Longitudinal Interval Research Articles

Relapse prevention of bipolar disorders: an explorative cluster analytical approach in a randomized controlled psychotherapy study

The aim of this study was to differentiate between types of bipolar disorders and the associated features using explorative analysis. The focus was particularly on the role of bipolar1 and bipolar2 disorders as well as the influence of prophylactic interventions for relapse in arandomized, controlled treatment study. Atotal of 274 of the 305 originally included persons could be investigated in the study. Patients participated in either cognitive behavioral group therapy (SEKT) or supportive, patient-centered group therapy (FEST). Treatment took place over 4 days separated by a1-month interval (equivalent to 16double hours). Depressive and manic symptoms were assessed using the longitudinal interval follow-up evaluation (LIFE). The symptoms were retrospectively assessed for the previous 6months, with respect to each week before and after the intervention phase and for 6‑month and 12-month follow-ups. The results show that the effects of both group therapies were comparable; however, there were statistically significant differences in amultivariate proportional hazards model for the factors bipolar1 and 2 as well as the interaction of therapy with bipolar1 and 2. In particular, bipolar2 patients benefited significantly less from the SEKT intervention than from the FEST intervention. There were three clusters identified that separated bipolar1 (SEKT, no comorbidity, predominantly no recurrences, younger patients), from bipolar2 (FEST, no comorbidity, at least 1 often 2recurrences, older patients) and from aheterogeneous group (SEKT and FEST, comorbidity). The distinction between bipolar1 and bipolar2 disorder is important and has so far not received sufficient attention. Bipolar2 disorders generally have aworse course and respond particularly poorly to cognitive behavioral therapy (SEKT). An open, unstructured, supportive, patient-centered psychotherapy (FEST) is generally effective.

Adjuvant Psychotherapies to Prevent Relapse in Bipolar Disorder

Several psychotherapy protocols have been evaluated as adjuncts to pharmacotherapy for patients with bipolar disorder (BD). Little is known about their comparative effectiveness. To compare the effectiveness of 2 types of group psychotherapy, skill-oriented, material-based cognitive behavioral therapy (SEKT) and supportive, patient-centered, emotion-focused therapy (FEST), to prevent relapse in patients with euthymic BD. This was a large, observer-blind, randomized clinical trial conducted over 18 months (posttreatment after 6 months; follow-up at 12 and 18 months). In addition to psychiatric care as usual (including mood-stabilizing medication), each participant at 9 clinical outpatient units in Germany received 24 hours of group psychotherapy over 4, full-day sessions spread over 5 months. Patients with euthymic BD type 1 (BD 1) or BD type 2 (BD 2) between the ages of 18 and 50 years were randomly assigned to 1 of 2 forms of psychotherapy, SEKT or FEST. Independent clinicians blinded to patient grouping performed assessments using structured interviews (Structured Clinical Interview for DSM Disorders and Longitudinal Interval Follow-Up Evaluation) and self-rating and clinician rating for inclusion criteria and outcome. Kaplan-Meier survival curves were calculated for time to relapse. Cox proportional hazards statistics and propensity score matching were calculated for the multivariate analysis. Study data were analyzed from March 2020 to September 2022. SEKT intervention is a structured cognitive behavioral therapy integrating elements of interpersonal social rhythm therapy, and of mindfulness-based cognitive therapy. FEST psychotherapy has its roots in emotion-focused, supportive, and nondirective therapy. Recurrence of a new affective episode assessed by blinded interviewer with the LIFE interview. In addition, self-rating and clinician rating of depressive and mania symptoms as well as level of social functioning were assessed. Of 348 screened referrals, 305 patients (median [IQR] age, 34 [18-50] years; 162 male [53%]) with euthymic BD 1 or BD 2 were included in the study. A total of 207 patients (68%) had BD 1, 98 (32%) had BD 2, and 278 (91%) received psychiatric care. Both therapies were equally effective in preventing recurrence of a new episode. Outcome (higher rate of new episodes) was not predicted by kind of treatment (SEKT: 69 [49%] relapse; FEST: 63 [46%] relapse) but was predicted by BD 2, comorbidity, attending all sessions, and the interaction of type of treatment by BD 1 or 2. Patients with BD 2 had the highest rate of relapse (60 [61%] relapse), in particular, when treated by SEKT (39 [70%] relapse). Results of this randomized clinical trial revealed that a structured, skill-oriented, material-based cognitive behavioral therapy (SEKT) and a supportive, patient-centered, emotion-focused therapy (FEST) were equally effective in preventing relapse of affective episodes when delivered in a new, intensive group format. Additionally, there were baseline factors, in particular BD 2, that influenced outcomes. ClinicalTrials.gov Identifier: NCT02506322.

Course of avoidant/restrictive food intake disorder: Emergence of overvaluation of shape/weight

BackgroundAvoidant/restrictive food intake disorder (ARFID) is a feeding/eating disorder characterized by avoidance/restriction of food intake by volume and/or variety. The emergence of shape/weight-related eating disorder symptoms in the longitudinal course of ARFID is an important clinical phenomenon that is neither robustly documented nor well understood. We aimed to characterize the emergence of eating disorder symptoms among adults with an initial diagnosis of ARFID who ultimately developed other eating disorders.MethodThirty-five participants (94% female; Mage = 23.17 ± 5.84 years) with a history of ARFID and a later, separate eating disorder completed clinical interviews (i.e., Structured Clinical Interview for DSM-5 – Research Version and Longitudinal Interval Follow-Up Evaluation) assessing the period between ARFID and the later eating disorder. Participants used calendars to aid in recall of symptoms over time. Descriptive statistics characterized the presence, order of, and time to each symptom. Paired samples t-tests compared weeks to emergence between symptoms.ResultsMost participants (71%) developed restricting eating disorders; the remainder (29%) developed binge-spectrum eating disorders. Cognitive symptoms (e.g., shape/weight concerns) tended to onset initially and were followed by behavioral symptoms. Shape/weight-related food avoidance presented first, objective binge eating, fasting, and excessive exercise occurred next, followed by subjective binge eating and purging.ConclusionsDiagnostic crossover from ARFID to another (typically restricting) eating disorder following the development of shape/weight concerns may represent the natural progression of a singular clinical phenomenon. Findings identify potential pathways from ARFID to the development of another eating disorder, highlighting possible clinical targets for preventing this outcome.

Predictive Validity of the K-CAT-SS in High-Risk Adolescents and Young Adults

Suicide is a leading cause of death in adolescents and young adults and has increased substantially in the past 15 years. Accurate suicide risk stratification based on rapid screening can help reverse these trends. This study aimed to assess the ability of the Kiddie Computerized Adaptive Test Suicide Scale (K-CAT-SS), a brief computerized adaptive test of suicidality, to predict suicide attempts (SAs) in high-risk youth. A total of 652 participants (age range, 12-24 years), 78% of whom presented with suicidal ideation or behavior, were recruited within 1 month of mental health care contact. The K-CAT-SS, scaled from 0 to 100, was administered at baseline, and participants were assessed at about 1, 3, and 6 months after intake. Weekly incidence of SAs was assessed using the Adolescent Longitudinal Interval Follow-up Evaluation and Columbia-Suicide Severity Rating Scale. A secondary outcome was suicidal behavior, including aborted, interrupted, and actual SAs. The K-CAT-SS showed a 4.91-fold increase in SAs for every 25-point increase in the baseline score (95% CI 2.83-8.52) and a 3.51-fold increase in suicidal behaviors (95% CI 2.32-5.30). These relations persisted following adjustment for prior attempts; demographic variables including age, sex, gender identity, sexual orientation, and race/ethnicity; and other measures of psychopathology. No moderating effects were identified. At 3 months, area under the receiver operating characteristic curve was 0.83 (95% CI 0.72-0.93) for 1 or more SAs. The K-CAT-SS is an excellent tool for suicide risk stratification, particularly in higher-risk populations where other measures have shown lower predictive validity.

Prospectively assessed summer mood status in major depression, recurrent with seasonal pattern: Evidence for SAD's construct validity

ObjectiveSeasonal patterns are often undetectable in population-based depression studies, calling into question the existence of winter seasonal affective disorder (SAD). If SAD has construct validity, individuals with SAD should show spontaneous depression remission in the summer. Data are sparse on prospectively assessed summer mood status in confirmed SAD patients. MethodWe conducted prospective summer followup of community adults who, the winter before, were diagnosed with Major Depression, Recurrent with Seasonal Pattern on the Structured Clinical Interview for DSM-IV Axis I Disorders, developed a current SAD episode on the Structured Interview Guide for the Hamilton Rating Scale for Depression—Seasonal Affective Disorder Version (SIGH-SAD), and enrolled in a clinical trial comparing group cognitive-behavioral therapy for SAD and light therapy. In July/August after treatment, 143/153 (93.5 %) participants provided data on the SIGH-SAD, the Beck Depression Inventory-Second Edition, and the Longitudinal Interval Followup Evaluation (LIFE). ResultsSummer mean depression scores were in the normal range, with the substantial majority in remission across different measures. On the LIFE, 113/143 (79.0 %) experienced complete summer remission, 19/143 (13.3 %) experienced partial summer remission, and 11/143 (7.7 %) had major depression in the summer. Depression scores were significantly lower at summer than post-treatment in both treatments, indicating incomplete treatment response. LimitationsThis was a single-site study with a relatively homogeneous sample. ConclusionsSupporting construct validity for SAD, the substantial majority experienced complete summer remission, with a minority in partial remission and a very small minority in episode. Both treatments left residual symptoms at treatment endpoint compared to summer.

How resilient are former CBT patients with generalized anxiety disorder in times of COVID-19? A follow-up study considering post-treatment depressive symptoms

Background: Research suggested that preexisting mental disorders, particularly generalized anxiety disorder (GAD), might increase the already elevated risk of responding to the COVID-19 pandemic with mental health impairments. The present follow-up study investigated the course of GAD symptoms during the pandemic in former outpatients (N = 86) of two randomized controlled trials who were treated with cognitive behavioral therapy (CBT) up to eight years ago. Methods: GAD symptomatology was examined as the probability for a “well month”, that is, a month with no or minimal symptoms, as assessed by the Longitudinal Interval Follow-Up Evaluation (LIFE), taking the periods pre-pandemic, early pandemic, lockdown, and post-lockdown into account, and considering depressive symptoms post-treatment as its predictor. Results: Generalized linear mixed models revealed lower odds ratios for a “well month” during the early pandemic period and higher odds ratios post-lockdown compared with pre-pandemic. Post-treatment depressive symptoms proved to be a significant predictor since pandemic onset. Strategies learned in CBT were analyzed for their applicability and helpfulness in coping with worries during the pandemic. Six particularly helpful strategies were identified by participants. Limitations: Although attrition was comparably low with no indication of an association between missingness and primary outcomes, bias cannot be ruled out. Conclusions: The findings provide preliminary support for the resilience of former CBT patients with GAD during COVID-19, for the long-term relevance of CBT strategies, and for post-treatment depressive symptoms as risk factors for exacerbation of GAD symptoms since the onset of the COVID-19 pandemic.

Numerical study of slamming and whipping loads in moderate and large regular waves for different forward speeds

This paper describes the development of a time-domain hydroelastic numerical model for investigating the slamming and whipping loads imposed on a ship traveling at different forward speeds. The numerical model integrates a beam model, the 3-D Rankine panel model, and the 2-D modified Logvinovich model. The tilt angle of the 2-D profile in the slamming model is determined by the direction of relative velocity, which takes the forward sailing speed into account. The computational results are validated against a segmented model test of a large cruise ship. The convergence of the model with different numbers of elastic modes and slamming profiles is studied to ensure that the numerical results are stable. The main contributor to the whipping response is found to be the vibration of the first-order elastic mode. The slamming force is sensitive to the longitudinal interval of the slamming profiles, especially in the stern. The characteristics of the slamming pressure under bow flare and the whipping response at midship are also investigated. The numerical and experimental whipping responses are found to be in good agreement, and the local slamming pressure based on the slamming profile is more accurate when considering the effect of the ship's forward speed.

NEGATIVE AGE STEREOTYPES TEMPORARILY MAKE YOU FEEL YOUNGER BUT MAKE YOU FEEL OLDER OVER TIME

Abstract Negative age stereotypes have negative, assimilative effects on the subjective aging experience due to internalization processes, but positive contrast effects are reported as well, reflecting dissociation and downward comparisons. Our aim was thus to compare short-term and long-term consequences of age stereotypes on the subjective aging experience, to test the hypothesis that contrast effects are visible cross-sectionally, whereas internalization processes are observed when considering more long-term effects. We assessed age stereotypes and subjective age in a sample of N=459 participants (initial age range 30 – 80 years) from the aging-as-future project (Lang et al., 2022) across three consecutive measurement occasions spanning a longitudinal interval of 10 years. Short-term and long-term effects were estimated with latent change-score models by assessing effects of age stereotypes on the intercepts (cross-sectional) and on the slopes (longitudinal) of subjective age, respectively, while also taking current self-views into account. Age stereotypes had opposite effects on subjective age depending on the time frame. A cross-sectional contrast effect was found (B = -.17, SE = .05, p < .001), whereas longitudinal effects were assimilative in nature (B = .36, SE = .18, p = .04). Our findings support the time-dependent nature of effects of age stereotypes on the subjective aging experience. Negative age stereotypes can temporarily lead to a significant younger subjective age, indicating dissociation from one’s age group and downward comparison. In the long run, however, negative (positive) age stereotypes become internalized into the self-views of older people and are linked to an older (younger) subjective age.

Feasibility of common, enjoyable game play for assessing daily cognitive functioning in older adults.

Frequent digital monitoring of cognition is a promising approach for assessing endpoints in prevention and treatment trials of Alzheimer's disease and related dementias (ADRD). This study evaluated the feasibility of the MIND GamePack© for recurrent semi-passive assessment of cognition across a longitudinal interval. The MIND GamePack consists of four iPad-based games selected to be both familiar and enjoyable: Word Scramble, Block Drop, FreeCell, and Memory Match. Participants were asked to play 20 min/day for 5 days (100 min) for 4 months. Feasibility of use by older adults was assessed by measuring gameplay time and game performance. We also evaluated compliance through semi-structured surveys. A linear generalized estimating equation (GEE) model was used to analyze changes in gameplay time, and a regression tree model was employed to estimate the days it took for game performance to plateau. Subjective and environmental factors associated with gameplay time and performance were examined, including daily self-reported questions of memory and thinking ability, mood, sleep, energy, current location, and distractions prior to gameplay. Twenty-six cognitively-unimpaired older adults participated (mean age ± SD = 71.9 ± 8.6; 73% female). Gameplay time remained stable throughout the 4-months, with an average compliance rate of 91% ± 11% (1946 days of data across all participants) and weekly average playtime of 210 ± 132 min per participant. We observed an initial learning curve of improving game performance which on average, plateaued after 22-39 days, depending on the game. Higher levels of self-reported memory and thinking ability were associated with more gameplay time and sessions. MIND GamePack is a feasible and well-designed semi-passive cognitive assessment platform which may provide complementary data to traditional neuropsychological testing in research on aging and dementia.

Long-term outcomes of once weekly v. twice weekly sessions of cognitive behavioral therapy and interpersonal psychotherapy for depression.

Twice weekly sessions of cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD) lead to less drop-out and quicker and better response compared to once weekly sessions at posttreatment, but it is unclear whether these effects hold over the long run. Compare the effects of twice weekly v. weekly sessions of CBT and IPT for depression up to 24 months since the start of treatment. Using a 2 × 2 factorial design, this multicentre study randomized 200 adults with MDD to once or twice weekly sessions of CBT or IPT over 16-24 weeks, up to a maximum of 20 sessions. Main outcome measures were depression severity, measured with the Beck Depression Inventory-II and the Longitudinal Interval Follow-up Evaluation. Intention-to-treat analyses were conducted. Compared with patients who received once weekly sessions, patients who received twice weekly sessions showed a significant decrease in depressive symptoms up through month 9, but this effect was no longer apparent at month 24. Patients who received CBT showed a significantly larger decrease in depressive symptoms up to month 24 compared to patients who received IPT, but the between-group effect size at month 24 was small. No differential effects between session frequencies or treatment modalities were found in response or relapse rates. Although a higher session frequency leads to better outcomes in the acute phase of treatment, the difference in depression severity dissipated over time and there was no significant difference in relapse.

Exploring the spatial hole burning effect on the mode-locking characteristics of self-mode-locked Nd:YVO4 lasers

The spatial hole burning (SHB) effect on the mode-locking characteristics of Nd:YVO4 self-mode-locked (SML) lasers are investigated. By varying the cavity length, pump power, and crystal temperature, we manipulate the SHB effect on the longitudinal mode distributions and the temporal waveforms of the SML lasers. The experimental results indicate that, at a pump power of 3395 mW and a cavity length of 23 mm, the SHB effect is minimal, the temporal waveform remains stable and the longitudinal mode spacing equals the fundamental longitudinal mode interval (FLMI). As increasing the cavity length to 75 mm, the experimental longitudinal mode spacing becomes 1 to 5 times the FLMI and the temporal waveforms are then multi-pulse mode-locked state, indicating an aggravation in the SHB effect of the SML laser. With the cavity length of 23 mm, as the pump power increases from 3.4 W to 9.7 W, the SHB effect on the mode-locking characteristics gradually also aggravates. The laser gradually changes from the fundamental mode-locked state to the spaced mode-locked state. By adjusting the crystal temperature from 25 °C to 35 °C, the aggravated SHB effect caused by the increase in pump power is counteracted.

Study on the effect of internal reefs deflection on the flow field effect of unit reef

Artificial reef (AR) is generally utilized by the structure shape of unit reef (UR) in practical applications, and the UR construction part is the most important part to exert the flow field impact. However, there is currently limited scientific study on the effect of internal flow field effect inside the UR and lacks systematic theoretical basis. In this paper, the numerical simulation method was first verified by flume tank experiment with Particle Image Velocimetry (PIV) technology, and the results showed that numerical results were consistent with the experimental results. The numerical simulation method was then employed to assess the impact of the longitudinal interval on the flow field effect of three reef arrays, using the upwelling efficiency index as the evaluation standard. The study also investigated the influence of the deflection of individual reefs within the UR on the overall flow effect. The results indicate that the deflection of the reefs encountering the inflow initially had the most significant impact on the flow field. The flow field effect of the UR was optimal when the deflection angle was 30°, while the influence of deflection angle on the reefs at other positions was not significant. This study aimed to provide a reference for the layout design of UR.

Internalization or Dissociation? Negative age stereotypes make you feel younger now but make you feel older later.

Negative age stereotypes have negative, assimilative effects on the subjective aging experience due to internalization processes, but sometimes positive contrast effects are reported as well, reflecting dissociation and downward comparisons. Our aim was thus to compare short-term and long-term consequences of age stereotypes on the subjective aging experience, to test the hypothesis that contrast effects are visible cross-sectionally, whereas internalization processes are observed when considering long-term changes. We assessed age stereotypes and subjective age in a core sample of N=459 participants (initial age range 30 - 80 years) from the Ageing as Future project (Lang et al., 2022) across three consecutive measurement occasions spanning a longitudinal interval of 10 years. Short-term and long-term effects were estimated with latent growth models by assessing effects of age stereotypes on the intercepts (cross-sectional) and on the slopes (longitudinal) of subjective age, respectively, while controlling for current self-views. Age stereotypes had opposite effects on subjective age depending on the time frame. A cross-sectional contrast effect was found, whereas longitudinal effects were assimilative in nature. Our findings support the time-dependent nature of effects of age stereotypes on the subjective aging experience. Negative age stereotypes temporarily lead to a significantly younger subjective age, indicating dissociation from one's age group and downward comparison. In the long run, however, negative (positive) age stereotypes become internalized into the self-views of older people and are linked to a relatively older (younger) subjective age.

Typical disease courses of patients with unipolar depressive disorder after in-patient treatments-results of a cluster analysis of the INDDEP project.

Previously established categories for the classification of disease courses of unipolar depressive disorder (relapse, remission, recovery, recurrence) are helpful, but insufficient in describing the naturalistic disease courses over time. The intention of the present study was to identify frequent disease courses of depression by means of a cluster analysis. For the longitudinal cluster analysis, 555 datasets of patients who participated in the INDDEP (INpatient and Day clinic treatment of DEPression) study, were used. The present study uses data of patients with at least moderate depressive symptoms (major depression) over a follow-up period of 1 year after their in-patient or day-care treatments using the LIFE (Longitudinal Interval Follow-Up Evaluation)-interview. Eight German psychosomatic hospitals participated in this naturalistic observational study. Considering only the Calinski-Harabatz index, a 2-cluster solution gives the best statistical results. In combination with other indices and clinical interpretations, the 5-cluster solution seems to be the most interesting. The cluster sizes are large enough and numerically balanced. The KML-cluster analyses revealed five well interpretable disease course clusters over the follow-up period: "sustained treatment response" (N = 202, 36.4% of the patients), "recurrence" (N = 80, 14.4%), "persisting relapse" (N = 115, 20.7%), "temporary relapse" (N = 95, 17.1%), and remission (N = 63, 11.4%). The disease courses of many patients diagnosed with a unipolar depression do not match with the historically developed categories such as relapse, remission, and recovery. Given this context, the introduction of disease course trajectories seems helpful. These findings may promote the implementation of new therapy options, adapted to the disease courses.

Culturally adapted psychoeducation for bipolar disorder in a low-resource setting: protocol for a multicentre randomized controlled trial

IntroductionBipolar disorder (BD) is a source of marked disability, morbidity, and premature death. There is a paucity of research on personalized psychosocial interventions for BD, especially in lowresource settings. A previously published pilot randomized controlled trial (RCT) of a Culturally adapted PsychoEducation (CaPE) intervention for BD in Pakistan reported higher patient satisfaction, enhanced medication adherence, knowledge and attitudes towards BD, and improvement in mood symptom scores and health-related quality of life measures compared to treatment-as-usual (TAU).ObjectivesThis protocol describes a larger multicentre RCT to confirm the clinical and cost-effectiveness of CaPE in Pakistan.MethodsA multicentre individual, parallel arm, RCT of CaPE in 300Pakistani adults with BD. Participants over the age of 18, with adiagnosis of bipolar I and II and who are currently euthymic, will berecruited from seven sites including Karachi, Lahore, Multan, Rawalpindi,Peshawar, Hyderabad and Quetta. Time to recurrence will be the primaryoutcome assessed using Longitudinal Interval Follow-up Evaluation(LIFE). Secondary measures will include mood symptomatology, qualityof life and functioning, adherence to psychotropic medications, andknowledge and attitudes towards BD.ResultsFull ethics approval has been received from National Bioethics Committee (NBC) of Pakistan and Centre for Addiction and Mental Health (CAMH), Toronto, Canada. The study has completed sixty-five screening across the seven centres, of which forty-eight participants have been randomised.ConclusionsA successful trial will lead to rapid implementation of CaPE in clinical practice, not only in Pakistan, but also in other low-resource settings including those in high-income countries, to improve clinical outcomes, social and occupational functioning, and quality of life in South Asian and other minority patients with BD.Disclosure of InterestNone Declared

Monitoring channel dynamics of Burhi Dihing River using multi-temporal satellite data

River channel is considered as a dynamic entity in the fluvial system. The Burhi Dihing river is an important south bank tributary of the river Brahmaputra, characterized by highly dynamic and unstable channel variations. The present study deals with the channel dynamics of river Burhi Dihing from Miau, Arunachal Pradesh to Dihingmukh, Assam using remote sensing techniques. Study of channel area, channel length, braiding index, sandbars and fill and erosion has been carried out for the period 1989-1999,1999-2008 and 2008- 2018 by dividing the study area into 6 grid at 15’ longitudinal interval. The river is witnessing more progression changes then regression changes as in last three decade the total amount of deposition done by the river is 3935.964 hectares whereas the total amount of erosion done by the river is only 1552.961 hectares. The area of the channel is decreasing from 102.78 sq km in the year 1989 to 78.949 sq km in the year 2018. During the last three decade, i.e. from 1989 to 2018 the river have has become more braided as in the year 1989 the B.I was 1.76 which have increased to 1.96 in the year 2018 as well as the total number of sandbars have also increased from 208 in the 1989 to 405 in 2018. The outcome of the study is obtained by using the Toposheet, LANDSET ETM image and Google earth images in QGIS 2.14 software.

Accurate measurement of aerosol optical properties using the multilongitudinal mode high-spectral-resolution lidar with self-tuning Mach–Zehnder interferometer

The multilongitudinal mode (MLM) high-spectral-resolution lidar (HSRL) based on the Mach–Zehnder interferometer (MZI) is constructed in Xi’an for accurate measurements of aerosol optical properties. The critical requirement of the optimal match between the free spectral range of MZI and the longitudinal mode interval of the MLM laser is influenced by the laboratory temperature, pressure, and vibration. To realize the optimal separation of aerosol Mie scattering signals and molecular Rayleigh scattering signals excited by the MLM laser, a self-tuning technique to dynamically adjust the optical path difference (OPD) of the MZI is proposed, which utilizes the maximum ratio between the received power of the Mie channel and Rayleigh channel as the criterion of the OPD displacement. The preliminary experiments show the feasibility of the MLM-HSRL with self-tuning MZI and the stable performance in the separation of aerosol Mie scattering signals and molecular Rayleigh scattering signals.

Validation of the Longitudinal Interval Follow-Up Evaluation for the Long-Term Measurement of Mood Symptoms in Bipolar Disorder.

The long-term burden of symptoms is an important outcome in bipolar disorder (BD). A method which has minimal burden of assessment uses a retrospective interview, the Longitudinal Interval Follow-up Examination (LIFE), although this may be subject to problems with recall. This study examines the relationship between the retrospective LIFE scale and concurrently-rated mood rating scales in two clinical trials of 18 months of psychotherapy for patients with BD. The Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) were administered every eight to nine weeks and the LIFE was carried out every 6 months. Correlations between scores on mood rating scales and at equivalent times on the LIFE were examined, as well as of potential clinical moderators. There were significant correlations between LIFE depression ratings and concurrent MADRS score (r = 0.57) and between LIFE mania ratings and YMRS score (r = 0.40). In determining "mild depression" on the MADRS, a receiver operating characteristics (ROC) analysis showed an AUC of 0.78 for LIFE scores. Correlations, particularly for depression scores, were high even when the LIFE rating was several months before the interview, suggesting that the LIFE has validity in examining the burden of mood symptoms over time, with relatively little burden of assessment. Future research should examine the relationship between symptom burden and quality of life measured in this way.

Spectral Broadening Suppressed by a Gain-Enhanced Fiber in Polarization Maintaining High-Power Systems

A gain-enhanced 10/125 μm polarization-maintaining Yb-doped fiber (PMYDF), with the cladding absorption of 7.5 dB/m at 976 nm, for narrow linewidth linearly polarized fiber oscillator or amplifiers is presented. By utilizing the gain-enhanced PMYDF in an all-fiber laser oscillator, an output power of 123 W is achieved with applying appropriate bending strategies and thermal management, corresponding to the slope efficiency of 86.7%. By applying the gain-enhanced PMYDF in seed, an increase of 34% in the longitudinal mode interval is effectively achieved compared to the commercial PMYDF, while the number of longitudinal modes is only 75%. According to the main oscillation power amplification (MOPA) system, the total amount of spectral broadening applying the seed with the gain-enhanced PMYDF are only 67%, 64% and 54% of applying the seed with the commercial PMYDF, corresponding to co-pumping, bi-pumping and counter-pumping schemes, respectively.

Culturally adapted psychoeducation for bipolar disorder in a low-resource setting: protocol for a multicentre randomised controlled trial

Bipolar disorder is a source of marked disability, morbidity and premature death. There is a paucity of research on personalised psychosocial interventions for bipolar disorder, especially in low-resource settings. A pilot randomised controlled trial (RCT) of a culturally adapted psychoeducation intervention for bipolar disorder (CaPE) in Pakistan reported higher patient satisfaction, enhanced medication adherence, knowledge and attitudes regarding bipolar disorder, and improvement in mood symptom scores and health-related quality of life measures compared with treatment as usual (TAU). The current protocol describes a larger multicentre RCT to confirm the clinical and cost-effectiveness of CaPE in Pakistan. Trial registration: NCT05223959. A multicentre individual, parallel-arm RCT of CaPE in 300 Pakistani adults with bipolar disorder. Participants over the age of 18, with a diagnosis of bipolar I or II disorder who are currently euthymic, will be recruited from seven sites: Karachi, Lahore, Multan, Rawalpindi, Peshawar, Hyderabad and Quetta. Time to recurrence will be the primary outcome assessed using the Longitudinal Interval Follow-up Evaluation (LIFE). Secondary measures will include mood symptoms, quality of life and functioning, adherence to psychotropic medications, and knowledge and attitudes regarding bipolar disorder. This trial will assess the effectiveness of the CaPE intervention compared with TAU in reducing the time to recurrence for people with bipolar disorder currently in remission in Pakistan and determine the effect on clinical outcomes, quality of life and functioning. A successful trial might lead to rapid implementation of CaPE in clinical practice, not only in Pakistan, but also in other low-resource settings, including those in high-income countries, to improve clinical outcomes, social and occupational functioning, and quality of life in South Asian and other minority group patients with bipolar disorder.