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Aggression in the animal kingdom is a necessary component of life; however, certain forms of aggression, especially in humans, are pathological behaviors that are detrimental to society. Animal models have been used to study a number of factors, including brain morphology, neuropeptides, alcohol consumption, and early life circumstances, to unravel the mechanisms underlying aggression. These animal models have shown validity as experimental models. Moreover, recent studies using mouse, dog, hamster, and drosophila models have indicated that aggression may be affected by the “microbiota–gut–brain axis.” Disturbing the gut microbiota of pregnant animals increases aggression in their offspring. In addition, behavioral analyses using germ-free mice have shown that manipulating the intestinal microbiota during early development suppresses aggression. These studies suggest that treating the host gut microbiota during early development is critical. However, few clinical studies have investigated gut-microbiota-targeted treatments with aggression as a primary endpoint. This review aims to clarify the effects of gut microbiota on aggression and discusses the therapeutic potential of regulating human aggression by intervening in gut microbiota.

Autism Spectrum Disorder (ASD) has been linked with risk of suicide, and several cases of suicide attempts by adolescents with ASD have been reported. However, there is scant research on therapeutic approaches to prevent suicide re-attempts by children with ASD who have already attempted suicide. We report our experience of treating an 11-year-old girl with adjustment disorder comorbid with ASD who was transported to our hospital after sustaining injuries from the suicide leap. Initially, she was diagnosed with adjustment disorder brought on by poor interpersonal relationships at school, and, upon reviewing the patient’s personal history, her underlying ASD characteristics became apparent. To prevent a re-attempt, it was crucial to reduce her risk factors and enhance her protective factors. To reduce her risk factors, we manipulated the environmental factor that triggered the patient’s suicide attempt. In addition, to reinforce her protective factors, we intervened in the parent-child relationship and addressed her hesitation to ask for help, which we identified as a predisposing factor since early childhood. Over the course of her treatment, she did not exhibit suicidal ideation or re-attempt suicide.

Objective: Recently, excessive and off-label prescribing of psychotropic drugs for children and adolescents have become a problem. Child and adolescent psychiatric patients receive treatment in many departments and department-specific psychotropic drug use has not been analyzed. We surveyed prescriptions for child and adolescent psychiatric outpatients during their first year of treatment. Methods: The participants were 302 patients, 15 years or younger, who made their first visit to the outpatient psychiatry department of Tokai University Hospital from September 1, 2015 to September 1, 2016. Prescription details and patient profiles were retrospectively investigated using medical records. Results: Medication was prescribed for 20.9% of patients (63/302) with the prescription rate increasing with age. Psychotropic drugs were prescribed for 15.6% of patients (48/302), with attention-deficit/hyperactivity disorder (ADHD) medications being most frequently prescribed (20 cases). Other than psychotropic drugs, iron pills (25 cases) and herbal medicines (21 cases) were prescribed frequently. Conclusions: The pharmacotherapy and psychotropic prescription rates were low. This may be due to the use of non-pharmacological interventions and the lack of inpatient facilities. With the publication of guidelines for pharmacotherapy in child psychiatry in Japan, measuring the patterns of psychotropic drug prescription in children and adolescents is important, and would make treatment more transparent. [ABSTRACT FROM AUTHOR]

Background: Although some studies have described the association between serum ferritin levels and specific disorders in child and adolescent psychiatry, few have focused on mental status per se with low serum ferritin levels in children and adolescents. This study examined the effects of iron administration on psychological status of children and adolescents with reduced serum ferritin concentration. Methods: This prospective study evaluated 19 participants aged 6-15 years with serum ferritin levels <30 ng/mL who visited a mental health clinic and received oral iron administration for 12 weeks. The participants were assessed using the Clinical Global Impression Severity (CGI-S), Profile of Mood States 2nd Edition Youth-Short (POMS), Center for Epidemiologic Studies Depression Scale (CES-D), and Pittsburgh Sleep Quality Index (PSQI). In addition to serum ferritin, blood biochemical values such as hemoglobin (Hb) and mean corpuscular volume (MCV) were examined. School attendance was recorded. Results: The most prevalent physical symptoms were fatigability and insomnia. The CGI-S, PSQI, and CES-D scores decreased significantly following iron supplementation, whereas the scores of almost all POMS subscales improved significantly at week 12. No participant had hemoglobin levels <12 g/dL. Serum ferritin concentration increased significantly, whereas Hb and MCV remained unchanged. At baseline, 74% of the participants did not attend school regularly; this number improved to varying degrees by week 12. Conclusions: Serum ferritin levels would be preferable to be measured in children and adolescents with insomnia and/or fatigability regardless of psychiatric diagnoses or gender. Iron supplementation can improve the hypoferritinemia-related psychological symptoms of children and adolescents, such as poor concentration, anxiety, depression, low energy and/or irritability. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome (IBS) is a disease in which gastrointestinal symptoms-primarily abdominal pain or discomfort and abnormal bowel movements persist chronically. For patients with IBS, mental illness, especially depression and/or anxiety, leads to a further lower quality of life. The purpose of this case study was to investigate the effects of mirtazapine (MIR) on mental health and IBS symptoms in a case of IBS accompanied by anxiety and a depressive state. This case report suggests that MIR is efficacious for the treatment of IBS with predominant diarrhea accompanied by depression and anxiety. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 51-year-old woman with a severe headache that began suddenly and with intense pain. She was first diagnosed with anxiety disorder and was prescribed with sertraline and loxoprofen. However, when she experienced recurrent headache episodes, a computed tomographic angiography was performed and showed segmental vasoconstriction of the bilateral cerebral arteries. An observation of an acute and transient psychotic disorder was made.

The effectiveness and safety of antipsychotics have not been fully established in children and adolescents. Many antipsychotics approved for use in adults are prescribed off-label to children and adolescents. We investigated the effectiveness and tolerability of antipsychotics for children and adolescents with schizophrenia and bipolar disorder. A literature review of the empirical evidence regarding the use of antipsychotics, particularly second-generation antipsychotics, in children and adolescents showed that these drugs were safe and effective for this population. Antipsychotics were similarly effective for treatment of schizophrenia and bipolar disorder in children and adolescents. When prescribing antipsychotics to this population, clinicians should consider adverse events and the discontinuation rate in treated patients. However, the current evidence shows a lack of consensus regarding the use of antipsychotics in children and adolescents. [ABSTRACT FROM AUTHOR]