Adult Psychiatric Disorders Research Articles

Aberrant Gray Matter Networks in Non-comorbid Medication-Naive Patients With Major Depressive Disorder and Those With Social Anxiety Disorder.

Major depressive disorder (MDD) and social anxiety disorder (SAD) are among the most prevalent and frequently co-occurring psychiatric disorders in adults and may have, at least in part, a common etiology. However, the unique and the shared neuroanatomical characteristics of the two disorders have not been fully identified. The aim of this study was to compare the topological organization of gray matter networks between non-comorbid medication-naive MDD patients and SAD patients. High-resolution T1-weighted images were acquired from 37 non-comorbid medication-naive MDD patients, 24 non-comorbid medication-naive SAD patients, and 41 healthy controls. Single-subject gray matter graphs were extracted from structural MRI scans, and whole-brain neuroanatomic organization was compared across the three groups. The relationships between brain network measures and clinical characteristics were analyzed. Relative to healthy controls, both the MDD and the SAD patients showed global decreases in clustering coefficient, normalized clustering coefficient, and small-worldness and locally decreased nodal centralities and morphological connections in the left insular, lingual, and calcarine cortices. Compared with healthy controls, the SAD patients exhibited increased nodal centralities and morphological connections mainly involving the prefrontal cortex and the sensorimotor network. Furthermore, compared to the SAD patients, the MDD patients showed increased characteristic path length, reduced global efficiency, and decreased nodal centralities and morphological connections in the right middle occipital gyrus and the right postcentral gyrus. Our findings provide new evidence for shared and specific similarity-based gray matter network alterations in MDD and SAD and emphasize that the psychopathological changes in the right middle occipital gyrus and the right postcentral gyrus might be different between the two disorders.

Childhood trauma, psychiatric disorders, and criminality in women: Associations with serum levels of brain-derived neurotrophic factor

Psychiatric disorders and childhood trauma are highly prevalent in female inmates. Brain-derived neurotrophic factor (BDNF) plays a number of roles in neuronal survival, structure, and function. Data in the literature suggest that it is a neurobiological substrate that moderates the impact of childhood adversities on the late expression of psychiatric disorders. The aim of this study was to determine whether five childhood trauma subtypes—physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect—are associated with adult psychiatric disorders, BDNF levels, and criminality among incarcerated women. This was a cross-sectional study involving a consecutive sample of 110 women, divided into three groups of women (forensic - mentally ill who committed crimes, clinical psychiatric inpatients and healthy controls). The Childhood Trauma Questionnaire and the Mini-International Neuropsychiatric Interview-Plus were applied in the whole sample, and BDNF levels were measured in a sub-sample of 54 women. The rates of mental illness and childhood trauma were high in the forensic group. Emotional abuse was higher in the clinical and forensic groups than in the healthy control group. Lower BDNF levels were associated with emotional abuse in the forensic group as well as with sexual abuse in the healthy control group. After multinomial logistic regression, lower levels of BDNF, higher levels of emotional abuse and the presence of familial offense were considered factors related to clinical psychiatric group. The results of this study underscore the idea that BDNF may be an important factor related to the development of diseases and criminality in women who are victims of childhood trauma, becoming a possible biological marker.

Evaluation of comorbid psychiatric disorders in patients with primary brain tumors before and after surgery

BackgroundA range of psychiatric disorders are associated with brain tumors. The aim of this study was to assess the frequency of psychiatric disorders in adults with primary brain tumors before and after surgery. MethodsThe study was conducted on 120 adult patients diagnosed with primary brain tumors (age ≥18 years). Patients with recent diagnosis (less than 6 months) who were hospitalized in Imam Reza Hospital of Tabriz between December 2016 and November 2017 were included. The diagnostic interview was performed based on DSM-IV criteria using a semi-structured interview with SCID-I before and one month after surgery. The frequency of psychiatric disorders in patients was then compared pre- and post-operation. ResultsPre-surgical studies revealed that 26.66 % of patients with primary brain tumors had symptoms of psychiatric disorders. The most prevalent disorders found in patients were depressive disorders (13.07 %), adjustment disorder (9/15 %) and anxiety disorders (5.88 %).Post-surgical evaluations indicated that the frequency of psychiatric disorders was reduced to 22.5 %. However, there was no significant difference between pre- and post-surgical outcomes. Among patients with psychiatric disorders, the most common location of brain tumors was frontal lobe and the most common pathology was meningioma. Further analysis also revealed that tumor location and pathology was not associated with the incidence and type of psychiatric disorders. ConclusionIn adults with primary brain tumors, the most common psychiatric disorder was depressive disorder.

Tolerance of transcranial direct current stimulation in psychiatric disorders: An analysis of 2000+ sessions

Transcranial direct current stimulation (tDCS), a non-invasive, neuromodulatory technique, is being increasingly applied to several psychiatric disorders. In this study, we describe the side-effect profile of repeated tDCS sessions (N = 2005) that were administered to 171 patients (156 adults and 15 adolescents) with different psychiatric disorders [schizophrenia [N = 109], obsessive-compulsive disorder [N = 28], alcohol dependence syndrome [N = 13], mild cognitive impairment [N = 10], depression [N = 6], dementia [N = 2] and other disorders [N = 3]]. tDCS was administered at a constant current strength of 2 mA with additional ramp-up and ramp-down phase of 20 s each at the beginning and end of the session, respectively. Other tDCS protocol parameters were: schizophrenia and obsessive-compulsive disorder: 5-days of twice-daily 20-min sessions with an inter-session interval of 3-h; Mild cognitive impairment/dementia and alcohol dependence syndrome: at least 5-days of once-daily 20-min session; Depression: 10-days of once-daily 30 min session. At the end of each tDCS session, any adverse event observed by the administrator and/or reported by the patient was systematically assessed using a comprehensive questionnaire. The commonly reported adverse events during tDCS included burning sensations (16.2%), skin redness (12.3%), scalp pain (10.1%), itching (6.7%), and tingling (6.3%). Most of the adverse events were noted to be mild, transient and well-tolerated. In summary, our observations suggest that tDCS is a safe mode for therapeutic non-invasive neuromodulation in psychiatric disorders in adults as well as the adolescent population.

Trajectories of violent victimization predicting PTSD and comorbidities among urban ethnic/racial minorities.

To examine the effect of long-term violent victimization from late adolescence to the mid-30s on posttraumatic stress disorder (PTSD) and comorbid psychiatric disorders in adulthood among urban African Americans and Puerto Ricans. Data were collected from a large urban community sample (N = 674) at 4 time points associated with mean ages of 19, 24, 29, and 36 years. Trajectories of violent victimization were extracted using growth mixture modeling and used to predict psychiatric disorders and comorbidities in adulthood. The sample was 52.8% African American and 47.2% Puerto Rican, with 60% females. Three trajectory groups of violent victimization were identified: high, intermediate, and low. Over half of the sample reported relatively high- and intermediate-level violent victimization experiences from adolescence to adulthood. Group comparisons showed that participants belonging to the relatively high-victimization group had greater odds of having PTSD, major depressive episode (MDE), and substance use disorder (SUD) separately, as well as comorbid PTSD-SUD and PTSD-MDE, compared with those classified as having relatively low levels of victimization. Having intermediate-level victimization experiences, compared with low-level victimization experiences, over time was associated with higher odds of PTSD and MDE separately and comorbid PTSD-MDE. Long-term exposure to relatively high levels of violent victimization during emerging and young adulthood is associated with PTSD and comorbid psychiatric disorders in the 30s. Social, structural, and interpersonal factors underlying the differential patterns of violent victimization in urban African American and LatinX youth need to be identified to adequately inform prevention efforts. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Neonatal Immune Activation May Provoke Long-term Depressive Attributes.

Studies have shown the relationship between neuroinflammation and depressive- like parameters. However, research still has not been carried out to evaluate neuroinflammation in the neonatal period and psychiatric disorders in adulthood. To verify the association between neonatal immune activation and depressive-like parameters in adulthood using an animal model. Two days old C57BL/6 animals were exposed to lipopolysaccharides (LPS) or phosphate- buffered saline (PBS). When the animals were 46 days old, they received PBS or Imipramine at 14 days. At 60 days, the consumption of sucrose; immobility time; adrenal gland and the hippocampus weight; levels of plasma corticosterone and hippocampal Brain-derived neurotrophic factor (BDNF) were evaluated. It was observed that the animals exposed to LPS in the neonatal period and evaluated in adulthood decreased the consumption of sucrose and had reducted hippocampus weight. Also, the exposed animals presented an increase of immobility time, adrenal gland weight and plasma levels of corticosteroids. The use of imipramine did not only modify the decreased hippocampal weight. On the other hand, there were no alterations in the BDNF levels in the hippocampus with or without the use of imipramine. These results suggest that neonatal immune activation may be associated with depressive- like parameters in adulthood. It is believed that endotoxemia may trigger physiological and behavioral alterations, increasing vulnerability for the development of depression in adulthood.

Are serum brain-derived neurotrophic factor concentrations related to brain structure and psychopathology in late childhood and early adolescence?

Mental disorders can have a major impact on brain development. Peripheral blood concentrations of brain-derived neurotrophic factor (BDNF) are lower in adult psychiatric disorders. Serum BDNF concentrations and BDNF genotype have been associated with cortical maturation in children and adolescents. In 2 large independent samples, this study tests associations between serum BDNF concentrations, brain structure, and psychopathology, and the effects of BDNF genotype on BDNF serum concentrations in late childhood and early adolescence. Children and adolescents (7-14 years old) from 2 cities (n=267 in Porto Alegre; n=273 in São Paulo) were evaluated as part of the Brazilian high-risk cohort (HRC) study. Serum BDNF concentrations were quantified by sandwich ELISA. Genotyping was conducted from blood or saliva samples using the SNParray Infinium HumanCore Array BeadChip. Subcortical volumes and cortical thickness were quantified using FreeSurfer. The Development and Well-Being Behavior Assessment was used to identify the presence of a psychiatric disorder. Serum BDNF concentrations were not associated with subcortical volumes or with cortical thickness. Serum BDNF concentration did not differ between participants with and without mental disorders, or between Val homozygotes and Met carriers. No evidence was found to support serum BDNF concentrations as a useful marker of developmental differences in brain and behavior in early life. Negative findings were replicated in 2 of the largest independent samples investigated to date.

Childhood temperament and its association with adult psychiatric disorders in a prospective cohort study

BackgroundChildhood temperament and its component factors have previously been shown to be associated with depression and anxiety disorders in later life. Studies have also suggested possible links between childhood temperament and later psychosis. AimsTo investigate the association between childhood temperament and its individual component factors, measured at age 5, and later psychiatric disorders. MethodUsing a sample from a Finnish birth cohort (N = 1014), we used logistic regression models to examine associations between maternal reported childhood temperament at age 5, and later psychiatric diagnosis, ascertained through linkage with the Finnish Hospital Discharge Register (FHDR). ResultsIndividuals with a childhood temperament rated as difficult at age 5 had almost 5-times the odds of developing a psychotic disorder in adulthood compared to those with a temperament rated as average by their mothers (OR = 4.91, 95% CI = 1.51–15.91). The individual temperament factors of approach withdrawal, adaptability and quality of mood were each independently associated with later psychotic disorder while the factors of regularity and threshold were associated with increased risk for mood disorders. ConclusionsThis study reports association between early childhood temperament and risk for psychosis and suggests that early childhood temperament may be a good target for early intervention to reduce the risk of psychiatric disorders.

The p factor: genetic analyses support a general dimension of psychopathology in childhood and adolescence.

BackgroundDiverse behaviour problems in childhood correlate phenotypically, suggesting a general dimension of psychopathology that has been called the p factor. The shared genetic architecture between childhood psychopathology traits also supports a genetic p. This study systematically investigates the manifestation of this common dimension across self‐, parent‐ and teacher‐rated measures in childhood and adolescence.MethodsThe sample included 7,026 twin pairs from the Twins Early Development Study (TEDS). First, we employed multivariate twin models to estimate common genetic and environmental influences on p based on diverse measures of behaviour problems rated by children, parents and teachers at ages 7, 9, 12 and 16 (depressive traits, emotional problems, peer problems, autism traits, hyperactivity, antisocial behaviour, conduct problems and psychopathic tendencies). Second, to assess the stability of genetic and environmental influences on p across time, we conducted longitudinal twin modelling of the first phenotypic principal components of childhood psychopathological measures across each of the four ages. Third, we created a genetic p factor in 7,026 unrelated genotyped individuals based on eight polygenic scores for psychiatric disorders to estimate how a general polygenic predisposition to mostly adult psychiatric disorders relates to childhood p.ResultsBehaviour problems were consistently correlated phenotypically and genetically across ages and raters. The p factor is substantially heritable (50%–60%) and manifests consistently across diverse ages and raters. However, residual variation in the common factor models indicates unique contributions as well. Genetic correlations of p components across childhood and adolescence suggest stability over time (49%–78%). A polygenic general psychopathology factor derived from studies of psychiatric disorders consistently predicted a general phenotypic p factor across development (0.3%–0.9%).ConclusionsDiverse forms of psychopathology generally load on a common p factor, which is highly heritable. There are substantial genetic influences on the stability of p across childhood. Our analyses indicate genetic overlap between general risk for psychiatric disorders in adulthood and p in childhood, even as young as age 7. The p factor has far‐reaching implications for genomic research and, eventually, for diagnosis and treatment of behaviour problems.

Prevalence of co-occurring psychiatric disorders in adults and adolescents with intellectual disability: A systematic review and meta-analysis.

Subjects with intellectual disability (ID) are vulnerable to experience psychiatric disorders. The present authors performed a systematic review and meta-analysis to estimate the prevalence of co-occurring psychiatric disorders, excluding co-occurringautism spectrum disorders, in subjects with intellectual disability. The present authors performed a random-effects meta-analysis of the prevalence of psychiatric disorders in adults and adolescents with intellectual disability. Twenty-two studies were included. The pooled prevalence of any co-occurring psychiatric disorders in intellectual disability was 33.6% (95% CI: 25.2%-43.1%) with high heterogeneity but no publication bias. Prevalence was lower in population-based studies, in studies that used ICD criteria for the psychopathology and in studies with low risk of bias. The prevalence was higher in mild, moderate and severe intellectual disability than in profound intellectual disability. Psychiatric disorders are common in subjects with intellectual disability, and the present authors found that clinical and methodological moderators affect the pooled prevalence.

Association of Childhood Maltreatment With Interpersonal Distance and Social Touch Preferences in Adulthood.

Childhood maltreatment is a major risk factor for psychopathology associated with interpersonal problems in adulthood, but the etiological pathways involved are still unclear. The authors propose that childhood maltreatment confers risk for dysfunctional behavior in social interactions by altering interpersonal distance preference and the processing of social touch. Ninety-two medication-free adults (64 of them female) with low, medium, and high levels of childhood maltreatment were tested with an interpersonal distance paradigm and subsequently underwent a social touch functional MRI task during which they rated the perceived comfort of slow touch (C-tactile [CT] optimal speed; 5 cm/s) and fast touch (non-CT-optimal speed; 20 cm/s). Participants with high childhood maltreatment levels preferred a larger interpersonal distance and experienced fast touch as less comforting compared with participants with no or moderate childhood maltreatment experiences. On the neural level, participants with severe childhood maltreatment exhibited exaggerated responses to fast touch in the right somatosensory and posterior insular cortex, which correlated with lower comfort ratings. Severe childhood maltreatment was associated with decreased activation in the right hippocampus in response to slow touch. This response pattern was not moderated or mediated by childhood maltreatment-associated region-specific reductions in gray matter volume. The study findings suggest that higher childhood maltreatment levels are associated with hypersensitivity characterized by a preference for larger interpersonal distance and discomfort of fast touch. These dysregulations were manifested in a sensory cortical hyperreactivity and limbic CT-related hypoactivation. These results may shed light on why individuals with severe childhood maltreatment exhibit an increased susceptibility to interpersonal dysfunctions and psychiatric disorders in adulthood.

Mental Health and Functional Outcomes in Young Adulthood of Children With Psychotic Symptoms: A Longitudinal Cohort Study.

BackgroundChildhood psychotic symptoms have been associated with various psychiatric disorders in adulthood but their role as early markers of poor outcomes during the crucial transition to adulthood is largely unknown. Therefore, we investigated associations between age-12 psychotic symptoms and a range of mental health problems and functional outcomes at age 18. MethodsData were used from the Environmental Risk Longitudinal Twin Study, a nationally representative birth cohort of 2232 twins born in 1994–1995 in England and Wales, followed to age 18 with 93% retention. Childhood psychotic symptoms were assessed in structured interviews at age 12. At age 18, study members’ mental health problems, functional outcomes, risky behaviors, and offending were measured using self-reports and official records. ResultsChildren with psychotic symptoms (N = 125, 5.9%) were more likely to experience a range of mental health problems in young adulthood than children without such symptoms. They were also more likely to be obese, smoke cigarettes, be lonely, be parents, and report a lower quality of life, but not more likely to commit crimes. Childhood psychotic symptoms predicted these poor outcomes over and above other emotional and behavioral problems during childhood. Nevertheless, twin analyses indicated that these associations were largely accounted for by shared family factors. ConclusionsPsychotic symptoms in childhood signal risk for pervasive mental health and functional difficulties in young adulthood and thus may provide a useful screen for an array of later problems. However, early psychotic symptoms and poor outcomes may be manifestations of shared environmental and genetic risks.

Short-term versus long-term psychotherapy for adult psychiatric disorders: a protocol for a systematic review with meta-analysis and trial sequential analysis

BackgroundPsychiatric disorders are highly prevalent and associated with great symptomatic, functional, and health economic burdens. Psychotherapy is among the recommended and used interventions for most psychiatric disorders and is becoming widely accessible in mental health systems. The effects of specific forms of psychotherapy (e.g., psychodynamic therapies, cognitive and behavioral therapies, humanistic therapies, and systemic therapies) have been assessed previously in systematic reviews, but the appropriate psychotherapy duration for psychiatric disorders has not been reviewed. The aim of this systematic review will be to synthesize the evidence of the effects of short-term compared with long-term psychotherapy for all adult psychiatric disorders.Methods/designA comprehensive search for relevant published literature will be undertaken in Cochrane Central Register of Controlled Trials (CENTRAL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Latin American and Caribbean Health Sciences Literature (LILACS), PsycINFO, Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Conference Proceedings Citation Index—Science (CPCI-S), and Conference Proceedings Citation Index—Social Science & Humanities (CPCI-SSH) to identify relevant trials. We will search all databases from their inception to the present. We will include randomized clinical trials comparing a short-term and a long-term version of the same psychotherapy type for adult psychiatric disorders including attention deficit hyperactivity disorder, psychotic disorders, depressive disorders, bipolar disorders, anxiety disorders, obsessive-compulsive disorder, trauma- and stressor-related disorders, eating disorders, and personality disorders (as defined by standardized diagnostic criteria). We will rely on the trialists defining their compared interventions as short term and long term (or similar terminology). Primary outcomes will be quality of life, serious adverse events, and symptom severity. Secondary outcomes will be suicide or suicide attempts, self-harm, and level of functioning. Two review authors will independently extract data and perform risk of bias assessment using the Cochrane risk of bias tool. A meta-analysis will be performed as recommended by the Cochrane Handbook for Systematic Review of Interventions, bias will be assessed with domains, and Trial Sequential Analysis will be conducted to control random errors. Certainty of the evidence will be assessed by GRADE.DiscussionAs psychotherapy is among the treatments of choice for most adult psychiatric disorders, a systematic review evaluating the benefits and harms of short-term compared with long-term psychotherapy is urgently needed. It is the hope that this review will be able to inform best practice in treatment and clinical research of these highly prevalent and burdensome disorders.Systematic review registrationPROSPERO CRD42019128535

Prevalence of psychiatric disorder in Bangladesh

The prevalence of psychiatric disorders is on rising trend in the country. This two stage nationwide multicentric community based cross sectional study was conducted by National Institute of Mental Health (NIMH), Dhaka during the period of September 2017 to July 2018 to determine the prevalence of psychiatric disordes and to identify common types of psychiatric disorders as well as to find out the physical illness in Bngladesh. In the first stage 19800 respondents in 140 clusters aged between 7 years and above were approached by the trained data collectors with standard printed questinnaires to collect information. Among them 19692 respondents were finally interviewed. Diagnoses of psychiatric disorders were made in the second stage of interview by research psychiatrists following DSM 5 diagnostic criteria of psychiatric disorders. The results showed that, the prevalence of psychiatric disorders was found 13.7% among population 18 years and above and 17.3% below 18 years of age. Division wise prevalence of adult psychiatric disorders were 15.5% in Rajshahi, 14.8% in Rangpur, 14.7% in Khulna, 14.2% in Dhaka, 13.8% in Chittagong, 13.6% in Sylhet and 13.0% in Barishal. Among total diagnosis of psychiatric disorders major depressive disorder were 24.8%, somatic symptom disorder 15.9%, generalized anxiety disorder 13.9%, neurodevelopmental disorders were 10.5%, schizophrenia spectrum and other psychotic disorders 4.7%, conduct disorder 4.7%, bipolar and related disorders 3.7%, obsessive compulsive disorder 3.1%, conversion disorder 1.8%, eneuresis 1.3% and dementia 1%. Data of this community survey will be used for planning of mental health services in Bangladesh. Bang J Psychiatry 2019; 33(1): 1-6

The use of melatonin in adult psychiatric disorders: Expert recommendations by the French institute of medical research on sleep (SFRMS)

Melatonin is a hormone secreted by the pineal gland at night. This hormone has many physiological functions, the main one being to synchronise individuals’ biological rhythms. Exogenous melatonin has the same chronobiotic action, even at small doses (0.125mg). In addition, a sleep-inducing (soporific) action appears to occur in a dose-effect relationship, i.e. as the dose increases. In psychiatric disorders, these two effects could have interesting applications in clinical practice. The French institute of medical research on sleep (SFRMS) appointed a group of experts to conduct a consensus conference to study the indications of melatonin and the conditions of its prescription. An account of the conclusions on adult psychiatric disorders (presented orally at the Congress on Sleep in Marseille, 23 November 2017) is given here. Exogenous melatonin proves to be useful among patients with a stabilized psychiatric disorder or in remission, to prevent relapse in case of associated complaints of insomnia, poor quality sleep or delayed sleep phase syndrome. During acute phases, melatonin could be used as an adjuvant treatment when there are insomnia symptoms, in mood disorders (bipolar disorder, major depressive disorder, seasonal affective disorder), in attention deficit hyperactivity disorder (ADHD), in peri-surgical anxiety and in schizophrenia. In somatoform disorders, melatonin is a possible treatment for painful symptoms in fibromyalgia, irritable bowel syndrome, functional dyspeptic syndrome and temporomandibular joint dysfunction.

Screening for comorbidity of psychiatric and substance use disorders using the Standard for Clinicians’ Interview in Psychiatry (SCIP)

The Standard for Clinicians’ Interview in Psychiatry (SCIP) is a clinician-administered valid and reliable semi-structured diagnostic interview for adult psychiatric disorders. The SCIP Screening Module includes 30 questions and covers 18 adult psychiatric disorders: generalized anxiety, panic, agoraphobia, social phobia, obsessive-compulsive, posttraumatic, major depressive, dysthymic, bipolar, schizoaffective, schizophrenia, attention deficit/hyperactivity, anorexia nervosa, bulimia nervosa, binge-eating, alcohol use, drug use, and somatic symptom disorders. The SCIP Screening Module has been used in clinical assessments, was found to have high sensitivity as a screening tool in a primary-care population, and has the potential to be useful in screening for mental disorders in a general population.

Patterns of Psychiatric Comorbidity and Genetic Correlations Provide New Insights Into Differences Between Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder

BackgroundAttention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) share common genetic factors but seem to have specific patterns of psychiatric comorbidities. There are few systematic studies on adults; therefore, we compared psychiatric comorbidities in adults with these two neurodevelopmental disorders using population-based data and analyzed their genetic correlations to evaluate underlying factors. MethodsUsing data from Norwegian registries, we assessed patterns of psychiatric disorders in adults with ADHD (n = 38,636; 2.3%), ASD (n = 7528; 0.4%), and both diagnoses (n = 1467; 0.1%) compared with the remaining adult population (n = 1,653,575). We calculated their prevalence ratios (PRs) and differences using Poisson regression, also examining sex-specific relations. Genetic correlations (rg) among ADHD, ASD, and the examined psychiatric disorders were calculated by linkage disequilibrium score regression, exploiting summary statistics from relevant genome-wide association studies. ResultsFor all psychiatric comorbidities, PRs differed between ADHD and ASD. Associations were strongest in individuals with ADHD and ADHD+ASD for most comorbidities, in both men and women. The relative prevalence increase of substance use disorder was three times larger in ADHD than in ASD (PRADHD, 6.2; 95% confidence interval [CI], 6.1–6.4; PRASD, 1.9; 95% CI, 1.7–2.2; p < .001); however, the opposite was true for schizophrenia (PRASD, 13.9; 95% CI, 12.7–15.2; PRADHD, 4.4; 95% CI, 4.1–4.7; p < .001). Genetic correlations supported these patterns but were significantly different between ADHD and ASD only for the substance use disorder proxies and personality traits (p < .006 for all). ConclusionsAdults with ADHD, ASD, or both ADHD and ASD have specific patterns of psychiatric comorbidities. This may partly be explained by differences in underlying genetic factors.

Common genetic variants shared among five major psychiatric disorders: a large-scale genome-wide combined analysis

Background. Genetic correlation and pleiotropic effects among psychiatric disorders have been reported. This study aimed to identify specific common genetic variants shared between five adult psychiatric disorders: schizophrenia, bipolar, major depressive disorder, attention deficit-hyperactivity disorder, and autism spectrum disorder. Methods. A combined p-value of about 8 million single nucleotide polymorphisms (SNPs) was calculated in an equivalent sample of 151,672 cases and 284,444 controls of European ancestry from published data based on the latest genome-wide association studies of five major psychiatric disorder. SNPs that achieved genome-wide significance (P&lt;5x10-08) were mapped to loci and genomic regions for further investigation; gene annotation and clustering were performed to understand the biological process and molecular function of the loci identified. We also examined CNVs and performed expression quantitative trait loci analysis for SNPs by genomic region. Results. We find that 6,293 SNPs mapped to 336 loci shared by the three adult psychiatric disorders, 1,108 variants at 73 loci shared by the childhood disorders, and 713 variants at 47 genes shared by all five disorders at genome-wide significance (P&lt;5x10-08). Of the 2,583 SNPs at the extended major histocompatibility complex identified for three adult disorders, none of them were associated with childhood disorders; and SNPs shared by all five disorders were located in regions that have been identified as containing copy number variation associated with autism and had largely neurodevelopmental functions. Conclusion. We show a number of specific SNPs associated with psychiatric disorders of childhood or adult-onset, illustrating not only genetic heterogeneity across these disorders but also developmental genes shared by them all. These results provide a manageable list of anchors from which to investigate epigenetic mechanism or gene-gene interaction on the development of neuropsychiatric disorders and for developing a measurement matrix for disease risk to potentially develop a novel taxonomy for precision medicine.

Surgical Removal of Multiple Gastric Foreign Bodies. Case Report

In the adult population, psychiatric disorders and mental retardation are risk factors for foreign body ingestion. Most cases of foreign body ingestion are managed by close observation or endoscopic intervention. However, surgical intervention is mandatory in some cases. Here, we present the case of an unusually huge amount of gastric foreign bodies, which were removed by surgical intervention. A 54-year-old male patient presented with epigastric pain. He was born with mental retardation and had a 10-year history of anxiety disorder. Before the presentation, a colonic foreign body (coin) was identified 5 months ago, and the foreign body had been passed through the colon without morbidity. Plain radiography showed several foreign bodies occupying the whole stomach, and computed tomography showed multiple oval-shaped radiopaque foreign bodies in the stomach without complications. Although gastroscopy was attempted to extract these foreign bodies, it was impossible to extract all of them. Thus, surgery was performed. The foreign bodies (pebbles and coins) were extracted by surgery, and plain radiography was performed to confirm that there were no residual foreign bodies. The postoperative course was uneventful. Three months after the surgery, a radiopaque round foreign body was detected, and it was resolved without any intervention. Thereafter, the patient course was uneventful during the 1-year follow-up. Although a case with such a large number of gastric foreign bodies is extremely rare in humans, it is important to have a close follow-up after the removal of foreign bodies in patients with psychiatric disorders.

Childhood physical abuse and emotional neglect are specifically associated with adult mental disorders

Background: Childhood adversities and trauma (CAT) are associated with adult mental disorders. Nevertheless, although CAT of different domains mostly co-occurs, and co-morbidity is common, the associations between CAT and mental disorders, when taking these interrelations into account, are not well known.Aims: We aimed to study differential associations between the five core domains of CAT and current axis-I disorders, taking into consideration their interrelations.Methods: Four hundred and fifteen outpatients attending adult primary (n = 255) and psychiatric care (n = 160) were assessed with the Trauma and Distress Scale (TADS) and the Mini International Neuropsychiatric Interview (MINI). Associations between CAT core domains and diagnostic categories were examined by path analyses.Results: At least some infrequent experience of CAT (83.6%), mostly of neglect, and current mental disorders (49.4%), mostly depression, was frequent, as were co-morbidities and co-occurrence of CAT domains. Considering these interrelations in a path model of excellent fit, physical abuse predicted depressive, manic, psychotic and anxiety disorders, whereas emotional neglect predicted depressive, anxiety and substance misuse disorders.Conclusions: Of all five CAT core domains, physical abuse and emotional neglect had the strongest association with adult psychiatric disorders and might have transmitted earlier reported main effects of other CAT domains onto mental disorders.