Mood Instability Research Articles

A study protocol for a randomized controlled feasibility trial of behavioural therapy for interepisode bipolar symptoms (STABILISE)

BackgroundIn between episodes of (hypo) mania and major depression, people with bipolar disorder can experience ongoing low mood or mood instability, and these may also be present as part of cyclothymic disorder. This is a phase II evaluation of an adapted form of behavioural therapy (STABILISE) for inter-episode bipolar symptoms. The study aims to establish the feasibility and acceptability of the therapy and research procedures, including an economic component, to inform a future definitive trial.MethodsPatients will be randomised 1:1 to either Treatment as Usual (control arm) or Treatment as Usual plus STABILISE intervention (intervention arm). Follow up points will be at 14, 30 and 52 weeks post eligibility confirmation, with 30 weeks as the primary end point. We aim to recruit 60 individuals meeting diagnostic criteria for a Bipolar Spectrum Disorder, and reporting ongoing bipolar symptoms (low mood or mood instability) outside of a manic or severe depressive episode. Feasibility and acceptability will be examined through recruitment and retention rates, completion rates for the candidate primary outcome measures (PHQ9, ALS-SF, QoL.BD and BRQ) and feedback from participants on their experience of study participation and therapy. Proceeding to a definitive trial will be indicated if the following criteria are met: (i) trial participation is deemed, or can be made, sufficiently safe; (ii) recruitment rate indicates that larger-scale recruitment would be feasible (recruitment rate of at least two participants per month within at least one site, with mitigation plan if overall target sample size not met); (iii) for candidate primary outcome measure follow up data is available at 30 weeks from at least 75% of participants, or from between 55 and 74% with clear plan for improvement.DiscussionThis study is a randomised, controlled feasibility trial that builds on an initial case series of the STABILISE approach. The findings will be used to establish whether a future, definitive trial is feasible and to refine the research procedures and therapy protocol.Trial registrationISRCTN18207465. Registered 13th March 2024, https://www.isrctn.com/ISRCTN18207465.

Exploring the Personality Traits of Substance Users

This study aimed to explore the relationship between personality traits and substance use across different drug categories, including heroin, cannabis, alcohol, sedatives, and methamphetamine (ice) users. The research was relevant as it provided insight into the personality characteristics that contribute to substance use and how these traits influence treatment outcomes. Existing literature suggests that substance use often correlates with specific personality patterns, such as impulsivity, introversion, and aggression. Using a qualitative research design, the study employed thematic analysis to examine data from individual interviews with one participant from each drug category, yielding a total sample size of five. Data collection involved semi-structured interviews, and the analysis focused on identifying prevalent themes and sub-themes related to personality traits. The findings revealed that different substance users exhibited distinct personality traits, with heroin users showing mood instability and low decision-making, cannabis users displaying defensiveness and low self-esteem, and ice users exhibiting aggressiveness and guilt. Sedative users, on the other hand, tended to be introverted, humble, and family-oriented. These results contribute to the understanding of how personality traits affect substance use patterns and have implications for tailoring therapeutic interventions. Limitations of the study include the small sample size and reliance on self-reported data, which may limit generalizability. Future research should explore larger samples and longitudinal designs to better understand the causal relationships between personality traits and substance use.

Longitudinal stability of mood-related resting-state networks in youth with symptomatic bipolar-I/II disorder

Bipolar disorder (BD) is characterized by temporal instability of mood and energy, but the neural correlates of this instability are poorly understood. In previous cross-sectional studies, mood state in BD has been associated with differential functional connectivity (FC) amongst several subcortical regions and ventromedial prefrontal cortex. Here, we assess whether BD is associated with longitudinal instability within this mood-related network of interest (NOI). Young people with BD-I/II were scanned 4-6 times and healthy controls (HC) were scanned 4 times over 9 months. Following preprocessing of 20-min resting-state scans, we assessed across-scan correlation of FC, focusing on FC between regions previously associated with BD mood state. Utilizing Bayesian models, we assessed the relationship between diagnostic group and within-person, across-scan correlation, adjusting for motion, time-of-day, and inter-scan interval; prediction intervals (PI) are reported. In a sample of 16 youth (11 BD, 5 HC; 16.3-23.3 years old) with 70 scans (50 BD, 20 HC), across-scan NOI stability was higher within- than between-person (0.70 vs. 0.54; p < 0.0001). BD (vs. HC) within-person scan-pairs showed lower NOI stability (mean −0.109; 95% PI −0.181, −0.038), distinguishing BD vs. HC with excellent accuracy (AUC = 0.95). NOI instability was more pronounced with manic symptoms (mean −0.012; 95% PI −0.023, −0.0002) and in BD-II (vs. BD-I; mean −0.071; 90% PI −0.136, −0.007). Results persisted after accounting for medications, comorbidity, and sleep/arousal measures. Within this pilot sample, BD is characterized by less within-person stability of a mood-related NOI. While preliminary, these results highlight a possible role for precision imaging approaches to elucidate neural mechanisms underlying BD.

A Brief Video-Based Intervention to Improve Digital Health Literacy for Individuals With Bipolar Disorder: Intervention Development and Results of a Single-Arm Quantitative Pilot Study.

Smartphone apps can improve access to bipolar disorder (BD) care by delivering elements of effective psychological interventions, thereby promoting quality of life and reducing relapse risk and mood instability in BD. While many people with BD are interested in using publicly available mental health smartphone apps, without guidance, they risk selecting apps that are unsafe or ineffective. This study aimed to co-design a brief educational video on identifying appropriate mental health apps and to evaluate the acceptability and impact of this video among individuals with BD. Individuals with lived experience of BD, including 2 peer researchers and members of 2 advisory groups (n=4 and n=7), were consulted to develop a video with information on selecting safe, effective, and engaging mental health apps for BD. Video acceptability and impact on self-reported digital health literacy (including both general eHealth literacy and more specific mobile health literacy) were evaluated via a web-based survey, including both a validated measure and complementary items developed by the research team. In total, 42 individuals with BD completed the evaluation survey (n=29, 69% women, mean age 38.6, SD 12.0 years). Digital health literacy, measured using the self-report eHealth Literacy Scale, significantly improved after viewing the video (pre: mean 32.40, SD 4.87 and post: mean 33.57, SD 4.67; t41=-3.236; P=.002; d=-0.50). Feedback supported the acceptability of the video content and format. Self-report items developed by the study team to assess mobile health literacy showed that individuals felt better able to determine which apps would protect their data (P=.004) and to ask their health care provider for support in choosing apps (P<.001) after watching the video. This study found preliminary evidence that an educational video can help people with BD improve their ability to identify, apply, and evaluate the quality of digital health resources. The video and a supplementary web-based educational module are freely available for implementation in health care settings and have the potential to be a cost-effective and accessible resource for clinicians to support patients with BD to navigate the public app marketplace in support of their self-management goals.

Psychedelic interventions for major depressive disorder in the elderly: Exploring novel therapies, promise and potential.

The global population is ageing rapidly, with the number of individuals aged 60 and older reaching 1 billion in 2019 and expected to double by 2050. As people age, neuropsychological health often deteriorates, leading to a higher prevalence of age-related depression. Symptoms may include anxiety, apathy, mood instability, sadness, and, in severe cases, suicidal thoughts. Depression in the elderly is a widespread concern, and conventional treatments such as antidepressants are often limited by side effects, reduced efficacy, and complications arising from polypharmacy. In response, novel therapeutic approaches are being explored, including psychedelic interventions. Recent clinical and preclinical studies suggest that psychedelics could offer a promising treatment for major depressive disorder (MDD) in older adults. These compounds, known for their profound neurobiological effects, have gained attention for their potential to address depression where traditional therapies fall short. This review aims to examine the therapeutic promise of psychedelic substances, focusing on those that show potential for treating MDD in the elderly. We also explore the underlying mechanisms through which psychedelics may exert their effects and highlight the preclinical models that support their use. Finally, we address safety considerations and propose strategies to enhance the effectiveness and safety of psychedelics in future clinical trials, offering new hope for treating age-related depressive disorders.

Adolescent Brain Development Following Early Life Stress: A Systematic Review of White Matter Alterations from Diffusion Tensor Imaging Studies

Abstract Experiences of early life stress are associated with long-term socioemotional, cognitive and mental health challenges. Despite the growing interest in elucidating the neurobiological consequences of early life stress, relatively little is known about its specific impacts on adolescent white matter maturation. The objective of this systematic review was to consolidate the current literature on neuroimaging studies utilizing diffusion tensor imaging to investigate white matter correlates of early life stress experiences in adolescents (10–25 years). A comprehensive search of online databases identified 546 studies, with 22 studies meeting the inclusion criteria. Early life stress was consistently associated with alterations across several white matter pathways, across Association, Projection and Commissural tracts. Compared to healthy controls, perturbed white matter integrity was observed in adolescents with early life stress exposure, as indexed by both increased and decreased fractional anisotropy. Compromised white matter integrity can have extensive impacts on adolescent development and associated functioning, including emotional dysregulation, mood instability, executive dysfunction, and sensorimotor impairments. Limitations of the current evidence base include the inconsistencies in the measurement of early life stress exposure and the lack of longitudinal research. Future investigations should track developmental trajectories of early life stress exposure and determine how this impacts adolescent neural connectivity.

Neurometabolic Imaging Studies in Bipolar Disorder and Primary Mitochondrial Disease Indicate That Mood Instability is Associated to Altered Mitochondrial Metabolism in the Anterior Cingulate

Neurometabolic Imaging Studies in Bipolar Disorder and Primary Mitochondrial Disease Indicate That Mood Instability is Associated to Altered Mitochondrial Metabolism in the Anterior Cingulate

91. Novel Methods for Characterizing and Predicting Mood Instability in Bipolar Disorder

91. Novel Methods for Characterizing and Predicting Mood Instability in Bipolar Disorder

GLP-1 Receptor Agonists for Treatment of Pediatric Obesity: Behavioral Health Considerations.

Background: Despite the rapid increase in glucagon-like peptide-1 receptor agonist (GLP-1) use for management of weight among adolescents (ages 12-18 years), there is limited guidance on associated behavioral health considerations. Adolescents on GLP-1 therapy represent a potentially vulnerable population at risk of experiencing medical and psychosocial effects of obesity and comorbidities, as well as side effects and behavioral implications of the medications. Method: This perspective discusses behavioral and psychosocial considerations for adolescents seeking GLP-1s. The limited and developing literature on the use of GLP-1s for pediatric obesity treatment was reviewed to evaluate key aspects of psychosocial functioning and health behavior engagement and to stimulate discussion, research, clinical innovation, and advocacy to support best practices for youth seeking GLP-1s to address weight concerns. Results: There is currently sparse research on the effects of GLP-1s on adolescents' psychosocial functioning. In the context of clinical practice, it may be important to assess for symptoms of eating disorders/disordered eating behaviors, mood instability, and general psychosocial functioning as well as quality of life, social support, health behaviors, and readiness to change prior to the initiation of and throughout the course of GLP-1 treatment. Conclusions: This perspective serves as a call to action for research and clinical innovation to address the psychosocial effects of GLP-1s on adolescents. Screening, monitoring, and future research will be key to ensuring safe and effective use of GLP-1 therapy as well as optimal psychosocial outcomes for youth utilizing GLP-1 medications for obesity treatment.

The Inaccuracy of the Mood Disorder Questionnaire for Bipolar Disorder in a Community Sample: From the "DYMERS" Construct Toward a New Instrument for Detecting Vulnerable Conditions.

Background/Objectives: The Mood Disorder Questionnaire (MDQ) is a widely used tool for the early detection of Bipolar Disorder (BD), yet its diagnostic accuracy remains debated. In particular, the MDQ often yields false positives in individuals with anxiety, stress-related, or personality disorders, raising questions about its clinical utility. This study aimed primarily to evaluate the sensitivity, specificity, and predictive values of the MDQ in identifying BD within a large, community-based sample using structured clinical interviews. Additionally, we explored the construct of DYMERS (Dysregulation of Mood, Energy, and Social Rhythms Syndrome), a proposed condition characterized by mood instability, hyperactivation traits, and rhythm dysregulation among MDQ-positive individuals without a formal psychiatric diagnosis. Methods: A total of 4999 adults were surveyed across six Italian regions using a stratified random sampling method. Psychiatric diagnoses were established using DSM-IV-TR criteria via the Advanced Neuropsychiatric Tools and Assessment Schedule (ANTAS). The MDQ was administered face to face in its validated Italian version, with a positivity cut-off of ≥7. The MDQ exhibited low sensitivity and high specificity (0.962; 95% CI: 0.961-0.963). Results: Among 2337 analyzable cases, the MDQ showed high specificity (96.2%) but low sensitivity (42.9%) for BD, indicating limited effectiveness as a screening tool. In clinical terms, this implies that while MDQ-positive individuals are unlikely to be false positives, a substantial proportion of true BD cases are not identified. Notably, a significant subgroup of MDQ-positive individuals without psychiatric diagnoses displayed features consistent with DYMERS. Conclusions: Our findings confirm the limited screening value of the MDQ for BD in community samples. However, MDQ positivity may help identify a broader spectrum of mood and rhythm dysregulation not captured by current diagnostic systems. Future research should focus on validating DYMERS as a clinical entity and on developing targeted diagnostic instruments capable of capturing this emerging dimension of psychopathology.

The impact of excessive cell phone use on mental and physical health among young adults: a community-based case study

The widespread use of smartphones has raised concerns about their impact on physical and mental health. Previous research suggests excessive phone usage may contribute to musculoskeletal issues, mood changes, and symptoms of depression. However, to the best of our knowledge, this study is the first to examine these associations specifically among young adults. The aim of the study was to examine the correlation between excessive smartphone use and physical and psychological alterations, such as back and neck pain, mood changes, and depression. A cross-sectional design was employed, using a binary yes/no survey completed by participants. Purposive sampling was used to recruit participants, and the data were analyzed to identify correlations between smartphone overuse and health-related outcomes. The results showed a strong correlation between excessive phone use and increased neck and back discomfort, mood instability, and depression. Emerging research suggests abnormal activity in the prefrontal cortex and altered functional connectivity in regions involved in emotional processing. Excessive smartphone use was also linked to reduced lateral orbitofrontal grey matter and anterior cingulate volume, similar to patterns seen in behavioral addictions. These findings highlight the need for further research into smartphone usage patterns and their consequences, including evaluation of addiction traits, psychiatric morbidity, stress levels, and personality factors.

Psychological and spiritual well-being of adolescents with autism spectrum disorder in Ghana

BackgroundAdolescents with Autism Spectrum Disorder (ASD) face significant psychological and spiritual challenges that impact their overall quality of life. This study explores the psychological well-being (e.g., mood instability, financial burdens) of adolescents with ASD, including mental health challenges and coping mechanisms. We also studied the role of spirituality (e.g., participation in religious activities) as a coping mechanism for adolescents with ASD within the Ghanaian cultural context.MethodsThis qualitative study utilized semi-structured interviews with 13 parents of adolescents with ASD in Accra, Ghana. Participants were selected through purposive sampling. Data were analyzed thematically to identify patterns related to psychological well-being and spiritual practices as experienced by adolescents with ASD and their families.ResultsTwo main themes emerged: (1) Psychological well-being of adolescents with autism, with parents reporting issues such as mood disturbances, depression, and social stigma affecting both adolescents and their families; and (2) Spiritual well-being, where religious engagement served as a coping resource, though sensory sensitivities posed participation challenges for some adolescents.ConclusionThe study highlights the importance of accessible mental health resources and supportive spiritual communities for adolescents with ASD in Ghana. Community-based mental health services and inclusive spiritual support can help families address the psychological and spiritual needs of adolescents with autism more effectively.

MINDFULNESS COUNSELING IN STABILIZING MOOD REGULATION IN BIPOLAR CLIENTS: A CASE STUDY IN AN ISLAMIC HIGHER EDUCATION SETTING

Purpose – This research explores the role of mindfulness counseling in reducing episodes of mania and depression in clients diagnosed with bipolar disorder within the context of Islamic higher education institutions. The study is framed within Kabat-Zinn’s theory of Mindfulness-Based Stress Reduction (MBSR), which emphasizes present-moment awareness and non-judgmental acceptance alongside the emotional regulation strategies from Dialectical Behaviour Therapy (DBT) by Marsha Linehan. These frameworks were employed to support participants in managing emotional fluctuations and building coping strategies during counseling.Methodology – Using a multiple case study approach, three participants with a history of severe mood instability participated in eight weeks of mindfulness counseling sessions. These sessions integrated core mindfulness techniques, including body scanning, breath awareness, mindfulness meditation, and guided visualization. Data were collected through in-depth interviews, direct observations, and participant self-reports using mood-tracking journals.Findings – The findings indicated significant improvements across all three participants, including a marked reduction in the frequency and intensity of manic and depressive episodes. Participants demonstrated increased self-awareness, improved emotional regulation, and developed coping strategies for managing mood triggers. They reported a greater sense of control over their thought patterns and an enhanced sense of psychological resilience. This study highlights the effectiveness of mindfulness counseling as a promising adjunctive therapy for managing bipolar disorder.Contribution—By integrating mindfulness techniques within the context of counseling, participants were equipped with practical tools that contributed to their emotional stability and long-term psychological well-being. This research supports the potential of mindfulness practices to offer valuable support for individuals with bipolar disorder, especially in the setting of Islamic higher education institutions.

Psychological Determinants of Patient Satisfaction in Aesthetic Surgery: The Impact of Preoperative Screening and Counselling

Introduction: Aesthetic surgery, while enhancing physical appearance, has significant psychological implications. This study explores the psychological factors influencing patient satisfaction following aesthetic surgery, focusing on the role of preoperative psychological screening and counselling in improving outcomes. Methodology: A cross-sectional study was conducted with 290 patients who underwent elective aesthetic surgery between March 2023 and December 2024. The Iowa Personality Disorder Screen (IPDS) was used to assess psychological vulnerabilities, including anxiety, body image concerns and maladaptive behaviours. Demographic factors such as gender, smoking status, prior surgeries, comorbidities and symptoms were analysed. Data were evaluated using frequency distributions, descriptive statistics and the z-test to assess significant differences among variables. Results: Among 290 participants, females comprised 52.1%, while males accounted for 47.9%. A prior history of psychiatric illness was reported in 3.4% of participants. The most prevalent maladaptive trait was reluctance to confide in others (23.79%), followed by bearing grudges (18.10%). Smokers exhibited significantly higher rates of mood instability (28.57%, Z = 3.67, P &lt; .001), reluctance to confide (40.48%, Z = 16.4, P &lt; .001) and difficulty with long-term goals (28.57%, Z = 4.05, P &lt; .001). Conclusion: Addressing personality disorder is vital in aesthetic surgery to ensure successful outcomes. Preoperative psychological evaluations, setting realistic expectations and providing tailored postoperative support improve satisfaction and reduce decision regret. A holistic approach that integrates mental health care with surgical precision promotes long-term emotional well-being, making psychological support a cornerstone of patient-centred aesthetic surgical practices.

Short Communication on Proposed Treatment Directions in Bipolar Disorder: A Psychotherapy Perspective.

Background/Objectives: Bipolar disorder (BD) is a chronic, severe mental health condition characterized by episodes of mood instability, including manic and depressive episodes. While pharmacological interventions remain foundational in BD treatment, psychotherapy offers significant benefits by addressing the psychological and behavioral components that contribute to mood episodes and overall functioning. The primary objective of this short communication is to propose new directions in psychotherapy for treating bipolar disorder, focusing on integrative models that combine evidence-based therapies such as Cognitive Behavioral Therapy (CBT), Interpersonal and Social Rhythm Therapy (IPSRT), Family-Focused Therapy (FFT), and mindfulness-based approaches. By integrating these therapies, clinicians can target both cognitive distortions and emotional dysregulation while simultaneously stabilizing sleep-wake cycles and improving interpersonal functioning. The secondary objective emphasizes the importance of better understanding and psychoeducation in family therapy, which can promote a better understanding of BD among family members and ensure more effective management of the disorder in daily life. Methods: We explore the potential of Cognitive Behavioral Therapy (CBT), Interpersonal and Social Rhythm Therapy (IPSRT), Family-Focused Therapy (FFT), and mindfulness-based interventions in enhancing symptom management and preventing relapse. Results: We identified psychoeducation and family therapy as critical components in supporting patients and improving treatment adherence. These therapeutic interventions play a pivotal role in enhancing patient engagement, improving coping strategies, and facilitating better overall treatment outcomes. Conclusions: We propose a multidisciplinary approach, integrating psychotherapy with pharmacotherapy, to optimize long-term outcomes and improve the overall quality of life for individuals with bipolar disorder.

Impaired Regulation of Emotion in Bipolar I Disorder: Behavioral and Neurophysiological Signatures.

People with bipolar disorder (BD) present with mood instability resulting from more frequent and intense emotions in response to environmental conditions relative to healthy subjects. The aim of this study was to investigate the time course of emotion regulation strategies, distraction, and reappraisal in euthymic BD patients (i.e., normal mood range) using electroencephalography (EEG). Fourteen BD patients and 13 matched healthy controls took part in an experiment constituting three conditions, i.e., a passive viewing of positive, negative, and neutral pictures, and two regulation conditions, one with a reappraisal strategy and the other with a distraction strategy. Critically, the ERP results indicated that during passive viewing, the Late Positive Potential (LPP) was larger in BD patients compared with healthy controls, but only for neutral pictures. During emotion regulation, LPP amplitude was reduced in distraction conditions compared with viewing ones, especially for negative emotions in both patients and controls. Importantly, LPP was reduced in reappraisal conditions compared with passive viewing in an early time window for negative emotions and in a later time window for positive emotions in controls but not in patients. Our findings showed that the temporal dynamics of emotion regulation by reappraisal are faster for negative than for positive emotions in controls but not in BD patients.

Analysis of cervical mucosal epithelium proliferation during the postmenopausal period

Introduction and aim. This study explores the proliferative growth of cervical mucosal epithelial cells during the postmeno pausal period, offering new insights on age-related changes in cervical tissues, a topic previously under-examined in post menopausal health research. By employing histologic analysis, immunostaining techniques, and Ki-67 mitotic index assess ment, this research provides novel data on the alterations in cervical epithelial cells during and after menopause. The findings enhance our understanding of the biological processes affecting cervical health in the postmenopausal phase, which is increas ingly significant as the global population ages and emphasizes the need for tailored healthcare approaches. The primary goal was to investigate the proliferative growth of cervical mucosal epithelial cells in postmenopausal women by assessment of Ki 67 gene activity in progesterone-positive cells in normal and pathological postmenopausal periods (PMPs) in the presence or absence of autonomic symptoms, manifested by mood instability, headaches and dizziness. Material and methods. This research involved analyzing tissue samples from 149 postmenopausal women with suspicion of malignancy using histologic and immunostaining methods to evaluate epithelial cell proliferation markers, with the Ki-67 mi totic index as a key measure. The average activity of the Ki-67 gene was evaluated using the global scoring method, with Ki-67 percentages below 2.5% considered low. Statistical analysis included both parametric and non-parametric methods, specifi cally Student’s t and Wilcoxon’s tests. Results. The study found a reduction in the proliferative activity of cervical mucosal epithelial cells during the normal post menopausal period, indicated by a significant decrease in Ki-67 expression in the exocervical zone and during the first year in the transformation zone and the endocervix (p&lt;0.01). Conclusion. Understanding the proliferative growth of cervical mucosal epithelial cells during the postmenopausal period helps to understand the dynamics of age-related cervical tissue. These results can lead to better prevention and monitoring strategies for cervical health in postmenopausal women.

Shin Ihda's "manifestation model of mood disorders" based on situation theory and twin studies.

This article introduces Shin Ihda's manifestation model of mood disorders. Ihda et al. reported eight cases of monozygotic twins with discrepancies in the onset and clinical presentation of mood disorders. The reports emphasize the prevalence of cyclothymic, melancholic-type, and manic-type personalities among the twins, as well as the differences in onset, clinical presentations, and course of the disorder, despite the twins being genetically nearly identical. Applying the twin study methodology, Ihda proposed the twins' developmental histories, personalities, and situations surrounding disorder onset as factors contributing to discrepancies in the clinical presentation and course of the disorder. Based on situation theory, he proposed a manifestation model of mood disorders, comprehensively explaining the development of a depression-prone personality through growth stages, situations that lead to depression or mania, and the disorder progression process based on inherent temperament. The model assumes five possible pathways: the revelation of underlying mood instability in defenseless cyclothymic personalities; the collapse of the illusionary feeling of omnipotence in manic-type individuals; the revelation of the need for objects in clinging individuals; the collapse of the illusionary feeling of integration with an authority figure through introjection in melancholic individuals; and neurosis. Ihda's insightful depiction of the specific interactions between genetics and environment has valuable implications for research and clinical practice.

Neonatal hypoxia: impacts on the developing mind and brain

This review examines the cognitive, emotional, and neurofunctional effects of neonatal hypoxia in both the short and long term. Neonatal hypoxic-ischemic encephalopathy (NHIE) is a critical condition with profound and lasting effects on brain development and function. This mini review examines the structural, cognitive, behavioral, and psychopathological outcomes associated with NHIE, highlighting its impact on neurodevelopment. NHIE is linked to structural abnormalities such as reduced white matter integrity, ventricular enlargement, and damage to key regions including the basal ganglia, hippocampus, and corpus callosum. These changes correlate with long-term impairments in cognition, memory, and motor skills, alongside elevated risks of neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD). Behavioral and emotional challenges, including anxiety, depression, and mood instability, are also prevalent. This review underscores the significant and multifaceted impact of NHIE on neurodevelopmental and behavioral health, emphasizing the importance of developing methodologies to eliminate or minimize neonatal hypoxic states as much as possible.

Love on the Edge: Navigating Disruptive Mood Dysregulation Disorder (DMDD) and Marital Distress – A Holistic Therapeutic Approach

The present case report illustrated the challenging diagnostic case of Disruptive Mood Disorder (DMDD) with marital conflict. The study emphasizes the importance of various therapeutic strategies that manage relational conflicts, mood instability, and anger outbursts. A 27-year-old married man presented with constant irritability, frequent temper tantrums, and impulsive verbal violence that seriously disrupted his marriage. His clinical diagnosis was confirmed as DMDD and related features were assessed using the MSE, BDI-II, and CAARS along with behavioral monitoring via in-depth history. The patient's mood instability, behavior patterns, and relational difficulties were tracked down over several therapeutic sessions (including Cognitive-behavioral techniques, Breathing-based relaxation techniques. Islamically integrated anger management guidelines, and Behavior modification strategies). The patient showed improved insight, better-coping mechanisms, and decreased hostility towards his partner. Couple therapy austerely focuses on mutual tolerance, lessens the communication gap, and improves resolution options for saving their marriage, therefore raising marital satisfaction. Progress in emotional and interpersonal well-being was achieved by both psychiatric medication and the consistent use of learned strategies. This study emphasizes the need for a comprehensive therapy paradigm in treating individual psychopathology as well as relational discomfort in DMD patients.