Comorbid Psychiatric Disorders Research Articles

Psychiatric morbidity among the patients of first ever ischemic stroke

Ischemic stroke is one of the leading causes of mortality and morbidity worldwide and third common cause of death in developed countries which consumes annually a great cost, directly or indirectly and stroke produces a wide range of psychiatric disorders. This was a cross sectional study, conducted in the department of Psychiatry, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from 1 July 2013 to 30 June 2014 to evaluate the psychiatric morbidity among the patients of first ever ischemic stroke. For this purpose, 66 ischemic stroke patients of first attack between 2 weeks to 2 years of stroke, aged above 18 years irrespective of sex and 66 accompanying healthy persons of the patients and other patients without any kind of stroke matching age and sex fulfilling inclusion and exclusion criteria were taken in Group[1]A and Group-B respectively. Psychiatric assessment was done using General Health Questionnaire (GHQ12) as a screening tool and all GHQ12 positive cases were evaluated using mental state examination. Diagnoses of psychiatric disorders of all respondents were confirmed by psychiatrist according to Diagnostic and statistical manual of mental disorders (DSM) 5 criteria. Ethical issues were maintained properly and an informed written consent was taken from every patient. After collecting data, editing was done manually and was analyzed with statistical package for social sciences (SPSS) version 21. The result showed that, the mean age of the respondents was 57.6 (SD±5.5) years which was almost identical to control group (p=0.130). Most (87.9%) of the patient were below the age of 65 years. Co-morbid psychiatric disorder was found in (34.8%) patients with ischemic stroke and (13.6%) control subjects (p=0.004). The most common psychiatric disorder was generalized anxiety disorder (13.6%) and major depressive disorder (21.2%) in ischemic stroke group. The results of this study suggested that, a significant number of patients with ischemic stroke were suffering from psychiatric disorders than the age and sex matched control. Bang J Psychiatry 2022;36(1):11-17

Estimates of epilepsy prevalence, psychiatric co-morbidity and cost

PurposeThis study estimated epilepsy prevalence, psychiatric co-morbidity and annual costs associated with epilepsy. MethodsWe used Danish national health registers to identify persons diagnosed with epilepsy and psychiatric disorders, and persons using antiseizure medication and persons using drugs for psychiatric disorders.We calculated the prevalence of epilepsy and co-morbid psychiatric disorders in Denmark on December 31, 2016, using information on epilepsy and psychiatric disorders based on combinations of hospital contacts and use of antiseizure and psychoactive medication. Further, direct and indirect annual costs associated with epilepsy were calculated using individual-level data from a range of socioeconomic registers. ResultsThere were 5,044,367 persons alive and living in Denmark on December 31, 2016, including 33,628 persons with at least one hospital contact with epilepsy in the previous five years (epilepsy prevalence 0.67% (0.69% males; 0.65% females)). Among these persons with epilepsy, we identified 12,562 (37.4%) persons with a psychiatric disorder or use of drugs used for psychiatric disorders as compared with 801,052 (15.9%) persons in the general population. The estimated total annual individual net costs associated with epilepsy was €30,683. Compared with prevalence estimates on December 31, 2006, the prevalence of epilepsy on December 31, 2016, was slightly higher in the older population and slightly lower in children ConclusionsPopulation estimates from national registers provide epilepsy prevalence estimates of approximately 0.6–0.7% - similar to previous reviews of epilepsy prevalence. In addition, the national sample allowed idenitfication of high prevalence of psychiatric disorders and high societal costs associated with epielspy.

A Holistic Approach to Physical and Mental Health: Associations Between Chronic Disease and Psychiatric Conditions

ABSTRACT Prior studies suggest that patients with chronic conditions are more likely to develop psychiatric disorders compared to healthy individuals without any medical conditions. The objective of this study was to investigate the link between chronic conditions and psychiatric disorders. The authors hypothesize that patients with chronic conditions have a higher comorbidity of certain psychiatric disorders compared to healthy individuals. Patients from Rowan University School of Osteopathic Medicine (Rowan SOM) Family Medicine offices completed an anonymous survey about medical and psychiatric diagnoses (Appendix 1). Multivariate analysis was used to examine the relationships between patients’ rank of control of their chronic medical and psychiatric conditions compared to the age of onset and total number of conditions. One-hundred thirteen study participants reported having at least one chronic condition and seventy-four reported having at least one psychiatric disorder listed on the survey. Among the participants comorbid with both medical and psychiatric conditions, patients’ ranking of control of their chronic conditions positively correlated with their ranking of control of their psychiatric disorders (p = 0.009). Patients’ ranking of control of their chronic conditions negatively correlated with the total number of psychiatric disorders (p = 0.002). The study did not generate significant evidence to support the original hypothesis. The results highlight a strong relationship between patients’ perceived control of their physical health and mental health. The comorbidity of both chronic conditions and psychiatric disorders may present challenges for patients. Utilizing a holistic approach to patient care can help clinicians improve patient outcomes.

Suicide and Epilepsy.

Epilepsy has a bidirectional association with suicidality, and epilepsy patients are at much higher risk for suicide than the general population. This article reviews the recent literature on suicide risk factors, assessments, and management as they pertain specifically to suicidality in people with epilepsy, a population that requires unique considerations. Risk factors for suicidality include younger age (independent of comorbid psychiatric disorders), poor social support, psychiatric comorbidity (depression, anxiety, obsessive-compulsive symptoms, and alcohol use), and epilepsy-related factors (more frequent seizures, temporal lobe epilepsy, and drug-resistant epilepsy). Most clinicians agree with the need for addressing suicidality; however, there is inconsistency in the approach to caring for these patients. An example neurology clinic-based approach is outlined. Although PWE are at risk for suicide and risk factors have been characterized, care gaps remain. Screening strategies may help close these gaps.

Retrospective review of opioid use in pediatric patients with chronic pain

Background and Hypothesis: Demographics and treatment of adult patients with chronic pain have been well characterized. The same has not been done in pediatric patients who are at increased risk of the consequences of opioid use including risk of addiction, truancy, and unemployment. We hypothesize that opioid use in pediatric patients with chronic pain leads to worse functional outcomes due to pain and maladaptive behaviors.
 
 Methods: From 2016-2019, 300 new patient consultations to the Riley comprehensive pain clinic were identified. A subpopulation interim analysis of 71 patients was retrospectively evaluated at 6-month intervals for medical, social, pain-related, and questionnaire data. Data was recorded in REDCap by a single researcher. Exported data was analyzed using Microsoft Excel.
 
 Results: Seventy-one patients were evaluated and 80% were female. Median age at diagnosis was 14 years (range birth to 18) with average follow-up of 20.5 months. Etiologies varied but contributed to neuropathic (49%), nociceptive (35%), and mixed (11%) pain syndromes. Comorbid psychiatric disorders and sleeping difficulties were present in 69% and 58%, respectively. Sixty-seven percent of age-appropriate patients graduated high school and were in college or employed on final follow-up. Patients managed with opioids did not report a change in visual analog or catastrophizing scales.
 
 Conclusion and Potential Impact: The primary demographic of pediatric chronic pain patients is adolescent females. Neuropathic pain syndromes are common, with a majority of patients exhibiting comorbid psychiatric disorders and dysfunctional sleep patterns. Use of opioid medications did not change reported pain scores, and one-third of these chronic pain patients did not attend college or were unemployed. Further analysis of our data set should help better understand the outcomes of pediatric patients with chronic pain.

Use of aripiprazole in an obsessive compulsive disorder case with associated motor tics

IntroductionObsessive compulsive disorder (OCD) is a pathology represented by thoughts, images, impulses or feelings that generate great anxiety and discomfort, as well as the development of compulsive acts and rituals that cause great dysfunction.The comorbidity of different psychiatric disorders with OCD is known, such as impulse control disorder and tic disorder.ObjectivesThe objective of this study is to describe the clinical characteristics, comorbidities and the treatment used in a patient with an OCD diagnosis and motor tics.MethodsDescription of a clinical case of motor tics associated with OCD in an adult patient.ResultsA 29-year-old man begins mental health follow-up for presenting, as a result of a choking episode, obsessive thoughts with significant emotional and behavioral repercussions, to the point of restricting his diet and losing several kilos of weight. He also manifested checks and rituals in order to avoid possible choking.Treatment with sertraline and clonazepam was started, without evidence of improvement in symptoms. Months later, bucolingual and guttural tics, difficult to control by the patient and which caused bite lesions in the mouth and tongue, were added to the described clinic. Oral aripiprazole was associated to the treatment and then prolonged- release intramuscular administration was used, achieving improvement in obsessive symptoms and motor tics.ConclusionsThe usefulness of adjuvant treatment with atypical antipsychotics has been demonstrated in adults with OCD who present an insufficient response to an SSRI. Injectable prolonged-release antipsychotics can help improve long-term prognosis by ensuring adherence.DisclosureNo significant relationships.

Treating Patients with Aripiprazol: A Safe Gamble?

IntroductionAripiprazole (ARI) is an atypical antipsychotic drug with D2 partial agonist properties, usually prescribed to treat mood disorders (major depression or bipolar disorder) and schizophrenic disorder (schizophrenia or schizoaffective disorder). Dopamine receptor agonists, as is ARI, have been implicated in some cases of impulse-control problems, such as gambling disorder (GD), increased spending, hypersexuality and compulsive eating.ObjectivesCurrently, it is hypothesized that aripiprazole may cause impulse-control problems because it can produce a hyperdopaminergic state in the mesolimbic pathway (reward system) through its predominant action on dopamine D3 receptors. We intend to do a non-systematic review of the scientific information regarding this subject.MethodsThe authors revised the published literature about this topic, selecting relevant articles, systematic reviews and case reports, with the topic words: “aripiprazol”, “gambling disorder” and “dopamine receptor” in scientific data base.ResultsOverall, a few cases of ARI-induced pathological gambling as well as ARI-induced hypersexuality have been reported. In one study it was verified that comorbid psychiatric and substance use disorders were common among those who have experienced GD or worsened GD after beginning ARI treatment. In another study, it was verified that the group of patients who reported this alleged side-effect were mostly young (mean age, 33.6 years), mostly men (88.2%) and most lived alone.ConclusionsAttributing to dopamine agonists the only factor that can explain the onset of GD is simplistic and dangerous. Many other potential risk factors, including individual vulnerability factors (temperament, genetics) as well as environmental factors, must be considered.DisclosureNo significant relationships.

The association between melatonin and suicide: a nationwide cohort study

IntroductionMelatonin is often prescribed to patients experiencing sleep disturbances, which has been linked to elevated risks of suicide. However, it remains to be assessed whether melatonin is associated with suicide and suicide attempts.ObjectivesWe aimed to investigate whether individuals in treatment with melatonin had higher rates of suicide and suicide attempt when compared to individuals not in treatment.MethodsUsing longitudinal data on all persons aged 10+ years living in Denmark between 2007-2016 were obtained. Data from the National Prescription Register was used to identify periods of being in treatment with melatonin based on number of tablets and daily defined dose. Suicide and suicide attempt were identified in hospital and cause of death registries.ResultsAmong 5,798,923 included individuals, 10,577 (0.18%) were in treatment with melatonin (mean treatment length 50 days). Out of 5,952 individuals who died by suicide, 22 (0.37%) were in melatonin treatment, while 134 (0.53%) out of 25,136 had a first suicide attempt. After adjustment for sex and age-group, people in treatment with melatonin were found to have a higher rate of suicide (IRR: 4.2; 95% CI, 2.7-6.4) and suicide attempt (IRR: 6.7-fold (95% CI, 5.7-7.9) when compared to those not in treatment.ConclusionsTreatment with melatonin was associated with higher rates of suicide and suicide attempt. The association might be explained through mediators, such as psychiatric comorbidity and sleep disorders. Our findings indicate that attention towards these issues might be warranted.DisclosureNo significant relationships.

ACT-Informed Treatment of Co-morbid Psychiatric Disorders in the Postpartum Period: A Case Report

The literature describing psychological interventions for co-occurring obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) is limited. Acceptance and Commitment Therapy (ACT) is a transdiagnostic intervention that targets functionally avoidant behavior underlying both OCD and PTSD. The current case report describes how an ACT-informed approach to treatment was implemented over 14 sessions to treat co-occurring OCD and PTSD in a 9-months postpartum adult woman. The patient was initially referred to psychotherapy by her psychiatrist and showed high motivation to engage in treatment. This case presentation outlines how the intervention targeted core ACT processes while also incorporating components from both exposure and response prevention (ERP) and cognitive processing therapy (CPT) to address the patient’s presenting concerns. Measurements of OCD and PTSD symptom severity, as well as of depressive and anxiety symptoms, over the course of treatment are included. Health-related comorbidities, psychiatric medications, and implications are discussed.

Seasonal changes and decrease of suicides and suicide attempts in France over the last 10 years

The objective of this study was to examine the evolution of suicides and suicide attempts over the last 10 years in France. We analyzed the number of deaths by suicide and suicide attempts in metropolitan France (2009–2018) from French national databases, on a daily, weekly or monthly basis. Seasonal variation in suicide rates was modeled using a cosinor function. Based on this model, we determined the association of suicides and suicide attempts with geographic characteristics, age, gender, means used and psychiatric disorders. The number of suicides and suicide attempts decreased over the last ten years in France (mean decrease of 14.49% and 11.69% per year). We observed a significant and recurrent seasonal pattern of suicides and suicide attempts in France, with a peak in spring. The suicide and suicide attempt rates were higher in the northern departments of France. Suicides were more frequent for men (75%) and middle-age individuals (45–54 years old), while suicide attempts were more frequent for women (62%) and young adults and middle-age individual (15–19 and 40–49 years old). Nearly two-thirds of the patients who attempted suicide suffered from comorbid psychiatric disorders. Mood disorders was the most frequent comorbid psychiatric disorder (54%). Voluntary drug intoxication was the most common means of suicide attempt (80%), and hanging was the most common means of suicide (54%). The number of suicides and suicide attempts decreased in France over the last 10 years, with large and recurrent seasonal variations. These findings could be used to alert and adjust prevention policies, as well as developing preventive strategies such as chronotherapeutics.

Heart-Focused Anxiety Affects Behavioral Cardiac Risk Factors and Quality of Life: A Follow-Up Study Using a Psycho-Cardiological Rehabilitation Concept.

BackgroundHeart-focused anxiety (HFA) raises the risk for adverse outcomes in patients with heart disease. Despite this great importance, it is rarely assessed in clinical practice. Three dimensions are commonly defined in the context of HFA: heart-related fear, avoidance, and attention. The impact of these aspects on cardiac risk factors is essentially unclear. In this study, we investigated the relationship between HFA and behavioral cardiac risk factors as well as health-related quality of life (HRQoL), which represent important treatment outcomes of inpatient psycho-cardiological rehabilitation.MethodsA prospective observational design was used to examine 238 rehabilitation inpatients with comorbidity of cardiac disease and psychiatric disorder. We assessed HFA using the Cardiac Anxiety Questionnaire (CAQ), HRQoL using the SF-12 Health Survey, exercise capacity using the 6-minute walk test, and smoking behavior, respectively at admission (t0) and discharge (t1). Physical activity was assessed at t0 and in a follow-up survey 6 months after discharge (t2) using the International Physical Activity Questionnaire (IPAQ). Multiple regression models were used to analyze the predictive value of HFA for the outcome variables at t0, t1, and t2, adjusted for socio-demographic factors and depression. Predictive values for changes over time were evaluated by the regressor variable approach.ResultsExercise capacity and physical activity were negatively predicted by baseline heart-related avoidance, both cross-sectionally and prospectively. Avoidance at t1 also negatively predicted long-term changes over time in physical activity at t2. Total HFA and the subcomponent avoidance negatively predicted physical HRQoL both cross-sectionally and prospectively. Mental HRQoL was cross-sectionally predicted by heart-focused attention at t0, and prospectively predicted by total HFA and by avoidance. Regarding changes in the course of rehabilitation, baseline avoidance negatively predicted improvement in physical HRQoL during rehabilitation. Concerning smoking behavior, no associations with HFA were found.ConclusionsHFA is a relevant inhibiting factor for the achievement of therapy goals in psycho-cardiological rehabilitation such as health behavior and HRQoL. Heart-related avoidance in particular, has a negative impact on exercise capacity, physical activity, and self-reported physical health. Its prospective negative predictive value for physical activity and physical health underlines the relevance of HFA for psycho-cardiological interventions.

Autism spectrum disorder: Comorbidity and demographics in a clinical sample

Objective: To determine the demographic and clinical characteristics of children followed up with the diagnosis of autism spectrum disorder (ASD) at a tertiary center in Southeeast Turkey. Methods: Children followed up with the diagnosis of ASD at a university hospital child psychiatry clinic between June 2016 and June 2021 were evaluated retrospectively for comorbidities, intellectual functioning and age at diagnosis. Results: In the preschool group, females displayed significantly more frequent cognitive developmental delay. Median age at diagnosis was 36 months (IQR= 22) regardless of gender. Approximately three-fourth (73.7%) of the cases had at least one psychiatric comorbid disorder while 22.8% had at least one medical diagnosis. Psychiatric comorbidity was found to be associated with later diagnosis. Conclusion: Although the age at first diagnosis in this study is relatively earlier than the studies in the literature, most of the children with ASD are still diagnosed very late. Psychiatric comorbidities may lead to later diagnosis due to overshadowing. Training of educational and primary healthcare workers on symptoms of ASD may enable earlier diagnosis.

Impact of Comorbid Psychiatric Disorders on Healthcare Utilization in Patients with Inflammatory Bowel Disease: A Nationally Representative Cohort Study.

Patients with inflammatory bowel disease (IBD) frequently experience comorbid psychiatric disorders, which negatively impact quality of life. We characterized the longitudinal burden of hospitalization-related healthcare utilization in adults with IBD with and without comorbid anxiety, depression, or bipolar disorder. In the 2017 Nationwide Readmissions Database (NRD), we identified 40,177 patients with IBD who were hospitalized between January 1, 2017 and June 30, 2017 and who were followed until December 31, 2017. In this cohort, we compared the annual burden (i.e., total days spent in hospital), costs, risk of readmission, inpatient mortality, and IBD-related surgery in patients with and without comorbid psychiatric disorders (anxiety, depression, or bipolar disorder). Of the 40,177 adults who were hospitalized for IBD, 25.7% had comorbid psychiatric disorders. Over a 10month-long period of follow-up, patients with comorbid psychiatric disorders spent more days in the hospital (median, 7days vs. 5days, p < 0.01), experienced higher 30-day (31.3 vs. 25.4%; p < 0.01) and 90-day (42.6 vs. 35.3%, p < 0.01) readmission rates, and had higher hospitalization-related costs (median, $41,418 vs. $39,242, p < 0.01). However, they were less likely to undergo IBD-related procedures or surgeries. There were no differences in risk of mortality. On Cox proportional hazard analysis, the presence of comorbid psychiatric disorders was associated with a 16% higher risk of readmission (HR, 1.16; 95% CI, 1.13-1.20) and a 13% higher risk of severe IBD-related hospitalization (HR, 1.13; 95% CI, 1.08-1.16). In adults with IBD, comorbid psychiatric disorders were independently associated with a higher burden and cost of hospitalization, without an increase in the risk of IBD-related surgery or procedures. Population-based interventions aimed at treating psychiatric comorbidities may decrease the risk of unplanned healthcare utilization.

Pediatric Chronic Pain, Resilience and Psychiatric Comorbidity in Canada: A Retrospective, Comparative Analysis.

Chronic pain compromises child and adolescent well-being and development. This study aimed to identify risk factors for chronic pain and exploration of how young people negotiate such risks and express resilience. We hypothesized children and youth with chronic pain would report greater prevalence of mental health disorders than the general population; and those demonstrating greater resilience would demonstrate less psychiatric comorbidity. A retrospective chart review was conducted for all patients (ages 7-17) attending the sole pediatric chronic pain clinic in Manitoba, from 2015 to 2019 (N = 116). Patients' demographic information and psychiatric illness burden were compared to provincial epidemiological data using Chi-Square tests. Pain sites, family history, psychiatric illness, psychosocial functioning, treatment history and treatment recommendations were explored. The sample was predominantly female (74%; N = 114). Sixty-eight percent of patients reported a family history of chronic pain. Thirty-seven percent of the patients (vs. 14.0% anticipated; N = 326 260) reported comorbid psychiatric disorder, X2 (1, N = 114) = 53.00, p < 0.001. Thirty-two percent reported diagnosis of mood and/or anxiety disorder (vs. 7.3%), X2 (1, N = 114) = 99.34, p < 0.001. Children and youth demonstrating resilience through engagement in more prosocial behaviors reported fewer psychiatric symptoms (rs = -0.292, N = 114, p = 0.002, Spearman's correlation). Female sex, family history, and lower socioeconomic status were associated with chronic pain. Psychiatric conditions were more prevalent in chronic pain patients than in the general population. Approaching chronic pain from a mind-body perspective, while building on patients' strengths, is central to informing treatment.

Psychiatric Comorbidities of Substance Use Disorders: Does Dual Diagnosis Predict Inpatient Detoxification Treatment Outcomes?

Comorbidity of substance use and psychiatric disorders, particularly depressive disorders, are well established. The impact of comorbidity on treatment outcomes, particularly following short-term inpatient detoxification and medical management units, has yet to be fully explored. This study reviewed 456 records of patients voluntarily presenting for medical management of substance misuse in Sydney, Australia. Documented psychiatric comorbidities and primary substance of misuse were extracted and used to predict length of stay, discharge against medical advice and number of readmissions. Our results showed that psychiatric comorbidity did not significantly predict treatment outcomes, although depression was reported in more than half our cohort, along with elevated rates of Post-traumatic Stress Disorder, anxiety disorders and bipolar affective disorders. Medication non-compliance and primary substance of misuse significantly predicted length of stay and discharge against medical advice. Further research into how specific substances interact and affect specific psychiatric disorders is needed to guide optimal treatment options.

Gender Differences in Psychiatric and Behavioral Health Burden Among Adults With Alcohol and Other Substance Use Disorders in the United States.

Studies report that women with opioid use disorder experience more comorbid psychiatric disorders and behavioral health burdens than men. We broadened the study of this phenomenon to alcohol use disorder (AUD) and other substance use disorders (SUDs) using national epidemiologic data. Data from the National Epidemiological Survey on Alcohol and Related Conditions Wave-III identified 2491 women and 3317 men with DSM-5 AUD or SUDs, and 30,501 men and women without such disorders. Women and men with AUD and SUDs were compared to those without such disorders on 22 measures of DSM-5 psychiatric disorders and behavioral histories (eg, incarceration and suicide attempt). The interaction of female sex and AUD in relation to these measures was evaluated and we repeated analyses for SUDs. Separate analyses of female and male adults with and without AUD or SUDs showed AUD and SUDs in both sexes were strongly associated with psychiatric disorders and behavioral histories. In pooled analyses, the interaction of female sex and AUD showed women with AUD had significantly greater likelihood than men of: borderline personality disorder, pain; parental history of incarceration; traumatic events; incarceration; and lifetime homelessness (P < 0.05 for all), but not for psychiatric diagnoses. Interaction of female sex with SUDs showed women had increased likelihood of all personality disorders, traumatic events, and past incarceration ( P < 0.05 for all). Certain personality disorders and behavioral histories, but not psychiatric diagnoses, may play a distinct role in leading to SUDs among women when compared to men.

Role of Neuregulin 3‐ErbB4 Signaling in a Murine Model of Co‐Morbid Nicotine Dependence and Schizophrenia

According to the NIH, rates of nicotine dependence among patients with schizophrenia are at nearly 90%, compared to smoking rates of approximately 12% in the general population. Current research shows that variations in the gene for Neuregulin 3 (NRG3), a member of the EGF superfamily and the cognate ligand for ErbB4 receptors, are considered some of the strongest genetic links contributing to schizophrenia risk. Additionally, NRG3 protein and mRNA have been found to be highly enriched following chronic nicotine exposure and withdrawal. However, specific mechanisms underpinning NRG3’s association with both increased schizophrenia risk and increased nicotine withdrawal symptomology are unknown. In this ongoing experiment, we are testing the overall hypothesis that NRG3‐ErbB4 signaling effects on NMDA receptor function may provide a discrete, mechanistic link between nicotine dependence and schizophrenia.We plan to utilize a novel genetic mouse model of both nicotine dependence and schizophrenia in a multidimensional approach to study how NRG3 mediates nicotine withdrawal‐induced alterations on behavioral and molecular levels and how the alterations relate to schizophrenic‐like dysfunction. To first begin these investigations, we examined the behavioral and molecular baseline effects of nicotine and aripiprazole, a long‐acting atypical antipsychotic used to treat schizophrenia, in wildtype littermates. Animals treated chronically for nicotine and then undergoing spontaneous nicotine withdrawal were examined in the alternating Y‐maze, social interaction test, and open field test for efficacy in reducing behavioral endophenotypes common to both nicotine withdrawal and schizophrenia in our model. Following behavioral testing, PFC tissues were analyzed to determine mRNA and protein expression of factors in the NRG3 signaling pathway. Preliminary results show differential changes in mRNA expression associated with glutamatergic and serotonergic transmission in the mPFC, OFC, and hippocampus. Ongoing experiments will extend these studies to include time‐ and site‐specific genetic deletion of NRG3 in the PFC and compare these results to those derived in wildtype littermates. Our findings will provide insight into the underlying mechanisms linking the NRG3 signaling pathway and nicotine dependence, and may provide a novel link between nicotine use and its highly co‐morbid psychiatric disorder, schizophrenia. Findings from these highly translational studies may lead to novel therapeutic development for both nicotine dependence and schizophrenia.

Relation between internet gaming addiction and comorbid psychiatric disorders and emotion avoidance among adolescents: A cross-sectional study

IntroductionInternet Gaming Disorder has been a controversial subject. Even though internet addiction has been studied among adolescents, there is a lack of evidence regarding Internet Gaming Disorder. The purpose of this study was to assess the prevalence rate of Internet Gaming Disorder and the relationship between Internet Gaming Disorder, comorbid psychiatric disorders, and emotion avoidance among adolescents. MethodsFour hundred seven adolescents aged 11 to 18 years old were recruited. Participants were divided into two groups based on the internet gaming addiction scale–Adolescents with IGA (N = 40) and adolescents without IGA (N = 367). All participants were evaluated for demographic data, the Strengths and Difficulties Questionnaire (SDQ), socioeconomic scale, and the Emotional Avoidance Strategy Inventory for Adolescents (EASI-A). ResultsThe adolescent with IGA had a higher mean of the number of hours and devices using Internet gaming apps than an adolescent without IGA. Regarding SDQ, adolescents with IGA had a significantly higher mean value for all subscales of SDQ except the prosocial scale and all subscales of EASI-A compared with adolescents without IGA. ConclusionsAdolescents with IGA had more hours and devices using Internet gaming apps; more comorbid psychiatric disorders and problems in emotional expression inform of using avoidance techniques than adolescents without IGA.

Transdiagnostic Psychiatry: Symptom Profiles and Their Direct and Indirect Relationship With Well-Being

Psychiatric disorders are known to affect both mental well-being and functional ability in patients. Heterogeneity and comorbidity in psychiatric disorders are common but create difficulties in the recognition and treatment of these disorders. However, most research does not cohere with this clinical reality and studies disorders and symptoms in isolation. Transdiagnostic psychiatric symptom profiles are hence instrumental for valid research into well-being and functioning in mental health care.

Depressive Symptoms and PANSS Symptom Dimensions in Patients With Predominant Negative Symptom Schizophrenia: A Network Analysis.

IntroductionSchizophrenia is a severe psychiatric disorder with a large symptomatic heterogeneity. Moreover, many patients with schizophrenia present with comorbid psychiatric symptoms or disorders. The relation between depressive symptoms and negative symptoms, such as blunted affect, alogia, anhedonia, asociality and avolition, is particularly intriguing. The negative symptoms can be primary or secondary of depression or overlapping with depressive symptoms. The aim of the present network analysis was to better understand the interactions between depressive symptoms and the different symptoms of schizophrenia and to investigate whether negative symptoms and depressive symptoms can be better delineated.MethodsA network analysis on the baseline item scores of the Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) from the cariprazine-risperidone study in patients with predominant negative symptoms (PNS) was performed. The connections between all these symptoms (PANSS and CDSS) were investiged: node strength and network centrality were estimated and the Mohr 5-factor model of the PANSS was applied to test the validity of its different symptoms clusters.ResultsAcross 460 patients with schizophrenia and PNS, the most central symptom (largest node strength) was depression (PANSS) followed by depression (CDSS), anxiety, lack of judgment and insight and tension. The PANSS negative symptom cluster together and was only poorly connected with CDSS depresson symptoms. The Mohr 5 factor model was clearly recognized in the overall clustering of symptoms.ConclusionThis network analysis suggests that depression and anxiety symptoms are the most central in this PNS patient population, despite the baseline low depression scores, and that negative symptoms are a clearly independent symptom cluster that can be delineated from depressive symptoms.