Bipolar Affective Disorder Research Articles

Use of antiepileptic drugs in mental disorders

Antiepileptic drugs (AEDs) are quite often used in psychiatric practice and are considered the drugs of choice for mental disorders, primarily recurrent and bipolar depression and mania, behavioral and anxiety disorders with signs of bipolar emotional dysregulation, mental disorders with dependence on psychoactive substances. The level of evidence for the use of AEDs varies, sometimes they are used outside the recommendations of the FDA, EMA, outside the instructions of the Pharmcenter of Ukraine. Currently, mood stabilizers such as valproate, lamotrigine, carbamazepine have the highest level of evidence. Most psychotropic drugs are recommended for use in the treatment of affective disorders (antipsychotics, antidepressants, lithium salts) and attention deficit hyperactivity disorders (psychostimulants, atomoxetine) from the age of 6, which explains the widespread use of valproate and lamotrigine in pediatric practice outside direct indications. Bipolar affective disorders have a high level of comorbidity with generalized anxiety and panic disorder, which sometimes demonstrate low sensitivity to benzodiazepine therapy, but respond well to valproic acid salt therapy. The use of gabapentin in anxiety disorders is based on the results of controlled studies. Anticonvulsants are widely used in alcohol and substance abuse, addictive disorders, emotional and behavioral disorders associated with withdrawal states. The therapeutic and side effects of AEDs are closely related to behavioral disorders in epilepsy. They can improve or worsen behavioral symptoms associated with signs of emotional bipolar dysregulation and attention deficit hyperactivity disorder. It is expected that the list of AEDs will continue to grow, and new proposals for use in psychiatric practice will appear.

Neurological Soft Signs in Type I Bipolar Disorder and Bipolar Spectrum Patients and Their Unaffected First‐Degree Relatives: A Cross‐Sectional Study

ABSTRACTBackground and AimsThis study aimed to compare neurological soft signs (NSSs) in type 1 bipolar disorder (BD), bipolar spectrum (BS) patients, and their unaffected first‐degree relatives.MethodsThis descriptive cross‐sectional study involved participants referred to the Psychiatric Department of Imam Hossein Hospital. Five groups (n = 25): patients with type 1 BD, patients with BS, unaffected first‐degree relatives of the two groups, and a control group were evaluated using the Neurological Evaluation Scale (NES).ResultsThe analysis revealed that patients with bipolar I disorder had the highest NES scores, with significant group differences (F(4.120) = 10.36, p < 0.001). The Bonferroni correction identified bipolar I patients as the primary source of this difference, while other groups did not significantly differ. ANCOVA showed that age (F(1.123) = 3.92, p = 0.052) and gender (F(1.123) = 0.1, p = 0.75) had no significant influence on NES scores. However, all four NES subsets significantly contributed to the overall score, except for the sensory subset. Differences were significant between bipolar I patients and most other groups, except the BS group, which showed no significant differences from the rest. No correlation was found with age, gender, or age of disease onset.ConclusionThe higher NSS severity in type I BD compared to BS and control groups highlights its potential link to the genetic and neurodevelopmental differences in BD type I. Further research is recommended.

Are indicated prevention and effective early intervention achievable goals for youth with bipolar mood disorders?

Compared with other areas of mental health research that are focused on the active and early management of youth presenting in the early stages of major mental disorders, there has been a relative lack of focus on young people with emerging or established bipolar disorders. Recently, this has stimulated both international professional societies (e.g., International Society for Bipolar Disorders [ISBD] Early Intervention Task Force) and funding agencies from Canada, UK, Australia, and the USA – including the Daymark Foundation (Jain et al. 2023), Wellcome Trust (2022), National Health and Medical Research Council, and BD2 – to promote a focus on identifying the major challenges in this field and gathering support for novel research and clinical service programmes.

Electroconvulsive Therapy - History and Current Use in Psychiatry: A Literature Review

Despite the numerous controversies associated with electroconvulsive therapy, in its favor is the relatively low number of contraindications, side effects and high level of safety. Purpose: The purpose of the publication was to collect and organize information on the use of electroconvulsive therapy in psychiatry and its effectiveness in specific disease entities, such as depression, schizophrenia, bipolar affective disorder and PTSD. Methods: A literature review was conducted using PubMed and Google Scholar containing information on the use of ECT in psychiatry. The search focused on the words electroconvulsive therapy, ECT, schizophrenia, depression, PTSD, bipolar affective disorder. Priority was given to using recent articles. Results: According to the most reliable sources, electroconvulsive therapy has a beneficial therapeutic effect in patients with depression, PTSD, schizophrenia and bipolar affective disorder. Conclusions: Due to the commonness of mental illnesses and the co-occurring resistance to pharmacological treatment, modern psychiatry is looking for alternative methods. One of them is electroconvulsive therapy, which has undergone modifications over time and is today considered a method with a high safety profile. Beneficial effects of the use of ECT can be observed in patients with bipolar disorder, schizophrenia and depression, and research on its effectiveness in the case of PTSD is still ongoing. ECT can be used in pregnant women, in patients with treatment-resistant depression and at high risk of suicide.

Long-term courses of bipolar disorders

Bipolar disorder (short: BD) is asevere illness with very heterogeneous trajectories. While some of the patients show no or hardly any long-term impairments, other affected individuals show substantial neurocognitive deficits with aclear decline in psychosocial functioning. Which factors influence the course of the disease is the subject of current research efforts. This review presents the long-term course of bipolar disease and the factors influencing it. In particular, differential trajectory types are discussed. The cognitive and psychosocial functional level as well as the psychopathological characteristics of the disease are elucidated. In addition, biological factors and treatment approaches influencing the course and prognosis are identified. Literature search using PubMed focusing on longitudinal studies over several years (see online supplement). To date, there are only a few predictors and biomarkers that allow prediction of long-term progression. None have been sufficiently studied to enable clinical use. Appropriate pharmacological and psychotherapeutic treatment of those affected is essential to avoid renewed episodes of the disease. The long-term course of bipolar disorder is highly heterogeneous and multifaceted. Despite intensive research efforts, no predictors have yet been identified that reliably predict the clinical course. This makes further research all the more important in order to offer individualized therapy options, develop new therapies and positively influence the course of the disease at an early stage.

Exploring autism spectrum disorder and co-occurring trait associations to elucidate multivariate genetic mechanisms and insights

BackgroundAutism spectrum disorder (ASD) is a partially heritable neurodevelopmental trait, and people with ASD may also have other co-occurring trait such as ADHD, anxiety disorders, depression, mental health issues, learning difficulty, physical health traits and communication challenges. The concomitant development of ASD and other neurological traits is assumed to result from a complex interplay between genetics and the environment. However, only a limited number of studies have performed multivariate genome-wide association studies (GWAS) for ASD.MethodsWe conducted to-date the largest multivariate GWAS on ASD and 8 ASD co-occurring traits (ADHD, ADHD childhood, anxiety stress (ASDR), bipolar (BIP), disruptive behaviour (DBD), educational attainment (EA), major depression, and schizophrenia (SCZ)) using summary statistics from leading studies. Multivariate associations and central traits were further identified. Subsequently, colocalization and Mendelian randomization (MR) analysis were performed on the associations identified with the central traits containing ASD. To further validate our findings, pathway and quantified trait loci (QTL) resources as well as independent datasets consisting of 112 (45 probands) whole genome sequence data from the GEMMA project were utilized.ResultsMultivariate GWAS resulted in 637 significant associations (p < 5e-8), among which 322 are reported for the first time for any trait. 37 SNPs were identified to contain ASD and one or more traits in their central trait set, including variants mapped to known SFARI ASD genes MAPT, CADPS and NEGR1 as well as novel ASD genes KANSL1, NSF and NTM, associated with immune response, synaptic transmission, and neurite growth respectively. Mendelian randomization analyses found that genetic liability for ADHD childhood, ASRD and DBT has causal effects on the risk of ASD while genetic liability for ASD has causal effects on the risk of ADHD, ADHD childhood, BIP, WA, MDD and SCZ. Frequency differences of SNPs found in NTM and CADPS genes, respectively associated with neurite growth and neural/endocrine calcium regulation, were found between GEMMA ASD probands and controls. Pathway, QTL and cell type enrichment implicated microbiome, enteric inflammation, and central nervous system enrichments.ConclusionsOur study, combining multivariate GWAS with systematic decomposition, identified novel genetic associations related to ASD and ASD co-occurring driver traits. Statistical tests were applied to discern evidence for shared and interpretable liability between ASD and co-occurring traits. These findings expand upon the current understanding of the complex genetics regulating ASD and reveal insights of neuronal brain disruptions potentially driving development and manifestation.

Features of mental state and reproductive function in dynamics inmentally ill women with infertility

Women suffering from a mental disorder are faced with the problem of pregnancy and the realisation of their reproductive rights throughout their lives. The presence of a mental disorder largely determines the onset, course and outcome of pregnancy. A deterioration in mental health is often accompanied by an impairment of menstrual and reproductive function, and an improvement contributes to their recovery.Objective: to analyse individual indicators of reproductive function in women with various mental disorders and infertility in dynamics according to the follow-up data.Material and methods. The study included 120 women with various mental disorders and infertility, who were observed for 2 years by a psychiatrist and a gynaecologist on the background of treatment of the existing disorders.Results. In 70% of cases, mentally ill women have primary infertility, with idiopathic infertility predominating (63.3%), especially in the context of secondary infertility (77.8%; p&lt;0.05). Treatment of infertility by gynaecologists and mental disorders by psychiatrists leads to the normalization of the menstrual cycle and the onset of pregnancy. Pregnancy is usually accompanied by obstetric and somatic complications (fetal growth retardation and miscarriage, placental disorders, hypertension, oedema, lipid metabolism disorders, gestational diabetes mellitus). Reproductive function is impaired mostly in patients with schizophrenia and affective disorders, they account for 80.8% of observed infertility. Fertility is lowest in patients with paranoid schizophrenia: pregnancy occurred in 12.9% of patients, none of them gave birth. In schizoaffective disorder, 43.75% of women became pregnant, but only 20% gave birth. In bipolar affective disorder (BAD) type I, pregnancy occurred in 87.5% of patients (of which 57.1% resulted in a childbirth), in bipolar disorder type II – in 43.75% (of which 42.8% resulted in a childbirth), and in recurrent depressive disorder – in 60% (of which 50% resulted in a childbirth). In these disorders, the duration of infertility correlates with the duration of the disease (p&lt;0.05). In neurotic disorders, fertility suffers to a lesser extent: pregnancy with recovery or significant improvement of the mental condition occurred in 75–100% of cases, but only 66.7% of cases resulted in a child birth. Childbirth was mainly performed by caesarean section.Conclusion. Reproductive function in mentally ill women depends largely on the type of mental disorder, the characteristics of its course, the efficacy of psychopharmacotherapy, the quality of remission and the degree of social and family adaptation, which must be taken into account in the diagnosis and treatment of infertility.

Anti-Neural Autoantibodies Associated with Major Depressive and Bipolar Disorders: Characterization of Psychopathology and Literature Review

Background; Neural autoantibodies in depression are rarely reported, and their prevalence in depression is unknown. Our study was therefore dedicated to analyzing the frequency of neural autoantibodies in a cohort of patients presenting mood disorders. In addition, the study served to describe the clinical psychopathology of the patients with depressive disorders and neural autoantibodies. Methods; We retrospectively examined a cohort of 41 patients with major depressive disorder and bipolar affective disorder. Patient files were evaluated for clinical data, psychopathological assessment, as well as magnetic resonance imaging (MRI), electroencephalography (EEG), cerebrospinal fluid analysis findings and serum and/or cerebrospinal fluid (CSF) neural autoantibodies. Results; Our study revealed neural autoantibodies in of 6 of 41 (14%) of patients with mood disorders suspicious for an underlying organic cause. CSF autoantibodies were verified in 3 of 41 (7%) patients with mood disorders. No differences between antibody-positive and -negative mood disorder patients were identified regarding psychiatric syndromes or CSF, EEG, MRI and psychopathological parameters. However, mood-disorder patients with autoantibodies revealed less loss of drive than those mood disorder patients without autoantibodies. Conclusions; Our findings indicate that a minority of mood disorders might be associated with neural autoantibodies. The proof of CSF autoantibodies in three of six autoantibody-positive patients suggests highly likely paraneoplastic or autoantibody-mediated autoimmunity. Our study’s novelty is the in-depth phenotyping of autoantibody-positive depressed patients via two different psychometric scoring systems. More research is required to confirm these preliminary results in larger cohorts with more homogeneous patient groups.

The link between endocrine parameters, serum lithium concentrations, and cognitive functions among individuals with affective disorders at risk of suicidal behavior. A study protocol.

Suicidal behavior is prevalent among individuals with mental disorders and constitutes a major global, clinical, and public health concern. It is generally accepted that the majority of persons who die by suicide are suffering from psychiatric disorders in most cases and that affective disorders make up the single commonest group. Suicide risk is highest during the years immediately following the onset of affective disorders; therefore, identifying risk factors and successful treatment of initially non-suicidal individuals with affective disorders can prevent developing suicidal behavior, help detecting, and predict it. Clarifying risk factors for individual types of major affective disorders could enhance earlier identification of suicidal risk, support preventive interventions and improve the treatment and prognosis of individuals at risk. We have developed a study protocol with the aim to address the complex interaction of endocrine parameters, lithium trace concentrations and cognitive functions with affective disorders and risk of suicidal behavior. A cross-sectional study will be done among individuals hospitalized after a suicidal attempt for treatment of affective disorders (group 1), hospitalized for the treatment of affective disorders without life time history of suicidal behavior (group 2), and control group individuals without life time history of mental disorders or suicidal behavior (group 3). Based on this study design we calculated the appropriate study sample size (N = 210). Venous blood samples of study participants will be collected for the evaluation of endocrine parameters, serum lithium concentrations, liver and kidney function. Data on sociodemographic factors, cognitive functions, history of mental disorders, and suicidality risk will be evaluated using validated questionnaires and instruments. Associations of endocrine parameters, serum lithium concentrations, cognitive functions, and suicidality risk will be analyzed using descriptive and inferential statistics, including linear and logistic regression. Based on this study design we calculated the appropriate study sample size (N = 210). Power analysis has shown that this sample size is appropriate for detection of significant differences between the groups. The findings of the potential influence of the associations between serum lithium trace concentrations, endocrine parameters, and cognitive functions on suicidality risk in individuals with affective disorders may help clinicians effectively plan suicide prevention and timely implement actions for treatment.

Probabilistic diagnosis of bipolar affective disorder: possibilities and limitations (literature review)

The literature review presents the main modern data on the epidemiology and socio-economic significance of bipolar affective disorder (BD), discusses the difficulties of early diagnosis of bipolar spectrum disorders, predictors of the bipolar course of affective disorders and a probabilistic approach to the diagnosis of BD, discusses controversial issues in the diagnosis of mixed affective states, the use of potential biomarkers both for the diagnosis of bipolar disorder and for the differential diagnosis of unipolar and bipolar depression, as well as possible therapeutic approaches for the probabilistic diagnosis of bipolar disorder.

Evaluating changes in recovery in people living with severe and persistent mental illness after psychiatric rehabilitation services at Moi Teaching and Referral Hospital, Eldoret, Kenya.

People living with severe and persistent mental illness (SPMI) in Kenya lack access to recovery-based services. In this study, we assessed changes in recovery in people living with SPMI in Kenya 6 months after receiving services at the Moi Teaching and Referral Hospital Nawiri Recovery and Skills Centre (Nawiri). A retrospective evaluation was conducted using a pretest/posttest design analyzing Nawiri care program data collected on admission and 6 months after discharge for recovery metrics. Thirty patients, with an average age of 33 years and of whom 57% are female, met criteria for the study, with the most common mental diagnoses being schizophrenia (60%) and bipolar mood disorder (30%); 76% of participants met the definition of extreme poverty and had a median of two psychiatric admissions in the 12 months before admission. Patients improved significantly on recovery outcomes 6 months after receiving care at Nawiri, including decreased psychiatric hospitalizations (from 1.33 to 0.07), improved rates of independence in life skills (75.9%-96.7%), improved engagement in income generating activities (23.3%-63.3%), improved food security (69.0%-96.7%), decreased days of functional impairment from symptoms (3.7 to 1.7 days in past week), decreased substance use (53.3%-13.8%), and improved engagement in outpatient mental health care (50.0%-93.3%). People living with SPMI had improved recovery 6 months after receiving residential psychiatric rehabilitation services in western Kenya. A more robust evaluation of program effectiveness and implementation is recommended to help explore generalizability and scalability to other resource limited settings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Experiences and subjective transformations: suffering and coercion in the use of psychotropic drugs in psychiatric treatment in Chile

This article analyzes the impact of psychotropic drug use on individuals diagnosed with schizophrenia, bipolar affective disorder, and severe depression in Chile. Using a qualitative narrative approach, the experiences of 25 patients from 2018 to 2021 are examined. Participants describe how these medications, while effective in symptom control, generate psychological suffering and a sense of coercion in daily life. The results reveal that prolonged use of psychotropic drugs leads to significant side effects, including physical, cognitive, and social deterioration, as well as a persistent sense of dependence on these medications. Furthermore, the article critiques the medicalization of mental disorders within modern psychiatry, where the biomedical approach predominates, reducing human distress to a neurochemical problem and disregarding social factors. The study concludes that while psychotropic drugs can stabilize patients, they also perpetuate forms of control and suffering.

Examining the Attitudes and Experiences of Nurses Working in a High Security Forensic Psychiatry Unit from a Psychiatric Perspective

Aim: This study aims to examine the approaches, attitudes, and experiences of nurses working in a High Security Forensic Psychiatry Unit (HSFPU) towards psychiatric disorders, conditions, and treatments and to reveal the associated factors. Material and Method: This cross-sectional study was conducted with nurses working at Elazığ Fethi Sekin City Hospital HSFPU who agreed to participate in the study. The participants filled out the Nurses’ Attitudes Towards Forensic Psychiatric Patients Scale (NAFPPS) along with a questionnaire including various variables. Results: Thirty-two nurses (22 females (68.80%), 10 males (31.20%)) were included in the study. Twenty-two nurses (31.20%) did not have sufficient knowledge of the Penal Code of Türkiye 32 (PCT 32). The psychiatric disorder that nurses found easiest to predict was bipolar spectrum disorder (43.80%), while the one that nurses found most difficult to predict was schizophrenia spectrum disorder (62.50%). The illicit substance that caused the most difficulty in nursing care was methamphetamine for 19 nurses (59.40%). Nurses' command of psychiatric terminology was not at the desired level. Twenty-three nurses (71.90%) thought that antidepressants caused addiction. Almost all of the nurses (96.90%) thought that antisocial and borderline personality traits make nursing care difficult. According to regression analysis, working duration in HFSPU predicts NAFPPS willingness to provide care subscale (constant p

Psychiatric Disorders and Cognitive Fluctuations in Parkinson's Disease: Changing Approaches in the First Decades of the 21st Century.

Parkinson's Disease (PD) is a multifaceted neurodegenerative disorder characterized, in addition to the well-recognized motor disturbances, by a complex interplay between cognitive and psychiatric manifestations. We dissect the complex landscape of PD-related psychiatric symptoms, taking into account the impact of functional neurological disorders, somatic delusions, impulse control disorders, and conditions within the bipolar spectrum. The newer entities of somatoform and functional neurological disorders, as well as preexisting bipolar spectrum disorders, are analyzed in detail. Moreover, we emphasize the need for a holistic understanding of PD, wherein the cognitive and psychiatric dimensions are valued alongside motor symptoms. Such an approach aims to facilitate early detection and personalized interventions, and enhance the overall quality of life for individuals suffering from this neurodegenerative disorder.

Model-informed precision dosing of quetiapine in bipolar affective disorder patients: initial dose recommendation.

Bipolar affective disorder (BAD) is a mood disorder with high morbidity and mortality. Quetiapine can be used in the treatment of patients with BAD; however, the precise administration regimen of quetiapine in these patients is still unknown. In this study, a population pharmacokinetic (PPK) model of quetiapine in patients with BAD was constructed based on model-informed precision dosing (MIPD) and real-world clinical data and an optimal initial dose of quetiapine in these patients was recommended. A total of 99 patients with BAD treated with quetiapine were included. At the same time, the quetiapine concentrations, the physical and chemical indices of the patients, and the drug combination information were collected. A quetiapine PPK model for patients with BAD was then constructed and an initial dose based on Monte Carlo simulation was recommended. In the final model of quetiapine for patients with BAD, the apparent oral clearance (CL/F) and the apparent volume of distribution (V/F) were 76.1 L/h and 530 L, respectively. For patients with BAD weighing 40-66 kg, the initial dose recommendation was 16 mg kg-1 day-1, the probability of reaching the therapeutic window was 78.8%-82.2%, and the probability of exceeding the upper limit of the therapeutic window was 5.2%-10.3%. For patients with BAD weighing 66-120 kg, the initial dose recommendation was 12 mg kg-1 day-1, the probability of reaching the therapeutic window was 81.5%-85.5%, and the probability of exceeding the upper limit of the therapeutic window was 3.6%-8.1%. The present study, for the first time, recommended an initial dose of quetiapine in patients with BAD based on MIPD and real-world data, providing an individualized reference for the administration of quetiapine in these patients.

Use of sodium valproate and other antiseizure drug treatments in England and Wales: quantitative analysis of nationwide linked electronic health records

ObjectiveTo investigate the use of sodium valproate in England and Wales, including during pregnancy, compared with other antiseizure drug treatments, based on national level electronic health records.DesignQuantitative analysis of nationwide...

Perceived Effectiveness of a Positive Thinking Training Course on Professional Identity: Reconciliation of Bipolar English as a Foreign Language Teachers with Positive Thinking

Objectives: About 5% of the world’s population suffer from bipolar disorder. These people, in general, and teachers in particular, have many personal, social, and working problems. Different approaches, such as positive thinking, have been suggested to cope with such issues. Moreover, professional identity, similar to general identity, has been applied in various ways in teacher and instructor training. Using a basic interpretive design, we explored perceptions of English foreign language (EFL) teachers with bipolar disorder and the effectiveness of a training course on positive thinking on their professional identity. Methods: The participants consisted of 25 (16 males and 9 females) bipolar EFL teachers who were purposefully selected from EFL teachers teaching in private language institutes in Kerman City, Iran. A bipolar spectrum diagnostic scale and a semi-structured interview were used to collect the study data. Also, a positive thinking training course was developed to be administered in ten 60-minute sessions. Results: Regarding the effectiveness of the positive thinking training course on professional identity, the output of a thematic analysis of the interviews conducted with bipolar EFL teachers were as follows: Improvement in communicative and motivational skills, enhancement of willingness to reach professional development and classroom management skills, working on English language proficiency, seeking the best teaching methods, attention to students’ needs, enhancement of verbal skills, and reducing teaching fear. Discussion: The research results help people participate in bipolar tests and psychological studies and strive for their mental health. It will also create a spirit of hope in patients. The findings have some implications for EFL teacher education administrators and bipolar EFL teachers. Training on positive thinking skills can contribute to positive changes and orientations in EFL bipolar teachers, reconstructing their professional identity.

Development and validation of a neuroticism scale: Assessment of reliability and validity

Neuroticism, a personality trait linked to emotional instability and negative emotions, is associated with increased anxiety, depression, and poor mental health outcomes, particularly in individuals with psychiatric disorders. However, existing neuroticism scales often have too many items, are not tailored for psychiatric populations, and lack cultural adaptation for Chinese contexts. We aimed to develop a brief neuroticism scale with adequate reliability and validity for the Chinese population, including individuals with psychiatric disorders. The 14-item scale was developed based on the five-factor model and Eysenck&amp;rsquo;s personality theory. The scale, in the form of a questionnaire, was distributed to college students from Southeast University and patients from the Affiliated Zhongda Hospital of Southeast University. A total of 554 participants were recruited, and demographic information, the neurotic subscale of the Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI), Patient Health Questionnaire (PHQ-9), and generalized anxiety disorder (GAD-7) were collected along with the neuroticism scale. Correlation analysis, Cronbach&amp;rsquo;s alpha, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were conducted to test and revise the scale. EFA indicated that the neuroticism scale consisted of four factors: Low self-esteem, excessive emotional sensitivity, unstable mood, and excessive worry. The Cronbach&amp;rsquo;s alpha was 0.926. CFA suggested a good fit of the scale structure (&amp;chi;2/df =2.506, root mean square error of approximation =0.039, Tucker&amp;ndash;Lewis index =0.947, comparative fit index =0.959, and standardized root mean square residual =0.032). The total scores of the neuroticism scale were positively related to those of PHQ-9, GAD-7, and NEO-FFI. The results indicate that the neuroticism scale exhibited a stable four-dimensional structure with good reliability and validity in the Chinese population. It is useful and time-saving for assessing neuroticism in individuals with psychiatric disorders.

The relationship between climate change and mental health: a systematic review of the association between eco-anxiety, psychological distress, and symptoms of major affective disorders

Background and objectivesThe adverse impacts of climate change on mental health is a burgeoning area, although findings are inconsistent. The emerging concept of eco-anxiety represents distress in relation to climate change and may be related to mental health. The aim of this study was to explore the relationship between eco-anxiety with validated mental health outcomes, specifically psychological distress and symptoms of major affective disorders.DesignSystematic review.MethodsEBSCO, ProQuest, and Web of Science databases were searched to February 2024 for studies of adult samples quantifying eco-anxiety (exposure, i.e. fear, worry or anxiety in relation to climate change) and symptoms of psychological distress and major affective disorders (outcomes), as assessed by validated measures.ResultsFull text review of 83 studies was performed, and k = 35 studies were included in the review (N = 45 667, 61% female, Mage 31.2 years). Consistently, eco-anxiety showed small to large positive correlations with mental health outcomes of psychological distress, depression symptoms, anxiety symptoms, and stress symptoms. However, results regarding post-traumatic stress disorder symptoms and pathological worry were mixed. Stronger associations were observed where eco-anxiety was operationalised as ‘anxiety’ rather than ‘worry’.ConclusionsFindings underscore that eco-anxiety is related to psychological burden. Greater consideration of eco-anxiety in assessment and treatment is needed in clinical practice and further policy development is warranted at the intersection of climate and health to address the mental health challenges posed by climate change.

Adverse psychiatric effects of psychedelic drugs: a systematic review of case reports.

Psychedelic drugs are a focus of interest in the treatment of depression and other disorders but there are longstanding concerns about possible adverse psychiatric consequences. Because the relevant literature is largely informal, the seriousness of these risks is difficult to evaluate. Searches were made for case reports of schizophrenia-spectrum, affective or other psychiatric disorders after use of psychedelic drugs. Case reports of flashbacks were also searched for. Individuals with recent use of other drugs (apart from cannabis and alcohol) and/or a previous history of major psychiatric disorder were excluded. Symptoms were tabulated using the Syndrome Check List of the Present State Examination (PSE-9). We found 17 case reports of schizophrenia spectrum disorder, 17 of affective disorder (depression, mania, or both), 3 cases of anxiety, 1 of depersonalization, and 1 of unclassifiable illness. The states could develop after a single use of the drug (5/17 schizophrenia; 6/17 affective disorder), and duration was highly variable. Recovery was the rule in cases of affective disorder but not in schizophrenia spectrum disorder. Twelve of 29 cases of flashbacks showed psychiatric symptomatology definitely outlasting the attacks, mainly anxiety (5 cases) and depression (8 cases). Flashback symptoms resolved within twelve months in approximately half of the cases but in a few persisted for years. Reliable descriptions of schizophrenia spectrum disorder and major affective disorder after psychedelic drug use disorder exist but are relatively uncommon. Flashbacks are sometimes but not always associated with psychiatric symptomatology, mainly anxiety or depression.