Mood Disorders Research Articles

Attention as the dimension that deteriorates first in patients with cognitive impairment after myocardial infarction

Abstract Background Previous publications by our team indicated a high prevalence (approximately 35%) of cognitive impairment (CI) in patients after myocardial infarction (MI). Moreover, we observed that the presence of peri-infarction deficits was not always associated with their occurrence after 6 months of follow-up and vice versa. This was the basis for distinguishing 4 groups of patients: a) group 1 – CI present peri-infarction and after 6 months; b) group 2 – CI present only peri-infarction; c) group 3 – CI present only after 6 months; d) group 4 – no CI during the study. Purpose The aim of the current study is to analyse the type of CI in patients after MI with a focus on its changes within the 4 groups mentioned. Methods The study included 326 patients hospitalised for MI treated by percutaneous coronary intervention. Cognitive function was assessed twice using the Mini–Mental State Examination (MMSE) and the Clock Drawing Test (CDT)-Shulman version during the first hospitalisation (on day 2-3 after MI) and 6 months later. In addition, the occurrence of sleep, aggression and mood disorders was assessed. The constructed research model was analysed with artificial intelligence algorithms. Results Persistent CI (group1) was found in 8.9%, peri-infarct CI (group 2) in 16.3%, and only after 6 months (group 3) in 7.7% of study participants (as assessed by MMSE). Analysis of the cognitive domains showed that in those who improve (group 2) or worsen cognitive function (group 3), analogous changes in attention function occurred, respectively improving in 81% and worsening in 100% of subjects in a given group. It was observed that there is a group of patients with a CI on the MMSE who perform CDT correctly, 12% peri-infarct and 11% at 6-month follow-up, respectively. Patients with a normal CDT score but CIs found in the MMSE have impaired attentional function regardless of the time of assessment. Conclusion CIs can occur both immediately after MI and during subsequent follow-up. However, after 6 months of intensive anti-atherosclerotic treatment (post-MI), cognitive functions improve in some patients, and deteriorate in others. At the same time, the cognitive function that undergoes similar changes in these groups is attention. The uniform type of impaired cognitive function and the lack of specific differences between the 4 groups allow us to assume a uniform etiology of cognitive deficits. Patients with normal CDT and disorders present in MMSE show deficits in attention functions. Performing CDT and using the MMSE component assessing attention function could prove sufficient for the initial assessment of cognitive functions in the population of patients after MI. The results require confirmation in a larger patient population.

Adaptive Hyperactivity and Biomarker Exploration: Insights from Elders in the Blue Zone of Sardinia

Background/Objectives: Adaptive hyperactivity characterized by increased activity levels and novelty-seeking traits without mood disorders is prevalent among older adults in Sardinia’s “blue zone,” an area with high longevity. This study aims to evaluate the adaptive nature of hyperactivity concerning quality of life, social rhythms, and mood symptoms in individuals from this region, particularly among elderly adults over 80. Methods: This observational cross-sectional study included adults and older adults over 80 from Sardinia’s blue zone. This study included a sample of patients followed at the Center for Consultation Psychiatry and Psychosomatics for Bipolar Disorder of the University Hospital of Cagliari and a homogeneous comparison sample of patients without psychiatric pathologies, referred to the Dermatology Clinic of the same hospital, for a period of 6 months, from February to August 2024. The general sample, divided into two parts—cases, represented by patients with psychiatric pathology, and controls, patients without psychiatric pathology—was divided in turn into three sub-groups: “adults” (18–64 years), young elders (65–79), and old elders (over 80 years). The participants underwent psychiatric interviews and completed the Mood Disorder Questionnaire (MDQ), Patient Health Questionnaire (PHQ-9), SF-12, and Brief Social Rhythm Scale (BSRS). Data were compared with national and regional normative data. Results: Older adults in the blue zone demonstrated higher MDQ positivity (22.58%) compared to the national averages (0.87%), without corresponding increases in dysregulated rhythms, depressive symptoms, or reduced quality of life. Younger old persons (65–79 years) showed increased rhythm dysregulation (BSRS score: 20.64 ± 7.02) compared to adults (17.40 ± 6.09, p = 0.040), but this trend was not observed in the oldest group (80+ years). No significant differences were found in the CH3SH and (CH3)2S levels between groups. Conclusions: The hyperactivity observed in older adults from Sardinia’s blue zone appears adaptive and not linked to social rhythm dysregulation, depressive symptoms, or a diminished quality of life, suggesting resilience factors which may contribute to longevity. These findings support the potential classification of such hyperactivity as beneficial rather than pathological, warranting further research into biomarkers and psychoeducational interventions to prevent the onset of bipolar disorders in predisposed individuals.

Ketamine-induced altered states of consciousness: a systematic review of implications for therapeutic outcomes in psychiatric practices.

This systematic review aims to elucidate the nexus between ketamine's psychoactive properties and its efficacy in treating a broad spectrum of psychiatric disorders. We searched three databases and used citation tracking to include 29 studies. Predominantly, mood disorders, including bipolar disorder (BD) and major depressive disorder (MDD) (MDD + BD: + n = 25studies), a large part of them involve treatment-resistant patients (n = 14studies), substance use disorder (SUD, n = 3studies), and social anxiety disorder (SAD, n = 1study). From all included studies(n=29), 15 (51.72%) of themidentified a positive relation between ketamine-induced altered states of consciousness and clinical outcomes, while 13studies (44.83%)showed no linkage between them, and one study (3.45%)delineated a negative association. Focusing solely on intravenous (IV) ketamine infusions (n = 25), 14 studies(56%)reported a positive modulation of ketamine's psychoactive effects and therapeutic benefits, whereas 10 studies(40%)confirmed no relationship, and one study (4%)showed a negative association. The single study(33.34%) involving subcutaneous ketamine and allthree studies (66.6%)intranasal administration did not demonstrate a significant interaction between ketamine's psychoactive effects and therapeutic response. All three SUD studies reported a positive correlation between ketamine's psychoactive effects and therapeutic response. In contrast, the single SAD study did not find a relationship between these parameters. For studies involvingmood disorders (n = 25), 12 studies (48%)reported a positive relationship between psychoactive effects and therapeutic response.Others 12studies (48%)identified a null relationship, and one study (4%)found a significant negative association. Although we have found a larger association than previous studies between ketamine's psychoactive properties and its efficacy in treating a broad spectrum of psychiatric disorders, its topic remains indeterminate, mainly due to the high heterogeneity.

Using marketing strategies to promote maternal health: an international students’ collaboration

Abstract Purpose About 1 in 8 birth parents experience symptoms of perinatal mood and anxiety disorders (PMADs). The purpose of this collaborative project was to create a social media deliverable to lower the risk of postpartum depression in pregnant and postpartum parents in Georgia, USA. Methods Using the SM 10-step model, Master of Public Health Students from Georgia Southern University (GSU), Georgia in collaboration with Creative Business students from Breda University of Applied Science (BUas), the Netherlands, designed an evidence-based SM product. They were mentored by public health and media faculty from both institutions. Roles and responsibilities according to the skill sets were divided, but briefly: students 1) identified a target audience; 2) conducted tertiary data collection; 3) set goals and objectives; 4) developed 4 P’s (product, price, place, and promotion) 5) developed marketing strategies.; 6) and used the strategy to create a specific social media deliverable. Results Utilizing the 10-step model social marketing strategy used state-of-the-art marketing and digital media techniques and evidence-based strategies to create a digital electronic booklet that focused on reducing the stigma associated with help seeking behaviors with the ultimate goal to reduce the incidence and prevalence of PMADs. The digital interactive booklet will be pilot tested in selected OBGYN offices and health departments in Southeast Georgia in July 2024. Conclusions This collaborative project demonstrates effective collaboration between disciplines from different world regions utilizing strengths from both teams: public health and digital media skills to create an SM product that will be utilized to promote social engagement among postpartum parents. Key messages • Students utilized social marketing strategies to create an electronic booklet to address postpartum depression using state-of-the-art digital media techniques and evidence-based strategies. • This collaborative project demonstrates effective collaboration between disciplines from different world regions and utilizes strengths from both teams.

20 (S)-Protopanaxadiol Alleviates DRP1-Mediated Mitochondrial Dysfunction in a Depressive Model In Vitro and In Vivo via the SIRT1/PGC-1α Signaling Pathway

Depression is a complex and common mental illness affecting physical and psychological health. Panax ginseng C. A. Mey is a traditional Chinese medicine with abundant pharmacological activity and applications in regulating mood disorders. 20 (S)-Protopanaxadiol is the major intestinal metabolite of ginsenoside and one of the active components in ginseng. In this study, we aimed to investigate the therapeutic effects of 20 (S)-Protopanaxadiol on neuronal damage and depression, which may involve mitochondrial dynamics. However, the mechanism underlying the antidepressant effects of 20 (S)-Protopanaxadiol is unelucidated. In the present study, we investigated the potential mechanisms underlying the antidepressant activity of 20 (S)-Protopanaxadiol by employing a corticosterone-induced HT22 cellular model and a chronic unpredicted mild stress (CUMS)-induced animal model in combination with a network pharmacology approach. In vitro, the results showed that 20 (S)-Protopanaxadiol ameliorated the corticosterone (CORT)-induced decrease in HT22 cell viability, decrease in 5-hydroxytryptamine (5-HT) levels, and increase in nitric oxide (NO) and malondialdehyde (MDA) levels. Furthermore, 20 (S)-Protopanaxadiol exerted improvement effects on the CORT-induced increase in HT22 cell mitochondrial reactive oxygen species, loss of mitochondrial membrane potential, and apoptosis. In vivo, the results showed that 20 (S)-Protopanaxadiol ameliorated depressive symptoms and hippocampal neuronal damage in CUMS mice, and sirtuin1 (SIRT1) and peroxisome proliferator-activated receptor-1-Alpha (PGC-1α) activity were activated in the hippocampus of mice, thereby alleviating mitochondrial dysfunction and promoting the clearance of damaged mitochondria. In both in vivo and in vitro models, after inhibiting SIRT1 expression, the protective effect of 20 (S)-Protopanaxadiol on mitochondria was significantly weakened, and dynamin-related protein 1 (DRP1)-mediated mitochondrial division was significantly reduced. These findings suggest that 20 (S)-Protopanaxadiol may exert neuroprotective and antidepressant effects by attenuating DRP1-mediated mitochondrial dysfunction and apoptosis by modulating the SIRT1/PGC-1α signaling pathway.

Childhood trajectories of emotional and behavioral difficulties are related to polygenic liability for mood and anxiety disorders.

Symptoms related to mood and anxiety disorders (emotional disorders) often present in childhood and adolescence. Some of the genetic liability for mental disorders, and emotional and behavioral difficulties seems to be shared. Yet, it is unclear how genetic liability for emotional disorders and related traits influence trajectories of childhood behavioral and emotional difficulties, and if specific developmental patterns are associated with higher genetic liability for these disorders. This study uses data from a genotyped sample of children (n = 54,839) from the Norwegian Mother, Father, and Child Cohort Study (MoBa). We use latent growth models (1.5-5 years) and latent profile analyses (1.5-8 years) to quantify childhood trajectories and profiles of emotional and behavioral difficulties and diagnoses. We examine associations between these trajectories and profiles with polygenic scores for bipolar disorder (PGSBD), anxiety (PGSANX), depression (PGSDEP), and neuroticism (PGSNEUR). Associations between PGSDEP, PGSANX, and PGSNEUR, and emotional and behavioral difficulties in childhood were more persistent than age-specific across early childhood (1.5-5 years). Higher PGSANX and PGSDEP were associated with steeper increases in behavioral difficulties across early childhood. Latent profile analyses identified five profiles with different associations with emotional disorder diagnosis. All PGS were associated with the probability of classification into profiles characterized by some form of difficulties (vs. a normative reference profile), but only PGSBD was uniquely associated with a single developmental profile. Genetic risk for mood disorders and related traits contribute to both a higher baseline level of, and a more rapid increase in, emotional and behavioral difficulties across early and middle childhood, with some indications for disorder-specific profiles. Our findings may inform research on developmental pathways to emotional disorders and the improvement of initiatives for early identification and targeted intervention.

USO DA CETAMINA COMO ESCOLHA NO TRATAMENTO EM ADULTOS E IDOSOS COM DEPRESSÃO RESISTENTE AO TRATAMENTO

Introduction: Increasingly, there has been a rise in the diagnosis of depressive disorders among the elderly, making this issue alarming as it directly affects their quality of life and functional capacity. In addition to these aspects, this situation increases the risk of morbidity and mortality. Antidepressants, either alone or in combination with other medications, can be used to treat this type of depressive disorder. Currently, there are several classes of antidepressants available, but in the case of patients with mood disorders, the response to common antidepressants may be unsatisfactory. Studies indicate that a relevant alternative for treating resistant depression (RD) is the use of ketamine. Objective: To gather and analyze information on the pharmacological approach of ketamine in the treatment of resistant depression in the elderly. Methodology: Articles published in indexed journals in the Scientific Electronic Library Online (SCIELO), National Library of Medicine/NLM (MEDLINE), and National Library of Medicine/NLM (PUBMED) databases were evaluated, in addition to official sites such as the Ministry of Health of Brazil and the World Health Organization, covering the period from 2014 to 2024. Results: After completing the data collection phase, 29 relevant articles were identified for analysis of the proposed theme. Discussion: Based on the results obtained and the objectives of this review, it is possible to highlight the most relevant aspects of the topic in question. Thus, a positive response to treatment-resistant depression (TRD) was observed in patients treated with ketamine. Conclusion: The use of ketamine in patients with depressive disorders demonstrates rapid and lasting antidepressant effects, making it a viable treatment alternative.

Bidirectional influence between benign prostatic hyperplasia, prostate cancer, and prostatitis and mental disorders: two-sample and multivariate mendelian randomization analyses

Background We aimed to use Mendelian randomization (MR) to determine the causality between fifteen major mental disorders (MDs) and benign prostatic hyperplasia (BPH), prostate cancer (PCa), and prostatitis. Methods The main MR analysis was performed using the inverse variance-weighted (IVW) method. Results The study found that insomnia (odds ratio [OR], 1.6190; p = .0017) was significantly associated with an increased risk of BPH, and mood disorders (OR, 1.1590; p = .0221) was nominally associated with an increased risk of BPH. Conversely, BPH was suggestively associated with a low epilepsy risk (OR, 0.9988; p = .0043), and was nominally associated with an increased risk of insomnia (OR, 1.0061; p = .0291). Furthermore, attention deficit hyperactivity disorder (ADHD) was suggestively associated with a low PCa risk (OR = 0.9474; p = .0058). However, no causal relationship was observed between PCa and MDs. Finally, anorexia nervosa (OR, 1.1686; p = .0248) and depression (OR, 336.5383; p = .0308) were nominally positively correlated with prostatitis. Prostatitis was suggestively associated with increased risk of ADHD (OR, 1.0868; p = .0413). Conclusion Our findings provide clinicians with a basis for developing programs to prevent or treat MDs and prostatic diseases.

The trajectory of substance use disorder among people formerly in foster care: A survival analysis.

Substance use disorder (SUD) represents a significant public health challenge, especially among individuals who have faced early life adversities. Foster care aims to provide a supportive environment for children; however, the relationship between a history of foster care and SUD development remains unclear. This study aims to examine the likelihood of developing SUD among individuals with a history of foster care, who have used substances during their lifetime, compared to those raised by biological parents. Using data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), we analyzed the prevalence of social demographics and clinical variables among individuals who have used alcohol, nicotine, or cannabis. We calculated the probabilities of developing SUD for each factor, including exposure to foster care. Various covariates that could impact SUD occurrence were also assessed. The duration from initial substance use to SUD onset was calculated for both groups. Survival analysis curves were generated for each substance to depict the probability of SUD development over time. Our analysis revealed that foster care may act as a protective factor against Cannabis Use Disorder (CUD), with a hazard ratio of 0.25 (95% CI [0.07, 0.88]). No significant associations were found with Alcohol Use Disorder (AUD) or Nicotine Use Disorder (NUD). Both foster and non-foster care groups exhibited higher probabilities of developing NUD compared to the general population. For cannabis users, the probability of developing CUD stabilizes after approximately 10 years. Family history of SUD and clinical predictors such as mood disorders consistently showed significant associations across all substance groups, highlighting their importance in SUD development. Our findings suggest that foster care may offer some protective benefits, particularly against CUD, emphasizing the need for further research into its protective factors and the development of targeted interventions to reduce SUD prevalence in this population.

Prospective analysis of sex differences and factors associated with suicidal thoughts and behaviours in young people from the MILESTONE Italian sample

Suicide is a significant leading cause of death among young people, particularly those struggling with mental disorders. The present study utilised data from 230 young people (aged 16–18 years) undergoing a transitional care process from Child and Adolescent Mental Health Services to Adult Mental Health Services within the MILESTONE European project (2014–2019), a longitudinal cluster randomised controlled trial. The objectives of this study were to monitor temporal patterns of general health and social functioning over two years, to detect sex differences, and to identify factors associated with Suicidal Thoughts and Behaviours (STB) at the first and last time points. The results demonstrate a decrease in STB over the two-year follow-up period among all participants. Females exhibited a higher prevalence of STB across all time points, whereas males only exhibited STB at the nine-month follow-up. The most influential factors associated with STB were previous suicide attempts and mood disorders at baseline, and mood disorders and relational problems at the end of follow-up. These findings emphasise the importance of monitoring STB and informing young people undergoing a transitional care period about its key risk factors. Moreover, sex differences in STB suggest the need for different preventive strategies for males and females.

Augmented cortisol and antiglucocorticoid therapy in mood disorders: the hippocampus as a potential drug target

The pathophysiology of many mood disorders is closely related to abnormal stress response associated with the dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and cortisol overproduction. The hippocampus, a key structure of the limbic system responsible for both cognitive and emotional spheres, is selectively vulnerable to excess of glucocorticoids (GCs) inducing neuroinflammation and neurodegeneration. The antiGC therapy of psychiatric diseases, in particular depressive disorders, may be a useful additional treatment. Among other approaches, targeting glucocorticoid receptors, abounded in the hippocampus, is regarded as highly promising. However, though the preclinical data provide fairly firm evidence to the concept of antiGC therapy for stress-related diseases, clinical studies still are at the proof-of-concept stage. Noteworthy, chronic GC excess is associated not only with mood diseases, but also with cognitive decline, metabolic disorders, diabetes. Potentially, antiGC (HPA axis modifying) therapy may alleviate affective symptoms, cognitive disturbances, GC and insulin resistance and adverse side effects of conventional drugs through beneficial effects on the hippocampus mitigating its dysfunction and neurodegeneration, neuroinflammation, and impairment of neurogenesis. Since stress/GC-associated neuroinflammation-mediated pathology of the limbic system and, specifically, the hippocampus, is a general feature typical for many brain diseases, the concept of antiGC therapy may be extended, tested and validated in a wider spectrum of cerebral pathologies.

The Association Between Obesity, Chronic Inflammation, Metabolic Disorders and Mood Disorders Among Patients up to 12 Months After Hospitalization for SARS-CoV-2

Background/Objectives: The relationship between BMI, inflammation, and mental health is complex. A high BMI, especially obesity, is associated with chronic inflammation, which can lead to mental disorders such as depression. Inflammatory cytokines affect neurotransmitters and the stress axis, worsening mental health. Obesity and mental disorders can mutually reinforce each other. New findings show that inflammation can lead to neurobiological changes, and the gut microbiota may play a key role. Obesity has been implicated as a factor in the high mortality and duration of influenza-like illnesses, even in people who do not have other chronic diseases that may increase the risk of complications. The aim of this study was to determine the associations between BMI and chronic inflammation, metabolic disorders, depression, and anxiety in patients hospitalized with COVID-19 up to 12 months after hospitalization. Methods: The study included 248 participants previously hospitalized for SARS-CoV-2 infection up to 12 months after hospitalization. The study was conducted in a multistage design using a diagnostic survey, anthropometric measurements, and laboratory methods. Results: A statistically significantly higher BDI-II score was observed among women. Statistical analysis showed a statistically significant higher GAD-7 score among women and those over 75 years of age. Conclusions: Higher BMI among subjects is often associated with elevated values of inflammatory markers and immune cells, such as WBC, neutrophils, monocytes, and CRP, as well as higher blood glucose levels. These associations may be related to the chronic inflammation and metabolic disorders that often accompany obesity. Lymphocytes and eosinophils may show more varied relationships depending on individual factors and specific health conditions. It is therefore important to continue research in this area.

Rare but Relevant: Characterizing Self-Inflicted Burn Injuries in the United States.

Self-inflicted burns (SIBs) represent a distinct entity in burn care often associated with an underlying psychiatric etiology. In this review, we summarize the existing evidence on SIBs in North America to inform targeted prevention and interventions for patients afflicted with SIBs. The following databases were queried to identify relevant articles used for literature review: PubMed, Embase, and Scopus. The main outcome measures were burn characteristics and risk factors of SIBs in the American population. A total of 14,189 patients were included across 13 included studies. The percent of total body surface area burned ranged from less than one to 100%, with a mean of 29.6 +/- 20.7%. Depressive disorders were the most reported overall; however, among mood disorders, bipolar disorder was also reported frequently, while anxiety was reported least. Motives for self-inflicting burn injury included premeditated self-injury as a coping mechanism, escape or response to delusions, impulsive self-injury, and most commonly, suicidal intention. The majority of the studies reported that pre-admission drug and alcohol abuse were associated with the occurrence of SIBs. Other identified risk factors for SIB injury included female sex, younger age, unemployment, and unmarried status. From this, it is imperative that targeted interventions are developed to address the complex interplay of psychiatric disorders, drug use, and other demographic risk factors among the American population. It is crucial for initiatives to emphasize early identification of individuals at-risk of self-harm, better access to mental health services, and stronger drug abuse programs to target SIB occurrence in the U.S..

Functional Principal Component Analysis for Continuous Non-Gaussian, Truncated, and Discrete Functional Data.

Mobile health studies often collect multiple within-day self-reported assessments of participants' behavior and well-being on different scales such as physical activity (continuous scale), pain levels (truncated scale), mood states (ordinal scale), and the occurrence of daily life events (binary scale). These assessments, when indexed by time of day, can be treated and analyzed as functional data corresponding to their respective types: continuous, truncated, ordinal, and binary. Motivated by these examples, we develop a functional principal component analysis that deals with all four types of functional data in a unified manner. It employs a semiparametric Gaussian copula model, assuming a generalized latent non-paranormal process as the underlying generating mechanism for these four types of functional data. We specify latent temporal dependence using a covariance estimated through Kendall's bridging method, incorporating smoothness in the bridging process. The approach is then extended with methods for handling both dense and sparse sampling designs, calculating subject-specific latent representations of observed data, latent principal components and principal component scores. Simulation studies demonstrate the method's competitive performance under both dense and sparse sampling designs. The method is applied to data from 497 participants in the National Institute of Mental Health Family Study of Mood Spectrum Disorders to characterize differences in within-day temporal patterns of mood in individuals with the major mood disorder subtypes, including Major Depressive Disorder and Type 1 and 2 Bipolar Disorder. Software implementation of the proposed method is provided in an R-package.

Effects of Neurodevelopmental Disorders on the Clinical Presentations and Therapeutic Outcomes of Children and Adolescents with Severe Mood Disorders: A Multicenter Observational Study.

Individuals with neurodevelopmental disorders (NDDs) are more susceptible to developing severe or resistant mood disorders. However, they often face challenges in accessing specific treatments. To understand the barriers to treatment in this group, we conducted a secondary analysis of a multicenter observational study on 305 adolescents referred to specialized care (mean age 14.38 ± 0.13 years, 57% girls, 9% bipolar disorder, 91% depressive disorders). NDDs were categorized based on the number of co-occurring NDDs for each subject (none: 67%, one: 18%, two: 7%, three: 5%, four and more: 2%). We explored the predictive value of the number of NDDs on various clinical and therapeutic factors. The analysis revealed significant associations between the number of NDDs and the duration of mood symptoms, persistent irritability, associated disruptive behavioral disorders, lower scores on the Children's Global Assessment Scale (CGAS) at baseline, and polypharmacy. The number of NDDs did not correlate with the use of antidepressants, the Clinical Global Impression-Improvement scale (CGI-I) at discharge, or changes in the CGAS score during the stay. The challenges in distinguishing mood disorders from chronic emotional and behavioral difficulties may contribute to the difficulties in accessing specific care for mood disorders. These results suggest that treatments for mood disorders demonstrate comparable effectiveness when provided regardless of the associations with NDDs.

Semantic fMRI neurofeedback of emotions: from basic principles to clinical applications.

During fMRI neurofeedback participants learn to self-regulate activity in relevant brain areas and networks based on ongoing feedback extracted from measured responses in those regions. This closed-loop approach has been successfully applied to reduce symptoms in mood disorders such as depression by showing participants a thermometer-like display indicating the strength of activity in emotion-related brain areas. The hitherto employed conventional neurofeedback is, however, 'blind' with respect to emotional content, i.e. patients instructed to engage in a specific positive emotion could drive the neurofeedback signal by engaging in a different (positive or negative) emotion. In this future perspective, we present a new form of neurofeedback that displays semantic information of emotions to the participant. Semantic information is extracted online using real-time representational similarity analysis of emotion-specific activity patterns. The extracted semantic information can be provided to participants in a two-dimensional semantic map depicting the current mental state as a point reflecting its distance to pre-measured emotional mental states (e.g. 'happy', 'content', 'sad', 'angry'). This new approach provides transparent feedback during self-regulation training, and it has the potential to enable more specific training effects for future therapeutic applications such as clinical interventions in mood disorders.This article is part of the theme issue 'Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation'.

Psychiatric hospitalizations among adolescents during the pandemic in Italy: a retrospective study.

The COVID-19 pandemic has negatively impacted child and adolescent mental health. The study outcome was the evaluation of the pandemic impact on adolescents' hospitalizations in an acute psychiatric ward. With an observational and retrospective design,we collected selected variables among adolescents hospitalized in an acute psychiatric ward from 01/07/2017 to 30/06/2022. Data were statistically processed. Our sample consisted of 118minors with an average age of 15.7±1.2 SD, mostly represented by females (61 %) and Italians (60.2 %), who made 204 hospitalizations inthe study period. The admissions by years drastically decreased in 2020 concomitantly with the lockdown and increased in the first half of 2022. The admission rate was higher in winter and spring, except in 2020 when all admissions decreased (p=0.000). Females more frequently were hospitalized for suicidal behavior and acute anxiety (p=0.000) and were discharged with acute stress reactions, eating disorders, and mood disorder diagnoses (p=0.000). Differently, males more frequently were hospitalized for aggressive behavior (p=0.000) and discharged with ADHD diagnosis (p=0.000). At multiple linear regression, the duration of hospitalization (dependent variable) was negatively associated with "the pandemic period" (p=0.017) and "absent aggressive behavior" (p=0.003), and positively with "autism" diagnosis (p=0.000). We highlighted the more stressful impact of COVID-19 pandemic on female adolescents, who required more frequently psychiatric hospitalizations due to suicidal behavior, anxiety and mood disorders.

Concurrent and prospective prediction of community-dwelling adults' psychosocial functioning with the Inventory of Depression and Anxiety Symptoms-II (IDAS-II).

Mood and anxiety disorders involve defining symptoms (e.g., dysphoria, anhedonia) that can impair psychosocial functioning (e.g., self-care, work, social relationships). The present study evaluated the validity of the Inventory of Depression and Anxiety Symptoms-II (IDAS-II; Watson et al., 2012) via convergence with a semistructured interview assessing mood and anxiety disorder symptoms and, moreover, prediction of psychosocial functioning. Community-dwelling adults (N = 601) completed the self-report IDAS-II, a semistructured diagnostic interview, and self-report and interview measures of psychosocial functioning. A retest subsample (ns = 497-501) completed the functioning measures again, on average 8 months later. Supporting our hypotheses, the IDAS-II converged robustly with interview-assessed symptoms and predicted psychosocial functioning significantly, both concurrently and prospectively. Moreover, the IDAS-II predicted functioning significantly better than did the diagnostic interview. These findings support use of the IDAS-II in research and clinical settings to assess mood and anxiety symptoms and their connections to psychosocial impairment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Rational Search for Betaine/GABA Transporter 1 Inhibitors─In Vitro Evaluation of Selected Hit Compound.

Inhibitory neurotransmission mediated by γ-aminobutyric acid (GABA) plays an important role in maintaining body homeostasis. Disturbances in GABA signaling are implicated in a multitude of neurologic and psychiatric conditions, including epilepsy, ischemia, anxiety, depression, insomnia, and mood disorders. Clinically relevant increases in GABA neurotransmitter level can be achieved by inhibition of its uptake into presynaptic neurons and surrounding glial cells, driven by GABA transporters (GAT1, BGT1, GAT2, and GAT3). Herein, we focused on the search for inhibitors of the BGT1 transporter which is understudied and for which the therapeutic potential of its inhibition is partly unknown. We applied multilevel virtual screening to identify compounds with inhibitory properties. Among selected hits, compound 9 was shown to be a preferential inhibitor of BGT1 (IC50 13.9 μM). The compound also revealed some inhibitory activity against GAT3 (4x lower) while showing no or low activity (IC50 > 100 μM) toward GAT1 and GAT2, respectively. The predicted binding mode of compound 9 was confirmed by mutagenesis studies on E52A, E52Y, Q299L, and E52A+Q299L human BGT1 mutants. Subsequent evaluation showed that the selected hit displayed no affinity toward major GABAA receptor subtypes. Moreover, it was nontoxic when tested on normal human astrocytes and even showed some neuroprotective activity in SH-SY5Y cells. Compound 9 is considered a promising candidate for further evaluation of the therapeutic potential of BGT1 transporter inhibition and the development of novel inhibitors.

Prevalence of Chronic Disease and Cost Effectiveness of a Free Clinic.

Free clinics are a widespread, yet limited research has examined the health status of people served and the cost effectiveness of free clinics. The purpose of this study was to describe the sociodemographic characteristics and prevalence of chronic conditions in patients seen at a free clinic and estimate the clinic's cost-effectiveness. The study was a retrospective chart review of 350 randomly selected paper medical charts (2009-2020) and 1,676 electronic medical records (2020-2022) at the Noor free clinic in California supported by private donors, non-profits, and foundations. Cost-effectiveness was calculated from annual clinic operating costs, services provided, quality-adjusted life years (QALYs) saved, and projected savings from preventing emergency department visits. Of the 350 paper charts reviewed, 336 met inclusion criteria. Patients had an average age of 46.6 years, with most identifying as female (60%), Hispanic (69%), Spanish-speaking (62%), and employed (59%). About 64% had incomes below the federal poverty line. Chronic conditions included overweight/obesity (75%), chronic pain (46%), hypertension (28%), hyperlipidemia (24%), type 2 diabetes (24%), and mood disorders (23%). A quarter of patients had at least one chronic condition, and over half had multiple conditions. The clinic's services in 2022 resulted in an estimated 146 QALYs saved, $11.5million in cost savings, and a return on investment of $13.18 per $1 invested. The free clinic provided medical care to low-income, Hispanic populations without insurance who historically have been disenfranchised from healthcare access. Cost-effectiveness analysis suggested that it provided significant health benefits and cost savings.