Behavioral Disturbances Research Articles

Efficacy of Aromatherapy Against Behavioral and Psychological Disturbances in People With Dementia: A Meta-Analysis of Randomized Controlled Trials

ObjectivesBehavioral and psychological symptoms of dementia (BPSD) are common in people with dementia. Aromatherapy may reduce the frequency and severity of BPSD. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of aromatherapy in relieving BPSD and improving functional ability in people with dementia. DesignSystematic review and meta-analysis. Setting and ParticipantsPatients with dementia receiving aromatherapy. MethodsA literature search was conducted using PubMed, Embase, and Cochrane Library for RCTs published before March 2024 comparing aromatherapy with control treatments in patients with dementia. ResultsThere were 15 trials involving 821 patients. Overall, significant reduction in BPSD was observed after 1 month of aromatherapy treatment. Among 15 trials, 9 reported the Cohen-Mansfield Agitation Inventory (CMAI) score, and 7 evaluated the Neuropsychiatric Inventory (NPI) score. The meta-analysis showed significant improvement in CMAI score [weighted mean difference (WMD) −6.31, 95% CI −9.52 to −3.11] and NPI score (WMD −8.07, 95% CI −13.53 to −2.61) in patients receiving 3 to 4 weeks of aromatherapy compared with the control group. Four of the 15 trials reported improvement in depressive mood and 3 trials reported no significant improvement in functional ability. Conclusions and ImplicationsIn conclusion, aromatherapy is a safe and viable nonpharmacologic treatment to improve BPSD in people with dementia and its combination with massage showed higher efficacy.

Successful Electroconvulsive Therapy in Aicardi-Goutières Syndrome Presenting Psychiatric Symptoms: An Unprecedented Clinical Case.

Aicardi-Goutières syndrome (AGS) is a rare genetic disorder that primarily affects the central nervous system and is characterized by severe intellectual and physical disabilities. Although AGS traditionally exhibits nonpsychiatric symptoms, our case challenges this norm by presenting an 18-year-old male with AGS who developed distinctive psychiatric manifestations that required hospital admission.The patient, diagnosed with spastic cerebral palsy and thrombotic vasculopathy, displayed abrupt behavioral disturbances, insomnia, and food aversion. Standard assessments revealed basal ganglia calcifications and chilblain-like lesions, and AGS was confirmed via genetic studies that showed a mutation in the SAMHD1 gene. Despite initial treatment with aripiprazole and diazepam, psychiatric symptoms persisted. This led to the initiation of electroconvulsive therapy (ECT) with substantial success, marking its first documented use in AGS.In conclusion, this unique case broadens the comprehension of AGS, introducing psychiatric symptoms and pioneering the successful application of ECT. The intricate interplay of neurovascular involvement, genetic nuances, and innovative treatments underscores the complexity of AGS, encouraging further exploration of its diverse clinical spectrum and evolving therapeutic strategies.

Noise disturbance increases negative emotions and unsafe behaviour among construction workers

Construction works and activities generate a high level of noise, which can have a negative impact on workers. Prolonged exposure to noise disturbance can result in psychological changes, such as reduced awareness, and physical changes, such as hearing impairment, in workers, which affect their behaviour. Coupled with negative emotions, noise disturbance can magnify workers’ unsafe behaviour. Adopting a case study research design, this research collected noise level data from an apartment project in Surabaya, Indonesia, and used a questionnaire survey to assess the level of noise disturbance, and workers’ negative emotions and unsafe behaviour in the project. The research found that the noise levels, particularly for structural works, were generally beyond the advisable threshold specified in the government’s regulation. As a result, workers who performed structural works experienced higher noise disturbance and more negative emotions, and tended to display more unsafe behaviour than workers who performed finishing works. The research also found that noise disturbance increases negative emotions and unsafe behaviour among construction workers. In addition, the result indicates that negative emotions can mediate the relationship between noise disturbance and unsafe behaviour. Managing noise levels, therefore, can be a strategy worth implementing to improve health and safety in construction projects. Furthermore, requiring workers to wear a hearing protection device is not adequate for construction noise management. Involving mitigation strategies higher in the hierarchy of risk controls is needed for this purpose.

Advanced temperature control in ethanol fermentation using a PSO-PID controller with split-range control strategy

Global energy demand is experiencing a notable surge due to growing energy security. Renewable energy sources, like ethanol, are becoming more viable. In the present study, the application of a PSO-PID (Particle Swarm Optimization – Proportional Integral Derivative) controller with a split-range control strategy was suggested for the regulation of temperature within the fermentation system. To optimize performance, a POS-PID controller with a split-range arrangement utilizing two control valves for hot and cold utilities was constructed. The study began by examining the open-loop dynamic response of the system to inlet temperature and concentration disturbances during ethanol production fermentation. Subsequently, a transfer function model was developed through linearization at the steady-state operating point. The split-range controller structure, implemented by optimizing the PSO-PID controller parameters using PSO, effectively demonstrated temperature control in simulations of a nonlinear model. In this investigation, the ethanol fermentation system was modeled as a CSTR using a modified Monod equation for microbial growth kinetics. Various dynamic behavioral disturbances were explored and verified in the model with plant data in this study. The simulation model results were validated through plant data. The proposed method showed superior closed-loop performance with respect to errors, with the actuators proving to be effective than other reported methods for temperature control.

A new cognitive conservation model for understanding Malaysian birders’ behaviour towards birds

ABSTRACT Birdwatching as a subset of ecotourism can produce recreational disturbance. This research aims to assess the validity and reliability of a formative conservation model regarding disturbance behaviour towards birds. This model uses cognitive theories to identify the key factors influencing behavioural intention towards disturbance behaviour on birds among Malaysian birdwatchers. We present the theory of planned behaviour (TPB), the theory of normative conduct, and the cognitive hierarchy model in the Predictor Bird Conservation Model (PBCM). The data was collected from 421 Malaysian birdwatchers using a field survey. The model was tested using the partial least squares (PLS) approach. This model provides managerial implications for determining the cognitive influential factors on intention towards target behaviour. Ten hypotheses are proposed and tested. The results showed subjective norms (SN) had the greatest substantial variance among other predictors of the study model. However, attitude and perceived behaviour had the lowest variance towards the intentions for target behaviour. The study contributes to existing literature regarding the implication of the TPB. This research also focuses on non-consuming behaviour which is considered critical for its potential for social pressure effect.

Neurological Disorders Induced by Drug Use: Effects of Adolescent and Embryonic Drug Exposure on Behavioral Neurodevelopment.

Clinical studies demonstrate that the risk of developing neurological disorders is increased by overconsumption of the commonly used drugs, alcohol, nicotine and cannabis. These drug-induced neurological disorders, which include substance use disorder (SUD) and its co-occurring emotional conditions such as anxiety and depression, are observed not only in adults but also with drug use during adolescence and after prenatal exposure to these drugs, and they are accompanied by long-lasting disturbances in brain development. This report provides overviews of clinical and preclinical studies, which confirm these adverse effects in adolescents and the offspring prenatally exposed to the drugs and include a more in-depth description of specific neuronal systems, their neurocircuitry and molecular mechanisms, affected by drug exposure and of specific techniques used to determine if these effects in the brain are causally related to the behavioral disturbances. With analysis of further studies, this review then addresses four specific questions that are important for fully understanding the impact that drug use in young individuals can have on future pregnancies and their offspring. Evidence demonstrates that the adverse effects on their brain and behavior can occur: (1) at low doses with short periods of drug exposure during pregnancy; (2) after pre-conception drug use by both females and males; (3) in subsequent generations following the initial drug exposure; and (4) in a sex-dependent manner, with drug use producing a greater risk in females than males of developing SUDs with emotional conditions and female offspring after prenatal drug exposure responding more adversely than male offspring. With the recent rise in drug use by adolescents and pregnant women that has occurred in association with the legalization of cannabis and increased availability of vaping tools, these conclusions from the clinical and preclinical literature are particularly alarming and underscore the urgent need to educate young women and men about the possible harmful effects of early drug use and to seek novel therapeutic strategies that might help to limit drug use in young individuals.

Enhancing prior-knowledge-based control with deep attention neural network for outlet moisture content of cut-tobacco

Monitoring and controlling the drying process is crucial, particularly for rotary dryers, to ensure optimal quality and efficiency. However, due to the process’s nonlinear behavior, delays, and input disturbances, achieving this can be quite challenging. Previous research has not adequately explored online forecasting for rotary dryer control in real production settings. To bridge this gap, our study focuses on tobacco drying in an actual plant and presents a novel online prediction model for moisture content. We conducted comparative experiments to validate the model’s practical application in production settings and demonstrate its effectiveness in enhancing drying control. Our approach, called MCTFormer, has proven to be scalable to high-dimensional problems. The results of our study indicate a 45% improvement in product quality through accurate prediction of outlet moisture content, better control over moisture levels, and reduced energy consumption.

Dementia Subtypes Defined Through Neuropsychiatric Symptom–Associated Brain Connectivity Patterns

Understanding the heterogeneity of neuropsychiatric symptoms (NPSs) and associated brain abnormalities is essential for effective management and treatment of dementia. To identify dementia subtypes with distinct functional connectivity associated with neuropsychiatric subsyndromes. Using data from the Open Access Series of Imaging Studies-3 (OASIS-3; recruitment began in 2005) and Alzheimer Disease Neuroimaging Initiative (ADNI; recruitment began in 2004) databases, this cross-sectional study analyzed resting-state functional magnetic resonance imaging (fMRI) scans, clinical assessments, and neuropsychological measures of participants aged 42 to 95 years. The fMRI data were processed from July 2022 to February 2024, with secondary analysis conducted from August 2022 to March 2024. Participants without medical conditions or medical contraindications for MRI were recruited. A multivariate sparse canonical correlation analysis was conducted to identify functional connectivity-informed NPS subsyndromes, including behavioral and anxiety subsyndromes. Subsequently, a clustering analysis was performed on obtained latent connectivity profiles to reveal neurophysiological subtypes, and differences in abnormal connectivity and phenotypic profiles between subtypes were examined. Among 1098 participants in OASIS-3, 177 individuals who had fMRI and at least 1 NPS at baseline were included (78 female [44.1%]; median [IQR] age, 72 [67-78] years) as a discovery dataset. There were 2 neuropsychiatric subsyndromes identified: behavioral (r = 0.22; P = .002; P for permutation = .007) and anxiety (r = 0.19; P = .01; P for permutation = .006) subsyndromes from connectivity NPS-associated latent features. The behavioral subsyndrome was characterized by connections predominantly involving the default mode (within-network contribution by summed correlation coefficients = 54) and somatomotor (within-network contribution = 58) networks and NPSs involving nighttime behavior disturbance (R = -0.29; P < .001), agitation (R = -0.28; P = .001), and apathy (R = -0.23; P = .007). The anxiety subsyndrome mainly consisted of connections involving the visual network (within-network contribution = 53) and anxiety-related NPSs (R = 0.36; P < .001). By clustering individuals along these 2 subsyndrome-associated connectivity latent features, 3 subtypes were found (subtype 1: 45 participants; subtype 2: 43 participants; subtype 3: 66 participants). Patients with dementia of subtype 3 exhibited similar brain connectivity and cognitive behavior patterns to those of healthy individuals. However, patients with dementia of subtypes 1 and 2 had different dysfunctional connectivity profiles involving the frontoparietal control network (FPC) and somatomotor network (the difference by summed z values was 230 within the SMN and 173 between the SMN and FPC for subtype 1 and 473 between the SMN and visual network for subtype 2) compared with those of healthy individuals. These dysfunctional connectivity patterns were associated with differences in baseline dementia severity (eg, the median [IQR] of the total score of NPSs was 2 [2-7] for subtype 3 vs 6 [3-8] for subtype 1; P = .04 and 5.5 [3-11] for subtype 2; P = .03) and longitudinal progression of cognitive impairment and behavioral dysfunction (eg, the overall interaction association between time and subtypes to orientation was F = 4.88; P = .008; using the time × subtype 3 interaction item as the reference level: β = 0.05; t = 2.6 for time × subtype 2; P = .01). These findings were further validated using a replication dataset of 193 participants (127 female [65.8%]; median [IQR] age, 74 [69-77] years) consisting of 154 newly released participants from OASIS-3 and 39 participants from ADNI. These findings may provide a novel framework to disentangle the neuropsychiatric and brain functional heterogeneity of dementia, offering a promising avenue to improve clinical management and facilitate the timely development of targeted interventions for patients with dementia.

Risk of behavioral disturbances in pediatric patients with epilepsy and mild to moderate cognitive impairment: A cross-sectional study.

The aim of the study was to assess whether children and adolescents with epilepsy are at higher risk of behavioral disturbances when they have concomitant cognitive disturbances. Behavioral scores were generated using the Child Behavior Checklist (CBCL). Cognitive evaluation was applied by using different age appropriate versions of the Wechsler Intelligence Scale. CBCL scores (total, externalizing, internalizing) were compared between patients with and without intellectual disability (IQ score < 70 and ≥70, respectively). 144 (10.2 mean age, 6.0-17.9 range) patients were recruited for the study. Patients with mild to moderate intellectual disability (full-scale intelligence quotient (FSIQ) < 70) were not at higher risk of behavioral disturbances (total CBCL score ≥ 63) than patients without cognitive impairment. The mean total CBCL score was 62.0 ± 10.6 (range 42.0-83.5, 95% CI 57.9-62.0) and 59.3 ± 10.3 (range 38.0-80.0, CI 57.4-61.2) for patients with FSIQ < 70 and ≥70, respectively. There was no correlation between FSIQ and total CBCL scores. These findings were true for all IQ subcategories. Behavioral disturbances among children and adolescents with epilepsy occur despite the presence or absence of intellectual dysfunction with respect to full-scale IQ.

Comparative efficacy and safety of olanzapine and risperidone in the treatment of psychiatric and behavioral symptoms of Alzheimer's disease: Systematic review and meta-analysis.

Olanzapine and risperidone have emerged as the most widely used drugs as short-term prescription in the treatment of behavioral disturbances in dementia. The present systematic review and meta-analysis was hence performed to investigate the effectiveness and safety profile of olanzapine and risperidone in the treatment of behavioral and psychological symptoms of dementia (BPSD), aiming to provide updated suggestion for clinical physicians and caregivers. Prospective controlled clinical studies were included, of which available data was extracted. Outcomes of BEHAVE-AD scores with the variation of grades, specific behaviors variables, as well as safety signals were pooled for the analysis by odds rates and weighted mean differences, respectively. Medline, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WanFang. Prospective, controlled clinical studies, conducted to compare the effectiveness and safety profile of olanzapine and risperidone in the treatment of BPSD. Interested data including baseline characteristics and necessary outcomes from the included studies were extracted independently by 2 investigators. BEHAVE-AD scale was adopted to assess the efficacy in the present study. All behaviors were evaluated at the time of the initiation of the treatment, as well as the completion of drugs courses. Adverse events were assessed with the criteria of Treatment Emergent Symptom Scale, or Coding Symbols for a Thesaurus of Adverse Reaction Terms dictionary. Weighted mean difference was used for the pooled analysis. A total of 2427 participants were included in the present meta-analysis. Comparative OR on response rate, and remarkable response rate between olanzapine and risperidone was 0.65 (95% CI: 0.51-0.84; P = .0008), and 0.62 (95% CI: 0.50-0.78; P < .0001), respectively. There were statistical differences observed by olanzapine on the improvement of variables including delusions (WMD, -1.83, 95% CI, -3.20, -0.47), and nighttime behavior disturbances (WMD, -1.99, 95% CI, -3.60, -0.38) when compared to risperidone. Our results suggested that olanzapine might be statistically superior to risperidone on the reduction of BPSD of Alzheimer's disease, especially in the relief of delusions and nighttime behavior disturbances. In addition, olanzapine was shown statistically lower risks of agitation, sleep disturbance, and extrapyramidal signs.

Efficacy of acupuncture combined with traditional Chinese herbal for primary epilepsy patients with cognitive impairment: A protocol for systematic review and meta-analysis.

Epilepsy is a common and serious chronic neurological disorder, and some patients suffer from cognitive dysfunction. We aim to assess the efficacy and safety of acupuncture combined with traditional Chinese herbal for primary epilepsy patients with cognitive impairment. To search the randomized control trials (RCTs) published before April 20, 2023 from PubMed, Embase, Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Web of science, and Wanfang Database. The risk of bias within each individual trial was evaluated using the Cochrane Collaboration tool. RevMan5.3 software was used for statistical analysis. The odds ratio (OR) or weighted mean difference (WMD) with a 95% confidence interval (CI) was calculated for each RCT before data pooling. The primary outcomes involve changes in cognitive function and behavioral disturbances. The secondary outcomes focused on quality of life and adverse effects. The results of this review are expected to provide new guidelines for the treatment of primary epilepsy patients with cognitive impairment. This systematic review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (Registration number: CRD42023415355).

PET Study of Microglial Activation in Kleine-Levin Syndrome.

Kleine-Levin syndrome (KLS) is a rare recurrent hypersomnolence disorder associated with cognitive and behavioral disturbances, of unknown origin, but inflammatory mechanisms could be involved. We aimed to explore in vivo microglia activation using [18F]DPA-714 PET imaging in patients with KLS compared with controls, and during symptomatic vs asymptomatic periods. Patients with KLS and controls underwent a standardized clinical evaluation and PET imaging, using a radiolabeled ligand specific to the 18 kDa translocator protein. Images were processed on the PMOD (peripheral module) interface using a standard uptake value (SUV). Five regions of interest (ROIs) were analyzed: hypothalamus, thalamus, frontal area, cerebellum, and whole brain. SUV ratios (SUVr) were calculated by normalizing SUV with cerebellum uptake. Images of 17 consecutive patients with KLS (7 during episodes, 10 out of episodes) and 14 controls were analyzed. We found no SUV/SUVr difference between KLS and controls, between patients in and out episodes in all ROIs, and no correlation between SUVr and episode duration at the time of PET scan. No association was found between SUVr and sex, disease duration, or orexin levels. Our findings do not support the presence of neuroinflammation in KLS. Further research is needed to identify relevant biomarkers in KLS.

Incidence of mental disorders in Kazakhstan in 2011-2020: an information-analytical study

Introduction. Mental disorders, characterized by disturbances in thinking, feeling, and behavior, pose a significant medical and social challenge. They affect a substantial portion of the population, leading to profound health implications and diminished quality of life. Despite the considerable interest in this area, data regarding the prevalence of mental disorders in the Republic of Kazakhstan still need to be made available. This study aims to analyze the trend of mental disorder prevalence in Kazakhstan from 2011 to 2020, considering various factors such as gender, age, and residency. Methods. This study employed an informational and analytical approach. Data from 10 statistical compilations of the Ministry of Health of the Republic of Kazakhstan spanning from 2011 to 2020 were utilized to assess the prevalence of mental disorders. Information about morbidity falling under the category of "mental disorders and behavioral disorders" was incorporated. The data were processed and presented in terms of absolute values and relative indicators. Results and conclusions. Analyzing mental disorder incidence data in Kazakhstan over the ten years revealed several trends. Overall morbidity rates showed a declining trend, notwithstanding some years witnessing minor increases in morbidity. The relative incidence rates also decreased, as evidenced by data per 100,000 population. Primary morbidity demonstrated a general decline, with a notable decrease observed in the first half of the study period. Across age groups, morbidity rates decreased in all categories, with the highest rates observed among adults. Moreover, there was a reduction in morbidity rates in both urban and rural populations, albeit with urban areas consistently exhibiting higher rates than rural areas. These findings could inform the development of interventions aimed at enhancing the mental well-being of the population and improving the management of this medical and social challenge in the future.

Impacts of Unhealthy Behaviors on Mental Health among Public Health Residents: The PHRASI Study.

Unhealthy behaviors (UBs) can affect mental health. The most impactful of these are alcohol abuse, sedentary behavior, and sleep disturbances. Since these UBs are not well explored in medical residents, this study aims to overcome this gap, focusing on outcomes such as depression and anxiety. The Public Health Residents' Anonymous Survey in Italy (PHRASI) is a nationwide cross-sectional study based on an 88-item questionnaire. UBs were explored through validated questionnaires: the Alcohol Use Disorders Identification Test-c (AUDIT-C), the International Physical Activity Questionnaire (IPAQ), and the Insomnia Severity Index (ISI). Depressive symptoms and anxiety were detected by Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Hierarchical cluster analysis described clusters using responses from the AUDIT-C, IPAQ, and ISI. A total of 375 participants were included in this study. Three distinct clusters (CL) were identified: CL1 was characterized by a moderate risk for alcohol abuse and high insomnia dissatisfaction, with a significantly higher frequency of depressive symptoms (46%, p < 0.001) and anxiety (53%, p < 0.001); CL2 had no risk for alcohol abuse, high sleep satisfaction, and better mental health profile, with the lowest prevalence of depressive symptoms (15%, p < 0.001); CL3 had the highest risk of alcohol abuse, the highest rate of physical activity (40%, p = 0.013), and the lowest prevalence of anxiety (27%, p < 0.001). Subjects belonging to CL1 required much more attention to prevent the worsening of mental outcomes. Interventions for promoting mental health should be addressed in all Public Health schools to create more sustainable working conditions.

Pilot educational intervention for the care of adolescents with autism spectrum disorder during puberty

ABSTRACT Puberty is a particularly vulnerable time for individuals with autism spectrum disorder (ASD) during which baseline challenges are exacerbated, functioning often deteriorates, and additional barriers emerge. Specific concerns include increased vulnerability, decreased safety, and increased mood and behavioral disturbances. Youth with ASD need guidance and explicit instruction/skill development on topics such as hygiene/self-care, appropriate sexual activity, and menstruation management. Lack of provider preparation, knowledge, and confidence, along with stigma about the needs and capabilities of individuals with ASD, are major barriers to care. Initiatives to expand the preparation of health care personnel, including nurse practitioners, to provide quality care to individuals with ASD are essential. This article describes the results of a pilot project using a brief, self-guided educational intervention for developing and practicing family nurse practitioners. Before and after viewing the educational module, participants completed author-created surveys assessing their self-perceived knowledge, attitudes, and intent to change practice. Expert analysis of survey items provided face validity. Comparison of mean presurvey and postsurvey responses showed significant increases in self-perceived knowledge, attitudes, and intent to implement practice changes. Lack of confidence was endorsed as the most common remaining barrier to change. Findings indicate that the brief module improved participants' self-reported knowledge, attitudes, and intent to implement practice recommendations. Such interventions can be easily incorporated into nursing education and professional development and are appropriate for dissemination to including nurse practitioners working within and outside primary care settings, as well as to related service providers.

Status epilepticus and psychosis: Lessons from SEEG

Psychotic manifestations are a classic feature of non-convulsive status epilepticus (NCSE) of temporal origin. For several decades now, the various psychiatric manifestations of NCSE have been described, and in particular, the diagnostic challenges they pose. However, studies using stereotactic-EEG (SEEG) recordings are very rare. Only a few cases have been reported, but they demonstrated the anatomical substrate of certain manifestations, including hallucinations, delusions, and emotional changes. The post-ictal origin of some of the manifestations should be emphasized. More generally, SEEG has shown that seizures affecting the temporal and frontal limbic systems can lead to intense emotional experiences and behavioural disturbances.

Emergency department mental health presentations in young children: a retrospective chart review

AimTo characterise key features of young people presenting to the emergency department (ED) with a mental health complaint when comparing children (aged 7 to 12 years) and teenagers (13 years and greater).MethodsRetrospective review of all ED mental health presentations in children aged 7–17 years presenting over a 12‐month period in 2018 to a tertiary children's hospital in Victoria, Australia. Univariate analyses were carried out to examine the relationship between children and teenagers and a number of key presentation variables. Odds Ratios (ORs) and 95% Confidence Intervals (CIs) were calculated for ED management outcomes.ResultsThere were 1691 ED mental health presentations in 2018. Of these presentations, 407 (24%) were children aged 12 years or less. The remaining 76% (1284) were teenagers. The younger aged cohort were more likely to be male (OR 2.43, CI 1.92–3.08) and have a past history of autism spectrum disorder (OR 1.92, CI 1.45–1.84). They were more likely to have a presenting complaint of acute behavioural disturbance (OR 2.03, CI 1.59–2.60), be physically restrained (OR 2.01, CI 1.18–3.37) and have sedative medication provided (OR 2.87, CI 1.63–5.04). The older aged cohort were more likely to have a past history of depression (OR 0.19, CI 0.12–0.29) and a presenting complaint of intentional self‐poisoning (OR 0.33, CI 0.15–0.65).ConclusionsChildren aged 12 years or less represent one‐quarter of all young people presenting to the ED with a mental health concern. They experience high rates of acute behavioural disturbance and are more likely to require restrictive interventions during their presentation.

Symptoms of dementia progression in cognitive impairment: the role of religious and spiritual activity

ABSTRACT This exploratory study explores the role of religious and spiritual (R/S) activity in cognitive impairment. We used data from respondents with Mild Cognitive Impairment (MCI) from the Health and Retirement Study and Aging, Demographics, and Memory sub-study to investigate associations between religious service attendance and behavioral expressions, cognition, and sleep disturbances independently at two different time points using Spearman’s Rho partial correlation. Religious service attendance was significantly associated with behavioral expressions, cognition, and sleep disturbances. Older adults with MCI who exhibited heightened levels of R/S activity engagement reported decreased behavioral expressions and better cognition at both time points.

Transcriptome analysis identifies an ASD-Like phenotype in oligodendrocytes and microglia from C58/J amygdala that is dependent on sex and sociability

BackgroundAutism Spectrum Disorder (ASD) is a group of neurodevelopmental disorders with higher incidence in males and is characterized by atypical verbal/nonverbal communication, restricted interests that can be accompanied by repetitive behavior, and disturbances in social behavior. This study investigated brain mechanisms that contribute to sociability deficits and sex differences in an ASD animal model.MethodsSociability was measured in C58/J and C57BL/6J mice using the 3-chamber social choice test. Bulk RNA-Seq and snRNA-Seq identified transcriptional changes in C58/J and C57BL/6J amygdala within which DMRseq was used to measure differentially methylated regions in amygdala.ResultsC58/J mice displayed divergent social strata in the 3-chamber test. Transcriptional and pathway signatures revealed immune-related biological processes differ between C58/J and C57BL/6J amygdala. Hypermethylated and hypomethylated genes were identified in C58/J versus C57BL/6J amygdala. snRNA-Seq data in C58/J amygdala identified differential transcriptional signatures within oligodendrocytes and microglia characterized by increased ASD risk gene expression and predicted impaired myelination that was dependent on sex and sociability. RNA velocity, gene regulatory network, and cell communication analysis showed diminished oligodendrocyte/microglia differentiation. Findings were verified using Bulk RNA-Seq and demonstrated oxytocin’s beneficial effects on myelin gene expression.LimitationsOur findings are significant. However, limitations can be noted. The cellular mechanisms linking reduced oligodendrocyte differentiation and reduced myelination to an ASD phenotype in C58/J mice need further investigation. Additional snRNA-Seq and spatial studies would determine if effects in oligodendrocytes/microglia are unique to amygdala or if this occurs in other brain regions. Oxytocin’s effects need further examination to understand its’ potential as an ASD therapeutic.ConclusionsOur work demonstrates the C58/J mouse model’s utility in evaluating the influence of sex and sociability on the transcriptome in concomitant brain regions involved in ASD. Our single-nucleus transcriptome analysis elucidates potential pathological roles of oligodendrocytes and microglia in ASD. This investigation provides details regarding regulatory features disrupted in these cell types, including transcriptional gene dysregulation, aberrant cell differentiation, altered gene regulatory networks, and changes to key pathways that promote microglia/oligodendrocyte differentiation. Our studies provide insight into interactions between genetic risk and epigenetic processes associated with divergent affiliative behavior and lack of positive sociability.

Succinic semialdehyde dehydrogenase deficiency: a metabolic and genomic approach to diagnosis.

Genomic sequencing offers an untargeted, data-driven approach to genetic diagnosis; however, variants of uncertain significance often hinder the diagnostic process. The discovery of rare genomic variants without previously known functional evidence of pathogenicity often results in variants being overlooked as potentially causative, particularly in individuals with undifferentiated phenotypes. Consequently, many neurometabolic conditions, including those in the GABA (gamma-aminobutyric acid) catabolism pathway, are underdiagnosed. Succinic semialdehyde dehydrogenase deficiency (SSADHD, OMIM #271980) is a neurometabolic disorder in the GABA catabolism pathway. The disorder is due to bi-allelic pathogenic variants in ALDH5A1 and is usually characterized by moderate-to-severe developmental delays, hypotonia, intellectual disability, ataxia, seizures, hyperkinetic behavior, aggression, psychiatric disorders, and sleep disturbances. In this study, we utilized an integrated approach to diagnosis of SSADHD by examining molecular, clinical, and metabolomic data from a single large commercial laboratory. Our analysis led to the identification of 16 patients with likely SSADHD along with three novel variants. We also showed that patients with this disorder have a clear metabolomic signature that, along with molecular and clinical findings, may allow for more rapid and efficient diagnosis. We further surveyed all available pathogenic/likely pathogenic variants and used this information to estimate the global prevalence of this disease. Taken together, our comprehensive analysis allows for a global approach to the diagnosis of SSADHD and provides a pathway to improved diagnosis and potential incorporation into newborn screening programs. Furthermore, early diagnosis facilitates referral to genetic counseling, family support, and access to targeted treatments-taken together, these provide the best outcomes for individuals living with either GABA-TD or SSADHD, as well as other rare conditions.