Clinical Interview Research Articles

Vision transformer and complex network analysis for autism spectrum disorder classification in T1 structural MRI.

Autism spectrum disorder (ASD) affects social interaction, communication, and behavior. Early diagnosis is important as it enables timely intervention that can significantly improve long-term outcomes, but current diagnostic, which rely heavily on behavioral observations and clinical interviews, are often subjective and time-consuming. This study introduces an AI-based approach that uses T1-weighted structural MRI (sMRI) scans, network analysis, and vision transformers to automatically diagnose ASD. sMRI data from 79 ASD patients and 105 healthy controls were obtained from the Autism Brain Imaging Data Exchange (ABIDE) database. Complex network analysis (CNA) features and ViT (Vision Transformer) features were developed for predicting ASD. Five models were developed for each type of features: logistic regression, support vector machine (SVM), gradient boosting (GB), K-nearest neighbors (KNN), and neural network (NN). 25 models were further developed by federating the two sets of 5 models. Model performance was evaluated using accuracy, area under the receiver operating characteristic curve (AUC-ROC), sensitivity, and specificity via fivefold cross-validation. The federate model CNA(KNN)-ViT(NN) achieved highest performance, with accuracy 0.951 ± 0.067, AUC-ROC 0.980 ± 0.020, sensitivity 0.963 ± 0.050, and specificity 0.943 ± 0.047. The performance of the ViT-based models exceeds that of the complex network-based models on 80% of the performance metrics. By federating CNA models, the ViT models can achieve better performance. This study demonstrates the feasibility of using CNA and ViT models for the automated diagnosis of ASD. The proposed CNA(KNN)-ViT(NN) model achieved better accuracy in ASD classification based solely on T1 sMRI images. The proposed method's reliance on widely available T1 sMRI scans highlights its potential for integration into routine clinical examinations, facilitating more efficient and accessible ASD screening.

Esthetic and Functional Restorative Management with Composite Resin Veneers in a Patient with Bruxism: A Case Report

A 40-year-old male patient presented with multiple fractures and failures in direct composite restorations on his maxillary anterior teeth, associated with nocturnal bruxism. He sought care at the clinical training facility of the Professional Master’s Program in Dentistry at the University of Fortaleza. Clinical examination, patient interview, and photographic documentation confirmed esthetic compromise and functional instability due to failed restorations. These were removed and replaced with direct composite resin veneers, following strict adhesive, insertion, polymerization, and polishing protocols. To manage the underlying parafunctional habit, a 2 mm-thick acrylic stabilizing occlusal splint was fabricated and delivered, along with occlusal adjustments on the teeth, restorations, and splint. In this case, nocturnal bruxism was considered the primary contributing factor to the repeated restorative failure, emphasizing the need for a multidisciplinary approach. Based on the treatment strategy applied and its outcomes, a clinical management suggestion is presented to support conservative esthetic and functional rehabilitation in similar cases.

<b>EVALUATING THE IMPACT OF MODERN ANTI-DIABETIC DRUGS ON SURVIVAL OUTCOMES IN LUNG CANCER PATIENTS WITH TYPE 2 DIABETES</b>

With coexisting type 2 diabetes mellitus (T2DM) progressively understood as a variable affecting prognosis, lung cancer still ranks among the top causes of cancer-related death globally. Modern antidiabetic medications SGLT2 inhibitors, DPP4 inhibitors, and GLP1 receptor agonists have shown pleiotropic effects beyond glycemic control, therefore research on their involvement in cancer outcomes is under progress. In 150 lung cancer patients with T2DM, this cross sectional study examined the effect of contemporary antidiabetic medications on survival results. Structured clinical data and patient interviews were used to gather data over six months in tertiary hospitals. Statistical analysis with logistic regression and chisquare tests revealed (p < 0.05) that patients on contemporary antidiabetic medications showed considerably better survival trends than those on traditional therapies. These results promote the inclusion of modern diabetic management into oncological therapy for diabetic lung cancer patients.

Students’ mathematics conceptual challenges: Exploring students’ thinking, understanding, and misconceptions in functions and graphs

Functions and graphs are fundamental mathematical concepts in mathematics and are vital to helping students comprehend the relationship between variables and other advanced topics in higher-level mathematics. Research has shown that students continually possess misconceptions and inaccurate thinking about functions and function representations. Function concepts such as variations, covariations, and function notations are challenges students face in conceptualizing function concepts in the classroom. Sources of these misconceptions may stem from the way students think about functions. The contributing factor to this problem is the teaching approaches or methods teachers use in mathematics classrooms, which focus on students demonstrating their skill in solving mathematics problems without helping students develop the conceptual understanding of the mathematics they teach. Although function forms the foundation of understanding higher mathematics, students’ and teachers’ understanding of function concepts appears to be mixed with many misconceptions and wrong assumptions.<br /> The researcher engaged the student in five clinical interview sessions to assess the student’s conceptual understanding of selected topics on functions and graphs. The researcher developed and implemented an instructional intervention to strengthen such understanding. A qualitative research method through clinical interview was used to engage a senior high school student in grade 11 in five one-hour meetings to assess the student’s conceptual understanding of selected topics under functions. Over the five clinical interview sessions, the interviewer engaged the student’s conceptual understanding of topics on functions, such as the meaning of functions, variations, covariations, and function notations.<br /> The researcher developed function assessment questions and validated them by experts for restructuring. All clinical interview sessions were voice recorded and transcribed, and photocopies of the student’s worksheets were collected and analyzed quantitatively to support the results and findings of this study. Findings from the study show that students continually develop procedural competencies over conceptual understanding in the mathematics classroom. The student over-relied on the <i>vertical line test</i> concept to determine whether a graph diagram represents a function. The student’s solutions to the covariation task showed a graphic representation of discrete points with a line drawn through the points to represent a continuous covariation. The designed interventions strengthened the students’ understanding and provided a means of testing/validating assumptions about the function concepts and understanding.

COMORBIDITY OF ANTISOCIAL PERSONALITY DISORDER AND SUBSTANCE USE DISORDER: PATTERNS AND RISK FACTORS IN DEHRADUN

Antisocial Personality Disorder (ASPD) and Substance Use Disorder (SUD) frequently co-occur, leading to severe behavioral, psychological, and social consequences. This study examines the comorbidity patterns and risk factors of ASPD and SUD among individuals receiving treatment in rehabilitation centers, psychiatric clinics, and de-addiction facilities in Dehradun, India. Using a purposive sampling method, 150 participants diagnosed with either or both disorders were assessed through structured clinical interviews and standardized psychological tools. Findings reveal a high prevalence of co-occurring ASPD and SUD, with males (78%) being disproportionately affected. Socioeconomic status, early childhood trauma, and impulsivity emerged as significant risk factors for dual diagnosis. Data analysis indicates a strong correlation between ASPD severity and substance dependency, particularly with alcohol and opioid use. Comparative analysis with previous studies suggests that the local prevalence rates align with national and global trends, highlighting the urgent need for targeted intervention strategies in Dehradun. The study underscores the importance of integrated mental health and substance abuse treatment programs to address comorbidity. It also provides policy recommendations for improving rehabilitation services in India. Future research should focus on longitudinal studies to explore the causal relationship between ASPD and SUD.

Exploring Potential Pathways Linking Childhood Maltreatment and Body Dysmorphic Disorder in Adolescents: A Cross-Sectional Study.

While previous studies have highlighted a link between childhood maltreatment and body dysmorphic disorder (BDD), the psychological mechanisms underlying this association remain unclear-especially during adolescence. This cross-sectional study investigated cognitive, emotional, and behavioral mechanisms associated with BDD in adolescents with a history of childhood maltreatment. Participants included three groups: adolescents with BDD (n = 61), psychiatric controls (n = 68), and healthy controls (n = 70). All participants completed standardized clinical interviews, self-report questionnaires, and behavioral tasks assessing childhood maltreatment, social-cognitive processing, emotion regulation, and cognitive-behavioral control. Compared to psychiatric and healthy controls, adolescents with BDD reported a higher prevalence of emotional abuse and neglect, greater fear of negative evaluation, and more threat-related interpretive biases. They also showed elevated maladaptive schemas and emotion regulation difficulties, increased attention to appearance-related emotional stimuli, and reduced cognitive control and behavioral inhibition. Findings suggest that childhood maltreatment-particularly emotional abuse and neglect-may be associated with cognitive-affective and neurobehavioral vulnerabilities in adolescents with BDD. These results highlight potential targets for early identification and intervention strategies during this sensitive developmental stage.

Scope and Criticality in Telling Family Migration Stories With Data

ABSTRACT We look at how families tell stories about their migration histories with data. Taking a cultural historical approach, we used video analysis methods to examine clinical interviews in which youth and parents together explored socioeconomic data visualizations to answer the question, “What moved my family?.” We provide examples to illustrate how families reflected on personal experiences in relation to power systems, what we term criticality, and expanded the generality of stories to broader social contexts, what we term scope, in data discussions. Our study suggests that family storytelling grounded in data explorations can shape learning personal and broader histories.

All the vista we cannot see: Scenes of wandering in French migrant psychiatry

Abstract These five prose poems engage French migrant psychiatry as an ethnographic object in the scene of wandering. They draw from observations of psychiatric consultations and scenes of migrant life in Paris, following ways homelessness and asylum refusal move through migrant life and clinical encounters. Poem (I) reflects on a clinical interview with a mother separated from her son at the border with Turkey, her protective silence; (II) reprises the colonial present in a searing scene of four lifeless bodies on a traffic junction; in (III), the case of a homeless man nursing a brain injury highlights displacements in the shifts of psychiatric practice between idealism, pragmatism, and complicity with the political order; (IV) exposes gendered power in the therapeutic relation, in the texture of chase and negotiation; (V) details a psychiatrist's work to craft the seeds of hope for a young woman from Congo who has witnessed the killings of all her relatives. The poems question ethnographic knowing in the site of displacement, if knowing might emerge more humanely from the changed relation of an oblique view, and exceed the routing of migrant alterity within political and clinical orthodoxy. This exposes a vista of all we cannot see.

Preschool Big Five Personality Traits Predict Childhood Peer Relationships and BPD but Not MDD in Late Adolescence.

Growing literatures highlight shared childhood predictors for future borderline personality disorder (BPD) and major depressive disorder (MDD). However, few longitudinal studies have examined both BPD and MDD as simultaneous outcomes. Childhood personality traits and poor peer relationships constitute transdiagnostic phenomena that could impact risk for later BPD and MDD. The current study examined whether school-age peer relationships mediated associations between preschool Big Five traits and adolescent BPD and/or MDD. Preschool Big Five traits were assessed through observational coding. School-age peer relationships were assessed via clinical interview, with separate child and parent reports. The Borderline Personality Features Scale for Children measured BPD symptoms in adolescence. The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) measured MDD symptoms in adolescence. Structural equation models with manifest composite variables were performed in a sample (n = 153) from the Preschool Depression Study, a prospective longitudinal study with assessments from preschool through adolescence. Lower preschool conscientiousness predicted adolescent BPD. Lower preschool conscientiousness also predicted poorer school-age peer relationships. In MDD models, preschool agreeableness and conscientiousness predicted better parent-reported school-age peer relationships, but not adolescent MDD. Mediation was not significant in the BPD or MDD models. This study identified preschool conscientiousness as one important factor relating to school-age peer relationships and future BPD, but not MDD. Our findings suggest that these pathways may be unique to BPD development and highlight the need for additional research targeting early personality and peer processes.

Implications of cooccurring ADHD for the cognitive behavioural treatment of anxiety in autistic children.

Childhood mental health conditions commonly cooccur, with potential treatment implications. Autistic children frequently experience anxiety and attention deficit/hyperactivity disorder (ADHD). We investigated the implications of this cooccurrence for Cognitive Behavioural Therapy (CBT), a front-line treatment for anxiety in autistic children. We tested whether (1) ADHD predicts anxiety treatment response, (2) ADHD improves in response to anxiety treatment and (3) ADHD improvement is related to reductions in anxiety. Autistic children with elevated anxiety (N = 167) enrolled in a multisite, randomised controlled trial comparing standard CBT, autism-adapted CBT and treatment as usual. ADHD symptoms and severity were assessed via a parent-report questionnaire and clinical interview, respectively. Linear regressions (questions 1 and 2) and linear mixed models (question 3) were conducted with adjustments for multiple comparisons. Participants meeting diagnostic criteria for ADHD (62%) had greater pretreatment anxiety severity and anxiety-related functional impairment, particularly at school. ADHD did not moderate anxiety response following CBT. Receiving CBT (standard or adapted) predicted reduction in evaluator-rated ADHD severity, but not parent-reported symptoms. Reduction in anxiety severity predicted reduction in ADHD symptoms and severity. Existing CBT programmes are suitable for treating anxiety in autistic children with cooccurring ADHD. Future research should identify mechanisms through which CBT for anxiety also mitigates ADHD, with the aim of improving treatment precision and effectiveness.

Improvement of anxiety in adolescent cancer patients with music therapy treatment

Objective: This randomized controlled trial aimed to evaluate the efficacy of structured music therapy interventions in alleviating anxiety symptoms among adolescent cancer patients through dual neuroendocrine and psychological mechanisms, specifically by modulating serotonin metabolism and enhancing stress adaptation capacities. Methods: Thirty-eight adolescents (aged 12–19 years) diagnosed with cancer-related anxiety disorders were randomly assigned to either a music therapy group (n = 19) receiving biweekly 50-min sessions (24 sessions over 12 weeks) combined with standard care or a control group (n = 19) receiving standard care alone. The multimodal assessment protocol included 1) biochemical markers (serum 5-HT and salivary cortisol levels), 2) standardized psychological instruments (Beck Anxiety Inventory [BAI] and Daily Hassles Questionnaire [DHQ]), and 3) semi-structured clinical interviews. Outcome measures were collected at baseline, post-intervention, and 4-week follow-up. Results: The music therapy group demonstrated significant neuroendocrine improvements compared to controls, with a 28.6% mean increase in 5-HT levels (95% CI 18.4–38.8%, p = 0.007) and a 34.1% reduction in cortisol concentrations (95% CI 25.3–42.9%, p = 0.003) post-intervention. Psychological assessments revealed clinically meaningful reductions in BAI scores and DHQ stress frequency scores. Treatment effects remained stable at follow-up (p > 0.05 for time interaction). No significant changes were observed in control group parameters across measurement periods. Conclusion: Systematic music therapy induces durable anxiolytic effects in adolescent oncology patients through coordinated neurobiological and psychological pathways, suggesting its potential as an adjuvant therapy in pediatric psycho-oncology. The dual modulation of serotoninergic activity and hypothalamic-pituitary-adrenal axis regulation provides mechanistic insights for non-pharmacological anxiety management.

A randomised controlled trial of amygdala fMRI-neurofeedback versus sham-feedback in borderline-personality disorder – systematic literature review and introduction to the BrainSTEADy trial

BackgroundIndividuals with Borderline-Personality Disorder (BPD) experience intensive, unstable negative emotions. Hyperactivity of the amygdala is assumed to drive exaggerated emotional responses in BPD. Functional Magnetic Resonance Imaging (fMRI)-based neurofeedback is an endogenous neuromodulation method intended to address the imbalance of neural circuits and thus holds the potential as a treatment for BPD. Many original articles and meta-analyses show that fMRI-neurofeedback can improve psychiatric symptoms. In contrast, there is a lack of publications that aggregate and evaluate data of the safety of the treatment. Furthermore, evidence on the efficacy of fMRI-neurofeedback for the treatment of BPD is limited. Preliminary evidence suggests that downregulation of amygdala hyperactivation through fMRI-neurofeedback can ameliorate emotion dysregulation. To test this assumption, BrainSTEADy (Brain Signal Training to Enhance Affect Down-regulation), a multi-center clinical trial, is conducted. First, we present a systematic literature review evaluating the safety of fMRI-neurofeedback and assessing clinical performance in BPD. Second, we describe the study protocol of BrainSTEADy.MethodsLiterature research: From 2,609 screened paper abstracts, 758 were identified as potentially relevant. Twenty studies reported adverse events or undesirable side effects. Two papers provided relevant data for the assessment of clinical performance in BPD. BrainSTEADy study protocol: During four sessions, patients will receive graphical fMRI-neurofeedback from their right amygdala or sham-feedback while viewing images with aversive content. The primary endpoint, ‘negative affect intensity’, will be assessed after the last neurofeedback session using Ecological Momentary Assessment (EMA). Secondary endpoints will be assessed after the last neurofeedback session, at 3-month and at 6-month follow-up. This trial is a multi-center, patient- and investigator-blind, randomized, parallel-group superiority study with a planned interim-analysis once half of the recruitment target is met (N = 82).DiscussionAs suggested by literature review, fMRI-neurofeedback is a safe treatment for patients, although future studies should systematically assess and report adverse events. Although fMRI-neurofeedback showed promising effects in BPD, current evidence is limited and calls for a randomized controlled trial such as BrainSTEADy, which aims to test whether amygdala-fMRI-neurofeedback specifically reduces emotion instability in BPD beyond nonspecific benefit. Endpoint measures encompassing EMA, clinical interviews, psychological questionnaires, quality of life, and neuroimaging will enable a comprehensive analysis of effects and mechanisms of neurofeedback treatment.Trial registrationThe study protocol was first posted 2024/10/04 on ClinicalTrials.gov and received the ID NCT06626789.

Exploring Clinicians' and Patients' Acceptance and Utilization of a Digital Solution to Support Individualized Care in Diabetes Specialist Outpatient Care (DigiDiaS): Qualitative Study.

With the increasing prevalence of type 1 diabetes alongside limited health care resources, the need for more sustainable health care services is apparent. Central to ensuring the standard of diabetes care while simultaneously optimizing resource utilization is improved patient-clinician communication and the provision of individualized care. Digital outpatient solutions incorporating patient-reported outcome measures (PROMs) have been introduced in diabetes outpatient care over recent years; however, features and delivery methods differ, and existing studies on their use and perceived clinical value are limited. Furthermore, clinicians' acceptance has been suggested as a key factor in the sustainability of digital solutions. Thus, to support the implementation of digital outpatient solutions perceived as valuable by clinicians and patients, we need more knowledge about how they are accepted and utilized in clinical practice. This study investigates how clinicians and patients with type 1 diabetes accept and utilize a digital outpatient solution to support individualized care in the context of full-scale implementation at a diabetes specialist outpatient clinic. Furthermore, we aim to explore the synchronous interaction between patients and clinicians when they are allowed to prepare through the filling and reviewing of asynchronous PROMs before consultations. This qualitative study uses interpretive description as a methodological approach. The digital outpatient solution features various components, including PROM questionnaires, asynchronous chat, remote consultations, e-learning, and information distribution. Data were collected through semistructured interviews with 10 clinicians and 20 patients with type 1 diabetes and observations of consultations. The data from the patient and clinician interviews (267 A4 pages) were analyzed separately before being jointly analyzed in the context of the findings from the observations (40 A4 pages). Our analysis resulted in the following three main themes that describe the interplay between clinicians' and patients' acceptance, utilization, and perceived clinical value of a digital outpatient solution: (1) clinicians' acceptance of the digital outpatient solution influences patients' acceptance, (2) variations in the use of different features influence the extent of individualized care, and (3) clinicians' and patients' utilization influences perceived care efficiency and quality. Those who demonstrated higher acceptance and more extensive utilization reported that the solution was more valuable in enhancing individualized care efficiency and quality. This study highlights the interplay between clinicians' and patients' acceptance, utilization, and perceived clinical value of a digital outpatient solution in diabetes specialist outpatient care. Our findings suggest that when clinicians and patients understand why and how digital solutions are used, such solutions can enhance care efficiency and quality, contributing to sustainable health care. Future research should aim to gain an in-depth understanding of clinicians' and patients' acceptance, as well as the effectiveness of change management strategies when implementing digital outpatient solutions in diabetes specialist outpatient care.

Validating the Traditional Chinese version of the Epilepsy Anxiety Survey Instrument (EASI) in Hong Kong

BackgroundAnxiety disorders are common and have a substantial impact on people with epilepsy (PWE). However, they often go under-recognized. In recent years, epilepsy-specific anxiety has gained increasing attention in the literature. To improve mental health care for people with epilepsy (PWE), we developed and validated the traditional Chinese versions of the Epilepsy Anxiety Survey Instrument (EASI) and its brief screener (brEASI) among PWE in Hong Kong.MethodWe developed the TC-EASI through forward and backward translation, followed by a review by an expert panel and a focus group. We tested the instrument among PWE aged 18 years and older using the Chinese Bilingual version of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (CB-SCID), which is the gold standard for diagnosing anxiety disorders. We examined the internal consistency and the test-retest reliability of the TC-EASI and TC-brEASI. We performed confirmatory factor analysis (CFA) to assess the factor structure of the TC-EASI. We also examined convergent and divergent validity using the Generalized Anxiety Disorder 7-item scale (GAD-7), the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), the Depression Anxiety Stress Scales 21 (DASS-21), and the Liverpool Adverse Events Profile (LAEP). Furthermore, we analyzed the receiver operating characteristics (ROC) of the TC-brEASI.ResultsWe included 203 Chinese PWE; 19.7% had at least one current anxiety disorder, 7.4% had a panic disorder, and 5.9% had agoraphobia without panic disorder. Both internal consistency and test-retest reliability were satisfactory. The TC-EASI revealed two latent constructs: epilepsy-specific anxiety and typical anxiety. Convergent and divergent validity were established. A cut-off score of ≥9 for the TC-brEASI yielded a sensitivity of 89.2% (95% CI = 79.2–99.2%), a specificity of 82.5% (95% CI = 76.8–88.3%), and an area under curve (AUC) of 0.925 (95% CI = 0.887–0.964).ConclusionThe traditional Chinese versions of the EASI and brEASI are reliable and valid epilepsy-specific measures.

Serum albumin level in a sample of Egyptian patients with major depressive and bipolar disorders; a case control comparative study

BackgroundInflammation plays a significant role in the development of major depression and bipolar disorders. This research examines albumin as a potential inflammatory biomarker in these conditions to detect its involvement and explore the connection between serum albumin levels and mood disorders during acute phases in a sample of Egyptian psychiatric patients.ObjectiveTo determine serum albumin levels in patients with major depressive disorder (MDD) and bipolar affective disorder (BAD) and healthy control; and identify the correlation between serum albumin levels and the severity of symptoms in both conditions.Patients and methodsThe study is a case control comparative study; the sample was comprised of 50 patients diagnosed with MDD and 50 with BAD, all of whom were experiencing acute episodes at the time of recruitment. Additionally, 50 healthy individuals were selected as the control group. Diagnosis was conducted using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), while symptom severity was assessed using the Beck Depression Inventory II (BDI-II) and the Young Mania Rating Scale (Y-MRS). Blood samples were collected to measure serum albumin levels, and the correlation between albumin levels and the scores from these assessment scales was analyzed.ResultsThe study revealed no statistically significant difference in the serum albumin level in the 3 study groups. However, the correlation coefficient between serum albumin and YMR (Young Mania Rating) score in bipolar patients is − 0.637, while the correlation coefficient between serum albumin and BDI (Beck Depression Inventory) score in major depression patients is − 0.929, both with P-values of less than 0.001, indicating statistical significance. In addition, there is a significant inverse correlation with the age of onset of symptoms of both patients’ groups, suggesting that late age at onset is associated with lower serum albumin levels. Moreover, serum albumin levels vary significantly by age group only in the major depression group, with higher levels observed in the 18–30 years age group compared to older age groups.ConclusionSerum albumin levels did not differ among the MDD, BD, and control groups. However, a notable negative correlation was observed between serum albumin levels and symptom severity in both MDD and BD patients. Further larger controlled studies are required to investigate the potential of serum albumin as a biomarker for assessing the severity of mood disorders.

Prevalence of dissociative identity disorder among psychiatric outpatients in different cultural groups

BackgroundDissociative disorders (DDs) are characterized by a disturbance in the organization of identity, consciousness, perception, or memory. This disturbance involves disruptions of consciousness and limited access to information. One of the valuable updates in the recent study of DDs is the well-established link between dissociation and trauma. Dissociative identity disorder (DID) is the most widely discussed and recognized of the DDs. This work aimed to determine the prevalence and contributing factors of DID among psychiatric outpatients in two hospitals representing two different cultural groups located in Sohag and Cairo.ResultsAccording to the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), the prevalence of DID patients is 4.8% and 6.8% according to DDIS, and the prevalence in Sohag versus Cairo is 5.3% versus 3.0% with no significant statistical difference. The prevalence of other dissociative disorders according to SCID-D in Sohag versus in Cairo is as follows: DDNOS 24 (8%) vs. 5 (5%), dissociative fugue 1 (0.3%) vs. 0 (0%), and depersonalization/derealization 6 (2%) vs. 1 (1%) with no significant statistical difference between the two studied groups.ConclusionThe total prevalence of DID patients is 4.8 according to SCID-D and 6.8% according to DDIS, and the prevalence in Sohag versus Cairo is 5.3% versus 3.0% with no significant statistical difference, which means that DID is more prevalent in our psychiatric patients than usually mentioned and the use of specific diagnostic tools will benefit our management plans. These findings highlight the need for greater clinical awareness of dissociative disorders and DID among different psychiatric disorders.

War’s psychological legacy: a study of mental health challenges among children and adolescents in Azerbaijan after the second Karabakh War

As a result of the Second Karabakh War in 2020, a significant number of children and adolescents in Azerbaijan experienced severe psycho-emotional difficulties, including post-traumatic stress disorder (PTSD), anxiety, and depression. This mixed-method longitudinal study aimed to comprehensively assess levels of anxiety, depression, and PTSD among children and adolescents in the affected regions of Azerbaijan, and to evaluate the effectiveness of psychological support interventions across three sequential phases from 2020 to 2023. Psycho-emotional status was assessed through clinical interviews, behavioral observations, and standardized questionnaires (State-Trait Anxiety Inventory, Beck Depression Inventory-II, PTSD Checklist for DSM-5–PCL-5, and CATS, parent version). All instruments were used in validated Azerbaijani versions. The study covered 2,400 participants aged 5–16 years. Findings revealed high levels of anxiety (65%), depression (40%), and PTSD (70%), with adolescents aged 12–14 being the most affected (depression prevalence reaching 50%). Girls reported higher anxiety levels than boys (70% vs. 60%). Intervention programs—including art therapy, group sessions, and parental training—were associated with a significant reduction in anxiety (65%) and depressive symptoms (40%) (p < 0.05). This is the first large-scale empirical study in Azerbaijan to address post-war mental health in children and adolescents, emphasizing the importance of long-term psychological support and integrated rehabilitation in post-conflict settings.

Assessment of Attention-Deficit/Hyperactivity Disorder in Young Autistic Children

ABSTRACT Objective Co-occurring attention-deficit/hyperactivity disorder (ADHD) is present for many autistic children and is associated with increased impairments, unique treatment needs, and decreased response to autism-specific interventions. Diagnosing ADHD in autistic children during the preschool and early school-age periods presents unique challenges for clinicians. Methods This work describes a clinically informed diagnostic framework for assessing ADHD in young autistic children. Clinical complexities are illustrated using descriptive data from caregiver and clinician ratings of ADHD symptoms in autistic children without ADHD (n = 83; mean age 63.6 months [SD = 19.2]) and with ADHD (n = 102; mean age 85.9 months [SD = 23.7]). Patterns of caregiver and clinician symptom endorsement are described. Logistic regression is employed to explore clinician confidence in diagnostic decision-making. Results Clinical interview probes are presented to help clinicians explore caregiver ratings of ADHD symptoms in the context of an autistic child’s presentation. Demonstrating the complexity of diagnosing ADHD in autistic children, caregiver-rated ADHD Rating Scale scores were elevated for both the autistic (M = 27.8; SD = 11.5) and autistic+ADHD groups (M = 34.9; SD = 9.37). Patterns of clinician-caregiver agreement on ADHD symptom ratings showed more disagreement on inattention items than on hyperactivity/impulsivity items across both groups. Clinicians were more confident in ADHD diagnosis in autistic children who were girls, older, and had higher developmental levels. Conclusions This manuscript highlights the clinical complexity of evaluating young autistic children for ADHD. Practical tips for addressing the unique challenges of diagnosing ADHD in autistic children are presented. Continued refinement and future validation of this diagnostic framework will help clinicians improve assessment of young children.

Association of premature ejaculation with adult attention deficit hyperactivity disorder: Relationship with digit ratio

Increased intrauterine testosterone exposure may be a common etiological factor for attention deficit hyperactivity disorder (ADHD) and premature ejaculation (PE). This study aimed to determine the frequency of PE in adult ADHD and its relationship with the ratio between the second digit (2D) and fourth digit (4D) (2D:4D), which is accepted as an indicator of fetal testosterone exposure. 24 ADHD patients and 38 healthy controls were included in the study. Patients were evaluated using the Wender Utah Rating Scale (WURS) and Adult ADD (Attention Deficit Disorder)/ADHD DSM (The Diagnostic and Statistical Manual of Mental Disorders) IV-Based Diagnostic Screening and Rating Scale. PE was diagnosed according to DSM-5 criteria during the clinical interview with the participants. The 2D and 4D of the participants were measured directly with a digital caliper (0.01 mm sensitivity). The 2D:4D of the 2 groups was compared with each other. The prevalence of PE was 45.8% in the ADHD group and 5.2% in the control group. There was a statistically significant difference between the ADHD and control groups in terms of the 2D:4D (P = .004). Although there was no statistically significant difference (P > .05), ADHD patients with PE had lower right and left 2D:4D compared to those without PE. In adults with ADHD, PE was found to be both more frequent and lower in the 2D:4D, suggesting that high testosterone levels play a role in both the etiology of ADHD and PE. For this reason, it was thought that the frequency of coexistence is high because of the possible common etiology of these 2 clinical diagnoses.

Psychometric Properties and Measurement Invariance of the Borderline Personality Features Scale for Children (BPFSC-11).

We examined the psychometric properties of the Borderline Personality Features Scale for Children (BPFSC-11) in a sample of n = 235 adolescents. This involved an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA). We meticulously assessed internal consistency, convergent, and concurrent validity by analyzing the relationship between BPFSC-11 scores and measurements of emotional dysregulation, self-efficacy, resilience, depression, anxiety sensitivity, and social anxiety. The EFA revealed a two-factor solution, a finding that the CFA robustly confirmed. The BPFSC-11 demonstrated excellent internal consistency with an alpha value of 0.87 and adequate validity. Measurement invariance was examined across five groups: sex assigned at birth, born in Norway, speaking primarily Norwegian at home, by treatment group, and longitudinally. These findings confirm the reliability and validity of the BPFSC-11, adding new and significant findings to provide a solid foundation for its use in the assessment and treatment of adolescents with borderline personality features. Limitations of the current study include the absence of a clinical interview to examine diagnostic validity, and participants' responses may have been influenced by response desirability bias. Future research should examine the validity of the scale, both cross-sectionally and longitudinally, to enhance understanding of its application in different cultural contexts.