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Complex post-traumatic stress disorder (cPTSD) is a clinical condition that features not only PTSD symptoms, but also disturbances in self-organization. Patients with cPTSD have a higher incidence of psychiatric comorbidities, including suicidality. A key construct tightly related to suicidality is hopelessness, described as a feeling of despair, with a state of mind giving low or negative expectancies regarding one's future. Since there is a paucity of studies investigating the link between cPTSD and hopelessness as a risk factor for suicidality, the aim of this study was to examine the role of post-traumatic symptomatology as the primary driver of suicidality, as measured by hopelessness. 211 patients were enrolled and divided into two groups: PTSD (143 patients) and cPTSD (78 patients). A set of standardized measures was administered to study post-traumatic symptomatology, depression, and hopelessness. The results showed that compared to PTSD, cPTSD patients experienced more severe symptoms in all clinical outcomes (p < 0.001). The mediation analysis revealed a significant positive association between post-traumatic symptomatology and hopelessness in the cPTSD group, which was not significant in the PTSD group. Among PTSD patients, depression mediated 43.37% of the impact of post-traumatic symptomatology on suicidal ideation. Our results contribute to a better understanding of complex post-traumatic symptomatology, further highlighting its role in the pathogenesis of suicidality. Hence, these findings have important clinical implications, suggesting that targeted, trauma-focused interventions might effectively prevent hopelessness and therefore suicide risk in patients with cPTSD. • Patients with cPTSD have a higher prevalence of psychiatric comorbidities. • Hopelessness is a widely established predictor of suicidality, especially in PTSD. • Our study shows cPTSD to have a higher suicide risk compared to PTSD. • In cPTSD, hopelessness is directly associated with post-traumatic symptomatology. • Trauma-focused interventions might prevent suicidality in patients with cPTSD. [ABSTRACT FROM AUTHOR]

A large body of evidence has established a tight relation between traumatic experiences (TEs) and psychotic-like experiences (PLEs). Nevertheless, more comprehensive models involving multiple interactions of serial or parallel mediations and moderations still need to be elucidated. Among the many potential mediators or moderators, insecure attachment and resilience play a key role in the association of stress with PLEs. Hence, we aim to explore the complex pathways that lead from different types of TEs to PLEs, involving attachment and resilience modeled as mediators or moderators. One thousand ten high school students completed the International Trauma Exposure Measure (ITEM), the 11-item Resilience Scale for Adults (RSA-11), the 16-item Prodromal Questionnaire (iPQ-16), and the Relationship Questionnaire (RQ). A path analysis was conducted to assess mediation and moderation. The final model showed that the impact of childhood TEs on PLEs was mediated by a pathway through anxious-insecure attachment styles (i.e., fearful and preoccupied, respectively, 8.75 % and 8.53 % of the total effect) and personal resilience resources. Conversely, the avoidant-insecure attachment was associated with lower interpersonal resilience (b = 0.14 [0.08, 0.20]), which in turn moderated the impact of recent TEs on PLEs (interaction term b = 0.34 [0.21, 0.47]). Our model examines a complex model that includes factors buffering the effect of traumatic experiences on PLEs. Our results highlight the importance of insecure-anxious attachment to personal resilience resources and of insecure-avoidant attachment to interpersonal resilience as potential targets for clinical practice. [Display omitted] [ABSTRACT FROM AUTHOR]

Introduction: Adjustment disorder (AjD) is a is a maladaptive emotional or behavioural reaction to a stressful event or change in a person's life. Compared to other previously validated tools, the International Adjustment Disorder Questionnaire (IADQ) stands out as one of the most reliable and handy one for AjD. Since no homologous instrument exists now, in this study, we aimed to validate an Italian version of the IADQ. Methods: Twenty‐one thousand two hundred and six subjects (80.4% females) during the initial stages of the SARS‐CoV‐2 pandemic were recruited. We conducted a confirmatory factor analysis (CFA), testing two latent models, a monofactorial and a bifactorial one. Concurrent validity by correlating the total and the two factors' scores with measures of depression, anxiety and post‐traumatic stress was then estimated. We finally estimated the rates of AjD among the population, and a binary logistic regression was conducted to analyse the predictors of such disorder. Results: CFA showed a bifactorial validity, with both excellent incremental and comparative fit indices. The IADQ scores correlated strongly with symptoms of depression, anxiety and stress. In the Italian sample, the prevalence of probable AjD was 8.23%. Female gender, being engaged, widowed and having COVID‐19‐related stressors resulted as significant independent risk factors for AjD. Conclusions: IADQ is an easy‐to‐use, brief and psychometrically sound self‐report measure for AjD. Thus, it may be considered a reliable tool for both research and clinical settings. To the best of our knowledge, our study reported for the first time the prevalence of AjD during COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Peter Abelard (1079–1142) is still considered one of the giants of philosophy, theology, and psychology, and the unsurpassed master of dialectical debate. Born in Le Pallet, near Nantes, Abelard became an academic and wandering cleric of great fame, founder of several schools that attracted students from all countries, arousing the admiration of his contemporaries and the profound envy of his colleagues. Around 1115, Abelard became master of the school of the Cathedral of Notre‐Dame. Shortly after, the canon Fulbert asked him to take his niece, the equally famous and highly cultured Héloïse d'Argenteuil (1092–1164), as a pupil. Thus a relationship began, celebrated for centuries to come, characterized by burning sexual and intellectual passion, by the famous correspondence, which will be the archetype of sentimental education and the template of romantic love letters, bythe birth of a son and consequent marriage, and by the cowardly revenge of Fulbert, who, together with a band of servants, mutilated "those parts of my body with which I had done what was the cause of their pain," as Abelard wrote. While this unclear self‐description has suggested to contemporaries and to posterity that Abelard was castrated, we aim to question this belief by analyzing in‐depth this historical‐andrological clinical case to understand if there is any evidence that could suggest that Abelard was instead the victim of an even more brutal punishment: penectomy. Signs and symptoms gleaned from the personal writings and historical perspectives of Abelard and his time are used here to provide a possible answer to a thousand‐year‐old question: what makes a man ... a man? [ABSTRACT FROM AUTHOR]

Introduction: Income inequality, a pivotal determinant of general and mental health, operates through intricate mechanisms at various geographical scales. While established at country or region levels, the impact of lower-level (municipal or neighborhood) inequality remains inconsistent. This study explores the influence of regional- and municipal-level income inequality on individual psychological distress during the COVID-19 pandemic in Italy, employing a multilevel data analysis. Materials and methods: In a post hoc analysis of data from the first wave of the pandemic (March to April 2020), three hierarchical levels were considered: individual participants, municipalities, and regions. Depressive and anxiety symptoms were measured using the PHQ-9 and GAD-7 scales, while the Gini coefficient gauged income inequality at municipal and regional levels. The analysis incorporated demographic variables as potential confounders. Results: The study encompassed 21 regions, 3,900 municipalities, and 21,477 subjects. Income inequality at both regional and municipal levels exhibited associations with distress scores, suggesting independent effects. Notably, higher distress scores were identified in southern regions with elevated inequality, despite a more substantial COVID-19 impact in the north. Discussion: Findings contribute to existing literature by emphasizing the independent impact of lower-level (municipal) and higher-level (regional) income inequality on population psychopathology. The study supports theories suggesting diverse pathways through which inequality at different levels influences health, such as potential associations with healthcare system dysfunction at the regional level and welfare dysfunction at the municipal level. The observed north-south gradient in distress scores highlights the need for psychosocial interventions to alleviate income inequality, especially in historically disadvantaged southern regions. Future research should explore the nuanced interplay between income inequality and various ecological variables to provide a comprehensive understanding of its health impact. [ABSTRACT FROM AUTHOR]

Adolescence is marked by increased susceptibility to trauma-related disorders and substance and behavioral addictions (SBAs). Complex post-traumatic stress disorder (cPTSD) is a newly recognized condition characterized by specific features in addition to those of classic PTSD and is often associated with SBAs. This study adopted a psychopathology network approach to explore which post-traumatic symptoms were explicitly associated with SBAs in a sample of late adolescents. We hypothesized that cPTSD symptoms would be particularly relevant to explain the comorbidity between PTSD and SBAs. A sample of 1010 late adolescents provided measures of post-traumatic symptomatology, cannabis and alcohol abuse, problematic internet use, and gambling. We estimated the network structure of PTSD/cPTSD symptoms and SBAs and assessed their bridge centrality indices. The results suggest that the SBAs had the highest bridge connections with the cPTSD dimension of affective dysregulation, which reported the highest centrality indices. Problematic internet use was the most central cluster of addictive behaviors among SBAs. Therefore, adolescents struggling with affective dysregulation may look for alternative ways to suppress their intense emotions, and SBAs may be sought as a maladaptive coping mechanism. These findings should prompt further research on affective dysregulation as a therapeutic target among adolescents. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Discussion and conclusion Anejaculation represents significant psychological distress and sexual and reproductive challenges among male individuals and couples. Effective fertility management options are available to address the reproductive challenges associated with anejaculation. However, there is a lack of methods to reverse the condition itself.This study aims to assess the effectiveness and safety of repetitive transcranial magnetic stimulation (rTMS) in patients suffering from anejaculation.A total of 94 patients with anejaculation individuals were randomly assigned to receive high‐frequency (HF) stimulation on the left dorsolateral prefrontal cortex (DLPFC), low‐frequency (LF) stimulation on the right DLPFC, and sham stimulation for 4 weeks, with daily sessions of stimulation occurring on five consecutive weekdays each week.After 4 weeks of rTMS treatment, the patients in both the HF and LF groups exhibited a similar reduction in their male sexual health questionnaire for ejaculatory dysfunction bother/satisfaction score, Hamilton Anxiety Scale score, Hamilton Depression Scale score, and Pittsburgh Sleep Quality Inventory score, which were statistically significant compared with sham treatment. Additionally, there were no significant differences observed in erectile function and cognitive function across the three groups. However, there were notable disparities in the cure rates between HF‐ and LF‐group patients (16.1% vs. 54.8%, p = 0.001). Additionally, it is worth noting that only two HF group patients and one LF group patient experienced spontaneously resolving minor adverse effects during the treatment process. At the 8‐week follow‐up, among patients who initially responded to the treatment, only one from the HF group experienced a relapse.The findings of this study demonstrate that rTMS represents a secure and efficacious remedy for anejaculation patients. [ABSTRACT FROM AUTHOR]

Background: Premature ejaculation (PE) is the most prevalent sexual dysfunction among men. Eejaculation involves a complex nervous mechanism in which the ejaculatory centers play a key role in modulating sperm emission. Although treatment possibilities span from psychotherapy to pharmacological approaches, results show inconsistent efficacy. In this context, the emergence of repetitive transcranial magnetic stimulation (rTMS) as a non‐invasive neuromodulatory approach represents a compelling avenue for potential therapeutic exploration. Objective: To investigate whether high‐frequency transcranial magnetic stimulation can modulate the ejaculatory behavior of rats with rapid ejaculation by altering neurotransmitter levels and neuroplasticity in the hippocampus. Methods: Rats have been screened for rapid ejaculation by observing behavioral indices of mating, and subsequently divided into two groups. The intervention group was administered with a 10 Hz rTMS stimulation, whereas the control group received a sham procedure. Upon the delivery of rTMS, we investigated ejaculation latency (EL), the hippocampal 5‐hydroxytryptamine (5‐HT) concentration, brain‐derived neurotrophic factor (BDNF), synaptophysin (SYN), and postsynaptic density protein 95 (PSD95) expressions, as well as BDNF‐receptor tyrosine kinase receptor B (TrkB) pathway upregulation. Results: After 14 days, EL was increased in the intervention group compared with the control group. 5‐HT concentration in the hippocampal region was increased, and high‐frequency rTMS activated the BDNF and TrkB pathways, including phosphorylation of cAMP response element‐binding protein (CREB), and upregulated the transcription and protein expression of SYN, and PSD95. Conclusion: RTMS upregulates BDNF, SYN, and PSD95 expression through activation of the BDNF–TrkB pathway and increases brain 5‐hydroxytryptamine thereby regulating neuroplasticity and improving ejaculation. [ABSTRACT FROM AUTHOR]

Objectives: To detect seed-based functional connectivity (FC) between various cortical sub-regions and the thalamus in lifelong premature ejaculation (LPE) patients and explore whether specific thalamocortical networks are significantly altered in PE patients compared to healthy controls (HCs) METHODS: Fifty non-medicated LPE patients and 40 age-matched HCs underwent a resting-state functional MRI. FC was adopted to identify specific thalamocortical connectivity between the thalamus and 6 cortical regions of interest (i.e., the motor cortex/supplementary motor, the prefrontal cortex, the temporal lobe, the posterior parietal cortex, the somatosensory cortex and the occipital lobe). In LPE patients, regression analysis was subsequently conducted to assess relationships of thalamocortical connectivity with the Premature Ejaculation Diagnostic Tool (PEDT) score and the Intravaginal Ejaculatory Latency Time (IELT).Results: LPE patients had significantly decreased FC between the motor cortex and bilateral ventral thalamus, between the prefrontal cortex and left dorsomedial thalamus, as well as between the temporal cortex and bilateral ventromedial thalamus. In LPE patients, PEDT score was significantly positively associated with the thalamus-posterior parietal cortex FC, and negatively associated with the thalamus-temporal cortex FC, while IELT was positively associated with the thalamus-temporal cortex and thalamus-motor cortex FC.Conclusion: These results enrich the imaging evidence for the understanding of the neurobiological mechanisms and/or consequences of LPE. [ABSTRACT FROM AUTHOR]

Traumatic experiences (TEs) are a risk factor for behavioral and substance addictions (SBAs). However, the role of post-traumatic stress disorder (PTSD) and complex PTSD (cPTSD) deserves further elucidation. The present study assesses the association between different types of TEs on cannabis, alcohol, gambling, and problematic internet use in late adolescents. Furthermore, this study aims at evaluating the role of PTSD and cPTSD as potential mediators. An observational cross-sectional study was conducted on one thousand ten late adolescents (510 males, 498 females; age: mean = 18.7, SD = 0.65). Data regarding intentional (iTEs) and unintentional TEs (uTEs), cannabis, alcohol, gambling and problematic use of the internet (PIU), PTSD, and cPTSD were collected. Association between TEs, SBAs, and PTSD/cPTSD symptoms were explored by means of logistic regressions. Mediation was assessed using a path analysis. uTEs were associated with cannabis use (OR = 1.34 [1.13,1.59]) and alcohol use (OR = 1.21 [1.10,1.35]), iTEs were associated with cannabis use (OR = 1.15 [1.06,1.25]), alcohol use (OR = 1.08 [1.02,1.13]), and PIU (OR = 1.17 [1.10,1.24]). PTSD was associated with alcohol use (OR = 1.59 [1.03,2.46]) and PIU (OR = 1.92 [1.18,3.13]). cPTSD was associated with cannabis use (OR = 3.54 [1.56,8.04]) and PIU (OR = 5.13 [2.71,9.70]). cPTSD mediated 58.75% of the total effect of iTEs on cannabis. Regarding PIU, PTSD mediated 68.18% of the effect of uTEs; the effect of iTEs on PIU was mediated by 65.5% via cPTSD and 34.45% via PTSD. cPTSD and SBAs show a complex pattern of association. A thorough assessment of stress-related conditions, including cPTSD, is of pivotal importance in treating SBAs. [ABSTRACT FROM AUTHOR]

Objective: A PHQ‐9 score ≥ 15, represented as PHQ‐9+, indicates major depressive disorder (MDD). On using PHQ‐9, the psychological burden of several patients with lifelong premature ejaculation (LPE) gets aggravated, which may lead to LPE development. We aim to construct a nomogram for predicting the individual risk of PHQ‐9+ in patients with LPE and discerning those with low risks, who should avoid the PHQ‐9. Methods: The nomogram was constructed by analysing data of 802 patients from Xijing Hospital and Northwest Women's & Children's Hospital. The LASSO and multivariable logistic regressions were used to identify independent predictors of PHQ‐9+, used for developing the nomogram. The discrimination, calibration and clinical usefulness of the nomogram were assessed in the derivation cohort and an independent validation cohort, which was composed of 505 prospectively enrolled patients from Daxing Hospital and Xijing Hospital. Results: The duration of PE, IELT, a history of PE exacerbation, IIEF‐5 score, urinary frequency and physical pain score were identified as independent predictors. The nomogram showed excellent calibration, discrimination and clinical usefulness in the derivation and validation cohorts, with a predictive accuracy of 0.781 and 0.763, respectively. Based on this nomogram, patients were divided into not recommended, recommended and strongly recommended PHQ‐9 filling groups, with PHQ‐9+ rates of 3.5%, 9.3% and 30.7%, respectively. Conclusion: A nomogram to discern LPE patients with low risks of PHQ‐9+ was established. This tool can increase the positivity of MDD screening and may improve the therapeutic outcomes of those in the low‐risk group. [ABSTRACT FROM AUTHOR]

To develop a comprehensive next-generation sequencing panel assay that screens genes known to cause developmental eye disorders and inherited eye disease and to evaluate its diagnostic yield in a pediatric cohort with malformations of the globe, anterior segment anomalies, childhood glaucoma, or a combination thereof. Evaluation of diagnostic test. Two hundred seventy-seven children, 0 to 16 years of age, diagnosed with nonsyndromic or syndromic developmental eye defects without a genetic diagnosis. We developed a new oculome panel using a custom-designed Agilent SureSelect QXT target capture method (Agilent Technologies, Santa Clara, CA) to capture and perform parallel high-throughput sequencing analysis of 429 genes associated with eye disorders. Bidirectional Sanger sequencing confirmed suspected pathogenic variants. Collated clinical details and oculome molecular genetic results. The oculome design covers 429 known eye disease genes; these are subdivided into 5 overlapping virtual subpanels for anterior segment developmental anomalies including glaucoma (ASDA; 59 genes), microphthalmia–anophthalmia–coloboma (MAC; 86 genes), congenital cataracts and lens-associated conditions (70 genes), retinal dystrophies (RET; 235 genes), and albinism (15 genes), as well as additional genes implicated in optic atrophy and complex strabismus (10 genes). Panel development and testing included analyzing 277 clinical samples and 3 positive control samples using Illumina sequencing platforms; more than 30× read depth was achieved for 99.5% of the targeted 1.77-Mb region. Bioinformatics analysis performed using a pipeline based on Freebayes and ExomeDepth to identify coding sequence and copy number variants, respectively, resulted in a definitive diagnosis in 68 of 277 samples, with variability in diagnostic yield between phenotypic subgroups: MAC, 8.2% (8 of 98 cases solved); ASDA, 24.8% (28 of 113 cases solved); other or syndromic, 37.5% (3 of 8 cases solved); RET, 42.8% (21 of 49 cases solved); and congenital cataracts and lens-associated conditions, 88.9% (8 of 9 cases solved). The oculome test diagnoses a comprehensive range of genetic conditions affecting the development of the eye, potentially replacing protracted and costly multidisciplinary assessments and allowing for faster targeted management. The oculome enabled molecular diagnosis of a significant number of cases in our sample cohort of varied ocular birth defects. [ABSTRACT FROM AUTHOR]

Determination of inorganic anions in waters of high salinity is one of the most difficult task in analytical chemistry. A simple column-switching method, based on an original chromatographic set-up, for the determination of nutrients (nitrate, nitrite and phosphate) in chloride rich aqueous matrices is presented. A pre-separation system (made of two in line pre-columns, Dionex AG9-HC 4 mm) connected to an analytical column (Dionex AS9-HC 4 mm) by a four way pneumatic valve, allows chloride to be eluted off into the waste and nutrients to be separated and detected by a conductimeter and/or a UV spectrophotometer. Neither chemical pre-treatment nor sample dilution are required; sample matrices presenting a large range of chloride concentrations can be investigated. Moreover by using this technology, automation for routine analysis, low analysis time and low costs can be achieved. LODs of 100, 300, 1000 μg/l for nitrate, nitrite and phosphate, respectively, have been obtained by spiking a synthetic sea water sample containing 20 000 mg/l of chloride and 3000 mg/l of sulphate. Analyte calibration curves of analytes are linear (r>0.99) in the range between the LODs and 60 mg/l. This method was applied to nutrients determination in sea water samples collected near a river outlet. [Copyright &y& Elsevier]

Irreversible photoreceptor cell death is a major cause of blindness in many retinal dystrophies. A better understanding of the molecular mechanisms underlying the progressive loss of photoreceptor cells remains therefore crucial. Abnormal expression of microRNAs (miRNAs) has been linked with the aetiology of a number of retinal dystrophies. However, their role during the degenerative process remains poorly understood. Loss of cone photoreceptors in the human macula has the greatest impact on sight as these cells provide high acuity vision. Using a Chrnb4-cre; Dicerflox/flox conditional knockout mouse (Dicer CKO) to delete Dicer1 from cone cells, we show that cone photoreceptor cells degenerate and die in the Dicer-deleted retina. Embryonic eye morphogenesis appeared normal in Dicer CKO mice. Cone photoreceptor abnormalities were apparent by 3 weeks of age, displaying either very short or absent outer segments. By 4 months 50% of cones were lost and cone function was impaired as assessed by electroretinography (ERG). RNAseq analysis of the Dicer CKO retina revealed altered expression of genes involved in the visual perception pathway. These data show that loss of Dicer1 leads to early-onset cone cell degeneration and suggest that Dicer1 is essential for cone photoreceptor survival and homeostasis. [ABSTRACT FROM AUTHOR]