WPA Action Plan 2020-2023: a way forward

Neuroimaging profiling identifies distinct brain maturational subtypes of youth with mood and anxiety disorders

Mood and anxiety disorders typically begin in adolescence and have overlapping clinical features but marked inter-individual variation in clinical presentation. The use of multimodal neuroimaging data may offer novel insights into the underlying brain mechanisms. We applied Heterogeneity Through Discriminative Analysis (HYDRA) to measures of regional brain morphometry, neurite density, and intracortical myelination to identify subtypes of youth, aged 9-10 years, with mood and anxiety disorders (N = 1931) compared to typically developing youth (N = 2823). We identified three subtypes that were robust to permutation testing and sample composition. Subtype 1 evidenced a pattern of imbalanced cortical-subcortical maturation compared to the typically developing group, with subcortical regions lagging behind prefrontal cortical thinning and myelination and greater cortical surface expansion globally. Subtype 2 displayed a pattern of delayed cortical maturation indicated by higher cortical thickness and lower cortical surface area expansion and myelination compared to the typically developing group. Subtype 3 showed evidence of atypical brain maturation involving globally lower cortical thickness and surface coupled with higher myelination and neural density. Subtype 1 had superior cognitive function in contrast to the other two subtypes that underperformed compared to the typically developing group. Higher levels of parental psychopathology, family conflict, and social adversity were common to all subtypes, with subtype 3 having the highest burden of adverse exposures. These analyses comprehensively characterize pre-adolescent mood and anxiety disorders, the biopsychosocial context in which they arise, and lay the foundation for the examination of the longitudinal evolution of the subtypes identified as the study sample transitions through adolescence.

Professional Values and Educational Needs among Mental Health Specialists in Russia: Survey Results

BACKGROUND

Exploring the professional values and educational needs of future and practicing mental health specialists is required to develop effective measures aiming at improving their skills and interest in their work.

AIM

Our aim was to explore professional values and educational needs of mental health specialists in Russia.

METHODS

We conducted a survey that captured socio-demographic data, professional characteristics, professional values, and educational needs. Fisher's exact test, logistic regression, and the k-means cluster analysis were used in our statistical analysis.

RESULTS

The survey included 133 participants, 71% of whom had completed their postgraduate education. The following items were mentioned as important professional values by the respondents: "Job opportunities", "Stimulation of intellectual activity", and "Work-life balance". The most popular options for educational activities were English language (63.4%), the principles of evidence-based medicine (63.4%), and developing skills for conducting scientific research (59.4%).In comparison with practicing specialists, respondents who had not yet completed their postgraduate education were more interested in developing their curriculum vitae (39% vs. 60%, p=0.044) and communication skills (49% vs. 77%, p=0.0048). Compared to male respondents, female respondents were more interested in developing skills in conducting scientific research (47 vs. 70%, p=0.0165).A cluster analysis showed that specialists who attached more importance to almost all professional values, in comparison to those who did not, were more interested in activities aimed at developing their research skills (64% vs. 41%, p=0.0287), learning about the principles of evidence-based medicine (70% vs. 41%, p=0.0063), and participating in journal clubs (39% vs. 11%, p=0.0193).

CONCLUSION

The present study suggests that job opportunities, intellectual stimulation, and work-life balance are the most important professional values for future and practicing mental health specialists. These findings might be used as a basis for developing educational activities for mental health specialists.

Delirium and Cognitive Impairment as Predisposing Factors of COVID-19 Infection in Neuropsychiatric Patients: A Narrative Review

SARS-CoV-2 neuroinvasive and neurotropic abilities may underlie delirium onset and neuropsychiatric outcomes. Only a limited number of studies have addressed the potential effect of SARS-CoV-2 infection on mental health so far. Most studies mainly reported the acute onset of mixed neuropsychiatric conditions in patients infected with SARS-CoV-2, characterized by agitated behavior, altered level of consciousness, and disorganized thinking, regardless of psychological or socioeconomic triggering factors. The present narrative review aims to analyze and discuss the mechanisms underlying the neuroinvasive/neurotropic properties of SARS-CoV-2 and the subsequent mental complications. Delirium appeared as a clinical manifestation of SARS-CoV-2 brain infection in some patients, without systemic or multiple organ failure symptoms. A small number of studies demonstrated that neuropsychiatric symptoms associated with COVID-19, initially presenting as a confused state, may subsequently evolve in a way that is consistent with the patients' neuropsychiatric history. A literature analysis on this topic prevalently showed case reports and case series of patients presenting delirium or delirium-like symptoms as the main outburst of COVID-19, plus a cognitive impairment, from mild to severe, which pre-existed or was demonstrated during the acute phase or after infection. Dementia appeared as one of the most frequent predisposing factors to SARS-CoV-2 infection complicated with delirium. Instead, contrasting data emerged on the potential link between COVID-19 and delirium in patients with cognitive impairment and without a neuropsychiatric history. Therefore, clinicians should contemplate the possibility that COVID-19 appears as delirium followed by a psychiatric exacerbation, even without other systemic symptoms. In addition, cognitive impairment might act as a predisposing factor for COVID-19 in patients with delirium.