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BACKGROUND: Psychiatric disorders may be a risk factor for long COVID, broadly defined as COVID-19 conditions continuing three months post-acute infection. In US Veterans with high psychiatric burden, we examined associations between psychiatric disorders and clinical diagnosis of long COVID. METHODS: We conducted a retrospective cohort study using health records from VA patients with a positive SARS-CoV-2 test from February 2020 to February 2023. Generalized linear models estimated associations between any psychiatric disorder and likelihood of subsequent diagnosis with long COVID (i.e. two or more long COVID clinical codes). Models were adjusted for socio-demographic, medical, and behavioral factors. Secondary models examined individual psychiatric disorders and age-stratified associations. RESULTS: Among 660 217 VA patients with positive SARS-CoV-2 tests, 56.3% had at least one psychiatric disorder diagnosis and 1.4% were diagnosed with long COVID. Individuals with any psychiatric disorder had higher risk for long COVID diagnosis in models adjusted for socio-demographic factors, vaccination status, smoking, and medical comorbidities (relative risk, RR = 1.28, 95% CI 1.21-1.35), with the strongest associations in younger individuals. Considering specific disorders, depressive, anxiety, and stress-related disorders were associated with increased risk for long COVID diagnoses (RRs = 1.36-1.48), but associations were in the opposite direction for substance use and psychotic disorders (RRs = 0.78-0.88). CONCLUSIONS: Psychiatric disorder diagnoses were associated with increased long COVID diagnosis risk in VA patients, with the strongest associations observed in younger individuals. Improved surveillance, treatment, and prevention for COVID-19 and its long-term sequelae should be considered for individuals with psychiatric conditions.

Wigner predicted that when the Coulomb interactions between electrons become much stronger than their kinetic energy, electrons crystallize into a closely packed lattice1. A variety of two-dimensional systems have shown evidence for Wigner crystals2-11 (WCs). However, a spontaneously formed classical or quantum WC has never been directly visualized. Neither the identification of the WC symmetry nor direct investigation of its melting has been accomplished. Here we use high-resolution scanning tunnelling microscopy measurements to directly image a magnetic-field-induced electron WC in Bernal-stacked bilayer graphene and examine its structural properties as a function of electron density, magnetic field and temperature. At high fields and the lowest temperature, we observe a triangular lattice electron WC in the lowest Landau level. The WC possesses the expected lattice constant and is robust between filling factor ν ≈ 0.13 and ν ≈ 0.38 except near fillings where it competes with fractional quantum Hall states. Increasing the density or temperature results in the melting of the WC into a liquid phase that is isotropic but has a modulated structure characterized by the Bragg wavevector of the WC. At low magnetic fields, the WC unexpectedly transitions into an anisotropic stripe phase, which has been commonly anticipated to form in higher Landau levels. Analysis of individual lattice sites shows signatures that may be related to the quantum zero-point motion of electrons in the WC lattice.

IntroductionAdverse childhood experiences (ACEs) are linked to higher rates of psychiatric disorders in adults. Previous neuroimaging studies with small samples have shown associations between ACEs and alterations in brain volume, connectivity, and blood flow. However, no study has explored these associations in a large clinical population to identify brain regions that may mediate the relationship between ACEs and psychiatric diagnoses. This study aims to evaluate how patient-reported ACEs are associated with brain function in adults, across diagnoses.MethodsWe analyzed 7,275 adults using HMPAO SPECT scans at rest and during a continuous performance task (CPT). We assessed the impact of ACEs on brain function across psychiatric diagnoses and performed mediation analyses where brain functional regions of interest acted as mediators between patient-reported ACEs and specific psychiatric diagnoses. We further evaluated the risk of being diagnosed with specific classes of mental illnesses as a function of increasing ACEs and identified which specific ACE questions were statistically related to each diagnosis in this cohort.ResultsIncreased ACEs were associated with higher activity in cognitive control and default mode networks and decreased activity in the dorsal striatum and cerebellum. Higher ACEs increased the risk of anxiety-related disorders, substance abuse, and depression. Several brain regions were identified as potential mediators between ACEs and adult psychiatric diagnoses.DiscussionThis study, utilizing a large clinical cohort, provides new insights into the neurobiological mechanisms linking ACEs to adult psychiatric conditions. The findings suggest that specific brain regions mediate the effects of ACEs on the risk of developing mental health disorders, highlighting potential targets for therapeutic interventions.

OBJECTIVE: This systematic review provides an overview of psychiatric medications in the late stages of development (Phase III clinical trials) as of June 1, 2024. It details the mechanisms of action, efficacy, dosing, and adverse effects of these medications. METHODS: We searched the PubMed database for Phase III studies of psychiatric medications published until June 1, 2024, using the keywords psychiatric OR psychopharm* AND medic* OR pharm*. Our review encompassed medications currently undergoing Phase III clinical trials and those that have completed Phase III but are awaiting approval from the United States Food and Drug Administration (FDA). We independently analyzed the identified studies and reached a consensus on the medications to be included in this systematic review. RESULTS: As of June 1, 2024, a total of 89 pipeline drug trials were identified, including nine for schizophrenia, five for bipolar disorders, 25 for depressive disorders, 11 for anxiety disorders, five for post-traumatic stress disorder (PTSD), one for obsessive compulsive disorder (OCD), two for eating disorders, two for sleep-wake disorders, three for sexual dysfunctions, one for substance-related and addictive disorders, 22 for neurocognitive disorders, and three for neurodevelopmental disorders, specifically attention deficit hyperactivity disorder (ADHD). CONCLUSION: The psychiatric medications in the pipeline as of June 1, 2024, demonstrate significant promise in treating psychiatric disorders.

Psychiatric disorders, including attention-deficit hyperactivity disorder (ADHD), depression, anxiety disorders, and dementia, manifest differently across life stages, impacting cognitive, emotional, and behavioral health. Understanding the causal relationships between various types of physical activity and these disorders is crucial for developing targeted interventions. The summary level data from GWAS was utilized to conduct a two-sample Mendelian Randomization (MR) analysis. We assessed the potential causal relationships between different types of physical activity including light do it yourself (DIY) activities, heavy DIY activities, strenuous sports, and aerobic exercises/other exercises and the prevalence of psychiatric disorders (ADHD, depression, anxiety disorders, and dementia) across different life stages. The MR analysis showed no causal relationship between light DIY activities and any of the psychiatric disorders studied. Heavy DIY activities showed a significant negative association with anxiety disorders but no links with ADHD, depression, or dementia. Strenuous sports did not demonstrate any causal relationship with the psychiatric disorders examined. Aerobic exercises were notably correlated with a reduced risk of depression, although no significant associations were found with ADHD, anxiety disorders, or dementia. The findings indicate that heavy DIY activities might contribute to reducing anxiety disorders, while aerobic exercises potentially lower the risk of depression. These results emphasize the potential benefits of promoting specific types of physical activity to improve mental health outcomes across different life stages. Future research could further investigate the mechanisms underlying these relationships and consider diverse populations and objective measures of physical activity. • GWAS data and two-sample MR analysis revealed causal links between physical activities and psychiatric disorders. • Heavy DIY reduced anxiety risk, aerobic exercises lowered depression risk; light DIY and strenuous sports showed no effects. • Promoting specific physical activities may enhance mental health across life stages. [ABSTRACT FROM AUTHOR]

Antisocial behavior (ASB) infringes on the rights of others and significantly disrupts social order. Studies have shown that ASB is phenotypically associated with various psychiatric disorders. However, these studies often neglected the importance of genetic foundations. This study utilized genome-wide association studies and pleiotropy analysis to explore the genetic correlation between ASB and psychiatric disorders. Linkage disequilibrium score regression (LDSC) and high-definition likelihood (HDL) methods were employed to assess genetic correlations, and the PLACO method was used for pleiotropy analysis. Functional annotation and biological pathway analysis of identified pleiotropic genes were performed using enrichment analysis. Furthermore, Mendelian randomization (MR) analysis was conducted to validate these causal relationships. LDSC and HDL analysis showed that significant positive genetic correlations were between ASB and attention deficit hyperactivity disorder (ADHD), schizophrenia (SCZ), major depressive disorder (MDD), and post-traumatic stress disorder (PTSD). Multiple potential pleiotropic genetic loci were identified, particularly the FOXP2 and MDFIC genes located at the 7q31.1 locus. Enrichment analysis showed that these pleiotropic genes are highly expressed in several brain regions (such as the hypothalamus, cerebellar hemisphere, cortex, and amygdala) and immune-related cells. MR analysis further confirmed the causal effects ADHD, SCZ, and MDD on ASB risk. This study reveals significant genetic correlations and potential causal mechanisms between ASB and various psychiatric disorders. The MR analysis confirmed the causal effects of psychiatric disorders on ASB. These findings deepen our understanding of the genetic architecture of psychiatric disorders and ASB. • There are genetic links between ASB and disorders like ADHD, MDD, SCZ, and PTSD. • The pleiotropic loci like FOXP2 and MDFIC at 7q31.1, linking ASB with psychiatric disorders. • There are causal links between ADHD, SCZ, MDD, and ASB. [ABSTRACT FROM AUTHOR]

Psychiatric disorders exhibit a shared neuropathology, yet the diverse presentations among patients necessitate the identification of transdiagnostic subtypes to enhance diagnostic and treatment strategies. This study aims to unveil potential transdiagnostic subtypes based on personalized gray matter morphological abnormalities. A total of 496 patients with psychiatric disorders and 255 healthy controls (HCs) from three distinct datasets (one for discovery and two for validation) were enrolled. Individualized gray matter morphological abnormalities were determined using normative modeling to identify transdiagnostic subtypes. In the discovery dataset, two transdiagnostic subtypes with contrasting patterns of structural abnormalities compared to HCs were identified. Reproducibility and generalizability analyses demonstrated that these subtypes could be generalized to new patients and even to new disorders in the validation datasets. These subtypes were characterized by distinct disease epicenters. The gray matter abnormal pattern in subtype 1 was mainly linked to excitatory receptors, whereas subtype 2 showed a predominant association with inhibitory receptors. Furthermore, we observed that the gray matter abnormal pattern in subtype 2 was correlated with transcriptional profiles of inflammation-related genes, while subtype 1 did not show this association. Our findings reveal two robust transdiagnostic biotypes, offering novel insights into psychiatric nosology. • We identify two robust transdiagnostic subtypes based on individualized gray matter morphological abnormalities. • These subtypes exhibiting contrasting patterns of structural abnormalities relative to healthy controls. • The identified subtypes are validated using independent datasets and can be extended to unseen disorders. [ABSTRACT FROM AUTHOR]

Introduction: Women are more likely than men to experience interpersonal trauma, with 1 in 3 women affected globally. This paper aims to give a 2-year report of the demographics, trauma history [i.e., non-interpersonal and interpersonal including adverse childhood event (ACEs)] and psychiatric disorders endorsed by premenopausal women screened for our cardiovascular research study. Methods: Premenopausal women were recruited from the Twin-Cities area using flyers. Interested participants were screened for this study via REDCap. Age, race, history of psychiatric disorders, menopausal status, contraceptives, and current medications were collected. Participants who met the eligibility criteria were enrolled and completed additional questionnaires focusing on trauma exposure and mental health. Results: The first 2 years our study was open to accrual, a total of 447 premenopausal women were screened. The majority (~ 71%) of our participants were between 18 and 30 years old. Among the 447 women, 35% reported a diagnosis of posttraumatic stress disorder (PTSD), while 46% reported depression and 53% an anxiety disorder, according to DSM-5. Further, we found that women between the ages of 21–25 years reported the most (23%) psychiatric disorders, mainly PTSD. The main type of trauma reported was interpersonal trauma (~ 62%), of which 76% were ACEs. Conclusion: Among the trauma-exposed women enrolled in our study, the age group between 21 and 25 years old endorsed the most psychiatric disorders, possibly stemming from ACEs. Our findings shed the light on the rising rate of psychiatric disorders in premenopausal women and support the growing public health burden of trauma exposure, particularly in childhood. [ABSTRACT FROM AUTHOR]

The omnigenic model posits that genetic risk for traits with complex heritability involves cumulative effects of peripheral genes on mechanistic "core genes," suggesting that in a network of genes, those closer to clusters including core genes should have higher GWAS signals. In gene co-expression networks, we confirmed that GWAS signals accumulate in genes more connected to risk-enriched gene clusters, highlighting across-network risk convergence. This was strongest in adult psychiatric disorders, especially schizophrenia (SCZ), spanning 70% of network genes, suggestive of super-polygenic architecture. In snRNA-seq cell type networks, SCZ risk convergence was strongest in L2/L3 excitatory neurons. We prioritized genes most connected to SCZ-GWAS genes, which showed robust association to a CRISPRa measure of PGC3 regulation and were consistently identified across several brain regions. Several genes, including dopamine-associated ones, were prioritized specifically in the striatum. This strategy thus retrieves current drug targets and can be used to prioritize other potential drug targets. • We test risk gradients in gene co-expression networks based on the omnigenic model • Across psychiatric disorders, schizophrenia risk best fits the model's predictions • Findings hold in networks from excitatory neurons and in iPSC-derived neurons • Prioritizing genes most connected to schizophrenia risk reveals potential targets Genetic risk for schizophrenia spans the entire genome. Borcuk et al. show that network neighbors of risk genes also harbor risk, most evidently in excitatory neurons. They leverage this property to propose potential risk genes that are "guilty by association." Stem cell data support the link between these genes and schizophrenia risk. [ABSTRACT FROM AUTHOR]

Background: Mental health is crucial for overall well-being, but rural areas often face difficulties in accessing mental health services and understanding psychiatric disorders. Aim: This study aimed to address these issues by assessing the prevalence of psychiatric disorders among adults in rural Jammu and examining how socio-cultural and demographic factors are related to these disorders. Methods: A sample of 1,016 adults from rural Jammu was surveyed using the Mini International Neuropsychiatric Interview (MINI). Data were collected through house-to-house visits conducted by trained investigators. Descriptive and inferential statistics, including frequency distribution and odds ratio, were employed to analyze the data respectively. Results: Overall, 20.67% of the participants had a psychiatric disorder. Alcohol dependence was the most common condition, affecting 12.30% of the individuals, followed by generalized anxiety disorder at 3.14%. The study found significant associations between psychiatric disorders and several factors. Specifically, older people were more likely to have psychiatric disorders, with an odds ratio of 3.7 [2.07-6.59]. Married individuals also had a higher likelihood of experiencing psychiatric disorders (OR: 2.3 [1.55-3.54]). Those with less schooling were at an increased risk, with an odds ratio of 7.77 [2.31-26.09], and people from lower socioeconomic backgrounds were more likely to have these disorders as well (OR: 5.1 [2.4-10.5]). Discussion and conclusion: The findings underscore the complex association between socio-demographic factors and mental health outcomes in rural areas of Jammu region. Addressing these disparities requires targeted interventions and policies that account for the unique socio-cultural contexts of rural populations. By understanding the specific challenges faced by these communities, policymakers and healthcare providers can develop more effective strategies to enhance mental health services and promote well-being. [ABSTRACT FROM AUTHOR]

Psychiatric disorders are a heterogeneous group of mental disorders with abnormal mental or behavioral patterns, which severely distress or disable affected individuals and can have a grave socioeconomic burden. Growing evidence indicates that mitochondrial function plays an important role in developing psychiatric disorders. This review discusses the neuropsychiatric consequences of mitochondrial abnormalities in both animal models and patients. We also discuss recent studies associated with compromised mitochondrial function in various psychiatric disorders, such as schizophrenia (SCZ), major depressive disorder (MD), and bipolar disorders (BD). These studies employ various approaches including postmortem studies, imaging studies, genetic studies, and induced pluripotent stem cells (iPSCs) studies. We also summarize the evidence from animal models and clinical trials to support mitochondrial function as a potential therapeutic target to treat various psychiatric disorders. This review will contribute to furthering our understanding of the metabolic etiology of various psychiatric disorders, and help guide the development of optimal therapies. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) is a debilitating lung disease characterized by chronic airflow limitation and persistent respiratory symptoms. It is a major cause of morbidity and mortality worldwide, significantly impacting healthcare systems with considerable socioeconomic consequences. The main risk factors include exposure to tobacco smoke, environmental pollutants, occupational dust, and genetic factors such as alpha-1 antitrypsin deficiency. COPD is often associated with extrapulmonary comorbidities, particularly psychiatric disorders like depression and anxiety, which worsen patients' quality of life and prognosis. The prevalence of these disorders in patients with COPD varies significantly but is always higher than in healthy controls. Psychiatric disorders can negatively influence COPD management and vice versa, creating a complex bidirectional interaction. Depression and anxiety are the most common psychiatric comorbidities in patients with COPD, influenced by factors such as social isolation, physical limitations, and fear of exacerbations. Diagnosis of these psychiatric disorders is complicated by the overlap of symptoms with those of COPD. However, some screening tools can facilitate early detection. The treatment of psychiatric disorders in patients with COPD in a rehabilitation setting requires a multidisciplinary approach involving pulmonologists, neurologists and psychologists. Pharmacological therapy with antidepressants shows mixed results in terms of efficacy and safety, with some studies reporting benefits on quality of life and others suggesting an increased risk of exacerbations and pneumonia. An integrated approach that includes the assessment and intervention of mental disorders is essential to improve the overall management of COPD and the quality of life of patients. This narrative review provides an overview of the main psychiatric comorbidities in COPD patients, aiming to fill gaps in the literature and suggest areas for future research. [ABSTRACT FROM AUTHOR]

FMR1 autosomal homolog 1 (FXR1) is an RNA-binding protein that belongs to the Fragile X-related protein (FXR) family. FXR1 is critical for development, as its loss of function is intolerant in humans and results in neonatal death in mice. Although FXR1 is expressed widely including the brain, functional studies on FXR1 have been mostly performed in cancer cells. Limited studies have demonstrated the importance of FXR1 in the brain. In this review, we will focus on the roles of FXR1 in brain development and pathogenesis of brain disorders. We will summarize the current knowledge in FXR1 in the context of neural biology, including structural features, isoform diversity and nomenclature, expression patterns, post-translational modifications, regulatory mechanisms, and molecular functions. Overall, FXR1 emerges as an important regulator of RNA metabolism in the brain, with strong implications in neurodevelopmental and psychiatric disorders. [ABSTRACT FROM AUTHOR]

Objective: Psychiatric disorders have been linked to poor social functioning, including deficits in relationship satisfaction. Treatments have shown strong effectiveness in reducing clinical symptoms for a range of disorders, though less is known of the effects disorder-focused treatments have on relationship satisfaction. Methods: The present study describes a systematic review that was conducted to determine the efficacy of treatments for specific psychiatric disorders in improving relationship satisfaction. Surprisingly, only seventeen studies were identified and included in the review. Results: We found that a majority of these studies reported modest improvement in relationship satisfaction among people who completed treatment. However, studies were severely hampered by methodological limitations, and all therapy-related improvements could be attributable to placebo effects or the passage of time. Conclusion: Important gaps in the literature were found that future research should seek to address to maximize treatment outcomes and psychosocial functioning. [ABSTRACT FROM AUTHOR]

There is limited synthesized evidence for weighted blankets usage in psychiatric patients. We performed a PRISMA compliant systematic review and meta-analysis of the effects of weighted blankets on sleep and mental health outcomes in psychiatric patients. MEDLINE, EMBASE, Cochrane Library, and PsycINFO were searched up to December 15th, 2023. Randomized controlled trials (RCT) or cohort studies reporting objective outcome scales of sleep and mental health were included. Standardized mean difference (SMD) measured effect size. Q and I2 tests measured heterogeneity. Cochrane Risk of Bias Tool 2 and NIH Quality Assessment Tool assessed risk of bias. Nine studies of 553 psychiatric inpatients and outpatients with diagnoses including depression, bipolar disorder, ADHD, and autism. 289 participants received weighted blankets and 264 were in control groups. Intervention length ranged from 5 min to one year. Four studies reported evidence for weighted blankets in improving insomnia, total sleep time, and sleep onset latency. Six studies reported evidence for reducing anxiety symptoms. When compared to placebo, those using weighted blankets had improvements to anxiety symptoms (SMD = −0.47, 95% CI: −0.68 to −0.25, p < 0.001). One RCT had low risk of bias, 3 had some concerns, 1 was high risk. Three cohort studies were "fair" and one was "poor" in quality. It was found that weighted blankets can be effective in reducing anxiety in psychiatric patients. However, the literature is limited by heterogeneity of outcome reporting, lack of well designed RCTs, and small sample sizes. Highlighting the need for higher quality studies. [Display omitted] • Sleep is disturbed in people suffering from mental illness • Weighted blankets are a non-pharmacological sleep aid that are easily accessible • Synthesized evidence for weighted blankets in psychiatric patients is limited • Weighted blankets improves symptoms of insomnia and total sleep time • Weighted blankets significantly improves symptoms of anxiety in psychiatric patients [ABSTRACT FROM AUTHOR]

Exposure to parental substance use problems has been associated with offsprings poor health and adverse social outcomes. In this study, we examined the association between exposure to parental substance use disorder (SUD) during childhood, and adolescence and offspring psychiatric conditions in young adulthood. This was a register-based cohort study comprising 562,095 males and 531,130 females born between 1981 and 1990 in Sweden. Parental SUD was captured between the offspring's birth and eighteenth birthday. Cox regression models were used to estimate the Hazard Ratio (HR) of psychiatric conditions from age 18 years to a maximum age of 35 years, from January 1, 1999 to December 31, 2016. About 4% of the study population was exposed to parental SUD during childhood and adolescence. The HR of psychiatric diagnosis was higher in males (1.80, 95% CI = 1.77–1.85) and females (1.56, 95% CI = 1.51–1.60) who were exposed to parental SUD, compared to those who were not; after adjusting for year of birth, domicile, origin, relative poverty, and other parental psychiatric diagnoses. The risks of psychiatric conditions were higher among males and females exposed to parental SUD during childhood compared to during adolescence. Exposure to parental SUD during childhood and adolescence was associated with an increased risk of psychiatric conditions in early adulthood for both males and females. Neither origin, poverty, municipality, or other parental psychiatric diagnoses fully explained the association. These risks seemed to be somewhat higher among males, and among those exposed during childhood when compared to during adolescence. • About 4 % experienced parental SUD during childhood and adolescence. • Exposure to parental SUD early in life was associated with an increased risk of psychiatric conditions in offspring. • There was more than a twofold increase risk of SUD, and externalizing disorders in exposed offspring. • The risks of psychiatric conditions were higher among males and among those exposed during childhood. [ABSTRACT FROM AUTHOR]

Aims: To estimate the strength of association between psychiatric disorders and substance use disorders (SUD), and cannabis use and cannabis use disorder (CUD) during early pregnancy. Design: Observational study. Setting: Kaiser Permanente Northern California, USA. Participants: 299 496 pregnancies from 227 555 individuals screened for cannabis use by self‐report and a urine toxicology test at entrance to prenatal care in Kaiser Permanente Northern California during January 2011–December 2021 (excepting year 2020). The sample was 62.5% non‐White, with a mean (standard deviation) age of 31.1 (5.5) years; 6.8% used cannabis; 0.2% had a CUD. Measurements: Exposure variables included electronic health record‐based psychiatric diagnoses of attention deficit hyperactivity, anxiety, bipolar, depressive, personality, posttraumatic stress and psychotic disorders; and alcohol, opioid, stimulant and tobacco use disorders, during the two years prior to pregnancy up to the day before the prenatal substance use screening date. Outcome variables were any cannabis use, frequency of self‐reported cannabis use and CUD during early pregnancy. Findings Psychiatric disorder prevalence ranged from 0.2% (psychotic) to 14.3% (anxiety), and SUD ranged from 0.3% (stimulant/opioid) to 3.8% (tobacco). Psychiatric disorders were associated with cannabis use and CUD, with the strongest association for any use found for bipolar disorder (adjusted odds ratio [aOR] = 2.83; 95% confidence interval [CI] = 2.53–3.17) and the strongest association for CUD found for psychotic disorders (aOR = 10.01, 95% CI = 6.52–15.37). SUDs were associated with cannabis use and CUD, with the strongest association for any use found for tobacco use disorder (aOR = 4.03, 95% CI = 3.82–4.24) and the strongest association for CUD found for stimulant use disorder (aOR = 21.99, 95% CI = 16.53–29.26). Anxiety, bipolar, depressive disorders and tobacco use disorder were associated with greater odds of daily than monthly or less cannabis use. Conclusions: Psychiatric disorders and substance use disorders appear to be associated with elevated odds of any and frequent cannabis use as well as cannabis use disorder during early pregnancy. In most cases, the associations with cannabis outcomes were stronger for substance use disorders than other psychiatric disorders. [ABSTRACT FROM AUTHOR]

Background: Over 50% of hospitalized patients have comorbid psychiatric diagnoses, resulting in increased risk of morbidity such as longer lengths of stay, worse health-related quality of life, and increased mortality. However, data regarding colorectal surgery postoperative outcomes in patients with psychiatric diagnoses (PD) are limited. Methods: We queried a single institution's National Surgical Quality Improvement Program from 2013-2019 for major colorectal procedures. Postsurgical outcomes for patients with and without PD were compared. Primary outcomes were prolonged length of stay (pLOS) and 30-day readmission. Results: From a total of 1447 patients, 402 (27.8%) had PD. PD had more smokers (20.9% vs 15%) and higher mean body mass index (29.1 kg/m2 vs 28.2 kg/m2). Bivariate outcomes showed more surgical site infections (SSI) (10.2% vs 6.12%), reoperation (9.45% vs 6.35%), and pLOS (34.8% vs 29.0%) (all P values <.05) in the PD group. On multivariate analysis, PD had higher likelihood of reoperation (OR 1.53, 95% CI: [1.02-2.80]) and SSI (OR 1.82, 95% CI: [1.25-2.66]). Discussion: Psychiatric diagnoses are a risk factor for adverse outcomes after colorectal procedures. Further studies are needed to evaluate the benefit of perioperative mental health support services for these patients. [ABSTRACT FROM AUTHOR]

With over 16 years of experience in clinical, research, and educational activities related to transcranial magnetic stimulation (TMS), I have written this article exploring the ethical dimensions of TMS. This article aims to provide valuable and informative content for those unfamiliar with TMS as well as those just starting in the field. Specifically, this article elaborates on four principles of medical ethics, including those applicable to TMS therapy, the disparity between public medical insurance coverage and medical indications in private practice for TMS therapy, and issues concerning research ethics in practice. I also provide recommendations regarding roles and strategies for adoption by academia and those in this field dedicated to making TMS therapy accessible to a larger patient population in a suitable manner. Lastly, it is my hope that this article will serve as a contemporary "Ethics of TMS Neuromodulation", resonating with the inherent human pursuit of "truth, goodness, and beauty" for a sound mind and spirit. [ABSTRACT FROM AUTHOR]

INTRODUCTION: People with neurodegenerative disorders (ND) frequently face diagnostic delay and misdiagnosis. We investigated blood and cerebrospinal fluid (CSF) neurofilament light chain (NfL) to distinguish ND from primary psychiatric disorders (PPD), a common challenge in clinical settings. METHODS: Plasma and CSF NfL levels were measured and compared between groups, adjusting for age, sex, and weight. RESULTS: A total of 337 participants were included: 136 ND, 77 PPD, and 124 Controls. Plasma NfL was 2.5‐fold elevated in ND compared to PPD and had strong diagnostic performance (area under the curve, [AUC]: 0.86, 81%/85% specificity/sensitivity) that was comparable to CSF NfL (2‐fold elevated, AUC: 0.89, 95%/71% specificity/sensitivity). Diagnostic performance was especially strong in younger people (40– < 60 years). Additional findings were cutoffs optimized for sensitivity and specificity, and issues important for future clinical translation. CONCLUSIONS: This study adds important evidence for a simple blood‐based biomarker to assist as a screening test for neurodegeneration and distinction from PPD, in clinical settings. Highlights: NfL levels were significantly higher in ND versus PPD.Plasma NfL showed strong diagnostic performance, comparable to CSF NfL, to distinguish ND from PPD.Diagnostic performance was higher in younger people, where diagnostic challenges are greater.Further research is needed on analytical and reference range factors, for clinical translation.These findings support a simple screening blood test for neurodegeneration. [ABSTRACT FROM AUTHOR]

Objective: The authors evaluated associations between employment at discharge from Veterans Health Administration Vocational Rehabilitation Service (VR) programs and suicide and other causes of death. Methods: For veterans receiving VR between October 1, 2005, and September 30, 2014 (N=78,293), proportional hazards analyses were used to test associations of employment with suicide, drug overdose, and external and natural cause mortality rates over 1 and 5 years postdischarge and through December 31, 2019. The analyses were adjusted for clinical and sociodemographic characteristics and propensity for employment. Results: Of the veterans, 94.1% had a psychiatric diagnosis, and 35.5% were employed at VR discharge. In proportional hazards analyses, employment was associated with lower mortality rates through 1 year (suicide, hazard ratio [HR]=0.54; overdose, HR=0.70; external causes, HR=0.62; and natural causes, HR=0.51) and 5 years postdischarge (overdose, HR=0.72; external causes, HR=0.81; and natural causes, HR=0.72). Through December 31, 2019, employment was associated with lower risks for overdose (HR=0.80) and death by external (HR=0.81) and natural (HR=0.80) causes. Conclusions: Employment at VR discharge was associated with lower mortality risk among veterans with psychiatric diagnoses. [ABSTRACT FROM AUTHOR]

Background: Psychiatric disorders, such as major depressive disorder (MDD), anxiety disorder (AD), bipolar disorder (BD), and schizophrenia (SCZ), are disturbances in brain activity that lead to disorders of cognition, behavior, and emotion regulation. Among Sjogren syndrome (SS) patients, psychiatric disorders are more prevalent than in the general population. Identifying associated risk factors can provide new evidence for clinical diagnosis and treatment. Methods: We selected genetic instruments based on published genome-wide association studies (GWASs) to determine predisposition. Then, we conducted a 2-sample bidirectional Mendelian randomization (MR) analysis to explore the potential causal associations between SS and four major psychiatric disorders. The primary analysis was performed using MR with the inverse-variance weighted method. Confirmation was achieved through Steiger filtering and testing to determine the causal direction. Sensitivity analyses were conducted using MR-Egger, MR-PRESSO, and "leave-one-out" method methods. Results: Our study showed that SS was linked to BD and SCZ, indicating that individuals with SS may have a reduced risk of developing BD (IVW: OR = 0.940, P=0.014) and SCZ (IVW: OR = 0.854, P=1.47*10-4), while there was no causal relationship between SS and MDD or AD. MR-Egger regression shows no evidence of pleiotropy (BD: intercept = 0.007, p = 0.774; SCZ: intercept = 0.051, p = 0.209). The same as the MR-PRESSO analysis (BD: global test p = 1.000; SCZ: global test p = 0.160). However, the results from the leave-one-out analysis demonstrated instability. Specifically, after excluding SNP rs3117581, the effects on BD and SCZ were found to be non-significant, suggesting the potential influence of unrecognized confounding factors. The results of the reverse MR show that four major psychiatric disorders had no causal effects on SS. Conclusions: Our research findings demonstrate a causal relationship between SS and SCZ, as well as between SS and BD. There are no causal effects between the four major psychiatric disorders and SS. These findings suggest that SS may have the potential to reduce the risk of both psychiatric disorders. This study provides new insight for their prevention and treatment. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionsRates of cannabis use disorder (CUD) have increased disproportionately among Veterans Administration (VA) patients with psychiatric disorders compared to patients with no disorder. However, VA patient samples are not representative of all U.S. adults, so results on disproportionate increases in CUD prevalence could have been biased. To address this concern, we investigated whether disproportionate increases in the prevalence of cannabis outcomes among those with psychiatric disorders would replicate in nationally representative samples of U.S. adults.Data came from two national surveys conducted in 2001-2002 (n = 43,093) and 2012-2013 (n = 36,309). Outcomes were any past-year non-medical cannabis use, frequent non-medical use (≥3 times weekly), and DSM-IV CUD. Psychiatric disorders included mood, anxiety and antisocial personality disorders. Logistic regression was used to generate predicted prevalences of the outcomes, prevalence differences calculated and additive interactions compared differences between those with and without psychiatric disorders.Cannabis outcomes increased more among those with psychiatric disorders. The difference in prevalence differences included any past-year non-medical cannabis use, 2.45% (95%CI = 1.29-3.62); frequent non-medical cannabis use, 1.58% (95%CI = 0.83-2.33); CUD, 1.40% (95%CI = 0.58-2.21). For most specific disorders, prevalences increased more among those with the disorder.In the U.S. general population, rates of cannabis use and CUD increased more among adults with psychiatric disorders than other adults, similar to findings from VA patient samples. Results suggest that although VA patients are not representative of all U.S. adults, findings from this important patient group can be informative. Greater clinical and policy attention to CUD is warranted for adults with psychiatric disorders. [ABSTRACT FROM AUTHOR]

A diagnosis of behavioral variant frontotemporal dementia (bvFTD) often relies on informant reports of significant behavioral changes. “BvFTD-by-proxy” describes situations of neuropsychiatric changes reported solely by an informant under circumstances that may raise questions regarding their objectivity. We present three cases of bvFTD-like symptoms reported by spouses, where progression was unclear, testing showed mild but stable executive dysfunction, and neuroimaging was unremarkable. The subjective nature of bvFTD criteria leaves patients vulnerable to misleading informant reports, especially amid relational discord, and may threaten patient autonomy. Recognizing and managing this situation is critical but time-consuming, often requiring coordinated care across multiple providers. [ABSTRACT FROM AUTHOR]

Introduction: Adverse childhood experiences (ACEs) are linked to higher rates of psychiatric disorders in adults. Previous neuroimaging studies with small samples have shown associations between ACEs and alterations in brain volume, connectivity, and blood flow. However, no study has explored these associations in a large clinical population to identify brain regions that may mediate the relationship between ACEs and psychiatric diagnoses. This study aims to evaluate how patient-reported ACEs are associated with brain function in adults, across diagnoses. Methods: We analyzed 7,275 adults using HMPAO SPECT scans at rest and during a continuous performance task (CPT). We assessed the impact of ACEs on brain function across psychiatric diagnoses and performed mediation analyses where brain functional regions of interest acted as mediators between patient-reported ACEs and specific psychiatric diagnoses. We further evaluated the risk of being diagnosed with specific classes of mental illnesses as a function of increasing ACEs and identified which specific ACE questions were statistically related to each diagnosis in this cohort. Results: Increased ACEs were associated with higher activity in cognitive control and default mode networks and decreased activity in the dorsal striatum and cerebellum. Higher ACEs increased the risk of anxiety-related disorders, substance abuse, and depression. Several brain regions were identified as potential mediators between ACEs and adult psychiatric diagnoses. Discussion: This study, utilizing a large clinical cohort, provides new insights into the neurobiological mechanisms linking ACEs to adult psychiatric conditions. The findings suggest that specific brain regions mediate the effects of ACEs on the risk of developing mental health disorders, highlighting potential targets for therapeutic interventions. [ABSTRACT FROM AUTHOR]

Introduction: Although cognitive behavioral therapy (CBT) effectively treats obsessive-compulsive disorder (OCD), many patients refuse CBT or drop out prematurely, partly because of anxiety regarding exposure and response prevention (ERP) exercises. Inference-based cognitive behavioral therapy (I-CBT) focuses on correcting distorted inferential thinking patterns, enhancing reality-based reasoning, and addressing obsessional doubt by targeting underlying dysfunctional reasoning, without incorporating an ERP component. We hypothesized that I-CBT would be non-inferior to CBT. Additionally, we hypothesized that I-CBT would be more tolerable than CBT. Methods: 197 participants were randomly assigned to 20 sessions CBT or I-CBT and assessed at baseline, posttreatment, and 6 and 12 months’ follow-up. The primary outcome was OCD symptom severity measured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; non-inferiority margin: 2 points). The secondary outcome, treatment tolerability, was assessed using the Treatment Acceptability/Adherence Scale (TAAS). A linear mixed-effects model was used to assess the non-inferiority of the primary outcome and superiority of secondary outcomes. Results: Statistically significant within-group improvements in the primary and secondary outcomes were observed in both treatments. No statistically significant between-group differences in Y-BOCS were found at any assessment point, but the confidence intervals exceeded the non-inferiority threshold, making the results inconclusive. The estimated mean posttreatment TAAS score was significantly higher in the I-CBT group than in the CBT group. Conclusion: While both CBT and I-CBT are effective for OCD, whether I-CBT is non-inferior to CBT in terms of OCD symptom severity remains inconclusive. Nevertheless, I-CBT offers better tolerability and warrants consideration as an alternative treatment for OCD. [ABSTRACT FROM AUTHOR]

Background: Data on Emotion Dysregulation among youth in Lebanon is scarce. Given that Emotion Dysregulation is associated with psychopathology and has a negative impact on youth outcomes, there is a need to better understand the prevalence, clinical and demographic correlates of Emotion Dysregulation. Methods: This study is a secondary analysis of the Psychopathology in Children and Adolescents in Lebanon Study which recruited 1517 youth and one parent from a nationally representative sample. Participants completed The Screen for Child Anxiety Related Emotional Disorders, Mood and Feelings Questionnaire, Strengths and Difficulties Questionnaire, Peer Relations Questionnaire, Conflict Behavior Questionnaire (CBQ).Parents completed a sociodemographic questionnaire and the General Health Questionnaire (GHQ). The Strengths and Difficulties Questionnaire-Dysregulation Profile was used to measure Emotion Dysregulation. Results: The prevalence of Emotion Dysregulation was 11.26% among children aged 5 to < 8 years, 9.40% among children aged 8 to < 12 years and 6.60% among those older than 12 years. Emotion Dysregulation was associated with psychopathology across age groups and a number of correlates were identified. In the final regression models, among children aged 5 to < 8 years; Emotion Dysregulation was associated with lower odds of father employment (OR = 0.235;CI[0.078,0.704]). For those aged 8 to < 12 years old, Emotion Dysregulation was associated with acceptable school performance (OR = 2.246,CI[1.209,4.173]) as opposed to a good school performance, having a chronic physical illness (OR = 2.962; CI [1.495,5.867)], and higher parental GHQ scores (OR = 1.034;CI [1.010,10.58)] indicating worse parental mental health. Adolescents aged 12 years and older who screened positive for Emotion Dysregulation were more likely to be younger (OR = 0.688, CI[0.527,0.899]), be a bully (OR = 2.467;CI[1.036,5.875] and to have higher parental CBQ scores (OR = 1.092;CI [1.011,1.180]), indicating worse parent-child conflict. Youth who screened positive for emotion dysregulation were more likely to seek psychiatric care than their counterparts who screen negative for emotion dysregulation. Conclusion: Age, school performance, parental mental health, parental conflict, chronic physical illness and bullying emerge as important correlates of Emotion Dysregulation. Findings add to the limited data on Emotion Dysregulation in Lebanon and the region and are a first step towards developing intervention and prevention strategies. [ABSTRACT FROM AUTHOR]

Periodic limb movements in sleep (PLMS) are a prevalent disorder characterized by rhythmic, involuntary movements of the lower limbs, such as dorsiflexion of the ankle and extension of the big toe, occurring in periodic intervals during sleep. These movements are often linked to disrupted autonomic nervous system (ANS) activity and altered interoception. Interoception involves perceiving internal bodily states, like heartbeat, breathing, hunger, and temperature, and plays a crucial role in maintaining homeostasis and the mind–body connection. This review explores the complex relationships between PLMS, heart rate variability (HRV), ANS dysregulation, and their impact on psychiatric disorders. By synthesizing the existing literature, it provides insights into how ANS dysregulation and altered interoceptive processes, alongside PLMS, contribute to psychiatric conditions. The review highlights the potential for integrated diagnostic and therapeutic approaches and presents a cause-and-effect model illustrating the mutual influence of psychiatric disorders, ANS dysregulation, PLMS, and interoception. [ABSTRACT FROM AUTHOR]

The prevalence of psychiatric disorders and neurodegenerative diseases is steadily increasing, placing a significant burden on both society and individuals. Given the intricate and multifaceted nature of these diseases, the precise underlying mechanisms remain elusive. Consequently, there is an increasing imperative to investigate the mechanisms, identify specific target sites for effective treatment, and provide for accurate diagnosis of patients with these diseases. Numerous studies have revealed significant alterations in the expression of long non-coding RNAs (lncRNAs) in psychiatric disorders and neurodegenerative diseases, suggesting their potential to increase the probability of these diseases. Moreover, these findings propose that lncRNAs could be used as highly valuable biomarkers in diagnosing and treating these diseases, thereby offering novel insights for future clinical interventions. The review presents a comprehensive summary of the origin, biological functions, and action mechanisms of lncRNAs, while exploring their implications in the pathogenesis of psychiatric disorders and neurodegenerative diseases and their potential utility as biomarkers. [ABSTRACT FROM AUTHOR]

Summary Presence of psychiatric comorbidities is well documented in narcolepsy type‐1 (NT1) but there are limited data on patients with ‘other central disorders of hypersomnolence’ (OCH). This study aimed to investigate frequency of psychiatric comorbidities in patients with NT1 and OCH, and to evaluate their impact on quality of life and sleep as an additive factor in combination with hypersomnolence‐related symptoms. This study was conducted within the scope of the international Swiss Primary Hypersomnolence and Narcolepsy Cohort Study (iSPHYNCS), which aims to find new biomarkers in central disorders of hypersomnolence (CDH). Study participants underwent Mini International Neuropsychiatric Interview and completed questionnaires related to quality of life and sleep. Comparative analysis was conducted to investigate group differences, and multivariable regression models were used to reveal the impact of psychiatric comorbidities. Among a total of 90 patients, 26 were diagnosed with NT1 and 64 with OCH. In all, 38 patients showed at least one psychiatric disorder, 27% of NT1 and 48% of OCH, with female dominance (50% in females versus 23% in males, p < 0.02). Major depressive episodes (n = 29) were most common, followed by suicidality (n = 13). Patients with a psychiatric diagnosis were more fatigued (β = 0.70, p < 0.05), apathic (β = −5.41, p < 0.002), had more disturbed sleep (β = 0.55, p < 0.02), worse sleep (β = 1.89, p < 0.001) and general health (β = −12.55, p < 0.02) quality. Comorbid psychiatric disorders are frequent in patients with CDH and worsen the impact of hypersomnolence‐related symptoms on daily activities regardless of the type of CDH. Psychiatric comorbidities may create a vicious circle with fatigue and avoidance of physical activities, which aggravates hypersomnolence‐related symptoms. [ABSTRACT FROM AUTHOR]

Suicide ranks as a leading cause of premature death among adolescents globally. Understanding the trends and key determinants of suicidal behavior in youth are critical for implementing educational policies and supporting preventive strategies in schools. This retrospective study examined all hospitalizations due to suicidal behavior in children and adolescents aged 11 to 18 years in Spain, using data from the Spanish National Registry of Hospital Discharges spanning 2000 to 2021. Over the 22-year study period, there were 2,015,589 hospitalizations among adolescents in Spain, with 118,609 (5.9 %) cases involving mental disorders. There were 2855 admissions with suicidal behavior, constituting 2.4 % of the hospitalizations among youth with mental disorders. Girls represented 73.4 % of all hospitalizations, with a median age of 16 years. Admissions for suicidal behavior saw a four-fold increase during the last decade (p < 0.001). The in-hospital mortality rate for adolescents with suicidal behavior doubled that of those hospitalized for other mental disorders. During the first year of the COVID-19 pandemic, admissions of adolescents with suicidal behavior decreased, only to surge by 2.5-fold during 2021. Hospital admissions for suicidal behavior among adolescents have risen in Spain over the last two decades. Girls represented 73.4 % of these admissions, yet in-hospital mortality was more frequent in boys. • A total of 2855 hospitalizations in adolescents with suicidal behavior were recorded in Spain from 2000 to 2021. • They represented 2.4 % of admissions due to mental disorders in youth. • Girls represented 73.4 % of hospitalizations with suicidal behavior, with a median age of 16 years. • In-hospital mortality was more frequent in boys than girls. • Admissions for suicidal behavior in youth saw a 4-fold increase during the last decade [ABSTRACT FROM AUTHOR]

To assess the long-term impact of the age of onset (AOO) of the first major depressive episode (MDE) according to 3 age groups and considering gender. Data were extracted from NESARC III, a representative U.S. sample. We included 8053 participants with an MDE history in a cross-sectional and retrospective cohort study. We defined 3 AOO groups: childhood-onset (< 13 yo), adolescence-onset (13–18 yo), and adult-onset (> 18 yo). We compared sociodemographic characteristics, lifetime psychiatric disorders per DSM-5 criteria, and health-related quality of life (HRQOL) in each group and performed gender-stratified analyses. Prevalence of childhood-onset MDE was 10.03 %, adolescence-onset was 14.12 %, and adult-onset was 75.85 %. Suicide attempts (AOR = 3.61; 95 % CI 2.90–4.50), anxiety disorders (AOR = 1.92; 95 % CI 1.62–2.27), and personality disorders (AOR = 3.08; 95 % CI 2.56–3.71) were more frequent in the childhood-onset than in the adult-onset one. Adolescence-onset group showed similar results. Physical Disability scale (p < 0.001) and Mental Disability scale (p < 0.001) were significantly lower in the childhood-onset group. Results were more nuanced in the adolescence-onset group. Women in childhood-onset and adolescence-onset groups had poorer outcomes than the adult-onset group. Differences were less pronounced in men. Recall and classification biases inherent to survey design. Individuals, particularly women, who experienced their first MDE during childhood or adolescence exhibit higher lifetime psychiatric disorder prevalence and poorer HRQOL than those with adult-onset MDE. These findings highlight the importance of preventive measures, early diagnosis, and treatment of youth depression. • MDE prevalence during childhood was 10.03 % and 14.12 % during adolescence. • Early onset MDE was associated with more psychiatric disorders in adult-life. • Measured health-related quality of life was lower in early onset groups. • Women were particularly impacted by an early onset. [ABSTRACT FROM AUTHOR]

Background: Administering radiation therapy to individuals with intellectual disabilities (ID) and psychiatric patients taking antipsychotics poses challenges, especially with whole breast irradiation (WBI) due to difficulty staying still (DSS). In such scenarios, intraoperative radiotherapy (TARGIT-IORT) provides an alternative. Although prior studies have shown its applicability in special cases where WBI may be contraindicated, there is a paucity of literature emphasizing its role in patients with ID and psychiatric conditions who have DSS. Therefore, our case series aims to highlight the applicability of administering TARGIT-IORT in such patients. Case reports: Four breast cancer patients underwent lumpectomy and TARGITIORT. Among them, two patients had ID, with one experiencing a decreased range of motion. The other two had psychiatric disorders, including schizophrenia and bipolar disorder, both manifesting involuntary movements and DSS. Three patients had invasive ductal carcinoma (IDC), and one had invasive lobular carcinoma (ILC). All patients undergoing TARGIT-IORT tolerated the procedure well. Notably, none of the patients exhibited evidence of disease on follow-up. Conclusion: Our study underscores the potential use of TARGIT-IORT as a viable treatment option for breast cancer patients with intellectual and psychiatric disabilities. Unlike traditional EBRT, TARGIT-IORT offers a single radiation dose, addressing challenges associated with compliance or DSS. Our findings demonstrate positive outcomes and tolerance, especially in patients where standard oncologic procedures are difficult to achieve. TARGIT-IORT could also benefit breast cancer patients with concurrent movement disorders like Parkinson’s disease and other movement disorders. Nonetheless, future studies are needed to reinforce its applicability for patients with DSS. [ABSTRACT FROM AUTHOR]

Background: People with intellectual/developmental disabilities (IDD) are known to have high rates of prescription drug use, particularly for psychotropic medications. This is of concern due to the many side effects associated with these medications and because of the risks of polypharmacy. In this paper we compare the most commonly dispensed drugs and all psychotropic medications for youth with IDD compared with youth without IDD. Methods: Using population‐level administrative health data over a 10‐year period, this study examined medications dispensed to youth with an IDD aged 15–24 years compared with youth without an IDD. The most common medications dispensed and the number of youth they were dispensed to were determined. As well a wide variety of psychotropic medications were examined. Results: There were a total of 20 591 youth with IDD and 1 293 791 youth without IDD identified. Youth with IDD had higher odds of being dispensed pain medications, amoxicillin, salbutamol, levothyroxine and all the psychotropic medications (antidepressants, antipsychotics, anxiolytics, anti‐adrenergic agents, mood stabilisers and stimulants). For youth with IDD, 6558 (31.85%) were dispensed two or more different psychotropic medications within a year, compared with 75 963 (5.87%) of youth without IDD. Discussion: Compared to youth without IDD, youth with IDD had significantly higher odds of being dispensed most of the prescription medications studied, including all of the psychotropic medications. They were also twice as likely to be dispensed two or more medications from different classes of psychotropic drugs within the same year. These findings have important implications for the health of people with IDD and for their health care providers. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) is prevalent but remains underdiagnosed and undertreated. Recognizing OSA in patients with psychiatric disorders can be challenging due to the conditions' overlapping symptoms. To aid primary care NPs in identifying OSA among patients with psychiatric disorders, this article examines overlapping symptoms and outlines diagnostic reasoning. It also provides an overview of the anatomy and neurotransmitters involved in OSA, as well as OSA-specific screening tools and risk stratification, to promote the condition's identification among this population. [ABSTRACT FROM AUTHOR]

Background: The causal connection between morning diurnal preference and psychiatric disorders remains enigmatic. Using bidirectional two-sample Mendelian randomization (MR), we aim to explore the potential causal associations between morning diurnal preference and seven prominent psychiatric disorders. Methods: MR is a genetic epidemiological method that leverages genetic variants as instrumental variables to infer causal associations between exposures and outcomes. We obtained morning diurnal preference data from genome-wide association study (GWAS) datasets and identified 252,287 individuals as morning people. Psychiatric disorder data were sourced from the FinnGen consortium R9 dataset. Our primary analysis used the inverse-variance weighted (IVW) approach to evaluate the overall causal effect by combining the estimates from each genetic variant. Addition analyses, including weighted median, MR-Egger regression, weighted mode, and simple mode techniques were conducted to ensure robustness. Results: Being a morning person is related to reduced odds of multiple psychiatric disorders, including depression or dysthymia (OR: 0.93, 95% CI: 0.88, 0.999), anxiety disorders (OR: 0.90, 95% CI: 0.84, 0.96), self-harming behaviors (OR: 0.87, 95% CI: 0.76, 0.99), substance-use disorders (OR: 0.81, 95% CI: 0.71, 0.93), alcohol dependence (OR: 0.82, 95% CI: 0.73, 0.92), alcohol use disorders (OR: 0.85, 95% CI: 0.76, 0.94), acute alcohol intoxication (OR: 0.86, 95% CI: 0.76, 0.96), schizophrenia (OR: 0.77, 95% CI: 0.65, 0.92), and schizophrenia or delusion (OR: 0.80, 95% CI: 0.70, 0.92). Alcohol dependence (OR: 0.97, 95% CI: 0.94, 0.999) and alcohol use disorders (OR: 0.96, 95% CI: 0.94, 0.99) were also related to a lower morning diurnal preference. Conclusions: Our study provides evidence that being a morning person is a protective factor for various psychiatric disorders from a genetic perspective. The results provide insights for potential targeted interventions to improve mental wellbeing. [ABSTRACT FROM AUTHOR]

Cannabis sativa is known for producing over 120 distinct phytocannabinoids, with Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) being the most prominent, primarily in their acidic forms. Beyond Δ9-THC and CBD, a wide array of lesser-known phytocannabinoids, along with terpenes, flavonoids, and alkaloids, demonstrate diverse pharmacological activities, interacting with the endocannabinoid system (eCB) and other biological pathways. These compounds, characterized by phenolic structures and hydroxyl groups, possess lipophilic properties, allowing them to cross the blood–brain barrier (BBB) effectively. Notably, their antioxidant, anti-inflammatory, and neuro-modulatory effects position them as promising agents in treating neurodegenerative disorders. While research has extensively examined the neuropsychiatric and neuroprotective effects of Δ9-THC, other minor phytocannabinoids remain underexplored. Due to the well-established neuroprotective potential of CBD, there is growing interest in the therapeutic benefits of non-psychotropic minor phytocannabinoids (NMPs) in brain disorders. This review highlights the emerging research on these lesser-known compounds and their neuroprotective potential. It offers insights into their therapeutic applications across various major neurological conditions. [ABSTRACT FROM AUTHOR]

Major depressive disorder (MDD) is a debilitating mental illness, and it is considered to be one of the leading causes of disability globally. The etiology of MDD is multifactorial, involving an interplay between biological, psychological, and social factors. Early life represents a critical period for development. Exposure to adverse childhood experiences is a major contributor to the global burden of disease and disability, doubling the risk of developing MDD later in life. Evidence suggests that stressful events experienced during that timeframe play a major role in the emergence of MDD, leading to epigenetic modifications, which might, in turn, influence brain structure, function, and behavior. Neuroplasticity seems to be a primary pathogenetic mechanism of MDD, and, similarly to epigenetic mechanisms, it is particularly sensitive to stress in the early postnatal period. In this review, we will collect and discuss recent studies supporting the role of epigenetics and neuroplasticity in the pathogenesis of MDD, with a focus on early life stress (ELS). We believe that understanding the epigenetic mechanisms by which ELS affects neuroplasticity offers potential pathways for identifying novel therapeutic targets for MDD, ultimately aiming to improve treatment outcomes for this debilitating disorder. [ABSTRACT FROM AUTHOR]

Introduction: There are limited data on how patients with pre-existing psychiatric disorders fare after sustaining a traumatic brain injury (TBI). The purpose of this study was to evaluate the impact of pre-existing psychiatric illness on clinical outcomes after TBI. Methods: A retrospective review was conducted at a regional level 1 trauma center of patients who suffered a TBI between 2012 and 2020. Propensity scores were used to match patients with psychiatric disorder 1:1 to controls. The matched population was used in analyses. Results: Totally, 5343 patients sustained TBI in the study period of which, 977 (18%) had a pre-existing psychiatric disorder. These patients had 1.6 times longer hospital length of stay (LOS) and 1.2 times longer ICU LOS, though days on a ventilator were not longer. TBI readmission, unrelated to the initial head injury, which was more frequent for patients with psychiatric disorder (OR = 2.6 [1.5, 4.6]). Conclusion: In patients sustaining a TBI, having a pre-existing psychiatric disorder is an independent risk factor for increased LOS, and TBI readmission. Identifying psychiatric patients as being of higher risk may allow for targeted modifications toward head injury prevention. [ABSTRACT FROM AUTHOR]

Neuroimaging databases for neuro‐psychiatric disorders enable researchers to implement data‐driven research approaches by providing access to rich data that can be used to study disease, build and validate machine learning models, and even redefine disease spectra. The importance of sharing large, multi‐center, multi‐disorder databases has gradually been recognized in order to truly translate brain imaging knowledge into real‐world clinical practice. Here, we review MRI databases that share data globally to serve multiple psychiatric or neurological disorders. We found 42 datasets consisting of 23,293 samples from patients with psychiatry and neurological disorders and healthy controls; 1245 samples from mood disorders (major depressive disorder and bipolar disorder), 2015 samples from developmental disorders (autism spectrum disorder, attention‐deficit hyperactivity disorder), 675 samples from schizophrenia, 1194 samples from Parkinson's disease, 5865 samples from dementia (including Alzheimer's disease), We recognize that large, multi‐center databases should include governance processes that allow data to be shared across national boundaries. Addressing technical and regulatory issues of existing databases can lead to better design and implementation and improve data access for the research community. The current trend toward the development of shareable MRI databases will contribute to a better understanding of the pathophysiology, diagnosis and assessment, and development of early interventions for neuropsychiatric disorders. [ABSTRACT FROM AUTHOR]

Ketamine is a versatile anesthetic that has been widely used off-label to treat a variety of indications. Esketamine, a derivative of ketamine, is FDA-approved to treat treatment-resistant depression. This report compares statewide prescription ketamine and esketamine trends. Using PDMP data from 2017–2023, prescription and prescriber characteristics, and patient demographics were compared between esketamine and ketamine prescriptions. During this time, ketamine prescriptions, patients, and providers rose 55.8%, 30.6%, and 2.8% since 2017. Esketamine prescriptions increased 1289.4% since 2019. In 2023, ketamine prescriptions were primarily in powder form (98.7%) and paid for out-of-pocket (83.9%), whereas esketamine prescriptions were primarily paid for by insurance (80.2%). The proportion of ketamine prescribed in RI but dispensed out-of-state have increased 22% since 2022 (18% of total dispensations). As more people seek treatment for mental health disorders, ketamine and esketamine prescriptions continue to rise. Understanding ketamine and esketamine use can help mitigate associated adverse events. [ABSTRACT FROM AUTHOR]

Background: In recent years, with the rapid development of technology, research on behavioral addiction concepts such as digital gaming disorders and problematic internet use has increased. As anime-watching has become widespread worldwide, it is thought that this behavior may be one of the areas of problematic technology use, especially in adolescence. However, studies evaluating problematic anime-watching behaviors within the framework of behavioral addictions are quite limited in the literature. In this study, problematic anime-watching behaviors, comorbid psychiatric disorders, and possible psychosocial factors were evaluated in 86 anime watchers aged between 12 and 18 years. Problematic anime-watching behaviors were evaluated according to the diagnostic criteria of other defined disorders related to addictive behaviors in ICD-11. A semi-structured interview tool was used to assess psychiatric comorbidities, and the IGDS9-SF adapted form for anime-watching, the Self-Efficacy Scale for Children, KIDCOPE, and the Social Anxiety Scale for Adolescents were used to collect other data. Results: It was determined that 36.8% of the 86 adolescents in our study had problematic anime-watching behavior. Compared to other adolescents, the problematic anime-watching group had significantly lower self-efficacy scores and significantly higher social anxiety and avoidant coping scores. A significant relationship was found between social anxiety disorder and watching problematic anime. Conclusions: The present study showed that problematic watching of anime may be a variant of behavioral addiction. In conclusion, the relationship between problematic anime-watching behaviors and mental health warrants further examination. [ABSTRACT FROM AUTHOR]

Objective: Understanding the associations between cognitive function and chronic exercise has gained significant attention in the last decade. This overview aims to consolidate current knowledge and shed light on potential benefits of long-term exercise on cognitive abilities. Method: Relevant databases, including Scopus, PubMed, and Web of Science, were searched through predefined keywords related to chronic exercise and cognitive function. We included all relevant systematic-reviews and metaanalysis in our data-synthesizing. Results: We identified 74 references across PubMed (33), Scopus (35), and Web of Sciences (6). After deduplication, 52 unique references remained. Screening by title and abstract yielded 28 relevant studies. Full-text review based on inclusion criteria resulted in nine eligible articles. Most were meta-analyses, examining 10 to 71 randomized controlled trials on executive functions across various age groups and health statuses. Both acute and chronic exercises demonstrated small to moderate positive effects on cognitive functions, with chronic exercise outcomes influenced by type, duration, frequency, session length, age, and cognitive status. Conclusion: Extensive research underscores a robust and compelling link between involving in regular, long-term physical exercise and enhancement of cognitive functioning. This connection emphasizes the critical role that consistent physical activity plays in safeguarding mental well-being and maintaining sharp cognitive abilities throughout various life stages. Positive effect of sustained physical exercise on cognitive functioning serves as a compelling reason to integrate exercise as a fundamental component of a holistic approach to mental wellness and cognitive longevity. [ABSTRACT FROM AUTHOR]

Objective: The systematic review evaluated the association of subclinical hypothyroidism (SCH) with metabolic syndrome (MetS) and specific MetS components in people with major psychiatric disorders. Methods: A systematic review and meta-analysis was conducted to evaluate the association of SCH with MetS and its components in people with major psychiatric conditions. Results: Five studies incorporating 24,158 participants met the inclusion criteria. All five studies comprised patients with depression and/or anxiety. Three studies incorporating 3365 participants were suitable for the meta-analysis. The pooled Odds Ratio (OR) of MetS was 3.46 (95% Confidence Interval/CI = 1.39–8.62) in major depressive disorder (MDD) and anxiety disorders patients with concurrent SCH compared to those without SCH. Meta-analysis showed a significant positive association between SCH and high body mass index (OR = 2.58, 95%CI = 1.33–5.01), high fasting plasma glucose (OR = 3.05, 95%CI = 1.79–5.18) and low high-density lipoprotein cholesterol (OR = 2.30, 95%CI = 1.82–2.92). Conclusions: These findings suggest a significant positive association between MetS and SCH in people with MDD and anxiety disorders. This review informed the clinical implications of MetS in MDD with comorbid SCH and the importance of early diagnosis and treatment for SCH and MetS in psychiatric patients. [ABSTRACT FROM AUTHOR]

Clinical mental health researchers may understandably struggle with how to incorporate biological assessments in clinical research. The options are numerous and are described in a vast and complex body of literature. Here we provide guidelines to assist mental health researchers seeking to include biological measures in their studies. Apart from a focus on behavioral outcomes as measured via interviews or questionnaires, we advocate for a focus on biological pathways in clinical trials and epidemiological studies that may help clarify pathophysiology and mechanisms of action, delineate biological subgroups of participants, mediate treatment effects, and inform personalized treatment strategies. With this paper we aim to bridge the gap between clinical and biological mental health research by (1) discussing the clinical relevance, measurement reliability, and feasibility of relevant peripheral biomarkers; (2) addressing five types of biological tissues, namely blood, saliva, urine, stool and hair; and (3) providing information on how to control sources of measurement variability. [ABSTRACT FROM AUTHOR]

The aim of rhinoplasty is to make the patient happier with their nose. The patient's perception plays a substantial role in their outcome satisfaction. Body dysmorphic disorder (BDD) is an obsessive-compulsive disorder concerning body image, which negatively distorts the patient's perception, rendering them dissatisfied with the outcome even if the results are close to the defined objectives. In this paper, we present a protocol with a two-specialist approach (rhinoplasty surgeon and a psychiatrist) to standardize BDD diagnosis using the DSM-5 criteria. The patients deemed suitable for cosmetic rhinoplasty by the rhinoplasty surgeon's first consultation were sent for Mandatory Psychiatric Evaluation (MPE) for further consultation and second opinion. MPE was employed with a semi-structured clinical interview by a psychiatrist incorporating the Cosmetic Procedure Screening Questionnaire and Appearance Anxiety Inventory. From 2010 to 2023, 1,602 patients attended our practice seeking cosmetic rhinoplasty, out of which, 892 were sent for MPE to the same psychiatrist. The MPE identified 2.5% (22/892) patients as having mild BDD; out of which, 15 were considered suitable for surgical intervention and underwent successful rhinoplasty (follow up: 1–10 years, M = 4.33 years). Although BDD is considered a contraindication in rhinoplasty, our experience shows that borderline and mild BDD can be offered surgery with good insight and support system. Moderate to severe BDD in our practice was filtered out at the first stage and was not offered surgical intervention. BDD among rhinoplasty aspirants is not as prevalent as previously reported. Standardized diagnostic protocols and studying the severity of BDD when present has clarified management of BDD in rhinoplasty aspirants in our practice. MPE is not easy to incorporate in every rhinoplasty practice, but we aim to present guidelines arising from our ongoing experience to help management of BDD in rhinoplasty. [ABSTRACT FROM AUTHOR]

Purpose: Atypical antipsychotics are associated with several adverse effects including metabolic syndrome, weight gain, QTc interval prolongation, and extrapyramidal effects. This study aims to investigate the risk of renal impairment in patients receiving atypical antipsychotics. Methods: A systematic literature search was conducted via PubMed and Ovid SP and Web of Science to retrieve studies reporting the risk of renal impairment in patients receiving atypical antipsychotic treatment. The pooled risk ratio (RR) of renal impairment and the subgroup analysis was calculated using the random-effects generic inverse variance method in Cochrane Review Manager. Results: A total of 4 studies involving 514,710 patients (221, 873 patients on atypical antipsychotics/CKD and 292, 837 controls) were included in this meta-analysis. Patients on atypical antipsychotics exhibited an increased risk of renal impairment, with a pooled risk ratio of 1.34 (95%CI 1.23–1.47). Subgroup analysis demonstrated that atypical antipsychotic use was associated with an increased risk of both acute kidney injury (AKI) (RR 1.51, 95%CI 1.34–1.71) and chronic kidney disease (CKD) (RR: 1.23, 95%CI 1.12–1.35). Conclusion: Patients receiving atypical antipsychotics have an increased risk of renal impairment. Quetiapine carries the highest risk of renal impairment encompassing both AKI and CKD. [ABSTRACT FROM AUTHOR]

Background: There are significant concerns regarding the relationship between mental health and criminal culpability since impulse control problems have long been linked to the genesis of criminal behavior. In trying to clarify the complex legal ramifications that result from this link, this study explores the close link between diseases that inhibit impulse control and their possible role in criminal behavior in patients coming to emergency department. Aim: This research aims to explore how impulse control disorders contribute to criminal actions, emphasizing significant correlations and calling for transformative changes in the emergency help for psychiatric patients and in criminal justice system. Methodology: This study utilized Bullion Words for a literature review, identifying 24,400 hits, and narrowing down to 24 papers after rigorous selection. The systematic review explores the interplay between impulse control disorders and criminal actions, emphasizing legal implications. Ethical considerations ensure confidentiality. The study concludes with key findings, relationship insights, legal discussions, and future research suggestions. Result: This systematic review reveals a nuanced understanding of how impulse control disorders contribute to criminal actions. Identifying specific disorders like kleptomania and intermittent explosive disorder emphasizes the complex interplay of genetic, environmental, and psychological factors. The legal implications highlight the need for a paradigm shift in the criminal justice system, advocating tailored interventions and rehabilitation strategies, and offering a novel perspective for future legal frameworks. Conclusion: This systematic review provides a comprehensive overview of the complex interconnection between impulse control disorders and criminal actions. The findings underscore the importance of recognizing these disorders in legal contexts and advocate for a nuanced approach to sentencing and treatment. Future research should focus on refining diagnostic criteria, exploring intervention strategies, and elucidating the long-term impact of impulse control disorders on legal outcomes. Overall, this review contributes to a more informed understanding of the legal implications surrounding impulse control disorders and criminal actions. [ABSTRACT FROM AUTHOR]

The document discusses the potential of transcranial direct current stimulation (tDCS) as an at-home treatment option for major depressive disorder (MDD). The rise in MDD cases, especially during the COVID-19 pandemic, highlights the need for accessible and effective treatments. While tDCS has shown promise in treating MDD, challenges such as inconsistent dosing parameters and placebo responses need to be addressed. Future research should focus on developing standardized protocols, exploring early response markers, and improving outcome measurements to make tDCS a widely accessible and effective treatment for MDD. [Extracted from the article]