Mood Symptoms Research Articles

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).

Bone morphogenetic protein levels relate to osteoarthritis and neurobehavioral outcomes in cognitively unimpaired older adults

AbstractBackgroundOsteoarthritis (OA) is a degenerative disorder of bone aging and risk factor for cognitive decline. Bone morphogenetic proteins (BMPs) are growth factor proteins that regulate skeletal and neural development, and circulating BMPs may mediate molecular cross‐talk between bone and brain. The present study examined plasma BMP levels in relation to OA and neurobehavioral outcomes in cognitively unimpaired (CU) older adults.MethodsParticipants included 65 CU adults (mean age= 76.45, 60% female) enrolled in the UCSF Brain Aging Network for Cognitive Health (BrANCH) study who underwent cross‐sectional neurological examination, neuropsychological testing, and blood draw. Participants were classified as OA (n=31) or control (CTL; n=34) based on clinician exam (UDS Medical Conditions). Plasma was assayed for 11 different BMPs via SomaScan v4.1. Composite z‐scores were calculated for cognitive domains of memory and executive functioning. Mood symptoms were quantified with the 30‐item Geriatric Depression Scale (GDS). ANCOVA compared BMP concentrations between OA and CTL, adjusting for age and sex. Separate multiple linear regressions examined the relationship between OA‐associated BMPs and neurobehavioral outcomes across the entire sample (cognitive z‐scores, GDS total score), adjusting for age, sex, and education.ResultsOA and CTL groups did not significantly differ on demographics or neurobehavioral outcomes (ps>0.10). Five BMPs were differentially abundant (ps<.05) between OA and CTL (lower in OA: BMP5, BMP7, BMP10, BMP6; higher in OA: BMP4). In neurobehavioral models, lower BMP6 and higher BMP4 levels related to worse executive functioning (BMP6: β=0.27, p=.03; BMP4: β=‐0.28, p=.02) and higher GDS scores (BMP6: β=‐0.33, p=.02; BMP4: β=0.34, p=.01). Higher BMP10 also related to lower GDS scores (β=‐0.31, p=.02). No associations were observed between BMPs and memory z‐scores (ps>0.05).ConclusionIn a cohort of CU older adults, OA related to differential plasma abundance of BMPs. In turn, circulating BMP levels, specifically BMP4, BMP6, and BMP10, were associated with executive function and depressive symptoms. These data help provide a molecular link connecting skeletal disorders of aging (e.g., OA) to adverse neurobehavioral outcomes. Given the diverse immunovascular, metabolic, and growth regulatory functions of BMPs, additional mechanistic work is needed to identify the precise pathways by which systemic BMPs interact with the central nervous system.

High sleep reactivity in shift workers is associated with increased sleep disturbance, mood problems, and reduced quality of life.

Shift work disrupts circadian rhythms, causing sleep and mood problems. Sleep reactivity-the sensitivity of sleep to stress-may affect how shift workers cope with these disruptions. This study investigated the relationship between sleep reactivity and shift work, exploring associations between sleep reactivity and sleep disturbance, mood symptoms, and quality of life in shift workers. In a cross-sectional design, 132 participants (79 shift workers and 53 controls) were assessed using the Ford Insomnia Response to Stress Test (FIRST), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and World Health Organization Quality of Life (WHOQOL). We compared the self-reported measurements between shift workers and controls. Two-way ANOVA was performed to explore the interaction effects between shift work and sleep reactivity on sleep, mood parameters, and quality of life. Multiple linear regression analysis was conducted to identify factors associated with sleep, mood, and quality of life among shift workers. Shift workers scored higher on ISI and BDI compared to controls. Two-way ANOVA revealed an interaction effect between shift work and sleep reactivity on WHOQOL. Regression analysis indicated that high sleep reactivity was associated with higher ISI, BDI, BAI, and lower WHOQOL among shift workers. Sleep reactivity significantly affected shift worker's quality of life. Our findings indicate that high sleep reactivity in shift workers was associated with increased sleep disturbance, mood problems, and decreased quality of life, implying that sleep reactivity may predict shift work tolerance.

Influence of tau pathology and anxiety and depressive symptoms on metamemory in cognitively normal older adults

AbstractBackgroundThe ability to accurately discern memory function (i.e., metamemory) decreases with age and is further diminished in Alzheimer’s disease (AD). As such, changes in metamemory may be a sensitive behavioral indicator of pre‐symptomatic AD.MethodCognitively normal older adult participants (N=48) completed a neuropsychological battery consisting of episodic memory tasks (California Verbal Learning Task, Face‐Name Associative Memory Exam) and self‐reported measures of metamemory (Multifactorial Memory Questionnaire) and anxiety and depressive symptoms (Geriatric Depression Scale, Penn State Worry Questionnaire, Mood and Anxiety Symptom Questionnaire). Z‐scores from each measure were combined into three separate composite scores: memory ability, metamemory, and anxiety and depressive symptoms. All participants also had a tau PET scan ([18F]MK‐6240) completed within 12.7 (SD = 11.6) months of neuropsychological testing in which standardized uptake value ratios (SUVR) referenced to the inferior cerebellar gray matter were calculated using Freesurfer‐defined ROIs for Braak I, Braak II, metatemporal, and amygdala regions of interest (ROIs). Linear regression models were used to test for the contribution of anxiety and depression symptoms, tau pathology, and memory ability on metamemory; education, age, and sex were entered as covariates in all models.ResultBehavioral analyses suggest that anxiety and depression symptoms (t = ‐2.1, p=0.046), but not memory ability (t = 0.4, p=0.698), were related to metamemory. Interestingly, tau pathology helped to explain additional variance in the relationship between metamemory and anxiety and depressive symptoms. Specifically, amygdala tau interacted with anxiety and depression symptoms to predict metamemory (t = ‐2.61, p=0.013), when controlling for age, sex, education, and memory ability, such that participants with both high levels of anxiety and depressive symptoms and high levels of amygdala tau pathology had lower self‐reported metamemory (Figure 1). This relationship was not observed in Braak I, Braak II, or metatemporal ROIs (ps > 0.07).ConclusionTogether, these results suggest that depressive and anxiety symptoms are an important metric to consider when examining the relationships between tau pathology and metamemory. Further, the results underscore that mechanisms supporting metamemory are likely distinct from those underlying memory ability and each merit unique consideration towards understanding their relationship to AD pathology.

Clinical Symptoms and Risk Factors in Older Adults with Limbic‐Predominant Age‐Related TDP‐43 Neuropathology in the Context of Mixed Dementia

AbstractBackgroundLimbic‐predominant age‐related TDP‐43 encephalopathy neuropathological change (LATE‐NC) is a pathological process diagnosed at autopsy, involving deposition of TDP‐43 in the medial temporal lobes. The name LATE‐NC was recently proposed to represent the pathological process, while “LATE” has been suggested to represent the clinical syndrome. However, there are currently no available criteria to diagnose this syndrome during life, and the clinical phenotype is not well understood.MethodA sample of autopsy cases (n = 39) from the University of British Columbia Hospital with moderate to severe Alzheimer and/or Lewy Body pathology, with and without LATE‐NC, underwent chart review. 19 individuals with LATE‐NC pathology (LATE+) were age‐matched to 20 controls (LATE‐) by age and by degree of Alzheimer and Lewy Body pathology. Clinical characteristics including ages at symptom onset, diagnosis and death; cognitive test scores; medical history and functional status were extracted from the clinical charts, and compared using the t‐test and χ2 statistics.ResultIn the two groups, mean age at death was 80.7 years (LATE+) and 79.7 years (LATE‐). Age at onset (66.4 versus 68.4 years) and disease duration (11.9 versus 11.2 years) were not significantly different. Years of education (14.9 versus 13.3, p = 0.03), and prior history of head injury (33.3% vs 5.3%, p = 0.04) were both significantly higher in the LATE+ group. There was a trend towards a higher prevalence of mood symptoms in the LATE+ group (55.6% versus 36.8%), and fewer psychotic symptoms (10.5% versus 36.8%), however these differences were not statistically significant. There were no significant differences in cognitive domains affected across the disease course, or baseline cognitive test scores.ConclusionIn this study, head injury and greater years of education were identified as possible risk factors for LATE‐NC. There were differences in the burden of neuropsychiatric symptoms between the two groups which require further investigation. However, the presence of LATE‐NC did not appear to accelerate disease progression, suggesting its clinical impact is small relative to the impact of severe Alzheimer or Lewy Body pathology. Additional study including those with little or no concomitant pathology may help to elucidate the clinical phenotype further.

Changes in peripheral AD biomarkers in a randomized controlled trial of Yoga vs. memory training in older women at risk for Alzheimer’s disease

AbstractBackgroundBiomarkers such as amyloid beta (Aβ) peptides and tau protein can correlate with changes in cognition and mood symptoms associated with AD. We aimed to investigate the blood biomarker response to a Kundalini Yoga (KY) compared to Memory Enhancement Training (MET) intervention as well as determine the predictive value of blood biomarkers on outcomes in a randomized trial targeting women at risk for Alzheimer's disease.MethodWomen aged 60 years old and older with subjective memory complaints and high cardiovascular risk score were randomized to a 12‐week RCT of Kundalini yoga or Memory enhancement training (MET). We obtained blood samples at baseline and week 24 (6 months) to measures AB40; AB42 and p‐Tau. Participants completed the Beck Depression Inventory (BDI) for depressive symptoms, and Memory Functioning Questionnaire (MFQ) for subjective memory reports. Regression models were used to examine whether baseline and changes in biomarker levels including Aβ40, Aβ42, Aβ42/40 ratio and tau were associated with changes in outcomes at 24 weeks.ResultA total of 79 patients (KY=40; MET=39) were randomized, and 63 completed the 24‐week follow‐up. There were no group differences in AD biomarkers at baseline or at 24‐week follow‐up. Baseline levels of Aβ40 were significantly associated with an increase in subjective memory (MFQ Frequency of Forgetting; r = 0.27, p=0.04). An increase in Aβ40 levels was significantly associated with a decrease in BDI (r = ‐0.33, p=0.02). There was no significant association of changes in Aβ42, Aβ42/40 ratio and tau with any outcomes.ConclusionOur findings indicate that greater levels of Aβ40 at baseline are associated with an increase in subjective memory at follow‐up and an increase in Aβ40 levels is correlated to a decrease in depressive symptoms as expected. It has been established that a low ratio of Aβ42/Aβ40 may reflect selective depletion of Aβ42 due to deposition in the growing plaques and subsequent AD pathology, while Aβ40 may have opposing effects on amyloid deposition and be neuroprotective. Our findings support the evidence that yoga can reduce stress, depression, and anxiety and may have an impact on peripheral AD biomarkers.

Web-based cognitive screening in bipolar disorder: validation of the Internet-based Cognitive Assessment Tool in remote administration settings

Background Cognitive impairments are prevalent during remission in bipolar disorder (BD), but existing cognitive screening tools are time- and resource-intensive. Digital, web-based options can facilitate detection and monitoring of these impairments across clinical and research settings. Methods This cross-sectional study investigated psychometric properties of the Internet-based Cognitive Assessment Tool (ICAT) when self-administered in home-based settings. Newly diagnosed, remitted outpatients with BD and healthy controls (HC) underwent cognitive testing with the standard paper-pencil tool Screen for Cognitive Impairment in Psychiatry (SCIP) in-clinic and ICAT at-home as part of baseline assessments for an intervention trial (ClinicalTrials ID: 2021-000862-14). Results Data were analyzed for 31 BD patients and 29 HC. We demonstrated a strong positive correlation between at-home ICAT and in-clinic SCIP total scores within patients with BD (r(29) = 0.66, p < .001), which survived subsyndromal mood symptoms adjustment (partial r(25) = 0.67, p < .001), indicating adequate concurrent validity. There was a moderate positive correlation between ICAT and SCIP total scores across the entire sample (r(54) = 0.56, p < .001) and between subtest scores (r = 0.29–0.61, ps ≤ .03), except the executive functions tasks (p = .1). BD patients exhibited no impaired performance compared to HC on ICAT or SCIP (ps ≥ .08). Conclusions ICAT is a valid and feasible online tool for remote cognitive screening in remitted patients with BD. Web-based screening constitutes an accessible and efficient approach for implementing systematic cognitive screening in BD.

Sleep Treatment Education Program for Cancer Survivors: Protocol for an Efficacy Trial.

Cancer survivors are at increased risk for chronic insomnia, even years after treatment completion. As insomnia is associated with a variety of long-term health consequences, access to insomnia treatment is critically important for the survivor population. Cognitive behavioral therapy for insomnia (CBTI) is the recommended first-line treatment for insomnia but remains largely unavailable to survivors. Treatment barriers include geographic limitations, a shortage of trained providers, and demanding treatment regimens. Designed with these limitations in mind, the Sleep Treatment Education Program (STEP-1) delivers components of CBTI in a low-intensity educational intervention delivered online. This is a phase II pilot randomized controlled trial. The primary aims are to test the efficacy of STEP-1 to improve (1) insomnia symptoms and (2) mood in cancer survivors compared to a control condition. The secondary aims will (1) explore participant factors associated with clinically significant response, (2) evaluate acceptability of the control intervention, (3) explore feasibility of delivering individualized coaching sessions for participants who do not have a significant response to STEP-1, and (4) describe participants' satisfaction with STEP-1 and suggestions for improvement. This 2-arm randomized controlled trial enrolled 70 off-treatment cancer survivors aged 40-89 years with clinically significant insomnia. Participants are randomized to receive either the STEP-1 intervention or control condition (relaxation education); interventions are delivered in one-on-one, synchronous, virtual videoconference sessions by trained interventionists. The STEP-1 intervention presents educational information on the development of insomnia after cancer and offers suggestions for improving insomnia symptoms based on the CBTI elements of sleep hygiene, stimulus control, and cognitive restructuring. With the interventionist, participants review the suggestions and develop a personalized sleep action plan for implementation. The relaxation education session provides information on the potential benefits of relaxation and how to independently access online relaxation exercises. The Insomnia Severity Index is used to measure insomnia symptoms, and the Profile of Mood States Short Form is used to measure mood at baseline and 4 and 8 weeks after intervention. The primary end point is change in the Insomnia Severity Index score at 8 weeks, and the secondary end point is change in mood symptoms (Profile of Mood States Short Form) at 8 weeks. This trial was funded in July 2022. Enrollment and data collection began in February 2023 and concluded in October 2024, with 70 participants enrolled. The analysis will begin in fall 2024, and the results are expected in winter 2025. Trial results will determine if STEP-1 effects go beyond those that could be attributed to placebo and other nonspecific treatment factors. Should results support the efficacy of STEP-1 to improve mood and insomnia symptoms, we anticipate developing efficacy and implementation trials of STEP-1 in larger and more diverse samples. ClinicalTrials.gov NCT05519982; https://clinicaltrials.gov/study/NCT05519982. DERR1-10.2196/60762.

Imagery-based cognitive therapy to reduce emotional dysregulation and mood instability in bipolar disorder: a case-series study.

Bipolar disorder (BD) has a significant impact on functioning in the absence of acute mood episodes. This has been associated with subsyndromal symptoms, co-morbidities, and emotional dysregulation. The present study aims to evaluate the acceptability and preliminary efficacy of imagery-based cognitive therapy (ImCT) in a French community setting. We were particularly interested in the link between mental imagery and emotional dysregulation as this may clarify the mechanisms involved in the potential efficacy of the therapy and ultimately improve its relevance. Ten participants underwent ImCT, with weekly assessments of mood fluctuations, anxiety, and emotional dysregulation conducted over 1 month (i.e. pre-therapy, post-therapy and 1-month follow-up). Recovery, post-traumatic stress symptoms and self-compassion were measured at baseline and post-therapy. Attrition rates and satisfaction were measured. All participants who completed therapy (n=8) reported high levels of satisfaction. Five of them showed reliable individual improvement on emotion dysregulation scores. At the group level, a significant decrease in mood fluctuation with a large effect size was found post-therapy. ImCT showed good acceptability among participants who completed the study. Importantly, our study is the first to provide an indication that ImCT may alleviate subsyndromal mood symptoms but also emotional dysregulation in individuals with BD. This latter finding is particularly relevant given the scarcity of validated psychosocial interventions targeting emotional dysregulation in BD.

The Go/No-Go P3 and Depressive Symptoms in Adolescents: Trial-Level Change and Mean Amplitude Relate Differently to Anhedonic Versus Negative Mood Symptoms.

Prior studies have found an association between reduced P3 brain responses-a neural marker of task engagement-and increased depressive symptoms during adolescence. However, it is unclear whether P3 correlates with depression globally, or with certain facets. Existing depression studies have also typically quantified P3 as a cross-trial average, neglecting possible trial-by-trial effects. Among 72 adolescents (44% female), the current study evaluated relations of distinct depression symptom facets-anhedonia and negative mood-with P3s from a three-stimulus go/no-go task, quantified both in average- and trial-level terms. Although no relationship was evident between overall depressive symptoms and average P3 amplitudes, opposing relations were found for each symptom facet with P3 to frequent and infrequent 'go' stimuli: higher anhedonia predicted smaller P3, whereas increased negative mood predicted larger P3. Single-trial, multilevel modeling analyses clarified these effects by showing reduced P3 across stimuli types at task outset, along with greater trial-to-trial attenuation of P3 to infrequent-go stimuli, for adolescents experiencing greater anhedonia. Conversely, increased negative mood was distinctly related to larger P3 at task onset but was unrelated to amplitude change across trials. Results demonstrate differential relations for anhedonic and negative mood symptoms with P3-indicative of task disengagement versus heightened vigilance, respectively-that may be obscured in analyses focusing on overall depressive symptoms. The divergent associations for anhedonia and negative mood with P3 underscore the need to consider these distinct symptom facets in research aimed at clarifying the nature of neural-circuitry dysfunction in depression.

Estradiol modulates resting-state connectivity in perimenopausal depression

The perimenopausal transition is marked by an increased risk for affective dysregulation and major depressive disorder (MDD), with hormone replacement therapy using estradiol (E2) showing promise for alleviating symptoms of perimenopausal-onset MDD (PO-MDD). Although E2's effectiveness is recognized, its mechanisms underlying mood symptom modulation remain to be fully elucidated. Building on previous research suggesting that E2 may influence mood by altering cortico-subcortical connectivity, this study investigated the effects of transdermal E2 on resting-state functional connectivity (rsFC) in perimenopausal women with and without PO-MDD, focusing on rsFC changes using seed regions within reward and emotion processing networks. In this pharmaco-fMRI study, 16 participants with PO-MDD and 18 controls underwent rsFC analysis before and after three weeks of transdermal E2 administration. Pre-E2 results showed that the PO-MDD group, compared to controls, exhibited increased connectivity between the right amygdala (seed) and medial prefrontal cortex and anterior cingulate cortex, and decreased connectivity with the supplementary motor area. Comparing groups on change from pre-E2 to post-E2 revealed several significant E2-induced changes in connectivity between the PO-MDD and control groups: PO-MDD showed increased connectivity between the right caudate nucleus (seed) and left insula, and decreased connectivity between the right putamen (seed) and left hippocampus, and the right amygdala (seed) and left ventromedial prefrontal cortex. Notably, changes in connectivity were predictive of symptom trajectories across anhedonia, depressive mood, somatic, and vasomotor domains in the PO-MDD group. These findings enrich our understanding of PO-MDD by highlighting distinct rsFC patterns characteristic of the disorder and their shifts in response to E2 treatment, suggesting potential neural mechanisms underlying E2's mood-modulating effects.

A potential candidate for prevention of PTSD: Prazosin prevents learned helplessness behavior in adult male rats

Post-Traumatic Stress Disorder (PTSD) is a debilitating psychiatric disorder that arises following exposure to an extreme stress. PTSD is characterized by five primary trauma-related symptom clusters, including symptoms of negative mood and hyperresponsivity to the traumatic event. Regrettably, the current therapy options are not highly effective. Therefore, prevention of PTSD is crucial and potentially applicable. Prazosin is an anti-adrenergic medication that is used to reduce nightmares in patient with PTSD, and can also mitigate the noradrenergic dysfunction caused by trauma. Here we show that administration of prazosin prior to the trauma prevented learned helplessness behavior in adult male rats. We show that the animals that were exposed to three days of inescapable foot shocks preceded by prazosin injections have fewer prazosin-treated animals showing learned helplessness compared to saline-treated animals. Nevertheless, there was no significant difference in anxiety-related behavior as measured in the elevated plus maze. Furthermore, the results of in vivo electrophysiological recordings of the ventral tegmental area shows that the prazosin group has a trend of increased number of active dopaminergic cells per track; this is significant when limited to central region of the ventral tegmental area. Our results demonstrate that prazosin has a potential for prevention of PTSD.

Phelan-McDermid syndrome-associated psychosis: a systematic review.

Phelan-McDermid syndrome is a rare genetic disorder characterised by various neurodevelopmental, medical, and psychiatric issues. Although bipolar disorder-like presentations and catatonia are particularly common, psychosis has also been reported but is less well described. As such, this systematic review sought to characterise the phenomenology of psychosis in Phelan-McDermid syndrome, clarify the association of psychotic symptoms with other neuropsychiatric features of the disorder, and describe antipsychotic treatment response. A literature search was completed in July 2024 using PubMed and Scopus. Only English-language articles that reported the occurrence of psychotic symptoms in Phelan-McDermid syndrome were eligible for inclusion. 18 articles describing 35 individuals were included in the main analyses. Three additional articles of relevance are discussed separately, as they either provided limited clinical information or did not present data in a patient-specific manner. The average age of psychosis onset was ∼17 years, and 65% of individuals developed symptoms at or before age 15. ∼69% of individuals also experienced catatonia, ∼81% experienced mood symptoms, and 50% experienced both. Visual hallucinations were the most commonly reported psychotic symptom. Where reported, ∼76% of individuals exhibited at least a partial and/or temporary response to antipsychotic therapy. Psychotic presentations in Phelan-McDermid syndrome may qualitatively differ from schizophrenia. Although numerous antipsychotics may be efficacious in the treatment of Phelan-McDermid syndrome-associated psychosis, this review most importantly highlights the paucity of available high-quality evidence to guide treatment decisions in this respect, and as such indicates the need for more reports to be published.

Neuropsychological morbidity in the First Seizure Clinic: Prominent mood symptoms and memory issues in epilepsy.

To examine the neuropsychological morbidity across the spectrum of patients presenting to a First Seizure Clinic, and test the hypothesis that cognitive and psychological compromise is especially prominent in those diagnosed with epilepsy. A sample of 201 patients referred to the Austin Hospital First Seizure Clinic (FSC) underwent cognitive screening via telephone and psychological screening via online questionnaire, all prior to their diagnostic evaluation (and any attendant treatment recommendation) at the FSC. Rates of cognitive (i.e., scores <10th percentile) and psychological impairment (using established clinical cut scores) were compared against 35 demographically matched controls. Cognitive differences were explored between the most frequently encountered patient subgroups (epilepsy, n = 48; first unprovoked seizure, n = 24; acute symptomatic seizure, n = 24; syncope, n = 35) via a multivariate analysis of variance, with diagnostic labels applied retrospectively after a period of follow-up. People with epilepsy were most likely to show cognitive impairments, particularly in learning and memory, with performances worse than all other FSC groups (F [3127] = 2.44, p = 0.03). Clinically significant depressive symptoms were similarly prevalent in all patient groups, with one in three at risk for Major Depressive Disorder. Elevated anxiety symptoms were common across patient groups; however, not significantly different to controls. Cognitive impairment in epilepsy and mood problems in all FSC groups are detectable via remote screening as early as the first seizure. Learning and memory difficulties are particularly prevalent in new-onset epilepsy and may lend diagnostic information when paired with clinical factors. This study explored cognitive and psychological differences between various patient groups attending an Australian First Seizure Clinic. We found that learning and memory abilities were poorer in people with epilepsy than other patient groups including those with non-epileptic seizures, and seizure-mimics (fainting episodes). Therefore, along with standard epilepsy investigations, memory performances could help to predict which patients have epilepsy versus a non-epileptic condition after a first suspected seizure. Further, approximately one in three from each patient group showed high symptoms of depression and anxiety. The findings highlight the importance of evaluating cognition and mood in people with first seizures.

Influence of sleep quality, excessive daytime sleepiness, circadian features and motor subtypes on depressive symptoms in Parkinson's disease

ObjectivesThe diagnosis of Parkinson's disease (PD) is mainly based on the assessment of motor symptoms, although the influence of non-motor symptoms sometimes may be more significant on the patient's disability than the cardinal clinical signs of the disease. The predominant subtype of postural instability and gait disturbance is known to be associated with more severe non-motor symptoms of Parkinson's disease. Yet, the association between motor subtypes and specific mood symptoms remains understudied. The study aimed to analyze an association between sleep and chronotype signs, motor subtypes, with the severity of depressive symptoms in PD patients. MethodsWe have included 64 patients in the clinical study. The studied population was divided into the following groups: PIGD group – patients with PD and dominance of postural instability and gait disorders; non-PIGD group – patients with PD and dominance of tremor or intermediate motor subtype. We used the Unified Parkinson's Disease Rating Scale, Beck Depression Inventory, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Munich Chronotype Questionnaire. ResultsPatients with the PIGD subtype have higher levels of depressive symptoms and excessive daytime sleepiness, poorer sleep quality, later sleep onset and mid-sleep, longer sleep latency, and sleep inertia. PIGD motor subtype (p < 0.001), poor sleep quality (p < 0.001), mid-sleep (p = 0.016), and sleep latency (p = 0.025) had a significant impact on the level of depression in univariate regression analysis. Still, only mid-sleep (p = 0.019) and poor sleep quality (p = 0.003) increased the probability of higher severity of depression in the multivariate model. ConclusionPoor sleep quality and later mid-sleep may be predictors of more severe depressive symptoms in PD.

Long-term changes on behavioral addictions symptoms among adults with attention deficithyperactivity disorder treated withmethylphenidate.

Attention deficit hyperactivity disorder (ADHD) and behavioral addictions (BAs) are highly comorbid but little is known about the effect of anti-ADHD medications on behavioral addiction symptoms. Thus, the aim of this naturalistic prospective study was to investigate the long-term changeson BAs symptoms among methylphenidate-treated adults with a primary diagnosis of ADHD. 37 consecutive adult ADHD outpatients completed a baseline and follow-up assessment of ADHD, mood and BAs symptoms (internet, shopping, food, sex addictions and gambling disorder) after one year of methylphenidate (flexible dose) treatment. Internet addiction test scores pre-treatment were significantly higher than post-treatment scores (p < 0.001). The same trend was seenfor the shopping addiction (p = 0.022), food addiction scores (p = 0.039) and sex addiction scores (p = 0.047). Gambling disorder scores did not differ pre and post treatment since none of the included patients reported significant gambling symptoms at baseline. The rate of ADHD patients with at least one comorbid BA was reduced after methylphenidate treatment (51.4% vs 35.1%). The correlation analyses showed a moderate positive correlation between the changes in sluggish cognitive tempo symptoms, cognitive impulsivity, mood and anxiety symptoms and changes in internet addiction symptoms. This is the first study showing that after one-year of treatment with methylphenidate,adult ADHD patients show a significant reduction on internet, food, shopping and sex addiction symptoms. Further controlled studies with larger samples should replicate these preliminaryresults and elucidate the role of methylphenidate and other moderator factors (such as concomitant psychological treatments or lifestyle habits changes) on BAs improvements.

Associations between lifetime reproductive events among postmenopausal women with bipolar disorder.

The premenstrual phase of the menstrual cycle, childbirth and perimenopause often coincide with a worsening of mood symptoms in women with bipolar disorder (BD). To date, findings from the limited number of studies investigating associations between these events among women with BD have been inconsistent. This study aimed to investigate associations between episodes in relation to the perimenopause and (i) premenstrual symptoms and (ii) postpartum mood episodes in a large sample of postmenopausal women with BD. Among 567 postmenopausal women with BD, recruited as part of the UK Bipolar Disorder Research Network, relationships between reproductive event-associated mood symptoms/episodes were examined. Multivariate binary analyses were carried out to identify if history of premenstrual symptoms and/or postpartum episodes predicted the occurrence of mood episodes in relation to the perimenopause, controlling for potential confounders including number of mood episodes per illness year. History of premenstrual symptoms was associated with experiencing any type of mood episode, and depression specifically, during the perimenopause (OR 6.189, p < 0.001 and OR 2.709, p = 0.019 respectively). History of postpartum depression within 6 weeks of delivery was associated with depressive episodes during the perimenopause (OR 2.635, p = 0.027). Postpartum mania was not a significant predictor. Our findings suggest that women with BD with a history of premenstrual symptoms and postpartum depression are potentially at increased risk of experiencing episodes of depression in relation to the perimenopause. There are clinical and self-management implications in identifying a subgroup of women with BD who may be particularly vulnerable to episodes of mood disturbance during reproductive events.

Performance of the Healthy Aging Brain Care Monitor Self Report in Monitoring Post-Intensive Care Syndrome Among Acute Respiratory Failure Survivors.

To describe the performance of the Healthy Aging Brain Care Monitor Self Report (HABC-M SR) in assessment of post-intensive care syndrome (PICS) among Acute Respiratory Failure ICU survivors. Secondary data analysis of a randomized controlled trial. Patients evaluated by a nurse care coordinator in an out-of-hospital setting. English-speaking adults 18 years old or older who were admitted to the ICU with acute respiratory failure requiring invasive or noninvasive mechanical ventilation for greater than or equal to 24 hours. Patients randomized to the intervention arm of the mobile critical care recovery program, a negative trial testing multidisciplinary care to improve quality of life. HABC-M SR scale was used to assess PICS in the intervention group at ICU discharge, 3, and 6 months post-discharge. Hospital Anxiety and Depression Scale; Pain, Enjoyment of Life, and General Activity Scale; Timed Up and Go; and Patient-Reported Outcomes Measurement Information System sleep scores were obtained at the same time. Mini-Mental State Examination (MMSE) was administered at baseline and 6 months. ICU survivors reported mild PICS symptoms, which improved over 6 months (mean HABC-M SR scores: baseline [8.5, sd 7.6], 3 mo [5.3 mo, sd 6.6 mo], and 6 mo [5.2 mo, sd 6.9 mo; p < 0.001]). HABC-M SR total score had moderate internal consistency that improved over time (Cronbach's alpha = 0.78 at baseline and 0.84 at 6 mo). The psychological subscale of HABC-M SR was moderately correlated with standardized scales for mood, pain, and sleep. The cognitive subscale was not significantly correlated with MMSE. While HABC-M SR correlated with mood, physical, and sleep symptoms, the cognitive subscale was less sensitive compared with standardized scales.

QOL-31. RESULTS OF A TELEHEALTH-BASED PSYCHOLOGICAL INTERVENTION FOR CAREGIVERS OF PATIENTS WITH PRIMARY MALIGNANT BRAIN TUMORS: A MODERATION ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL

Abstract BACKGROUND In a recent randomized controlled trial, caregivers of patients with primary malignant brain tumors (PMBT) who received NeuroCARE—a six-session, telehealth-based psychological intervention—demonstrated improved anxiety and depression symptoms, coping, and self-efficacy at 11-weeks compared to usual care (UC) participants. We now explore how sociodemographic variables, disease-specific factors, and baseline mood symptoms moderate intervention effects on anxiety and depression symptoms. METHODS We examined data from 120 enrolled caregivers (Mage=53 years; 83% female, 92% White, 70% spouses/partners) of PMBT patients (84% glioblastoma). Eligible caregivers had elevated anxiety (Generalized Anxiety Disorder-7 ≥ 5). Participants were randomized 1:1 to NeuroCARE or UC and completed baseline sociodemographic questionnaires and the Hospital Anxiety and Depression Scale at baseline and 11-weeks. We used linear regression to evaluate whether selected sociodemographic characteristics (gender, age, relationship to patient), tumor characteristics (tumor location/laterality, IDH mutation status), and baseline mood symptoms moderated intervention effects on anxiety and depression symptoms. We report the group-by-moderator (b) effects, using a 0.20 significance level. RESULTS The beneficial effects of NeuroCARE on reducing 11-week anxiety symptoms were greater in women compared to men (b=-2.63, CI: -6.17, 0.91, p=0.14) and greater in caregivers who reported higher baseline anxiety symptoms (b=-0.43, CI: -0.78, -0.08, p=0.02) and depression symptoms (b=-0.56, CI: -0.96, -0.17, p=0.01). The beneficial effects of NeuroCARE on reducing 11-week depression symptoms were greater in caregivers of patients with IDH-wildtype tumors compared to caregivers of patients with IDH-mutant tumors (b=2.49, CI: -0.26, 5.24, p=0.08). Caregiver age, relationship to patient, and tumor location/laterality did not significantly moderate NeuroCARE effects on mood. CONCLUSIONS The positive effects of NeuroCARE were particularly salient for caregivers with elevated anxiety and/or depression symptoms and those caring for patients with IDH-wildtype tumors. Content may be further tailored to account for the unique needs of men and caregivers of patients with IDH-mutant tumors.

Changes in Private Psychiatric Outservice Related to SARS-CoV-2 Pandemic

The SARS-CoV-2 pandemic, which began in late 2019, initially manifested with acute respiratory symptoms, including bilateral pneumonia, and later emerged as a systemic disease. This brief report assesses changes in the clinical profiles of psychiatric outpatients before, during, and after the pandemic’s most severe periods, focusing on mood, anxiety, and cognitive symptoms. Data from a private psychiatric facility in Rome reveal that both pandemic-related stressors and SARS-CoV-2 infection itself may contribute to enduring affective and cognitive symptoms in both older and younger adult subgroups. Notably, during the pandemic, older patients showed elevated psychopathology scores (BPRS-24) compared to younger individuals. In the post-pandemic period, younger adults exhibited increased positive symptoms on the PANSS Positive subscale, suggesting a gradual worsening in symptoms post-pandemic ( = 0.47). Cognitive assessments (MMSE and PM38) further highlighted fluctuating performance over time, with older adults showing two distinct declines during the pandemic and in 2024. This work underscores the importance of sustained mental health interventions to address the pandemic’s psychosocial and neuroinflammatory legacy. This perspective also considers new data on the CNS effects of “toxin-like peptides” synthesized by microbiome bacteria.