Clinical Interview Research Articles

A - 34 CBT Improves Cognitive Functioning in ADHD, Mixed Type

Abstract Objective To further expand on previous smaller study (with 25 participants) that found that children with ADHD, Mixed Type, improved their cognitive functioning after 12 weeks of CBT. Method In the current study 68 children (20 girls) diagnosed with ADHD, mixed type, between the ages of 9 and 12 (M = 10.25, SD = 1.88) were assessed with the WISC-V, CBCL, TEA-Ch2, and CPT-2, clinical interview with parents and teachers before the beginning of CBT. The same assessment was repeated 14 weeks later, following 12, weeks of individualized CBT. CBT included thought restructuring, impulse control exercises, relaxation techniques, and mindfulness exercises. Results Average Based Change (ABC) was employed and significant improvements, with large Cohen’s d (>. 80) effect size, were detected for Working Memory, Hyperactivity, Externalizing Behavior, Impulsivity, Selective, Sustained, and Everyday Attention. Ratings, during interviews, by teachers, psychologists, and parents agreed also that there was a significant clinical improvement. Conclusion In agreement with the first study, and other literature, CBT seems to be an important tool in helping significantly children with ADHD, Mixed Type, improve in behavior and cognitive functioning. More studies with younger and older children are needed to cement the utility of CBT with children and teens.

A - 122 Neuropsychological Case Study: Late-Onset Huntington’s Disease

Abstract Objective We present the neuropsychological profile of a 65-year-old male diagnosed with late-onset Huntington’s Disease (HD) in April 2024. In the context of very subtle chorea movements over the past several years, he started experiencing mood disturbances (e.g., increased irritability and social withdrawal) starting in June 2023. These changes were followed by cognitive difficulties, which led to a hospitalization for autoimmune encephalitis workup in February 2024. He described difficulties with learning and memory for future events, concentration, and executive functions (e.g., organizing and problem-solving). Method Referral from neurology to conduct a comprehensive neuropsychological evaluation to characterize his cognitive functioning. Exam, chart review, and clinical interviews were conducted. Results The cognitive profile was largely preserved, with mild attentional and executive difficulties, as well as mild challenges retrieving unstructured verbal information. This indicated subtle frontosubcortical network disruption. Self-report questionnaires indicated mild hopelessness but minimal anxiety and mood concerns. During the course of the neuropsychological evaluation, he underwent genetic testing, which was consistent with a diagnosis of HD (41 CAG repeats in the HTT gene). From a neuropsychological perspective, his psychiatric and cognitive disruption were also consistent with a diagnosis of HD. Conclusion The patient’s psychiatric and cognitive decline are now understood in light of his recent HD diagnosis. While cognitive difficulties are prevalent in individuals with HD, the low prevalence of late-onset HD makes the results of this case report particularly informative. This report contributes valuable insights into the neuropsychological presentation of older adults with HD.

Neuropsychiatric manifestations of hospitalized patients with coronavirus disease 2019 during the second wave in Egypt

BackgroundStudies suggested that COVID-19 virus causes neurological and psychiatric manifestations with different mechanisms. However, prevalence of neurological and psychiatric manifestations among COVID-19 patients varies across studies from 18.1%: 82.3%. The objective of this study was to determine neuropsychiatric manifestations in a sample of Egyptian COVID-19 hospitalized patients during the second wave of the pandemic and to detect factors affecting neurological and psychiatric prevalence. This cross-sectional study was conducted at Ain Shams university isolation hospitals and included 110 hospitalized COVID-19 patients, over a 2-month period from June 2021 to August 2021. Patients underwent a careful history taking, full neurological examination including Mini-Mental State Examination, the Structured Clinical Interview for DSM-IV (SCID I), COVID-19 severity criteria. Any available imaging and laboratory tests were recorded.Results83 (75.5%) patients had neurological manifestations. The most common neurological manifestations were headache (50.9%), hypogeusia (24.5%), hyposmia, paresthesia (23.6% each) and coma (15.5%). After exclusion of 17 patients who could not be examined by Mini-Mental State Examination, psychiatric manifestations were seen in 56 patients (61.5%) out of the remaining 91 patients. The most prevalent psychiatric disorders were delirium (30.8%), depression (19%), and adjustment disorder (17.5%). Moreover, hypertension, COVID-19 severity, place of admission, and high levels of LDH and ALT affected neurological manifestations prevalence.ConclusionsCOVID-19 infection and its immune reaction along with its social and psychological effects have a great impact on mental and physical health. Hence, neuropsychiatric evaluation cannot be ignored in any case with COVID-19 infection.

B - 17 Cognition, Social and Occupational Functioning, and Symptom Severity as Predictors on Family Burden in First Episode Psychosis

Abstract Objective Individuals with first episode psychosis (FEP) are often dependent on family members to assist with recovery following diagnosis. Family members frequently become caregivers, helping with scheduling and transportation to appointments, medication management, and tasks of daily living. However, such caregiving responsibilities can impact financial resources, employment, family routine, and cause higher rates of stress within the family. The following study examined cognitive, demographic and symptom predictors of self-reported caregiver burden in FEP. Methods Participants included 61 individuals experiencing their first episode of psychosis (26.2% female; mean age = 20.7). IQ was assessed with the WASI-II. Psychosis symptom severity over the past 7 days was assessed using the Structured Clinical Interview for DSM-5 Disorders. Demographic data and social and occupational functioning were also collected. The Family Assessment Scale was completed by the primary caregiver to assess different domains of family burden (e.g., finance, employment, recreational activities, leisure time, stigma, and emotions). Results Multiple regression analyses indicated that severity of delusions was a significant predictor of caregiver burden. However, IQ, race, age, and social and occupational functioning were not significant predictors. Conclusions Current results indicate that for FEP, delusions severity is a stronger predictor of caregiver burden than other factors expected to impact burden, such as IQ and social and occupational functioning. Results provide preliminary evidence indicating that early in the course of psychotic illness, active delusions play a key role in increased caregiver burden.

AGR – 2 The Multi-Dimensional Role of Neuropsychology in Diagnostically Complex Epilepsy Patients: Refining the Surgical Plan and Post-Operative Expectations

Abstract Objective We present a case highlighting the importance of neuropsychological involvement at all phases of a pre-surgical epilepsy work-up, including clinical interview, neuropsychological evaluation, Wada testing, extra-operative electrical stimulation mapping (ESM), and psychoeducation. Method A 24-year-old, right-handed, Caucasian female presented with non-lesional, intractable left-hemisphere localization-related epilepsy characterized by frequent experiences of déjà vu and autonomic sensations. Results Neuropsychological evaluation revealed weaknesses in processing speed and verbal memory implicating left hippocampal involvement. Wada testing suggested minimal contralateral memory support, indicating poor candidacy for resective surgery. The patient underwent prolonged sEEG monitoring to refine a plan for device implantation (i.e., responsive neurostimulation; RNS). No typical events were captured during extended study. Episodic somatosensory changes were captured, which had no electrographic correlate and were presumed to be non-epileptic. ESM evoked the patient’s classic semiology, elucidating nuanced information about her seizure onset zone and network. Barriers to extended monitoring and consistent, reliable engagement during ESM included depression, anxiety, and trauma; considerable neuropsychologist-led emotional support was required. Typical seizure semiology was elicited during stimulation of entorhinal cortices, posterior and anterior hippocampi, amygdala, cingulate and insula. RNS placement included a depth electrode targeting the medial structures (via a posterior approach) with a sub-temporal strip. Conclusions Involvement of neocortical and mesial temporal structures, coupled with a clear neuropsychiatric component, were believed to be poly-etiological factors to the patient’s presentation. Neuropsychological input at all phases of pre-surgical assessment was instrumental in systematically identifying and addressing her complex needs. Psychotherapeutic intervention was suggested to be equally as important to clinical, long-term patient outcome.

Clinical characteristics of adults with alcohol dependence syndrome comorbid with antisocial personality disorder: a cross-sectional study.

Antisocial Personality Disorder (ASPD) is characterized by a pervasive pattern of disregard for and violation of the rights of others, typically emerging by age 15 years and involving behaviors such as deceitfulness, impulsivity, and aggressiveness. The present study sought to examine the prevalence of the comorbid ASPD in adult people with Alcohol Dependence Syndrome (ADS) and identify clinical characteristics associated with ASPD. A cross-sectional study of 100 consecutive subjects diagnosed with ADS was conducted. Subjects were examined between August 2023 and September 2023. Various assessments and questionnaires were employed, including the Montreal Cognitive Assessment (MoCA), Alcohol Use Disorders Identification Test (AUDIT), and Structured Clinical Interview for DSM-IV (SCID-II). A computed tomography (CT) scan of the brain was performed on 47.5% participants. Out of the 100 individuals screened for the study, 20 were excluded. The study found that 35% of the examined study participants had a comorbid ASPD. Individuals with both ADS and ASPD were more likely to be younger, started drinking at an earlier age, had higher hospitalization rates, and scored higher on the AUDIT test (all P < 0.05%). Also, they had lower education levels, higher rates of unemployment, and lower marriage rates (all P < 0.05%). In addition, they reported more family members with ADS, incarceration, or mental illness and a higher frequency of traumatic experiences (all P < 0.05%). Depression, anxiety, stress (all P < 0.05%), and sleep problems (P = 0.058) were correlated with ASPD. Participants with the comorbid ASPD had lower MoCA scores (P = 0.046) and struggled with attention and linguistic subtests compared to subjects with ADS only. The study highlights the high prevalence of comorbid ASPD in participants with ADS, shedding light on their demographic and psychometric characteristics. Individuals with the comorbid ASPD are more likely to face cognitive deficits, especially in linguistic and attention-related tasks. The findings underline the importance of considering the comorbidity of ASPD in ADS subjects. The study implies that the understanding of the associated risk factors can aid in developing more targeted treatment interventions.

B - 30 Influence of Military Blast Exposure on Subjective Post-Concussion Symptom Reporting

Abstract Objective Repeated subconcussive blast exposure associated with explosive breaching, mortars, and shoulder-fired artillery weapons is commonly seen in the military/veteran population and has been found to contribute to adverse neurological outcomes; however, the extent is not fully understood. The aim of this study was to assess the effects of blast exposure during military or other training exercises on neurobehavioral symptom endorsement. Method Cross-sectional data from 48 nonclinical post-deployment Operation Enduring Freedom/Operation Iraqi Freedom veterans prospectively-recruited for a study examining posttraumatic stress and cognitive correlates at an urban VA Medical Center were examined (M age = 36.02; SD = 6.12; M years of education = 14.94; SD = 1.84). The sample was 96% male, 41% White, 39% Black, 4% Asian, and 16% Other. The Neurobehavioral Symptom Inventory (NSI) was used to assess self-reported vestibular, somatosensory, cognitive, and affective post-concussion symptoms, and the Boston Assessment of Traumatic Brain Injury-Lifetime semi-structured clinical interview assessed military-related blast exposure. Results There was a significant difference in neurobehavioral symptoms based on blast exposure, F(4,43) = 3.49, p = 0.015; Wilk’s Λ = 0.755, partial η2 = 0.25. Follow-up analyses showed that veterans with history of blast exposure endorsed significantly higher levels of somatosensory (F(1,47) = 7.69, p = 0.008, η2 = 0.143); affective (F(1,47) = 12.66, p &amp;lt; 0.001, η2 = 0.216); cognitive (F(1,47) = 5.97, p = 0.018, η2 = 0.115); and vestibular (F(1,47) = 7.21, p = 0.010, η2 = 0.136) post-concussive symptoms on the NSI compared to those without history of military blast exposure. Conclusion Veterans with blast exposure during military service reported significantly greater levels of post-concussion symptoms. This demonstrates the need to assess history of blast exposure, implement prevention measures through safeguards and decreased exposure when possible, and establish treatment modalities to improve outcomes.

Autonomic regulation and comorbid symptoms in children with attention deficit hyperactivity disorder.

Vagally-mediated heart rate variability (vmHRV) is regarded as transdiagnostic marker of emotion regulation and cognitive control capacity. We analysed vmHRV of children with attention deficit/hyperactivity disorder (ADHD). Based on previous research, we expected to find comorbid symptom dimensions (i.e. internalizing symptoms, conduct problems (CP), and callous unemotional (CU) traits) to relate to vmHRV measures. The sample comprised 100 (70 boys) medication naïve children with ADHD. Children were 6 to 11 years old. High frequency HRV (HF-HRV) was measured at rest and during a delay of gratification task. Additionally, sympathetic reactivity was assessed via skin conductance responses (SCR). Comorbid symptoms were assessed by parent-report questionnaires and clinical interviews. The multiple correlation between CU traits and the HF-HRV scores proved statistically significant. Higher CU traits were associated with higher HRV resting-state and response scores. CP were positively associated with the SCR score. In children with ADHD, increased CU traits might point to a comparatively less impaired self-regulation capacity in the reward-related context. The result corresponds to findings from previous studies. In the future, CU traits should be considered in analyses of autonomic regulation in ADHD.

Influencing factors of posttraumatic stress disorder in Shidu parents who have lost their only child: a cross-sectional survey

BackgroundIn China, parents who have lost their only child are referred to as Shidu parents (SDPs). This study aimed to investigate the prevalence and risk factors of post-traumatic stress disorder (PTSD) and investigate the influence of depressive and anxiety symptoms on the development of PTSD.MethodFour hundred and thirty-six SDPs completed assessments of PTSD (Structured Clinical Interview for DSM-IV Disorders, SCID-IV; The Clinician-Administered PTSD Scale-IV, CAPS-IV), depression (Hamilton depression scale), and anxiety (Hamilton Anxiety Scale) via in-person interviews. Logistic regression and hierarchical multiple linear regression analyses were used to explore the association of demographic characteristics, depression, and anxiety symptoms with PTSD.ResultsThe prevalence of PTSD in SDPs was 14.45%. The comorbidity of depression and anxiety symptoms was 87.30% in the SDPs with PTSD. The logistic regression model, which included factors of gender, age, education, depression, and anxiety, which contributed to the development of PTSD, was significant [χ² (11) = 122.47, p < 0.001]. The hierarchical multiple linear regression analysis indicated that female gender and the severity of comorbidities (depression and anxiety) were positively associated with the severity of PTSD.ConclusionThis study found that the severity of depression and anxiety was closely related to the severity of PTSD, supporting that SDPs are highly prone to the co-occurrence of PTSD, depression, and anxiety after bereavement. Our findings may provide more insights into the development of individualized interventions for parents who have experienced the loss of their only child.

Mothers and Babies Virtual Group (MBVG) for perinatal Latina women: study protocol for a hybrid type-1 effectiveness-implementation randomized controlled trial

BackgroundImmigrant Latinas (who are foreign-born but now reside in the USA) are at greater risk for developing postpartum depression than the general perinatal population, but many face barriers to treatment. To address these barriers, we adapted the Mothers and Babies Course—an evidence-based intervention for postpartum depression prevention—to a virtual group format. Additional adaptations are inclusion of tailored supplemental child health content and nutrition benefit assistance. We are partnering with Early Learning Centers (ELC) across the state of Maryland to deliver and test the adapted intervention.MethodsThe design is a Hybrid Type I Effectiveness-Implementation Trial. A total of 300 participants will be individually randomized to immediate (N = 150) versus delayed (N = 150) receipt of the intervention, Mothers and Babies Virtual Group (MB-VG). The intervention will be delivered by trained Early Learning Center staff. The primary outcomes are depressive symptoms (measured via the Center for Epidemiologic Studies-Depression Scale), parenting self-efficacy (measured via the Parental Cognition and Conduct Towards the Infant Scale (PACOTIS) Parenting Self-Efficacy subscale), and parenting responsiveness (measured via the Maternal Infant Responsiveness Instrument) at 1-week, 3-month, and 6-month post-intervention. Depressive episodes (Structured Clinical Interview for DSM-V- Disorders Research Version) at 3-month and 6-month post-intervention will also be assessed. Secondary outcomes include social support, mood management, anxiety symptoms, perceived stress, food insecurity, and mental health stigma at 1-week, 3-month, and 6-month post-intervention. Exploratory child outcomes are dysregulation and school readiness at 6-month post-intervention. Intervention fidelity, feasibility, acceptability, and appropriateness will also be assessed guided by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.DiscussionThis study will be one of the first to test the efficacy of a group-based virtual perinatal depression intervention with Latina immigrants, for whom stark disparities exist in access to health services. The hybrid effectiveness-implementation design will allow rigorous examination of barriers and facilitators to delivery of the intervention package (including supplemental components) which will provide important information on factors influencing intervention effectiveness and the scalability of intervention components in Early Learning Centers and other child-serving settings.Registration.ClinicalTrials.gov NCT05873569.

An exploration of psychological and socio-cultural facets in perinatal distress of Pakistani couples: a triangulated qualitative study

The phenomenon of perinatal distress in terms of depression, anxiety, bipolar, and psychotic disorders is well-explored in the West but barely investigated in South Asia; particularly research evidence highlighting the cultural expression of couples’ mental health with respect to Pakistan is rare. The purpose of this research is to focus on the exploration of psycho-socio-cultural expression of couples’ perinatal distress and coping strategies used in the Pakistani context in relation to maternal and paternal mental health, with implications for the wellbeing of their unborn or born progeny. The research design focused on qualitative interpretative approaches. In data triangulation, reflexive thematic analysis and interpretative phenomenological analyses were applied on the verbatim of the semi-structured interviews conducted with the mental health professionals (n = 9) and the couples (n = 8), screened positive for perinatal distress. Four couples were screened out of 325 perinatal women visiting the gynaecological ward of Aziz Bhatti Shaheed Teaching Hospital, Gujrat. Edinburg Postnatal Depression Scale, Generalized Anxiety Disorder-7 and Washington Early Recognition Center Affectivity and Psychosis Screen are the standardized instruments considered to be used for screening perinatal distress among couples. The Urdu version of WERCAP Screen was developed by a standardized forward-backward translation procedure. The rest of the four couples were purposively selected from the psychiatric ward of the same hospital. The Simplified Negative and Positive Symptoms Interviews were administered to the couples after getting approval for the Urdu version form. All couples were probed with an indigenously developed Structured Clinical Interview Schedule for DSM Disorders based on DSM-5-TR. The triangulation carried out with reflexive thematic analysis and interpretative phenomenological analysis revealed cultural conception of perinatal distress as perceived by the mental health professionals and experienced by the couples during the antenatal and postnatal period of their lives. They were enlightened with a constructive view aimed at promoting transformational change in terms of their mental health care and coping. The implications suggested implementation of a psychotherapeutic intervention for reduction in the level of distress and subsequent enhancement of well-being in couples during the perinatal period.

The family alliance as a facilitator of therapeutic change in systemic relational psychotherapy for borderline personality disorder: A case study.

Managing the Therapeutic Alliance is often complex when it comes to the treatment of borderline personality disorder (BPD), but the alliance is crucial for the success of the therapy. Combined individual and family interventions have been shown to be very useful in treating of these cases. This study has two objectives. First, to describe how the family therapeutic alliance facilitates therapeutic change through family psychotherapy for families with a member diagnosed with BPD. Second, to analyze how the therapeutic change achieved through combined individual and family systemic relational psychotherapy affects the individual functioning of the patient with BPD. This single case study used the System of Observation of Family Therapy Alliances (SOFTA-o) to analyze the therapeutic alliance, along with two semi-structured clinical interviews, one at the beginning and one at the end of therapy. Results show a dynamic and positive evolution of the therapeutic alliance throughout the therapeutic process and how this alliance facilitated therapeutic change, both reducing the symptomatology of the patient with BPD and improving family communication and functioning. Results contribute to highlighting the importance of including family therapy as an intervention unit in protocols for patients with BPD.

Migrant survivors of conflict-related sexual violence accessing a specialist health service in Turin, Italy: a qualitative analysis of clinical forensic interview transcripts.

The Sexual Violence Relief center Soccorso Violenza Sessuale (SVS) is a specialist service, situated in Sant'Anna Hospital, an Obstetrics and Gynecology facility in Turin, North-West Italy. The study aimed to qualitatively analyze the transcripts of interviews routinely conducted by gynecologist and midwife in the first part of the medical examination of migrant patients accessing care at SVS after being subjected to conflict-related sexual violence (CRSV) in their home country or during migration and to explore the adverse outcomes of such violence on their health. Interview transcripts were purposely selected to include adult migrant patients (age > 18) subjected to CRSV in the different phases of migration and accessing SVS from January 1st, 2014, to September 4th, 2023. Data was extracted from the SVS archive, anonymized, and thematically analyzed. In total, 43 interview transcripts were eligible for inclusion. All of them were related to cisgender women of Sub-Saharan origin describing different forms of violence as a driver for migration. CRSV was disclosed by 18 survivors as occurring in their home country and by 31 in transit (e.g., Libya), the most reported type being rape. 49% of the patients described adverse physical outcomes of CRSV, while 72% reported psychological sequelae. The findings confirm high levels and different modalities of violence throughout the migratory route. Qualitative analysis of interview transcripts served as a valuable source for understanding how survivors described the CRSV they endured, its consequences, as well as other violence encountered during migration.

Influence of Stress Factors on the Development of Post-Traumatic Stress Disorder in Children: Risk Factors

In the current conditions of the ongoing war in Ukraine, which began in February 2022, Ukrainian children might develop post-traumatic stress disorder (PTSD) due to stress factors caused by the conflict between Ukraine and Russian-backed separatist forces, along with the Russian military. In particular, the relationship between reduced emotional intelligence and the development of post-traumatic stress disorder in children has become more relevant. This study aimed to assess structural and cognitive changes in children with PTSD and their relationship to depression, anxiety, and event segmentation. The study methods included clinical interviews (CAPS-CA-5 scale), neuropsychological tests (short-term and long-term memory tests), self-assessment questionnaires (standardised CDI, RCADS and SCAS-Child scales), and a single-shotMRI. The results showed that patients with post-traumatic stress disorder had reduced hippocampal volume (p=0.018) and the volume of cingulate cortex isthmus (p=0.026). Diffusion in the cerebellum-hippocampal tract was reduced (p=0.014). The level of depression was positively correlated with hippocampal volume (r=0.32, p=0.021) and anxiety with the volume of cingulate cortex isthmus (r=0.26, p=0.048). These results emphasise the importance of the relationship between structural changes and levels of depression and anxiety in patients with PTSD. Prospects for further research are based on the study of the long-term effects of psychotherapeutic interventions aimed at improving cognitive function in patients with posttraumatic stress disorder.

The psychosocial impacts of the 15 March terrorist attack on the Christchurch Muslim community: A descriptive, cross-sectional assessment.

On 15 March 2019, a white supremacist terrorist carried out sequential attacks on two mosques in Christchurch, New Zealand during Friday prayers. This resulted in the loss of 51 lives, 40 others sustained gunshot injuries, and there were approximately 250 survivors. This study aimed to evaluate the impacts on community members, assess clinical needs, facilitate access to appropriate interventions and provide insights into working with a traumatised and diverse population. This cross-sectional study used semi-structured clinical interviews and self-report measures to assess social and demographic factors, mental health disorders and well-being for adult Muslims 11-32 months post-attack. A total of 189 participants completed assessments. The sample was diverse, representing 34 different ethnicities and participant proximity to the attack was complex, with personal and familial exposures. Elevated levels of psychological distress and psychopathology were found with 38% of participants reporting moderate/severe psychological distress on the Kessler-10, 39% reporting post-traumatic stress disorder on the post-traumatic stress disorder checklist-5, and 40% reporting poor well-being or possible depression on the World Health Organization-5 Well Being Index. Secondary stressors were also documented, as well as high scores for post-traumatic growth and the importance of faith. This study provides valuable insights into the repercussions of the Christchurch mosque attack on the affected community, describing the complexity of exposure and the substantial burden of morbidity experienced. It also highlights the high levels of social connectedness and the role of faith in promoting positive outcomes in the recovery process for this population.

Characterization of pain and somatization and its relationship with psychopathology in early onset psychosis

BackgroundEarly onset psychosis (EOP) frequently presents with a severe clinical phenotype and poor long-term prognosis. Clinical experience suggests that individuals with EOP have abnormal pain and somatosensory processing, yet relative to adult-onset psychosis, pain and somatic sensory processing in EOP have rarely been studied. MethodsThe history of two characteristic patients is described to illustrate clinical presentations of pain in EOP patients. Furthermore, 31 patients with EOP were studied with self-reported questionnaires informing on pain severity, pain catastrophizing, central sensitization, and somatization. Structured clinical interviews were administered to confirm Diagnostic and Statistical Manual of Mental Disorders-5 EOP diagnosis and the patient's dimensions of psychopathology were measured by the Brief Psychiatric Rating Scale (BPRS). ResultsOut of 31 EOP patients, 22 reported distressing pain, where higher pain severity corresponded with greater BPRS total and affectivity and resistance subscale scores. The degree of psychopathology was associated (N = 31; p < 0.05, FDR-corrected) with the magnitude of pain catastrophizing, central sensitization, and somatization. Multivariate analysis revealed relationships (N = 31; p < 0.05, FDR-corrected) between BPRS subscale (negative symptoms and activation) scores with somatization severity. The observed associations occurred independent of antipsychotic medication usage as quantified by chlorpromazine equivalent doses. ConclusionsPain and somatosensory symptoms could be a frequent cause of distress in patients with EOP and their severity associated with the degree of psychopathology. Future studies should determine if treating pain and somatic symptoms in EOP patients can lead to better control of psychosis as well as improve quality of life.

Psychotic symptoms in Chinese adolescent patients with major depressive disorder: prevalence and related endocrine clinical factors

ObjectiveMajor depressive disorder (MDD) is often accompanied by psychotic symptoms. However, few studies have examined the relationship between psychotic symptoms and endocrine factors in adolescent patients with MDD. Therefore, this study aimed to investigate the prevalence and related endocrine clinical factors of psychotic symptoms in Chinese adolescent patients with MDD.MethodsIn total, 601 patients (aged 12–18) with MDD were recruited. The Patient Health Questionnaire – 9 items (PHQ – 9) was utilized for assessing depressive symptoms. Psychotic symptoms were assessed through clinical interviews. Prolactin (PRL), thyroid-stimulating hormone (TSH), triiodothyronine (T3), free triiodothyronine (FT3), thyroxine (T4), and free thyroxine (FT4) were also measured.ResultsThe incidence of psychotic symptoms in adolescent patients with MDD was 22.6%. The findings demonstrated that age, self-harming behavior, PHQ-9 score, FT4, and normalized PRL were independently associated with psychotic symptoms in patients with MDD (All p < 0.05).ConclusionsPRL and FT4 levels are more likely to be abnormally elevated in major depressive adolescents with psychotic symptoms. Prolactin and thyroid hormones in patients with MDD should be paid more attention.

Mental Health and Social Correlates of Reincarceration of Youths as Adults.

The rise in the U.S. prison population over the past 40 years has heightened scrutiny of the incarceration of children and adolescents. Correlates of later reincarceration in this group, especially correlates relating to psychiatric and substance use disorders, are understudied in the U.S. population. We aimed to establish the prevalence and correlates of the reincarceration as adults of people incarcerated before age 18. Data were derived from clinical interviews and from validated diagnostic and psychometric instruments. They were obtained as part of a cross-sectional representative survey of the civilian U.S. population, the National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III). We identified 1,543 adults (4.3% of the NESARC sample) who had been incarcerated before they were 18. Of these, 55.9 percent had subsequently been incarcerated as adults. In addition to variables that have been repeatedly identified in criminological research (less education, past antisocial behavior, and parental imprisonment), substance use disorder, bipolar disorder, and longer childhood incarceration were independently associated with incarceration as an adult. The possibility that psychiatric treatment could reduce reincarceration in this group warrants longitudinal and experimental research.

Facial image analysis for automated suicide risk detection with deep neural networks

Accurately assessing suicide risk is a critical concern in mental health care. Traditional methods, which often rely on self-reporting and clinical interviews, are limited by their subjective nature and may overlook non-verbal cues. This study introduces an innovative approach to suicide risk assessment using facial image analysis. The Suicidal Visual Indicators Prediction (SVIP) Framework leverages EfficientNetb0 and ResNet architectures, enhanced through Bayesian optimization techniques, to detect nuanced facial expressions indicating mental state. The models’ interpretability is improved using GRADCAM, Occlusion Sensitivity, and LIME, which highlight significant facial regions for predictions. Using datasets DB1 and DB2, which consist of full and cropped facial images from social media profiles of individuals with known suicide outcomes, the method achieved 67.93% accuracy with EfficientNetb0 on DB1 and up to 76.6% accuracy with a Bayesian-optimized Support Vector Machine model using ResNet18 features on DB2. This approach provides a less intrusive, accessible alternative to video-based methods and demonstrates the substantial potential for early detection and intervention in mental health care.

Current clinical practice of prurigo nodularis in Japan: A cross-sectional web-survey among dermatologists.

Prurigo nodularis (PN) is a chronic inflammatory skin disease associated with intense pruritic nodules. The unclear patho-etiological mechanisms of PN cause difficulty in disease management; and there is a paucity of information on the current diagnosis and treatment options for PN in Japan. To describe the current management from a dermatologists' perspective we conducted a web-based survey (UMIN Clinical Trial Registry UMIN000047643) in 2022 among dermatologists from a Japanese commercially available physician panel, who had seen at least one patient with PN within the last 3 months. The survey included 117 dermatologists. The dermatologists diagnosed PN mainly by confirming clinical signs and patient interviews, while to assess the severity of PN, the number of pruritic nodules and the degree of itching were primarily utilized. Topical corticosteroids and antihistamines were the most used drugs, as recommended in the current guidelines on the diagnosis and treatment of prurigo. Dermatologists' treatment satisfaction decreased with increasing assumed severity of PN; almost 65% dermatologists were not satisfied with the treatment of severe PN. These results suggest the need of more effective medications and diagnostic tools for better management of PN in Japan.