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Background: The push to systematically follow treatment outcomes in psychotherapies to improve health care is increasing worldwide. To manage psychotherapeutic services and facilitate tailoring of therapy according to feedback a comprehensive and feasible data system is needed., Aims: To describe the Finnish Psychotherapy Quality Register (FPQR), a comprehensive database on availability, quality, and outcomes of psychotherapies., Methods: We describe the development of the FPQR and outcome for outsourced psychotherapies for adults in Helsinki and Uusimaa hospital district (HUS). Symptom severity and functioning are measured with validated measures (e.g. CORE-OM, PHQ-9, OASIS, AUDIT, and SOFAS). Questionnaires on therapeutic alliance, risks, methods, and goals are gathered from patients and psychotherapist., Results: During 2018-2021, the FPQR included baseline data for 7274 unique patients and 336 psychotherapists. Response rate of measures was 85-98%. The use of the register was mandatory for the outsourced therapist of the hospital districts, and the patients were strongly recommended to fulfill the questionnaires. We report outcome for three groups of patients ( n  = 1844) with final/midterm data. The effect sizes for long psychotherapy (Hedge's g  = 0.65 of SOFAS) were smaller than those for short psychotherapy ( g  = 0.75-0.91). Within three months of referral, 26-60% entered treatment depending on short- or long-term therapy., Conclusion: The FPQR forms a novel rich database with commensurate data on availability and outcomes of outsourced psychotherapies. It may serve as a basis for a national comprehensive follow-up system of psychosocial treatments. The Finnish system seems to refer patients with milder symptoms to more intensive treatments and achieve poorer results compared to the IAPT model in UK, Norway, or Australia.

Objective: Major public and scientific interest exists on, whether quarantine as a containment measure, could have adverse effects on individual's mental health. We investigated psychic well-being and distress, symptoms of depression and anxiety among individuals imposed to home quarantine., Methods: By total population sampling in a Finnish suburban city, a total of 57 quarantined cases (participation rate 97%) were identified and followed up for two weeks until expiration of the quarantine. A randomized control group ( n  = 53) was formed of people seeking laboratory testing for suspected Sars-CoV-2 infection. Primary outcome was the psychic well-being and distress experienced during quarantine measured by the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM). The cases were followed up by the Clinical Outcomes in Routine Evaluation-10 (CORE-10), Patient Health Questionnaire-9 (PHQ-9), and by the Overall Anxiety Severity and Impairment Scale (OASIS)., Results: The median CORE-OM score for the cases was 3.53 (95% CI: 2.23-4.66), and for the controls 3.24 (1.76-3.82), being mostly in the nonclinical to mild range. The difference between the groups was statistically nonsignificant ( p  = .19). Higher levels of psychic distress were explained by previous psychiatric disorders and living alone, but not having been quarantined. In comparison to controls, the quarantined participants experienced significantly, but slightly lower level of life functioning. At the follow-up, the quarantined participants rated further low on the CORE-10 (median 2.00; 95% CI: 1.00-3.00), the PHQ-9 (1.50; 0.00-3.00), and the OASIS (0.00; 0.00-0.00)., Conclusions: The distress associated with short-term home quarantine may not be to the degree of a mental disorder.

Rare coding variation has historically provided the most direct connections between gene function and disease pathogenesis. By meta-analysing the whole exomes of 24,248 schizophrenia cases and 97,322 controls, we implicate ultra-rare coding variants (URVs) in 10 genes as conferring substantial risk for schizophrenia (odds ratios of 3-50, P < 2.14 × 10 -6 ) and 32 genes at a false discovery rate of <5%. These genes have the greatest expression in central nervous system neurons and have diverse molecular functions that include the formation, structure and function of the synapse. The associations of the NMDA (N-methyl-D-aspartate) receptor subunit GRIN2A and AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid) receptor subunit GRIA3 provide support for dysfunction of the glutamatergic system as a mechanistic hypothesis in the pathogenesis of schizophrenia. We observe an overlap of rare variant risk among schizophrenia, autism spectrum disorders 1 , epilepsy and severe neurodevelopmental disorders 2 , although different mutation types are implicated in some shared genes. Most genes described here, however, are not implicated in neurodevelopment. We demonstrate that genes prioritized from common variant analyses of schizophrenia are enriched in rare variant risk 3 , suggesting that common and rare genetic risk factors converge at least partially on the same underlying pathogenic biological processes. Even after excluding significantly associated genes, schizophrenia cases still carry a substantial excess of URVs, which indicates that more risk genes await discovery using this approach., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)