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Léda-Rêgo G, Studart-Bottó P, Abbade P, Rabelo-Da-Ponte FD, Casqueiro JS, Sarmento S, Dallalana C, Troesch M, Prates S, Miranda-Scippa Â. Lifetime prevalence of psychiatric comorbidities in patients with bipolar disorder: A systematic review and meta-analysis. Psychiatry Res 2024; 337:115953. [PMID: 38763079 DOI: 10.1016/j.psychres.2024.115953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/26/2024] [Accepted: 05/07/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Bipolar disorder (BD) is a severe psychiatric disease and part of its burden is related to the high rates of lifetime psychiatric comorbidity (PC), with diagnostic, therapeutic, and prognostic implications. METHODS Registered in PROSPERO (CRD42021282356). Meta-analyses were performed, searching for relevant papers published from 1993 to 2022 in Medline/PubMed (including E-Pub Ahead of Print), Embase, Cochrane Library (Central), PsycINFO, Scopus, Web of Science and via hand-searching, without language restrictions. 12.698 studies were initially identified, 114 of which were ultimately chosen based on the eligibility criteria. We performed two meta-analyses (prevalence and risk ratio) of mental health conditions among subjects with BD and then conducted a comprehensive examination of moderator effects using multivariable meta-regression models for moderators identified as significant in the univariable analysis. FINDINGS Overall PC prevalence of at least one disorder was 38.91 % (95 % CI 35.24-42.70) and the most frequent disorders were: anxiety (40.4 % [34.97-46.06]), SUD (30.7 % [23.73-38.73]), ADHD (18.6 % [10.66-30.33]) and Disruptive, impulse-control and conduct disorder (15 % [6.21-31.84). The moderators with higher association with individual prevalences were UN's Human Development Index (HDI), female gender, age, suicide attempt, and age at onset (AAO). INTERPRETATION It becomes evident that the prevalence of PC among individuals with BD is notably high, surpassing rates observed in the general population. This heightened prevalence persists despite significant heterogeneity across studies. Consequently, it is imperative to redirect clinical focus towards comprehensive mental health assessments, emphasizing personalized and routine screening. Additionally, there is a pressing need for the enhancement of public policies to create a supportive environment for individuals with BD, ensuring better therapeutic conditions and sustained assistance. By addressing these aspects, we can collectively strive towards fostering improved mental health outcomes for individuals with BD.
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Affiliation(s)
- Gabriela Léda-Rêgo
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil.
| | - Paula Studart-Bottó
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil
| | - Pedro Abbade
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
| | - F Diego Rabelo-Da-Ponte
- Institute of Psychiatry, Psychology, and Neurosciences, King's College London, United Kingdom
| | - Juliana Socorro Casqueiro
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil; Departamento de Neurociências e Saúde Mental, Faculdade de Medicina, UFBA, Salvador, BA, Brasil
| | - Stella Sarmento
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil
| | - Caroline Dallalana
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil
| | - Mariana Troesch
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil
| | - Sarah Prates
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil
| | - Ângela Miranda-Scippa
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil; Departamento de Neurociências e Saúde Mental, Faculdade de Medicina, UFBA, Salvador, BA, Brasil
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Yang Y, Wang J, Su Q, Yang J, Bo Z, Zheng C, Xie Y, Chen K, Wang J, Chen G, Wang Y. The Mediation/Moderation Effects of Gut Microbiota on Sleep Quality and Primary Liver Cancer: A Mendelian Randomization and Case-Control Study. Nat Sci Sleep 2024; 16:663-674. [PMID: 38841051 PMCID: PMC11152056 DOI: 10.2147/nss.s458491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 05/25/2024] [Indexed: 06/07/2024] Open
Abstract
Background Primary liver cancer (PLC) is a fatal malignancy, sleep quality and gut microbiota were shown to be associated with PLC. However, the mechanism of how sleep quality affects PLC is unclear. This study aims to investigate the mediation/moderation effects of gut microbiota on sleep quality and the occurrence of PLC. Methods The causality of sleep quality and the occurrence of PLC was detected through the Mendelian randomization (MR) analysis based on the data including 305,359 individuals (Finland Database) and 456,348 participants (UK Biobank). The primary method used for MR analysis was inverse-variance weighted analysis. Gut microbiota' mediation/moderation effects were uncovered in the case-control study including 254 patients with PLC and 193 people with benign liver diseases through the mediation/moderation effect analyses. People's sleep quality was evaluated through the Pittsburgh sleep quality index (PSQI). Results Poor sleep quality could lead to PLC through the MR analysis (P = 0.026). The case-control study uncovered that Actinobacteria had mediation effects on the relationship between PSQI score, self-sleep quality, and the occurrence of PLC (P = 0.048, P = 0.046). Actinobacteria and Bifidobacterium could inhibit the development of PLC caused by short night sleep duration (P = 0.021, P = 0.022). Erysipelotrichales could weaken the influence of daytime dysfunction on PLC (P = 0.033). Roseburia modulated the contribution of nocturnal insomnia and poor sleep quality to PLC (P = 0.009, P = 0.017). Conclusion Poor sleep quality was associated with PLC. Gut microbiota' mediation/moderation effects on poor sleep quality and the occurrence of PLC prompted an insightful idea for the prevention of PLC.
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Affiliation(s)
- Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
| | - Jingxian Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
| | - Qing Su
- Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
| | - Jinhuan Yang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
| | - Zhiyuan Bo
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
| | - Chongming Zheng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
| | - Yitong Xie
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
| | - Kaiwen Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
| | - Juejin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
| | - Gang Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
| | - Yi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
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Fiorillo A, Albert U, Dell'Osso B, Pompili M, Sani G, Sampogna G. The clinical utility and relevance in clinical practice of DSM-5 specifiers for major depressive disorder: A Delphi expert consensus study. Compr Psychiatry 2024; 133:152502. [PMID: 38810371 DOI: 10.1016/j.comppsych.2024.152502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 05/06/2024] [Accepted: 05/18/2024] [Indexed: 05/31/2024] Open
Abstract
Major depressive disorder (MDD) is a heterogeneous syndrome, associated with different levels of severity and impairment on the personal functioning for each patient. Classification systems in psychiatry, including ICD-11 and DSM-5, are used by clinicians in order to simplify the complexity of clinical manifestations. In particular, the DSM-5 introduced specifiers, subtypes, severity ratings, and cross-cutting symptom assessments allowing clinicians to better describe the specific clinical features of each patient. However, the use of DSM-5 specifiers for major depressive disorder in ordinary clinical practice is quite heterogeneous. The present study, using a Delphi method, aims to evaluate the consensus of a representative group of expert psychiatrists on a series of statements regarding the clinical utility and relevance of DSM-5 specifiers for major depressive disorder in ordinary clinical practice. Experts reached an almost perfect agreement on statements related to the use and clinical utility of DSM-5 specifiers in ordinary clinical practice. In particular, a complete consensus was found regarding the clinical utility for ordinary clinical practice of using DSM-5 specifiers. The use of specifiers is considered a first step toward a "dimensional" approach to the diagnosis of mental disorders.
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Affiliation(s)
- Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Italy
| | - Bernardo Dell'Osso
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences and Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milano, Italy; Department of Psychiatry and Behavioural Sciences, Stanford University, USA
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, University Cattolica del Sacro Cuore, Rome, Italy; Department of Neuroscience, Sensory organs and Thorax, Department of Psychiatry, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Nikiema JN, Thiam D, Bayani A, Ayotte A, Sourial N, Bally M. Assessing the impact of transitioning to 11th revision of the International Classification of Diseases (ICD-11) on comorbidity indices. J Am Med Inform Assoc 2024; 31:1219-1226. [PMID: 38489540 PMCID: PMC11105143 DOI: 10.1093/jamia/ocae046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/19/2024] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES This study aimed to support the implementation of the 11th Revision of the International Classification of Diseases (ICD-11). We used common comorbidity indices as a case study for proactively assessing the impact of transitioning to ICD-11 for mortality and morbidity statistics (ICD-11-MMS) on real-world data analyses. MATERIALS AND METHODS Using the MIMIC IV database and a table of mappings between the clinical modification of previous versions of ICD and ICD-11-MMS, we assembled a population whose diagnosis can be represented in ICD-11-MMS. We assessed the impact of ICD version on cross-sectional analyses by comparing the populations' distribution of Charlson and Elixhauser comorbidity indices (CCI, ECI) across different ICD versions, along with the adjustment in comorbidity weighting. RESULTS We found that ICD versioning could lead to (1) alterations in the population distribution and (2) changes in the weight that can be assigned to a comorbidity category in a reweighting initiative. In addition, this study allowed the creation of the corresponding ICD-11-MMS codes list for each component of the CCI and the ECI. DISCUSSION In common with the implementations of previous versions of ICD, implementation of ICD-11-MMS potentially hinders comparability of comorbidity burden on health outcomes in research and clinical settings. CONCLUSION Further research is essential to enhance ICD-11-MMS usability, while mitigating, after identification, its adverse effects on comparability of analyses.
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Affiliation(s)
- Jean Noel Nikiema
- Systèmes de soins et de santé publique, Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, Québec, H3N 1X9, Canada
- Laboratoire Transformation Numérique en Santé (LabTNS), Montréal, Québec, H2X 0A9, Canada
- Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, Québec, H3N 1X9, Canada
| | - Djeneba Thiam
- Systèmes de soins et de santé publique, Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, Québec, H3N 1X9, Canada
- Laboratoire Transformation Numérique en Santé (LabTNS), Montréal, Québec, H2X 0A9, Canada
| | - Azadeh Bayani
- Systèmes de soins et de santé publique, Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, Québec, H3N 1X9, Canada
- Laboratoire Transformation Numérique en Santé (LabTNS), Montréal, Québec, H2X 0A9, Canada
| | - Alexandre Ayotte
- Systèmes de soins et de santé publique, Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, Québec, H3N 1X9, Canada
- Laboratoire Transformation Numérique en Santé (LabTNS), Montréal, Québec, H2X 0A9, Canada
| | - Nadia Sourial
- Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, Québec, H3N 1X9, Canada
- Carrefour de l'innovation, Research Center, Centre hospitalier de l’Université de Montréal, Montréal, Québec, H2X 0A9, Canada
| | - Michèle Bally
- Carrefour de l'innovation, Research Center, Centre hospitalier de l’Université de Montréal, Montréal, Québec, H2X 0A9, Canada
- Faculté de Pharmacie, Université de Montréal, Montréal, Québec, H3T 1J4, Canada
- Département de Pharmacie, Centre hospitalier de l’Université de Montréal, Montréal, Québec, H2X 0C1, Canada
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Gill J, Jones A, Price K, Goodison E, Tyson P. A mixed-method systematic review of the perspectives of young people, carers and professionals on psychiatric diagnosis in childhood and adolescence. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2024; 37:e12459. [PMID: 38522014 DOI: 10.1111/jcap.12459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 02/22/2024] [Accepted: 03/01/2024] [Indexed: 03/25/2024]
Abstract
PROBLEM The significance and complexities of a psychiatric diagnosis have been well-documented in existing literature. Despite the reliability and accuracy of such diagnoses, the impact and use of diagnostic labelling on young people remains unclear. METHODS A systematic review was conducted using six databases, identifying 13 studies that explored psychiatric diagnosis experiences in professionals, caregivers, and young people. FINDINGS This review focuses on three main themes related to psychiatric diagnosis in young people. The first theme is diagnostic subjectivity, which explores the accuracy, usefulness, potential harm and alternatives (e.g. psychological formulation) to psychiatric diagnosis in this population. The second theme is the utility of psychiatric diagnosis, which considers whether it helps young people access appropriate support and gain a better understanding of themselves and their presenting issues. The third theme is stigma, which examines the negative experiences and discrimination that young people may face due to their psychiatric diagnosis. CONCLUSIONS There is relatively limited literature which discusses the experience of psychiatric diagnosis in young people, caregivers and professionals. The available literature is difficult to compare due to discrepancies between methodologies and services, and there are several gaps i.e. a limited focus on the experience of young people themselves. Different views and experiences of psychiatric diagnosis among professionals, caregivers, and young people could impact young people's quality of life, access to healthcare, and identity development. The current literature needs to be more comprehensive to draw firm conclusions about young people's experiences with psychiatric diagnosis.
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Affiliation(s)
- Jodie Gill
- School of Psychology and Therapeutic Studies, University of South Wales, Treforest Campus, Pontypridd, Wales, United Kingdom
| | - Alexis Jones
- School of Psychology and Therapeutic Studies, University of South Wales, Treforest Campus, Pontypridd, Wales, United Kingdom
| | - Klara Price
- School of Psychology and Therapeutic Studies, University of South Wales, Treforest Campus, Pontypridd, Wales, United Kingdom
| | - Egan Goodison
- School of Psychology and Therapeutic Studies, University of South Wales, Treforest Campus, Pontypridd, Wales, United Kingdom
| | - Philip Tyson
- School of Psychology and Therapeutic Studies, University of South Wales, Treforest Campus, Pontypridd, Wales, United Kingdom
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Drobnič Radobuljac M, Grošelj U, Kaltiala R, Vermeiren R, Crommen S, Kotsis K, Danese A, Hoekstra PJ, Fegert JM. ESCAP statement on the care for children and adolescents with gender dysphoria: an urgent need for safeguarding clinical, scientific, and ethical standards. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02440-8. [PMID: 38678135 DOI: 10.1007/s00787-024-02440-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Affiliation(s)
- Maja Drobnič Radobuljac
- Department of Psychiaty, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
- Centre for Mental Health, University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia.
| | - Urh Grošelj
- Department of Endocrinology, Diabetes and Metabolism, UMC - University Children's Hospital Ljubljana, Ljubljana, Slovenia
- Department of Pediatrics, University of Ljubljana, Ljubljana, Slovenia
- Department of Medical Ethics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- National Medical Ethics Committee of Slovenia, Ljubljana, Slovenia
| | - Riittakerttu Kaltiala
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland
- Vanha Vaasa Hospital, Vaasa, Finland
| | - Robert Vermeiren
- Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Konstantinos Kotsis
- Community CAMHS, and Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Andrea Danese
- Department of Child and Adolescent Psychiatry and Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, London, UK
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen; and University Medical Center Groningen, Groningen, The Netherlands
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany
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Eilers R, Ertl V, Kasparik B, Kost A, Rosner R. [Posttraumatic stress disorder in children and adolescents: results of a cross-sectional study on the effects of the newly formulated PTSD and CPTSD diagnoses in the ICD-11]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:409-418. [PMID: 38498186 PMCID: PMC10995073 DOI: 10.1007/s00103-024-03860-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/27/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND ICD-11 presents narrowed criteria for posttraumatic stress disorder (PTSD) and introduces complex PTSD (CPTSD) with additional difficulties in self-organization (DSO). These changes can have significant effects on the frequency of the diagnosis. The aim of this study was to investigate which ICD-11 symptom clusters cause children and adolescents to miss the diagnosis and whether caregivers are more likely to attribute changes in DSO to developmental level or to the traumatic event, and how these attributions are in turn related to symptom severity. METHODS N = 88 German-speaking children and adolescents (age: 7-17 years) after traumatic events and N = 79 caregivers participated between September 2019 and November 2020 in a survey on PTSD symptom severity (CATS-2) and attribution of DSO symptoms (caregiver questionnaire). RESULTS The ICD-11 criteria (CATS‑2 and a developmentally adapted version) showed lower frequency rates for PTSD as compared to DSM‑5 and ICD-10. The ICD-11 clusters re-experiencing and hyperarousal were met the least often. Changes in DSO symptoms were predominantly rated as event-related. This attribution was associated with higher PTSD and DSO symptom severity in caregiver reports. The age-related attribution was associated with higher DSO-symptom severity, but not PTSD symptom severity in caregiver reports. DISCUSSION In the context of the diagnostic process and the revision of diagnostic instruments for ICD-11 (C)PTSD, development-specific symptoms should be taken into account. The trauma-related differentiation of DSO symptom changes as compared to development-related fluctuations is challenging and therefore requires several sources of information.
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Affiliation(s)
- Rebekka Eilers
- Institut für Psychologie, Katholische Universität Eichstätt-Ingolstadt, Eichstätt, Deutschland
| | - Verena Ertl
- Institut für Psychologie, Katholische Universität Eichstätt-Ingolstadt, Eichstätt, Deutschland.
- Katholische Universität Eichstätt-Ingolstadt, Ostenstr. 25, 85072, Eichstätt, Deutschland.
| | - Barbara Kasparik
- Institut für Psychologie, Katholische Universität Eichstätt-Ingolstadt, Eichstätt, Deutschland
| | - Anne Kost
- Altonaer Kinderkrankenhaus, Kinder- und Jugendsomatik, Hamburg, Deutschland
| | - Rita Rosner
- Institut für Psychologie, Katholische Universität Eichstätt-Ingolstadt, Eichstätt, Deutschland
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Lydecker JA, Ivezaj V, Wiedemann AA, Kerrigan S, Grilo CM. Reliability of the original and brief versions of the Eating Disorder Examination in binge-eating disorder. Obesity (Silver Spring) 2024; 32:702-709. [PMID: 38311600 DOI: 10.1002/oby.23993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/20/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVE Psychometric studies evaluating the reliability of eating-disorder assessment among individuals with binge-eating disorder (BED) have been limited. The current study documents the interrater reliability and internal consistency of the Eating Disorder Examination (EDE) interview when administered to adults with Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5)-defined BED. METHODS Participants (N = 56) were adults seeking treatment for BED in the context of clinical trials testing pharmacological and psychological treatments. Doctoral-level, trained, and supervised clinical researchers evaluated eating-disorder psychopathology using the EDE interview and audio-recorded the interview. A second doctoral-level, trained, and supervised clinical researcher, who did not conduct the initial assessment, coded eating-disorder psychopathology using the audio recording. RESULTS Agreement among raters on the number of binge-eating episodes was near perfect. There was excellent interrater reliability for nearly all scales of the EDE interview. Agreement among raters for behavioral indicators of loss of control and marked distress regarding binge eating ranged from moderate to perfect. Internal consistency was variable for all scales, ranging from unacceptable to good. CONCLUSIONS Our study suggests that the EDE can be administered reliably by multiple interviewers to assess adults with BED. However, internal consistency was mostly subpar. Tests of reliability and other psychometric properties (e.g., validity) in other patient groups such as children with BED are warranted.
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Affiliation(s)
- Janet A Lydecker
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Valentina Ivezaj
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ashley A Wiedemann
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Stephanie Kerrigan
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychology, Yale University, New Haven, Connecticut, USA
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Huțul TD, Karner-Huțuleac A, Huțul A, Popescu A. Examination of Gender Differences in Depression, Relationship Satisfaction, and Problematic Pornography Use Among Romanian Gay Men and Lesbian Women. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2024; 36:205-220. [PMID: 38616793 PMCID: PMC11008547 DOI: 10.1080/19317611.2024.2329973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/08/2024] [Indexed: 04/16/2024]
Abstract
This study investigates factors influencing the psychological well-being of gay and lesbian individuals in Romania. Participants (N = 172) included 61.6% gay and 38.4% lesbians, currently in relationships, aged between 18 and 62 years (M = 28.28; SD = 9.53). Surveys assessed relationship satisfaction, depression, and problematic pornography use. Significant associations were found among these variables, with gender differences observed. We tested a regression model for problematic pornography use, where depression provided additional explanatory power to the initial model. Age, gender, and depression accounted for 18% of the variance in problematic pornography use. The theoretical and practical implications are discussed.
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Affiliation(s)
- Tudor-Daniel Huțul
- Psychology and Education Sciences, Alexandru Ioan Cuza University of Iași, Romania
| | | | - Andreea Huțul
- Psychology and Education Sciences, Alexandru Ioan Cuza University of Iași, Romania
| | - Alexandru Popescu
- Psychology and Education Sciences, Alexandru Ioan Cuza University of Iași, Romania
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10
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Lee AC, Herrieven E, Harrower NA. Health inequalities for people with learning disabilities: why it matters and what emergency physicians need to know. Br J Hosp Med (Lond) 2024; 85:1-7. [PMID: 38416523 DOI: 10.12968/hmed.2023.0357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
People with learning disabilities die on average 16 years earlier than the general population in England. They are a vulnerable group and may have unhealthy lifestyles and multimorbidity that lead to poor health outcomes. Worryingly, premature deaths are also more common and these often have contributory healthcare causes. This may be a result of staff lacking awareness, expertise and experience managing people with learning disabilities, the lack of reasonable adjustments, or discriminatory attitudes. Other issues include polypharmacy and inappropriate prescribing of sedatives, inappropriate use of do not resuscitate orders, and diagnostic overshadowing leading to delayed or misdiagnoses. Emergency physicians need to be aware of subtle or atypical presentations of illnesses such as sepsis. Carers and family can be vital informants, helping clinicians to interpret subtle signs and aid communication with people with learning disabilities. One simple approach to reasonable adjustments, as required by law, is the TEACH mnemonic: people with learning disabilities need more time (T), in a conducive environment (E), with clinicians approaching them with the right attitude (A) and an open mind. Good communication (C) is essential and clinicians must make every attempt to understand their patients and to be understood by their patients. Finally clinicians need to consider what 'help' (H) the patient and their carers or family needs. With the right approach, time and environment, emergency physicians can optimise the care delivered to people with learning disabilities to address their needs.
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Affiliation(s)
- Andrew Ck Lee
- School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
| | - Elizabeth Herrieven
- Department of Emergency Medicine, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Neil A Harrower
- Department of Child Development and Neurodisability, Sheffield Children's NHS Foundation Trust, Sheffield, UK
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11
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Micek A, Jagielski P, Bolesławska I, Witkowska AM, Waśkiewicz A, Wajda Z, Kamińska A, Cebula A, Godos J. Negative Association of Lignan and Phytosterol Intake with Stress Perception during the COVID-19 Pandemic-A Polish Study on Young Adults. Nutrients 2024; 16:445. [PMID: 38337729 PMCID: PMC10857242 DOI: 10.3390/nu16030445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND There has been an increasing global prevalence of depression and other psychiatric diseases in recent years. Perceived stress has been proven to be associated with psychiatric and somatic symptoms. Some animal and human studies have suggested that consuming foods abundant in lignans and phytosterols may be associated with lower levels of stress, depression, and anxiety. Still, the evidence is not yet strong enough to draw firm conclusions. Thus, we investigated the association between dietary intake of these phytochemicals and the level of stress experienced by adult individuals. METHODS Diet was assessed using self-reported 7-day dietary records. The intakes of lignans and phytosterols were estimated using databases with their content in various food products. The Perceived Stress Scale (PSS) was implemented to measure the level of perceived stress. A logistic regression analysis was used to test for associations. RESULTS The odds of elevated PSS were negatively associated with dietary intake of total phytosterols, stigmasterol, and β-sitosterol, with evidence of a decreasing trend across tertiles of phytochemicals. The analysis for doubling the intake reinforced the aforementioned relationships and found protective effects against PSS for total lignans, pinoresinol, and campesterol. CONCLUSIONS Habitual inclusion of lignans and phytosterols in the diet may play a role in psychological health. To address the global outbreak of depression and other mental health issues triggered by stress, it is important to take a holistic approach. There is a need to develop effective strategies for prevention and treatment, among which certain dietary interventions such as consumption of products abundant in lignans and phytosterols may play a substantial role.
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Affiliation(s)
- Agnieszka Micek
- Statistical Laboratory, Jagiellonian University Medical College, 31-126 Kraków, Poland
| | - Paweł Jagielski
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Kraków, Poland;
| | - Izabela Bolesławska
- Department of Bromatology, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
| | - Anna Maria Witkowska
- Department of Food Biotechnology, Medical University of Bialystok, 15-295 Bialystok, Poland;
| | - Anna Waśkiewicz
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology, 04-628 Warszawa, Poland;
| | - Zbigniew Wajda
- Faculty of Management and Social Communication, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland;
| | - Anna Kamińska
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, 31-121 Kraków, Poland; (A.K.); (A.C.)
| | - Aneta Cebula
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, 31-121 Kraków, Poland; (A.K.); (A.C.)
| | - Justyna Godos
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
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12
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Williams LM, Carpenter WT, Carretta C, Papanastasiou E, Vaidyanathan U. Precision psychiatry and Research Domain Criteria: Implications for clinical trials and future practice. CNS Spectr 2024; 29:26-39. [PMID: 37675453 DOI: 10.1017/s1092852923002420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Psychiatric disorders are associated with significant social and economic burdens, many of which are related to issues with current diagnosis and treatments. The coronavirus (COVID-19) pandemic is estimated to have increased the prevalence and burden of major depressive and anxiety disorders, indicating an urgent need to strengthen mental health systems globally. To date, current approaches adopted in drug discovery and development for psychiatric disorders have been relatively unsuccessful. Precision psychiatry aims to tailor healthcare more closely to the needs of individual patients and, when informed by neuroscience, can offer the opportunity to improve the accuracy of disease classification, treatment decisions, and prevention efforts. In this review, we highlight the growing global interest in precision psychiatry and the potential for the National Institute of Health-devised Research Domain Criteria (RDoC) to facilitate the implementation of transdiagnostic and improved treatment approaches. The need for current psychiatric nosology to evolve with recent scientific advancements and increase awareness in emerging investigators/clinicians of the value of this approach is essential. Finally, we examine current challenges and future opportunities of adopting the RDoC-associated translational and transdiagnostic approaches in clinical studies, acknowledging that the strength of RDoC is that they form a dynamic framework of guiding principles that is intended to evolve continuously with scientific developments into the future. A collaborative approach that recruits expertise from multiple disciplines, while also considering the patient perspective, is needed to pave the way for precision psychiatry that can improve the prognosis and quality of life of psychiatric patients.
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Affiliation(s)
- Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - William T Carpenter
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Evangelos Papanastasiou
- Boehringer Ingelheim Pharma GmbH & Co, Ingelheim am Rhein, Rhineland-Palatinate, Germany
- HMNC Holding GmbH, Wilhelm-Wagenfeld-Strasse 20, 80807Munich, Bavaria, Germany
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13
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Loreto BBL, Sordi AO, de Castro MN, Ornell F, Guarnieri EP, Roza TH, Schuch JB, Cima MDS, Pechansky F, Grevet EH, Grassi-Oliveira R, von Diemen L, Kessler FHP. Proposing an integrative, dynamic and transdiagnostic model for addictions: dysregulation phenomena of the three main modes of the predostatic mind. Front Psychiatry 2024; 14:1298002. [PMID: 38274436 PMCID: PMC10808830 DOI: 10.3389/fpsyt.2023.1298002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/28/2023] [Indexed: 01/27/2024] Open
Abstract
Several theories have been proposed to explain the complex diagnostic aspects related to addiction disorders and their development. Recent frameworks tend to focus on dimensional perspectives of symptoms rather than categorical systems, since substance use disorders are frequently comorbid with other psychiatric and especially personality disorders. However, useful transdiagnostic models that could integrate clinical evaluation derived from neuroscientific theories are lacking. In the present manuscript, the authors propose a model based on a new paradigm, in an attempt to better explain this complex, multifaceted phenomenon. The new paradigm presupposes that emotions and behavior are a response to risk prediction. Individuals make choices and engage in actions to manage potential risks/rewards in order to seek or maintain homeostasis in their internal and external environments - a mechanism that the authors call predostatic (predictive mechanism with homeostatic purpose). The model considers three main modes of the predostatic mind: (1) Alarm Mode, activated by high and/or imminent risk prediction; (2) Seek Mode, activated by long-term risk or reward prediction; and (3) Balance Mode, a self-regulating state of mind related to low risk prediction, a soothing system and a calm state. Addiction is seen as a chronic dysregulation of organism systems leading to internalizing or externalizing phenomena mainly related to the Seek and Alarm Modes, which are persistently activated by reward and risk prediction, respectively, thus hindering Balance. Addiction neuroscience research has shown that chronic drug use or engagement in addictive behaviors can lead to neuroadaptations in the brain reward circuitry, disrupting normal balance and the regulation of reward processes. This dysregulation can contribute to persistent drug-seeking/addictive behaviors despite negative consequences. This newly proposed dynamic and integrative model, named dysregulation based on externalizing and internalizing phenomena of the three main modes of the predostatic mind (DREXI3), proposes six dysregulation dimensions with basic emotional and behavioral symptoms, such as neurophysiological alterations, impulsivity, compulsion, cognitive impairment/psychosis, mood, and anxiety/anger. In this paper, the authors explain the rationale behind DREXI3 and present some hypothetical clinical examples to better illustrate the use of the model in clinical practice. The development of this innovative model could possibly guide tailored treatment interventions in the addiction field.
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Affiliation(s)
- Bibiana Bolten Lucion Loreto
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Anne Orgler Sordi
- Addiction and Forensic Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Melina Nogueira de Castro
- Addiction and Forensic Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Felipe Ornell
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Eduardo Pegoraro Guarnieri
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Jaqueline Bohrer Schuch
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Marcos da Silveira Cima
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flavio Pechansky
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Eugênio Horácio Grevet
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Rodrigo Grassi-Oliveira
- Department of Clinical Medicine, Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
| | - Lisia von Diemen
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Felix Henrique Paim Kessler
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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14
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Laurito LD, dos Santos-Ribeiro S, Moreira-de-Oliveira ME, Loureiro CP, Hühne V, Torres B, de Faro LFT, de Menezes GB, Fontenelle LF. Online group therapies for anxiety, obsessive-compulsive, and trauma-related disorders: a systematic review. Front Hum Neurosci 2024; 17:1286865. [PMID: 38273884 PMCID: PMC10809799 DOI: 10.3389/fnhum.2023.1286865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/27/2023] [Indexed: 01/27/2024] Open
Abstract
Background This systematic review examined the existing literature to determine the evidence supporting the efficacy of online group treatments for anxiety-, obsessive-compulsive- and trauma-related disorders (AOTDs). Methods A systematic review using the PUBMED, PsycInfo, Web of Science, and ClinicalTrials databases with no language, date, or study design filters was performed. The inclusion criteria comprised studies that examined individuals who had received a formal diagnosis of AOTDs, were aged 18 years or older, and had baseline and endpoint assessments of symptom severity using formal tools. Results Five studies on social anxiety disorder (SAD), four on post-traumatic stress disorder (PTSD) and one on tic disorders (TDs) were found. The studies were open-label (n = 2) and randomized controlled trials (RCTs) (n = 8), with five of the RCTs being non-inferiority trials. Most studies were conducted in the US and investigated psychological CBT based interventions via internet-based therapies (IBT: n = 4), video teleconferencing (VTC: n = 5) or a combination of both (n = 1). In SAD, IBT studies associated with a clinician assisted web-based forum (here termed "forum-enhanced" studies) were superior to waiting lists and not inferior to similar versions that were also "forum enhanced" but self-guided, "telephone enhanced" by a contact with a non-specialist, and "email enhanced" by a contact with a clinician individually. Studies involving VTC have shown comparable effectiveness to in-person interventions across some online group CBT based treatments for PTSD. Two open trials also demonstrated symptoms reductions of social anxiety and tics through VTC. Conclusion There is evidence supporting the effectiveness of online group treatments for SAD and PTSD. Further studies from different research groups may be needed to replicate the use of these and other forms of online treatments in individuals with SAD, PTSD, and other clinical populations, such as OCD, panic disorder, agoraphobia and specific phobias. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023408491.
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Affiliation(s)
- Luana D. Laurito
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Samara dos Santos-Ribeiro
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria E. Moreira-de-Oliveira
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carla P. Loureiro
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Verônica Hühne
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bianca Torres
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Livi Ferreira Testoni de Faro
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gabriela B. de Menezes
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Leonardo F. Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
- Department of Psychiatry, Monash University, Clayton, VIC, Australia
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15
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Mutlu C, Birinci T, Senel A, Mustafaoglu R, Bulanık Koc E, Karacetin G, Kaya Mutlu E. A multi-dimensional assessment of internet gaming disorder in children and adolescents: A case-control study. Work 2024; 77:1089-1099. [PMID: 38007630 DOI: 10.3233/wor-220652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Internet gaming disorder (IGD) leads to social disturbances and isolation, neglect of daily responsibilities, behavioral disorders, and physical impairments. OBJECTIVE This study aimed to investigate the effect of IGD on spine biomechanics, range of motion in the neck and low back, and lung functions and respiratory muscle strength in children and adolescents. METHODS Sixty-four children and adolescents with IGD (Group I) and 41 healthy controls (Group II) were included in the study. The outcomes were assessed with the Visual Analogue Scale (VAS), Internet Addiction Scale, active range of motion (AROM) in the neck and lumbar spine, posture and spinal alignment, lung function tests, and respiratory muscle strength. RESULTS There is a significant difference in pain intensity at rest, during activity, and daily sitting time between groups (p < 0.05). Craniovertebral angle, shoulder asymmetry, thoracic kyphosis angle, cervical extension and rotation, and right lumbar rotation significantly decreased in Group I than in Group II (p < 0.05). Besides, the PEF, FEF 25-75%, and respiratory muscle strength were lower in Group I than in Group II (p < 0.05). With a multiple linear regression model, MEP, FEV1, and weekly time spent playing online games were significant predictors of internet addiction intensity (R2 = 0.28; p = 0.02, p = 0.01, and p < 0.001, respectively). CONCLUSION Postural misalignment and increased sedentary time cause physical health deterioration and negatively affect lung functions in children and adolescents with IGD. Consequently, considering both psychological and physical health is necessary to assess the problematic nature of internet gaming. A comprehensive assessment and multidisciplinary team approach is essential to managing the IGD.
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Affiliation(s)
- Caner Mutlu
- Department of Child and Adolescent Mental Health and Diseases, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Tansu Birinci
- Department of Physiotherapy and Rehabilitationf, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Aybike Senel
- Division of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Rustem Mustafaoglu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Esra Bulanık Koc
- Clinic of Child and Adolescent Psychiatry, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, University of Health Science, Istanbul, Turkey
| | - Gul Karacetin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Bandirma, Turkey
| | - Ebru Kaya Mutlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Bandirma, Turkey
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16
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Li M, Gao W, Zhang Y, Luo Q, Xiang Y, Bao K, Zaki N. Secular trends in the incidence of major depressive disorder and dysthymia in China from 1990 to 2019. BMC Public Health 2023; 23:2162. [PMID: 37926849 PMCID: PMC10626640 DOI: 10.1186/s12889-023-17025-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Depression is increasingly recognized as a worldwide serious, public health concern. A better understanding of depression is important for advancing its management and learning the difference between major depressive disorder (MDD) and dysthymia. Our aim is to conduct a concurrent analysis of the trends of both MDD and dysthymia in China. METHODS The data on depression from 1990 to 2019 were collected from the Global Burden of Disease Study 2019 (GBD 2019). To determine the average annual percent changes (AAPC) and relative risks (RRs), joinpoint regression and the age-period-cohort models were employed, respectively. RESULTS The incidence number of MDD and dysthymia continuously increased in China from 1990 to 2019, however, the age-standardized rates (ASR) had a decreasing trend in both men and women. The results from joinpoint regression showed that a declining trend was presented in young people (< 50 years) but an increased trend in the elderly (≥ 50 years) both in men and women, during 1990-2019. Age is the most influential factor for MDD and dysthymia. Age RRs for MDD incidence had an overall increasing trend with age. Period RR in MDD presented a U-shaped pattern, while Cohort RRs presented an inverted U-shaped pattern. On the other hand, RRs in dysthymia for period and cohort effects had no statistical significance, only the age effect presented an inverted U-shaped pattern. CONCLUSIONS The disparities in trends observed between MDD and dysthymia during the period of 1990-2019 indicated the significance of distinguishing between these two disorders. The age, period and cohort effects all had a greater impact on MDD than on dysthymia, and age effects presented different influential patterns in these two. To alleviate the burden of depressive disorders in China, proactive measures need to be implemented, with particular attention to the elderly population.
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Affiliation(s)
- Ming Li
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China
| | - Wenlong Gao
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China.
| | - Yuqi Zhang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China
| | - Qiuxia Luo
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China
| | - Yuanyuan Xiang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China
| | - Kai Bao
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China
| | - Noha Zaki
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China
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17
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Seemüller F. ICD-11 and mental disorders: important changes, controversies, and future directions. BMC Psychiatry 2023; 23:698. [PMID: 37749513 PMCID: PMC10521444 DOI: 10.1186/s12888-023-05186-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023] Open
Abstract
About a year and a half after publishing ICD-11, we aim to gather initial feedback, comments, opinions, and even recent study results from experts in the relevant fields through this collection. We hope to facilitate a preliminary summary of whether the new classification truly represents progress, and how it has changed treatment, and research of mental illnesses.
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Affiliation(s)
- Florian Seemüller
- Department for Psychiatry, Psychosomatics and Psychotherapy, kbo-Lech-Mangfall-Klinik Garmisch-Partenkirchen, Auenstrasse 6, Garmisch-Partenkirchen, 82467, Germany.
- Department for Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstrasse 7, Munich, 80336, Germany.
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18
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Quadflieg N, Voderholzer U, Meule A, Fichter MM. Comparing ICD-11 and DSM-5 eating disorder diagnoses with the Munich eating and feeding disorder questionnaire (ED-Quest). Int J Eat Disord 2023; 56:1826-1831. [PMID: 37309255 DOI: 10.1002/eat.24010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 06/02/2023] [Accepted: 06/02/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The new ICD-11 eating disorders (ED) guidelines are similar to the DSM-5 criteria. One difference to the DSM-5 is the inclusion of subjective binges in the definition of bulimia nervosa (BN) and binge-eating disorder (BED). The aim of this study was to identify differences between the ICD-11 guidelines and DSM-5 ED criteria, which could impact access to medical care and early treatment. METHOD Data of 3863 ED inpatients who completed the Munich Eating and Feeding Disorder Questionnaire were analyzed using standardized diagnostic algorithms for DSM-5 and ICD-11. RESULTS Agreement of diagnoses was high (Krippendorff's α = .88, 95% CI [.86, .89]) for anorexia nervosa (AN; 98.9%), BN (97.2%) and BED (100%), and lower for other feeding and eating disorders (OFED; 75.2%). Of the 721 patients with a DSM-5 OFED, 19.8% were diagnosed with AN, BN or BED by the ICD-11 diagnostic algorithm, reducing the number of OFED diagnoses. One-hundred and twenty-one patients received an ICD-11 diagnosis of BN or BED because of subjective binges. DISCUSSION For over 90% of patients, applying either DSM-5 or ICD-11 diagnostic criteria/guidelines resulted in the same full-threshold ED diagnosis. Sub-threshold and feeding disorders exhibited a discrepancy of 25%. PUBLIC SIGNIFICANCE STATEMENT For about 98% of inpatients, the ICD-11 and DSM-5 agree on the same specified eating disorder diagnosis. This is important when comparing diagnoses made by different diagnostic systems. Including subjective binges in the definition of bulimia nervosa and binge-eating disorder contributes to improved ED diagnoses. Clarifying the wording of diagnostic criteria at several places could further increase this agreement.
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Affiliation(s)
- Norbert Quadflieg
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Munich, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Freiburg, Germany
| | - Adrian Meule
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Manfred Maximilian Fichter
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
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19
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Düplois D, Brosig L, Hiemisch A, Kiess W, Hilbert A, Schlensog-Schuster F, Schmidt R. Distribution and clinical comparison of restrictive feeding and eating disorders using ICD-10 and ICD-11 criteria. Int J Eat Disord 2023; 56:1717-1729. [PMID: 37243388 DOI: 10.1002/eat.23994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Within the eleventh edition of the International Classification of Diseases (ICD-11), diagnostic criteria for feeding and eating disorders were revised and new diagnoses including avoidant/restrictive food intake disorder (ARFID) are classifiable; however, nothing is known about how these changes affect the prevalence of feeding and eating disorders. This study compared the distribution and clinical characteristics of restrictive feeding and eating disorders between ICD-10 and ICD-11. METHOD The Eating Disorder Examination (EDE), its child version, and the EDE ARFID module were administered to N = 82 patients (0-17 years) seeking treatment for restrictive feeding and eating disorders and their parents. Clinical characteristics were derived from medical records, questionnaires, and objective anthropometrics. RESULTS The number of residual restrictive eating disorders (rrED) significantly decreased from ICD-10 to ICD-11 due to a crossover to full-threshold disorders, especially anorexia nervosa (AN) or ARFID. Patients reclassified to ICD-11 ARFID were younger, had an earlier age of illness onset, more restrictive eating behaviors, and tended to have more somatic comorbidities compared to those reclassified to ICD-11 AN. Patients with rrED according to both ICD-10 and ICD-11 were younger, had an earlier age of illness onset, less shape concern, and more somatic comorbidities than patients who were reclassified from ICD-10 rrED to ICD-11 AN or ARFID. DISCUSSION This study highlights the inclusive approach of ICD-11 criteria, paving the way for more targeted treatment, and ARFID's high clinical relevance. Future studies considering nonrestrictive feeding and eating disorders across the life span may allow further analyses on diagnostic crossover. PUBLIC SIGNIFICANCE Changes in diagnostic criteria for restrictive eating disorders within the newly published ICD-11 led to an increase in full-threshold disorders, while the number of rrED was significantly lowered compared to ICD-10 criteria. The results thus highlight the diagnostic utility of ICD-11 criteria and may help providing adequate treatment to children and adolescents with rrED.
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Affiliation(s)
- Dominik Düplois
- Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, Integrated Research and Treatment Center AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
| | - Luise Brosig
- Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, Integrated Research and Treatment Center AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
| | - Andreas Hiemisch
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Hospital for Children and Adolescents, Center for Pediatric Research, Leipzig University Medical Center, Leipzig, Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Hospital for Children and Adolescents, Center for Pediatric Research, Leipzig University Medical Center, Leipzig, Germany
| | - Anja Hilbert
- Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, Integrated Research and Treatment Center AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
| | - Franziska Schlensog-Schuster
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Leipzig University Medical Center, Leipzig, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Ricarda Schmidt
- Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, Integrated Research and Treatment Center AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
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Marx W, Penninx BWJH, Solmi M, Furukawa TA, Firth J, Carvalho AF, Berk M. Major depressive disorder. Nat Rev Dis Primers 2023; 9:44. [PMID: 37620370 DOI: 10.1038/s41572-023-00454-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 08/26/2023]
Abstract
Major depressive disorder (MDD) is characterized by persistent depressed mood, loss of interest or pleasure in previously enjoyable activities, recurrent thoughts of death, and physical and cognitive symptoms. People with MDD can have reduced quality of life owing to the disorder itself as well as related medical comorbidities, social factors, and impaired functional outcomes. MDD is a complex disorder that cannot be fully explained by any one single established biological or environmental pathway. Instead, MDD seems to be caused by a combination of genetic, environmental, psychological and biological factors. Treatment for MDD commonly involves pharmacological therapy with antidepressant medications, psychotherapy or a combination of both. In people with severe and/or treatment-resistant MDD, other biological therapies, such as electroconvulsive therapy, may also be offered.
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Affiliation(s)
- Wolfgang Marx
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Victoria, Australia.
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
- On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ottawa, Ontario, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Andre F Carvalho
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Victoria, Australia
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Barbuti M, Menculini G, Verdolini N, Pacchiarotti I, Kotzalidis GD, Tortorella A, Vieta E, Perugi G. A systematic review of manic/hypomanic and depressive switches in patients with bipolar disorder in naturalistic settings: The role of antidepressant and antipsychotic drugs. Eur Neuropsychopharmacol 2023; 73:1-15. [PMID: 37119556 DOI: 10.1016/j.euroneuro.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 03/13/2023] [Accepted: 04/13/2023] [Indexed: 05/01/2023]
Abstract
The present systematic review was aimed at critically summarizing the evidence about treatment-emergent manic/hypomanic and depressive switches during the course of bipolar disorder (BD). A systematic search of the MEDLINE, EMBASE, CINAHL, Web of Science, and PsycInfo electronic databases was conducted until March 24th, 2021, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Observational studies clearly reporting data regarding the prevalence of treatment-emergent mood switches in patients with BD were considered for inclusion. Thirty-two original studies met the inclusion criteria. In the majority of cases, manic switches were analyzed; only 3 papers investigated depressive switches in type I BD. Treatment-emergent mania/hypomania in BD subjects ranged from 17.3% to 48.8% and was more frequent with antidepressant monotherapy compared to combination treatment with mood stabilizers, especially lithium, or second-generation antipsychotics. A higher likelihood of mood switch has been reported with tricyclics and a lower rate with bupropion. Depressive switches were detected in 5-16% of type I BD subjects and were associated with first-generation antipsychotic use, the concomitant use of first- and second-generation antipsychotics, and benzodiazepines. The included studies presented considerable methodological heterogeneity, small sample sizes and comparability flaws. In conclusion, many studies, although heterogeneous and partly discordant, have been conducted on manic/hypomanic switches, whereas depressive switches during treatment with antipsychotics are poorly investigated. In BD subjects, both antidepressant and antipsychotic medications seems to play a role in the occurrence of mood switches, although the effects of different pharmacological compounds have yet to be fully investigated.
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Affiliation(s)
- Margherita Barbuti
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, PI, Italy
| | - Giulia Menculini
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel, 08036, Barcelona, Catalonia, Spain
| | - Isabella Pacchiarotti
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel, 08036, Barcelona, Catalonia, Spain
| | - Georgios D Kotzalidis
- Centro Lucio Bini, Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Via Crescenzio 42, Via di Grottarossa 1035-1039, 00189, 00193, Rome, Italy
| | - Alfonso Tortorella
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel, 08036, Barcelona, Catalonia, Spain
| | - Giulio Perugi
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, PI, Italy.
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22
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Packness A, Sparle Christensen K, Simonsen E. Concurrent validity of the anxiety symptom-scale compared to two well-being scales: results from the Lolland-Falster health study. Nord J Psychiatry 2023; 77:532-539. [PMID: 36914934 DOI: 10.1080/08039488.2023.2174593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 12/19/2022] [Accepted: 01/24/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE To examine the concurrent validity of the Anxiety Symptom-scale against two well-being scales, the Cantril Ladder (CL) and World Health Organization Well-Being Index (WHO-5), to test the algorithm defining anxiety against these scales, and identify cut-off points for the Anxiety Symptom-scale sum score. SUBJECTS 14,405 adult respondents completing all psychometric questions in the Lolland Falster Health Study. METHOD Receiver operating characteristic analyses comparing Anxiety Symptom-scale WHO-5 and CL. RESULTS 2.5% of respondents had an anxiety disorder (3% female and 2% male) according to the Anxiety Symptom-scale algorithm. The area under the curve (AUC) was 0.87 for CL and 0.90 for WHO-5 (using inverse scores), indicating high concordance with anxiety disorder as identified by the scale. A score solely ≥2 on item 10 is a relevant cut off to low wellbeing. Anxiety disorder covers a broad range on the scale's sum score, with 3 to 4 indicating low well-being in this population sample and a sensitivity of 0.85 - 0.99 against CL and WHO-5. CONCLUSION The Anxiety Symptom-scale is a sensitive and valid instrument for the identification of patients in low well-being with symptoms of anxiety. A score ≥2 on the functional impact (Item 10) of all symptoms is a relevant indicator of anxiety associated with low well-being in this sample. A higher Anxiety Symptom-scale sum score is coherent with lower well-being, though without specific cut-off points. Further validation of the Anxiety Symptom-scale in a clinical setting is recommended.
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Affiliation(s)
- Aake Packness
- Psychiatric Research Unit, Psychiatry Region Zealand, Denmark
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Kaj Sparle Christensen
- Research Unit for General Practice, Department of Public Health, Aarhus University, Denmark
- Department of Public Health, Aarhus University, Denmark
| | - Erik Simonsen
- Mental Health Services, Psychiatry East, Copenhagen University Hospital, Region Zealand, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
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23
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Scotto G, Fazio V, Massa S, Lo Muzio L, Spirito F. COVID-19 and Oral Lichen Planus: Between an "Intriguing Plot" and the "Fata Morgana Effect". J Clin Med 2023; 12:4829. [PMID: 37510944 PMCID: PMC10381768 DOI: 10.3390/jcm12144829] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/23/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has led to significant morbidity and mortality worldwide since its declaration as a global pandemic in March 2020. Alongside the typical respiratory symptoms, unusual clinical manifestations such as oral lichen planus (OLP) have been observed. OLP is a chronic inflammatory mucocutaneous dermatosis that results from a cell-mediated reaction, and its pathogenesis involves the loss of immunological tolerance. OLP has been associated with several triggering factors, such as certain drugs, stress, smoking, and even some viruses. Exposure to the spike protein antigen of SARS-CoV-2 during an infection can trigger autoimmune reactions and lead to the onset or flare of OLP. The E3 protein ligase TRIM21, which is identified in the lamina propria of OLP lesions, is overexpressed in COVID-19 patients and plays a critical role in autoimmune pathologies. Furthermore, the psychological stress of the lockdown and quarantine can be a trigger for the onset or exacerbation of OLP. However, the diagnosis of OLP is complex and requires a biopsy in order to confirm a clinical diagnosis, rule out other pathologies, and establish the most appropriate therapeutic procedure. Further research is needed to understand the potential link between Co-19 and OLP.
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Affiliation(s)
- Gaetano Scotto
- Infectious Diseases Unit, University Hospital "OORR" Foggia, 71122 Foggia, Italy
| | - Vincenzina Fazio
- Clinical Chemistry Laboratory, Virology Unit, University Hospital "OORR" Foggia, 71122 Foggia, Italy
| | - Salvatore Massa
- Department of Agriculture, Food, Natural Resource and Engineering, University of Foggia, 71122 Foggia, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
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24
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Perelman H, Gilbert K, Grilo CM, Lydecker JA. Loss of control in binge-eating disorder: Fear and resignation. Int J Eat Disord 2023; 56:1199-1206. [PMID: 36920120 PMCID: PMC10247475 DOI: 10.1002/eat.23929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Binge-eating disorder involves overeating while feeling a loss of control (LOC). Emotions around LOC appear to vary; some patients fear LOC whereas others feel powerless or "resigned" to LOC. This study examined differences in psychopathology among treatment-seeking patients with binge-eating disorder categorized with fear of LOC, resignation to LOC, and no fear/resignation of LOC. METHOD Doctoral research clinicians administered diagnostic and semistructured interviews to characterize psychopathology and establish a diagnosis of binge-eating disorder in participants (N = 382). The interview assessed fear of LOC in the past month. Further queries assessed whether, in the absence of fear of LOC, patients were resigned to LOC or had no fear/resignation. RESULTS Patients with fear of LOC and resigned to LOC endorsed significantly greater global eating-disorder psychopathology than patients with no fear/resignation. Patients with fear of LOC reported greater distress about binge eating and greater depression than those with no fear/resignation. Patients resigned to LOC reported significantly more frequent binge-eating episodes than those with fear of LOC and no fear/resignation. Black individuals and men were more likely to report no fear/resignation than other demographic groups. DISCUSSION This study describes a novel clinical aspect of binge-eating disorder: resignation to LOC. Findings highlight the importance of including anticipatory cognitive-affective experiences in treatment formulations and planning. Future research should examine co-occurrence of these experiences and their association with impairment. Future research should also examine how fear of LOC and resignation to LOC change during treatment and whether they predict or moderate treatment outcomes. PUBLIC SIGNIFICANCE Adults with binge-eating disorder have anticipatory cognitive-affective experiences about loss of control (LOC) over eating (i.e., fear of LOC, resigned to LOC, no fear nor resignation of LOC). Individuals who experience fear of LOC and those who are resigned to LOC had more severe psychopathology than those without fear/resignation. Binge-eating disorder has the highest prevalence of the eating disorders; thus, findings have high public significance in guiding clinicians' treatment planning.
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Affiliation(s)
- Hayley Perelman
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Counseling Psychology and Applied Human Development, Boston University, Boston, Massachusetts, USA
| | - Kelsey Gilbert
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychology, University of Hartford, Hartford, Connecticut, USA
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Janet A Lydecker
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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25
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Castro-Calvo J, Giménez-García C, García-Barba M, Gil-Llario MD, Ballester-Arnal R. Atypical Sexual Interests in Compulsive Sexual Behavior: Results From a Phallometric Study. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2023; 35:164-187. [PMID: 35482997 DOI: 10.1177/10790632221098358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The link between Compulsive Sexual Behavior (CSB) and atypical sexual interests is elusive. This study aimed to provide preliminary insights into the relationship between both aspects. The study sample comprised 61 self-identified straight men. CSB was measured through a composite self-report index assessing symptoms of CSB, whereas sexual interests -atypical and normophilic- were assessed objectively through penile plethysmography. The CSB index had small, non-significant correlation with greater sexual response to different sexual stimuli (rgeneral sexual responsiveness=.127 [95% CI: -.137, .384]). In terms of overall sexual interest, increased scores on the CSB index had small, non-significant correlation with a higher preference for younger sexual stimuli (r = -.098 [95% CI: -.499, .215]) and persuasive sex (r = .10 [95% CI: -.168, .316]). Finally, CSB had a moderate correlation with sexual response when presented with stimuli depicting "female toddler coercive" (r = .27 [95% CI: -.083, .544]). We conclude that our findings do not support the hypotheses that CSB is significantly related to an increased arousability across sexual stimuli. The study findings also suggest that CSB may be, to a small degree, predisposed to experience sexual attraction toward children. Given the preliminary nature of the study, these conclusions warrant further research. Alternative explanations for the study findings related to the particular components of CSB that may be related to typical and atypical sexual interests are also considered.
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Affiliation(s)
- Jesús Castro-Calvo
- Dpto. Personalidad, Evaluación y Tratamientos Psicológicos, 16781Universitat de València, Estudi General, Spain
| | - Cristina Giménez-García
- Dpto. Psicología Básica, Clínica y Psicobiología, 16748Universitat Jaume I, Castellón, Spain
| | - Marta García-Barba
- Dpto. Psicología Básica, Clínica y Psicobiología, 16748Universitat Jaume I, Castellón, Spain
| | - María Dolores Gil-Llario
- Dpto. Psicología Evolutiva y de la Educación, 16781Universitat de València. Estudi General, Spain
| | - Rafael Ballester-Arnal
- Dpto. Psicología Básica, Clínica y Psicobiología, 16748Universitat Jaume I, Castellón, Spain
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Shevlin M, Hyland P, Butter S, McBride O, Hartman TK, Karatzias T, Bentall RP. The development and initial validation of self-report measures of ICD-11 depressive episode and generalized anxiety disorder: The International Depression Questionnaire (IDQ) and the International Anxiety Questionnaire (IAQ). J Clin Psychol 2023; 79:854-870. [PMID: 36215152 PMCID: PMC10092474 DOI: 10.1002/jclp.23446] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/11/2022] [Accepted: 09/22/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND The new International Classification of Diseases came into effect in 2022 (ICD-11; World Health Organization, 2022) and included updated descriptions and diagnostic rules for "Depressive Episode" and "Generalized Anxiety Disorder." No self-report measures align with these disorders so this study reports the development and initial validation of the "International Depression Questionnaire" (IDQ) and "International Anxiety Questionnaire" (IAQ). METHODS Items were developed that aligned to the ICD-11 descriptions and their performance was assessed using data from a community sample (N = 2058) that was representative of the United Kingdom adult population. RESULTS Item response theory models indicated that the two scales were unidimensional, and the items performed well in terms of difficulty and discrimination. Estimates of internal reliability were high. Based on ICD-11 derived diagnostic algorithms, 7.4% met requirements for ICD-11 Depressive Episode and 7.1% for Generalized Anxiety Disorder. CONCLUSIONS The IDQ and the IAQ are short, easy to use, self-report measures aligned to the new and updated ICD-11 diagnostic descriptions. This study provides initial evidence that the scales produce scores that are reliable and valid.
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Affiliation(s)
- Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Sarah Butter
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Orla McBride
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Todd K Hartman
- Department of Social Statistics, University of Manchester, Manchester, England
| | - Thanos Karatzias
- School of Health & Social Care, Napier University, Edinburgh, Scotland
| | - Richard P Bentall
- Department of Psychology, University of Sheffield, Sheffield, England
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27
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Dong Y, Weir NM. Antidepressants: A content analysis of healthcare providers' tweets. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 9:100232. [PMID: 36876146 PMCID: PMC9976573 DOI: 10.1016/j.rcsop.2023.100232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/25/2023] [Accepted: 01/28/2023] [Indexed: 02/12/2023] Open
Abstract
Background Antidepressants are the primary treatment for depression, and social support from social media may offer another support route. Whilst Twitter has become an interactive platform for healthcare providers and their patients, previous studies found low engagement of healthcare providers when discussing antidepressants on Twitter. This study aims to analyse the Twitter posts of healthcare providers related to antidepressants and to explore the healthcare providers' engagement and their areas of interest. Method Tweets within a 10-day period were collected through multiple searches with a list of keywords within Twitter. The results were filtered against several inclusion criteria, including a manual screening to identify healthcare providers. A content analysis was conducted on eligible tweets where correlative themes and subthemes were identified. Key findings Healthcare providers contributed 5.9% of the antidepressant-related tweets (n = 770/13,005). The major clinical topics referred to in the tweets were side effects, antidepressants for the treatment of COVID-19, and antidepressant studies of psychedelics. Nurses posted more tweets sharing personal experiences with commonly negative attitudes, in contrast to physicians. Links to external webpages were commonly used among healthcare providers, especially users representing healthcare organisations. Conclusions A relatively low proportion of healthcare providers' engagement on Twitter regarding antidepressants (5.9%) was identified, with a minimal increase throughout the COVID-19 pandemic when compared to previous studies. The major clinical topics referred to in the tweets were side effects, antidepressants for the treatment of COVID-19 and antidepressant studies of psychedelics, which have been made publicly available. In general, the findings confirmed that social media platforms are a mechanism by which healthcare providers, organisations and students support patients, share information about adverse drug effects, communicate personal experiences, and share research. It is plausible that this could impact the belief and behaviours of people with lived experience of depression who may see these tweets.
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Affiliation(s)
| | - Natalie M. Weir
- Corresponding author at: 161 Cathedral Street, Glasgow G4 0NR, United Kingdom.
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28
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Packness A, Sparle Christensen K, Simonsen E. Prevalence of anxiety disorders and association to socioeconomic position. Results from the Lolland Falster Health Study. Nord J Psychiatry 2023:1-8. [PMID: 36662161 DOI: 10.1080/08039488.2022.2154836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE The purpose of this study is to describe the prevalence of anxiety disorders in a general population and the association to socioeconomic position (SEP), which has not been described in a Danish context before. MATERIAL AND METHODS We present data on anxiety symptoms from respondents in the rural-provincial Lolland-Falster population Health Study (LOFUS). Analyses of the questionnaire responses to the Anxiety Symptom Scale were done by descriptive statistics and logistic regression analyses adjusted for sex and age. RESULTS 14,834 LOFUS respondents who completed the Anxiety Symptom Scale were included; According to the original algorithm 371 (2.5%) had an anxiety disorder. The adjusted odds ratios (aOR) for anxiety disorder were strongly associated to SEP. We found aOR for anxiety to be: 3.8 (confidence interval (CI 95%) 2.54 - 5.92) for respondents with no postsecondary education compared to those with 3+ years of postsecondary education; 11.9 (CI 8.89 - 16.01) for respondents temporarily out of a job compared to those working; 9.4 (CI 6.06 - 14.51) for those experiencing constant financial strain compared to those not experiencing financial strain. Relaxing the criteria for anxiety to item 10 > 1, the prevalence raised to 3.9%. The association was unchanged related to education; however, the aOR dropped to 9 and 8 respectively, for being temporally out of job, or in financial strain every month- when doing same comparisons. CONCLUSIONS The 14-day prevalence of anxiety disorder seems low but strongly associated to SEP especially for individuals temporarily out of a job or experiencing financial strain.
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Affiliation(s)
- Aake Packness
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark.,Department of Public Health, Research Unit for General Practice, University of Southern Denmark, Odense, Denmark
| | - Kaj Sparle Christensen
- Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Erik Simonsen
- Mental Health Services, Psychiatry East, Psychiatry Region Zealand, Slagelse, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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von Mücke-Heim IA, Urbina-Treviño L, Bordes J, Ries C, Schmidt MV, Deussing JM. Introducing a depression-like syndrome for translational neuropsychiatry: a plea for taxonomical validity and improved comparability between humans and mice. Mol Psychiatry 2023; 28:329-340. [PMID: 36104436 PMCID: PMC9812782 DOI: 10.1038/s41380-022-01762-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/09/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023]
Abstract
Depressive disorders are the most burdensome psychiatric disorders worldwide. Although huge efforts have been made to advance treatment, outcomes remain unsatisfactory. Many factors contribute to this gridlock including suboptimal animal models. Especially limited study comparability and replicability due to imprecise terminology concerning depressive-like states are major problems. To overcome these issues, new approaches are needed. Here, we introduce a taxonomical concept for modelling depression in laboratory mice, which we call depression-like syndrome (DLS). It hinges on growing evidence suggesting that mice possess advanced socioemotional abilities and can display non-random symptom patterns indicative of an evolutionary conserved disorder-like phenotype. The DLS approach uses a combined heuristic method based on clinical depression criteria and the Research Domain Criteria to provide a biobehavioural reference syndrome for preclinical rodent models of depression. The DLS criteria are based on available, species-specific evidence and are as follows: (I) minimum duration of phenotype, (II) significant sociofunctional impairment, (III) core biological features, (IV) necessary depressive-like symptoms. To assess DLS presence and severity, we have designed an algorithm to ensure statistical and biological relevance of findings. The algorithm uses a minimum combined threshold for statistical significance and effect size (p value ≤ 0.05 plus moderate effect size) for each DLS criterion. Taken together, the DLS is a novel, biologically founded, and species-specific minimum threshold approach. Its long-term objective is to gradually develop into an inter-model validation standard and microframework to improve phenotyping methodology in translational research.
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Affiliation(s)
- Iven-Alex von Mücke-Heim
- grid.419548.50000 0000 9497 5095Max Planck Institute of Psychiatry, Molecular Neurogenetics, Munich, Germany ,grid.419548.50000 0000 9497 5095Department of Translational Research, Max Planck Institute of Psychiatry, Munich, Germany ,grid.4372.20000 0001 2105 1091International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Lidia Urbina-Treviño
- grid.419548.50000 0000 9497 5095Max Planck Institute of Psychiatry, Molecular Neurogenetics, Munich, Germany
| | - Joeri Bordes
- grid.4372.20000 0001 2105 1091International Max Planck Research School for Translational Psychiatry, Munich, Germany ,grid.419548.50000 0000 9497 5095Max Planck Institute of Psychiatry, Neurobiology of Stress Resilience, Munich, Germany
| | - Clemens Ries
- grid.419548.50000 0000 9497 5095Max Planck Institute of Psychiatry, Molecular Neurogenetics, Munich, Germany ,grid.4372.20000 0001 2105 1091International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Mathias V. Schmidt
- grid.419548.50000 0000 9497 5095Max Planck Institute of Psychiatry, Neurobiology of Stress Resilience, Munich, Germany
| | - Jan M. Deussing
- grid.419548.50000 0000 9497 5095Max Planck Institute of Psychiatry, Molecular Neurogenetics, Munich, Germany
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30
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Cervigón-Carrasco V, Schulze-Steinen L, Ballester-Arnal R, Billieux J, Juliá BG, Giménez-Garcia C, Castro-Calvo J. Attentional inhibitory control interference related to videogames, pornography, and TV series exposure: An experimental study in three independent samples. COMPUTERS IN HUMAN BEHAVIOR 2023. [DOI: 10.1016/j.chb.2023.107683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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31
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Fernell E, Gillberg C. Autism under the umbrella of ESSENCE. Front Psychiatry 2023; 14:1002228. [PMID: 36756219 PMCID: PMC9901504 DOI: 10.3389/fpsyt.2023.1002228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 01/09/2023] [Indexed: 01/24/2023] Open
Abstract
This brief article gives a short overview of "comorbidity" in autism. The most common co-occurring disorders will be presented and discussed within the context of ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations), a concept that provides a holistic perspective for neurodevelopmental disorders. The ESSENCE concept also considers the heterogeneous and changing clinical panorama of developmental disorders over time, and also the multifactorial etiologies, including so called behavioral phenotype syndromes. Aspects on behavioral interventions in autism are presented-interventions that need to be adapted and take into account all non-autism associated ESSENCE, including intellectual disability and Attention-Deficit/Hyperactivity Disorder (ADHD). The article also focuses on current research on pharmacological intervention based on the hypothesis of imbalance in excitatory/inhibitory transmitter systems in autism and some other ESSENCE.
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Affiliation(s)
- Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
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Wainberg M, Zhukovsky P, Hill SL, Felsky D, Voineskos A, Kennedy S, Hawco C, Tripathy SJ. Symptom dimensions of major depression in a large community-based cohort. Psychol Med 2023; 53:438-445. [PMID: 34008483 DOI: 10.1017/s0033291721001707] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Our understanding of major depression is complicated by substantial heterogeneity in disease presentation, which can be disentangled by data-driven analyses of depressive symptom dimensions. We aimed to determine the clinical portrait of such symptom dimensions among individuals in the community. METHODS This cross-sectional study consisted of 25 261 self-reported White UK Biobank participants with major depression. Nine questions from the UK Biobank Mental Health Questionnaire encompassing depressive symptoms were decomposed into underlying factors or 'symptom dimensions' via factor analysis, which were then tested for association with psychiatric diagnoses and polygenic risk scores for major depressive disorder (MDD), bipolar disorder and schizophrenia. Replication was performed among 655 self-reported non-White participants, across sexes, and among 7190 individuals with an ICD-10 code for MDD from linked inpatient or primary care records. RESULTS Four broad symptom dimensions were identified, encompassing negative cognition, functional impairment, insomnia and atypical symptoms. These dimensions replicated across ancestries, sexes and individuals with inpatient or primary care MDD diagnoses, and were also consistent among 43 090 self-reported White participants with undiagnosed self-reported depression. Every dimension was associated with increased risk of nearly every psychiatric diagnosis and polygenic risk score. However, while certain psychiatric diagnoses were disproportionately associated with specific symptom dimensions, the three polygenic risk scores did not show the same specificity of associations. CONCLUSIONS An analysis of questionnaire data from a large community-based cohort reveals four replicable symptom dimensions of depression with distinct clinical, but not genetic, correlates.
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Affiliation(s)
- Michael Wainberg
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Peter Zhukovsky
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sean L Hill
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Department of Physiology, University of Toronto, Toronto, Canada
| | - Daniel Felsky
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
| | - Aristotle Voineskos
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
| | - Sidney Kennedy
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Krembil Research Institute, University Health Network, Toronto, Canada
- Li Ka Shing Knowledge Institute, Saint Michael's Hospital, Toronto, Canada
| | - Colin Hawco
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
| | - Shreejoy J Tripathy
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Department of Physiology, University of Toronto, Toronto, Canada
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Chakrabarti S. Bipolar disorder in the International Classification of Diseases-Eleventh version: A review of the changes, their basis, and usefulness. World J Psychiatry 2022; 12:1335-1355. [PMID: 36579354 PMCID: PMC9791613 DOI: 10.5498/wjp.v12.i12.1335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/07/2022] [Accepted: 11/22/2022] [Indexed: 12/16/2022] Open
Abstract
The World Health Organization’s 11th revision of the International Classification of Diseases (ICD-11) including the chapter on mental disorders has come into effect this year. This review focuses on the “Bipolar or Related Disorders” section of the ICD-11 draft. It describes the benchmarks for the new version, particularly the foremost principle of clinical utility. The alterations made to the diagnosis of bipolar disorder (BD) are evaluated on their scientific basis and clinical utility. The change in the diagnostic requirements for manic and hypomanic episodes has been much debated. Whether the current criteria have achieved an optimum balance between sensitivity and specificity is still not clear. The ICD-11 definition of depressive episodes is substantially different, but the lack of empirical support for the changes has meant that the reliability and utility of bipolar depression are relatively low. Unlike the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), the ICD-11 has retained the category of mixed episodes. Although the concept of mixed episodes in the ICD-11 is not perfect, it appears to be more inclusive than the DSM-5 approach. Additionally, there are some uncertainties about the guidelines for the subtypes of BD and cyclothymic disorder. The initial results on the reliability and clinical utility of BD are promising, but the newly created diagnostic categories also appear to have some limitations. Although further improvement and research are needed, the focus should now be on facing the challenges of implementation, dissemination, and education and training in the use of these guidelines.
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Affiliation(s)
- Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, UT, India
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Ventriglio A, Castaldelli-Maia JM, Torales J, Chumakov E, De Berardis D, Bhugra D. New approaches for mental health of social minorities. Int Rev Psychiatry 2022; 34:760-769. [PMID: 36786116 DOI: 10.1080/09540261.2022.2133993] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Mental health of social minorities is a challenge of modern psychiatry. It is largely described that people reporting sexual, cultural, religious variations are exposed to an amount of social stress deriving from the contrast between their minority status and the dominant societal norms and values. Minority stress leads to higher level of psychosocial distress and mental illness among these vulnerable populations. This conceptual research paper reports on evidences regarding the mental health issues related to the minority social condition and proposes a set of actions to address these challenges in a global perspective. Specifically, political, social and educational interventions are discussed in order to contrast stigma, discrimination, promote integration and health services for vulnerable populations. Policymakers are invited to deliver ad-hoc policies on minorities and homeless people with specific funding to address related public mental health issues. Educational programs are encouraged in the school setting as well as in the training of health care professionals in order to improve the level of acceptance and competencies in the treatment of minorities' health needs. We firmly believe there is no healthy society without healthy minorities.
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Affiliation(s)
- Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - João Mauricio Castaldelli-Maia
- Department of Neuroscience, Medical School, Fundação do ABC, Santo André, Brazil.,Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
| | - Julio Torales
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, Asunción, Paraguay
| | - Egor Chumakov
- St. Petersburg State University, Saint-Petersburg, Russia
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35
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Grilo CM, Ivezaj V, Duffy AJ, Gueorguieva R. 24-Month follow-up of randomized controlled trial of guided-self-help for loss-of-control eating after bariatric surgery. Int J Eat Disord 2022; 55:1521-1531. [PMID: 36054766 DOI: 10.1002/eat.23804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/10/2022] [Accepted: 08/10/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Loss-of-control (LOC)-eating postoperatively predicts suboptimal longer-term outcomes following bariatric surgery. This study examined longer-term effects through 24-month follow-ups after completing treatments in a randomized controlled trial testing guided-self-help treatments (cognitive-behavioral therapy [gshCBT] and behavioral weight-loss [gshBWL]) and control (CON) delivered postoperatively for LOC-eating. METHODS 140 patients with LOC-eating 6 months after bariatric surgery were randomized (5:5:2 ratio) to 3-months of gshCBT (n = 56), gshBWL (n = 60), or CON (n = 24) delivered by trained allied-health clinicians. Independent assessments were performed throughout/after treatments and at 6-, 12-, 18-, and 24-month follow-ups; 83% of patients were assessed at 24-month follow-up. RESULTS Intention-to-treat analyses comparing the three groups (gshCBT vs. gshBWL vs. CON) in LOC-eating abstinence at posttreatment (30%, 27%, 38%), 12-month follow-up (34%, 32%, 42%), and 24-month follow-up (45%, 32%, 38%) revealed no significant differences. Mixed-models revealed significantly reduced LOC-eating frequency through posttreatment, no significant changes in LOC-eating frequency during follow-up, and no differences between the three groups. Weight reduced significantly, albeit modestly, through posttreatment but increased significantly and substantially during follow-ups, with no differences between groups. CONCLUSIONS Overall, the 12-week scalable guided-self-help treatments did not differ from each other or control, were associated with significantly reduced frequency of LOC-eating and modest weight loss at posttreatment but were followed by significant weight gain during the 24-month follow-up. Weight gain was substantial and nearly universal whereas the frequency of LOC-eating did not change over time (i.e., LOC-eating reductions and abstinence rates were well maintained through 24-moth follow-ups). Patients with postoperative LOC-eating require more intensive adjunctive treatments. PUBLIC SIGNIFICANCE Loss-of-control (LOC) eating postoperatively predicts poorer bariatric surgery outcomes and the longer-term effects of postoperative adjunctive postoperative interventions for LOC eating are unknown. In this 24-month follow-up of a controlled study of scalable guided-self-help treatments and a control condition, improvements in LOC-eating frequency, eating-disorder psychopathology, and depression during treatment were maintained well, with no differences between the three groups. Proportion of patients achieving abstinence from LOC-eating at the 24-month follow-up ranged from 38% to 45% across the three groups. In contrast, weight increased significantly during the 24-month follow-ups, with no differences between the three groups. Findings suggest LOC-eating following bariatric surgery might represent a "marker" for a subgroup of patients that are at risk for substantial weight gains over time. LOC eating following bariatric surgery is challenging to treat with low-intensity scalable treatments and may require more intensive specialist treatments.
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Affiliation(s)
- Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Valentina Ivezaj
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Andrew J Duffy
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ralitza Gueorguieva
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
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Radden J. Capturing the anorexia nervosa phenotype: Conceptual and normative issues in ICD-11. J Eval Clin Pract 2022; 28:807-813. [PMID: 34121277 DOI: 10.1111/jep.13586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 05/04/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION ICD-11's diagnostic definition possesses conceptual lacunae and normative implications calling for further attention. METHOD Assumptions underlying it and their ethical implications, are examined employing philosophical analysis; particularly, these are (1) changes to eliminate implications of voluntary agency to caloric restriction; (2) definitions of "dangerously low weight;" and (3) disorder boundaries as stated in qualifications and exclusions. RESULTS (1) The extent to which AN behaviour can be acknowledged to be driven by forces out of, or limiting, voluntary control is unresolved; this is illustrated using the contested part played by excessive exercise, clarification of which requires understanding of AN motivation. (2) AN's uncertain aetiology leaves doubt over the sub-threshold state. This affects not only when treatment is appropriate, but how definitions of morbidly low body weight are determined, putting individuals with prodromal symptoms at the social risks associated with "medicalizing" normal variation. Concluded here is not that ICD-11's conservative definition is mistaken but that since false positives are common, they must be factored into the complex cost-risk assessments involved. (3) ICD-11 efforts to minimize reliance on subjective motivation reveal limitations in exclusion criteria. Were AN motivation itself better understood, it would be possible to deal with non-anorexic motivation by exclusion. But the history of "fat fears" illustrates that uncertainty attaches to interpretations of AN motivation. Neither AN motivation nor cultural norms around other forms of self-starvation admit of clear characterization, leaving an impasse. DISCUSSION At least with present day medical and scientific knowledge, a complete characterization of the AN phenotype cannot be achieved without reference to psychological states of motivation. And more research, not only clinical, genetic and neurobiological but also conceptual and ethical, will be required to resolve the challenges presented by AN.
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Affiliation(s)
- Jennifer Radden
- Philosophy Department, University of Massachusetts Boston, Boston, Massachusetts, USA
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Castagnini A, Foldager L, Caffo E, Berrios GE. The predictive validity and outcome of ICD-10 and DSM-5 short-lived psychotic disorders: a review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 2022; 272:1157-1168. [PMID: 34988647 DOI: 10.1007/s00406-021-01356-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 11/08/2021] [Indexed: 11/30/2022]
Abstract
The ICD-10 Classification of Mental and Behavioural Disorders introduced the category of 'acute and transient psychotic disorders' (ATPDs) encompassing polymorphic, schizophrenic and predominantly delusional subtypes, and the forthcoming ICD-11 revision has restricted it to polymorphic psychotic disorder, while the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) listed 'brief psychotic disorder' (BPD). To assess the predictive validity and outcome of ATPDs and BPD, relevant papers in English, French and German were searched in PubMed and Web of Science. Where possible meta-analysis of prognostic validators (diagnostic stability, course, outcome and response to treatment) was conducted. Fifty studies published between January 1993 and July 2019 were found. The clinical and functional outcome of ATPDs proved better than in schizophrenia and related disorders, but mortality risk is high, particularly suicide, and treatment trials provide little evidence. Meta-analysis of 25 studies (13,507 cases) revealed that 55% (95% CI 49-62) do not change diagnosis, 25% (95% CI 20-31) converted into schizophrenia and related disorders, and 12% (95% CI 7-16) into affective disorders on average over 6.3 years. Subgroup meta-analysis estimated prospective consistency of polymorphic psychotic disorder (55%; 95% CI 52-58) significantly greater than that of the ATPD subtypes with schizophrenic (OR 1.7; 95% CI 1.4-2.0) and predominantly delusional (OR 1.3; 95% CI 1.1-1.5) symptoms. Moreover, the diagnostic stability of BPD (13 studies; 294 cases) was 45% (95% CI 32-50) over a mean 4.2 years. Although these findings indicate that short-lived psychotic disorders have little predictive validity, significant differences among the ATPD subtypes support the revised ICD-11 ATPD category.
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Affiliation(s)
- Augusto Castagnini
- School of Child Neuropsychiatry, University of Modena and Reggio Emilia, Modena, Italy.
| | - Leslie Foldager
- Health Research Unit, Department of Animal Science, Aarhus University, Tjele, Denmark.,Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Ernesto Caffo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - German E Berrios
- Department of Psychiatry and Robinson College, University of Cambridge, Cambridge, UK
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Meals, Microbiota and Mental Health in Children and Adolescents (MMM-Study): A protocol for an observational longitudinal case-control study. PLoS One 2022; 17:e0273855. [PMID: 36048886 PMCID: PMC9436124 DOI: 10.1371/journal.pone.0273855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 08/15/2022] [Indexed: 11/19/2022] Open
Abstract
Recent studies indicate that the interplay between diet, intestinal microbiota composition, and intestinal permeability can impact mental health. More than 10% of children and adolescents in Iceland suffer from mental disorders, and rates of psychotropics use are very high. The aim of this novel observational longitudinal case-control study, “Meals, Microbiota and Mental Health in Children and Adolescents (MMM-Study)” is to contribute to the promotion of treatment options for children and adolescents diagnosed with mental disorders through identification of patterns that may affect the symptoms. All children and adolescents, 5–15 years referred to the outpatient clinic of the Child and Adolescent Psychiatry Department at The National University Hospital in Reykjavik, Iceland, for one year (n≈150) will be invited to participate. There are two control groups, i.e., sex-matched children from the same postal area (n≈150) and same parent siblings (full siblings) in the same household close in age +/- 3 years (n<150). A three-day food diary, rating scales for mental health, and multiple questionnaires will be completed. Biosamples (fecal-, urine-, saliva-, blood samples, and buccal swab) will be collected and used for 16S rRNA gene amplicon sequencing of the oral and gut microbiome, measurements of serum factors, quantification of urine metabolites and host genotype, respectively. For longitudinal follow-up, data collection will be repeated after three years in the same groups. Integrative analysis of diet, gut microbiota, intestinal permeability, serum metabolites, and mental health will be conducted applying bioinformatics and systems biology approaches. Extensive population-based data of this quality has not been collected before, with collection repeated in three years’ time, contributing to the high scientific value. The MMM-study follows the “Strengthening the Reporting of Observational Studies in Epidemiology” (STROBE) guidelines. Approval has been obtained from the Icelandic National Bioethics Committee, and the study is registered with Clinicaltrials.gov. The study will contribute to an improved understanding of the links between diet, gut microbiota and mental health in children through good quality study design by collecting information on multiple components, and a longitudinal approach. Furthermore, the study creates knowledge on possibilities for targeted and more personalized dietary and lifestyle interventions in subgroups.
Trial registration numbers: VSN-19-225 & NCT04330703.
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Online dialectical behavioral therapy for adults with internet addiction: A quasi-experimental trial during the COVID-19 pandemic. Psychiatry Res 2022; 315:114698. [PMID: 35792416 DOI: 10.1016/j.psychres.2022.114698] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 06/19/2022] [Accepted: 06/25/2022] [Indexed: 11/20/2022]
Abstract
The pathological use of the Internet has surged during the pandemic, even though service provisions were negatively impacted. Telepsychiatry can be used as a solution to maintain psychiatric addiction services. This study examined the efficacy of online group dialectical behavioral therapy (DBT) for Internet addiction (IA), compared to cognitive behavioral therapy (CBT). Participants were divided into two arms for 8 weeks: the experimental arm received eight sessions of online DBT skill group training (n = 20), and the control arm received four sessions of online individual CBT (n = 20). All participants were required to complete a sociodemographic and Internet use survey, the Internet Addiction Test (IAT), and the University of Rhode Island Change Assessment (URICA). All participants completed the therapy. Of the 40 participants, six (15%) perceived the need for therapy and one (2.5%) participant had a history of seeking IA therapy. In the pre-post comparison, significant improvements were noted in the IAT and URICA scores as well as Internet use duration for both arms. No significant differences were observed across the arms and in the time-by-arm interaction. Online group DBT is a viable alternative to online CBT in an acute constrained setting, although further studies are required to scrutinize its long-term efficacy. Trial Registration: ISRCTN17273762.
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40
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Lyon RE, Rizeq J, Flora DB, Martinussen R, Andrade BF, Toplak ME. Age-Related Variance in Performance versus Ratings of Attention and Impulse Regulation in Children: Implications for the Assessment of ADHD. Brain Sci 2022; 12:brainsci12081033. [PMID: 36009096 PMCID: PMC9406227 DOI: 10.3390/brainsci12081033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/31/2022] [Accepted: 08/01/2022] [Indexed: 02/04/2023] Open
Abstract
Executive function task (EF) deficits are hypothesized to underlie difficulties with self-regulation. However, tasks assessing EF impairments have only been weakly correlated with rating scales that index self-regulation difficulties. A community sample of children and youth aged between 8 and 20 years old were assessed longitudinally. Growth curve analyses and correlations were conducted to better understand how these two types of measures relate to one another across development, as well as the impact of age-related variance. EF was assessed using the Stroop Task and Trail Making test and behavioral ratings of self-regulation were captured using the SWAN scale. EF task performance improved steeply until age 14–15, whereas the SWAN Scale showed small age-related decreases. EF task performance was moderately correlated with age among 8–13-year-olds and to a lesser extent among 14–20-year-olds. SWAN scores were not significantly related to age in either group. Correlations were similar in an ADHD “at-risk” subgroup. EF task performance and parent ratings of attention regulation have different developmental trajectories, which may partly explain why correlations are low to modest in these samples. In particular, age-related variance is an important methodological consideration with significant implications for the assessment of self-regulation in children and youth with ADHD.
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Affiliation(s)
- Rachael E. Lyon
- Department of Psychology, York University, Toronto, ON M3J 1P3, Canada
- LaMarsh Centre for Child and Youth Research, York University, Toronto, ON M3J 1P3, Canada
- Correspondence:
| | - Jala Rizeq
- School of Health & Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK
| | - David B. Flora
- Department of Psychology, York University, Toronto, ON M3J 1P3, Canada
| | - Rhonda Martinussen
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education (OISE), Toronto, ON M5S 1V6, Canada
| | - Brendan F. Andrade
- Child Youth & Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Maggie E. Toplak
- Department of Psychology, York University, Toronto, ON M3J 1P3, Canada
- LaMarsh Centre for Child and Youth Research, York University, Toronto, ON M3J 1P3, Canada
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Streeter B, Sadek J. Developmental Risk, Adversity Experiences and ADHD Clinical Profiles: A Naturalistic Exploratory Study. Brain Sci 2022; 12:brainsci12070919. [PMID: 35884726 PMCID: PMC9313383 DOI: 10.3390/brainsci12070919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 02/04/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a persistent neurodevelopmental disorder that results from complex interactions of multiple genes and environmental risk and adversity factors. Some researchers have suggested a need for additional research into differing clinical presentations of ADHD for further classification. In this context, this study aimed to investigate whether increases in risk and adversity factors increase the severity of ADHD and the number of comorbid psychiatric disorders. This is a naturalistic retrospective chart review exploratory study in 100 patients 16 years or older who have a confirmed diagnosis of ADHD. The quantitative data were analyzed using SPSS, using the Mann–Whitney test for parametric data and the Chi-square and Kruskal–Wallis p value tests for non-parametric and categorical data. Qualitative data were tabulated and described. The study found that (1) the average number of comorbidities increases with the severity of ADHD, (2) the average number of risk and adversity factors increases with the severity of ADHD, (3) the number of risk and adversity factors were positively associated with the number of comorbidities, and (4) Level of education was negatively associated with the number of risk and adversity factors and the number of comorbidities. The implications of these findings are discussed, and future research in this important area is suggested.
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Affiliation(s)
- Brooke Streeter
- Faculty of Sciences (Medical Sciences), Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Joseph Sadek
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Correspondence:
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López I, Förster J. Trastornos del neurodesarrollo: dónde estamos hoy y hacia dónde nos dirigimos. REVISTA MÉDICA CLÍNICA LAS CONDES 2022. [DOI: 10.1016/j.rmclc.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Gupta R. Gender Affirmation in India—The Current State of Knowledge, Management, Legal and Legislative Situation. Indian J Plast Surg 2022; 55:139-143. [PMID: 36017406 PMCID: PMC9398521 DOI: 10.1055/s-0041-1740528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
A mismatch between the birth sex of a person and psychological recognition of self (gender) leads to a gender expression, which is at variance with the societal norms, and thus gives rise to gender incongruence (GI). In the past few years, there has been a significant change in demographics, understanding of etiology, management, laws and legislations in the field of GI. The authors, who have been performing gender affirmative surgeries (GAS) since the past 27 years, present their experience in gender affirmation together with the current state of knowledge. Recent studies report a significant rise in prevalence of GI, which is similar to the experience of author and other large volume Gender identity clinics in India and worldwide. This article endeavors to provide the medical professional with the current state of knowledge in the field of GI, so that they are better equipped to optimally manage these patients.
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Affiliation(s)
- Richie Gupta
- Department of Plastic, Aesthetic and Reconstructive Surgery, and Gender Identity Clinic, Fortis Hospital, Delhi, India
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Siste K, Hanafi E, Sen LT, Damayanti R, Beatrice E, Ismail RI. Psychometric properties of the Indonesian Ten-item Internet Gaming Disorder Test and a latent class analysis of gamer population among youths. PLoS One 2022; 17:e0269528. [PMID: 35700179 PMCID: PMC9197045 DOI: 10.1371/journal.pone.0269528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/23/2022] [Indexed: 11/19/2022] Open
Abstract
Internet gaming disorder (IGD) is a rising health concern. Indonesia has yet to have any validated instrument specifically designed to screen for this disorder. This study aims to validate the Indonesian version of the Ten-item Internet Gaming Disorder Test (IGDT-10) and conduct a latent class analysis of gamers among the youth. An online survey was conducted between October and December 2020 at two universities in Depok and Jakarta, Indonesia. In total, 1233 respondents (62.6% female and 20.3±1.90 years old) gave valid responses and played video games. Confirmatory factor analysis (CFA) confirmed the unidimensional structure of the scale. Cronbach’s alpha was 0.72 and composite reliability was 0.92. The latent class analysis yielded three distinct classes of gamers. The continuation and negative consequences were highly distinctive for the group at high risk of IGD (class 3). Deception had the lowest endorsement rate (41.7%); while, the continuation domain had the highest endorsement, 91.2%. The IGD prevalence estimate was 1.90% among the respondents. Approximately 70.2% of the gamers did not show IGD symptoms. The adapted Indonesian IGDT-10 was demonstrated as valid and reliable among Indonesian youths. Consistent with previous studies, the deception domain had a low endorsement rate. The detected IGD rates were comparable to the global range. The majority of the current sample disclosed no symptoms; however, a considerable proportion would benefit from early preventive measures.
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Affiliation(s)
- Kristiana Siste
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia–dr, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Enjeline Hanafi
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia–dr, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Lee Thung Sen
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia–dr, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Reza Damayanti
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia–dr, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Evania Beatrice
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia–dr, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Raden Irawati Ismail
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia–dr, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- * E-mail:
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Tanaka M, Spekker E, Szabó Á, Polyák H, Vécsei L. Modelling the neurodevelopmental pathogenesis in neuropsychiatric disorders. Bioactive kynurenines and their analogues as neuroprotective agents-in celebration of 80th birthday of Professor Peter Riederer. J Neural Transm (Vienna) 2022; 129:627-642. [PMID: 35624406 DOI: 10.1007/s00702-022-02513-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 05/05/2022] [Indexed: 02/06/2023]
Abstract
Following introduction of the monoamine oxidase type B inhibitor selegiline for the treatment of Parkinson's disease (PD), discovery of the action mechanism of Alzheimer's disease-modifying agent memantine, the role of iron in PD, and the loss of electron transport chain complex I in PD, and development of the concept of clinical neuroprotection, Peter Riederer launched one of the most challenging research project neurodevelopmental aspects of neuropsychiatric disorders. The neurodevelopmental theory holds that a disruption of normal brain development in utero or during early life underlies the subsequent emergence of neuropsychiatric symptoms during later life. Indeed, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the International Classification of Diseases, 11th Revision categorize autism spectrum disorder and attention deficit hyperactivity disorder in neurodevelopmental disorders (NDDs). More and more evidence, especially from preclinical studies, is revealing that neurodevelopmental pathology is not limited to the diagnostic class above, but also contributes to the development of other psychiatric disorders such as schizophrenia, bipolar disorder, and obsessive-compulsive disorder as well as neurodegenerative diseases such as PD and Huntington's disease. Preclinical animal research is taking a lead in understanding the pathomechanisms of NDDs, searching for novel targets, and developing new neuroprotective agents against NDDs. This narrative review discusses emerging evidence of the neurodevelopmental etiology of neuropsychiatric disorders, recent advances in modelling neurodevelopmental pathogenesis, potential strategies of clinical neuroprotection using novel kynurenine metabolites and analogues, and future research direction for NDDs.
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Affiliation(s)
- Masaru Tanaka
- MTA-SZTE Neuroscience Research Group, Hungarian Academy of Sciences, University of Szeged (MTA-SZTE), Semmelweis u. 6, 6725, Szeged, Hungary
| | - Eleonóra Spekker
- MTA-SZTE Neuroscience Research Group, Hungarian Academy of Sciences, University of Szeged (MTA-SZTE), Semmelweis u. 6, 6725, Szeged, Hungary
| | - Ágnes Szabó
- Department of Neurology, Albert Szent-György Medical School, University of Szeged, Semmelweis u. 6, 6725, Szeged, Hungary
| | - Helga Polyák
- Department of Neurology, Albert Szent-György Medical School, University of Szeged, Semmelweis u. 6, 6725, Szeged, Hungary
| | - László Vécsei
- MTA-SZTE Neuroscience Research Group, Hungarian Academy of Sciences, University of Szeged (MTA-SZTE), Semmelweis u. 6, 6725, Szeged, Hungary. .,Department of Neurology, Albert Szent-György Medical School, University of Szeged, Semmelweis u. 6, 6725, Szeged, Hungary.
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Bhugra D, Killaspy H, Kar A, Levin S, Chumakov E, Rogoza D, Harvey C, Bagga H, Owino-Wamari Y, Everall I, Bishop A, Javate KR, Westmore I, Ahuja A, Torales J, Rubin H, Castaldelli-Maia J, Ng R, Nakajima GA, Levounis P, Ventriglio A. IRP commission: sexual minorities and mental health: global perspectives. Int Rev Psychiatry 2022; 34:171-199. [PMID: 36151836 DOI: 10.1080/09540261.2022.2045912] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Sexual orientation is a key determinant of the identity of human beings. It has also been seen as a social determinant of health. People whose sexual orientation is non-heterosexual or sexual minorities or sexually diverse are included in the broad umbrella term LGBT (Lesbian, Gay, Bisexual, and Transgender) which is a commonly used acronym in activism, social policy, and subsequently cultural literature. For this reason, this Commission focuses primarily on sexual orientation i.e. lesbian, gay and bisexual (LGB) groups. We have used terms non-heterosexual, sexual minorities or sexual variation interchangeably. We have not considered asexual individuals as research in the field is too limited. We are cognisant of the fact that topics relating to mental health and sexual orientation discussed in this Commission will intersect with other issues of personal, cultural and social identity, and will thus be relevant to individuals including many transgender individuals. The inclusion of mental health issues relevant to gender-diverse individuals as well as gender identity is important and deserves its own separate detailed discussion. The exact number of sexually diverse individuals in a population is often difficult to estimate but is likely to be somewhere around 5% of the population. Rates of various psychiatry disorders and suicidal ideation and acts of suicide in LGB populations are higher than general population and these have been attributed to minority stress hypothesis. Elimination of inequality in law can lead to reduction in psychiatric morbidity in these groups. However, these are all diverse groups but even within each group there is diversity and each individual has a distinct and unique experiences, upbringing, responses to their own sexual orientation, and generating varying responses from families, peers and friends as well as communities (including healthcare professionals). The mental healthcare needs of sexual minority individuals vary and these variations must be taken into account in design, development and delivery of healthcare and policies. Improving access to services will help engagement and outcomes and also reduce stigma. The commission recommends that there is no role for so-called conversion therapies and other recommendations are made for clinicians, researchers and policymakers.
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Affiliation(s)
- Dinesh Bhugra
- Emeritus Mental Health & Cultural Diversity, PO72, Centre for Affective Disorders, Institute of Psychiatry, Kings College, London, UK
| | - Helen Killaspy
- Rehabilitation Psychiatry, University College, London, UK
| | - Anindya Kar
- Advanced Neuropsychiatry Institute, Kolkata, India
| | - Saul Levin
- Chief Executive and Medical Director, American Psychiatric Association, Washington, DC, USA
| | - Egor Chumakov
- Department of Psychiatry, St Petersburg State University, St Petersburg, Russia
| | - Daniel Rogoza
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Carol Harvey
- Department of Psychiatry, University of Melbourne and North Western Mental Health, Melbourne, Australia
| | | | | | - Ian Everall
- Institute of Psychiatry, Kings College, London, UK
| | - Amie Bishop
- OutRight Action International, Seattle, WA, USA
| | | | - Ian Westmore
- South African Society of Psychiatrists, Bloemfonten, South Africa
| | - Amir Ahuja
- Los Angeles LGBT Center, AGLP: The Association of LGBTQ Psychiatrists, Los Angeles, CA, USA
| | - Julio Torales
- Department of Psychiatry, National University of Asunción, San Lorenzo, Paraguay
| | - Howard Rubin
- Department of Psychiatry, UCSF School of Medicine, San Francisco, CA, USA
| | - Joao Castaldelli-Maia
- Department of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil.,Columbia University, New York, NY, USA
| | - Roger Ng
- Alpha Clinic, Central, Hong Kong, China
| | | | - Petros Levounis
- Department of Psychiatry, Rutgers New Jersey Medical School, Newark, NJ, USA
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Existing and emerging pharmacological approaches to the treatment of mania: A critical overview. Transl Psychiatry 2022; 12:169. [PMID: 35461339 PMCID: PMC9035148 DOI: 10.1038/s41398-022-01928-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 12/12/2022] Open
Abstract
Manic episodes are a defining, frequent and dramatically disabling occurrence in the course of Bipolar Disorder type I. Current pharmacotherapy of mania lists a good number of agents, but differences in efficacy and safety profiles among these agents must be considered in order to tailor personalized therapies, especially when the long-term course of the illness is considered. There is wide room and need to ameliorate current pharmacological approaches to mania, but ongoing pharmacological research on the topic is scant. In this work we try to critically assess clinical factors and patients' characteristics that may influence the treatment choice for manic episodes. In addition, we conduct a narrative review on experimental pharmacology of bipolar mania and psychotic disorders, presenting a critical overview on agents which could represent treatment alternatives for a manic episode in the next future. Results show limited novel or ongoing research on agents acting as mood stabilizers (Ebselen, Valnoctamide and Eslicarbazepine did not reach statistical significance in demonstrating antimanic efficacy). As for the emerging experimental antipsychotic, some of them (including KarXT, SEP-363856, RO6889450, ALKS3831) have demonstrated good antipsychotic efficacy and a favorable safety profile, but little is known about their use in patients with bipolar disorder and specifically designed trials are needed. Lastly, some benefits for the treatment of mania could be expected to come in the next future from non-mood stabilizers/non-antipsychotic agents (especially PKC inhibitors like Endoxifen): long-term trials are needed to confirm positive results in terms of long-term efficacy and safety.
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Clinical observations and neuroscientific evidence tell a similar story: Schizophrenia is a disorder of the self-other boundary. Schizophr Res 2022; 242:45-48. [PMID: 35027299 DOI: 10.1016/j.schres.2021.12.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 12/13/2022]
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Smith AP, Lindeque JZ, van der Walt MM. Untargeted Metabolomics Reveals the Potential Antidepressant Activity of a Novel Adenosine Receptor Antagonist. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27072094. [PMID: 35408500 PMCID: PMC9000263 DOI: 10.3390/molecules27072094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/17/2022] [Accepted: 03/19/2022] [Indexed: 11/16/2022]
Abstract
Depression is the most common mental illness, affecting approximately 4.4% of the global population. Despite many available treatments, some patients exhibit treatment-resistant depression. Thus, the need to develop new and alternative treatments cannot be overstated. Adenosine receptor antagonists have emerged as a promising new class of antidepressants. The current study investigates a novel dual A1/A2A adenosine receptor antagonist, namely 2-(3,4-dihydroxybenzylidene)-4-methoxy-2,3-dihydro-1H-inden-1-one (1a), for antidepressant capabilities by determining its metabolic profiles and comparing them to those of two reference compounds (imipramine and KW-6002). The metabolic profiles were obtained by treating male Sprague-Dawley rats with 1a and the reference compounds and subjecting them to the forced swim test. Serum and brain material was consequently collected from the animals following euthanasia, after which the metabolites were extracted and analyzed through untargeted metabolomics using both 1H-NMR and GC-TOFMS. The current study provides insight into compound 1a's metabolic profile. The metabolic profile of 1a was similar to those of the reference compounds. They potentially exhibit their antidepressive capabilities via downstream effects on amino acid and lipid metabolism.
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Heady N, Watkins A, John A, Hutchings H. Prevalence of neurodevelopmental disorders and their impact on the health and social well-being among looked after children (LAC): a systematic review protocol. Syst Rev 2022; 11:49. [PMID: 35305681 PMCID: PMC8934470 DOI: 10.1186/s13643-022-01923-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Looked after children (LAC) that are placed in either a foster, kinship, residential care setting or transition to adoption continue to develop debilitating disorders that significantly impact their overall health and social well-being. The prevalence of these disorders is often depicted under broad categories such as mental, behavioural or neurodevelopmental disorders (NDDs). Limited in research is the prevalence of what specific disorders fall under these broad categories. NDDs such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) which fall under an umbrella group in the expert field of genetics and neuropsychiatry will be explored. Unsupported, these disorders can lead to suboptimal health and social outcomes for both the child and family. In the general population, the prevalence of these NDDs and impacts on health and social well-being are relatively well documented, but for minority groups such as LAC, research is extremely limited. This review aims to estimate the prevalence of NDDs among LAC and explore how they might impact the health and social well-being of these vulnerable children. If feasible, the review will compare the prevalence rates to those children who are not looked after, to illuminate any differences or similarities between populations. METHODS PubMed, ASSIA, IBSS, Web of Science, PsychINFO, Scopus, Psych articles, Social Care Online, secondary, grey literature and government publications will be searched to identify any eligible studies. No restrictions will be placed on country, design or year of publication. Studies must provide primary data on the prevalence or incidence of NDDs for individuals < 25 years of age, supported by either a diagnostic code, standardised diagnostic assessment tool or survey response. The Joanna Briggs Institute (JBI) critical appraisal tools will be utilised to assess the quality and bias and the random-effects model used to estimate a pooled prevalence of NDDs. DISCUSSION Attaining an estimated prevalence of these NDDs and identifying any impacts on health and social well-being might inform key stakeholders in health, educational and social sectors with important information that might aid in the early identification and intervention to safeguard and meet the unique needs of these children. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD4201913103 .
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Affiliation(s)
- Nicola Heady
- Swansea University Medical School, Institute of Life Science 2, Floor 2, Singleton Campus, Swansea, SA2 8PP, Wales.
| | - Alan Watkins
- Swansea University Medical School, Institute of Life Science 2, Floor 2, Singleton Campus, Swansea, SA2 8PP, Wales
| | - Ann John
- Swansea University Medical School, Institute of Life Science 2, Floor 2, Singleton Campus, Swansea, SA2 8PP, Wales
| | - Hayley Hutchings
- Swansea University Medical School, Institute of Life Science 2, Floor 2, Singleton Campus, Swansea, SA2 8PP, Wales
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