonal, and epigenetic environment in the development of affective disorders. • Similarities and differences between molecular mechanisms underlying MDD and PSD • The treatments currently available in medical practice [ABSTRACT FROM AUTHOR]

Despite the critical role of self-disturbance in psychiatric diagnosis and treatment, its diverse behavioral manifestations remain poorly understood. This investigation aimed to elucidate unique patterns of self-referential processing in affective disorders and first-episode schizophrenia. A total of 156 participants (41 first-episode schizophrenia [SZ], 33 bipolar disorder [BD], 44 major depressive disorder [MDD], and 38 healthy controls [HC]) engaged in a self-referential effect (SRE) task, assessing trait adjectives for self-descriptiveness, applicability to mother, or others, followed by an unexpected recognition test. All groups displayed preferential self- and mother-referential processing with no significant differences in recognition scores. However, MDD patients showed significantly enhanced self-referential recognition scores and increased bias compared to HC, first-episode SZ, and BD. The present study provides empirical evidence for increased self-focus in MDD and demonstrates that first-episode SZ and BD patients maintain intact self-referential processing abilities. These findings refine our understanding of self-referential processing impairments across psychiatric conditions, suggesting that it could serve as a supplementary measure for assessing treatment response in first-episode SZ and potentially function as a discriminative diagnostic criterion between MDD and BD. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to outline the picture of the sexual functions of male patients with affective disorders as an important part of their lives. Methods: The sample consisted of 57 male patients diagnosed with mood disorders in remission. They were interviewed for demographic and clinical data, asked to fill in number of self-descriptive questionnaires’ Sexual Function of Man (SFM/K), the Montgomery-Åsberg Depression Scale (MADRS) and Young Mania Scale (YMRS), and the Alcohol Use Disorders Identification Test (AUDIT). Results: Lower levels of sexual functioning were experienced by patients who had suffered from affective disorder for a longer time, and who had a diagnosis of recurrent depressive disorder (F33), in comparison with patients with bipolar disorder (F31). The most common sexual dysfunction was premature ejaculation, while the rarest was erectile dysfunction. An occurrence of any sexual disorder at least once in the past was reported by 66% of all patients. Participants did not have problems with alcohol usage. Conclusions: A worse quality of sexual functioning was associated with a longer history of affective disorder. Sexual dysfunction can be affected by even the most minor depressive and manic-depressive components. The tools used excluded non-heterosexual patients. Further research based on bigger samples is required. [ABSTRACT FROM AUTHOR]

Background: Persistent cognitive impairment is frequent across bipolar disorder (BD) and major depressive disorder (MDD), highlighting an urgent need for pro-cognitive treatments. Aim: This study investigated effects of erythropoietin (EPO) on cognitive impairment and dorsal prefrontal cortex (dPFC) activity in affective disorders. Methods: In this randomized, double-blinded, placebo-controlled trial, cognitively impaired patients with remitted BD or MDD received 1 weekly recombinant human EPO (40,000 IU/mL) or saline infusion for a 12-week period. Assessments were conducted at baseline, after 2 weeks of treatment (week 3), immediately after treatment (week 13) and at 6-months follow-up. Participants underwent functional MRI during performance on a n-back working memory (WM) task at baseline and week 3, and for a subgroup 6 weeks post-treatment (week 18). The primary outcome was a cognitive composite score at week 13, whereas secondary outcomes comprised sustained attention and functioning. WM-related dPFC activity was a tertiary outcome. Results: Data were analysed for 101 of the 103 included patients (EPO, n = 58; saline, n = 43). There were no effects of EPO over saline on any cognitive or functional outcomes or on WM-related dPFC activity. Conclusions: The absence of treatment-related changes in cognition and neural activity was unexpected and contrasts with multiple previous preclinical and clinical studies. It is possible that the lack of effects resulted from a recent change in the manufacturing process for EPO. Nevertheless, the findings support the validity of dPFC target engagement as a biomarker model for pro-cognitive effects, according to which treatments that do not improve cognition should not modulate dPFC activity. Trial registrations: EudraCT no.: 2016–004023-24; ClinicalTrials.gov identifier: NCT03315897. [ABSTRACT FROM AUTHOR]

Adverse early life experiences can have remarkably enduring negative consequences on mental health, with numerous, varied psychiatric conditions sharing this developmental origin. Yet, the mechanisms linking adverse experiences to these conditions remain poorly understood. Here, we draw on a principled model of interval timing to propose that statistically optimal adaptation of temporal representations to an unpredictable early life environment can produce key characteristics of anhedonia, a transdiagnostic symptom associated with affective disorders like depression and anxiety. The core observation is that early temporal unpredictability produces broader, more imprecise temporal expectations. As a result, reward anticipation is diminished, and associative learning is slowed. When agents with such representations are later introduced to more stable environments, they demonstrate a negativity bias, responding more to the omission of reward than its receipt. Increased encoding of negative events has been proposed to contribute to disorders with anhedonia as a symptom. We then examined how unpredictability interacts with another form of adversity, low reward availability. We found that unpredictability's effect was most strongly felt in richer environments, potentially leading to categorically different phenotypic expressions. In sum, our formalization suggests a single mechanism can help to link early life adversity to a range of behaviors associated with anhedonia, and offers novel insights into the interactive impacts of multiple adversities.

Abstract Humans can decode emotional states from the body odors of the conspecifics and this type of emotional communication is particularly relevant in conditions in which social interactions are impaired, as in depression and social anxiety. The present study aimed to explore how body odors collected in happiness and fearful conditions modulate the subjective ratings, the psychophysiological response and the neural processing of neutral faces in individuals with depressive symptoms, social anxiety symptoms, and healthy controls (N = 22 per group). To this aim, electrocardiogram (ECG) and HD-EEG were recorded continuously. Heart Rate Variability (HRV) was extracted from the ECG as a measure of vagal tone, event-related potentials (ERPs) and event-related spectral perturbations (ERPSs) were extracted from the EEG. The results revealed that the HRV increased during the fear and happiness body odors conditions compared to clean air, but no group differences emerged. For ERPs data, repeated measure ANOVA did not show any significant effects. However, the ERPSs analyses revealed a late increase in delta power and a reduced beta power both at an early and a late stage of stimulus processing in response to the neutral faces presented with the emotional body odors, regardless of the presence of depressive or social anxiety symptoms. The current research offers new insights, demonstrating that emotional chemosignals serve as potent environmental cues. This represents a substantial advancement in comprehending the impact of emotional chemosignals in both individuals with and without affective disorders.

Objectives Cognitive and metacognitive deficits depict important factors in depression, but the relationship between these concepts remains to be elucidated. The present study investigated the difference between patients with depression and controls in metacognitive judgements regarding the domain of attention. Furthermore, the associations between different metacognitive abilities, depressiveness and confidence were investigated, as well as in how far the derived correlates would predict depression. Methods Thirty patients with a major depressive episode and 30 healthy participants were enrolled in the current study. Attention and executive functioning ability were assessed including metacognitive judgements of performance and confidence with regard to the test performance in the Stroop test. To examine further aspects related to (meta-)cognitive abilities, decentering skills, aspects of self-conscious attention, self-assessed intelligence and metacognitive beliefs, judgements and monitoring tendencies were assessed. Results Albeit groups' metacognitive judgements of performance did not differ, patients indicated to be significantly less confident in their judgements. Depressive patients showed less decentering abilities compared to healthy participants and there was a significant association between decentering and confidence ratings. Moreover, depressiveness was associated with dysfunctional self-consciousness and low cognitive confidence. Finally, lower decentering skills and higher dysfunctional self-attention were the best predictors for depressiveness. Conclusions Results favor the assumption that patients' metacognitive abilities regarding the domain of attention are not generally deficient. Rather, the lower confidence in their judgements and dysfunctional (meta-)cognitive abilities, like decentering, metacognitive beliefs and aspects of self-conscious attention and intelligence, seem to mirror the patients' impairments., Author(s): Barbara Drueke [sup.1] , Siegfried Gauggel [sup.1] , Lorenz Weise [sup.1] , Thomas Forkmann [sup.2] , Verena Mainz [sup.1] Author Affiliations: (1) grid.412301.5, 0000 0000 8653 1507, Institute of [...]

The aim of this study was to assess brain functional alterations in BN patients with affective disorders and their association with maladaptive eating behaviors. A total of 42 BN patients with affective disorders (anxiety and depression) and 47 healthy controls (HCs) were enrolled in this study. The resting-state fMRI data were analyzed for functional changes as indicated by regional homogeneity based on Kendall's coefficient of concordance (KCC-ReHo) and seed-based functional connectivity (FC). A principal component analysis (PCA) model was used to identify the commonalities within the behavioral questionnaires from the BN group. Patients in the BN group showed decreased ReHo in the bilateral middle frontal gyrus (MFG) and right supramarginal gyrus (SMG). Additionally, the BN group showed increased FC between the left MFG and the right inferior temporal gyrus (ITG); decreased FC between the right MFG and the bilateral insula and the left middle temporal gyrus (MTG); and decreased FC between the right SMG and the left superior temporal gyrus (STG) and right inferior frontal gyrus (IFG). In the FC-behavior association analysis, the second principal component (PC2) was negatively correlated with FC between the left MFG and the right ITG. Based on a brain functional analysis (ReHo and FC), this study revealed significant aberrant changes in the frontal-temporal regions of BN patients with affective disorders. These regions, which serve as fronto-temporal circuitry, are associated with restraint and emotional eating behaviors. Our findings shed new light on the neural mechanisms underlying the condition. • Anxiety and depression are the most common affective comorbidities in patients with bulimia nervosa • Little is known about the neuropathic mechanisms underlying comorbid affective disorders in bulimia nervosa • Potential disturbance in the recruitment of fronto-temporal circuitry in BN patients with comorbid affective disorders • The brain functional changes were correlated with disordered eating behaviors • Interplay between BN-specific and comorbid psychopathological effects may contribute to specific brain functional activity [ABSTRACT FROM AUTHOR]

To explore the phenomenon of non-attendance for psychotherapy in psychiatric outpatient care for patients with affective disorders. Ten patients, seven women and three men, aged 25–51 years, agreed to participate in the study. The participants were recruited from a psychiatric outpatient clinic for patients with affective disorders at Sahlgrenska University Hospital, Sweden. A semi-structured interview guide was used during the interviews, which were audiotaped, transcribed and analyzed using content analysis. All informants expressed concern that they had been absent from booked appointments. The main reason given was that the mental illness that caused the need for treatment also caused the absence. They expressed ambiguity about the goals and method of treatment and showed ambivalence regarding the possibility of being helped and achieving change. The participants also highlighted shortcomings in communication with the psychologist regarding their non-attendance. Four themes were generated: A vicious circle, Processes without direction, Ambivalence and Inadequate communication. The study shows that missed appointments have a negative effect on the treatment process. If the patient and the psychologist jointly decide to start psychotherapy, it is thus important that the psychologist promptly addresses the problem of missed appointments and takes a professional responsibility for limiting the risk of another failed attempt at psychotherapy. In some cases, it is necessary to consider whether psychotherapy is an appropriate form of treatment or not. The study shows the importance of a careful assessment phase, where questions about motivation, goals and previous experiences of missed appointments are examined. The informants were not able to raise the issue of missed appointments in a larger perspective; their but focus was rather on the current symptom burden. It is therefore the responsibility of the psychologist to raise the issue and maintain a dialogue about goals, direction and evaluation of the psychotherapy. The psychologist bears a professional responsibility to limit the risk of another failed attempt to provide psychotherapy. [ABSTRACT FROM AUTHOR]

The closure of schools, social hubs, and extracurricular activities due to lockdown measures imposed to curb the spread of SARS‐CoV‐2, has increased the risk factors for students' mental health. This cross‐sectional study, conducted from March 2020 to March 2021, aimed to estimate socio‐emotional, cognitive, and affective disorders and substance use in a sample of first‐ and second‐grade high school students in Northern Italy. This study compared data from 284 Italian students' self‐perceptions along with the perceptions of their parents and teachers through a web‐based survey. The differences in the perceptions of the three groups (students, parents, and teachers) were analyzed using an analysis of variance test, applying a Bonferroni correction. The χ2 test was used to assess the comparison between students, parents, and teachers in the substance use questions. The results showed statistically significant differences among the three groups. The most important outcomes were sociality, scholastic performance, extracurricular activity, emotional symptoms, affective disorders (depression and anxiety), and substance use. These findings could be interesting for the promotion of mental health and prevention of psychopathological risks in students. Practitioner Points: The closure of schools due to COVID‐19 lockdown measures has increased the risk factors for students' mental health.There is significant differences among the perceptions of students, parents, and teachers, especially concerning sociality, scholastic performance, extracurricular activity, emotional symptoms, affective disorders, and substance use.Training initiatives should be developed to improve teachers' perceptions of their students and parents' perceptions of their children for the promotion of well‐being and the prevention of early school dropout, self‐addiction, and psychopathological risks in young people. [ABSTRACT FROM AUTHOR]

Introduction: Affective disorders and carbohydrate metabolism disorders are problems of increasing importance in the population of children, teenagers and young adults. Much evidence indicates that these problems may co-occur with increased frequency and have much more serious consequences than on their own. Material and methods: Inclusion criteria were established for the review of studies and comprised participants under 25 years of age diagnosed with carbohydrate metabolism disorders, psychometric measurements of symptoms of affective disorders and self-aggressive tendencies. Review of the MEDLINE database was conducted. Discussion: The results of 10 out of 12 studies included in the review indicated significantly increased risk of depression and suicidal tendencies in patients with diabetes. In the described publications, the frequency of affective disorders in a specific population ranged from 1.2% to 47.6% and up to 60.4% for unspecified affective disorder, sub-threshold and fully symptomatic, and the HR ranged from 1.33 to 2.0 for fully symptomatic affective disorders and up to 6.49 for unspecified affective disorder, sub-threshold and fully symptomatic. Descriptions of the incidence of self-injurious behavior and suicidal tendencies estimate them in the range from 0.8% to 35.7%, and in the studies comparing to a control group, the risk for a suicide attempt was between HR: 1.7 and 3.25. Conclusions: The occurrence of affective disorders in children and young adults is significantly more frequent in patients with diabetes compared to patients without carbohydrate metabolism disorders. [ABSTRACT FROM AUTHOR]

Adverse early life experiences can have remarkably enduring negative consequences on mental health, with numerous, varied psychiatric conditions sharing this developmental origin. Yet, the mechanisms linking adverse experiences to these conditions remain poorly understood. Here, we draw on a principled model of interval timing to propose that statistically optimal adaptation of temporal representations to an unpredictable early life environment can produce key characteristics of anhedonia, a transdiagnostic symptom associated with affective disorders like depression and anxiety. The core observation is that early temporal unpredictability produces broader, more imprecise temporal expectations. As a result, reward anticipation is diminished, and associative learning is slowed. When agents with such representations are later introduced to more stable environments, they demonstrate a negativity bias, responding more to the omission of reward than its receipt. Increased encoding of negative events has been proposed to contribute to disorders with anhedonia as a symptom. We then examined how unpredictability interacts with another form of adversity, low reward availability. We found that unpredictability's effect was most strongly felt in richer environments, potentially leading to categorically different phenotypic expressions. In sum, our formalization suggests a single mechanism can help to link early life adversity to a range of behaviors associated with anhedonia, and offers novel insights into the interactive impacts of multiple adversities. Harhen and Bornstein extend a reinforcement learning model of interval timing to demonstrate that statistically rational adaptation to an unpredictable early life environment can give rise to a variety of presumed maladaptive behaviors that define anhedonia. They then use this model to test whether distinct forms of early life adversity exert unique impacts on learning. They find that these forms of adversity interact non‐additively, running counter to a core assumption of the widely used 'cumulative risk' approach of measuring adversity. [ABSTRACT FROM AUTHOR]

Abstract Background Motor alterations and lowered physical activity are common in affective disorders. Previous research has indicated a link between depressive symptoms and declining muscle strength primarily focusing on the elderly but not younger individuals. Thus, we aimed to evaluate the relationship between mood and muscle strength in a sample of N = 73 young to middle-aged hospitalized patients (18–49 years, mean age 30.7 years) diagnosed with major depressive, bipolar and schizoaffective disorder, with a focus on moderating effects of psychopharmacotherapy. The study was carried out as a prospective observational study at a German psychiatric university hospital between September 2021 and March 2022. Methods Employing a standardized strength circuit consisting of computerized strength training devices, we measured the maximal muscle strength (Fmax) using three repetitions maximum across four muscle regions (abdomen, arm, back, leg) at three time points (t1-t3) over four weeks accompanied by psychometric testing (MADRS, BPRS, YRMS) and blood lipid profiling in a clinical setting. For analysis of psychopharmacotherapy, medication was split into activating (AM) and inhibiting (IM) medication and dosages were normalized by the respective WHO defined daily dose. Results While we observed a significant decrease of the MADRS score and increase of the relative total Fmax (rTFmax) in the first two weeks (t1-t2) but not later (both p

Abstract Despite the critical role of self-disturbance in psychiatric diagnosis and treatment, its diverse behavioral manifestations remain poorly understood. This investigation aimed to elucidate unique patterns of self-referential processing in affective disorders and first-episode schizophrenia. A total of 156 participants (41 first-episode schizophrenia [SZ], 33 bipolar disorder [BD], 44 major depressive disorder [MDD], and 38 healthy controls [HC]) engaged in a self-referential effect (SRE) task, assessing trait adjectives for self-descriptiveness, applicability to mother, or others, followed by an unexpected recognition test. All groups displayed preferential self- and mother-referential processing with no significant differences in recognition scores. However, MDD patients showed significantly enhanced self-referential recognition scores and increased bias compared to HC, first-episode SZ, and BD. The present study provides empirical evidence for increased self-focus in MDD and demonstrates that first-episode SZ and BD patients maintain intact self-referential processing abilities. These findings refine our understanding of self-referential processing impairments across psychiatric conditions, suggesting that it could serve as a supplementary measure for assessing treatment response in first-episode SZ and potentially function as a discriminative diagnostic criterion between MDD and BD.

Abstract Background Severe mental disorders, including affective disorders (AD), are associated with high rates of physical illnesses that lead to premature patient death. Excess somatic comorbidity may be partially explained by lifestyle factors. This study aimed to investigate the health behaviours (HBs) of patients with AD in comparison to the HBs of patients with type 2 diabetes (T2D) and healthy controls (HCs) and to examine associations among HBs and sociodemographic and clinical factors, subjective quality of life and health status, and health locus of control. Methods The sample consisted of 108 patients with AD, including 60 with bipolar disorder (BP) and 48 with unipolar disorder (UAD). Analyses included comparisons with a subgroup of AD individuals, patients with T2D and HCs matched in age and sex. The Health Behaviour Inventory was used to evaluate the overall levels of HBs and 4 HB categories. To identify independent determinants of health behaviours, a multivariate linear regression analysis was performed with factors identified as significant in bivariate analyses. Results Most AD patients had a low level of HBs (40%), followed by moderate (35%) and high levels (25%), and there were no significant differences in HBs between the BP and UAD groups. Compared with the T2D and HC groups, the AD group had a significantly lower level of overall HBs and lower levels of HBs in one of the categories. Independent predictors of overall HBs were quality of life (β = 0.28, p

This review aims to explore the intricate relationship among epigenetic mechanisms, stress, and affective disorders, focusing on how early life experiences and coping mechanisms contribute to susceptibility to mood disorders. Epigenetic factors play a crucial role in regulating gene expression without altering the DNA (deoxyribonucleic acid) sequence, and recent research has revealed associations between epigenetic changes and maladaptive responses to stress or psychiatric disorders. A scoping review of 33 studies employing the PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Statement) guidelines investigates the role of stress-induced epigenetic mechanisms and coping strategies in affective disorder occurrence, development, and progression. The analysis encompasses various stress factors, including childhood trauma, work-related stress, and dietary deficiencies, alongside epigenetic changes, such as DNA methylation and altered gene expression. Findings indicate that specific stress-related genes frequently exhibit epigenetic changes associated with affective disorders. Moreover, the review examines coping mechanisms in patients with bipolar disorder and major depressive disorder, revealing mixed associations between coping strategies and symptom severity. While active coping is correlated with better outcomes, emotion-focused coping may exacerbate depressive or manic episodes. Overall, this review underscores the complex interplay among genetic predisposition, environmental stressors, coping mechanisms, and affective disorders. Understanding these interactions is essential for developing targeted interventions and personalized treatment strategies for individuals with mood disorders. However, further research is needed to elucidate specific genomic loci involved in affective disorders and the clinical implications of coping strategies in therapeutic settings.

Background: Lipids influence brain function and mental health. Understanding the role of apolipoproteins in affective disorders could provide valuable insights and potentially pave the way for novel therapeutic approaches. Methods: We examined the apolipoprotein E genotype and ApoE-levels, lipid profiles, and the correlation with cognition in 204 monozygotic (MZ) twins with unipolar or bipolar disorder in remission or partial remission (affected, AT), their unaffected co-twins (high-risk, HR), and twins with no personal or family history of affective disorder (low-risk, LR). Results: The APOE genotype was not associated with affective disorders. No significant group differences in ApoE levels were found between the three risk groups. Post hoc analysis group-wise comparisons showed higher ApoE levels in the AT than HR twins and in the concordant AT twin pairs relative to the discordant twin pairs. Within the discordant twin pairs, higher ApoE levels were observed in the affected twins (AT = 39.4 mg/L vs. HR = 36.8 mg/L, p = 0.037). Limitations: The present study could benefit from a larger sample size. We did not assess dietary habits. Conclusions: The results did not support our main hypothesis. However, exploratory post hoc analysis suggests a role for plasma ApoE and triglycerides in affective disorders. Future research is needed.