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La pesca a pequeña escala es una actividad económica que brinda alimentos nutritivos para la población y contribuye a la generación de riqueza. Actualmente, la pesca afronta desafíos como la sobreexplotación, la pesca ilegal, la contaminación marina y el cambio climático. Para superar estos desafíos, los Objetivos de Desarrollo Sostenible 2030 trazan una agenda a 15 años y abogan por la protección del ambiente, la seguridad alimentaria y el crecimiento económico equilibrado. Bajo este panorama global, la investigación se compromete con dichos objetivos desde un contexto local, al develar la estructura y los impactos territoriales de la actividad pesquera comercial ribereña en los puertos de la Reserva Estatal El Palmar (47.931,45 ha): Celestún y Sisal (Yucatán, México). Las teorías de la organización espacial de la economía y el impacto territorial fundamentan esta investigación que se apoya en datos cuantitativos e información cualitativa. Los resultados reflejan el predominio de los impactos negativos como consecuencia de la falta de ordenación territorial de la actividad. Lo que pone en duda la sostenibilidad de la pesca ribereña en aquella área natural protegida.

Vortioxetine is a multimodal-acting antidepressant that provides improvements on cognitive function aside from antidepressants and anxiolytic effects. Vortioxetine has been found to be one of the most effective and best tolerated options for major depressive disorder (MDD) in head-to-head trials.The present review intends to gather the most relevant and pragmatic data of vortioxetine in MDD, specially focusing on new studies that emerged between 2015 and 2020.Vortioxetine is the first antidepressant that has shown improvements both in depression and cognitive symptoms, due to the unique multimodal mechanism of action that combine the 5-HT reuptake inhibition with modulations of other key pre- and post-synaptic 5-HT receptors (agonism of 5-HT

A nivel global, México es de los países con mayor biodiversidad, pero también de los que soporta una destacada explotación de sus recursos naturales. La declaración de áreas naturales protegidas se ha convertido en una de las principales estrategias mexicanas para conservar la naturaleza. El artículo analiza los desafíos de esta herramienta de gestión territorial partiendo de la capacidad de gestión. Para alcanzar este fin, se realiza la oportuna revisión bibliográfica y el análisis de cuestionarios semiestructurados aplicados a actores clave de dos casos de estudio: las reservas de la biosfera Los Tuxtlas y Los Petenes. Los resultados demuestran que, si bien los espacios protegidas han contribuido a disminuir la destrucción del patrimonio natural, éste aún sigue sufriendo graves afectaciones a causa de los insuficientes recursos destinados a las políticas ambientales, lo que debilita la capacidad de gestión y, consiguientemente, dificulta alcanzar los objetivos de conservación.

Los acuerdos internacionales sobre el derecho del mar y las responsabilidades en el manejo de los recursos acuáticos vivos son relativamente recientes (Convención de las Naciones Unidas sobre el Derecho del Mar, 1982). Hoy se constata que los países en desarrollo son suministradores de pescados y mariscos de los países desarrollados, impactándoles socioeconómicamente. La investigación tiene por objeto reconocer los acuerdos y los instrumentos normativos vigentes (internacionales y nacionales) que vinculan pesca y acuicultura con el desarrollo sostenible; realizar un acercamiento socioeconómico a mencionadas actividades en México; y sintetizar los desafíos de aquellos sectores. Fundado en los pilares de la sostenibilidad, base de la economía azul, se aprecia sintonía entre las escalas regulatorias, aunque la falta de capacidad de gestión, las disfunciones por ausencia de ordenamiento y su impacto ambiental condicionan el desarrollo sostenible. Esta situación demanda más atención si cabe, en el comienzo del ‘Decenio de las Ciencias Oceánicas para el Desarrollo Sostenible (2021-2030)’ propuesto para el 1 de enero de 2021.

Lithium is one of the first therapeutic options for bipolar disorder, which is characterized by recurrent mood swings that strongly reduce quality of life. Our purpose was to achieve professional consensus criteria to define the contents of an information sheet for patients with bipolar disorder that are starting treatment with lithium.A modified Delphi method in two rounds was used. The Scientific Committee-made up by nine psychiatrists-created a 20-item questionnaire about the information that must be given to the patient treated with lithium and selected a panel of ambulatory and hospital psychiatric experts to agree on this information. Panelists scored each item based on a Likert scale of 9 points and could add comments in a confidential manner. It was considered consensus in agreement when median scores were within the range of [7-9] and in disagreement within the range of [1-3].A high level of consensus was reached. In the first round, there was agreement on 17 out of 20 items and, after the second round, there was disagreement on just one item containing information about the discovery of lithium. Finally, said item was modified in the Patient's Information Sheet based on the comments suggested by the panelists.This study allowed to create an information sheet for patients with bipolar disorder under treatment with lithium, with information agreed upon by a group of experts from different health care settings.

Introduction: Lithium is one of the first therapeutic options for bipolar disorder, which is characterized by recurrent mood swings that strongly reduce quality of life. Our purpose was to achieve professional consensus criteria to define the contents of an information sheet for patients with bipolar disorder that are starting treatment with lithium. Material and methods: A modified Delphi method in two rounds was used. The Scientific Committee—made up by nine psychiatrists—created a 20-item questionnaire about the information that must be given to the patient treated with lithium and selected a panel of ambulatory and hospital psychiatric experts to agree on this information. Panelists scored each item based on a Likert scale of 9 points and could add comments in a confidential manner. It was considered consensus in agreement when median scores were within the range of [7-9] and in disagreement within the range of [1-3]. Results: A high level of consensus was reached. In the first round, there was agreement on 17 out of 20 items and, after the second round, there was disagreement on just one item containing information about the discovery of lithium. Finally, said item was modified in the Patient's Information Sheet based on the comments suggested by the panelists. Conclusions: This study allowed to create an information sheet for patients with bipolar disorder under treatment with lithium, with information agreed upon by a group of experts from different health care settings.

The use of convolutional neuronal networks (CNN) for the treatment of interferometric fringes has been introduced in recent years. In this paper, we optimize and build a CNN model, based U-NET architecture, to maximize its performance processing electronic speckle interferometry fringes (ESPI). The proposed approach is based on quick and light trainings to select the architecture parameters (network depth and kernel sizes) to maximize the performance of the neural network improving the visibility of ESPI images. To measure the performance, the structural similarity index (SSMI) will be the lead indicator, and the need for large datasets to train neural networks, unavailable for ESPI images, forces the use of a simulated ESPI image dataset along the process. This dataset is computed using Zernike polynomials to simulate local surface deformations in the specimen under test and simulated true speckle fields for the reference and object field involved in ESPI techniques.

espanolEl presente articulo supone una breve reflexion acerca del concepto de paisaje, entendido como la percepcion del territorio, y de la necesidad de contribuir a la formacion de una sociedad consciente de que es un elemento esencial de la calidad de vida de las personas. Desde una perspectiva educativa, supone un recurso didactico idoneo para comprender las relaciones que la sociedad establece con el medio fisico que habita. EnglishThe European Landscape Convention (CEP), approved by the Council of Europe in 2000, raises the need for landscape education in order to contribute to the formation of a society that values and demands quality landscapes, since they play a important role of general interest in the cultural, ecological, environmental and social fields. Therefore, the landscape has become part of the curricular contents of the different educational stages. Therefore, it is necessary to train future teachers in landscape issues, firstly so that they are sensitized and develop respect and appreciation skills. Second, to provide them with the tools and knowledge necessary to carry out the landscape education of their future students.

The aim of our study was to examine whether there are sex-based differences in the relationship between personality traits and hypothalamic-pituitary-adrenal (HPA) axis measures. A total of 106 healthy volunteers (56.6% women; age: 48.0 ± 15.8 years) were studied. The revised temperament and character inventory (TCI-R) and the Childhood Trauma Questionnaire (CTQ) were administered. HPA axis function was assessed using three dynamic measures: the cortisol awakening response (CAR), the diurnal cortisol slope, and the cortisol suppression ratio with 0.25 mg of dexamethasone (DSTR). Female sex was associated with an increased CAR and a more flattened diurnal cortisol slope, although a negative significant interaction between harm avoidance and female sex was found. Regarding the DSTR, perseverance was associated with increased cortisol suppression after dexamethasone; sex did not affect this association. Our study suggests that the relationship between specific personality traits (harm avoidance) and HPA axis measures (CAR, diurnal slope) differs according to sex.

Dataset of Spanish authors' publications about Didactics of Geography and Education for Sustainable Development. Authors’ own with data of [http://www.didacticageografia.age-geografia.es/index.php?m=4] and [http://www.age-geografia.es/didacticageografica/index.php/didacticageografica/index]

La pesca en el lago Metztitlán (estado de Hidalgo) acontece desde tiempos inmemoriales, por lo que no es de extrañar que abunden las investigaciones hidrobiológicas, geológicas e históricas, sin embargo, escasean los estudios enfocados en lo social. Conjugando metodologías geográficas y antropológicas, se reconstruyen los procesos territoriales sucedidos en el lago desde los años 1950, década a la que se remontan los recuerdos de los actores entrevistados, hasta 2020 último año en el que el lago se secó. Asimismo, se indaga sobre las relaciones establecidas entre dos territorialidades superpuestas: la estatal (relativa al Estado) y la comunitaria (vinculada a los acuerdos locales). Los resultados distinguen tres etapas: «no capitalista» (1950-1984), «capitalista productivista» (1985-1999) y «hacia el capitalismo verde» (2000-2020); también fundamentan que el lago se convirtió en un territorio capitalista por los poderes públicos que, si bien inicialmente entendieron la pesca como medio para mejorar la alimentación de la comarca, más adelante la convertirían en una actividad comercial; por último, confirman que las relaciones territoriales establecidas son convergentes.

Introduction: There is evidence that early intervention contributes to improving the prognosis and course of first-episode psychosis (FEP). However, further randomised treatment clinical trials are needed. Objectives: The aim of this study was to compare the efficacy of a combined clinical treatment involving Cognitive Behavioural Therapy (CBT) as an adjunctive to treatment-as-usual (TAU) (CBT+TAU) versus TAU alone for FEP. Patients and methods: In this multicentre, single-blind, randomised controlled trial, 177 participants were randomly allocated to either CBT+TAU or TAU. The primary outcome was post-treatment patient functioning. Results: The CBT+TAU group showed a greater improvement in functioning, which was measured using the Global Assessment Functioning (GAF) and Functioning Assessment Short Test (FAST), compared to the TAU group post-treatment. The CBT+TAU participants exhibited a greater decline in depressive, negative, and general psychotic symptoms, a better awareness of the disease and treatment adherence, and a greater increase in brain-derived neurotrophic factor levels than TAU participants. Conclusions: Early intervention based on a combined clinical treatment involving CBT as an adjunctive to standard treatment may improve clinical and functional outcomes in FEP.

Relationships among childhood maltreatment (CM), hypothalamic-pituitary-adrenal (HPA) axis disturbances, major depressive disorder (MDD), poor functionality, and lower quality of life (QoL) in adulthood have been described. We aimed to study the roles of the remission status of depression and HPA axis function in the relationships between CM and functionality and QoL. Ninety-seven patients with MDD and 97 healthy controls were included. The cortisol awakening response, cortisol suppression ratio in the dexamethasone suppression test, and diurnal cortisol slope were assessed. Participants completed measures of psychopathology, CM, functionality, and QoL. Multiple linear regression analyses were performed to study the relationships between CM and functionality and QoL. Only non-remitted MDD patients showed lower functionality and QoL than controls, indicating that depressive symptoms may partly predict functionality and QoL. Cortisol measures did not differ between remitted and non-remitted patients. Although neither HPA axis measures nor depression remission status were consistently associated with functionality or QoL, these factors moderated the effects of CM on functionality and QoL. In conclusion, subtle neurobiological dysfunctions in stress-related systems could help to explain diminished functionality and QoL in individuals with CM and MDD and contribute to the persistence of these impairments even after the remission of depressive symptoms.

Background: Childhood maltreatment (CM) is associated with impaired hypothalamic-pituitary-adrenal (HPA) axis negative feedback and cognitive dysfunction, resembling those abnormalities linked to major depressive disorder (MDD). Objectives: We aimed to assess the potential modulating effects of MDD diagnosis or HPA axis function in the association between different types of CM and cognitive performance in adulthood. Methods: Sixty-eight MDD patients and 87 healthy controls were recruited. CM was assessed with the Childhood Trauma Questionnaire. We obtained three latent variables for neuropsychological performance (verbal memory, visual memory and executive function/processing speed) after running a confirmatory factor analysis with cognitive tests applied. Dexamethasone suppression test ratio (DSTR) was performed using dexamethasone 0.25 mg. Results: Different types of CM had different effects on cognition, modulated by MDD diagnosis and HPA axis function. Individuals with physical maltreatment and MDD presented with enhanced cognition in certain domains. The DSTR differentially modulated the association between visual memory and physical neglect or sexual abuse. Conclusions: HPA axis-related neurobiological mechanisms leading to cognitive impairment might differ depending upon the type of CM. Our results suggest a need for early assessment and intervention on cognition and resilience mechanisms in individuals exposed to CM to minimize its deleterious and lasting effects., Summary HIGHLIGHTS • We studied the effects of childhood maltreatment (CM), HPA axis feedback (DST), and depression on cognition. • Different types of CM had a distinct impact on cognitive performance. • MDD diagnosis and DST modulated the association between CM and cognition.

Cognitive impairment has been associated with both childhood adversity and abnormalities of hypothalamic-pituitary-adrenal (HPA) axis function. An interaction exists between the functional polymorphism rs1360780 in the FKBP5 gene and childhood maltreatment, influencing a variety of clinical outcomes. Our goal was to study the relationship between different types of childhood trauma, HPA axis functionality, rs1360780 genotype and cognitive function in 198 healthy individuals who participated in the study. We obtained clinical data, childhood maltreatment scores and neurocognitive performance by clinical assessment; HPA negative feedback was analysed using the dexamethasone suppression test ratio (DSTR) after administration of 0.25 mg of dexamethasone; and the FKBP5 rs1360780 polymorphism was genotyped in DNA obtained from blood samples. The results showed a significant influence of physical neglect on measures of neurocognition as well as an interaction between the DSTR and physical and emotional neglect. Regarding social cognition, a significant association was found with sexual and physical abuse as well as with rs1360780 risk-allele carrier status. Moreover, an interaction between the rs1360780 genotype and the presence of physical abuse was significantly associated with social cognition results. Our results suggest a specific impact of different kinds of childhood maltreatment on measures of neurocognition and social cognition, which might be influenced by HPA axis reactivity and genetic variants in HPA axis-related genes such as FKBP5. Disentangling the relationship between these elements and their influence on cognitive performance might help identify susceptible individuals with higher stress vulnerability and develop preventive interventions.

High doses of antidepressants, particularly clomipramine and selective serotonin reuptake inhibitors (SSRIs), are the well-established treatment for obsessive-compulsive disorder (OCD), but manic/hypomanic episodes are potential adverse events associated with this treatment. A systematic literature review was performed on manic/ hypomanic episodes in non-bipolar OCD patients. Clinical, sociodemographic and antidepressant characteristics during the manic/hypomanic switch were extracted using descriptive statistics. Data were obtained from 20 case reports and case series. Switching episodes mostly appeared in the first 12 weeks after antidepressant initiation and took place more frequently during SSRI use (mostly fluoxetine) in 64.3% of cases. Clomipramine and SSRI use differed non-significantly between the switching episodes that appeared during the first 12 weeks of antidepressant treatment and the episodes that appeared beyond 12 weeks. Switching episodes emerging before 12 weeks were associated with a lower defined daily dose of antidepressants than episodes emerging after 12 weeks. These findings suggest that there are two independent characteristics involved in manic/hypomanic switch in OCD: a) they appeared most frequently with SSRI use (fluoxetine) regardless of the time of it use, and b) episodes appeared in the first 12 weeks after SSRI or clomipramine initiation had a lower dose of antidepressant than episodes appeared after 12 weeks.

Seasonal changes in mood and diurnal preference are two well-characterized chronobiological phenotypes in major depressive disorder (MDD) and bipolar disorder (BD). The biological mechanisms regulating physiological changes related to seasonality and chronotype involve several genes known as "clock" or circadian genes. Our goal was to study the relationship between the polygenic risk score (PRS) obtained from a set of clock genes and chronobiological traits in patients with mood disorders. The sample included 445 patients with mood disorders (256 MDD; 189 BD). Seasonality was assessed using the Seasonal Pattern Assessment Questionnaire (SPAQ), and chronotype was assessed using the Horne and Östberg Morningness-Eveningness Questionnaire. We selected 248 single nucleotide polymorphisms located within 19 genes. PRS for both MDD and BD was calculated using the Psychiatric Genetics Consortium latest datasets as discovery samples. Another PRS was calculated using results from a genome-wide association study focusing on chronotype. SPAQ results were significantly associated with MDD-PRS (p = 0.037) and chronotype-PRS (p = 0.019), which also showed a significant interaction with age (p = 0.039). No significant association was observed between the measured PRS and chronotype. Our results reflect that small effect variants associated with MDD and chronotype within clock genes are associated with seasonality traits in patients with mood disorders, further explaining the mechanism through which the circadian system might influence mood disorder clinical presentation. Future studies measuring PRS from specific gene sets and focusing on biological endophenotypes will help to elucidate the pathways from genetic variations to clinical outcome.

Altres ajuts: This study was supported in part by grants from the European Regional Development Fund (ERDF) "A way to build Europe", the Fundació La Marató de TV3 (092230/092231), CIBERSAM. Samples from patients included in this study were processed and preserved by the Biobank IISPV and the Biobank HUB-ICO-IDIBELL, integrated in the Spanish National Biobanks Network (PT17/0015/0024) and Xarxa Banc de Tumors. The funders had no role in the study design,data collection and analysis, decision to publish, or preparation of the manuscript. Sleep plays a crucial role in cognitive processes. Sleep and wake memory consolidation seem to be regulated by glucocorticoids, pointing out the potential role of the hypothalamic-pituitary-adrenal (HPA) axis in the relationship between sleep quality and cognitive abilities. Trait anxiety is another factor that is likely to moderate the relationship between sleep and cognition, because poorer sleep quality and subtle HPA axis abnormalities have been reported in people with high trait anxiety. The current study aimed to explore whether HPA axis activity or trait anxiety moderate the relationship between sleep quality and cognitive abilities in healthy individuals. We studied 203 healthy individuals. We measured verbal and visual memory, working memory, processing speed, attention and executive function. Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Trait anxiety was assessed with the State-Trait Anxiety Inventory. HPA axis measures included the cortisol awakening response (CAR), diurnal cortisol slope and cortisol levels during the day. Multiple linear regression analyses explored the relationship between sleep quality and cognition and tested potential moderating effects by HPA axis measures and trait anxiety. Poor sleep quality was associated with poorer performance in memory, processing speed and executive function tasks. In people with poorer sleep quality, a blunted CAR was associated with poorer verbal and visual memory and executive functions, and higher cortisol levels during the day were associated with poorer processing speed. Trait anxiety was a moderator of visual memory and executive functioning. These results suggest that subtle abnormalities in the HPA axis and higher trait anxiety contribute to the relationship between lower sleep quality and poorer cognitive functioning in healthy individuals.

Small-scale fishing is a significant activity from a socioeconomic, environmental and alimentary perspective; and is considered in the goal number 14 of the Agenda 2030 for Sustainable Development. In this global context, it is relevant to reveal its territorial traits in natural protected areas, which participate in international trade, as in the case of the Los Petenes Biosphere Reserve (282,858 ha). In order to reach this objective, the following aspects are recognized: infrastructure, the organization of the fishermen, the use of the resources and the commercial flows. The investigation, which uses both qualitative and quantitative data, is substantiated by the theory on the spatial organization of the economy. The results show a sector with good access to national and international commercialization channels, but with multiple territorial imbalances. La pesca a pequeña escala tiene una significativa perspectiva socioeconómica, ambiental y alimentaria; está conside­rada en la meta número 14 de la Agenda 2030 de Desarrollo Sostenible. En este marco global, resulta pertinente develar los rasgos territoriales de mencionada actividad en áreas protegidas que participan en el comercio internacional: tal es el caso de la Reserva de la Biosfera Los Petenes (282.858 ha). Para alcanzar dicho objetivo se reconocen: las infraestructuras, la organización de los pescadores, la explotación de los recursos y los flujos comerciales. La teoría de la Organización Espacial de la Economía funda­menta esta investigación que utiliza datos cuantitativos y cualitativos. Los resultados muestran un sector con buen acceso a los canales de comercialización nacional e internacional, pero con múltiples desajustes territoriales.

Major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) have both been linked to abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis. Polymorphisms in the genes involved in HPA axis activity, such as FKBP5, and their interactions with childhood trauma have been associated with stress-related mental disorders. Our goal was to study the role of FKBP5 genetic variants in HPA axis negative feedback regulation as a possible risk factor for different mental disorders such as MDD and OCD, while controlling for childhood trauma, anxiety and depressive symptoms. The sample included 266 participants divided into three groups: 1) MDD (n = 89 [n = 73 melancholic; n = 3 atypical]), 2) OCD (n = 51; 39% with comorbid MDD [n = 13 melancholic; n = 7 atypical]) and 3) healthy controls (n = 126). Childhood trauma, trait anxiety and depressive symptoms were assessed. HPA negative feedback was analyzed using the dexamethasone suppression test ratio (DSTR) after administration of 0.25 mg of dexamethasone. Twelve SNPs in the FKBP5 gene were selected for genotyping. Multiple linear regressions, after adjusting for the covariates considered, showed a reduced DSTR in individuals with the rs9470079-A variant that was significant after correction for multiple testing. Childhood trauma did not moderate the association between the rs9470079 and DSTR. Our results support the evidence that FKBP5 genetic variation could lead to abnormal HPA axis negative feedback independent of diagnosis. Therefore, this association can be identified as a transdiagnostic feature, offering an interesting opportunity to identify patients with higher stress vulnerability. Further studies focusing on the influence of FKBP5 on measurable biological endophenotypes are needed.

The UN’s Sustainable Development Goals (SDGs) should be known and assumed by the community of geography teachers in all levels of education as a key part of their educational work. In order for well-grounded SDGs-related geographic didactic proposals to be presented, and for researchers in didactics to find a way to incorporate and promote SDG-related contents in daily teaching, a thorough knowledge of the relevant geographical literature is mandatory. The aim of this work is to present the results of a review comprising 1183 papers submitted to the 22 congresses on the didactics of Geography organised by the Spanish Association of Geography working group in didactics from 1988 to 2019, as well as 186 works published in the only Spanish journal on the Didactics of Geography, Didáctica Geográfica. This analysis focuses on the contents addressed in these studies, as well as on the skills and didactic strategies related to the teaching of SDGs. It was found that most SDGs-related contributions in Spain deal with landscape and the environment. Regarding skills, it was concluded that much remains to be done concerning Education for Sustainable Development (ESD). Finally, the current and future role of ESD in geographical teaching in Spain is assessed.

México tuvo una participación muy activa en los foros de consulta de la Agenda 2030, y en particular en su ODS-14. Como resultado, creó el Consejo Nacional de la Agenda 2030 para el Desarrollo Sostenible; constituyó el Comité Técnico Especializado en Desarrollo Sostenible, y configuró el Grupo de Trabajo sobre la Agenda 2030 en el Senado. Este compromiso seguramente se deba a que México es el tercer país americano con mayor extensión litoral (23 761 km), tras Canadá (1 478 106 km) y Estados Unidos (133 312 km). Además, entre 2003 y 2012, el país mesoamericano registró un promedio de capturas marinas de 1 352 000 t, cantidad que lo consolidó entre los 20 primeros países productores del mundo (FAO, 2016). En 2014 extrajo 1 396 205 t, el 1.7% de la producción mundial. A pesar de estos datos, México no es un país consumidor de pescado, difícilmente supera los 12 kg por habitante al año (SAGARPA, 2016). Por tanto, posee una destacada vocación exportadora.

Breast milk is considered the best source of nutrients and provides much better protection than immune modified milk. However, the postpartum period is a phase of increased risk for all women to experience psychiatric symptoms and recurrences or new episodes of bipolar disorder (BD), especially in those who have discontinued treatment. This is a systematic review of the risks and benefits of mood stabilizers and antipsychotics during breastfeeding as they relate to the health and well-being of mothers and their infants. Evidence-based treatment advice for women with BD during lactation is also provided. This systematic review has been conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. We included studies examining the exposure and the effects of antipsychotics and mood stabilizers used to treat BD on infants during breastfeeding clearly reporting the estimated amount of drug or effects on infants. The final selection included 56 studies. The available data supports the use of lithium as a possible treatment option during breastfeeding. Carbamazepine and valproic acid are also considered relatively safe. Lamotrigine can be used but at the lowest doses and considered for individual cases. Among the antipsychotics, quetiapine and olanzapine should be considered as first-line treatment options. Risperidone may be compatible with breastfeeding under medical supervision. Clozapine and amisulpiride are currently contraindicated. Long-term outcome studies evaluating the infant׳s health and psychosocial and cognitive functioning are needed.

Background Previous studies have shown associations between obsessive-compulsive disorder (OCD) and hypothalamic-pituitary-adrenal axis activity (HPA). We aimed to investigate the association between obsessive-compulsive (OC) symptoms and HPA axis functionality in a non-clinical sample and to explore whether there are sex differences in this relationship. Methods One hundred eighty-three healthy individuals without any psychiatric diagnosis (80 men, 103 women; mean age 41.3 ± 17.9 years) were recruited from the general population. The Obsessive-Compulsive Inventory Revised (OCI-R) was used to assess OC symptoms. State-trait anxiety, perceived stress, and stressful life events were also assessed. Saliva cortisol levels were determined at 6 time points (awakening, 30 and 60 min post-awakening, 10:00 a.m., 23:00 p.m. and 10:00 a.m. the following day of 0.25 mg dexamethasone intake [that occurred at 23:00 p.m.]). Three HPA axis measures were calculated: cortisol awakening response (CAR), cortisol diurnal slope, and cortisol suppression ratio after dexamethasone (DSTR). Multiple linear regression analyses were used to explore the association between OC symptoms and HPA axis measures while adjusting for covariates. Our main analyses were focused on OCI-R total score, but we also explored associations with specific OC symptom dimensions. Results No significant differences were observed between males and females in OC symptoms, anxiety measures, stress, or cortisol measures. In the multiple linear regression analyses between overall OC symptoms and HPA axis measures, a female sex by OC symptoms significant interaction (standardized beta = − 0.322; p = 0.023) for the CAR (but not cortisol diurnal slope nor DSTR) was found. Regarding specific symptom dimensions, two other sex interactions were found: a blunted CAR was associated with obsessing symptoms in women, whereas a more flattened diurnal cortisol slope was associated with ordering symptoms in men. Conclusions There are sex differences in the association between OC symptoms and HPA axis measures in healthy individuals.

Brain-derived neurotrophic factor (BDNF) gene regulation has been linked to the pathophysiology of major depressive disorder (MDD). MDD patients show cognitive deficits, and altered BDNF regulation has a relevant role in neurocognitive functions. Our goal was to explore the association between BDNF genetic and epigenetic variations with neurocognitive performance in a group of MDD patients and healthy controls considering possible modulating factors. The sample included 134 subjects, 64 MDD patients, and 70 healthy controls. Clinical data, childhood maltreatment, and neurocognitive performance were assessed in all participants. Eleven single nucleotide polymorphisms (SNPs) and two promoter regions in the BDNF gene were selected for genotype and methylation analysis. The role of interactions between BDNF genetic and epigenetic variations with MDD diagnosis, sex, and Childhood Trauma Questionnaire (CTQ) scores was also explored. We observed significant associations between neurocognitive performance and two BDNF SNPs (rs908867 and rs925946), an effect that was significantly mediated by methylation values at specific promoter I sites. We identified significant associations between neurocognitive results and methylation status as well as its interactions with MDD diagnosis, sex, and CTQ scores. Our results support the hypothesis that BDNF gene SNPs and methylation status, as well as their interactions with modulating factors, can influence cognition. Further studies are required to confirm the effect of BDNF variations and cognitive function in larger samples. This study was supported in part by grants from the Carlos III Health Institute through the Ministry of Economy and Competitiveness (PI10/01753, PIE14/00034 and PI15/00662), co-funded by the European Regional Development Fund (ERDF) “A way to build Europe”, CIBERSAM, and the Catalan Agency for the Management of University and Research Grants (AGAUR 2017 SGR 1247). We also thank CERCA Programme/ Generalitat de Catalunya for institutional support. The genotyping and methylation services were carried out at CEGEN-PRB3-ISCIII and were supported by grants PT13/0001 and PT17/0019, ISCIII-SGEFI/FEDER. Dr. Labad received an Intensification of the Research Activity Grant (SLT006/17/00012). Dr. Costas was supported by a Miguel Servet II contract from the Carlos III Health Institute (CPII16/00019). Dr. Soriano-Mas was supported by a Miguel Servet contract from the Carlos III Health Institute (CPII16/00048) SI

Subtle social cognitive deficits in unaffected relatives of schizophrenia patients have received increasing attention over the last few years, supporting their potential endophenotypic role for this disorder. The current study assessed non-psychotic first-degree relatives' performance on a multidimensional measure of emotional intelligence (EI): the Mayer–Salovey–Caruso Emotional Intelligence Test 2.0 (MSCEIT). Endorsed by the National Institute of Mental Health, the MSCEIT is a valid and reliable instrument for detecting emotion-processing deficits among schizophrenia patients and people high in schizotypy. Method : Thirty-seven first-degree relatives, 37 schizophrenia outpatients and 37 healthy controls completed the MSCEIT, which comprises eight subscales aimed to assess the four branches of EI: Identifying, Facilitating, Understanding and Managing Emotions. Potential associations with cognitive function and schizotypy levels, measured with the Schizotypal Personality Questionnaire–Brief, were further evaluated. Results : Relatives had significantly lower MSCEIT total scores than controls and also significantly lower scores on the Identifying emotions branch. Nevertheless, schizophrenia patients still had the poorest global EI performance. The strongest positive correlations were found in relatives and controls with measures of executive function, processing speed and general intelligence. A higher level of schizotypy correlated significantly with lower MSCEIT scores among controls, but not among relatives. Conclusions : Contrary to expectations in the general population, the current study observed subtle EI impairment in non-psychotic first-degree relatives of schizophrenia patients. These findings support the hypothesis that these EI deficiencies may be potential endophenotypes located between the clinical phenotype and the genetic predisposition for schizophrenia.

Hypothalamic-pituitary-adrenal (HPA) axis dysregulation and cognitive deficits are two well-characterized endophenotypes present in different serious mental illnesses (SMIs), including major depressive disorder, bipolar disorder and schizophrenia. Our aim was to study the influence of genetic and epigenetic variations in HPA axis-related genes on cognitive performance in clinical samples, including patients with major mood disorders and schizophrenia. A systematic search was performed using PubMed (Medline), PsycINFO and Scopus databases. The systematic review identified 12 studies dealing with HPA-related genes and cognition in samples including patients with SMIs, focusing on single nucleotide polymorphism (SNP) variants, while no studies analysing epigenetic variations were found. The results suggest different and specific effects on the cognitive performance of SNP variants in the HPA axis-related genes studied, as well as interactions with traumatic experiences. There was high heterogeneity in the studied samples, genes analysed, and cognitive tasks evaluated. The relationship between HPA-related genes and cognition in SMIs is still largely unknown, and further studies including larger samples and epigenetic variations are needed.