Related Mental Disorders Research Articles

Advances in neural circuits of innate fear defense behavior.

Fear, a negative emotion triggered by dangerous stimuli, can lead to psychiatric disorders such as phobias, anxiety disorders, and depression. Investigating the neural circuitry underlying congenital fear can offer insights into the pathophysiological mechanisms of related psychiatric conditions. Research on innate fear primarily centers on the response mechanisms to various sensory signals, including olfactory, visual, and auditory stimuli. Different types of fear signal inputs are regulated by distinct neural circuits. The neural circuits of the main and accessory olfactory systems receive and process olfactory stimuli, mediating defensive responses like freezing. Escape behaviors elicited by visual stimuli are primarily regulated through the superior colliculus and hypothalamic projection circuits. And auditory stimuli-induced responses, including escape, are mainly mediated through auditory cortex projection circuits. As for auditory stimuli, they are mainly triggered by the auditory cortical projection circuits, leading to escape and other responses. In this article, we review the research progress on the neural circuits of innate fear defensive behaviors in animals from different sensory systems, especially the projection circuits of olfactory, visual, and auditory systems, to provide references for the mechanistic study of related mental disorders.

Cerebrospinal fluid findings in patients with obsessive–compulsive disorder, Tourette syndrome, and PANDAS: A systematic literature review

BackgroundObsessive-compulsive disorder (OCD) and Tourette syndrome (TS) are related mental disorders that share genetic, neurobiological, and phenomenological features. Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) is a neuropsychiatric autoimmune disorder with symptoms of OCD and/or TS associated with streptococcal infections. Therefore, PANDAS represents a strong link between OCD, TS, and autoimmunity. Notably, cerebrospinal fluid (CSF) analyses can provide insight into the central nervous processes in OCD, TS, and PANDAS. MethodsA systematic literature search according to the PRISMA criteria was conducted to collect all CSF studies in patients with OCD, TS, and PANDAS. The total number of cases and the heterogeneity of the low number of studies were not sufficient for a meta-analysis to provide a high level of evidence. Nevertheless, meta-analytical statistics could be performed for glutamate, 5-hydroxyindoleacetic acid (degradation product of serotonin), homovanillic acid (degradation product of dopamine), 3-methoxy-4-hydroxyphenylglycol (major metabolite of noradrenaline), and corticotropin-releasing hormone (CRH) in OCD. A risk-of-bias assessment was implemented using the Cochrane ROBINS-E tool. ResultsMeta-analytical testing identified elevated glutamate levels in the CSF of OCD patients compared with healthy controls, while no significant differences were found in other neurotransmitters or CRH. Single studies detected novel neuronal antibodies in OCD patients and elevated oligoclonal bands in TS patients. For TS and PANDAS groups, there was a dearth of data. Risk of bias assessment indicated a substantial risk of bias in most of the included studies. ConclusionsThis systematic review of available CSF data shows that too few studies are currently available for conclusions with good evidence. The existing data indicates glutamate alterations in OCD and possible immunological abnormalities in OCD and TS. More CSF studies avoiding sources of bias are needed.

Prevalence of Post-traumatic stress disorder among Physicians during the COVID-19 Pandemic

The healthcare professionals endured a major physical as well as psychological burden against the coronavirus disease (COVID-19) global catastrophe. Owing to their role in the frontline, they were the most exposed group who faced the deadly virus head-on which increased their mental health problems during this pandemic. The study was designed as a cross-sectional study to assess the prevalence of PTSD among 314 working physicians from the purposively selected government and private hospitals during the COVID-19 pandemic in Dhaka city. ‘Impact of Event Scale-Revised’ (IES-R) was used to construct the questionnaire. The mean age of the physician was 32.2±4.7 years. One-fifth of them (21.0%) diagnosed COVID-19 positive by the rt-PCR test. The most prevalent co-morbidities were found bronchial asthma (74.2%), hypertension (32.3%) and diabetes mellitus (19.4%). About half of the physicians (48.6%) had mild PTSD. The test of significance denotes the significant associations of the prevalence of mild PTSD level with physician’s age, gender, marital state, work settings, results of COVID-19 positive and had co-morbidities in physicians (p<0.05). The prevalence of mild PTSD was higher in the age group of 25-35 years (49.1%), in females (49.8%), unmarried (50.0%), work in private settings (51.5%), ever been COVID-19 positive (59.1%) and had co-morbidities (51.6%). This study reveals that about half the physicians are suffering from mild PTSD. A high encumbrance of COVID-19 related mental disorders and fear among frontline physicians’ entreaties to government and policymakers' prompt regard for taking appropriate preventive measures. Bangladesh Med J. 2021 Sept; 51(1): 52-58

Forensic Law in Hypoglycaemia-3

“Environmental Enrichment” (EE) is a proven alternative therapy for Type 2 diabetes related complications. EE preserves the Purkinje cells in the brain. The latter is a promising therapy for prevention of diabetes related mental disorders. Sensory nerves are at higher risk of damage in the hyperglycemic milieu leading to diabetic neuropathy. Patients lose sensation in their lower extremities making them vulnerable to injury because they do not feel the pain, which is a warning sign of tissue damage. That can lead to catastrophic outcomes because with high blood glucose, wounds get difficult to heal. Gas gangrene and tissue necrosis develop, leading to the only resort being amputation and life change challenge. Early diagnosis of diabetes is nevertheless crucial in prolonging the onset of diabetes and its complication. To date many candidate early biomolecules have been reported which are promising early indicators for diabetes. However, advancement in this field of research has not been reported. Holistically diet, lifestyle, mental health and clinical treatment of Diabetes and Thyroid Disease, including Addison’s Disease, plays an important role in patient welfare. Tragically many patients die young or go through life suffering from the old Victorian Stigma of being tainted by having to treat an uncurable illness. This is not a joke as suggested in September 2006 in ignorance by a Hertfordshire Insurance Broker describing Diabetes with Neuroglycopenia as a Joke and Nonsense. This caused Obstructed Justice in Law of a critical life-threatening complication of Diabetes and Endocrinology Disease in Hypoglycaemia Unawareness and now in 2023 Otitis Externa and Osteomyelitis as disclosed in a tragic young law student death with likely clinically undiagnosed Otitis Externa and Osteomyelitis. A patient requiring clinician prescribed Insulin justifies clinical respect and understanding in English Law which has been misunderstood since 1994 with sad consequences in this investigation. Today in recovering and managing the COVID-19 Pandemic of 2020 we move forward with new welfare ideas. It is a delight to be able to share some latest work for future research based on 44 years T1 Diabetes experience complimented by Purkinje Cell environmental welfare.

DiGeorge syndrome critical region gene 2 (DGCR2), a schizophrenia risk gene, regulates dendritic spine development through cell adhesion

BackgroundDendritic spines are the sites of excitatory synapses on pyramidal neurons, and their development is crucial for neural circuits and brain functions. The spine shape, size, or number alterations are associated with neurological disorders, including schizophrenia. DiGeorge syndrome critical region gene 2 (DGCR2) is one of the deleted genes within the 22q11.2 deletion syndrome (22q11DS), which is a high risk for developing schizophrenia. DGCR2 expression was reduced in schizophrenics. However, the pathophysiological mechanism of DGCR2 in schizophrenia or 22q11DS is still unclear.ResultsHere, we report that DGCR2 expression was increased during the neurodevelopmental period and enriched in the postsynaptic densities (PSDs). DGCR2-deficient hippocampal neurons formed fewer spines. In agreement, glutamatergic transmission and synaptic plasticity were decreased in the hippocampus of DGCR2-deficient mice. Further molecular studies showed that the extracellular domain (ECD) of DGCR2 is responsible for its transcellular interaction with cell adhesion molecule Neurexin1 (NRXN1) and spine development. Consequently, abnormal behaviors, like anxiety, were observed in DGCR2-deficient mice.ConclusionsThese observations indicate that DGCR2 is a novel cell adhesion molecule required for spine development and synaptic plasticity, and its deficiency induces abnormal behaviors in mice. This study provides a potential pathophysiological mechanism of DGCR2 in 22q11DS and related mental disorders.

How Mental Health Affects Injury Risk and Outcomes in Athletes.

The importance of mental health among athletes is becoming more recognized and valued. Athletes experience symptoms of depression, anxiety, and related mental health disorders at rates similar to those of the general population, but because athletes face unique cultural and environmental pressures, such disorders are exacerbated in the context of an injury. Furthermore, we review the less well-known evidence that mental health disorders in athletes are associated with an increased risk of injury. We discuss the increasing awareness of the deficiencies in mental health support for athletes, which has been especially highlighted during the COVID-19 pandemic as well as in prominent professional and Olympic athletes, and describe both internal and external barriers to appropriate care. We searched PubMed for pertinent peer-reviewed studies. Clinical review. Level 5. There is a known psychological response to injury that can prolong recovery from musculoskeletal injury; conversely, mental health disorders in athletes are not only associated with an increased injury risk but also portend poorer outcomes subsequently, including prolonged recovery times, increased rates of injury recurrence, decreased rates of return to sport, and reduced performance upon return. Because of inherent barriers to appropriate care of athletes, including identification, stigma, and resource availability, there are currently various ongoing efforts nationally to create and implement initiatives regarding athlete mental health screening, support systems, and directed interventions to address the inextricably linked physical and mental health of athletes. Athletic injury negatively impacts the mental health of athletes. Likewise, mental health can and does influence athletic performance and is also intimately tied to the risk of athletic injury, thus creating a complex cycle with inability to separate physical and mental health.

Altered amygdala functional connectivity after real-time functional MRI emotion self-regulation training.

Real-time functional MRI neurofeedback (rtfMRI-NF) is a noninvasive technique that extracts concurrent brain states and provides feedback to subjects in an online method. Our study aims to investigate the effect of rtfMRI-NF on amygdala-based emotion self-regulation by analyzing resting-state functional connectivity. We conducted a task experiment to train subjects in self-regulating amygdala activity in response to emotional stimuli. Twenty subjects were divided into two groups. The up-regulate group (URG) viewed positive stimulus, while the down-regulate group (DRG) viewed negative stimulus. The rtfMRI-NF experiment paradigm consisted of three conditions. The URG's percent amplitude fluctuation (PerAF) scores are significant, indicating that positive emotions may be a partial side effect, with increased activity in the left hemisphere. Resting-state functional connectivity was analyzed via a paired-sample t-test before and after neurofeedback training. Brain network properties and functional connectivity analysis showed a significant difference between the default mode network (DMN) and the brain region associated with the limbic system. These results reveal to some extent the mechanism of neurofeedback training to improve individuals' emotional regulate regulation ability. Our study has shown that rtfMRI-neurofeedback training can effectively enhance the ability to voluntarily control brain responses. Furthermore, the results of the functional analysis have revealed distinct changes in the amygdala functional connectivity circuits following rtfMRI-neurofeedback training. These findings may suggest the potential clinical applications of rtfMRI-neurofeedback as a new therapy for emotionally related mental disorders.

Alexithymia and related mental and psychosomatic disorders

Rationale. Currently, there is a growing number of mental disorders, which are infl uenced by various external and internal factors, including the presence of alexithymia. Most studies focus on the prevalence of somatic diseases among patients with alexithymia, while the prevalence of mental disorders in these patients remains insuffi ciently studied. Presumably, alexithymia can serve as a background for the development of mental disorders such as anxiety, depressive, and mixed anxiety-depressive disorders. The aim of the study is to investigate the correlation between alexithymia and mental disorders, somatic diseases, and suicidal thoughts in patients.Material and methods. A total of 184 outpatients (107 women and 77 men) with various illnesses were examined. Clinical rating was conducted using the TAS, HADS, and MADRS scales. Additionally, medical history was collected.Results. A higher incidence of mental disorders was detected in patients with alexithymia (correlation coeffi cient 0.71). Depression was most frequently observed in these patients (73.5%), followed by anxiety disorder and mixed anxietydepressive disorder (13.2%). Patients with alexithymia also had a higher incidence of psychosomatic disorders (correlation coeffi cient 0.68), with multiple psychosomatic diseases usually occurring in the same person. Moreover, a higher incidence of hypertension (47%), ischemic heart disease (25%), skin diseases such as neurodermatitis, psoriasis, atopic dermatitis, and others (59.6%), gastrointestinal diseases such as peptic ulcer and irritable bowel syndrome (28.7%), bronchial asthma (8.8%), thyrotoxicosis (0.7%), and rheumatoid arthritis (0.7%) was detected in patients with alexithymia. As the degree of alexithymia increased, suicidal thoughts were more frequent and severe (correlation coeffi cient 0.74).Conclusion. The hypothesis of the correlation between alexithymia and the development of mental and psychosomatic disorders and the appearance of suicidal thoughts has been confi rmed.

The EPIDIA4Kids protocol for a digital epidemiology study on brain functioning in children, based on a multimodality biometry tool running on an unmodified tablet.

Neurodevelopment and related mental disorders (NDDs) are one of the most frequent disabilities among young people. They have complex clinical phenotypes often associated with transnosographic dimensions, such as emotion dysregulation and executive dysfunction, that lead to adverse impacts in personal, social, academic, and occupational functioning. Strong overlap exists then across NDDs phenotypes that are challenging for diagnosis and therapeutic intervention. Recently, digital epidemiology uses the rapidly growing data streams from various devices to advance our understanding of health's and disorders' dynamics, both in individuals and the general population, once coupled with computational science. An alternative transdiagnostic approach using digital epidemiology may thus better help understanding brain functioning and hereby NDDs in the general population. The EPIDIA4Kids study aims to propose and evaluate in children, a new transdiagnostic approach for brain functioning examination, combining AI-based multimodality biometry and clinical e-assessments on an unmodified tablet. We will examine this digital epidemiology approach in an ecological context through data-driven methods to characterize cognition, emotion, and behavior, and ultimately the potential of transdiagnostic models of NDDs for children in real-life practice. The EPIDIA4Kids is an uncontrolled open-label study. 786 participants will be recruited and enrolled if eligible: they are (1) aged 7 to 12 years and (2) are French speaker/reader; (3) have no severe intellectual deficiencies. Legal representative and children will complete online demographic, psychosocial and health assessments. During the same visit, children will perform additionally a paper/pencil neuro-assessments followed by a 30-min gamified assessment on a touch-screen tablet. Multi-stream data including questionnaires, video, audio, digit-tracking, will be collected, and the resulting multimodality biometrics will be generated using machine- and deep-learning algorithms. The trial will start in March 2023 and is expected to end by December 2024. We hypothesize that the biometrics and digital biomarkers will be capable of detecting early onset symptoms of neurodevelopment compared to paper-based screening while as or more accessible in real-life practice.

Mathematical model and artificial intelligence for diagnosis of Alzheimer's disease.

Degeneration of the neurological system linked to cognitive deficits, daily living exercise clutters, and behavioral disturbing impacts may define Alzheimer's disease. Alzheimer's disease research conducted later in life focuses on describing ways for early detection of dementia, a kind of mental disorder. To tailor our care to each patient, we utilized visual cues to determine how they were feeling. We did this by outlining two approaches to diagnosing a person's mental health. Support vector machine is the first technique. Image characteristics are extracted using a fractal model for classification in this method. With this technique, the histogram of a picture is modeled after a Gaussian distribution. Classification was performed with several support vector machines kernels, and the outcomes were compared. Step two proposes using a deep convolutional neural network architecture to identify Alzheimer's-related mental disorders. According to the findings, the support vector machines approach accurately recognized over 93% of the photos tested. The deep convolutional neural network approach was one hundred percent accurate during model training, whereas the support vector machines approach achieved just 93 percent accuracy. In contrast to support vector machines accuracy of 89.3%, the deep convolutional neural network model test findings were accurate 98.8% of the time. Based on the findings reported here, the proposed deep convolutional neural network architecture may be used for diagnostic purposes involving the patient's mental state.

Schizophrenia spectrum disorders in Denmark between 2000 and 2018: Incidence and early diagnostic transition.

Schizophrenia spectrum disorders (SSD) comprise a group of related mental disorders, which share clinical features and common genetic disposition, but it is unknown if there is a diagnostic transition between these disorders over time. We aimed to study the incidence at the first SSD diagnosis between 2000 and 2018, defined as schizophrenia, schizotypal or schizoaffective disorder, and the early diagnostic transition between these disorders. Using Danish nationwide healthcare registers, we identified all individuals aged 15-64 years during the period from 2000 to 2018 in Denmark and calculated the yearly incidence rates for the specific SSDs. We studied the diagnostic pathways from the first ever diagnosis of an SSD across the subsequent two treatment courses with an SSD diagnosis to evaluate early diagnostic stability, and explore potential changes over time. Among 21,538 patients, yearly incidence rates per 10,000 individuals were similar during the observation period for schizophrenia (2000: 1.8; 2018: 1.6), lower for schizoaffective disorder (2000: 0.3; 2018: 0.1) and increasing for schizotypal disorder (2000: 0.7; 2018: 1.3). Among the subgroup of 13,417 individuals with three separate treatment courses, early diagnostic stability was present among 89.9% which differed between the disorders (schizophrenia: 95.4%; schizotypal disorder: 78.0%; schizoaffective disorder: 80.5%). Among 1352 (10.1%) experiencing an early diagnostic transition, 398 (3.0%) were diagnosed with schizotypal disorder after a schizophrenia or schizoaffective disorder diagnosis. This study provides comprehensive incidence rates for SSDs. The majority of patients experienced early diagnostic stability, but sizable proportions of people with initial schizophrenia or schizoaffective disorder are subsequently diagnosed with schizotypal disorder.

Structural insight to elucidate the binding specificity of the anti-cortisol Fab fragment with glucocorticoids

Cortisol is a steroid hormone that is produced by the adrenal gland. It is a primary stress hormone that increases glucose levels in the blood stream. High concentrations of cortisol in the body can be used as a biomarker for acute and chronic stress and related mental and physiological disorders. Therefore, the accurate quantification of cortisol levels in body fluids is essential for clinical diagnosis. In this article, we describe the isolation of recombinant anti-cortisol antibodies with high affinity for cortisol and discover their cross-reactivity with other glucocorticoids. To describe the cortisol binding site and elucidate the structural basis for the binding specificity, the high-resolution crystal structures of the anti-cortisol (17) Fab fragment in the absence of glucocorticoid (2.00 Å) and the presence of cortisol (2.26 Å), corticosterone (1.86 Å), cortisone (1.85 Å) and prednisolone (2.00 Å) were determined. To our knowledge, this is the first determined crystal structure of a cortisol-specific antibody. The recognition of cortisol is driven by hydrophobic interactions and hydrogen bonding at the protein–ligand interface coupled with a conformational transition. Comparison of ligand-free and ligand-bound structures showed that the side chains of residues Tyr58-H and Arg56-H can undergo local conformational changes at the binding site, most likely prior to the binding event via a conformational selection mechanism. Compared to other anti-steroid antibody–antigen complexes, (17) Fab possesses a structurally unique steroid binding site, as the H3 loop from the CDR area has only a minor contribution, but framework residues have a prominent contribution to hapten binding.

Prevalence of Alcohol Use Disorders among Patients in the Psychiatry Unit of Kampala International University Teaching Hospital in South Western Uganda

Globally, the World Health Organization (WHO) estimated that, there are 2 billion people worldwide who consume alcoholic beverages. The burden of alcohol use is a public health concern. In South, East and West Africa, prevalence of alcohol abuse ranges between 10%- 70%. Uganda has previously reported that, annual per capital alcohol consumption was 23.7 litters. The objective of this study was to determine the prevalence of alcohol use disorders among patients attending psychiatry unit of KIU-TH. The researcher used a retrospective study in patients admitted at KIU-TH psychiatry unit within a period of six months from January, 2017 to June, 2017. From the results of this study, mental health problems were on the increase and up to 34% of admissions were due to alcohol related mental disorders, 70.6% are new admissions. Alcohol induced psychosis is the most prevalent diagnosed alcohol related mental illness with 41.2%, followed by Alcohol abuse with 23.5%, then alcohol withdrawal with 17.6%. Stress was the number one factor associated with alcohol use mental disorder with 70.6%. However, when treated, alcohol related mental disorders has a good prognosis of 82.6%. It is recommended that KIUTH in collaboration with the University section should create awareness of alcoholism as a mental health disorder that can be managed and treated. Youths should abstain from alcohol completely or limit their intake of alcohol. Alcohol sale and use should be strictly limited to few licensed shops. Keywords: Alcohol, Youth, psychiatry, mental disorders

Federated Multi-Task Learning for Joint Diagnosis of Multiple Mental Disorders on MRI Scans.

Deep learning (DL) techniques have been introduced to assist doctors in the interpretation of medical images by detecting image-derived phenotype abnormality. Yet the privacy-preserving policy of medical images disables the effective training of DL model using sufficiently large datasets. As a decentralized computing paradigm to address this issue, federated learning (FL) allows the training process to occur in individual institutions with local datasets, and then aggregates the resultant weights without risk of privacy leakage. We propose an effective federated multi-task learning (MTL) framework to jointly identify multiple related mental disorders based on functional magnetic resonance imaging data. A federated contrastive learning-based feature extractor is developed to extract high-level features across client models. To ease the optimization conflicts of updating shared parameters in MTL, we present a federated multi-gate mixture of expert classifier for the joint classification. The proposed framework also provides practical modules, including personalized model learning, privacy protection, and federated biomarker interpretation. On real-world datasets, the proposed framework achieves robust diagnosis accuracies of 69.48 ± 1.6%, 71.44 ± 3.2%, and 83.29 ± 3.2% in autism spectrum disorder, attention deficit/hyperactivity disorder, and schizophrenia, respectively. The proposed framework can effectively ease the domain shift between clients via federated MTL. The current work provides insights into exploiting the advantageous knowledge shared in related mental disorders for improving the generalization capability of computer-aided detection approaches.

Neural circuit mapping of waiting impulsivity and proactive inhibition with convergent evidence from fMRI and TMS

IntroductionWaiting and stopping are essential and distinct elements of appropriate behavioral control with its dysfunction implicated in various impulsivity related mental disorders. Although rodent and human studies have investigated both phenomena, the role of preparing to stop in waiting impulsivity has rarely been investigated. Furthermore, convergent evidence from multi-modal investigation tools remains a poorly utilized approach in addressing such questions.ObjectivesHere, we conducted two separate, but hierarchical studies, using functional magnetic resonance imaging (fMRI) to map the neural circuit involved in waiting impulsivity and proactive stopping, and subsequently provide mechanistic and causal evidence of disruption of this circuit by transcranial magnetic stimulation (TMS). In the second study, based on our fMRI study data, we attempted to investigate possible causation between the LIFG and waiting impulsivity by modulating LIFG, i.e. non-invasively producing a “virtual lesion” with an inhibitory transcranial magnetic stimulation (TMS) protocol called continuous theta burst stimulationMethodsWe recruited 41 healthy volunteers who performed an adapted version (1CSRT) of the well-established 5 choice serial reaction time task to capture waiting impulsivity. We developed a novel task measuring proactive inhibition. We scanned participants while completing these two tasks. Our fMRI data showed a strong association between LIFG activity and waiting impulsivity on the 1CSRT task. We conducted a single-blind, randomized, between-subjects design of cTBS of the LIFG on a sample of 51 healthy volunteers who completed an adapted version of the 1CSRT task (2CSRT task). Our a priori hypothesis was that cTBS would transiently decrease local cortical activity of the LIFG and increase the frequency of premature responses on both fixed and delayed cue-target interval trials on the 2CSRT task.ResultsWe first show a shared neural network comprising the pre-supplementary motor area and bilateral anterior insula underlying both waiting impulsivity and proactive stopping. We further demonstrate activity in dorsomedial prefrontal cortex and left inferior frontal gyrus (LIFG) negatively correlated with waiting impulsivity in trials with additional target onset delay. We demonstrate active stimulation significantly increased waiting impulsivity.ConclusionsIn these two studies, we validated a novel task measuring proactive inhibition. We further validated the significance of task structure for assessing distinct aspects of impulsivity, which is of translational interest. We further established a causal role of lIFG for waiting impulsivity thus highlighting the integrity of LIFG and related neural circuitry required in waiting impulsivity.Disclosure of InterestNone Declared

Genetic liability to mental disorders in relation to the risk of hypertension.

Observational studies have indicated that psychosocial factors contribute to hypertension; however, the causality of these associations remains unclear due to reverse causality and confounders. We aim to assess the causal associations of mental health disorders with hypertension. Instrumental variables of anxiety disorder, attention deficit/hyperactivity disorder, autism spectrum disorder, depression, obsessive-compulsive disorder, post-traumatic stress disorder, schizophrenia, and subjective well-being measure were obtained from the corresponding largest genome-wide association studies. Summary statistics for the association of essential hypertension were obtained from the FinnGen Study (42,857 cases and 162,837 controls) and UK Biobank cohort (54,358 cases and 408,652 controls). The multiplicative random-effects inverse-variance weighted method was utilized as the primary analysis and three other statistical methods were conducted in the supplementary analyses. The results were combined using the fixed-effects method. In the pooled analyses, genetic liability to depression was associated with higher risk of hypertension (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.17-1.35; p < 0.001). Besides, a suggestive association was found between genetically predicted higher weighted neuroticism sum-score and increased risk of hypertension (OR, 1.16; 95% CI, 1.02-1.33; p < 0.05). No associations were found for other mental health disorders. Sensitivity analyses revealed consistent evidence as the main results. We provide consistent evidence for the causal effect of genetic liability to depression on hypertension, which highlights the importance of blood pressure measurement and monitoring in patients with depression.

The effect of acupuncture at the Yuji point on resting-state brain function in anxiety.

The COVID-19 epidemic has placed a lot of mental burdens on school students, causing anxiety. Clinically, it has been found that the Yuji point (LU10) can relieve anxiety by regulating Qi. Thirty-six volunteers with anxiety disorders were divided into 3 groups, all of whom underwent 2 MRI examinations. The Yuji and nonacupoint groups received acupuncture between functional magnetic resonance imagings. We used the amplitude of low-frequency fluctuation to analyze regional brain activity, and seed-based functional connectivity (FC) to analyze changes in brain networks. After acupuncture, the LU10 was able to activate the frontal lobe, medial frontal gyrus, anterior cingulate gyrus, temporal lobe, hippocampus, etc in the left brain compared to the control group. The frontal lobe, medial frontal gyrus, cingulate gyrus, and anterior cingulate gyrus in the left brain were activated compared to those in the nonacupoint group. Compared with the control group, LU10 showed increased FC in the right parietal lobe, right precuneus, left temporal lobe, left superior temporal gyrus, and with cingulate gyrus. FC was enhanced among the hippocampus with the left temporal lobe and the superior temporal gyrus and reduced in the right lingual gyrus and right occipital lobe. Acupuncture at LU10s can regulate anxiety by upregulating or downregulating the relevant brain regions and networks. LU10s can be used to treat not only lung disorders but also related mental disorders.

Screening for affective dysregulation in school-aged children: relationship with comprehensive measures of affective dysregulation and related mental disorders

Affective dysregulation (AD) is characterized by irritability, severe temper outbursts, anger, and unpredictable mood swings, and is typically classified as a transdiagnostic entity. A reliable and valid measure is needed to adequately identify children at risk of AD. This study sought to validate a parent-rated screening questionnaire, which is part of the comprehensive Diagnostic Tool for Affective Dysregulation in Children (DADYS-Screen), by analyzing relationships with comprehensive measures of AD and related mental disorders in a community sample of children with and without AD. The sample comprised 1114 children aged 8–12 years and their parents. We used clinical, parent, and child ratings for our analyses. Across all raters, the DADYS-Screen showed large correlations with comprehensive measures of AD. As expected, correlations were stronger for measures of externalizing symptoms than for measures of internalizing symptoms. Moreover, we found negative associations with emotion regulation strategies and health-related quality of life. In receiver operating characteristic (ROC) analyses, the DADYS-Screen adequately identified children with AD and provided an optimal cut-off. We conclude that the DADYS-Screen appears to be a reliable and valid measure to identify school-aged children at risk of AD.

Polygenic risk for mental disorders as predictors of posttraumatic stress disorder after mild traumatic brain injury

Many patients with mild traumatic brain injury (mTBI) are at risk for mental health problems such as posttraumatic stress disorder (PTSD). The objective of this study was to determine whether the polygenic risk for PTSD (or for related mental health disorders or traits including major depressive disorder [MDD] and neuroticism [NEU]) was associated with an increased likelihood of PTSD in the aftermath of mTBI. We used data from individuals of European ancestry with mTBI enrolled in TRACK-TBI (n = 714), a prospective longitudinal study of level 1 trauma center patients. One hundred and sixteen mTBI patients (16.3%) had probable PTSD (PCL-5 score ≥33) at 6 months post-injury. We used summary statistics from recent GWAS studies of PTSD, MDD, and NEU to generate polygenic risk scores (PRS) for individuals in our sample. A multivariable model that included age, sex, pre-injury history of mental disorder, and cause of injury explained 7% of the variance in the PTSD outcome; the addition of the PTSD-PRS (and five ancestral principal components) significantly increased the variance explained to 11%. The adjusted odds of PTSD in the uppermost PTSD-PRS quintile was nearly four times higher (aOR = 3.71, 95% CI 1.80–7.65) than in the lowest PTSD-PRS quintile. There was no evidence of a statistically significant interaction between PTSD-PRS and prior history of mental disorder, indicating that PTSD-PRS had similar predictive utility among those with and without pre-injury psychiatric illness. When added to the model, neither MDD-PRS nor NEU-PRS were significantly associated with the PTSD outcome. These findings show that the risk for PTSD in the context of mTBI is, in part, genetically influenced. They also raise the possibility that an individual’s PRS could be clinically actionable if used—possibly with other non-genetic predictors—to signal the need for enhanced follow-up and early intervention; this precision medicine approach needs to be prospectively studied.

Role of Ayurvedic Herbs in the Management of Attention Deficit Hyperactivity Disorder in Children

Ayurvedic system of medicine has a treasury of description of several Ayurveda herbs that elevate the mental as well as intellectual power primarily claimed as 'Medhya'. Firstly, the Rasayana drugs which are mentioned in Charaka Samhita called 'Medhya Rasayana' are supposed to be having specific influence on brain functions. Cognitive deficit can be present from birth or result from environmental causes such as brain damage, mental illness, or neurological abnormalities. This causes significant restrictions to the ability to learn and operate, like in ADHD. Sufferer of this clinical entity children stay confused, unable to do daily routine work normally, face difficulty in learning and understanding, unable to focus on one thing at a time. In Ayurvedic literature, impairment of memory is mentioned as Smriti bhramsha which occurs due to vitiation of Raja and Tama dosha. It has been noted that cognitive functions are thoroughly affected due to stress, anxiety and other related psychological disorders. It has been explained that Medha (intellect) and Buddhi (wisdom) get deteriorated in this condition. Some features of ADHD are resembled with Unmada. Medhya drugs mentioned in Ayurveda have multi-dimensional actions including effect on memory. These not only enhance the intellectual capacity but also rejuvenate the whole body system and their pathways. This review article delineates the introduction of ADHD, its Ayurvedic association and the herbs that are effective in management of ADHD.