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ObjectivePostpartum depression (PPD) is a serious condition with debilitating consequences for the mother, offspring, and the whole family. The scope of negative outcomes of PPD highlights the need to specify effective diagnostics and treatment which might differ from major depressive disorder (MDD). In order to improve our clinical care, we need to better understand the underlying neuropathological mechanisms of PPD. Therefore, we conducted a systematic review of published neuroimaging studies assessing functional, structural, and metabolic correlates of PPD.MethodsRelevant papers were identified using a search code for English-written studies in the PubMed, Scopus, and Web of Science databases published by March 2022. Included were studies with structural magnetic resonance imaging, functional magnetic resonance imaging, both resting-state and task-related, magnetic resonance spectroscopy, or positron emission tomography. The findings were analyzed to assess signatures in PPD-diagnosed women compared to healthy controls. The review protocol was registered in PROSPERO (CRD42022313794).ResultsThe total of 3,368 references were initially identified. After the removal of duplicates and non-applicable papers, the search yielded 74 full-text studies assessed for eligibility. Of them, 26 met the inclusion criteria and their findings were analyzed and synthesized. The results showed consistent functional, structural, and metabolic changes in the default mode network and the salient network in women with PPD. During emotion-related tasks, PPD was associated with changes in the corticolimbic system activity, especially the amygdala.DiscussionThis review offers a comprehensive summary of neuroimaging signatures in PPD-diagnosed women. It indicates the brain regions and networks which show functional, structural, and metabolic changes. Our findings offer better understanding of the nature of PPD, which clearly copies some features of MDD, while differs in others.

We performed a secondary analysis of the data from Czech epidemiological study on mental health to determine the prevalence of mental disorders among Czech women on maternity or parental leave and to assess the present treatment gap. Any mental disorder was present in 17.6% (n = 21) of the total sample of 119 women. The treatment gap was present among 76% (n = 16) of them. In conclusion, most women on maternity or parental leave facing a mental disorder were not receiving treatment. The present study is the first of its kind in the region of Central and Eastern Europe.

Generalizovana uzkostna porucha je onemocněni, ktere se vyznacuje přetrvavajici anxietou a obavami z každodennich situaci, ktere jsou doprovazeny sirokou paletou somatických symptomů. V přehledovem clanku se zaměřujeme předevsim na soucasne doporucene postupy ve farmakoterapii a jeji aktualni novinky. Dale se zabývame psychoterapeutickými možnostmi a možnostmi lecby rTMS ci ketaminem. Po desetileti relativni stagnace dochazi opět k otevřeni klinickeho výzkumu i u skupiny uzkostných onemocněni. V nasem přehledu proto okrajově zmiňujeme i aktualně hlasene klinicke výzkumy, ktere přinaseji možný výhled lecby generalizovane uzkostne poruchy do budoucna.

To determine current and lifetime psychopathology and assess quality of life (QoL) in offspring of a parent with bipolar disorder (BD).We investigated 43 offspring of bipolar parents (high-risk offspring [HRO]) (mean age 12.5 ± 3.1; range 6.7-17.9 years) and 43 comparison offspring matched for sex, age, and IQ of healthy parents. Lifetime and current presence of Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) diagnoses were assessed using Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). We administered parent and self-report versions of General Behavior Inventory and the Screen for Child Anxiety-Related Emotional Disorders (SCARED). QoL was evaluated using the self-report questionnaire KIDSCREN-52.Thirty-seven HRO (86%) and 18 controls (42%) met DSM-5 criteria for at least one lifetime psychiatric diagnosis (adjusted OR = 7.20; 95% CI 2.27-22.81). Compared to controls, HRO had higher lifetime frequency of any mood disorder (33% vs. 2%, p 0.001), anxiety disorder (60% vs. 14%, p 0.001), and attention-deficit/hyperactivity disorder (26% vs. 5%, p = 0.01). After adjustment for confounders, only mood (OR = 13.05; 95% CI 1.41-120.60) and anxiety (OR = 9.69; 95% CI 2.75-34.31) disorders remained significantly more frequent in the HRO group. In comparison with controls, HRO scored lower in the following domains: QoL, social support and relationship with peers (p = 0.003; Cohen's d = 0.91), parent relationships and home life (p = 0.008; d = 0.67), as well as self-perception (p = 0.04; d = 0.55).In agreement with other studies, we found a higher rate of lifetime anxiety and mood disorders in children and adolescents at confirmed familial risk for BD. Reduction in QoL was already evident across a number of domains. Adult psychiatrists should incorporate into their assessment procedures targeted questions on the presence of psychopathology in offspring of their adult patients with severe mental disorders and child services should bridge with adult services providing accessible services to children of affected parents.

This article is a summary of perspectives on training curricula from child and adolescent psychiatry trainees globally. We aimed to identify the relative strengths, weaknesses and gaps in learning needs from a trainee's perspective. The 20 early-career child psychiatrists who contributed are from 16 countries and represent all the five continents. We could identify some global challenges as well as local/regional challenges that need to be addressed to develop competent child psychiatrists.

Background: Although a positive family history is the strongest predictor for bipolar disorder (BD), most offspring of BD parents (BO) will not develop the disorder. Identification of vulnerability markers for BD is essential for specific individual risk estimation. Impairments in cognitive functioning and the presence of specific temperament traits are considered promising candidates. Methods: Sixty-three BO (48% female; 11.8 ± 3.3 years) and 54 control offspring (CO; 44% female; 12.3 ± 3.2 years) comparable in sex (p = 0.4) and age (p = 0.4) were enrolled. Detection of current sub/threshold mood symptoms by the Kiddie Schedule for Affective Disorders and Schizophrenia and General Behavior Inventory was applied to separate BO into ultrahigh-risk (UHR) and high-risk (HR) subgroups. Cognitive functions were tested by the Developmental Neuropsychological Assessment II test battery, d2 Test of Attention, and Amsterdam Neuropsychological Tasks. Temperament was assessed by the Temperament in Middle Childhood and Early Adolescent Temperament Questionnaires. Results: The BO sample consisted of 5 BD, 17 UHR, and 41 HR participants. We did not observe any significant differences between the BO and CO groups or between the UHR, HR, and CO subgroups (Hedges' g = 0.21–0.39) in cognitive functioning. The BO differed significantly in some temperament traits from the CO (g = 0.42–0.61), while the UHR subgroup exhibited lower effortful control and attention focusing than both HR and CO participants (g = 0.92–1.19). Limitations: The cross-sectional design and wide age range of the sample limited our findings. Conclusions: Neuropsychological impairment does not seem to be a trait marker of BD in the premorbid stage. Temperament with low effortful control and low attention focusing might be associated with the development of mood disorders in BO.

Background Impairment of sleep and circadian rhythm is a typical feature of bipolar disorder (BD). We carried out an exploratory cross-sectional case-control study to extend the knowledge of sleep characteristics in offspring at risk for BD. Methods We investigated 42 offspring of bipolar parents (OB) (mean age 12.5 ± 3.2) and 42 sex and age matched comparison offspring of healthy parents. We administered the Pediatric Sleep Questionnaire, the Morningness/Eveningness Questionnaire and The General Behavior Inventory Sleep Subscale (GBISS) to assess circadian preference, and to identify sleep impairment symptoms. In addition, the participants completed 14 days of actigraphy to characterise sleep and wake patterns. The current psychopathology profile was assessed using Kiddie Schedule for Affective Disorders and Schizophrenia. Results Prevalence of sleep disturbance symptoms was higher among OB than controls (headache after waking up, 17.9% vs. 2.4%, p = 0.03; excessive daytime sleepiness, 38.5% vs. 10.0%, p = 0.004; apparent tiredness at wake-up times, 43.6% vs. 15.0%, p = 0.007 and nightmares, 21.6% vs. 2.4%, p = 0.01), but the differences between groups were not significant after adjusting for current psychopathology. OB had higher GBISS total score (parental version, p

Treatment resistance is a barrier to the successful care of patients with OCD. Glutamate modulators such as n-acetylcysteine (NAC) represent a promising new treatment option. To elucidate the current evidence of the efficacy and safety of NAC, we performed a systematic review and meta-analysis of double-blind, randomized, placebo-controlled trials. Primary outcomes were full and partial response rates and a reduction in the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Improvement in other clinical scales and the prevalence of various adverse events were also analyzed. Five RCTs (a total of 102 NAC and 100 placebo participants) were found eligible for inclusion. No significant differences in full responses (RR = 1.60; 95% CI = 0.37–6.95, Z = 0.63; p = 0.53), in partial responses (RR = 1.24; 95% CI = 0.76–2.03, Z = 0.85; p = 0.39), and in the reduction in the Y-BOCS (SMD = −0.66; 95% CI = −1.50 – 0.17, Z = 1.56; p = 0.12) were observed between the groups. In general, NAC was well tolerated and no significant differences in the prevalence of adverse events were found between the groups. The current evidence that NAC augmentation is an effective option for treatment resistant OCD is limited.