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Objective: The current guidelines and canonical norms of diagnosis or treatment for Post-traumatic stress disorder (PTSD) with sleep disorder are still conflicting and have not yet reached a consensus. This study aimed to unravel the most effective countermeasures between two categories (psychotherapy and pharmacotherapy) put forward by the National Institute for Health and Clinical Excellence (NICE) and World Federation of Societies of Biological Psychiatry (WFSBP) respectively to treat PTSD individuals co-exist with sleep disorders. Methods: Four databases, including PubMed, EMBASE, Cochrane Library, and APA PsyNet, were searched from inception to February 02, 2023. Results: Twenty articles with 24 Randomized controlled trials (RCTs) and a total number of 1,647 participants were included. As demonstrated in the network meta-analysis comparison results, CBT-I (standardized mean differences (SMD) =-1.51,95% confidence interval (CI):-2.55 to -0.47), CBT-I plus IRT (SMD=-1.71, 95%CI:-3.39, -0.03), prazosin (SMD=-0.87, 95%CI:-1.59 to -0.16) and hydroxyzine (SMD=-1.06, 95%CI: -1.94 to -0.19) significantly reduced PTSD symptoms compared with placebo. In contrast to placebo, CBT-I (SMD=-5.61, 95%CI:-8.82 to -2.40) significantly improved sleep quality. For nightmare severity, IRT (SMD=-0.65, 95%CI:-1.00 to -0.31), prazosin (SMD=-1.20, 95%CI:-1.72 to -0.67) and hydroxyzine (SMD=-0.98,95%CI:-1.58 to -0.37) significantly reduced nightmare severity in comparison with placebo. Conclusions: This study suggested that under most circumstances, psychotherapy namely CBT-I had a favorable profile, but pharmacotherapy with prazosin was effective in managing nightmare severity. The sole avail of CBT-I was recommended to improving sleep quality while CBT-I and CBT-I plus IRT showed excellent management of PTSD symptom severity. Exposure to CBT-I is recommended for depression. The relevant clinical guidelines for the management of individuals with PTSD and sleep disorders may regard this as a reference. PROSPERO: CRD42023415240. [ABSTRACT FROM AUTHOR]

Resilience is studied by researchers from various disciplines such as psychology, psychiatry and biological disciplines. Though the resiliency literature has expanded to a considerable extent, only a few studies have examined the resiliency patterns in child asylum-seekers/refugees. Using the constructivist perspective, the aim of the research to identify whether Syrian asylum-seeker children are able to develop resilience in Turkish education system. The date for this research were collected through a comprehensive field work based on interviews with a total of 100 Syrian children who are in the Turkish education system aged 13–18 living in Turkey, Kocaeli province. In the study, participants identified eight resilience strategies to deal with current traumatic stress generators and five education resilience parameters. These strategies positively influenced Syrian children to strengthen their sense of belonging, self-confidence and self-esteem. Based on the results, 64.4% of the participants believed that education is a significant tool to deal with struggles in host society; 60.6% stated education enabled them to find out their abilities; 81.6% emphasized if they did not join a class, they could feel more anxious and depressed; 82.2% reported that they have a fulfilling relationship with their teachers, 88.9% stated that they feel safe at school environment. [ABSTRACT FROM AUTHOR]

As clinical psychological science and biological psychiatry push to assess, model, and integrate heterogeneity and individual differences, approaches leveraging computational modeling, translational methods, and dimensional approaches to psychopathology are increasingly useful in establishing brain–behavior relationships. The field is ultimately interested in complex human behavior, and disruptions in such behaviors can arise through many different pathways, leading to heterogeneity in etiology for seemingly similar presentations. Parsing this complexity may be enhanced using "simple" tasks—which we define as those assaying elemental processes that are the building blocks to complexity. Using eyeblink conditioning as one illustrative example, we propose that simple tasks assessing elemental processes can be leveraged by and enhance computational psychiatry and dimensional approaches in service of understanding heterogeneity in psychiatry, especially when these tasks meet three principles: (a) an extensively mapped circuit, (b) clear brain–behavior relationships, and (c) relevance to understanding etiological processes and/or treatment. General Scientific Summary: Heterogeneity has been a major challenge in the study of psychopathology and clinical science. Here, we proposed that simple tasks, which allow scientists to assess elemental processes of complex human behavior, have great value toward this problem. To effectively leverage these tasks in understanding and embracing heterogeneity, we recommend they be used according to three key principles of utility. [ABSTRACT FROM AUTHOR]

This article updates a 2019 review of the research about the incidence of major cardiac events following electroconvulsive therapy (ECT), and critiques claim that these are rare and, therefore, inconsequential. It concludes that the 2019 review misrepresents its own findings which were, anyway, based on a rather obvious miscalculation of the probability of cardiac events. Having corrected the review, and updated it with five subsequent studies, it is calculated that the probability of ECT causing one or more of six cardiac events (myocardial infarction, life-threatening arrhythmia, acute pulmonary edema, pulmonary embolism, acute heart failure, and cardiac arrest) is between 1 in 15 and 1 in 30 patients and that these cardiac events are a major cause of ECT-related deaths. The ethical principle of informed consent is being routinely breached by ECT psychiatrists. [ABSTRACT FROM AUTHOR]

Objectives: ULK4 is an established candidate gene for mental disorders and antipsychotic treatment response. We investigated the association of functional genetic variation at the ULK4 locus with the human extended dopaminergic reward system using fMRI during the performance of a well-established reward paradigm. Methods: Two hundred and thirty-four patients were included in this study. Association of genetic variation in the ULK4 gene with reward system functioning were determined using the Desire-Reason-Dilemma (DRD) paradigm which allows to assess brain activation in response to conditioned reward stimuli. Results: Variant prioritisation revealed the strongest functional signatures for the ULK4 variant rs17215589, coding for amino acid exchange Ala715Thr. For rs17215589 minor allele carriers, we detected increased activation responses to conditioned reward stimuli in the ventral tegmental area, nucleus accumbens and several cortical brain regions of the extended reward system. Conclusions: Our findings provide further evidence in humans that genetic variation in ULK4 may increase the vulnerability to mental disorders, by modulating the extended reward system function. Future studies are needed to confirm the modulation of the extended reward system by ULK4 and to specify the role of this mechanism in the pathogenesis of psychiatric disorders. [ABSTRACT FROM AUTHOR]

Interdisciplinary study in neurobiology, liberation psychology, and social work highlight the ways in which the brain is related to various cognitive, personality, and behavioral characteristics within a cultural context by blurring lines between dimensions, such as nature and nurture, person and environment, and micro and macro. This paper considers study findings that generate potential clinical social work strategies that are particularly relevant for communities of color experiencing ethno-racial trauma. The purpose of this paper is to support clinical practitioners' efforts to use holistic approaches and practices by incorporating the "bio" component of the biopsychosocial paradigm as it relates to racism. There are at least three pathways by which racism may produce neurobiological consequences that affect the biopsychosocial functioning of populations of color: (a) socio-structural/environmental, (b) stress and/or trauma, and (c) epigenetics. The Flint, Michigan water crisis—wherein the local government allowed lead to contaminate the city's drinking water causing negative health (brain and body) consequences for Flint residents, a predominantly Black and Brown community—presents an example of the intersecting pathways and autopoietic nature of racism that infects relationships, institutions and systems; causes dehumanizing affects; and produces ill effects as evidenced by racial health inequities. The issues, such as racial health inequities, that social workers struggle to resolve tend to be complex and multi-dimensional. Therefore, comprehensive practice is needed to support healthy biopsychosocial functioning. As such, this paper offers Critical Clinical Social Work Practice (CCSWP) informed by the Critical Transformative Potential Development (CTPD) framework. CTPD centers a trauma-informed and healing-centered approach to CCSWP by transforming consciousness into action to change self, relationships, and environment; ideally, working cyclically from the molecular to the macro. Given the field's enduring commitment to social justice, the biopsychosocial model, and the person-in-environment perspective, social work is in a unique position to critically consider how brain health (bio) is affected by trauma (psycho) stemming from racism (social). These multi-level (molecular to macro) considerations empower clinical social workers to innovate integrated strategies that can overcome complex challenges perpetuating racial health inequities. [ABSTRACT FROM AUTHOR]

Unipolar depression is a prevalent and disabling condition, often left untreated. In the outpatient setting, general practitioners fail to recognize depression in about 50% of cases mainly due to somatic comorbidities. Given the significant economic, social, and interpersonal impact of depression and its increasing prevalence, there is a need to improve its diagnosis and treatment in outpatient care. Various efforts have been made to isolate individual biological markers for depression to streamline diagnostic and therapeutic approaches. However, the intricate and dynamic interplay between neuroinflammation, metabolic abnormalities, and relevant neurobiological correlates of depression is not yet fully understood. To address this issue, we propose a naturalistic prospective study involving outpatients with unipolar depression, individuals without depression or comorbidities, and healthy controls. In addition to clinical assessments, cardiovascular parameters, metabolic factors, and inflammatory parameters are collected. For analysis we will use conventional statistics as well as machine learning algorithms. We aim to detect relevant participant subgroups by data-driven cluster algorithms and their impact on the subjects' long-term prognosis. The POKAL-PSY study is a subproject of the research network POKAL (Predictors and Clinical Outcomes in Depressive Disorders; GRK 2621). [ABSTRACT FROM AUTHOR]

Aim: Short tandem repeats (STRs) are repetitive DNA sequences and highly mutable in various human disorders. While the involvement of STRs in various genetic disorders has been extensively studied, their role in autism spectrum disorder (ASD) remains largely unexplored. In this study, we aimed to investigate genetic association of STR expansions with ASD using whole genome sequencing (WGS) and identify risk loci associated with ASD phenotypes. Methods: We analyzed WGS data of 634 ASD families and performed genome‐wide evaluation for 12,929 STR loci. We found rare STR expansions that exceeded normal repeat lengths in autism cases compared to unaffected controls. By integrating single cell RNA and ATAC sequencing datasets of human postmortem brains, we prioritized STR loci in genes specifically expressed in cortical development stages. A deep learning method was used to predict functionality of ASD‐associated STR loci. Results: In ASD cases, rare STR expansions predominantly occurred in early cortical layer‐specific genes involved in neurodevelopment, highlighting the cellular specificity of STR‐associated genes in ASD risk. Leveraging deep learning prediction models, we demonstrated that these STR expansions disrupted the regulatory activity of enhancers and promoters, suggesting a potential mechanism through which they contribute to ASD pathogenesis. We found that individuals with ASD‐associated STR expansions exhibited more severe ASD phenotypes and diminished adaptability compared to non‐carriers. Conclusion: Short tandem repeat expansions in cortical layer‐specific genes are associated with ASD and could potentially be a risk genetic factor for ASD. Our study is the first to show evidence of STR expansion associated with ASD in an under‐investigated population. [ABSTRACT FROM AUTHOR]

Since its inception, psychiatry has undergone several periods of radical identity transformation. Initially limited to psychotherapy alone, the advent of medications stimulated an era of biological psychiatry. For years, medications served as the mainstay of biological treatments, paralleled by a rise in treatment resistance. Brain stimulation therapies are psychiatry's newest arm of intervention and represent an area ripe for exploration. These techniques offer new hope to treatment-resistant patients, but in a manner often dissociated from psychoanalytic conceptualization and the practice of psychotherapy. There is growing interest in bridging this divide. In this article, we continue the efforts at interweaving what may seem to be disparate approaches through the topic of treatment resistance. This article aims to engage interventional psychiatrists in considering psychosocial dimensions of their treatments and to provide education for psychoanalytic clinicians on the history, mechanism of action, and applications of brain stimulation technologies. [ABSTRACT FROM AUTHOR]

Slouching (looking down while rounding the back) is the predominant postural position of people looking at cellphones and working on laptops. This position affects mood, breathing, visual awareness, and energy level. When students implemented posture awareness for 4 weeks and wore a posture feedback device for 3 weeks, they reported an increase in attention, confidence, concentration, and school performance. The wearable feedback device helped students identify situations that evoke slouching and implement changes to counter the slouching. One 22-year-old male student offered the following: "When I sit with good posture on my computer, I am significantly more engaged in what I'm doing. When I slouch on my computer I tend to procrastinate, go on my phone, and get distracted so it ends up taking much longer to do my work when my posture is bad.... I have ADHD and I struggle a lot with my mind wandering when I should be paying attention. Having good posture really helps me to lock in and focus." To enhance the well-being of all students, we recommend offering a 4-week self-practice module that incorporates wearable posture feedback. [ABSTRACT FROM AUTHOR]

Main Topic: Artificial Intelligence and Digitalization: Applications to Neurosurgery and Neuroradiology. On behalf of the SSNS and SSNR, we are pleased to present the Abstracts of the Joint Annual Meeting, which is held at the Congress Kursaal Interlaken, Switzerland, 20–21 June 2024. In total, 62 abstracts were selected, of which 19 abstracts are oral presentations and 43 abstracts are for ePoster. We congratulate all the presenters on their research work and contribution. [ABSTRACT FROM AUTHOR]

On behalf of the SNS, we are pleased to present the Abstracts of the Annual Meeting which is held at the Congress Center in Basel, Switzerland, from 6–7 June 2024. In total, 83 abstracts were selected, whereof we include 8 abstracts for the Plenary Sessions, 6 abstracts for the SAYN GemSession, 30 abstracts for Poster flash presentations, and 39 abstracts as ePosters. We congratulate all the presenters on their research work and contributions. [ABSTRACT FROM AUTHOR]

This article explores the concept of externalism in psychiatry and its implications for the understanding of mental disorders. The author argues that the idea of mental disorders as solely brain disorders is challenged by the externalist objection, which suggests that societal norms and environmental conditions must also be considered. The article discusses the main features of this perspective and reviews externalist objections. It also mentions the "4E" cognition approach, which emphasizes the complex interaction between the brain, body, and environment in understanding the mind. Overall, the article suggests that a comprehensive understanding of mental disorders requires considering external factors beyond the brain. [Extracted from the article]

Neuroscience attracted increasing attention in mass media during the last decades. Indeed, neuroscience advances raise high expectations in society concerning major societal issues such as mental health and learning difficulties. Unfortunately, according to leading experts, neuroscience advances have not yet benefited patients, students and socially deprived families. Yet, neuroscience findings are widely overstated and misrepresented in the media. Academic studies, briefly described here, showed that most data misrepresentations were already present in the neuroscience literature before spreading in mass media. This triumphalist neuroscience discourse reinforces a neuro-essentialist conception of mental disorders and of learning difficulties. By emphasizing brain plasticity, this discourse fuels the neoliberal ethics that overvalue autonomy, rationality, flexibility and individual responsibility. According to this unrealistic rhetoric, neuroscience-based techniques will soon bring inexpensive private solutions to enduring social problems. When considering the social consequences of this rhetoric, neuroscientists should refrain from overstating the interpretation of their observations in their scientific publications and in their exchanges with journalists.

A common challenge people face in today's cross-cultural world is how to solve a series of adaptation problems caused by cultural conflict. Exploring Bruce Lee's successful cross-cultural experiences through psychobiography offers some inspiration and thoughts. How did Bruce Lee successfully integrate martial arts, symbolising the Eastern culture, with films representing the Western culture, finally propelling kung fu films onto the international stage? Numerous publicly available materials about Bruce Lee were collected for this study, and the research data were evaluated using thematic analysis. Bruce Lee's success benefitted from reconstructing cultural environment information and exercising his initiative to shape a new cultural environment. His life experiences reflect individual cognition behaviour and social and cultural environments as two aspects of a dynamic circulation system and show that the two have reached internal and spiralling harmony through mutual integration. In the context of the Oriental collectivism culture's family narrative, Chinese adults' personality development features the unique theme of 'inheritance and innovation'. Dealing with the relationship between self-actualisation and familism is another important and challenging task in developing the Chinese personality. [ABSTRACT FROM AUTHOR]

This psychobiography of Frida Kahlo explores the psychology of the famous Mexican artist. Drawing upon Kahlo's paintings and diary entries, a rich psychological analysis of the feminist icon is juxtaposed with the zeitgeist of 20th century Mexico. Framed through the theoretical model of feminist psychology, Kahlo's role in promoting gender equality and dismantling patriarchal society is discussed. Physical pain resulting from illness and impalement by a metal pole in a trolley accident was matched, if not exceeded, by the psychological pain the artist felt due to resulting issues with fertility and the long-sought but never-realized role of motherhood, infidelity within her marriage, and the eventual loss of her ability to paint. Nevertheless, Kahlo's perseverance and strength led to worldwide recognition of her bold and vibrant paintings, vulnerably depicting her rich inner world. The present study utilises perspectives from art therapy and attachment theory to elucidate the factors contributing to Frida Kahlo's resilience in the face of lifelong trauma and chronic pain. Ultimately, Kahlo's life and work offer valuable insight into the psychological experiences of women in patriarchal societies, emphasising the importance of feminist perspectives in psychological research and highlighting the healing and resilience-promoting role of art. [ABSTRACT FROM AUTHOR]

An editorial is presents the evolving landscape of psychobiography, emphasizing the need to integrate socio-cultural perspectives into the study of extraordinary individuals' lives. Topics include the historical dominance of psychoanalytic theories, the call for greater inclusivity beyond WEIRD contexts, and the Special Issue's proposal to expand disciplinary theories to encompass socio-cultural influences.

This article promotes and advocates for the integration of psychobiography into academic training in psychology. While psychobiography has been foundational to the discipline of psychology since Freud's study of Leonardo da Vinci, its procedures and methods have been sorely neglected in academic psychology. Following a brief introduction to psychobiography, the authors provide a historical review of the specialty area, review the current scope of psychobiographical training in psychology, and summarize the benefits of psychobiography to both the training of students and the broader psychology field. Next, models and examples of psychobiography integration across three continents and five countries are provided. The article concludes with specific recommendations for advancing psychobiography in academic psychology. [ABSTRACT FROM AUTHOR]

Ida B. Wells (1862-1931) led an extraordinary life as a journalist, educator, and activist while navigating the intersecting social realities of race, gender, and class. She embodied courage, advocating for the civil rights of Black Americans in an uncompromising fashion. Building on decades of research in social psychology, sociologist Cecilia L. Ridgeway presents (2019) a cultural schema theory of status. She contends that issues of status in interpersonal contexts are an unavoidable aspect of the human condition. Despite the ubiquity of status as a sociocultural force, Ridgeway believes that status hierarchies may be undermined. The present study is a psychobiographical exploration of Wells through the lens of Ridgeway's status theory. It explores: the development of Wells' cultural schemas; how Wells navigated her own status; the inter-relationship between Wells and her sociocultural context; and how Wells undermined and overcame status hierarchies. [ABSTRACT FROM AUTHOR]

Lawrence Kohlberg (1927–1987) was a moral development specialist and moral teacher. He is considered an exceptional individual due to the success he obtained from developing his Theory of Moral Development. Throughout Kohlberg's life, there was a reciprocal influence between Kohlberg's development and the sociocultural influences of his time, guiding his life story. This psychobiography used a longitudinal, single-case research design from the qualitative paradigm, utilising the descriptive-interpretive approach to explore the influences which shaped major life events in Kohlberg's life. This research design enabled the illumination of how sociocultural circumstances shaped various spheres in Kohlberg's life, such as his identity, education, career path and vocational success. This was done through using Bronfenbrenner's Bioecological Theory of Human Development Framework, by including its enmeshed, most up-to-date scientific research design, the Proximal-Person-Context-Time Model. [ABSTRACT FROM AUTHOR]

Like most historical leaders, Israel's fourth prime minister, Golda Meir, is a controversial figure. Some consider her the worst prime minister in Israel's history, who was responsible for Israel's lack of preparedness for the Yom Kippur War, and others perceive her to be the only 'man' who stood in the way of Arabs' countries victory over Israel. Some view her to be conservative, not brilliant, dogmatic, masculine, and racist, and some others, as a simple, modest, warm, and empathetic woman. The authors bridge between these two conflicting views by employing theories of identity, culture, and gender role bias to investigate how Golda Meir's early age trauma caused by pogroms against Jews, cultural transition between Russia, the USA, and Mandatory Palestine, and serving as a powerful woman leader in an all-men political system, influenced her personal and political behaviour and her public image. [ABSTRACT FROM AUTHOR]

This article examines the scientific career of Edward Trautner, who did pioneering research in the 1950s on lithium treatment for psychiatric disorders. Trautner was the first scientist to study the mechanism of action of lithium as a psychiatric medication. His research established that lithium could be used safely and rationally, and anticipated by a decade the large volume of research in the 1960s and 1970s that led to international acceptance of lithium treatment for mood disorders. Trautner was a pioneer of biological psychiatry who considered pharmacology to be a useful therapeutical tool rather than a permanent cure for putative chemical imbalances. His research involved cross-disciplinary collaborations that combined clinical and laboratory research in the disciplines of psychiatry, physiology, biochemistry, teratology, and even oncology. Trautner himself had a multidisciplinary background that included publications in literature and philosophy. [ABSTRACT FROM AUTHOR]

Many decades has passed since the Indian Association for Social Psychiatry was founded, and the social psychiatry movement in India began, but overall growth in this discipline has been gradual. In India, the field of psychiatry is rapidly expanding, and there is a need to reflect and consider what may be done to address the issues of social psychiatry. In recent years, it has been stated that social psychiatry is in trouble as an academic and medical discipline. We have attempted to highlight the importance of social psychiatry and its current state, developments, and challenges in this article. We also tried to envision future scenarios and offer suggestions for overcoming obstacles. [ABSTRACT FROM AUTHOR]

There is increasing appreciation that certain biological processes may not be equally related to all psychiatric symptoms in a given diagnostic category. Research on the biological phenotyping of psychopathology has begun examining the etiological and treatment implications of identified biotypes; however, little attention has been paid to a critical methodological implication of these results: measurement noninvariance. Measurement invariance is the ability of an instrument to measure the same construct, the same way, across different people, or across different time points for the same individual. If what a measure quantifies differs across different people (e.g., those with or without a particular biotype) or time points, then it is invalid to directly compare means on that measure. Using a running example of inflammatory phenotypes of depression, we first describe the biological phenotyping of psychopathology. Second, we discuss three types of measurement invariance. Third, we demonstrate how differential biology-symptom associations invariably creates measurement noninvariance using a theoretical example and simulated data (for which code is provided). We also show how this issue can lead to false conclusions about the broader diagnostic construct. Finally, we provide several suggestions for addressing these important issues to help advance the field of biological psychiatry.

Modern research in psychiatry is increasingly focusing on the possible identification of potentially useful biomarkers for early and differential diagnosis and patient-tailored therapy. In this context, old and new biomarkers are gaining attention, and bilirubin could represent a low-cost and widespread tool in this regard. In the following paper, we present a case report of a patient with juvenile-onset schizophrenia successfully treated with oral risperidone on 2 separate occasions, whose clinical exacerbation phases overlapped with hyperbilirubinemia peaks, while comfort phases were associated with serum bilirubin within the normal range. The patient was later diagnosed with Gilbert's syndrome, a benign, congenital condition of hyperbilirubinemia, with alternating phases of mostly asymptomatic bilirubin levels. This case highlights a possible relationship between psychotic symptoms and plasma bilirubin levels. While not representing by itself a sufficient condition to determine a relationship between the 2 phenomena, it poses a relevant question for future clinical and research investigations. [ABSTRACT FROM AUTHOR]

The biopsychosocial model (BPSM) was proposed by George Engel in 1977 as an improvement to the biomedical model (BMM), to take account of psychological and social as well as biological factors relevant to health and disease. Since then the BPSM has had a mixed reputation, as the overarching framework for psychiatry, perhaps for medicine generally, while also being criticized for being theoretically and empirically vacuous. Over the past few decades, substantial evidence has accumulated supporting the BPSM but its theory remains less clear. The first part of this paper reviews recent well-known, general theories in the relevant sciences that can provide a theoretical framework of the model, constituting a revitalized BPSM capable of theorizing causal interactions within and between biological, psychological, and social domains. Fundamental concepts in this new framework include causation as regulation and dysfunction as dysregulation. Associated research paradigms are outlined in Part 2. Research in psychological therapies and social epidemiology are major examples of programs that have produced results anomalous for the BMM and consistent with the BPSM. Theorized models of causal mechanisms enrich empirical data and two biopsychosocial examples are models of chronic stress and pain perception. Clinical implications are reviewed in Part 3. The BPSM accommodates psychological and social as well as biological treatment effects evident in the clinical trials literature. Personal, interpersonal, and institutional aspects of clinical care are out of the scope of the BMM, assigned to the art of healthcare rather than the science, but can be accommodated and theorized in the BPSM. [ABSTRACT FROM AUTHOR]

The emergence and swift global spread of COVID-19 brought increased anxiety worldwide (Santabárbara et al. (Progress in Neuro-Psychopharmacology & Biological Psychiatry, 109, 110207, 2021)). Research regarding the COVID-19 outbreak addressed factors that contribute to anxiety people experienced as they tried to handle the changes in their lives associated with COVID-19 (Holmes et al. (The Lancet Psychiatry, 7(6), 547–560, 2020)). This paper focuses on diagnosis uncertainty as a particular source of anxiety. We use self-reported anxiety measures to understand how different stressors, and particularly how being sick or being unsure if one or one's close friends or relatives are sick, relate to overall anxiety levels. Five-hundred and thirty-three participants from a country with a stringent COVID-19 testing policy were surveyed in the spring of 2020 on various aspects of their anxiety and risk for depression, as well as on whether they or their friends or family had COVID-19. Analysis of survey results found that anxiety related to uncertainty regarding whether the survey responder or their friends or family were carrying COVID-19 may be even greater than fear of the virus itself. This paper discusses directional issues related to this finding and offers policy implications for decreasing anxiety during pandemics for certain types of communities. In addition to the main findings regarding diagnosis uncertainty and anxiety, this paper's results also indicate the importance of providing participants with an option for "not sure" in closed questions and imply the increased knowledge that can be gained by analyzing an unsure response independently of "yes" or "no". [ABSTRACT FROM AUTHOR]

On behalf of the SNS and SSNS, we are pleased to present the abstracts of the Joint Annual Meeting to be held in Zurich, Switzerland, on 23–24 November, 2023. In total, 119 abstracts have been selected: 4 abstracts for the Plenary Sessions, 12 abstracts for Free Communications, 18 abstracts for Poster flash presentations, 6 abstracts for the SAYN GemSession, and 79 abstracts as ePosters. We congratulate all the presenters on their research work and contributions. [ABSTRACT FROM AUTHOR]

This 2023 update of the WFSBP guidelines for the pharmacological treatment of eating disorders (EDs) reflects the latest diagnostic and psychopharmacological progress and the improved WFSBP recommendations for the assessment of the level of evidence (LoE) and the grade of recommendation (GoR). The WFSBP Task Force EDs reviewed the relevant literature and provided a timely grading of the LoE and the GoR. In anorexia nervosa (AN), only a limited recommendation (LoE: A; GoR: 2) for olanzapine can be given, because the available evidence is restricted to weight gain, and its effect on psychopathology is less clear. In bulimia nervosa (BN), the current literature prompts a recommendation for fluoxetine (LoE: A; GoR: 1) or topiramate (LoE: A; GoR: 1). In binge-eating disorder (BED), lisdexamfetamine (LDX; LoE: A; GoR: 1) or topiramate (LoE: A; GoR: 1) can be recommended. There is only sparse evidence for the drug treatment of avoidant restrictive food intake disorder (ARFID), pica, and rumination disorder (RD). In BN, fluoxetine, and topiramate, and in BED, LDX and topiramate can be recommended. Despite the published evidence, olanzapine and topiramate have not received marketing authorisation for use in EDs from any medicine regulatory agency. [ABSTRACT FROM AUTHOR]

The first audit in medicine was reported in 1980 on the use of electroconvulsive therapy (ECT) for mental disorders in the United Kingdom. John Read and colleagues have recently conducted an update auditing the extent to which patients are informed of treatment hazards. Their report also audits the response of British health services to being audited about ECT. The response from services was poor on both the details given to patients and the extent to which services responded to questions from the audit team. This review questions how likely it was that Read and colleagues would get a response and given the heterogeneity of patients given ECT whether any response was likely to be meaningful. [ABSTRACT FROM AUTHOR]

In 1962, in the wake of the thalidomide crisis, a new Amendment to the Food and Drugs Act introduced Randomized Controlled Trials (RCTs) into the regulations governing the licensing of medicines. It was believed that requiring companies to demonstrate their products were effective through RCTs would contribute to safety. In 1962, RCTs were a little-understood technique. It was thought trials would produce generalizable knowledge with similar outcomes for successive trials. As a result, regulators adopted a criterion of two positive placebo-controlled trials for licensing medicine. For physicians keen to stall therapeutic bandwagons and eliminate ineffective treatments, a negative RCT result was a good outcome. When made a gateway to the market, companies, in contrast, had an interest to transform RCTs from assessments that might throw up unexpected or negative results into Randomized Controlled Assays (RCAs) that efficiently generated approvable results. This article outlines the differences between RCTs and RCAs, the steps companies took to transform RCTs into RCAs, and the consequences of this transformation. [ABSTRACT FROM AUTHOR]

The present paper is the personal narration of the author reviewing her scientific pathways that led her toward the study of oxytocin. My work began with a pioneering study showing a decreased number of the serotonin transporter proteins in romantic lovers. This unexpected finding promoted my interest in the neurobiology of human emotions and feelings, and significantly shifted my research focus from diseases to physiological states that underlie “love.” During this time increasing experimental data broadened the spectrum of activities of oxytocin from female functions, such as parturition and lactation, to modulation of the stress and immune system. The literature also began to reveal an important role for oxytocin in a sense of safety and wellbeing, processes that are critical to both love and survival. I suggest here that future studies should disentangle different emerging questions regarding the exact role of oxytocin within human nature, as well as its possible therapeutic applications in different physiological conditions and pathological states. Understanding these, in turn, holds the potential to improve the lives of both individuals and societies.

It has been a century since Otto Rank boldly broke away from Freudian orthodoxy and declared that babies at birth are sentient and highly impressionable human beings. Since then, evidence for embryonic consciousness has been firmly established with data from neuroscience, biology, psychiatry, and medicine, always tending to earlier prenatal awareness models. Some have even made the case that we remember our intrauterine lives back to existence as a single fertilized cell. And yet, the methods by which we measure and assess the emotional universe that precedes birth are limited. Mythobiogenesis, a theory developed by the author, draws on the insights of prenatal pioneers in order to open a true window into the womb. That window, not so surprisingly, is mythology, inclusive of fairy tales, sacred scripture, religious belief, and ritual. Donnalt Winnicott put it economically, "Mythology may be the key to our embryological experience." Following Winnicott's intuition, Mythobiogenesis asserts that much of what we call mythology, fairy tales, and even sacred scripture derives from a fundamental impulse to tell the universal intrauterine experience of life before birth in culturally specific ways. We remember conception. We tell of it in our stories. In this article, we explore the biblical narrative of Noah, correlating each story point with those found in other traditions, leading to the conclusion that Noah and his ark are nothing more, nor less, than a single fertilized cell floating toward implantation. [ABSTRACT FROM AUTHOR]

The foundation of a German Society of Biological Psychiatry (DGBP) was initiated at the Second World Congress of Biological Psychiatry of the WFSBP in Barcelona in 1978. Its mission was and is to promote interdisciplinary research on the biology of mental disorders and to translate results of biological research into clinical practice. During the presidency of Peter Falkai, its tasks were defined to improve the quality and support of biologically oriented research in Germany by the DFG (Deutsche Forschungsgemeinschaft; German Research Foundation), BMBF (Bundesministerium für Bildung und Forschung) and EU (European Union), to promote young researchers doing biologically oriented research, to improve on the diagnosis and therapy of mental disorders and to advise policy makers by taking part in legal processes. The DGBP has been a corporate member of the WFSBP from its beginning, became a cooperative member of the DGPPN (Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde), later of the German Brain Council, and fostered relationships with other scientific societies. Over the past 45 years, more than twenty congresses were held in Germany and neighboring countries. Emerging from the pandemic, the DGBP is ready to continue its mission to promote interdisciplinary research on the biology of mental disorders with a focus on the development of young scientists and to translate results of biological research into clinical practice, with regard to pharmacotherapy in close cooperation with the Arbeitsgemeinschaft Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP). In this sense, this article also aims to stimulate the cooperation of the society with other national and international partners and to foster new relationships with young scientists and professionals interested in the aims and goals of the DGBP. [ABSTRACT FROM AUTHOR]

The identification of a blood marker of brain pathology that is sensitive to substance-induced neurotoxicity and dynamically responds to longitudinal changes in substance intake would substantially improve clinical monitoring in the field of substance use and addiction. Here, we explored the hypothesis that plasma levels of neurofilament light chain (NfL), a promising marker of neuroaxonal pathology, are elevated in chronic cocaine users and longitudinally associated with changes in cocaine use. Plasma NfL levels were determined using single molecule array (SIMOA) technology at baseline and at a 4-month follow-up. Substance use was subjectively assessed with an extensive interview and objectively measured via toxicological analysis of urine and 4-month hair samples. In a generalized linear model corrected for sex, age, and body mass index, NfL plasma levels were elevated in cocaine users (n=35) compared to stimulant-naïve healthy controls (n=35). A positive correlation between cocaine hair concentration and NfL levels was also found. Changes in cocaine hair concentration (group analysis of increasers vs. decreasers) over the 4-month interval predicted NfL levels at follow-up, indicating a rise in NfL with increased cocaine use and a reduction with decreased use. No associations between use or change of use of other substances (including the neurotoxic cocaine adulterant levamisole) and NfL levels were found. Our findings demonstrate that NfL is a sensitive marker for assessing cocaine-related neuroaxonal pathology, supporting the utility of blood NfL analysis in addiction research but also suggesting the detailed assessment of substance use in neurological studies and diagnostics. [ABSTRACT FROM AUTHOR]

The National Institutes of Health has established the PhenX Toolkit as a web-based resource containing consensus measures freely available to the research community. The National Institute of Mental Health (NIMH) has introduced the Mental Health Research Core Collection as part of the PhenX Toolkit and recently convened the PhenX Early Psychosis Working Group to generate the PhenX Early Psychosis Specialty Collection. The Working Group consisted of two complementary panels for clinical and translational research. We review the process, deliberations, and products of the translational research panel. The Early Psychosis Specialty Collection rationale for measure selection as well as additional information and protocols for obtaining each measure are available on the PhenX website (https://www.phenxtoolkit.org). The NIMH strongly encourages investigators to use instruments from the PhenX Mental Health Research Collections in NIMH-funded studies and discourages use of alternative measures to collect similar data without justification. We also discuss some of the potential advances that can be achieved by collecting common data elements across large-scale longitudinal studies of early psychosis.

Major psychiatric disorders create a significant public health burden, and mental disorders such as major depressive disorder, bipolar disorder, and schizophrenia are major contributors to the national disease burden. The search for biomarkers has been a leading endeavor in the field of biological psychiatry in recent decades. And the application of cross-scale and multi-omics approaches combining genes and imaging in major psychiatric studies has facilitated the elucidation of gene-related pathogenesis and the exploration of potential biomarkers. In this article, we summarize the results of using combined transcriptomics and magnetic resonance imaging to understand structural and functional brain changes associated with major psychiatric disorders in the last decade, demonstrating the neurobiological mechanisms of genetically related structural and functional brain alterations in multiple directions, and providing new avenues for the development of quantifiable objective biomarkers, as well as clinical diagnostic and prognostic indicators. [ABSTRACT FROM AUTHOR]

'If I experience X, is it because of the illness, the medication, or is it 'just me'?' (Karp 2009) [Is it me or my Meds? Living with Antidepressants. Harvard University Press]. This issue is known as self-illness ambiguity (SIA) (Sadler 2007) ["The Psychiatric Significance of the Personal Self." Psychiatry: Interpersonal and Biological Processes 70 (2): 113–129]. In her paper Know Thyself: Bipolar Disorder and Self-concept, Carls-Diamante (2022) ["Know Thyself: Bipolar Disorder and Self-Concept." Philosophical Explorations, 1–17] offers a taxonomy of different ways in which Bipolar Disorder can be related to one's self and self-concept. In contrast to the essentialist model of mental disorders she seems to adopt, I propose a different outlook on SIA, following an enactive approach to psychiatric disorders as disorders of sense-making. One's way of making sense of the world and/or oneself can become stuck in a rigid pattern that is stronger than oneself and at odds with how one would want to be. I argue that it is helpful to distinguish between the experiential SIA of specific experiences (Am I over/underreacting?) and the long term concerns of existential SIA (How to live my life in accordance with what matters to me despite/while having certain vulnerabilities?). I conclude that knowing oneself is not an intra-individual matter, nor primarily a matter of reflection: it is rather a relational and material practice of trying to live your life in accordance with what matters to you. [ABSTRACT FROM AUTHOR]

Self report measures have been widely used in research to illustrate high rates of exposure to violence among youth in trauma-saturated regions, such as Cape Town, South Africa. To better understand the risk and resilience factors of youth who have been exposed to, witnessed, or directly experienced violence, the current study used a multi-method assessment in a naturalistic setting that included heart rate variability (an index of regulatory flexibility and cardiovascular health), a computerized risk-taking task, and self report measures. Youth (N = 83) from Cape Town, South Africa, participated in a psychobiological assessment. Findings suggest elevated age-adjusted heart rate variability compared to age related norms, which is indicative of overregulation of behavior and emotion. Additionally, youth, all of whom had witnessed or experienced violence at least once, demonstrated a low risk taking and reward seeking propensity. Low risk taking in the context of elevated heart rate variability may reflect youth's affective and behavioral inhibition, suggestive of stress among children who have an overgeneralized threat response. These results both demonstrate the feasibility of psychophysiological research in community youth settings, and counter the traditional narrative that there is an overarching lack of capacity to regulate and a high propensity to risk in violence-exposed youth. [ABSTRACT FROM AUTHOR]

Disrupted auditory networks play an important role in the pathophysiology of psychosis, with abnormalities already observed in individuals at clinical high-risk for psychosis (CHR). Here, we examine structural and functional connectivity of an auditory network in CHR utilising state-of-the-art electroencephalography and diffusion imaging techniques. Twenty-six CHR subjects and 13 healthy controls (HC) underwent diffusion MRI and electroencephalography while performing an auditory task. We investigated structural connectivity, measured as fractional anisotropy in the Arcuate Fasciculus (AF), Cingulum Bundle, and Superior Longitudinal Fasciculus-II. Gamma-band lagged-phase synchronisation, a functional connectivity measure, was calculated between cortical regions connected by these tracts. CHR subjects showed significantly higher structural connectivity in the right AF than HC (p <.001). Although non-significant, functional connectivity between cortical areas connected by the AF was lower in CHR than HC (p =.078). Structural and functional connectivity were correlated in HC (p =.056) but not in CHR (p =.29). We observe significant differences in structural connectivity of the AF, without a concomitant significant change in functional connectivity in CHR subjects. This may suggest that the CHR state is characterised by a decoupling of structural and functional connectivity, possibly due to abnormal white matter maturation. [ABSTRACT FROM AUTHOR]

The primary objectives of these international guidelines were to provide a global audience of clinicians with (a) a series of evidence-based recommendations for the provision of lifestyle-based mental health care in clinical practice for adults with Major Depressive Disorder (MDD) and (b) a series of implementation considerations that may be applicable across a range of settings. Recommendations and associated evidence-based gradings were based on a series of systematic literature searches of published research as well as the clinical expertise of taskforce members. The focus of the guidelines was eight lifestyle domains: physical activity and exercise, smoking cessation, work-directed interventions, mindfulness-based and stress management therapies, diet, sleep, loneliness and social support, and green space interaction. The following electronic bibliographic databases were searched for articles published prior to June 2020: PubMed, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), CINAHL, PsycINFO. Evidence grading was based on the level of evidence specific to MDD and risk of bias, in accordance with the World Federation of Societies for Biological Psychiatry criteria. Nine recommendations were formed. The recommendations with the highest ratings to improve MDD were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies (Grade 2). Interventions related to diet and green space were recommended, but with a lower strength of evidence (Grade 3). Recommendations regarding smoking cessation and loneliness and social support were based on expert opinion. Key implementation considerations included the need for input from allied health professionals and support networks to implement this type of approach, the importance of partnering such recommendations with behaviour change support, and the need to deliver interventions using a biopsychosocial-cultural framework. Lifestyle-based interventions are recommended as a foundational component of mental health care in clinical practice for adults with Major Depressive Disorder, where other evidence-based therapies can be added or used in combination. The findings and recommendations of these guidelines support the need for further research to address existing gaps in efficacy and implementation research, especially for emerging lifestyle-based approaches (e.g. green space, loneliness and social support interventions) where data are limited. Further work is also needed to develop innovative approaches for delivery and models of care, and to support the training of health professionals regarding lifestyle-based mental health care. [ABSTRACT FROM AUTHOR]

Introduction: Treatment of severe mental illness (SMI) symptoms, especially negative symptoms and cognitive dysfunction in schizophrenia, remains a major unmet need. There is good evidence that SMIs have a strong genetic background and are characterized by multiple biological alterations, including disturbed brain circuits and connectivity, dysregulated neuronal excitation-inhibition, disturbed dopaminergic and glutamatergic pathways, and partially dysregulated inflammatory processes. The ways in which the dysregulated signaling pathways are interconnected remains largely unknown, in part because well-characterized clinical studies on comprehensive biomaterial are lacking. Furthermore, the development of drugs to treat SMIs such as schizophrenia is limited by the use of operationalized symptom-based clusters for diagnosis. Methods: In line with the Research Domain Criteria initiative, the Clinical Deep Phenotyping (CDP) study is using a multimodal approach to reveal the neurobiological underpinnings of clinically relevant schizophrenia subgroups by performing broad transdiagnostic clinical characterization with standardized neurocognitive assessments, multimodal neuroimaging, electrophysiological assessments, retinal investigations, and omics-based analyzes of blood and cerebrospinal fluid. Moreover, to bridge the translational gap in biological psychiatry the study includes in vitro investigations on human-induced pluripotent stem cells, which are available from a subset of participants. Results: Here, we report on the feasibility of this multimodal approach, which has been successfully initiated in the first participants in the CDP cohort; to date, the cohort comprises over 194 individuals with SMI and 187 age and gender matched healthy controls. In addition, we describe the applied research modalities and study objectives. Discussion: The identification of cross-diagnostic and diagnosis-specific biotypeinformed subgroups of patients and the translational dissection of those subgroups may help to pave the way toward precision medicine with artificial intelligencesupported tailored interventions and treatment. This aim is particularly important in psychiatry, a field where innovation is urgently needed because specific symptom domains, such as negative symptoms and cognitive dysfunction, and treatmentresistant symptoms in general are still difficult to treat. [ABSTRACT FROM AUTHOR]

The dexamethasone suppression test (DST) assesses the functionality of the HPA axis and can be regarded as the first potential biomarker in psychiatry. In 1981, a group of researchers at the University of Michigan published a groundbreaking paper regarding its use for diagnosing melancholic depression, reporting a diagnostic sensitivity of 67% and a specificity of 95%. While this study generated much enthusiasm and high expectations in the field of biological psychiatry, subsequent studies produced equivocal results, leading to the test being rejected by the American Psychiatric Association. The scientific reasons leading to the rise and fall of the DST are assessed in this review, suggestions are provided as to how the original test can be improved, and its potential applications in clinical psychiatry are discussed. An improved, standardized, and validated version of the DST would be a biologically meaningful and useful biomarker in psychiatry, providing a tool for clinicians caring for depressed patients in the areas of diagnosis, treatment, and prognosis, and predicting the risk of suicide. Additionally, such a test could be a crucial part in the generation of biologically homogenous patient cohorts, necessary for the successful development of new psychotropic medications. [ABSTRACT FROM AUTHOR]

Modern psychiatry is a house divided. On the one hand, the dominant concept of biological reductionism means that the great bulk of research funding and effort is directed at finding a physical cause for mental disorders. On the other hand, many practitioners are unhappy with the apparent inhumanity of looking at the mentally disturbed as "biological specimens." They prefer an approach that allows them to integrate psychological, social, cultural, and other historical elements in their management. Unfortunately, until recently, there has been no such model available. The biocognitive model for psychiatry argues that reductionism is wrong, and offers a highly developed mentalist model in its place. The goal is to allow the integration of psychosociocultural information in a formal, scientific model of the mind. [ABSTRACT FROM AUTHOR]