Symptoms Of Affective Disorders Research Articles

Combined EEG-tDCS approach in resting state to reduce comorbid anxiety and depressive symptoms in affective disorders: A sham-controlled pilot study

Continuous challenges have been imposed on mental health science by Anxiety and Depression disorders as the most prevalent and debilitating psychiatric conditions worldwide. Pharmacologic and cognitive behavioral therapies, either alone or in combination, have been considered as the first-line therapies, however, resistant symptomatology is prevalent in comorbid conditions with symptoms remaining after interventions. The demand for new therapeutic solutions has given space to the development of non-invasive brain stimulation techniques (NIBS), and the transmagnetic direct current stimulation (tDCS) has been reported as a safe and well-tolerated technique for the treatment of several mental health conditions, including Anxiety and Depression disorders. Relying on quantitative electroencephalography(qEEG)- tDCS approach, the current study aims to inspect the effect of tDCS intervention on patients who suffer from anxiety-depression comorbidity, in particular, the impact of tDCS intervention on qEEG spectral power activity and resting-state connectivity organization during eyes closed and eyes open protocols. QEEG data were acquired from eight patients suffering from moderate to severe anxiety-depression comorbid symptoms along with poor coping skills to manage stress and negative affect. Twelve control subjects allocated in the control group exhibiting low to moderate symptoms in both anxiety and depression conditions went also through the qEEG data acquisition. In addition, a sham-controlled study was conducted, and the patient group went through resting-state qEEG-tDCS neuromodulation once a week for ten weeks. Various-stage qEEG recordings were performed to inspect the efficacy of tDCS treatment during the modulation of brain regions involved in the regulation of affective responses. Our results demonstrated that after tDCS neuromodulation, the patients' groups exhibited decreased absolute power abnormalities over the left anterior cingulate cortex and reduced abnormal activity in the alpha band over posterior regions; improved functional connectivity indexes; decreased anxiety and depressive scores while positive affect score was improved. Besides the promising improvements, our study did not find a significant tDCS effect on perceived stress and negative affect scores. Consistently, significant differences in absolute spectral power over the left anterior cingulate cortex were detected among the patient group, as compared to the controls, as expected. Therefore, our study offers preliminary data to understand the neuroplasticity changes that potentially result from the manipulation of cortical excitability during affective regulation protocols followed by the consequent decrease of comorbid anxiety and depressive symptomatology. The pilot study was followed by prospective registration with ChiCTR2200062142.

The Emotion Beliefs Questionnaire: Psychometric properties, norms, and links to affective outcomes

BackgroundThe Emotion Beliefs Questionnaire was recently developed to measure beliefs about the controllability and usefulness of negative and positive emotions. These are beliefs that have been theorised to be influential for emotion regulation and psychological outcomes. However, to date there are few studies utilising large, representative samples to examine the EBQ's psychometric properties and affective correlates. Our aim was to fill this gap by examining the EBQ's psychometric properties and exploring associations between emotion beliefs, emotion regulation, and affective disorder symptoms. MethodsA sample of 1175 adults recruited from the general population in the United States completed measures of emotion beliefs, emotion regulation, and affective disorder symptoms. ResultsConfirmatory factor analyses supported the EBQ's intended subscale structure, where controllability and usefulness beliefs were separated by valence. This structure was invariant across gender, age, and education categories. The EBQ correlated in expected ways with other measures, demonstrating good validity, and had good to excellent levels of internal consistency reliability. LimitationsThis study used a non-clinical sample that was predominantly White. Future work should utilise clinical and cross-cultural samples to maximise generalisability of findings. ConclusionsOur findings indicate that the EBQ is a psychometrically sound tool for measuring the multidimensional emotion belief construct. The EBQ may have clinical utility in the conceptualisation, assessment, and treatment of maladaptive emotion beliefs. Furthermore, our results highlight the importance of considering the potential influence of maladaptive emotion beliefs in emotion dysregulation and affective disorder symptoms.

Changes in Psychotropic Drug Concentrations Across the Menstrual Cycle: A Pilot Study.

The escalating prescription of psychopharmacological medications to women of reproductive age underscores the growing significance of sex-specific variations in pharmacotherapy. Despite this, clinical trials have largely overlooked these differences. Preliminary data indicate sex-specific variations in the neurobiology of affective disorders and in the metabolism, pharmacodynamics, and kinetics of therapeutic drugs. This underscores the imperative for a more nuanced exploration of menstrual cycle-dependent fluctuations in psychotropic drugs. This pilot study aimed to investigate drug and hormone fluctuations in female patients with affective disorders, aiming to enhance comprehension of the interplay between cycle-related hormone fluctuations and pharmacokinetics. The ultimate goal is to facilitate more effective and safer pharmacological therapy in the future. Blood samples were collected from 27 patients and 27 age-matched control participants at 3 distinct time points (early follicular phase, ovulation, and late luteal phase) during each menstrual cycle. Depressive and manic symptoms were assessed, and hormone concentrations were measured in the entire sample, while drug concentrations were assessed solely in the affective disorder sample using mass spectrometry. Significant variations in drug concentration were observed throughout the menstrual cycle for bupropion, with a trend toward altered concentration for venlafaxine. Moreover, notable differences in hormone concentrations were identified between patients and controls, even after accounting for the impact of contraceptive use, diagnoses, and medication. This pilot study reinforces previously reported data, underscoring the significance of sex-specific pharmacological therapy approaches. It provides further evidence supporting the interaction among sex hormones, drugs, and symptoms of affective disorders.

Beyond the Clinic Walls: Fostering Well-Being in a Client with Schizoaffective Disorder (SAD) Through Home Care and Clozapine Therapy - A Case Report

Schizoaffective disorder SAD is a chronic severe and disabling illness associated with concurrent presentation of symptoms of schizophrenia and affective disorders. The mainstay of treatment is a combination of antipsychotic medications and depending on the subtype of schizoaffective disorder either mood stabilizers or antidepressants are given. Clozapine is a second-generation antipsychotic used in the treatment of SAD. Clozapine-induced agranulocytosis has the highest risk of occurrence during the first few months of treatment. Other common side effects are sialorrhea constipation dehydration and hyperglycaemia. Adequately managing side effects can improve adherence and quality of life. Physical health should be monitored at each clinical review particularly in the first few months of treatment to reduce the occurrence of serious sometimes fatal adverse reactions. Many clients find clozapine to help with their psychosis but they often need to balance the positive effect of psychosis with some of the side effects that clozapine can cause.

Social and psychological features of affective disorders in people during crisis periods of life

The study’s relevance is due to the association between mental disorders and environmental instability. A frequent consequence of stress is post-traumatic disorder, which can significantly affect the personality and disrupt adaptation, causing subjective suffering. The purpose of the article is to update information on the structure and dynamics of socio-psychological features of affective personality disorders in the crisis period of life in the Ukrainian population associated with the war. The article uses the following methods: clinical and psychological, psychometric, and statistical (in particular, descriptive statistics) methods. The results of the study demonstrate various courses of bipolar affective disorders of the continuum type with the transformation of their dynamics. The study showed a significant increase in the negative symptoms of affective disorders under the influence of stress. The researchers demonstrated the severity of both depressive and manic phases of affective disorders under the impact of stress factors. The results indicate an exacerbation of the course of affective disorders in people under difficult life circumstances. The findings have theoretical significance and are promising for further research on typologisation, classification and identifying clinical and biological manifestations to represent the specifics of pathogenesis.

Risk for Seasonal Affective Disorder (SAD) Linked to Circadian Clock Gene Variants.

Molecular pathways affecting mood are associated with circadian clock gene variants and are influenced, in part, by the circadian clock, but the molecular mechanisms underlying this link are poorly understood. We use machine learning and statistical analyses to determine the circadian gene variants and clinical features most highly associated with symptoms of seasonality and seasonal affective disorder (SAD) in a deeply phenotyped population sample. We report sex-specific clock gene effects on seasonality and SAD symptoms; genotypic combinations of CLOCK3111/ZBTB20 and PER2/PER3B were significant genetic risk factors for males, and CRY2/PER3C and CRY2/PER3-VNTR were significant risk factors for females. Anxiety, eveningness, and increasing age were significant clinical risk factors for seasonality and SAD for females. Protective factors for SAD symptoms (in females only) included single gene variants: CRY1-GG and PER3-VNTR-4,5. Clock gene effects were partially or fully mediated by diurnal preference or chronotype, suggesting multiple indirect effects of clock genes on seasonality symptoms. Interestingly, protective effects of CRY1-GG, PER3-VNTR-4,5, and ZBTB20 genotypes on seasonality and depression were not mediated by chronotype, suggesting some clock variants have direct effects on depressive symptoms related to SAD. Our results support previous links between CRY2, PER2, and ZBTB20 genes and identify novel links for CLOCK and PER3 with symptoms of seasonality and SAD. Our findings reinforce the sex-specific nature of circadian clock influences on seasonality and SAD and underscore the multiple pathways by which clock variants affect downstream mood pathways via direct and indirect mechanisms.

Music listening as emotion regulation: Associations with other emotion regulation strategies and symptoms of depression and anxiety

Music listening, an inherently emotional activity, is commonly used as a form of emotion regulation (ER). Although research suggests that some strategies of listening to music to regulate emotion are linked with psychological well-being and symptoms of affective disorders, the mechanisms underlying these relationships have not been thoroughly explored. The present study examined whether associations between music as ER and symptoms of depression and anxiety were mediated by individuals’ use of other adaptive and maladaptive ER strategies. A nationwide online sample of US adults ( n = 146) completed measures assessing their use of music as ER, other adaptive and maladaptive ER strategies, and symptoms of depression and anxiety. The results indicated that the overall use of music as ER was not directly associated with symptoms of depression and anxiety, whereas using music as discharge (venting negative emotions by listening to mood-congruent music) was positively associated with such symptoms. Mediational analyses revealed that adaptive ER mediated the relationship between overall use of music as ER and symptoms of depression and anxiety, whereas maladaptive ER mediated the relationships between discharge and symptoms. These findings suggest that people use music as ER alongside their other ER efforts, which in turn are linked with symptoms of depression and anxiety. Furthermore, although the overall use of music to regulate emotion may be beneficial for well-being via its association with adaptive ER, a more maladaptive pattern when using music for emotional discharge suggests that music plays a more nuanced role in ER and mental health.

Indicators of quality of life, anxiety-depressive symptoms and severity of dysmenorrhea in adolescent girls with peritoneal endometriosis during conservative therapy for a year

Introduction. Delayed diagnosis and treatment of endometriosis lead to impaired quality of life and pain chronification in young female patients.Aim. To study indicators of quality of life, anxiety, depression and pain syndrome in adolescents with peritoneal endometriosis (PE) over a one-year period of conservative therapy.Materials and methods. A total of 45 girls aged 13 to 17 years with a confirmed diagnosis of PE were enrolled in a prospective longitudinal study. Pain syndrome (VAS, McGill Pain Questionnaire), anxiety-depressive symptoms (Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), Spielberger State-Trait Anxiety Inventory (STAI)), quality of life indicators (SF-36) were assessed before and after one year of treatment in female patients (dienogest administered continuously, NSAIDs and drotaverine for immediate pain relief only).Results. One year of therapy resulted in a significant decrease in the severity of dysmenorrhea and chronic pelvic pain, gastrointestinal symptoms and dysuria, daily activity and productivity impairment (p < 0.001) in girls with PE. In addition, the study demonstrated decreased indicators of anxiety and depressive disorders (BDI depression, HADS anxiety and depression, STAI reactive and personal anxiety (p < 0.001)) and an improvement in quality-of-life indicators (physical and psychological component, average index (p < 0.001)). There was a declining trend in blood hormone and inflammation test results within the reference range during treatment. The estradiol level has been shown to be a risk factor for high levels of affective disorder symptoms in adolescents with PE: STAI reactive anxiety (p = 0.046), HADS anxiety and depression (p = 0.044 and 0.033, respectively).Conclusion. The one-year therapy of PE in adolescents (dienogest administered continuously, a combination of NSAIDs and drotaverine in pain syndrome only) was associated with significantly improved quality of life, decreased severity of anxietydepressive disorders and pain, which confirms the need to start therapy when symptoms of the disease begin to show them-selves in adolescence.

Prevalence and Pattern of Olanzapine Emergent Obsessive–Compulsive Symptoms: A Cross-sectional Study

Objective: Olanzapine is an atypical antipsychotic medication and known for metabolic side effects but olanzapine-induced obsessive–compulsive symptoms are another important behavioral side effects which are less studied and only a few case reports reported these side effects. This study aims to estimate the prevalence and pattern of olanzapine-induced obsessive–compulsive symptoms in schizophrenia and bipolar affective disorders (BPADs). Methods: Subjects were recruited from psychiatry outpatient department. Subjects with schizophrenia ( n = 41) and BPAD ( n = 18) taking olanzapine at least more than 6 months were evaluated for clinical profile and the presence of obsession and compulsion symptoms by means of Yale-Brown Obsessive–Compulsive Symptom (YBOCS) checklist scale and data were collected on the structured format. Results: Eighteen (30.5%) of the 59 patients met YBOCS checklist scale for both obsessive–compulsive symptoms among subjects with schizophrenia and BPAD subjects. The mean duration of olanzapine intake was 2 years and the mean dose of olanzapine was 12.5 ± 5.21 mg in obsessive–compulsive symptoms (OCSs) present subjects and the mean dose was 13.78 ± 5.21 mg in subjects not having OCSs. Contamination was the most common obsession and checking was the most common compulsion. Conclusions: These findings suggest that obsessive–compulsive symptoms occur in a substantial percentage of patients taking olanzapine in schizophrenia and BPAD and most of the subjects had more than one OCS.

Levels of IL-6 are Associated with Lifetime Attempted Suicide in Alcohol Use Disorder Patients.

Patients with alcohol use disorder (AUD) have an increased risk of suicide. Neuroimmunological measures, such as cytokines, are shown to deviate in people with attempted suicide. Few studies have investigated this among AUD patients. One-hundred and fourteen patients undergoing residential treatment for AUD were interviewed on lifetime suicide attempts (SA) along with several other background variables and clinical characteristics. Serum blood samples were drawn for analysis of cytokines. Thirty-one patients (27%) reported at least one SA. These patients had more symptoms of current affective disorders and more severe dependence. In bivariate analysis only IL-6 and IL-10 appeared to be associated with lifetime SA but without reaching statistical significance. In multivariate linear regression, adjusting for sex, nicotine use, somatic illness, and the use of anti-inflammatory drugs, IL-6 was associated to SA (p = 0.033). The cytokine IL-6 has repeatedly been found to be associated with suicidality. The present study concurs with this role of IL-6 in a naturalistic observational study of AUD patients.

Masculine depression and its problem behaviors: use alcohol and drugs, work hard, and avoid psychiatry!

The gender role influences vulnerability to mental illness. Substance use, even critical in scale, is perceived as masculine, just like hard (over-)work, while not seeking help. With the ongoing separation between gender and sex, masculine norms become more relevant also to females’ mental health. The male depression concept highlights the role of male symptoms in affective disorders. However, the empirical evidence is still limited. Here, we use the denomination ‘masculine depression’ to open the category for female patients and tested substance use patterns, health services’ utilization, and working hours as predictors in a case–control study of 163 depressed in-patients (44% women; masculine vs. non-masculine depression according to a median split of the Male Depression Rating Scale-22) and 176 controls (51% women). We assessed higher depression severity in patients with masculine (vs. non-masculine) depression. Masculine depression (vs. non-masculine depression and vs. no depression) was predicted by more frequent and critical use of alcohol (including binge drinking), tobacco, and illicit drugs, and by longer working times. Moreover, fewer health services contacts due to mental complaints during the previous year were associated with masculine (vs. non-masculine) depression. Alarmingly, even critical substance misuse was not significantly associated with more frequent health services contacts; however, the higher the depression severity, the more contacts the patients reported. Here, we provide evidence that patients with masculine depression are highly burdened and undertreated, which applies equally to female and male patients. This study identified promising targets to establish specialized care offers.

The Perth Alexithymia Questionnaire-Short Form (PAQ-S): A 6-item measure of alexithymia

BackgroundAlexithymia is a trait characterized by difficulties identifying feelings, difficulties describing feelings, and externally orientated thinking. It is widely regarded as an important transdiagnostic risk factor for a range of psychopathologies, including depressive and anxiety disorders. Whilst several well-validated psychometric measures of alexithymia exist, these are relatively lengthy, thus limiting their utility in time-pressured settings. In this paper, we address this gap by introducing and validating a brief 6-item version of the Perth Alexithymia Questionnaire, called the Perth Alexithymia Questionnaire-Short Form (PAQ-S). MethodAcross two studies with adult samples (Study 1 N = 508 United States community; Study 2 = 378 Australian college students), we examined the psychometric properties of the PAQ-S in terms of its factor structure, reliability, and concurrent/criterion validity. ResultsIn exploratory and confirmatory factor analyses, all PAQ-S items loaded well on a single general alexithymia factor. The PAQ-S total score had high reliability, and correlated as expected with the long-form of the PAQ, as well as other established markers of alexithymia, emotion regulation, and affective disorder symptoms. LimitationsOur samples were general community or college student samples from two Western countries; future validation work in clinical samples and more diverse cultural groups is thus needed. ConclusionsThe PAQ-S retains the psychometric strengths of the PAQ. As such, the PAQ-S can be used as a quick, robust measure of overall alexithymia levels. The introduction of the PAQ-S hence enables valid assessments of alexithymia in a more diverse range of settings and research designs.

Emotion regulation strategies and mental health symptoms during COVID-19: the mediating role of insomnia.

COVID-19 has become a major source of stress for people around the world. Stressful life events play a role in the pathogenesis of sleep disorders such as insomnia which is considered a risk factor for anxiety and depression. Emotion regulation is an important factor linked with sleep and mental health problems. Therefore, the main goal of the present study was to examine whether insomnia could constitute a mediation mechanism that explains the relationship between emotion regulation strategies (rumination, reappraisal, suppression) and stress-induced mental health outcomes during the COVID-19 pandemic. The cross-sectional study was conducted among young (M±SD 24.8±2.24) individuals (N = 281, 85.4% women) during the time of the third wave of infections in Poland. Data were collected by means of selfreport questionnaires, including the Emotion Regulation Questionnaire; Cognitive Emotion Regulation Questionnaire; Athens Insomnia Scale; Depression, Anxiety and Stress Scale. The direct and indirect effects of emotion regulation strategies on depression, anxiety, and stress were calculated using a bootstrap estimation technique. All analyzed indirect effects were significant. The results show that insomnia mediates the relationships between all 3 emotion regulation strategies and stress, anxiety and depression. The presented results shed the light on the role of insomnia on the relationships between emotion regulation strategies and emotional states experienced during the COVID-19 pandemic. Additionally, the present study suggests that educational and therapeutic interventions aimed at improving emotion regulation might be useful for improving symptoms of insomnia and, through it, symptoms of affective disorders. Int J Occup Med Environ Health. 2023;36(1):151-59.

Chronic running-wheel exercise from adolescence leads to increased anxiety and depression-like phenotypes in adulthood in rats: Effects on stress markers and interaction with BDNF Val66Met genotype.

Exercise has been shown to be beneficial in reducing symptoms of affective disorders and to increase the expression of brain-derived neurotrophic factor (BDNF). The BDNF Val66Met polymorphism is associated with reduced activity-dependent BDNF release and increased risk for anxiety and depression. Male and female Val66Met rats were given access to running wheels from 3weeks of age and compared to sedentary controls. Anxiety- and depression-like behaviors were measured in adulthood using the elevated plus maze (EPM), open field (OF), and forced swim test (FST). Expression of BDNF and a number of stress-related genes, the glucocorticoid receptor (Nr3c1), serum/glucocorticoid-regulated kinase 1 (Sgk1), and FK506 binding protein 51 (Fkbp5) in the hippocampus were also measured. Rats given access to running wheels developed high levels of voluntary exercise, decreased open-arm time on the EPM and center-field time in the OF, reduced overall exploratory activity in the open field, and increased immobility time in the FST with no differences between genotypes. Chronic exercise induced a significant increase in Bdnf mRNA and BDNF protein levels in the hippocampus with some of these effects being genotype specific. Exercise decreased the expression of Nr3c1 and Sgk1, but increased the expression of Fkbp5. These results suggest that chronic running-wheel exercise from adolescence increased anxiety and depression-like phenotypes in adulthood, independent of BDNF Val66Met genotype. Further studies are required to confirm that increased indices of anxiety-like behavior are independent from reduced overall locomotor activity.

Low circadian amplitude and delayed phase are linked to seasonal affective disorder (SAD)

• Symptoms of seasonal affective disorder (SAD) are linked to in-vivo circadian mRNA oscillations. • SAD symptoms are associated with low circadian amplitude and delayed winter phase. • Our computational modeling results link SAD with clock gene variants associated with SAD. • Females and evening chronotypes are at higher risk for SAD. : Symptoms of seasonal affective disorder (SAD) can affect up to 10-20% of individuals in temperate populations and are more common in females. Depressive symptoms within SAD individuals provide a model for investigating how genetic, environmental, and physiological factors interact to influence mood. Winter-type SAD occurs during short photoperiod seasons, suggesting circadian physiology may influence susceptibility to SAD. : Using a longitudinal cross-season design in a Northeastern US population (n=213), we tested how SAD symptoms (SPAQ-GSS) were associated with gender, depression scores (BDI-II), chronotype (MCTQ-MSF), and in-vivo circadian phase and amplitude. In addition, we used computational modeling to simulate whether circadian gene variants reproduce SAD phenotypes across seasons. : We found that high seasonality scores are associated with lower circadian amplitude, delayed circadian phases in winter, and evening chronotypes. Our model reproduces seasonal decreases in amplitude and delayed phases for circadian gene variants associated with SAD. Modeling further suggests that transcriptional increases for variants in Cry1 and Cry2 genes and changes in transcription, phosphorylation and/or degradation rates of Per3 variants may be associated with these seasonal changes. : Our study examined clock gene expression from peripheral tissues which represent circadian rhythms influenced by both intrinsic, physiological and external, environmental factors. The mutant conditions for the modeling study are limited, and many biochemical reaction rates in humans are unknown. : Our study validates previous results linking SAD symptoms with gender, chronotype, and depressive symptoms and provides evidence for potential genetic and physiological mechanisms of SAD—low circadian amplitude and seasonally delayed circadian phase.

Depression and Anxiety Symptoms Are Associated with Mean Platelet Volume in Autoimmune Disorders.

Platelets are increasingly considered a bridge between mental and immunological disorders. However, data relating to platelet parameters in patients with autoimmune disorders are limited. The aim of the present study was to investigate, for the first time, the association of platelet parameters with the symptoms of affective disorders in patients with autoimmune conditions. In this cross-sectional study, we measured the complete blood count (CBC), the Generalized Anxiety Disorder Scale for anxiety (GAD-7), and the Beck Depression Inventory for depression (BDI) in 121 patients with autoimmune disorders. Mean platelet volume (MPV) was positively correlated with both anxiety and depression. Platelet distribution width (PDW) was negatively correlated with anxiety and depression. Before adjustment for covariates, logistic regression analysis revealed a significant association of MPV with depression and anxiety. After adjustment for covariates, only depression was associated with MPV. The area under the ROC curve of MPV for GAD-7 determined anxiety and BDI determined depression was 0.63. Our study showed that among the CBC hematological parameters, the MPV might be a useful biomarker of depression and anxiety in patients with autoimmune disorders. Further investigations of platelet parameters in controlled prospective studies are warranted to confirm our preliminary results.

The Perinatal Assessment of Paternal Affectivity (PAPA): Italian validation of a new tool for the screening of perinatal depression and affective disorders in fathers

BackgroundQuestionnaires for the screening of paternal perinatal psychological distress are based on clinical manifestations expressed by women, showing limitations in capturing the wide array of signs and symptoms exhibited by men. The current study aimed to validate the Perinatal Assessment of Paternal Affectivity, a new self-report tool for the screening of paternal depressive and affective disorder. MethodThis study used a cross-sectional design with a 3-month test-retest, involving respectively 385 (T1) and a sub-sample of 111(T2) fathers. Confirmatory factor analysis (CFA) was performed to test structural validity and concurrent validity was assessed by Spearman correlations. We assessed reliability using McDonald's ω and ordinal alpha. Group differences in PAPA scores based on sociodemographic were also tested. ResultsThe CFA reported a one factor structure as the optimal solution. The PAPA also showed adequate reliability and internal consistency as well as acceptable test–retest indices. Concurrent validity was confirmed by significant correlations between PAPA total score and standardized test scores. Non-Italian fathers and fathers who experienced recent stressful life events reported higher PAPA scores. LimitationsOur sample was not homogeneous in terms of nationality and most of the participants, were from Northern Italy. Some risk factors associated with paternal parental psychological distress (e.g., unplanned pregnancy) have not been considered. ConclusionThis study provides initial evidence of validity and reliability of the PAPA as a brief and sensitive screening tool to detect signs and symptoms of paternal affective disorder during both prenatal and postnatal period.

A dimensional approach to affective disorder: The relations between Scl-90 subdimensions and QEEG parameters.

ObjectivesQEEG reflects neuronal activity directly rather than using indirect parameters, such as blood deoxygenation and glucose utilization, as in fMRI and PET. The correlation between QEEG spectral power density and Symptom Check List-90-R may help identify biomarkers pertaining to brain function, associated with affective disorder symptoms. This study aims at determining whether there is a relation between QEEG spectral power density and Symptom Check List-90-R symptom scores in affective disorders.MethodsThis study evaluates 363 patients who were referred for the initial application and diagnosed with affective disorders according to DSM-V, with QEEG and Scl-90-R. Spectral power density was calculated for the 18 electrodes representing brain regions.ResultsSomatization scores were found to be correlated with Pz and O1 theta, O1 and O2 high beta. Whereas FP1 delta activities were correlated with anxiety, F3, F4, and Pz theta were correlated with obsession scores. Interpersonal sensitivity scores were found to be correlated with F4 delta, P3, T5, P4, T6 alpha and T5, and T6 theta activities. While depression scores were correlated with P3 and T4 delta, as well as T4 theta, there was a correlation between anger and F4, as well as T4 alpha and F8 high beta activities. Paranoia scores are correlated with FP1, F7, T6 and F8 theta, T5 and F8 delta, and O2 high beta activities.ConclusionsAccording to our results, anxiety, obsession, interpersonal sensitivity, depression, anger, and paranoia are related to some spectral powers of QEEG. Delta-beta coupling seems to be a neural biomarker for affective dysregulation.

Symptoms of Affective Register as an Onset of Mental Disorders in Adolescents

Background: mental disorders of different origin often begin with affective symptoms. The inuence of adolescence is recognized and concerns psychopathological manifestations following diagnostics difculties. The aim of the study was to investigate the structure of mental disorders with symptoms of affective disorder in adolescents rstly admitted for psychiatric advice. Patients and method: the study involved 120 adolescents (aged 17.1 ± 2.37) who became patients of the psychoneurological dispensary for the rst time in 2020–2021 due to affective register symptoms. The clinical, psychopathological and statistical methods were used in the study. Results: all respondents had initial symptoms before seeking psychiatric help, the average age of occurrence of which was 14.5 ± 33.18 years. Among the initial manifestations, a decrease in mood, irritability, and emotional lability predominated. Symptoms detected at the initial stage, persisted until the moment of seeking psychiatric help, and were the cause of the violation of social adaptation: a decrease in academic performance in 52 cases (42.28%), school absences in 44 patients (35.77%), narrowing of the range of interests in 17 (13.82%) and conicts in 11 (8.94%) cases. At the same time, psychopathological symptoms noticed by the adolescents themselves and their parents were not a reason to seek help and, in most cases, were considered as manifestations of the puberty crisis. At the rst request of teenagers for psychiatric help, mood disorders (F30–F39) — 48,5%, neurotic, stress-related and somatoform disorders (F40–F49) — 25% dominated in the structure of diagnoses, according to ICD-10. Conclusions: mental disorders, including affective pathology, debuting in adolescence, can have a prodromal period and be often misinterpreted as a puberty crisis. The symptoms of affective disorder in adolescence differ in polymorphism and can lead to a variety of diagnoses. Underestimation of initial preclinical manifestations of affective pathology, despite signicant difculties in social adaptation, can result in untimely therapeutic intervention, severe clinical manifestations and conversion of the diseases into a chronic course. The obtained data conrm the need for a thorough differential diagnosis of initial manifestations of mental disorders, subsequent clinical and follow up care and proper treatment.

Effect of Medical Marijuana Card Ownership on Pain, Insomnia, and Affective Disorder Symptoms in Adults

Despite the legalization and widespread use of cannabis products for a variety of medical concerns in the US, there is not yet a strong clinical literature to support such use. The risks and benefits of obtaining a medical marijuana card for common clinical outcomes are largely unknown. To evaluate the effect of obtaining a medical marijuana card on target clinical and cannabis use disorder (CUD) symptoms in adults with a chief concern of chronic pain, insomnia, or anxiety or depressive symptoms. This pragmatic, single-site, single-blind randomized clinical trial was conducted in the Greater Boston area from July 1, 2017, to July 31, 2020. Participants were adults aged 18 to 65 years with a chief concern of pain, insomnia, or anxiety or depressive symptoms. Participants were randomized 2:1 to either the immediate card acquisition group (n = 105) or the delayed card acquisition group (n = 81). Randomization was stratified by chief concern, age, and sex. The statistical analysis followed an evaluable population approach. The immediate card acquisition group was allowed to obtain a medical marijuana card immediately after randomization. The delayed card acquisition group was asked to wait 12 weeks before obtaining a medical marijuana card. All participants could choose cannabis products from a dispensary, the dose, and the frequency of use. Participants could continue their usual medical or psychiatric care. Primary outcomes were changes in CUD symptoms, anxiety and depressive symptoms, pain severity, and insomnia symptoms during the trial. A logistic regression model was used to estimate the odds ratio (OR) for CUD diagnosis, and linear models were used for continuous outcomes to estimate the mean difference (MD) in symptom scores. A total of 186 participants (mean [SD] age 37.2 [14.4] years; 122 women [65.6%]) were randomized and included in the analyses. Compared with the delayed card acquisition group, the immediate card acquisition group had more CUD symptoms (MD, 0.28; 95% CI, 0.15-0.40; P < .001); fewer self-rated insomnia symptoms (MD, -2.90; 95% CI, -4.31 to -1.51; P < .001); and reported no significant changes in pain severity or anxiety or depressive symptoms. Participants in the immediate card acquisition group also had a higher incidence of CUD during the intervention (17.1% [n = 18] in the immediate card acquisition group vs 8.6% [n = 7] in the delayed card acquisition group; adjusted odds ratio, 2.88; 95% CI, 1.17-7.07; P = .02), particularly those with a chief concern of anxiety or depressive symptoms. This randomized clinical trial found that immediate acquisition of a medical marijuana card led to a higher incidence and severity of CUD; resulted in no significant improvement in pain, anxiety, or depressive symptoms; and improved self-rating of insomnia symptoms. Further investigation of the benefits of medical marijuana card ownership for insomnia and the risk of CUD are needed, particularly for individuals with anxiety or depressive symptoms. ClinicalTrials.gov Identifier: NCT03224468.