The Global Prevalence of Conduct Disorder: A Systematic Review and Meta-Analysis

Behavioral disorders in multiple sclerosis: a comprehensive review

Multiple sclerosis (MS) is a heterogenous autoimmune-mediated disease of the central nervous system (CNS) characterized by inflammation, demyelination and chronic progressive neurodegeneration. Among its broad and unpredictable range of neuropsychiatric symptoms, behavioral changes are common, even from the early stages of the disease, while they are associated with cognitive deficits in advanced MS. According to DSM-5, behavioral disorders include attention deficits, oppositional, defiant and conduct disorders, anxiety, panic, obsessive-compulsive disorders (OCD), disruptive and emotional disorders, while others include also irritability, agitation, aggression and executive dysfunctions. Approximately 30 to 80% of individuals with MS demonstrate behavioral changes associated with disease progression. They are often combined with depression and other neuropsychiatric disorders, but usually not correlated with motor deficits, suggesting different pathomechanisms. These and other alterations contribute to disability in MS. While no specific neuropathological data for behavioral changes in MS are available, those in demyelination animal models share similarities with white matter and neuroinflammatory abnormalities in humans. Neuroimaging revealed prefrontal cortical atrophy, interhemispheric inhibition and disruption of fronto-striato-thalamic and frontoparietal networks. This indicates multi-regional patterns of cerebral disturbances within the MS pathology although their pathogenic mechanisms await further elucidation. Benefits of social, psychological, behavioral interventions and exercise were reported. Based on systematical analysis of PubMed, Google Scholar and Cochrane library, current epidemiological, clinical, neuroimaging and pathogenetic evidence are reviewed that may aid early identification of behavioral symptoms in MS, and promote new therapeutic targets and strategies.

A randomized controlled trial of therapist-facilitated brief online behavioral parent training for reducing child disruptive behavior

Background

Addressing child disruptive behavior in low and middle-income countries (LMICs) is challenging. Therapist-facilitated, multisession, brief, online group parent training offers hope for mitigating this issue. However, trials, particularly in Asia, are limited.

Objective

This study primarily assessed the effectiveness of Brief Behavior Parent Training Vietnam (BBPTV) in reducing child disruptive behavior.

Method

This study was a randomized controlled trial involving 109 Vietnamese parents (mean age = 34.1, 96 % were mothers) of preschool children displaying ongoing disruptive behaviors. Interventions included the BBPTV group (n = 56) receiving a therapist-facilitated, four-session program conducted through online group meetings and the care-as-usual (CAU) group (n = 53) having a 15 min individual online consultation. Primary outcomes, assessed online at two and six months postintervention, encompassed the intensity and frequency of children's disruptive problems. Secondary outcomes involved parenting practices, coercive interactions, marital conflicts, parenting self-efficacy, and parental mental health.

Results

In contrast to CAU, the BBPTV group showed lower child disruptive intensity, reduced parent-child coercive interactions, and diminished marital conflicts, with a higher score in involving parenting two months post-intervention. Six months postintervention, BBPTV also exhibited significantly lower scores in child disruptive intensity and problems, harsh parenting, and coercive processes compared to CAU.

Conclusions

The therapist-facilitated, four-session, internet-delivered group parent intervention resulted in superior and sustained improvements in child disruptive behavior, parenting practices, and parent-child coercive interaction compared to usual care, highlighting the potential for online BBPT to extend mental health care in Vietnam and other LMICs.

Umbrella Review of the Global Prevalence of Conduct Disorder in Children and Adolescents

With the ever-increasing prevalence of mental health issues worldwide, a robust synthesis of existing epidemiological data on the prevalence of Conduct disorder (CD) in children and adolescents is needed to strengthen the knowledge base. This quantitative umbrella review aims to provide a robust synthesis of evidence on the prevalence of CD children and adolescents from meta-analytic systematic reviews. We searched PubMed, Web of Science, PsychINFO, and Scopus to identify relevant articles. The study protocol has been registered with PROSPERO (CRD42023447620). The methodological quality of the studies was evaluated by using a Measurement Tool to Assess Systematic Reviews (AMSTAR). Invariance variance weighted random-effect meta-analysis was performed to pool prevalence estimates from the included articles. Seven meta-analyses, encompassing 138 primary studies and slightly over 48 million CD cases were included in this umbrella review. The quantitative analysis of these studies found a pooled prevalence of CD 3.0% (95%CI 2.0-5%) in children and adolescents, based on random effect meta-analyses. In a stratified analysis, the prevalence estimate of CD was 2.6 times higher in boys compared to girls. Evidence from our quantitative umbrella review showed that the prevalence of CD is relatively high in children and adolescents with boys 2.6 times more likely to experience the disorders when compared to girls. Our findings underlie that attention should be given to preventing, identifying, and treating CD in children and adolescents.

Contemporary diagnosis and treatment of conduct disorder in youth

INTRODUCTION

Conduct disorder (CD) is characterized by repetitive and persistent antisocial behaviors, being among the most frequently reported reasons of referral in youth. CD is a highly heterogeneous disorder, with possible specifiers defined according to age at onset, Limited Prosocial Emotions (LPE) otherwise known as Callous-Unemotional (CU) traits, Emotional Dysregulation (ED), and patterns of comorbidity, each with its own specific developmental trajectories.

AREAS COVERED

The authors review the evidence from published literature on the clinical presentations, diagnostic procedures, psychotherapeutic and psychoeducational approaches, and pharmacological interventions from RCT and naturalistic studies in youth. Evidence from studies including youths with LPE/CU traits, ED and aggression are also reviewed, as response moderators.

EXPERT OPINION

Due to its clinical heterogeneity, relevant subtypes of CD should be carefully characterized to gain reliable information on prognosis and treatments. Thus, disentangling this broad category in subtypes is crucial as a first step in diagnosis. Psychosocial interventions are the first option, possibly improving LPE/CU traits and ED, especially if implemented early during development. Instead, limited information, based on low-quality studies, supports pharmacological options. Second-generation antipsychotics, mood stabilizers, and stimulants are first-line medications, according to different target symptoms, such as aggression and emotional reactivity. Developmental pathways including ADHD suggest a specific role of psychostimulants.

Electrodeposition of dopamine onto carbon fiber microelectrodes to enhance the detection of Cu2+ via fast-scan cyclic voltammetry

The etiology of neurodegenerative diseases is poorly understood; however, studies have shown that heavy metals, such as copper, play a critical role in neurotoxicity, thus, adversely affecting the development of these diseases. Because of the limitations associated with classical metal detection tools to obtain accurate speciation information of ultra-low concentrations of heavy metals in the brain, analysis is primarily performed in blood, urine, or postmortem tissues, limiting the translatability of acquired knowledge to living systems. Inadequate and less accurate data obtained with such techniques provide little or no information for developing efficient therapeutics that aid in slowing down the deterioration of brain cells. In this study, we developed a biocompatible, ultra-fast, low-cost, and robust surface-modified electrode with carbon fibers by electrodepositing dopamine via fast-scan cyclic voltammetry (FSCV) to detect Cu²⁺ in modified tris buffer. We studied the surface morphology of our newly introduced sensors using high-resolution images by atomic force microscopy under different deposition conditions. The limit of detection (LOD) of our surface-modified sensor was 0.01 µM (0.64 ppb), and the sensitivity was 11.28 nA/µM. The LOD and sensitivity are fifty and two times greater, respectively, compared to those of a bare electrode. The sensor's response is not affected by the presence of dopamine in the matrix. It also exhibited excellent stability to multiple subsequent injections and repeated measurements of Cu²⁺ over a month, thus showing its strength to be developed into an accurate, fast, robust electrochemical tool to monitor ultra-low concentrations of heavy metals in the brain in real time.

The modulation of neuroinflammation by inducible nitric oxide synthase

The accumulation and propagation of misfolded proteins in the brain is a pathological hallmark shared by many neurodegenerative diseases, such as the depositions of β-amyloid and hyperphosphorylated tau proteins in Alzheimer's disease. Initial evidence shows the role of nitric oxide synthases in the development of neurodegenerative diseases. A recent, in an exciting paper (Bourgognon et al. in Proc Natl Acad Sci USA 118, 1-11, 2021. 10.1073/pnas.2009579118) it was shown that the inducible nitric oxide synthase plays an important role in promoting oxidative and nitrergic stress leading to neuroinflammation and consequently neuronal function impairments and decline in synaptic strength in mouse prion disease. In this context, we reviewed the possible mechanisms of nitric oxide synthase in the generation of neurodegenerative diseases.

Common mental health problems among adolescents in sub-Saharan Africa: A systematic review and meta-analysis

Background and aim: This review examined the prevalence of mental health problems among adolescents in sub-Saharan Africa.Methods: The review included studies indexed in the MEDLINE, EMBASE, and PsycINFO databases, supplemented by a search on Google Scholar and tracking of references from articles identified. A total of 725 articles were found, of which 28 met the inclusion criteria. Finally, 22 eligible studies were reviewed.Findings: The pooled current prevalence of mental health problems was 23% (95% CI: 18; 28, I2 = 99.41%). Any depression, 19% (95% CI: 9; 30, I2 = 99.64%), and anxiety, 20% (95% CI: 01; 31, I2 = 99.64%), were the most common mental health problems reported. Attention deficit hyperactivity disorder, 5% (95% CI: 3; 7, I2 = 97.60%), and conduct disorders, 15% (95% CI: 8; 22, I2 = 99.58%), were also significant mental health problems among adolescents in the region.Conclusion: About one in five adolescents in sub-Saharan Africa suffer from one or more mental health problems. The findings have important implications for policy and practice as they indicate that mental health problems are a major public health issue among adolescents in sub-Saharan Africa and that there is a need for effective and context-specific interventions that address mental health.