Psychiatric Diagnosis Research Articles

Patterns and predictors of orbitofrontal sulcogyral morphology in a nonclinical population

Abstract Less common orbitofrontal cortex (OFC) sucogyral patterns are observed at higher rates among those witth psychopathology. Previous work has assumed demographic characteristics have no influence on OFC sulcogyral patterns. However, the influence of sociodemographic and health-related characteristics on OFC patterns within a neurotypical population has not been formally evaluated. We used structural brain magnetic resonance imaging (MRI) from a cohort from the Human Connectome Project (HCP) with existing OFC sulcogyral characterizations (n = 238); none of the participants had psychiatric diagnoses. We evaluated distributions of participant demographics (i.e., age), socioeconomic factors (i.e., employment), and health history-related factors (i.e., smoking history) by OFC sulcogyral pattern within each hemisphere. We then used logistic regression to estimate the odds of OFC sulcogyral pattern by participant characteristics. Distributions of study sample characteristics did not vary substantially by OFC sulcogyral pattern type within either hemisphere. Findings from logistic regression analyses suggest no association between OFC sulcogyral pattern and any of the demographic or socioeconomic characteristics. Two health history-related characteristics, body mass index (BMI) and smoking history, were associated with increased odds of having specific OFC pattern types. For example, individuals with obesity had 2.65 increased odds (95% CI: 1.17, 6.65) of having OFC sulcogyral pattern Type II, III, or IV, compared with Type I in the left hemisphere with normal BMIs. We did not observe substantial influence of demographic or socioeconomic characteristics on OFC sulcogyral patterns. These results confirm assumptions made in previous work that demographic and socioeconomic characteristics do not seem to impact OFC patterns. We do show some evidence for an influence of health history-related factors (obesity and smoking history); future work should evaluate whether these and other phenotypic risk factors interact to modify the relationship between psychiatric diagnoses and OFC sulcogyral patterns.

Injury patterns of suicide attempts in the head and neck area-a retrospective analysis over 15years.

Suicide attempts may involve various parts of the body with different severity grades and therefore represent a multidisciplinary challenge. The head and neck region is highly vulnerable to severe self-inflicted injuries, yet literature on this topic remains limited. A retrospective analysis was performed of patients with suicide attempts in an Otorhinolaryngology (ORL) department of a tertiary referral hospital over a 15-year period. The aim of the study was to analyse their clinical course and injury patterns. 70 patients were included (m: 42/70; f: 28/70). The mean age at suicide attempt was 43.7 years. Women were significantly younger than men (p = 0.046). Seven injury types were differentiated: strangulation (44.3%), stabbing (17.1%), jumping from a height and firearm use (10.0% each), jumping in front of a moving vehicle and ingestion of acids/bases (7.1% each) as well as ingestion of pills (4.3%). Men were dominantly involved in strangulation (14/42; 33.3%) and stabbing (11/42; 26.2%), whereas women appeared with strangulation (17/28; 60.7%) and tablet ingestion (3/28; 10.7%). Men required ORL-specific surgical care significantly more often than women (43.9% vs. 7.1%; p < 0.001). Men chose "violent" methods more frequently than women (90.5% vs. 46.4%; p < 0.001). Women were more likely to receive psychiatric treatment (p = 0.0011). Violent suicide attempts were more common in males and therefore required more often surgical intervention. Soft attempts and psychiatric diagnoses were more often associated with female gender. Routine laryngoscopy is recommendedwithin 24h after the initial trauma.All individuals were successfully treated in an interdisciplinary setting and survived with moderate morbidity.

Examining Systemic and Interpersonal Bias in Violence Risk Assessments of Patients in Acute Psychiatric Care.

The assessment and management of inpatient risk for violence in acute psychiatric care are challenges that introduce the potential for bias. This study aimed to examine inequities based on social determinants of health (SDoH) (e.g., race-ethnicity, gender, or mode of admission to acute care) that may lead to unfair assessment of psychiatric patients. The authors analyzed electronic health records of 7,424 acute care patients across 12,650 stays (2016-2022) at a large Canadian psychiatric hospital. Risk ratios (RRs) were calculated by SDoH for staff assessments of high risk (perceived risk), for violent incidents (actual risk), and for potentially biased risk assessment (particularly when a patient was assessed as high risk but did not become violent). In univariate analyses, patients assessed as high risk who did not become violent were more likely to be male than female and to be Black, Indigenous, or Middle Eastern than White. When RRs were mutually adjusted for all variables, the associations for gender and race-ethnicity were attenuated or were no longer statistically significant. Associations with potentially biased risks that remained significant included most psychiatric diagnoses (vs. a depressive or anxiety disorder), supportive or unstable housing (vs. owning a home), and admission by police (vs. self-admission; RR=2.14, 95% CI=1.92-2.40). Systemic factors, such as admission by police and housing status, and having severe mental illness were the primary drivers of observed inequities in risk assessments of patients from racial-ethnic minority groups. Addressing these systemic factors might be key to improving acute psychiatric care.

Traumatic experiences, dissociative symptoms, and alexithymia in patients with alopecia areata.

Although genetic, environmental, autoimmune, and psychological factors are believed to play a role in the onset of alopecia areata (AA), the exact cause remains unknown. This study aimed to investigate whether there are differences in traumatic experiences, dissociative symptoms, and alexithymia levels between groups. Fifty eight patients diagnosed with AA, 58 individuals with dermatological diseases thought to have a low psychosomatic component, and 58 individuals not diagnosed with any chronic disease were included in the study. All participants were assessed using the Childhood Trauma Questionnaire (CTQ-28), Dissociative Experiences Scale (DES), Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), and Toronto Alexithymia Scale (TAS-20). A Structured Clinical Interview for DSM-5 (SCID-5-CV) form was used to exclude additional psychiatric diagnoses. Mean scores on the CTQ-28 scale revealed differences between groups in terms of physical neglect and emotional neglect scores (p < 0.001; p = 0.022; p < 0.001). There were no differences in DES scores between groups (p = 0.085). When compared in terms of TAS-20 and PCL-5 scores, differences were found (p = 0.016; p = 0.024). As a result of this study, it was concluded that physical neglect and emotional neglect could play a significant role in the onset of AA. Alexithymia and traumatic stress disorder symptoms might be more prevalent in patients with AA.

Possibilities of Analyzing the Speech of Patients with Mental Disorders Using Mathematical Methods and Artificial Intelligence Algorithms

Thinking is a fundamental cognitive process assessed in psychiatric practice through speech and non-verbal signals. While speech is the primary basis for evaluating thought, thinking can occur independently of speech. Disorganized thinking, particularly associated with schizophrenia, involves weakened associations and cognitive disruptions that impact neural networks. Modern definitions of disorganized thinking, rooted in the three-factor model of psychotic disorders, highlight formal disturbances in thought, speech, and behavior. This conceptualization has been substantiated through neuroimaging studies, revealing structural connectivity issues in brain regions responsible for social-emotional processing. Despite its potential, artificial intelligence (AI) has yet to be fully integrated into psychiatric diagnostics, though its success in other medical fields suggests promising applications. AI could enhance psychiatric assessments by analyzing speech, facial expressions, and behavior, offering new diagnostic tools.

Young and adult patients with gaming disorder: Psychiatric co-morbidities and progression of problematic gaming

BackgroundPrevious research suggests age-dependent differences in the progression of addiction, and evidence is accumulating, showing that an early initiation of gaming increases the risk for addiction. With the recent introduction of gaming disorder (GD) as a psychiatric diagnosis, there is a need to extend the knowledge of the clinical characteristics of patients seeking treatment for GD of all age groups. Compared to adolescents and young adults, less is known about treatment-seeking adults. This study aimed to investigate whether there are clinically relevant age-dependent differences among patients seeking treatment for GD.MethodParticipants were recruited among patients seeking treatment and fulfilling diagnosis for GD at an outpatient clinic specialized in the treatment of GD. During the study period, 142 patients went through assessment for GD at the clinic, 37 did not fulfill the diagnosis for GD, and 36 declined participation, leaving a sample of 69 patients (age range = 15–56) for analysis. The sample (men, n = 66; women, n = 3) was divided in two age groups: adolescents and young adults (25 years or younger) and adults (26 years or older). Gaming-related data and information about psychiatric co-morbidity was collected through structured clinical interviews and questionnaires.ResultsThe adolescents and young adults (AYAs) reported a more rapid progression into problematic gaming than the adult group. The younger group developed problematic gaming four years faster than the adults. We also observed comparable clinical profiles in both groups. Both age groups had similar levels of GD as well as symptoms of psychiatric co-morbidities including possible attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASD) and problematic gambling. We also noticed that half of our study population consisted of adults.ConclusionWith the increasing prevalence of gaming in all age groups, it is unknown how the occurrence of GD will develop in different stages of life. We conclude that the adolescents and young adults had almost double as fast progression to problematic gaming than the adult group, highlighting the need for preventive strategies. The similarity in clinical profiles indicates that treatments with the same type of interventions could be offered to both age groups.

Contribution of rare chromosome 22q11.2 copy number variants to non-syndromic bicuspid aortic valve

BackgroundBicuspid aortic valve (BAV) is the most common congenital heart defect in adults, often leading to complications such as thoracic aortic aneurysms and aortic stenosis. While BAV is frequently associated...

Magnetic Seizure Therapy in Refractory Psychiatric Disorders: A Systematic Review and Meta-Analysis: La thérapie par convulsions magnétiques pour la prise en charge des troubles psychiatriques réfractaires : revue systématique et méta-analyse.

To qualitatively and quantitatively synthesize the literature on the efficacy and safety of magnetic seizure therapy (MST) in psychiatric disorders. A literature search was conducted of the OVID Medline, OVID EMBASE, PsychINFO, CINAHL, Web of Science and Cochrane databases from inception to 14 January 2024, using subject headings and key words for "magnetic seizure therapy." Randomized controlled trials (RCTs), post-hoc analyses of RCTs, open-label trials, or case series investigating MST in adults with a verified psychiatric diagnosis and reporting on two possible primary outcomes (1) psychiatric symptom reduction (as measured by validated rating scale) or (2) neurocognitive outcomes (as measured by standardized testing), were included. Abstracts, individual case reports, reviews and editorials were excluded. Extracted data included: (1) basic study details; (2) study design; (3) sample size; (4) baseline demographics; (5) outcome data (including secondary outcomes of suicidal ideation and adverse events); and (6) stimulation parameters. Cochrane's risk of bias tool was applied. A quantitative analysis was conducted for the depression studies, using Hedge's g effect sizes. A total of 24 studies (n = 377) were eligible for inclusion. Seventeen studies in depression (including three RCTs), four studies in schizophrenia (including one RCT), one study in bipolar disorder, one study in obsessive-compulsive disorder and one study in borderline personality disorder were summarized. We found no significant difference in depressive symptom reduction between MST and electroconvulsive therapy (ECT) in randomized, controlled trials (g = 0.207 towards ECT, 95% confidence interval (CI) -0.132 to 0.545, P = 0.232). We found a significant reduction in depressive symptoms overall with MST in the pooled RCT and open-label analysis (g = 1.749, CI 1.219 to 2.279, P < 0.005). It is suggested that MST has modest cognitive side effects. Large-scale RCTs are necessary to confirm early signals of MST as an effective intervention in psychiatric disorders with a cognitive profile that is potentially more favourable than ECT.

Eating Disorders, Co-Morbid Disorders and Early Risk Factors Amongst Post-9/11 Veteran Men and Women.

To assess, by interview, the rates of eating disorders in a nationally representative sample of recent veterans, describe their DSM-5 eating disorder diagnoses and the occurrence of comorbid psychiatric disorders. To conduct an exploratory case-control analysis of previously documented and additional specific military risk factors before eating disorder onset to inform studies of prospective risk. Using a two-stage design, probable cases and controls were identified by screening questionnaires from a sample of 1494 veterans who completed a survey study and interviewed to establish case status and confirm probable co-morbid psychiatric diagnoses. Previously documented risk factors and military risk factors occurring before disorder onset were investigated. Ninety-one cases and 51 controls were confirmed. Weighted prevalence for any eating disorder was 5.2%, with estimates for anorexia nervosa, bulimia nervosa, binge eating disorder and other specified eating disorder being 0.01%, 0.6%, 1.4%, and 1.6%, respectively. Seventy-nine (86.8%) confirmed cases had a diagnosis of one or more co-morbid psychiatric disorders. Previously documented risk factors were associated with subsequent case status, while in this sample, military risk factors were not. Rates of eating disorder and co-occurring psychiatric disorders in recent veterans were comparable to those reported for non-veterans, with levels of posttraumatic stress disorder likely higher. As co-occurring psychiatric disorders, particularly posttraumatic stress disorder, may complicate achieving good outcomes with existing evidence-based treatments, there is an urgent need to adapt them where necessary to improve outcomes. Military risk factors may maintain or exacerbate pre-existing problems and need to be investigated alongside other maintaining factors in longitudinal studies. Rates of eating disorder and co-occurring psychiatric disorders in recent veterans were comparable to those reported for non-veterans, highlighting a need to detect eating problems and address unmet treatment need. Co-occurring psychiatric disorders may complicate achieving good outcomes with existing treatments, emphasising a need to adapt them to improve outcomes. Investigating maintaining factors, including military factors in longitudinal studies will likely aid treatment development.

AI depictions of psychiatric diagnoses: a preliminary study of generative image outputs in Midjourney V.6 and DALL-E 3

ObjectiveThis paper investigates how state-of-the-art generative artificial intelligence (AI) image models represent common psychiatric diagnoses. We offer key lessons derived from these representations to inform clinicians, researchers, generative AI companies,...

Psychiatric Disorders and Their Impact on Herpes Zoster Incidence: Five Years of Data from Turkiye

Background/Objectives: This study investigates the relationship between psychiatric disorders and herpes zoster (HZ). Emergency and outpatient admissions to Kırşehir Education and Research Hospital between 2019 and 2023 were examined. Psychiatric disorders are known in the literature as one of the factors that weaken the immune system, thereby increasing the risk of infection. Methods: In our study, the past diagnoses and sociodemographic data of all individuals over the age of 18 who applied to the Kırşehir Education and Research Hospital between 2019 and 2023 were obtained from hospital system records. Patients receiving immunosuppressive treatment or those with diseases that could affect immune system function were excluded from the study. The sample was divided into two groups: those with and without psychiatric disorders diagnosed with HZ. Sociodemographic features, change of HZ frequency over the years, and differences among psychiatric diagnosis subgroups were examined between the groups. Results: Individuals with psychiatric diseases had a significantly higher frequency of HZ compared to those without psychiatric diseases (0.0040% vs. 0.0016%, p &lt; 0.001). No significant difference was found in the frequency of HZ among different types of psychiatric disorders (p = 0.60). Additionally, no statistically significant difference was found in the median age between the groups (p = 0.11). In terms of gender distribution, it was determined that women were more frequently diagnosed with HZ compared to men. Conclusions: The frequency of HZ was found to be higher in individuals with psychiatric disorders. However, further research is needed to explore the association between specific psychiatric diagnoses and HZ frequency.

The Relationship Between Psychopathology, Personality Traits, and a History of Traumatic Brain Injury.

To determine whether history of traumatic brain injury (TBI) is associated with psychopathology, and, in particular, substance use disorder (SUD) in young adults with a history of athletic participation. Observational study. University in the northeastern United States. A large (n = 534) and mixed sex (57% female) sample of varsity and club sport athletes older than 18 years. None. The Ohio State University Traumatic Brain Injury ID assessment and the Structured Clinical Interview for the diagnostic and statistical manual of mental disorders, fifth edition. Twenty-five percent of participants reported no history of head injuries, 32% reported 1 head injury, and 43% reported more than 1 head injury. Thirty-eight percent of participants had been diagnosed with 1 or more concussions. Twenty-eight percent of participants had a current psychiatric diagnosis and 49% had at least 1 lifetime diagnosis. Head injuries and concussions were significantly associated with the presence of lifetime psychiatric diagnosis and symptoms or diagnosis of alcohol or SUD. More head injuries were associated with symptoms of post-traumatic stress disorder. Higher number of self-reported head injuries and diagnosed concussions were associated with a lifetime history of psychopathology, and specifically, with alcohol and substance use disorders. These relationships are similar to those seen in the general population of adults. The relationships also raise several interesting questions about recovery from head injuries in young adult athletes.

Phenome-wide diagnostic comparison among suicide deaths and living individuals with chronic pain diagnoses

BackgroundChronic pain, regardless of its type, is a significant risk factor for suicide. However, not all individuals with chronic pain also experience suicidal thoughts and behaviors. Better characterization of clinical risk profiles and comorbidities across the medical spectrum among people with chronic pain who die by suicide is urgently needed to aid treatment and prevention strategies.MethodsThis case–control study leverages population-based data from the Utah Suicide Mortality Risk Study. Specifically, we identify clinical phenotypes from diagnostic data that differentiate between individuals that died by suicide with chronic pain diagnoses (N = 1,410) and living control individuals who also had chronic pain diagnoses (N = 4,664). Medical diagnostic codes were aggregated via phecodes to perform a phenotype-based phenome-wide association study. Using multivariable logistic regression analysis adjusting for covariates and multiple testing, differences in 1,727 common clinical phenotypes (phecodes) were assessed between suicide deaths and controls with chronic pain diagnoses. Models were also stratified by sex.ResultsChronic pain diagnoses were nearly three times more prevalent in individuals who died by suicide compared with those who did not. Sixty-five phecodes were significantly overrepresented among suicide deaths with chronic pain diagnoses compared with controls with chronic pain diagnoses. Utah suicide deaths with chronic pain had significantly more psychiatric diagnoses (mood disorders, anxiety disorders, attention deficit hyperactivity disorder, posttraumatic stress disorder, personality disorders, schizophrenia/psychosis, substance use related traits and prior overdoses, and diagnoses related to previous suicidal thoughts and behaviors) in addition to insomnia and specific pain related diagnoses compared to Utah controls with chronic pain (odds ratios ranged from 1.40–7.10). Twenty-five phecodes were overrepresented in controls with chronic pain compared to suicides. These were related to preventative care, cancer, obesity and other conditions (odds ratios ranged from 0.16–0.73). Sex-specific analyses largely replicated the combined analyses, yet the strength of the association was stronger for women with phecodes related to prior self-harm.ConclusionsResults identified multiple clinical comorbidities with chronic pain that differentiate suicide deaths from living control individuals with a history of diagnosed chronic pain. Our findings may help discern individuals with chronic pain who may be at greater risk for suicide death.

Incidence rate of suicidal behavior stratified by diagnosis among high-risk patients

BackgroundPsychiatric diagnoses are known to increase suicide risk, but whether this risk varies across specific disorders remains unclear. Previous studies have often relied on retrospective designs or population-based databases, limiting comparability due to heterogeneous methodologies and follow-up periods. AimsThis study aimed to compare the incidence rates of unfavorable events (suicide or suicide attempts) among high-risk patients with Major Depressive Disorder (MDD), Bipolar Disorder (BD), and Schizophrenia over a 24-month follow-up period. MethodsThis secondary analysis was conducted as part of a multicenter prospective cohort study involving 324 patients admitted to emergency departments for suicidal ideation or a recent suicide attempt. Clinical evaluations were performed at baseline and every six months to assess for unfavorable events. Additionally, Kaplan-Meier curves were estimated for each diagnosis, and Cox regression models were used to evaluate whether the diagnosis is associated with unfavorable events, adjusted for covariates such as age, history of childhood sexual abuse, and number of previous suicide attempts. ResultsThe incidence rates of suicide attempts were 27,000, 20,400, and 21,100 per 100,000 person-years for patients with MDD, BD, and Schizophrenia, respectively, while suicide rates were 1,600 per 100,000 person-years across all groups. No statistically significant differences were found in the risk of unfavorable events among diagnostic groups (p = 0.653), as confirmed by Kaplan-Meier survival analysis and Cox regression models. ConclusionsOver a 2-year follow-up, psychiatric diagnosis alone did not predict significant differences in unfavorable events rates. Comprehensive suicide risk assessments should prioritize individual risk profiles over diagnostic categories. These findings underscore the importance of integrating biopsychosocial factors in suicide prevention strategies for high-risk psychiatric populations.

Lived experiences of mothers: A longitudinal study of impacts and adjustment following adolescent psychiatric hospitalization for suicide attempts or other reasons.

Parents play crucial roles in monitoring and supporting youth who have been hospitalized after suicide attempts, but their adjustment in the period following hospitalization has been understudied. This study assessed the adjustment and impacts on mothers during the year following hospitalization. Participants included 135 mothers of suicidal adolescents and 117 mothers of adolescents hospitalized for other reasons. The Structured Clinical Interview for DSM (SCID) and the Child and Adolescent Impact Assessment were used to assess psychiatric diagnoses of Major Depressive Disorder [MDD], Generalized Anxiety Disorder [GAD], and Post-Traumatic Stress Disorder [PTSD], and impacts on caregivers at one, three, six, and 12 months after hospitalization. Higher rates of MDD, GAD, and PTSD, and greater impacts were evidenced closer in time to the hospitalization. There were few overall differences between mothers of youth with and without suicidal behavior. However, family history of suicidal behavior was related to higher rates of MDD and PTSD, and greater severity of youth suicidal thoughts and behavior over the follow-up was related to greater impact upon mothers of suicidal youth. This study highlights the mental health struggles of mothers of suicidal and other hospitalized youth and underscores the importance of support for caregivers.

Examining the Relationship Among Parental-Reported Problems, Self-Reported Problems, and Psychiatric Diagnosis in Children and Adolescents

The study aims to investigate the relationship among psychiatric diagnosis, parental reported problems, and the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV) results of children. The sample of the study consisted of 78 children and adolescents (36 girls and 42 boys), and statistical analyses were made using the chi-square test and Fisher’s exact test. Relationships identified between the following pairs: worry problems with Generalized Anxiety Disorder (GAD), distraction problems with Attention Deficit and Hyperactivity Disorder (ADHD), hyperactivity problems with Tic and Tourette's Syndrome, obsession problems with Obsessive-Compulsive Disorder (OCD), unhappiness with Major Depressive Disorder or dysthymia, and avoidance of communication with autism spectrum disorder. Furthermore, when examining the relationship between psychiatric diagnoses and diagnoses according to the RCADS-CV, we found other connections, such as the psychiatric diagnosis of separation anxiety and RCADS-CV separation anxiety, as well as the psychiatric diagnosis of separation anxiety and RCADS-CV social phobia. Lastly, when investigating the relationship between parentally reported problems and RCADS-CV diagnoses, several associations emerged, including the connection between obsession problems and RCADS-CV OCD diagnosis, relationship problems and RCADS-CV’s OCD diagnosis, unhappiness problems, and RCADS-CV’s depression diagnosis. In conclusion, our findings demonstrate a substantial overlap among parentally reported problems, psychiatric diagnoses, and diagnoses based on RCADS-CV.

The Catatonia Quick Screen (CQS): A Rapid Screening Tool for Catatonia in Adult and Pediatric Populations.

Catatonia is a neuropsychiatric disorder marked by significant disturbances in motor, cognitive, and affective functioning and that is frequently under-diagnosed. To enhance clinical detection of catatonia, this study aimed to develop a rapid, sensitive Catatonia Quick Screen (CQS) using a reduced set of catatonic signs to facilitate screening in adult and pediatric patients. Data were derived from two retrospective cohorts totaling 446 patients (254 adults, 192 children) who screened positive for catatonia using the Bush Francis Catatonia Screening Instrument (BFCSI). Sensitivity analyses were performed for all combinations of BFCSI signs, with sensitivity defined as the proportion of patients identified by each subset relative to the full BFCSI. The CQS was developed by selecting signs from the BFCSI based on sensitivity, ease of assessment, and relevance to diverse catatonia presentations. Screening for the presence of any one of four signs-excitement, mutism, staring, or posturing-using the CQS yielded a theoretical sensitivity of 97% (95% CI: 95 to 98%) relative to the full BFCSI (which requires two signs out of 14). The CQS demonstrated 97% sensitivity across both pediatric and adult subsets. The Catatonia Quick Screen provides a rapid screening alternative to the BFCSI with high sensitivity, potentially improving early detection of catatonia in clinical settings. Future prospective studies are necessary to validate the CQS's sensitivity and to determine its specificity in clinical populations. The Catatonia Quick Scale (CQS) is a newly developed rapid screen for catatonia.Assessment for any one of four signs-excitement, mutism, staring, and posturing-has 97% sensitivity for detecting catatonia relative to the BFCSI.This screening is sensitive in both adult and pediatric populations. The study relies on retrospective data.Only patients who initially screened positive for catatonia were included, so the specificity of the CQS could not be assessed.Most of the sample has a primary psychiatric diagnosis so the generalizability to patients with primary medical disorders is unclear.

Psychometric evidence of the adaptation to the Brazilian context of the Childhood Mania Rating Scale - Parent/Guardian Version (CMRS-P).

To carry out the process of cross-cultural adaptation of the Child Mania Rating Scale - Parent Version (CMRS-P) for the Brazilian context. Statistical procedures were carried out, based on the analysis of the validity of the internal structure of the scale, as well as its relationship with external variables. 224 parents/guardians of children/adolescents aged between five and 18 years participated in the study. The data collection form included instruments for assessing (hypo)manic symptoms, irritability, inattention, hyperactivity, emotional symptoms and behavioral problems. Data were collected in person, at a public school and at a Psychosocial Care Center, and online (via Google forms). Exploratory and confirmatory factor analyses, measurement invariance analyses, reliability analyzes were performed, as well as convergent and concurrent validity analyses. The one-dimensional model was investigated, showing satisfactory results, similar to those of the original scale. A reduced version was proposed with the ten most robust items from this study. Validity analyzes based on hypotheses indicated higher scores among those subjects with more clinical problems, such as the previous existence of a psychiatric diagnosis. Statistically significant and positive correlations, of low and moderate magnitudes, were observed with the scores of the other instruments used. The results indicated that the adapted versions of the CMRS-P (full scale and reduced form) are promising instruments for use in the country.

Use of antipsychotic drugs during radiotherapy in adult cancer patients in Korea: a nationwide retrospective cohort study based on the national health insurance service database

BackgroundAntipsychotic drugs (APDs) are used for treating mental illnesses and are also used by cancer patients. This study aimed to evaluate APD use in adult cancer patients who received radiotherapy (RT) in South Korea and assess the effects of APD use during RT on survival.MethodsThis retrospective cohort study utilized the National Health Insurance Service database database of Korea. We included adult cancer patients who underwent RT or chemotherapy (CTx, cisplatin, or 5-Fluorouracil) between 2010 and 2020. The APDs included in the analysis were aripiprazole, quetiapine, olanzapine, risperidone, haloperidol, and chlorpromazine.ResultsOverall, 725,897 patients received RT, and 115,500 received concomitant chemo-radiotherapy (CCRT). Of them, 41,118 (5.6%) took APDs during RT, and 8,129 (7%) took APDs during CCRT. Overall, 27,789 (67.58%) patients who took APDs during RT were men, and 28,004 (68.2%) were aged ≥ 60 years. The most frequently used APD during RT was quetiapine (64.93%). Patients who took APDs during RT and during CCRT had higher mortality rates (HR: 3.45 and 1.72, p < 0.0001, respectively) compared to the non-APD patients. Of the patients who used APDs during RT, patients accompanying psychiatric diagnosis, taking high-dose APD, and taking APD for more than 3 months had lower mortality than patients without psychiatric diagnosis, taking low-dose APD, and taking APD for less than 3 months, respectively (HR: 0.88, 0.87 and 0.80, respectively, p < 0.0001).ConclusionsOnly 5.6% of patients who underwent RT used APDs, and quetiapine was the most frequently prescribed APD during RT. The use of APD during RT may adversely affect survival. Further studies are required to elucidate the effects of APDs on cancer patients.Trial registrationThis study is retrospectively registered.

Effects of psychoplastogens on blood levels of brain-derived neurotrophic factor (BDNF) in humans: a systematic review and meta-analysis.

Peripheral levels of brain-derived neurotrophic factor (BDNF) are often used as a biomarker for the rapid plasticity-promoting effects of ketamine, psychedelics, and other psychoplastogens in humans. However, studies analyzing peripheral BDNF after psychoplastogen exposure show mixed results. In this meta-analysis, we aimed to test whether the rapid upregulation of neuroplasticity seen in preclinical studies is detectable using peripheral BDNF in humans. This analysis was pre-registered (PROSPERO ID: CRD42022333096) and funded by the University of Fribourg. We systematically searched PubMed, Web of Science, and PsycINFO to meta-analyze the effects of all available psychoplastogens on peripheral BDNF levels in humans, including ketamine, esketamine, LSD, psilocybin, ayahuasca, DMT, MDMA, scopolamine, and rapastinel. Risk of bias was assessed using Cochrane Risk of Bias Tools. Using meta-regressions and mixed effects models, we additionally analyzed the impact of several potential moderators. We included 29 studies and found no evidence that psychoplastogens elevate peripheral BDNF levels in humans (SMD = 0.024, p = 0.64). This result was not affected by drug, dose, blood fraction, participant age, or psychiatric diagnoses. In general, studies with better-controlled designs and fewer missing values reported smaller effect sizes. Later measurement timepoints showed minimally larger effects on BDNF. These data suggest that peripheral BDNF levels do not change after psychoplastogen administration in humans. It is possible that peripheral BDNF is not an informative marker of rapid changes in neuroplasticity, or that preclinical findings on psychoplastogens and neuroplasticity may not translate to human subjects. Limitations of this analysis include the reliability and validity of BDNF measurement and low variation in some potential moderators. More precise methods of measuring rapid changes in neuroplasticity, including neuroimaging and stimulation-based methods, are recommended for future studies attempting to translate preclinical findings to humans.