The influence of childhood trauma on social media-induced secondary traumatic stress among college students: the chain mediating effect of self-compassion and resilience

Background: Studies have shown that media exposure to critical public events can lead to secondary traumatic stress (STS). Personal trauma history, self-compassion and resilience are important factors influencing STS in healthy professionals. However, whether these variables are associated with social media-induced STS in college students and the underlying mechanisms remain unclear. The purpose of this study was to explore the complex relationship linking childhood trauma to social media-induced STS in a large sample of college students.Methods: A total of 1151 Chinese college students from Chengdu, Sichuan Province of China completed a web-based cross-sectional survey, which included standard assessments of childhood trauma, self-compassion, resilience and social media-induced STS, as well as sociodemographic questionnaires. The chain mediation model was tested using the PROCESS macro programme in SPSS software.Results: There was a moderate correlation between childhood trauma and social media-induced STS (r = 0.34, p < .001). This association was significantly mediated by self-compassion (indirect effect [95% CI] = 0.14[0.11, 0.17]) and resilience (indirect effect = 0.03[0.01, 0.04]), respectively. Further, a chained mediating effect was observed with self-compassion and resilience consecutively mediated the relationship between childhood trauma and social media-induced STS (indirect effect = 0.02[0.01, 0.03]). These results persisted after sociodemographic characteristics were included as controlling variables.Conclusions: Early life trauma impacts STS induced by exposure to traumatic materials on social media through self-compassion and resilience among Chinese college students. Psychological interventions targeting self-compassion and resilience can be implemented to reduce the risk of STS, especially in vulnerable individuals.

Identification of biomarkers for chronic renal fibrosis and their relationship with immune infiltration and cell death

BACKGROUND

Chronic kidney disease (CKD) represents a significant global public health challenge. This study aims to identify biomarkers of renal fibrosis and elucidate the relationship between unilateral ureteral obstruction (UUO), immune infiltration, and cell death.

METHODS

Gene expression matrices for UUO were retrieved from the gene expression omnibus (GSE36496, GSE79443, GSE217650, and GSE217654). Seven genes identified through Protein-Protein Interaction (PPI) network and Support Vector Machine-Recursive Feature Elimination (SVM-RFE) analysis were validated using qRT-PCR in both in vivo and in vitro UUO experiments. WB assays were employed to investigate the role of Clec4n within NF-κB signaling pathway in renal fibrosis. The composition of immune cells in UUO was assessed using CIBERSORT, and gene set variant analysis (GSVA) was utilized to evaluate prevalent signaling pathways and cell death indices.

RESULTS

GO and KEGG enrichment analyses revealed numerous inflammation-related pathways significantly enriched in UUO conditions. Bcl2a1b, Clec4n, and Col1a1 were identified as potential diagnostic biomarkers for UUO. Analysis of immune cell infiltration indicated a correlation between UUO and enhanced mast cell activation. Silencing Clec4n expression appeared to mitigate the inflammatory response in renal fibrosis. GSVA results indicated elevated inflammatory pathway scores in UUO, with significant differences in disulfiram and cuproptosis scores compared to those in the normal murine kidney group.

CONCLUSION

Bcl2a1b, Clec4n, and Col1a1 may serve as biomarkers for diagnosing UUO. UUO development is closely linked to immune cell infiltration, activation of inflammatory pathways, disulfiram, and cuproptosis processes.

Innovative approaches to managing chronic multimorbidity: A multidisciplinary perspective

The rising prevalence of chronic multimorbidity poses substantial challenges to healthcare systems, necessitating the development of innovative management strategies to optimize patient care and system efficiency. The study by Fontalba-Navas et al investigates the implementation of a novel high complexity unit (HCU) specifically designed to improve the management of patients with chronic complex conditions. By adopting a multidisciplinary approach, the HCU aims to provide comprehensive, patient-centered care that enhances health outcomes and alleviates the strain on traditional hospital services. Utilizing a longitudinal analysis of data from the Basic Minimum Data Set, this study compares hospitalization metrics among the HCU, Internal Medicine, and other departments within a regional hospital throughout 2022. The findings reveal that the HCU's integrated care model significantly reduces readmission rates and boosts patient satisfaction compared to conventional care practices. The study highlights the HCU's potential as a replicable model for managing chronic multimorbidity, emphasizing its effectiveness in minimizing unnecessary hospitalizations and enhancing the overall quality of patient care. This innovative approach not only addresses the complexities associated with chronic multimorbid conditions but also offers a sustainable framework for healthcare systems confronting similar challenges.

MicroRNAs as potential biomarkers for diagnosis of post-traumatic stress disorder

Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events. Currently, there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with and without post-traumatic stress disorder. In addition, the heterogeneity of clinical presentations of post-traumatic stress disorder and the overlap of symptoms with other conditions can lead to misdiagnosis and inappropriate treatment. Evidence suggests that this condition is a multisystem disorder that affects many biological systems, raising the possibility that peripheral markers of disease may be used to diagnose post-traumatic stress disorder. We performed a PubMed search for microRNAs (miRNAs) in post-traumatic stress disorder (PTSD) that could serve as diagnostic biomarkers and found 18 original research articles on studies performed with human patients and published January 2012 to December 2023. These included four studies with whole blood, seven with peripheral blood mononuclear cells, four with plasma extracellular vesicles/exosomes, and one with serum exosomes. One of these studies had also used whole plasma. Two studies were excluded as they did not involve microRNA biomarkers. Most of the studies had collected samples from adult male Veterans who had returned from deployment and been exposed to combat, and only two were from recently traumatized adult subjects. In measuring miRNA expression levels, many of the studies had used microarray miRNA analysis, miRNA Seq analysis, or NanoString panels. Only six studies had used real time polymerase chain reaction assay to determine/validate miRNA expression in PTSD subjects compared to controls. The miRNAs that were found/validated in these studies may be considered as potential candidate biomarkers for PTSD and include miR-3130-5p in whole blood; miR-193a-5p, -7113-5p, -125a, -181c, and -671-5p in peripheral blood mononuclear cells; miR-10b-5p, -203a-3p, -4488, -502-3p, -874-3p, -5100, and -7641 in plasma extracellular vesicles/exosomes; and miR-18a-3p and -7-1-5p in blood plasma. Several important limitations identified in the studies need to be taken into account in future studies. Further studies are warranted with war veterans and recently traumatized children, adolescents, and adults having PTSD and use of animal models subjected to various stressors and the effects of suppressing or overexpressing specific microRNAs.

Increased excitatory amino acid transporter 2 levels in basolateral amygdala astrocytes mediate chronic stress-induced anxiety-like behavior

JOURNAL/nrgr/04.03/01300535-202506000-00024/figure1/v/2024-08-05T133530Z/r/image-tiff The conventional perception of astrocytes as mere supportive cells within the brain has recently been called into question by empirical evidence, which has revealed their active involvement in regulating brain function and encoding behaviors associated with emotions. Specifically, astrocytes in the basolateral amygdala have been found to play a role in the modulation of anxiety-like behaviors triggered by chronic stress. Nevertheless, the precise molecular mechanisms by which basolateral amygdala astrocytes regulate chronic stress-induced anxiety-like behaviors remain to be fully elucidated. In this study, we found that in a mouse model of anxiety triggered by unpredictable chronic mild stress, the expression of excitatory amino acid transporter 2 was upregulated in the basolateral amygdala. Interestingly, our findings indicate that the targeted knockdown of excitatory amino acid transporter 2 specifically within the basolateral amygdala astrocytes was able to rescue the anxiety-like behavior in mice subjected to stress. Furthermore, we found that the overexpression of excitatory amino acid transporter 2 in the basolateral amygdala, whether achieved through intracranial administration of excitatory amino acid transporter 2 agonists or through injection of excitatory amino acid transporter 2-overexpressing viruses with GfaABC1D promoters, evoked anxiety-like behavior in mice. Our single-nucleus RNA sequencing analysis further confirmed that chronic stress induced an upregulation of excitatory amino acid transporter 2 specifically in astrocytes in the basolateral amygdala. Moreover, through in vivo calcium signal recordings, we found that the frequency of calcium activity in the basolateral amygdala of mice subjected to chronic stress was higher compared with normal mice. After knocking down the expression of excitatory amino acid transporter 2 in the basolateral amygdala, the frequency of calcium activity was not significantly increased, and anxiety-like behavior was obviously mitigated. Additionally, administration of an excitatory amino acid transporter 2 inhibitor in the basolateral amygdala yielded a notable reduction in anxiety level among mice subjected to stress. These results suggest that basolateral amygdala astrocytic excitatory amino acid transporter 2 plays a role in in the regulation of unpredictable chronic mild stress-induced anxiety-like behavior by impacting the activity of local glutamatergic neurons, and targeting excitatory amino acid transporter 2 in the basolateral amygdala holds therapeutic promise for addressing anxiety disorders.

Efficacy and safety of iclepertin (BI 425809) with adjunctive computerized cognitive training in patients with schizophrenia

Despite significant patient burden, there are no approved pharmacotherapies to treat symptoms of cognitive impairment associated with schizophrenia (CIAS). This double-blind, placebo-controlled, parallel-group Phase II trial assessed the efficacy and safety of pharmacological augmentation of at-home computerized cognitive training (CCT) with iclepertin (BI 425809, a glycine transporter-1 inhibitor). Participants with schizophrenia (aged 18-50 years) on stable antipsychotic therapy, who were compliant with CCT during the run-in period, were enrolled. Patients were randomized (1:1) to once daily iclepertin 10 mg or placebo for 12 weeks, and all patients completed adjunctive CCT. At Week 12, the change from baseline in neurocognitive composite T-score of the MATRICS Consensus Cognitive Battery (primary endpoint), Schizophrenia Cognition Rating Scale interviewer total score, and Positive and Negative Syndrome Scale total score (secondary endpoints) were assessed. Performance was also assessed using Virtual Reality Functional Capacity Assessment Tool adjusted total time T-score. Of 200 randomized patients, 154 (77.0 %) completed the trial. At efficacy endpoint assessment, no differences were observed between treatment groups. Adverse events (AEs) were reported by 39 patients in the iclepertin 10 mg + CCT group and 57 patients in the placebo + CCT group; most AEs were mild to moderate. To our knowledge, this trial is the largest of its kind combining daily pharmacotherapy for CIAS with at-home CCT. Although efficacy was not demonstrated, the safety profile of iclepertin 10 mg was consistent with previous studies and no new risks were identified.

Clinical trial registration

ClinicalTrials.gov identifier: NCT03859973.

Bidirectional association between sarcopenia and depression: A systematic review and meta-analysis

PURPOSE

Recent research has reported a potential bidirectional association between sarcopenia and depression, yet systematic evidence supporting this relationship is still lacking. This study evaluated the bidirectional association of sarcopenia with depression to provide reliable evidence for the development of specific prevention and control strategies.

METHODS

Relevant articles were extracted from PubMed, Embase, Cochrane, and Web of Science from inception to July 4, 2024. Quality was assessed using the Newcastle-Ottawa Scale (NOS) for cohort and case-control studies, and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for cross-sectional studies. Changes in the association between sarcopenia and depression were compared across different study designs, sources of study subjects, and sarcopenia diagnostic criteria by subgroup analyses. Meta-analysis was conducted using R 4.4.1.

RESULTS

Thirty-three original studies involving 119,421 subjects were incorporated into this review. Pooled analysis revealed a significant reciprocal relationship between sarcopenia and depression in community populations. The risk of depression increased when sarcopenia was the exposure factor [OR = 2.40(95 % CI: 1.87, 3.08)]. Conversely, the risk of sarcopenia significantly increased when depression was the exposure factor [OR = 1.90(95 % CI: 1.44, 2.50)]. Additionally, there was a markedly increased risk of sarcopenia when depressive symptoms were the exposure factor [OR = 1.38(95 % CI: 1.25, 1.53)]. Similar conclusions were obtained in patients with other diseases.

CONCLUSIONS

The significant bidirectional association between sarcopenia and depression enhances the prevention, screening, diagnosis, and treatment of depression, thereby improving quality of life and outcomes.

Is adult attention deficit hyperactivity disorder associated with non-suicidal self-injury and/or suicidal behaviors? A study on the role of borderline personality disorder comorbidity

Although several studies have suggested an association between attention deficit hyperactivity disorder (ADHD) and non-suicidal self-injury (NSSI) as well as suicidal attempts (SA), few have considered the confounding impact of a comorbid borderline personality disorder (BPD). In the present study, we conducted a retrospective analysis on 147 ADHD patients to assess the role played by BPD in the association between ADHD and lifetime history/number of NSSI and SA. BPD was considered both categorically and dimensionally. Overall, ADHD symptoms were positively associated with a higher lifetime history/number of NSSI and SA. This association was maintained after further adjustment on comorbid BPD status, but not after adjustment on BPD symptoms. While being only exploratory, these results add evidence on the complex links between ADHD and NSSI/SA and suggest a potential role played by BPD symptoms in this association.

Heterogeneity of mature oligodendrocytes in the central nervous system

Mature oligodendrocytes form myelin sheaths that are crucial for the insulation of axons and efficient signal transmission in the central nervous system. Recent evidence has challenged the classical view of the functionally static mature oligodendrocyte and revealed a gamut of dynamic functions such as the ability to modulate neuronal circuitry and provide metabolic support to axons. Despite the recognition of potential heterogeneity in mature oligodendrocyte function, a comprehensive summary of mature oligodendrocyte diversity is lacking. We delve into early 20 th -century studies by Robertson and Río-Hortega that laid the foundation for the modern identification of regional and morphological heterogeneity in mature oligodendrocytes. Indeed, recent morphologic and functional studies call into question the long-assumed homogeneity of mature oligodendrocyte function through the identification of distinct subtypes with varying myelination preferences. Furthermore, modern molecular investigations, employing techniques such as single cell/nucleus RNA sequencing, consistently unveil at least six mature oligodendrocyte subpopulations in the human central nervous system that are highly transcriptomically diverse and vary with central nervous system region. Age and disease related mature oligodendrocyte variation denotes the impact of pathological conditions such as multiple sclerosis, Alzheimer's disease, and psychiatric disorders. Nevertheless, caution is warranted when subclassifying mature oligodendrocytes because of the simplification needed to make conclusions about cell identity from temporally confined investigations. Future studies leveraging advanced techniques like spatial transcriptomics and single-cell proteomics promise a more nuanced understanding of mature oligodendrocyte heterogeneity. Such research avenues that precisely evaluate mature oligodendrocyte heterogeneity with care to understand the mitigating influence of species, sex, central nervous system region, age, and disease, hold promise for the development of therapeutic interventions targeting varied central nervous system pathology.

Abnormal resting-state functional connectivity in panic disorder: An exploratory whole-brain MRI study

BACKGROUND

Panic disorder (PD) is characterized by prolonged anxiety about panic attacks, significantly impairing social functioning. Despite this impact, resting-state brain function anomalies in PD are insufficiently understood. We conducted a data-driven investigation of resting-state functional connectivity (rsFC) in PD.

METHODS

MRI scans and clinical assessments were performed on PD patients and healthy controls (HCs). Differences in rsFC were analyzed using the cluster-wise analysis of 9045 connections among 135 regions across the brain. For significant clusters, correlations between rsFC and clinical scores for panic and anxiety symptoms were examined.

RESULTS

Thirty-nine patients and 44 HCs were included in the analyses. A significant cluster-level difference in rsFC was observed between groups, involving connections between the medial occipital region and the paracingulate gyrus within the anterior cingulate cortex (ACC). In this cluster, PD patients exhibited higher rsFC in 11 connections, with eight of these showing positive correlations with State-Trait Anxiety Inventory scores.

LIMITATIONS

The comprehensive analysis of 9045 connections may have diluted statistical power, potentially obscuring other relevant connections.

CONCLUSIONS

Increased rsFC between the medial occipital region and the ACC was observed in PD. This suggests that anxiety-evoking visual imagery generated in the occipital lobe may disproportionately influence self-referential thought process mediated by the ACC. Interventions targeting visual imagery may help alleviate daily anxiety in PD patients.

In vivo calcium extrusion from accumbal astrocytes reduces anxiety-like behaviors but increases compulsive-like responses and compulsive ethanol drinking in mice

The ventral striatum is crucially involved in reward processing. The present study investigates the behavioral effects of astrocyte-specific calcium extrusion virus "CalEx" on perseverative responses in the operant five-choice serial reaction time task and ethanol-conditioned place preference. Mice were injected with CalEx via the GfaABC1D promoter to extrude cytosolic calcium from astrocytes within the ventral striatum. We found that CalEx transfection in the ventral striatum reduced evoked response duration, the maximum amplitude, and the response frequency to 500 μM ATP as measured by ΔF/F fluorescence intensity of the genetically encoded calcium indicator targeting astrocytes GCaMP6f. During the five-choice serial reaction time task, CalEx mice persisted in perseverative responses compared to their counterparts. Additionally, during ethanol-conditioned place preference, CalEx mice showed increased place preference for a low ethanol concentration compared to control group. Furthermore, we found that accumbal astrocytic calcium extrusion increased quinine adulterated ethanol drinking. Our findings suggest that diminishing ventral striatum astrocyte calcium activity contributes to compulsive behaviors, ethanol drinking, and enhanced ethanol drug reward.

A shotgun metagenomic study identified short-chain fatty acid-producing species and their functions in the gut microbiome of adults with depressive symptoms: Large-scale shotgun sequencing data of the gut microbiota using a cross-sectional design

BACKGROUND

The gut-brain axis is emerging as a novel mechanism to explain depressive disorders.

METHODS

We performed shotgun metagenomic sequencing of stool samples obtained from 133 individuals with depression and 532 without depression. This study examined the taxonomy, functional pathways, and predicted metabolites profiles associated with depressive symptoms, using generalized linear models. To explore links between the taxonomic and functional pathway results, we compared the relative abundance of specific species contributing to pathways significantly associated with depressive symptoms.

RESULTS

Taxonomic composition suggested a disruption in short-chain fatty acid (SCFA)-producing capacity of the gut microbiome in the depressed group. Pathways related to SCFA biosynthesis were also depleted in this group. Faecalibacterium prausnitzii, a well-known SCFA-producing bacterium, was significantly decreased in the depressed group and was identified as a major contributor to the depleted pathways. When inferring the metabolites related to depression from metagenomic data, higher levels of docosapentaenoic acid, stearoyl ethanolamide, putrescine, and bilirubin were more likely to be found in the depressed group.

CONCLUSION

The present findings highlight the altered gut microbiota and associated SCFA-related pathways in individuals with depression. The depletion of F. prausnitzii and its contribution to SCFA production suggest that it is a potential therapeutic target for depression.

Astrocytes Mediate Psychostimulant-Induced Alterations of Spike-Timing Dependent Synaptic Plasticity

At cellular and circuit levels, drug addiction is considered a dysregulation of synaptic plasticity. In addition, dysfunction of the glutamate transporter 1 (GLT-1) in the nucleus accumbens (NAc) has also been proposed as a mechanism underlying drug addiction. However, the cellular and synaptic impact of GLT-1 alterations in the NAc remain unclear. Here we show in the NAc that 10 days withdraw after 5 days treatment with cocaine or amphetamine decreases GLT-1 expression in astrocytes, which results in the prolongation of the excitatory postsynaptic potential (EPSP) decay kinetics in D1 receptor-containing medium spiny neurons (D1R-MSNs). Using the spike timing dependent plasticity (STDP) paradigm, we found that enlargement of EPSP duration results in switching the LTP elicited in control animals to LTD in psychostimulant-treated mice. In contrast to D1-MSNs, D2-MSNs did not display changes in EPSP kinetics and synaptic plasticity. Notably, the psychostimulant-induced synaptic transmission and synaptic plasticity effects were absent in IP3R2-/- mice, which lack astrocyte calcium signal, but were mimicked by the selective astrocytes stimulation with DREADDs. Finally, ceftriaxone, which upregulates GLT-1, restored normal GLT-1 function, EPSP kinetics, and synaptic plasticity in psychostimulant-treated mice. Therefore, we propose that cocaine and amphetamine increase dopaminergic levels in the NAc, which stimulates astrocytes and downregulates the GLT-1. The decreased GLT-1 function prolonged the EPSP kinetics, leading to the modulation of the STDP, transforming the LTP observed in control animals into LTD in psychostimulant-treated mice. Present work reveals a novel mechanism underlying the synaptic plasticity changes induced by these drugs of abuse.

Metabolic syndrome in patients with schizophrenia: Underlying mechanisms and therapeutic approaches (Review)

Schizophrenia (SCZ) represents a considerable health concern, not only due to its impact on cognitive and psychiatric domains, but also because of its association with metabolic abnormalities. Individuals with SCZ face an increased risk of developing metabolic syndrome (MS), which contributes to the increased cardiovascular burden and reduced life expectancy observed in this population. Metabolic alterations are associated with both the SCZ condition itself and extrinsic factors, particularly the use of antipsychotic medications. Additionally, the link between SCZ and MS seems to be guided by distinct genetic parameters. The present narrative review summarizes the relationship between SCZ and MS and emphasizes the various therapeutic approaches for managing its components in patients with these conditions. Recommended therapeutic approaches include lifestyle modifications as the primary strategy, with a focus on behavioral lifestyle programs, addressing dietary patterns and physical activity. Pharmacological interventions include administering common antidiabetic medications and the selection of less metabolically harmful antipsychotics. Alternative interventions with limited clinical application are also discussed. Ultimately, a personalized therapeutic approach encompassing both the psychological and metabolic aspects is essential for the effective management of MS in patients with SCZ.

The efficacy of antenatal Cognitive Behavioural Therapy for antenatal and postnatal depression: A PRISMA based systematic review and meta-analysis

BACKGROUND

Considerable research has assessed the effectiveness of Cognitive Behavioural Therapy (CBT) for perinatal depression, however limited attention has been paid to its effectiveness when delivered during pregnancy. The primary aim of this review was to review evidence of the efficacy of CBT interventions delivered antenatally to treat symptoms of depression in women during the antenatal and postnatal periods. The review's secondary aim was to evaluate potential moderators of treatment outcome.

METHODS

Electronic Databases; CINAHL, PsycINFO, Medline, Scopus, and Web of Science were searched for studies that employed CBT in response to symptoms of depression in pregnant women. Randomized control trials were included if they compared outcomes for pregnant women with outcomes of inactive controls. A systematic review and meta-analysis was conducted on n = 12 eligible studies.

RESULTS

CBT yielded statistically significant, within and between groups' effects on depressive symptoms during the antenatal period. CBT delivered at that time also yielded smaller yet statistically significant within and between groups' effects on depressive symptoms experienced postnatally. CBT was found to be more effective for women of greater age, higher number of weeks gestation, or who were multiparous. The facilitator of treatment, delivery mode, the assessment measures used to evaluate treatment outcome, and symptom severity also moderated treatment outcome.

LIMITATIONS

Significant publication bias and heterogeneity were evident across studies indicating a need to focus future research.

CONCLUSIONS

Overall, findings support the use of CBT delivered antenatally to reduce depression experienced during, and following, pregnancy.

Sigma-1 receptor agonist PRE-084 increases BDNF by activating the ERK/CREB pathway to rescue learning and memory impairment caused by type II diabetes

Sigma-1 receptor (Sig-1R) agonists has therapeutic effects in neurological disorders and possesses properties that can reverse cognitive dysfunction. This study investigated the therapeutic efficacy of Sig-1R activation on cognitive dysfunction in streptozotocin (STZ) combined with high fat and high sugar diet (HFD)-induced type 2 diabetic rats. By employing morris water maze (MWM) testing and computed tomography (CT) imaging, we observed that activation of Sig-1R effectively mitigated brain atrophy and cognitive impairment in diabetes-induced cognitive impairment (DCI) rats. Given the fundamental role of intact hippocampal synaptic plasticity in maintaining cognitive function, we investigated the correlation between Sig-1R and Brain-Derived Neurotrophic Factor (BDNF), a well-established neurotrophic factor. And we also analyzed the expression of Postsynaptic density protein-95 (PSD95) protein. Golgi staining, Haematoxylin-eosin (HE) staining, Nissl staining, and immunofluorescence results show that activating Sig-1R can upregulate BDNF expression and reducing synaptic damage in hippocampal neurons. To elucidate the mechanism by which Sig-1R activation leads to increased BDNF levels, we investigated the Extracellular Signal-Regulated Kinase/Cyclic AMP Response Element-Binding Protein(ERK/CREB) protein pathway. In vitro and in vivo, we observed that Sig-1R activates the ERK/CREB signaling pathway, thereby stimulating BDNF release and increased PSD95 expression. Further intervention with BD1047 antagonist and Tropomyosin-Related Kinase B (TrkB) antagonist ANA-12 confirmed our conclusion that Sig-1R activation upregulated p-ERK and p-CREB protein expression, promoted BDNF transcription, the expression of PSD95 protein was up-regulated, reduces synaptic damage in damaged hippocampal neurons, and rescued cognitive impairment in DCI rats.

Age-related eye diseases and subsequent risk of mental disorders in older adults: A real-world multicenter study

BACKGROUND

The relationship between age-related eye diseases and the subsequent risk of dementia and depressive disorders remains inconsistent. Furthermore, the effects on anxiety disorders and sleep disorders have been underexplored. This study aims to comprehensively examine the impact of age-related eye diseases on common mental disorders in older adults, thereby enhancing our understanding of the mental health implications in these conditions.

METHODS

The electronic health records of 1,522,036 patients aged over 60 from ten institutions in South Korea were analyzed. Patients with and without age-related eye diseases were identified, and 1:4 propensity score matching (PSM) was implemented. A 10-year longitudinal analysis was conducted using the Cox proportional hazards model to calculate the hazard ratios (HR). A meta-analysis was performed to combine the results from different institutions. Subgroup analyses were conducted to explore the impact of specific age-related eye diseases (cataract, glaucoma, age-related macular degeneration) on mental disorders.

RESULTS

A total of 41,637 patients with age-related eye disease were matched with 134,908 patients without such conditions. Patients with age-related eye disease showed a significantly higher risk of mental disorders (dementia, HR: 1.21 [95 % CI: 1.14-1.27]; depressive disorders, HR: 1.28 [95 % CI: 1.20-1.36]; anxiety disorders, HR: 1.31 [95 % CI: 1.22-1.41]; sleep disorders, HR: 1.29 [95 % CI: 1.22-1.37]). In subgroup analyses, each of the three age-related eye diseases was significantly associated with an increased risk of mental disorders. (cataract, HR: 1.25-1.33; glaucoma, HR: 1.15-1.49; age-related macular degeneration, HR: 1.18-1.37).

CONCLUSION

Age-related eye diseases increase the risk of developing mental disorders in older adults, highlighting the need for a multidisciplinary approach to patient care in these conditions.

Metabolomics signatures of serotonin reuptake inhibitor (escitalopram), serotonin norepinephrine reuptake inhibitor (duloxetine) and cognitive-behavioral therapy on key neurotransmitter pathways in major depressive disorder

Metabolomics provides powerful tools that can inform about heterogeneity in disease and response to treatments. In this exploratory study, we employed an electrochemistry-based targeted metabolomics platform to assess the metabolic effects of three randomly-assigned treatments: escitalopram, duloxetine, and Cognitive-Behavioral Therapy (CBT) in 163 treatment-naïve outpatients with major depressive disorder. Serum samples from baseline and 12 weeks post-treatment were analyzed using targeted liquid chromatography-electrochemistry for metabolites related to tryptophan, tyrosine metabolism and related pathways. Changes in metabolite concentrations related to each treatment arm were identified and compared to define metabolic signatures of exposure. In addition, association between metabolites and depressive symptom severity (assessed with the 17-item Hamilton Rating Scale for Depression [HRSD17]) and anxiety symptom severity (assessed with the 14-item Hamilton Rating Scale for Anxiety [HRSA14]) were evaluated, both at baseline and after 12 weeks of treatment. Significant reductions in serum serotonin level and increases in tryptophan-derived indoles that are gut bacterially derived were observed with escitalopram and duloxetine arms but not in CBT arm. These include indole-3-propionic acid (I3PA), indole-3-lactic acid (I3LA) and Indoxyl sulfate (IS), a uremic toxin. Purine-related metabolites were decreased across all arms. Different metabolites correlated with improved symptoms in the different treatment arms revealing potentially different mechanisms between response to antidepressant medications and to CBT.

Prevalence and sociodemographic configurations of anxiety and depression among caregivers of individuals with mental illness: A meta-analysis and qualitative comparative analysis

BACKGROUND

Caring for individuals with mental illness involves significant challenges from both the unique symptoms and societal stigma associated with these conditions, often leading to caregiver neglect despite the heightened risk of anxiety and depression among caregivers. This study was designed to quantify the prevalence of anxiety and depression among caregivers and to offer a detailed configurational analysis of their sociodemographic attributes.

METHODS

Random-effects meta-analyses were conducted using generalized linear mixed models to calculate the prevalence rates for each study. We explored potential sources of heterogeneity through meta-regression and subgroup analyses. Qualitative Comparative Analysis (QCA) was utilized to identify sociodemographic configurations that contribute to anxiety and depression. The study was pre-registered in PROSPERO (CRD42023478003).

RESULTS

A total of 52 studies involving 10,232 participants were included. The prevalence of depression was 43.91 % (95 % CI: 34.62 %-53.65 %), anxiety was 66.56 % (95 % CI: 48.45 %-80.82 %), and comorbidity was 37.24 % (95 % CI, 19.75 %-58.85 %). QCA identified four sociodemographic configurations contributing to depression and two contributing to anxiety. Key contributors to depression included younger, unmarried, highly educated female caregivers, as well as older, married caregivers caring for patients with schizophrenia. Anxiety was more prevalent among older, married caregivers of patients with schizophrenia and younger, highly educated female caregivers.

LIMITATIONS

Differences in the measurement tools used across studies may have impacted the results of this study.

CONCLUSIONS

The high prevalence of depression and anxiety among caregivers of individuals with mental illness underscores the need for targeted mental health services and policies.

Hospitalizations for depressive disorders in Ecuador: An eight-year nationwide analysis of trends and demographic insights

BACKGROUND

Sociodemographic characteristics and limited mental health care access may contribute to higher depression rates in low- and middle-income countries. This study aimed to analyze nationwide depressive disorder hospitalizations in Ecuador.

METHODS

We assessed the sociodemographic characteristics, severity, recurrence, and duration of hospitalizations for depressive disorders. The dataset used is publicly available on the Ecuadorian National Institute of Statistics and Censuses website. Multivariable multinomial logistic regression was performed to calculate adjusted relative risk ratios (aRRR).

RESULTS

14,586 hospitalizations were analyzed during 2015-2022. There was a significant increase in depressive disorders hospitalizations, from 9.41 cases per 100,000 inhabitants in 2015 to 13.9 in 2022. Females accounted for 65.7 % of hospital admissions. Depressive disorder hospitalizations had a mean age of 33.43 years. Severe depressive disorders without psychotic symptoms had the highest average hospitalization rate during 2015-2022 with 3.53 cases per 100,000 inhabitants. Individuals aged 20-29 years (aRRR 1.68, 95 % CI 1.27-2.22) and those aged 30-39 years (aRRR 1.81, 95 % CI 1.32-2.47) had higher probabilities of hospitalization for severe depressive disorder without psychotic symptoms. Patients with severe depression with or without psychotic symptoms were more likely of being hospitalized for seven or more days. Ethnic minorities were less likely to be hospitalized for severe depressive disorder without psychotic symptoms.

CONCLUSION

These findings highlight the increasing rates of depressive disorders in low- and middle-income countries such as Ecuador and emphasize the necessity for public health strategies focused on vulnerable groups.

Involuntary Psychiatric Commitments Among Non-Western Immigrants During the Muhammad Cartoon Controversy in Denmark

Persons deemed a danger to themselves, others, or gravely disabled may receive involuntary psychiatric commitment if family, other residents, law enforcement, or clinicians initiate this process. On September 30, 2005, a Danish newspaper published cartoons depicting the Prophet Muhammad. This publication led to the worst foreign policy crisis in Denmark since World War II. Whereas protests within Denmark against the cartoon remained peaceful, this cartoon controversy-including the attacks on four Danish embassies outside of Denmark-may have reduced societal tolerance for threatening or deviant behavior among non-Western immigrants. We applied Box-Jenkins interrupted time-series methods to test whether this cartoon controversy coincided with greater than expected counts of new involuntary psychiatric commitments among non-Western immigrants. The analytic period spans 48 quarters from January 1995 to December 2006. Findings support the hypothesis in that new involuntary psychiatric commitments rose 43% during the controversy (p <.01). Changes in help-seeking overall for mental health services do not appear to account for this rise in new involuntary commitments. Population-wide controversies may lower societal tolerance for behavior deemed deviant-and in this case, specifically among non-Western immigrants.

Electroconvulsive therapy in the treatment of catatonia in a patient with Budd Chiari syndrome: a case report

Catatonia may manifest as an independent entity or as a feature of a neuropsychiatric or medical illness. While electroconvulsive therapy (ECT) is the gold standard treatment for catatonia, it is typically administered if the patient's symptoms fail to respond to benzodiazepines. We describe the case of a 22-year-old male with Budd Chiari induced cirrhosis and no prior psychiatric history, who presented with symptoms of psychosis and hepatic encephalopathy, was treated in the ICU for multi-factorial delirium, developed symptoms of catatonia that failed to respond to lorazepam, ultimately requiring ECT with a favorable response. This report hopes to add to the literature by discussing potential etiologies of catatonia and by providing an illustrative example of the treatment of catatonia and its considerations in patients with hepatic impairment.

Targeting depression and diabetes comorbidity: A generalization meta-analysis of randomized controlled trials on cognitive-behavioural therapy efficacy

AIMS

This study evaluated the effectiveness of cognitive-behavioural therapy (CBT) in managing comorbid depression and diabetes by examining its influence on psychological and metabolic outcomes, addressing inconsistencies in existing research.

METHODS

A systematic review of 26 randomized controlled trials (RCTs) involving 4220 participants conducted between 2000 and 2024 was performed. Subgroup analyses evaluated geographic location, delivery modes, and intervention characteristics, including session duration and frequency.

RESULTS

CBT significantly reduced depressive symptoms (SMD = -1.30, 95 % CI -2.46 to -0.13, p < 0.05), demonstrating substantial psychological benefits. Its effect on glycemic control, measured by HbA1c levels, was modest and not statistically significant (SMD = -0.56, 95 % CI -1.12-0.01, p > 0.05). Subgroup analyses revealed variations based on region and intervention characteristics. High heterogeneity across studies highlighted the need for tailored approaches that consider context-specific factors and delivery methods.

CONCLUSIONS

CBT effectively reduces depressive symptoms in individuals with diabetes, supporting its role in integrated care models. However, its association with glycemic control remains inconclusive. Future research should refine CBT protocols to enhance both psychological and metabolic outcomes while addressing diverse needs.

Extracellular vesicles derived from mesenchymal stem cells alleviate depressive-like behavior in a rat model of chronic stress

Depression is a prevalent chronic psychiatric disorder with a growing impact on global health. Current treatments often fail to achieve full remission, highlighting the need for alternative therapeutic strategies. Mesenchymal stem cells (MSCs) have attracted significant interest for their therapeutic potential in neuropsychiatric disorders, primarily due to their capacity to target neuroinflammation. This study aimed to investigate if extracellular vesicles derived from human umbilical MSCs (hucMSCs) promote behavioral beneficial actions in a rat model of chronic unpredictable mild stress (CUMS). We show that a single dose of hucMSCs or their derived EVs (hucMSC-EVs) via the tail vein alleviated depressive-like behavior in rats, reduced markers of neuroinflammation, reduced pro-inflammatory cytokines (IL-1β and TNF-α), and increased the number and dendritic complexity of DCX-positive cells in the dentate gyrus. Proteomic analysis of EVs revealed the presence of proteins involved in modulation of inflammatory processes and cell activation. Our study demonstrates EVs derived from hucMSCs can effectively mitigate depressive symptoms by modulating neuroinflammatory pathways and enhancing neurogenesis. These findings support further exploration of MSC-derived EVs as a novel therapeutic option for neuropsychiatric disorders.

Lateralized white matter integrity changes across the lifespan in major depression: AES-SDM meta-analysis

This meta-analysis examined white matter fractional anisotropy (FA) differences across the lifespan to better understand underlying neurobiological mechanisms of major depressive disorder (MDD). Using anisotropic effect size-based-signed differential mapping (AES-SDM), the study meta-analyzed 67 whole-brain FA voxel-based analysis (VBA) and tract-based spatial statistics (TBSS) studies. The sample included 3620 individuals with MDD and 3764 age-matched healthy controls, ranging from adolescence to older adulthood. AES-SDM uses anisotropic kernels combined with random-effects models and permutation tests to perform robust neuroimaging meta-analysis. Between-group analyses uncovered a lateralization effect: Adolescent and adult MDD were associated with left-hemisphere abnormalities, while older adult MDD was associated with right-hemisphere abnormalities. Specifically, MDD was associated with lower left anterior thalamic projection, left pons, left corticospinal projection, and left cingulum FA in adolescents; lower left optic radiation, left striatum, left cingulum, and left inferior longitudinal fasciculus FA in adults; and lower right anterior thalamic projection, right fronto-occipital fasciculus, right striatum, right superior longitudinal fasciculus, and left inferior longitudinal fasciculus FA in older adults. The laterality seen in the current data and previous research could potentially serve as biomarkers to improve diagnostic accuracy. It is recommended that future white matter MDD primary studies include more adolescents and older adults.

Molecular and micro-architectural mapping of gray matter alterations in psychosis

The psychosis spectrum encompasses a heterogeneous range of clinical conditions associated with abnormal brain development. Detecting patterns of atypical neuroanatomical maturation across psychiatric disorders requires an interpretable metric standardized by age-, sex- and site-effect. The molecular and micro-architectural attributes that account for these deviations in brain structure from typical neurodevelopment are still unknown. Here, we aggregate structural magnetic resonance imaging data from 38,696 healthy controls (HC) and 1256 psychosis-related conditions, including first-degree relatives of schizophrenia (SCZ) and schizoaffective disorder (SAD) patients (n = 160), individuals who had psychotic experiences (n = 157), patients who experienced a first episode of psychosis (FEP, n = 352), and individuals with chronic SCZ or SAD (n = 587). Using a normative modeling approach, we generated centile scores for cortical gray matter (GM) phenotypes, identifying deviations in regional volumes below the expected trajectory for all conditions, with a greater impact on the clinically diagnosed ones, FEP and chronic. Additionally, we mapped 46 neurobiological features from healthy individuals (including neurotransmitters, cell types, layer thickness, microstructure, cortical expansion, and metabolism) to these abnormal centiles using a multivariate approach. Results revealed that neurobiological features were highly co-localized with centile deviations, where metabolism (e.g., cerebral metabolic rate of oxygen (CMRGlu) and cerebral blood flow (CBF)) and neurotransmitter concentrations (e.g., serotonin (5-HT) and acetylcholine (α4β2) receptors) showed the most consistent spatial overlap with abnormal GM trajectories. Taken together these findings shed light on the vulnerability factors that may underlie atypical brain maturation during different stages of psychosis.

Large-scale brain connectivity changes following the administration of lysergic acid diethylamide, d-amphetamine, and 3,4-methylenedioxyamphetamine

Psychedelics have recently attracted significant attention for their potential to mitigate symptoms associated with various psychiatric disorders. However, the precise neurobiological mechanisms responsible for these effects remain incompletely understood. A valuable approach to gaining insights into the specific mechanisms of action involves comparing psychedelics with substances that have partially overlapping neurophysiological effects, i.e., modulating the same neurotransmitter systems. Imaging data were obtained from the clinical trial NCT03019822, which explored the acute effects of lysergic acid diethylamide (LSD), d-amphetamine, and 3,4-methylenedioxymethamphetamine (MDMA) in 28 healthy volunteers. The clinical trial employed a double-blind, placebo-controlled, crossover design. Herein, various resting-state connectivity measures were examined, including within-network connectivity (integrity), between-network connectivity (segregation), seed-based connectivity of resting-state networks, and global connectivity. Differences between placebo and the active conditions were assessed using repeated-measures ANOVA, followed by post-hoc pairwise t-tests. Changes in voxel-wise seed-based connectivity were correlated with serotonin 2 A receptor density maps. Compared to placebo, all substances reduced integrity in several networks, indicating both common and unique effects. While LSD uniquely reduced integrity in the default-mode network (DMN), the amphetamines, in contrast to our expectations, reduced integrity in more networks than LSD. However, LSD exhibited more pronounced segregation effects, characterized solely by decreases, in contrast to the amphetamines, which also induced increases. Across all substances, seed-based connectivity mostly increased between networks, with LSD demonstrating more pronounced effects than both amphetamines. Finally, while all substances decreased global connectivity in visual areas, compared to placebo, LSD specifically increased global connectivity in the basal ganglia and thalamus. These findings advance our understanding of the distinctive neurobiological effects of psychedelics, prompting further exploration of their therapeutic potential.

The Risk of Cardiovascular Disease Risk Among Adults with Vision Impairment from Low-, Middle- and High-Income Countries

PURPOSE

The limited evidence for cardiovascular disease (CVD) among adults with vision impairment (VI) has often been from developed countries using self-reported VI. This study evaluated the association of objectively-determined VI with the risk of CVD among adults from low-, middle-, and high-income countries.

METHODS

Data were from 32,268 adults aged 30-74 years without CVD or blindness from China, Ghana, India, Mexico, Russian Federation, South Africa, and the United States during 2007-2010. VI and severe VI was defined as presenting visual acuity worse than 6/18, and 6/60, respectively. The Framingham risk algorithm was used to estimate the risk for incident CVD. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals.

RESULTS

The mean age of participants was 46.4 years, with half of them being women (49.3%). The age-adjusted prevalence of VI ranged from 1.1% (United States) to 14.2% (South Africa) while severe VI ranged from 0.4% (United States) to 4.5% (Ghana). In models adjusting for country, sociodemographic factors, waist girth, healthcare use, activities of daily living and other health-related factors, VI was associated with CVD risk ≥ 10% (OR = 1.69, 95% CI: 1.22-2.36). This observed association was largely consistent across countries (p = 0.119). The observed CVD risk was similar among adults with moderate or severe VI (OR = 0.95, 95% CI: 0.50-1.83). CVD risk was higher among adults with VI who were <65 years old (OR = 1.89, 95% CI: 1.36-2.63) or were employed (OR = 2.24, 95% CI: 1.58-3.16).

CONLUSIONS

This cross-national study shows that individuals with VI are at high risk for future CVD.

Social Media Addiction and Poor Mental Health: Examining the Mediating Roles of Internet Addiction and Phubbing

Many researchers have examined the potential detrimental role of problematic social media use (often referred as 'social media addiction') on mental health. The present study investigated how social media addiction is associated with three components of mental health: depression, anxiety, and stress. In addition, structural equation modeling was used to test the mediating roles of internet addiction and phubbing among a sample of young adults (N = 603). Results showed that social media addiction was associated with poorer mental health via internet addiction and phubbing. More specifically, associations between social media addiction and stress, and social media addiction and anxiety were explained by both internet addiction and phubbing. The association between social media addiction and depression was explained by internet addiction only. These results remained consistent after controlling for gender, age, frequency of internet use, frequency of social media use, and frequency of smartphone use. These findings extend the extant literature by providing evidence for the dual roles of internet addiction and phubbing in explaining the relationship between social media addiction and poor mental health. Social media addiction did not directly influence poorer mental health but did via internet addiction and phubbing. Therefore, greater awareness of the inter-relationships between technology-based behaviors and their impact on mental health is needed among a wide range of stakeholders, and these inter-relationships need considering in the prevention and treatment of technology-based disorders.

Correlation Between Severity of Schizophrenia with Certain Trace Elements and TNF-α Gene Expression and Its Circulatory Level in the Population of Western India

This cross-sectional study aimed to assess serum trace element (TE) concentrations, TNF-α gene expression, protein levels in schizophrenia (SZ) patients, and their correlation with disease severity measured by Positive and Negative Syndrome Scale (PANSS) scores. Forty SZ cases and 40 healthy controls aged 18-60 were recruited. Forty (n = 40) cases who meet ICD-10 criteria for SZ and 40 (n = 40) healthy individuals (controls) between 18 and 60 years of age were recruited in the study. Sandwich enzyme-linked immunosorbent assay (ELISA) and RT-qPCR (quantitative real-time PCR) were used to estimate pro-inflammatory cytokine TNF-α protein and gene expression. Inductively coupled plasma-optical emission spectroscopy (ICP-OES) and graphite furnace atomic absorption spectroscopy (GFAAS) were used to assess serum levels of trace elements (TEs): Fe, Zn, Cu, Mg, and Se. Compared to healthy controls, cases had significantly higher levels of TNF-α protein, as well as Fe, Cu, and Se (p < 0.05). Cu correlated positively with TNF-α protein level (rho = 0.234; p = 0.048) and gene expression (rho = 0.333; p = 0.041) and with PANSS negative (rho = 0.531), general (rho = 0.643), and total (rho = 0.541) scores. Additionally, Zn negatively correlated with serum Mg (rho =  - 0.426, p < 0.01) and positively with serum Se (rho = 0.343, p < 0.05). In conclusion, elevated Cu levels could potentially contribute to the development of SZ. Elevated Cu levels in cases and their correlation with the TNF-α gene and protein and PANSS score indicate Cu's potential role in exacerbating SZ severity through inflammatory cytokines. This suggests the involvement of metals and cytokines in the pathophysiology of SZ.

Evaluation of alpha neurofeedback training to enhance sleep in remitted depression and anxiety sufferers with persistent insomnia

This study evaluates whether neurofeedback training (NFT) to boost alpha wave activity in the central brain may effectively mitigate persistent insomnia in patients with remitted depression and anxiety. Thirty-two participants in clinical remission from depression or anxiety were enrolled and evaluated for insomnia severity. Individuals were randomly assigned in a single-blinded manner to either NFT or the sham treatment. The effectiveness of the intervention was measured using recognized scales for depression, anxiety and sleep quality. While subjective sleep quality, measured by the PSQI, showed significant improvements in the active group compared to the sham group at post training, 1-month, 3-month, and 6-month follow-up, objective measures of sleep quality largely remained within the normal range, with few significant changes observed. Specifically, the active group exhibited notable improvements in alpha amplitude and duration during NFT sessions, which were not seen in the sham group. This highlights the potential of NFT as a complementary approach for improving sleep perception in this population, but further research is needed to confirm its effects on actual sleep architecture and long-term outcomes.

Understanding the reasons to avoid seeking mental health professionals: Validation of the MITOS-MENTAL questionnaire in Peru population

There is still much resistance, myths, beliefs, and misconceptions regarding the seeking of mental health services for diagnosis and treatment. The objective was to validate an instrument to determine why Peruvian workers would not seek mental health professionals. In an instrumental study, literature was searched, and mental health professionals were asked about the most common reasons for not attending consultations. An expert panel undertook exploratory and confirmatory factor analyses (CFA), which were applied to a large population. Descriptive and instrumental statistics were used for the data. The 20 experts gave excellent ratings to the initial questions. In the pilot (250 people), it was confirmed that all questions had saturations >0.40. The item modification technique was also performed, eliminating six questions. With the CFA in 1312 respondents, it was seen that the goodness-of-fit indices were not adequate for three questions, then the index modification technique was used, achieving a satisfactory factorial structure model (χ2 = 61.497; df = 9; p < 0.001; RMR = 0.015; TLI = 0.984; CFI = 0.990, and RMSEA = 0.067). A scale of six questions was validated to measure the most important reasons why Peruvian workers do not want to attend mental health consultations.

Concordance of Mother and Father Reports of Intimate Partner Violence and Observed Interactions in Unmarried Black Coparents Expecting Their First Child

Concordance between partner reports of Intimate Partner Violence (IPV) is generally low, but self-reporting of IPV and concordance between partners among expectant parents in marginalized communities has not been explored, nor have associations among each partner's reports of IPV and their behaviors in observed conflict discussions. This study will examine these gaps. One hundred and thirty-eight low-income, unmarried, Black, coparenting dyads expecting their first child together (136 mothers and 136 fathers) completed the Revised-Conflict Tactics Scale and a video recorded and coded conflict discussion. There was low concordance between parent's reports of IPV overall with moderate levels of concordance for coparents who were living together and had more harmonious relationships. Linear regression analyses indicated only mothers' reports of fathers' psychological and physical IPV but not fathers' reports of IPV were significantly associated with observed negative communication. Neither coparents' reports of psychological or physical IPV were associated with positive communication during a conflict discussion. These findings suggest that at the time of parenthood transitions, mothers' reports of fathers' IPV behaviors may be more robust in their association with negative/unhealthy couple communication patterns than fathers' reports and should be used when making safety determinations with families.

Physical and Psychosocial Challenges as Predictors of Vision Difficulty in Children: A Nationally Representative Survey Analysis

PURPOSE

To elicit associations between vision difficulties and physical or psychosocial challenges in children in the United States.

METHODS

Children aged 2-17 years old from the 2021 National Health Interview Survey with data pertaining to vision difficulty were included in our retrospective, population-based analysis. Our primary aim was investigating physical and psychosocial challenges as predictors of vision difficulty. Logistic regression models were performed on Stata version 17.0 (StataCorp LLC, College Station, Texas). Analyses were accompanied by an odds ratio (OR) and 95% confidence interval (CI).

RESULTS

A total of 7,373 children had data pertaining to their level of vision difficulty and were included in our sample. In our multivariable analysis, children with a good/fair (OR = 1.84, 95% CI = [1.31, 2.60], p < 0.01), or poor (OR = 5.08, 95% CI = [1.61, 16.04], p < 0.01) general health status had higher odds of vision difficulty relative to children with an excellent/very good health status. Furthermore, children with difficulties hearing (OR = 8.67, 95% CI = [5.25, 14.31], p < 0.01), communicating (OR = 1.96, 95% CI = [1.18, 3.25], p < 0.01), learning (OR = 1.93, 95% CI = [1.27, 2.93], p < 0.01), and making friends (OR = 1.94, 95% CI = [1.12, 3.36], p = 0.02) had higher odds of vision difficulty. Nonetheless, the following factors were only predictors of vision difficulty in our univariable analysis: requiring equipment for mobility (p < 0.01), experiencing anxiety (p < 0.01), and experiencing depression (p < 0.01).

CONCLUSION

Several factors pertaining to physical and psychosocial challenges in children are associated with vision difficulty. Future research should further explore potential causal links between vision difficulty and physical or psychosocial factors to aid in coordinating public health efforts dedicated to vision health equity.

The relationship between childhood trauma and obsession is mediated by emotional schema and reappraisal

BACKGROUND

Research literature has illustrated a substantial relationship between the variables of emotional schema (ES), suppression (S), and reappraisal (R) with childhood trauma (CT) and obsession (O). In addition, it has not been studied from the perspective of the mediating function of the variables mentioned above in the association between CT and O, both in the clinical and the non-clinical populations. As a result, this study was carried out to investigate the mediating roles of ES, S, and R in the association between CT and O within the non-clinical setting.

METHOD

681 Iranian students responded to CTQ-SF, ERQ, LESS-II, and OCI-R. The structural equation model method has been utilized to investigate the mediation of variables.

RESULTS

Results indicated that CT had a positive relationship with ES, S, and O and a negative relationship with R. Findings illustrated the full mediation of the study model, affirming the roles of ES and R as mediators and rejecting the role of S as a mediator in the connection between CT and O.

LIMITATION

The present study used cross-sectional analysis and self-report questionnaires, investigated the model in a non-clinical population, and exhibited gender imbalance in its sample.

CONCLUSION

Current research is essential because therapeutic interventions should focus on R and modifying ES in CT survivors instead of emphasizing S and CT to prevent or reduce O.

Mapping global evidence of caregiver experiences in bipolar disorder in low and middle-income countries: A scoping review

BACKGROUND

Bipolar disorder (BD) imposes significant social, psychological, and economic burdens on individuals and their caregivers. While developing treatments for BD patients is crucial, supportive interventions for caregivers in low- and middle-income countries (LMICs) are equally important, given the limited resources and healthcare infrastructure. Understanding caregiver experiences in these settings is essential for creating effective interventions. This scoping review synthesizes knowledge of caregiver experiences in assisting individuals with BD in LMICs.

METHODS

Following Arksey and O'Malley's scoping review framework, we examined quantitative and qualitative studies on caregiver experiences. A comprehensive literature search was conducted across five databases, with two authors independently screening studies, extracting data, and reviewing references for additional eligible studies. Findings are presented through narrative synthesis according to PRISMA-ScR guidelines.

RESULTS

Out of 3518 records, 104 studies met the eligibility criteria. Five main themes and eight subthemes were identified: (1) burden of caregiving (impaired quality of life), (2) caregiver challenges (lack of understanding, family/social disruptions, financial restraints, mental and physical fatigue), (3) caregiver needs (information access, involvement, social support, financial assistance), (4) coping mechanisms, and (5) the silver lining in caregiving.

CONCLUSIONS

This review highlights significant challenges faced by caregivers of individuals with BD in LMICs, emphasizing the need for better psychoeducation, healthcare communication, and supportive resources. Addressing financial constraints and stigma is also crucial. Future research should focus on culturally adapting evidence-based strategies to support caregivers in these settings.

The involvement of brain norepinephrine nuclei in eating disorders

While many individuals with anorexia nervosa (AN) undergo remission of the disorder, a significant proportion will experience relapse and/or persistent symptoms. The persistence of AN is thought to be driven by changes in neural circuits that underline treatment-resistant symptoms (maladaptive plasticity). Recent evidence about the biology of AN suggests it extends beyond psychiatric symptoms to involve also systemic metabolic dysfunction, which is based on alterations of the mechanistic Target Of Rapamycin Complex 1 (mTORC1). In this review, we propose that AN's maladaptive plasticity and mTORC1 alterations involve norepinephrine (NE) nuclei, which spread neurobiological alterations concomitantly to the forebrain as well as to peripheral organs through the autonomic nervous system. In this review, we will present current evidence supporting this new perspective about the role of NE neurons in producing the psycho-metabolic dysfunction occurring in AN and discuss how it may inform more effective treatments for AN in the future.

How 'miracle' weight-loss semaglutide promises to change medicine but can we afford the expense?

Obesity is a complex and growing global concern, affecting one in eight individuals and compromising health, quality of life and life expectancy. It carries significant metabolic, cardiovascular, oncological, hepatorenal, skeletal and psychiatric risks, imposing substantial costs on health-care systems. Traditional treatments have often been ineffective or have led to relapse after lifestyle changes. Whereas bariatric surgery is effective, it also involves risks such as mortality and hospitalisation. Semaglutide, licensed in 2018, is a synthetic analogue of glucagon-like peptide 1 which regulates glucose metabolism and gastrointestinal (GI) motility. Studies show that semaglutide, administered either weekly and subcutaneously, or daily orally, induces an average weight loss of -11.62 kg compared to placebo and reduces waist circumference by up to -9.4 cm. It also improves blood pressure, fasting glucose levels, C-reactive protein levels and lipid profiles. The most common adverse events are mild-to-moderate GI complaints occurring more frequently with daily administration than weekly doses; hypoglycaemia is more common without lifestyle intervention. Weight regain often follows semaglutide withdrawal. Furthermore, semaglutide offers cardiovascular benefits for patients with established atherosclerotic cardiovascular disease (CVD), lowers the risk of kidney outcomes and cardiovascular-related death, resolves nonalcoholic steatohepatitis in many cases, and positively impacts mental health and quality of life. In conclusion, semaglutide therapy could significantly benefit many adults regarding CVD and mortality if made widely accessible. Ethical and financial considerations must be addressed for personalised obesity treatment approaches.

Recurrence of Tic disorders in children after medication withdrawal: A cohort study on long-term outcomes

AIM

To evaluate the relapse rate in children with tic disorders following medication withdrawal and to identify the risk factors associated with tic recurrence.

METHODS

This prospective cohort study enrolled 387 children who had recently discontinued medication and had been tic-free for at least 3 months. Participants were followed monthly for 12 months to monitor tic relapse. The primary outcome was the time from medication discontinuation to tic recurrence, while the secondary outcome was the characteristics of the recurrence. Cox regression models were used to identify prognostic factors associated with relapse.

RESULTS

During the 12-month follow-up, 235 participants (61 %) experienced tic relapse. Among these, 120 participants (51 %) had a recurrence of their original tic symptoms, 75 (32 %) developed new symptoms alongside their original tics, and 39 (17 %) presented with entirely new tic symptoms. Significant prognostic factors for tic recurrence included treatment duration, Yale Global Tic Severity Scale score at the worst-ever phase, average daily screen time, negative emotional stimuli, and snack consumption.

CONCLUSION

Tic recurrence following medication discontinuation is common in children with tic disorders and is associated with several modifiable prognostic factors. Clinicians should address these predictors to develop more effective prevention strategies and reduce tic recurrence.

The Effect of a Physical Activity Program on Subjective Well-Being, Happiness and Problem-Solving Skills in Patients with Schizophrenia: A Randomized Controlled Trial

The aim of this randomized controlled trial was to examine the effect of Physical Activity Program applied to patients with schizophrenia on subjective well-being, happiness and problem-solving skills levels. This study was conducted with a total of 86 individuals diagnosed with schizophrenia (43 intervention and 43 control) registered in a family health center. Subjective Well-Being Scale, the Short Form of the Oxford Happiness Questionnaire and Problem-Solving Inventory were used to collect the data at baseline and, post-intervention. Significant increases in subjective well-being, happiness, and problem-solving skills were found in the intervention group after the total of 12 weeks of the Physical Activity Program, which included walking and exercises, compared to the control group. Accordingly, it can be said that the Physical Activity Program is an effective method that increases subjective well-being, happiness and problem-solving skills. ClinicalTrials.gov Identifier number is NCT15976921 and date of registration is 21/11/2023, retrospectively registered.

Pediatric Attention-Deficit/Hyperactivity Disorder and Disruptive Mood Dysregulation Disorder: Analyzing National Treatment Trends

OBJECTIVE

This study investigated how a disruptive mood dysregulation disorder (DMDD) diagnosis influences treatment selection and sequencing in children with attention-deficit/hyperactivity disorder (ADHD).

STUDY DESIGN

This multicenter, population-based, retrospective cohort study analyzed data from TriNetX Research Network (June 2013 through July 2024). Youth with ADHD (without DMDD) formed the control cohort (n = 631 295). Youth with ADHD + DMDD (n = 24 723) formed the study cohort. Odds ratios (ORs) and relative risks were calculated to analyze associations.

RESULTS

Compared with controls, ADHD + DMDD cohort was more likely to be composed of non-Hispanic ethnicity and exhibited higher rates of psychiatric comorbidities, inpatient and emergency service utilization, and billed psychotherapy (ORs range 1.25-6.95). Youth with ADHD + DMDD were more likely to receive ADHD medications (ORs range 1.55-4.80), as well as antidepressants, mood stabilizers, and antipsychotics (ORs range 5.05-13.16). Hispanic youth with DMDD utilized more psychotropics but less psychotherapy, while White youth used all services more. Before the use of non-ADHD medications for aggression, only 25% of ADHD + DMDD youth had a therapy code, and around 11% showed evidence of optimization of ADHD medication. After a DMDD diagnosis, treatment rates for other psychotropics increased more than those for central nervous system stimulants.

CONCLUSIONS

In youth with ADHD, a DMDD diagnosis is associated with increases in the spectrum of pharmacological and nonpharmacological treatments deployed with patterns varying by race and ethnicity. Antipsychotic and mood stabilizer prescriptions increased most prominently, often before receiving psychotherapy services or efforts to optimize ADHD medication. Future research should address disparities in DMDD treatment patterns and identify the optimal treatment sequences for DMDD.

Where do we go from here? The personal impact of adverse events and complications in surgeons: Results from a cross-sectional study

OBJECTIVE

Medical error is an inevitable part of modern healthcare, with a potential harmful impact for the patient and the surgeon. The phenomenon of negative personal responses for healthcare workers in the aftermath of adverse events is described as the "second casualty" and can involve significant physical and psychological distress. We present results from a cross-sectional survey of surgeons and their experience in the aftermath of adverse events or complications.

SUBJECTS AND METHODS

Following ethical approval an anonymous online survey was distributed to all training and consultant surgeons in the Republic of Ireland. Data collected included basic demographics, personal response to an adverse event, coping strategies, contributing factors and perception of potential support structures.

RESULTS

A total of 110 responses were received representing surgeons with a broad range of experience and specialty. Eighty-nine percent (n = 98) of surgeons described negative psychological symptoms in the aftermath of adverse events. The predominant responses were anxiety, guilt and low mood. Sixty-seven percent (n = 74) reported that their training did not prepare them for the personal impact of events but found informal peer and family support to be beneficial and were open to the implementation of formal support structures.

CONCLUSION

Surgeons suffer in the aftermath of negative outcomes and feel unprepared to manage the personal consequences. Institutions and representative bodies must step forward to change culture and develop supports for surgeons in the aftermath of adverse events and complications.

A unified pathogenic hypothesis for mental disorders based on schismogenesis

Major Depressive Disorder, Bipolar Disorder, and Schizophrenia, share significant genetic, epigenetic, and phenotypic overlap, manifesting as dimensional psychopathology and convergent neuroimaging findings. These shared features have led to various models exploring common underlying pathophysiological mechanisms, including excitatory-inhibitory imbalance, the triple network model, network analysis, and social disconnection. While these models offer valuable insights, a unifying framework remains elusive. Schismogenesis, a transdisciplinary construct, is proposed to reconcile divergent perspectives on mental health conditions. Characterized by positive feedback loops leading to functional dissociation due to insufficient inhibitory control, complementary schismogenesis results in rigid hyperactivation and hypoactivation within neural, cognitive, and social networks, compromising system flexibility. This pathological process underlies the core features of Major Depressive Disorder, Bipolar Disorder, and Schizophrenia, depending on its location within networks. The schismogenesis hypothesis suggests that when individuals are overwhelmed by excessive stress or tension, they may experience a breakdown or disconnection to prevent irreversible damage, reflecting evolutionary adaptations. Importantly, the potential reversibility of schismogenesis, particularly through interventions that facilitate system reintegration, suggests promising therapeutic avenues for further exploration.

Five hypothesized biological mechanisms linking adverse childhood experiences with anxiety, depression, and PTSD: A scoping review

Adults with symptoms of anxiety, depression, or PTSD and a history of adverse childhood experiences (ACEs) may experience more severe symptoms than those without ACEs. The identification of mechanisms linking ACEs to later mental health problems may provide salient treatment targets to improve outcomes. Several biological markers (cortisol, inflammation, allostatic load, DNA methylation, and telomere length) that are indicative of functional variation in stress response systems, have been hypothesized as potential mechanisms linking ACEs to later mental health outcomes. Much of the evidence supporting this hypothesis examines isolated pairwise associations between variables and it is unclear whether statistical tests of mediation support these conclusions. It is also unclear how much of the extant research has used theory to guide mediation analyses, which may be a salient factor in the recognition of a mechanism. This scoping review surveyed research conducting mediation analysis examining the indirect effect of any of these five biological markers on the relationship between ACEs and anxiety, depression, or PTSD. It further surveyed the use of theory in these analyses. Pubmed and seven electronic databases were searched: (1) APA PsychInfo (2) CINAHL Plus (3) Health Source: Nursing/Academic Edition (4) MEDLINE (5) Psychology and Behavioral Sciences Collection (6) Science and Technology Collection, and (7) SocINDEX. A total of 16 articles were identified. The majority of studies examined depression as an outcome and the statistical significance of indirect effects were mixed across mediators. Common theoretical models and frameworks were consistent with life course theory and evolutionary or developmental perspectives.

Untangling the complex relationship between bipolar disorder and anxiety: a comprehensive review of prevalence, prognosis, and therapy

Bipolar disorder (BD) frequently coexists with anxiety disorders, creating complex challenges in clinical therapy and management. This study investigates the prevalence, prognostic implications, and treatment strategies for comorbid BD and anxiety disorders. High comorbidity rates, particularly with generalized anxiety disorder, underscore the necessity of thorough clinical assessments to guide effective management. Our findings suggest that anxiety disorders may serve as precursors to BD, especially in high-risk populations, making early detection of anxiety symptoms crucial for timely intervention and prevention. We also found that comorbid anxiety can negatively affect the course of BD, increasing clinical severity, reducing treatment responsiveness, and worsening prognosis. These complexities highlight the need for caution in using antidepressants, which may destabilize mood. Alternatively, cognitive-behavioral therapy presents a promising, targeted approach for managing BD with comorbid anxiety. In summary, this study provides essential insights for clinicians and researchers, enhancing understanding of BD and anxiety comorbidity and guiding more precise diagnostics and tailored interventions to improve overall patient care.

HMGB1: Different secretion pathways with pivotal role in epilepsy and major depressive disorder

High-mobility group box 1 (HMGB1) protein is a highly prevalent protein that, once it is translocated to an extracellular site, can contribute to the pathogenesis of autoimmune and inflammatory responses, including epilepsy and depression. The conditions needed for release are associated with the production of multiple isoforms, and this translocation may occur in response to both immune cell activation and cell death. HMGB1 has been shown to interact with different mediators, including exportin 1, notch receptors, mitogen-activated protein kinase, STAT, tumor protein 53, and inflammasomes. Furthermore, as a crucial inflammatory mediator, HMGB1 has demonstrated upregulated expression and a higher percentage of translocation from the nucleus to the cytoplasm, acting on downstream receptors such as toll-like receptor 4 and receptor for advanced glycation end products, thereby activating interleukin-1 beta and nuclear factor kappa-B, intensifying inflammatory responses. In this review, we aim to discuss the different molecular interactions for the secretion of HMGB1 along with its pivotal role in epilepsy and major depressive disorder.

Impact of depression, anxiety, inflammatory factors, and stress levels on treatment outcomes in patients with chronic trauma

This editorial discusses a recent article published by Li et al in 2024, which highlights a critical yet underexplored dimension of chronic wound care: The impact of psychological factors such as depression and anxiety on treatment outcomes. With the increasing prevalence of chronic wounds in China, driven by population aging, traffic accidents, and chronic diseases, chronic wounds have emerged as a significant public health concern. They not only pose serious threats to individual health but also impose considerable social and economic burdens on healthcare systems. Against this backdrop, the study by Li et al aimed to explore how psychological distress affects the management and recovery of patients with chronic wounds. In their research, chronic wound patients were meticulously evaluated for depression and anxiety using validated psychological assessment scales and blood biomarkers. The findings reveal a stark reality: Individuals with severe depression and anxiety exhibit markedly lower treatment adherence, slower recovery rates, and diminished post-treatment quality of life. These psychological challenges hinder patients’ active engagement with their care plans and may directly impede physiological healing processes. Importantly, the study underscored that factors such as wound size, anxiety, and depression significantly influence therapeutic outcomes in chronic wound patients. This insight calls for a more holistic approach to wound care, where addressing psychological well-being becomes an integral component of treatment protocols. As such, the study highlighted the necessity of early identification and targeted intervention for depression and anxiety in chronic wound patients. By prioritizing psychological support alongside medical treatment, healthcare providers can enhance therapeutic efficacy and improve patients’ long-term quality of life. This integrative approach can not only optimize clinical outcomes but also alleviate the broader societal and economic impact of chronic wounds.

Analysis of anxiety and depression status and related factors among mothers of children in neonatal intensive care unit

BACKGROUND

Newborns are immediately admitted to the neonatal intensive care unit (NICU) after birth, and thus mothers suffer from the pain of mother-infant separation. Some mothers worry about alterations in their child’s condition and the uncertainty and high medical costs of possible sequelae, which frequently cause anxiety, depression, and other adverse emotions.

AIM

To investigate the anxiety and depression status of mothers of children in the NICU and its related factors.

METHODS

A convenient sampling method is adopted. The research objects included the mothers of 191 children in the NICU of Suzhou Ninth Hospital Affiliated with Suzhou University from January 2023 to July 2024. The general information questionnaire, personal control scale, self-rating anxiety scale, and self-rating depression scale were utilized for investigation. Anxiety and depression status in mothers of children in the NICU and its related factors were analyzed.

RESULTS

The incidences of maternal anxiety and depression among 191 hospitalized children in the NICU were 32.98% (63/191) and 23.56% (45/191), respectively. Single-factor analysis reveals that family monthly income, individual sense of control, gestational age of the child, and the number of diseases in the child are associated with the anxiety and depression experienced by the mother of the child in the NICU (P < 0.05). Multivariate logistic regression analysis revealed that family monthly income of < 5000 yuan (RMB), poor individual control, gestational age of < 32 weeks, and the number of diseases of ≥ 3 kinds are all related factors for anxiety and depression in mothers of children admitted to the NICU (P < 0.05).

CONCLUSION

Mothers of children admitted to the NICU demonstrated high anxiety and depression incidences. The nursing staff in the neonatal department established intervention measures for each related factor, strengthened communication and communication with the mother of the child, and did a good job in psychological counseling.

Catatonia in an acute adult inpatient population in mental health units in Khartoum, Sudan: A cross-sectional study

BACKGROUND

Catatonic syndrome is a mental health issue, as well as a medical, neurological, and toxic condition. There are few published data on catatonic syndrome in African countries and none in Sudan, the third-largest African country.

AIM

To assess the prevalence and presenting symptoms of catatonic syndrome in an acute psychiatric inpatient population in four governmental psychiatric hospitals in Sudan.

METHODS

A cross-sectional study was conducted in four psychiatric hospitals in the capital, Khartoum, in Sudan. The data were collected using an interviewer-administered questionnaire tool, which included sociodemographic data (age, sex, educational level, marital status, and residence). Signs and symptoms of catatonic syndrome were assessed using the Bush–Francis Catatonia Rating Scale (BFCRS) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria. χ² tests were used to compare categorized variables. Multivariate analysis was not performed because none of the variables were found to be different between patients with and without catatonic syndrome.

RESULTS

Of the 384 patients, 50.0% and 49.3% were males and females, respectively, and their median age was 30.0 years. One hundred and sixty-three (42.4%) patients had catatonic syndrome according to the BFCRS criteria. Of these patients, 104 fulfilled the DSM-5 criteria, with a 27.1% prevalence of catatonic syndrome. Echopraxia/echolalia (84.5%), mutism (71.2%), posturing/catalepsy (67.3%), and mannerisms (66.3%) were the main manifestations among patients with catatonic syndrome. There was no significant difference in age, sex, marital status, or job between patients with and those without catatonic syndrome. Of the 163 patients with catatonic syndrome, 31.3% had bipolar disorder, 28.2% had schizophrenia, and 19.6% had major depressive disorder.

CONCLUSION

Catatonic syndrome is highly prevalent in an acute psychiatric inpatient population in Sudan regardless of age or sex. Echopraxia/echolalia (84.5%) and mutism were the main manifestations among the patients with catatonic syndrome.