Effects Of Psychiatric Disorders Research Articles

Abstract 4713: Chlorpromazine affects glioblastoma bioenergetics by interfering with pyruvate kinase M2: A route for drug repurposing in glioblastoma

Abstract Glioblastoma, the most common and deadly brain tumor, remains a critical unmet medical need due to the limited effectiveness of current treatments. Drug repurposing has recently emerged as a promising strategy to improve glioblastoma outcomes. Antipsychotic drugs, with their established safety profile and potential to disrupt tumor-neuron interactions, have drawn particular attention. Among these, chlorpromazine, a well-tolerated medication included in the 2021 WHO Model List of Essential Medicines, holds promise due to its therapeutic effects in psychiatric disorders stemming from its non-specific interference with various CNS neurotransmitter receptors. Our recent studies have demonstrated chlorpromazine's ability to inhibit several molecular and cellular processes in glioblastoma cells, suggesting its potential as a novel treatment option for this challenging disease.To elucidate chlorpromazine's mechanism of action as a potential anticancer drug, we employed two proteomics approaches: Reverse-Phase Protein microArrays to evaluate its impact on signal transduction pathways and Activity-Based Protein Profiling followed by mass spectrometry to identify novel molecular targets.Our data revealed that chlorpromazine significantly modulates major signal transduction pathways and implicates pyruvate kinase (PK) M2 as a drug target. PKM2, a PK variant characteristic of many cancers, plays a crucial role in orchestrating metabolic alterations, exemplified by the Warburg effect – the high glucose consumption and lactate production by cancer cells even under oxygen-rich conditions. PKM2 functions as a tetramer in the glycolytic pathway, while its dimeric form acquires nuclear localization, protein kinase activity, and interacts with various transcription factors, contributing to its pro-tumorigenic activity.Consistent with its ability to target PKM2, chlorpromazine promoted PKM2 tetramerization in glioblastoma cells, leading to significant alterations in glioblastoma energy metabolism. Notably, RPE-1 non-cancer neuroepithelial cells showed a reduced response to the drug. Additionally, silencing PKM2 diminished the effects of chlorpromazine. 3D modeling revealed that chlorpromazine interacts with the PKM2 tetramer at the same site involved in binding other small-molecule activators that stabilize the PKM2 tetramer.These findings suggest that chlorpromazine counteracts the Warburg effect and, consequently, malignancy in glioblastoma cells, while sparing non-cancerous RPE-1 cells. This preclinical evidence supports the rationale behind our recently completed multicenter Phase II clinical trial investigating the role of chlorpromazine in glioblastoma treatment. The study is registered as EudraCT #2019-001988-75 and ClinicalTrials.gov Identifier #NCT0422444. Citation Format: Claudia Abbruzzese, Silvia Matteoni, Paola Matarrese, Michele Signore, Barbara Ascione, Elisabetta Iessi, Aymone Gurtner, Andrea Sacconi, Andrea Pace, Veronica Villani, Andrea Polo, Susan Costantini, Alfredo Budillon, Gennaro Ciliberto, Marco G. Paggi. Chlorpromazine affects glioblastoma bioenergetics by interfering with pyruvate kinase M2: A route for drug repurposing in glioblastoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4713.

The effects of psychiatric disorders on the risk of chronic heart failure: a univariable and multivariable Mendelian randomization study.

Substantial evidence suggests an association between psychiatric disorders and chronic heart failure. However, further investigation is needed to confirm the causal relationship between these psychiatric disorders and chronic heart failure. To address this, we evaluated the potential effects of five psychiatric disorders on chronic heart failure using two-sample Mendelian Randomization (MR). We selected single nucleotide polymorphisms (SNPs) associated with chronic heart failure and five psychiatric disorders (Attention-Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), Major Depression, Bipolar Disorder and Schizophrenia (SCZ)). Univariable (UVMR) and multivariable two-sample Mendelian Randomization (MVMR) were employed to assess causality between these conditions. Ever smoked and alcohol consumption were controlled for mediating effects in the multivariable MR. The inverse variance weighting (IVW) and Wald ratio estimator methods served as the primary analytical methods for estimating potential causal effects. MR-Egger and weighted median analyses were also conducted to validate the results. Sensitivity analyses included the funnel plot, leave-one-out, and MR-Egger intercept tests. Additionally, potential mediators were investigated through risk factor analyses. Genetically predicted heart failure was significantly associated with ADHD (odds ratio (OR), 1.12; 95% CI, 1.04-1.20; p = 0.001), ASD (OR, 1.29; 95% CI, 1.07-1.56; p = 0.008), bipolar disorder (OR, 0.89; 95% CI, 0.83-0.96; p = 0.001), major depression (OR, 1.15; 95% CI, 1.03-1.29; p = 0.015), SCZ (OR, 1.04; 95% CI, 1.00-1.07; p = 0.024). Several risk factors for heart failure are implicated in the above cause-and-effect relationship, including ever smoked and alcohol consumption. Our study demonstrated ADHD, ASD, SCZ and major depression may have a causal relationship with an increased risk of heart failure. In contrast, bipolar disorder was associated with a reduced risk of heart failure, which could potentially be mediated by ever smoked and alcohol consumption. Therefore, prevention strategies for heart failure should also incorporate mental health considerations, and vice versa.

Cardiometabolic Effects of Antipsychotics in Challenging Behavior and Neuropsychiatric Symptoms in Patients With Intellectual Disability.

Introduction Despite the well-established association between antipsychotics and metabolic adverse effects in psychiatric disorders, the variable influence of long-term and off-label antipsychotic medication on behavioral disorders has not been investigated in detail. Objective To clarify the impact of antipsychotic use on challenging behavior (CB) and neuropsychiatric symptoms (NPS), we evaluated the clinical findings and cardiometabolic effects in individuals with intellectual disability (ID) hospitalized in our residential facility for profoundly disabled patients. Patients and methods A total of 130 individuals hospitalized in our residential facility were retrospectively investigated and divided into two groups - individuals with and without CB and NPS. Antipsychotics (first- and second-generation antipsychotics) are prescribed to all individuals in the CB and NPS-positive ID group. Conversely, antipsychotics were not prescribed to any individuals in the CB- and NPS-negative ID groups. To investigate the cardiometabolic effects of antipsychotics, the following metabolic parameters were measured: body weight (BW), total calorie intake per day, body mass index (BMI), blood pressure, serum lipid levels (total cholesterol, high-density lipoprotein cholesterol, and triglyceride), and corrected QT interval (QTc) of electrocardiogram (ECG). The etiology of disabilities, level of ID, severity of motor disability, and presence or absence of epilepsy were also examined. Results Two main results were derived: (1) Autism spectrum disorder was the most predominant etiology in individuals with CB and NPS who were prescribed antipsychotics, and (2) the mean values of metabolic parameters were all normal in both medicated and nonmedicated individuals, but the total calorie intake was significantly higher in individuals who were prescribed antipsychotics. Conclusions Our investigation demonstrated that in individuals with an adequate energy intake, most metabolic parameters can be maintained within normal limits. We suggest that body weight control is the primary step in avoiding the cardiometabolic adverse effects of antipsychotics in intellectually disabled individuals with CB and NPS.

Why does patient mental health matter? part 5: chronic orofacial pain as a consequence of psychiatric disorders

This is the final article in a series looking at psychiatric presentations in dentistry. Recently, the oral health of people with severe mental illness (SMI) has gained significant media attention after the Office of the Chief Dental Officer for England published a statement on the importance of prioritizing oral health for people with SMI. Furthermore, a consensus statement has set out a 5-year plan to improve oral health in people with SMI. In Part 4, we discussed how a psychiatric disorder can result in dental pathology by contributing to risk factors associated with tooth surface loss. This article explores chronic orofacial pain symptoms and their link with psychiatry, considering the role of the primary dental care team in early recognition of psychiatric disorders. Given the range of chronic orofacial pain subtypes, we will present two separate fictionalized case-based discussions to explore their presentation. CPD/Clinical Relevance: The primary care dental team has a role in recognition of psychiatric conditions and subsequent chronic orofacial pain.

The Effect of Psychiatric Disorders and Stressful Environmental Factors in Correlation with Smoking and Coronary Heart Disease

The Effect of Psychiatric Disorders and Stressful Environmental Factors in Correlation with Smoking and Coronary Heart Disease

Sleep Complaints Among Adults With Major Depressive Episode Are Associated With Increased Risk of Incident Psychiatric Disorders

Objective: Sleep alterations have been suggested as a cause and consequence of psychiatric disorders. In this context, we evaluated the incidence of psychiatric disorders following sleep complaints in adults with major depressive episode (MDE).Methods: In a large, nationally representative 3-year prospective survey, the National Epidemiologic Survey on Alcohol and Related Conditions conducted in 2001-2002 (Wave 1) and 2004-2005 (Wave 2), we used structural equation modeling to examine shared and specific effects of trouble falling asleep, early morning awakening, and hypersomnia on incidence of common comorbid DSM-IV disorders among patients with MDE. The analyses adjusted for sociodemographic and clinical characteristics, including sedative or tranquilizer use.Results: Among participants with MDE at Wave 1, 3-year incidence rates were dysthymia = 2.9%, general anxiety disorder = 8.2%, panic disorder = 3.4%, social anxiety disorder = 4.0%, specific phobia = 3.0%, alcohol use disorder = 8.1%, nicotine dependence = 6.2%, cannabis use disorder = 2.7%, and other drug use disorder = 4.9%. Participants with 3-year incident psychiatric disorders commonly had trouble falling asleep (67.6% for cannabis use disorder to 76.4% for panic disorder), early morning awakening (43.3% for cannabis use disorder to 55.6% for dysthymia), and hypersomnia (51.3% for nicotine use disorder to 72.1% for social anxiety disorder). The effects of the incident general psychopathology factor, representing mechanisms related to incidence of all psychiatric disorders, were exerted almost exclusively through a factor representing shared effect across all sleep complaints. Sleep complaints were associated with increased risk of incident psychiatric disorders, independent of sociodemographic and clinical characteristics.Conclusions: These findings suggest that sleep complaints should be clinically assessed in all psychiatric disorders, as these prodromal symptoms might constitute transdiagnostic biomarkers and therapeutic targets for prevention.

Psychological strategies for dealing with mental disorders in the preoperative and postoperative period

Surgery is a very stressful situation for humans, resulting in various psychiatric problems. Fear of the operation process, fear of the unknown, death anxiety along with changes in primary personal, family and professional roles, cause the manifestation of problems from the mental realm. The effects of psychiatric disorders can have a profound effect on both the mental and physical health of the patient.

Psychological Strategies for Dealing with Mental Disorders in the Preoperative and Postoperative Period

Surgery is a very stressful situation for humans, resulting in various psychiatric problems. Fear of the operation process, fear of the unknown, death anxiety along with changes in primary personal, family and professional roles, cause the manifestation of problems from the mental realm. The effects of psychiatric disorders can have a profound effect on both the mental and physical health of the patient. Aim: The aim of this study is to present psychiatric disorders during the perioperative period.

Erythropoietin and Non-Erythropoietic Derivatives in Cognition.

Cognitive deficits are widespread in psychiatric disorders, including major depression and schizophrenia. These deficits are known to contribute significantly to the accompanying functional impairment. Progress in the development of targeted treatments of cognitive deficits has been limited and there exists a major unmet need to develop more efficacious treatments. Erythropoietin (Epo) has shown promising procognitive effects in psychiatric disorders, providing support for a neurotrophic drug development approach. Several preclinical studies with non-erythropoietic derivatives have demonstrated that the modulation of behavior is independent of erythropoiesis. In this review, we examine the molecular, cellular and cognitive actions of Epo and non-erythropoietic molecular derivatives by focusing on their neurotrophic, synaptic, myelin plasticity, anti-inflammatory and neurogenic mechanisms in the brain. We also discuss the role of receptor signaling in Epo and non-erythropoietic EPO-mimetic molecules in their procognitive effects.

A pilot to assess the feasibility and potential clinical utility of enhanced sleep management on inpatient wards in a mental health trust

AimsTo assess the feasibility and utility of introducing the following changes on to in-patient units:Structural and cultural adaptation to create a sleep friendly ward environmentA “Protected Sleep Time” between midnight and 6amRoutine screening for sleep disorders, including obstructive sleep apnoea and restless leg syndromeBackgroundInsomnia and other sleep disturbances are cause, correlate and consequence of psychiatric disorders. Routine hourly night time observations, ward noise, bright lights at night time, sleep disorders, insufficient exercise, insufficient day light exposure, too much caffeine and inappropriate psychotropic use are all causes of disturbed sleep (Horne 2018).MethodSeven wards participated in a pilot (SleepWell). These consisted of one male and two female Acute Wards (General Adult), a High Dependency Unit, a Neurorehabilitation ward, an in-patient dementia service and one rehabilitation ward. These wards were supported via an existing trust management structure and the pilot was specifically supported by two trust managers (RW and RB) and by a clinical director (PK). The expectation was that each ward would identify a sleep champion from existing staff to facilitate the changes. A “product” was developed which identified core sleep management features but, in addition, wards were not confined to these. The existing policy that all inpatients should be checked each hour over night was suspended for the pilot wards and the patients had protected sleep time (PST) if the MDT agreed that it was clinically appropriate.Quantitative and qualitative techniques were used to identify facilitators of change, impact on sleep and, outcome.ResultProtected sleep was viewed positively by all staff and approximately 50% of patients on the pilot wards were able to have PST at some point in their admission. Routine sleep disorder assessments were harder to implement and 33% of patients were screened. There were no deaths or significant events on patients due to PST. Hypnotic use on the pilot wards reduced. It is anticipated that PST where it is safe will be rolled out across all adult and old age wards in the trust.ConclusionWith support, it has been feasible to change many aspects of sleep management across a breadth of inpatient units in a large NHS trust.

A Comparative Analysis of Erythropoietin and Carbamoylated Erythropoietin Proteome Profiles.

In recent years, erythropoietin (EPO) has emerged as a useful neuroprotective and neurotrophic molecule that produces antidepressant and cognitive-enhancing effects in psychiatric disorders. However, EPO robustly induces erythropoiesis and elevates red blood cell counts. Chronic administration is therefore likely to increase blood viscosity and produce adverse effects in non-anemic populations. Carbamoylated erythropoietin (CEPO), a chemically engineered modification of EPO, is non-erythropoietic but retains the neurotrophic and neurotrophic activity of EPO. Blood profile analysis after EPO and CEPO administration showed that CEPO has no effect on red blood cell or platelet counts. We conducted an unbiased, quantitative, mass spectrometry-based proteomics study to comparatively investigate EPO and CEPO-induced protein profiles in neuronal phenotype PC12 cells. Bioinformatics enrichment analysis of the protein expression profiles revealed the upregulation of protein functions related to memory formation such as synaptic plasticity, long term potentiation (LTP), neurotransmitter transport, synaptic vesicle priming, and dendritic spine development. The regulated proteins, with roles in LTP and synaptic plasticity, include calcium/calmodulin-dependent protein kinase type 1 (Camk1), Synaptosomal-Associated Protein, 25 kDa (SNAP-25), Sectretogranin-1 (Chgb), Cortactin (Cttn), Elongation initiation factor 3a (Eif3a) and 60S acidic ribosomal protein P2 (Rplp2). We examined the expression of a subset of regulated proteins, Cortactin, Grb2 and Pleiotrophin, by immunofluorescence analysis in the rat brain. Grb2 was increased in the dentate gyrus by EPO and CEPO. Cortactin was induced by CEPO in the molecular layer, and pleiotrophin was increased in the vasculature by EPO. The results of our study shed light on potential mechanisms whereby EPO and CEPO produce cognitive-enhancing effects in clinical and preclinical studies.

Controlled direct effect of psychiatric disorders on cardiovascular disease: evidence from a large Kurdish cohort

BackgroundPsychiatric disorders are significantly associated with the incidence and prevalence of cardiovascular diseases, mortality, hospital readmissionn. Oral and dental hygiene may play a role in such association. This study aimed to evaluate the controlled direct effect of psychiatric disorders on cardiovascular diseases by controlling the mediating effect of oral and dental hygiene.MethodsThe data used for this study came from the baseline phase of Ravansar Non-communicable Disease (RaNCD) cohort study. RaNCD cohort study is including a representative sample of 10,065 adults (35–65 years old) living in Ravansar, a city in the west of Iran. The marginal structural model with stabilized inverse probability weights accounted for potential confounders was used to estimate the controlled direct effect of psychiatric disorders on cardiovascular diseases. Three different models using three mediators including oral and dental hygiene behaviors, oral ulcer and lesions, and decayed, missing, and filled tooth, were used.ResultsPsychiatric disorders increase the odds of cardiovascular diseases by 83% (OR = 1.83, CI 1.27, 2.61) and about two times (OR = 2.14, 95% CI 1.74, 2.63) when controlled for oral and dental hygiene behaviors, and oral ulcer and lesions as mediators, respectively. When decayed, missing, and filled tooth, as a mediator, was set at ≤ 8, there was no statistically significant controlled direct effect of psychiatric disorders on cardiovascular diseases (OR = 0.90, 95% CI 0.62, 1.30).ConclusionOur results suggested that psychiatric disorder was directly related to cardiovascular diseases even if it was possible to have good oral and dental hygiene. The results suggested that interventions targeting people with psychiatric disorders could reduce prevalence of the cardiovascular diseases.

Molecular Correlates of Topiramate and GRIK1 rs2832407 Genotype in Pluripotent Stem Cell-Derived Neural Cultures.

There is growing evidence that the anticonvulsant topiramate is efficacious in reducing alcohol consumption. Further, an intronic single nucleotide polymorphism (rs2832407, C A) in the GRIK1 gene, which encodes the GluK1 subunit of the excitatory kainate receptor, predicted topiramate's effectiveness in reducing heavy drinking in a clinical trial. The molecular correlates of GRIK1 genotype that may relate to topiramate's ability to reduce drinking remain unknown. We differentiated induced pluripotent stem cells (iPSCs) characterized by GRIK1 rs2832407 genotype from 8 A/A and 8 C/C donors into forebrain-lineage neural cultures. Our differentiation protocol yielded mixed neural cultures enriched for glutamatergic neurons. Basal mRNA expression of the GRIK1 locus was examined via quantitative polymerase chain reaction (qPCR). The effects of acute topiramate exposure on excitatory spontaneous synaptic activity were examined via whole-cell patch-clamp electrophysiology. Results were compared and contrasted between iPSC donor genotypes. Although characterization of the GRIK1 locus revealed no effect of rs2832407 genotype on GRIK1 isoform mRNA expression, a significant difference was observed on GRIK1 antisense-2 expression, which was greater in C/C neural cultures. Differential effects of acute exposure to 5μM topiramate were observed on spontaneous synaptic activity in A/A versus C/C neurons, with a smaller reduction in excitatory event frequency observed in C/C donor neurons. This work highlights the use of iPSC technologies to study pharmacogenetic treatment effects in psychiatric disorders and furthers our understanding of the molecular effects of topiramate exposure in human neural cells.

Inflammation Biomarkers in Psychiatry

Introduction: There has long been a need for diagnostic, theragnostic, and prognostic biomarkers for psychiatric disorders. Biomarkers help in reducing ambiguity and arbitrariness and increase objectivity. In this context, many candidates for hormonal, immunological, serological, and neuroimaging markers have been proposed, but none of these marker candidates alone nor a biomarker panel has been approved for any disease. The fact that almost all psychiatric disorders are heterogeneous makes this process challenging. However, strong biomarker candidates have been identified, especially in light of the large number of clinical and preclinical studies conducted within the last five years. Objective: The aim of this article was to compile and discuss the current information on immune biomarkers in major psychiatric disorders, such as schizophrenia, depression, bipolar disorder, and anxiety disorders. Methods: In this study, respected scientific databases were searched using key terms related to the subject, and the related literature was examined in detail. Results: There are many relationships between psychiatric disorders and immune system parameters. Evidence also suggests that neuroinflammation is involved in the etiopathogenesis of psychiatric disorders. Markers, such as proinflammatory cytokines, tumor necrosis factor alpha, and C-reactive protein have been associated with psychiatric disorders in numerous studies. Conclusions: The neuroinflammation hypothesis has an important place in the etiopathogenesis of psychiatric disorders. Uncertainty remains as to whether neuroinflammation is a cause or consequence of psychiatric disorders. Some researchers have indicated that intestinal microbiota composition disorders and dysbiosis are sources of neuroinflammation. Immune marker studies are of great importance in terms of eliminating this uncertainty and overcoming diagnostic and treatment difficulties in the clinic. In this review, biomarker studies on psychiatric disorders were examined from the viewpoint of the immune system and discussed in light of the current studies.

Psychiatric disorders and risk for multiple adverse outcomes: a national prospective study.

Most psychiatric disorders, when examined individually, are associated with a broad range of adverse outcomes. However, psychiatric disorders often co-occur and their co-occurrence is well explained by a limited number of transdiagnostic factors. Yet it remains unclear whether the risk of these adverse outcomes is due to specific psychiatric disorders, specific dimensions of psychopathology (i.e., internalizing and externalizing dimensions), a general psychopathology factor or a combination of these explanations. In a large nationally representative prospective survey, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we used structural equation modeling to examine the shared and specific effects of common Axis I and Axis II disorders on the risk of ten adverse outcomes (unemployment; financial crisis; low income; poorer general health; worse mental and physical health; legal problems; divorce; problems with a neighbor, friend or relative; and violence) in the general adult population. Effects of psychiatric disorders were exerted mostly through a general psychopathology factor representing the shared effect across all disorders, independent of sociodemographic characteristics and the presence of the adverse outcomes at baseline. Violence and legal problems were further associated with the externalizing factor, but there were no independent associations of the internalizing factor or any individual psychiatric disorders with any of the adverse outcomes. Our findings reveal that associations between psychiatric disorders and adverse outcomes occur through broad psychological dimensions. Understanding the biological and psychological mechanisms underlying these dimensions should yield key intervention targets to decrease the individual suffering and societal burden associated with common psychiatric disorders.

Dysregulation of the gut-brain axis in schizophrenia and bipolar disorder: probiotic supplementation as a supportive treatment in psychiatric disorders.

Schizophrenia (SCZ) and bipolar disorder are severe mental disorders, both placing a significant burden on individuals' wellbeing and global health generally. The complex interaction of multiple mechanisms, underlying these disorders, still needs further elucidation. Increased activation of components of the immune system may be involved, including alterations in intestinal permeability and gut microbiome. Probiotics, defined as living microorganisms conferring health benefits to the host when administered in adequate amounts, seem to have supportive therapeutic effect in psychiatric disorders. The authors in this review provide an overview of this emerging research field and summarize both the publicated microbiome studies in SCZ and bipolar disorder and the current clinical research using probiotic supplementation in patients diagnosed with these disorders. The current data indicate that there are differences in the microbiome in SCZ and bipolar disorder patients as compared with healthy controls. Part of these differences may be induced by medication use, others by smoking and other lifestyle factors. Correlations between microbiome quantification and symptom severity have been observed in cross-sectional studies, but unfortunately, no replicated findings so far. Probiotic supplementation was shown not only to alleviate gastrointestinal complaints but also reduce symptom severity, rehospitalization rates and cognitive improvement. Replication of improvement of cognition is needed. Differences in microbiome have been shown in both SCZ and bipolar disorder in comparison to healthy controls. Evidence that probiotics can improve psychiatric functioning is still very limited.

Digital rectal stimulation associated with psychiatric disorders as a rare reason of solitary rectal ulcer in children and adolescents: a case series study

Solitary rectal ulcer syndrome is one of the rare causes of rectal bleeding in children and adolescents. Traumatic and ischemic mucosal injury is the main cause of its etiopathogenesis. A rare but important cause of traumatic mucosal injury is digital rectal stimulation. It is known that digital rectal stimulation is used in order to increase intestinal motility and to reduce the feeling of inadequate defecation. In this study, it was emphasized that digital rectal stimulation can be seen as a consequence of psychiatric disorders, and with proper psychiatric interventions, digital stimulation behavior and solitary rectal ulcer syndrome can be improved. Moreover, the importance of a cooperation between gastroenterologist and psychiatrist in such cases has been stressed.

Psychaesthenic Syndrome: A Review on its Implication in Female Sexual Arousal

Objectives: Psychaesthenic syndrome in the recent classification of DSM-5 comes under ‘Cultural Concepts of Distress.’ This can be the equivalent of Dhat syndrome in males. There is a paucity of literature regarding psychaesthenic syndrome. In this paper, we have tried to review the available literature regarding psychiatric and sexual comorbidities of psychaesthenic syndrome. Our paper also aims to ascertain the role and implication of psychaesthenic syndrome in female sexual arousal.Methods: PubMed, Google Scholar, and other databases were used to conduct the search. Research published in English was included. We searched the databases using the terms ‘psychaesthenic syndrome,’ ‘female Dhat syndrome,’ ‘nonpathological white discharge per vagina (NPWDPV),’ ‘leucorrhea,’ ‘female sexual disorders,’ etc.Results: For this review, we could find around 65 papers pertaining to the subject. These focused on the presence and effect of psychiatric disorders on sexual functioning. The effect of psychaesthenic syndrome on sexual functioning was also explored. The discomfort caused by NPWDPV may itself lead to decreased interest in sex. As inhibited sexual desire and sexual arousal disorder are estimated to be among the most common sexual disorders in women, it is probable that difficulty in sexual arousal is one of the major perceived effects of psychaesthenic syndrome. It has been found that depression often leads to difficulty in sexual arousal, amongst other sexual dysfunctions. Thus, there is an indirect causation of female sexual arousal disorder in psychaesthenic syndrome if depression is the manifestation of the syndrome.Conclusion: Very few studies have been done regarding the role of psychaesthenic syndrome in female sexual arousal till now. We are in the process of a major population-based study to delineate the epidemiological aspects, clinical features, management, and prevention aspects related to psychaesthenic syndrome. This review presents the available literature, issues of concern, and methods to manage NPWDPV.

Effects of Psychiatric Disorders on Suicide Attempt: Similarities and Differences Between Older and Younger Adults in a National Cohort Study.

Several common psychiatric disorders are associated with increased risk of suicide attempts, and the strength of these associations may vary between younger and older adults, which may explain age differences in suicide risk. Because psychiatric disorders often co-occur, it remains unclear whether (1) the risk of suicide attempt in older and younger adults is due to specific psychiatric disorders or underlying psychopathology dimensions (ie, internalizing and externalizing dimensions) and (2) the extent to which individual psychiatric disorders make distinct contributions to suicide attempt risk varies by age. In a large nationally representative longitudinal survey, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; Wave 1, 2001-2002; Wave 2, 2004-2005), multiple-group structural equation modeling was used to examine shared and specific effects of DSM-IV-TR Axis I and Axis II disorders on the 3-year occurrence of suicide attempts in 4 different age groups (18-30 years, 31-40 years, 41-49 years, and ≥ 50 years). The study population included 34,653 individuals. In each age group, effect of psychiatric disorders on risk of attempting suicide was almost exclusively mediated through a general psychopathology factor representing the shared effect across all disorders (P < .01). The magnitude of this effect was significantly lower in older than in younger adults (P < .05). No individual disorder had significant additional effects on attempt risk. These findings underscore the importance of assessing suicide attempt risk in patients at all ages who present with common psychiatric disorders and the need for prevention strategies focused on the general psychopathology dimension.

Melatonin concentrations in serum of primary glaucoma patients.

To determine whether glaucoma patients exhibit an abnormal melatonin concentration in serum and the effects of psychiatric disorders caused by glaucoma in melatonin secretion. A sample of 80 primary angle-closure glaucoma (PACG) patients, 120 primary open angle glaucoma (POAG) patients, and 120 normal controls were enrolled in this study. All the participants were asked to complete the following questionnaires: Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS), and self-rating depression scale (SDS). Variance analysis was used to compare the subscores between the groups. After that, we chose 58 patients with primary glaucoma and 20 non-glaucoma control patients to collect their serum samples at 7-10 a.m. Serum melatonin levels were measured using enzyme linked immunosorbent assay (ELISA). Of all participants, the scores of PSQI, SAS, and SDS in PACG and POAG group were 9.38±0.40, 46.08±8.99, 51.11±10.72 and 7.43±0.35, 45.42±9.87, 49.04±12.24 respectively, significantly higher than those in control group (4.16±0.28, 35.49±9.18, 40.31±13.08). The serum melatonin levels in PACG (37.29±2.99 pg/mL) and POAG (35.97±3.64 pg/mL) were significantly higher than the controls (29.96±3.94 pg/mL) (P<0.001). But no difference was found between the PACG and POAG (P=0.216). Glaucoma patients with sleep disorders, anxiety and depression were more likely resulting in the increase of melatonin levels. There is a significant increase in serum melatonin levels in glaucoma patients compared to the controls especially in glaucoma patients with psychiatric disorders such as sleep disorders, anxiety and depression.