Disorder Patients Research Articles

The role of gender factors influencing multiple dimensions of somatic symptoms in major depressive disorder patients with suicidal ideation: insights from the Chinese NSSD study

BackgroundThe study aimed to explore the influence of gender on the prevalence of various somatic symptoms and their associations with suicidal ideation (SI) among patients with major depressive disorder (MDD).MethodsWe recruited 3,275 patients with MDD from the National Survey on Symptomatology of Depression (NSSD), among whom 1,745 patients had SI. The clinical characteristics and the prevalence of somatic symptoms across 20 dimensions in MDD patients with SI were compared between male and female patients. Spearman correlation analysis and logistic regression analysis were used to explore the relationship between somatic symptoms and SI.ResultsIn patients with SI, 32.2% of female participants attributed the onset of MDD to physical concerns, whereas 27% of male patients held a similar perspective (P = 0.032). Female patients exhibited a higher prevalence of early insomnia (64.6% vs. 70.2%) and a lower prevalence of hypersomnia (17.2% vs. 12.9%) and urinary system symptoms (25.0% vs. 17.8%). Logistic regression analysis indicated that female patients displayed a broader range of somatic symptoms identified as risk factors for SI, including increased appetite, respiratory symptoms, circulatory system symptoms, limb pain, and various others.ConclusionThis study unveils gender-specific patterns in somatic symptoms among MDD patients with SI, highlighting the clinical significance of these symptoms in diagnosis and intervention. Understanding how physical concerns contribute to MDD, especially among females, underscores the need for tailored clinical approaches. Recognizing and addressing these symptoms could guide more effective suicide prevention strategies and enhance MDD management in clinical practice.

Specific Associations in the Alpha Frequency Between the Subcomponents of Rumination and the Subsystems of the Default Mode Network Among Bipolar I Disorder Patients.

Introduction: Rumination in bipolar disorder (BD) is well documented. Recent neuroimaging studies highlight the role of the default mode network (DMN) in rumination, while few studies have evaluated the DMN activity in BD rumination, particularly the underlying neuroelectrophysiology. Methods: A total of 44 patients with depressed bipolar I disorder (BD-I) and 46 healthy controls underwent resting-state magnetoencephalography. Two core hubs of the DMN, the posterior cingulate cortex (PCC), and anterior medial prefrontal cortex, together with the dorsal medial prefrontal cortex (dmPFC) and the medial temporal lobe (MTL) subsystems, were identified as the regions of interest. The power envelope method was used to determine the alpha band's cross-subsystem functional connectivity (FC). After comparing the rumination and DMN FC between the groups, Spearman partial correlation analysis was performed to evaluate the relationship between aberrant FC and rumination in BD-I patients. Results: BD-I patients demonstrated more global rumination, including higher subcomponent scores of brooding and reflection. In addition, the alpha frequency FC of the PCC-dmPFC and dmPFC-MTL subsystems within the DMN was dramatically increased in the BD-I group. The former was strongly associated with reflection, whereas the latter was related to brooding. Conclusion: The findings suggest that the reflection and brooding components of rumination are selectively related to the alpha frequency FC of the PCC-dmPFC and dmPFC-MTL subsystems, respectively. These associations highlight the significance of DMN activities in rumination among BD-I patients and have implications for future rumination interventions.

Challenges in transitioning from adolescent to Adult Mental Health Services for young adults with ADHD in Italy: an observational study.

Ensuring a successful transition to Adult Mental Health Services (AMHS) is fundamental for attention deficit/hyperactivity disorder (ADHD) patients to prevent adverse scenarios in adults (e.g., psychiatric disorders, substance or alcohol abuse). Yet, most European nations do not have appropriate transition guidelines and still fail to adequately support transition processes. This study aims to enquire about the current transition paths in Italy and the perceived experiences of the patients and their clinicians. The present observational study collected 36 interviews with young adults with ADHD who turned 18 between 2017 and 2021. Simultaneously, two questionnaires were filled in by the clinicians (both from paediatric and AMHS) who were involved in their transition paths. These tools collected information about the transition process, the services that cared for the young adults and well-being indicators such as impairment in daily life, employment status and the presence of sentinel events (e.g., critical stage accesses to the emergency room or hospitalizations). Successful and failed referrals were analysed. A referral to an AMHS was attempted for 16 young adults (8 before age 18 and 8 when turning 18), and 8 patients (22.2% overall) were successfully taken into the care of the AMHS. Twenty patients were not referred since it was deemed unnecessary (N = 6) or because of the lack of specialized services or compliance (N = 14). At the time of the interview, only nine participants were still under AMHS care. Of eleven individuals with a high need for care (identified by the level of impairment, support needs or sentinel events), five were not followed by a mental health professional at the time of the interview. For the majority of ADHD young adults, a transition path was never started or completed. While this is partly due to mild levels of impairment, in many cases it was difficult to find a service that could care for the adult patient. Only one out of four young adults are successfully transferred to AMHS care. Creating or improving evidence-based transition guidelines should be a priority of the public health system to ensure healthcare for as many patients as possible. The results of this study will converge towards the need for recommendations for the transition of services from adolescence to adulthood for young people with ADHD for Italian clinical practice.

Effect of ayurveda-based panchakarma and lifestyle modification on global longitudinal strain in cardiac disorder patients

Effect of ayurveda-based panchakarma and lifestyle modification on global longitudinal strain in cardiac disorder patients

06 Eating disorder toolkit 2023: Standards of practice in the primary care setting

Abstract Background Throughout the COVID 19 pandemic, physicians across Canada began to see a 'shadow pandemic' unfold as new diagnosis of eating disorders and hospital admissions for patients with medically unstable eating disorders increased exponentially. As these rates remain high, specialists stressed the importance of the role primary care physicians play in the early recognition, assessment, and diagnosis of eating disorders as a way to improve prognosis. Further, the high volume of patients has resulted in the need to manage patients in the community or engage in collaborative care between the eating disorder specialist and primary care physician. This Eating Disorder Toolkit was created as a knowledge mobilization resource to provide primary care and community providers with Standards of Practice and improve care for eating disorder patients. Objectives 1. Provide an updated and easily readable evidence-based reference tool for PCPs 2. Clarify PCPs role in working with, monitoring, and treating EDs in a shared care model 3. Strive for early diagnosis and connection to care for improved prognosis and decreased morbidity 4. Highlight unique considerations for specific populations 5. Align with the upcoming Eating Disorders Pathway project Design/Methods The first edition of the ED Toolkit was reviewed and based on feedback sought and provided by key partners including PCPs already using the Toolkit, areas of improvement were identified. These included formatting to improve accessibility in the primary care setting, updating the guidelines, and including unique considerations for specific populations. A literature review of current guidelines and practices internationally was completed. Experienced paediatric and adult ED specialists reviewed the material to ensure it was appropriate for clinical practice. Key partners contacted for feedback and collaboration included the Provincial ED Steering Committee, Provincial ED Pathway Project Committee, UBC Continuing Professional Development, and Primary Care physicians. This ensured the resource was meeting PCPs identified needs and was usable in the primary care setting. Edits were made to reflect the feedback received. Finally, the resource was reviewed to ensure alignment with the upcoming Provincial ED Pathway Project. Results The Eating Disorder Toolkit 2023: Standards of Practice in the Primary Care Setting is now available and has been distributed widely across British Columbia. In addition, Kelty Mental Health and Compass, leading resource hubs in the province, host the live document on their sites. Finally, the toolkit is also provided to any health providers upon request to their regional ED clinic. While we have not formally studied the outcome of this resources, anecdotal reports via email and verbal feedback from nurse practitioners, paediatricians, and ED specialists across the province has been positive. Conclusion Eating disorders are complex illnesses associated with significant medical and psychiatric complications. Early recognition and management improves prognosis. Community providers play a crucial role in recognizing and managing these patients, however many do not have expertise in this area. It is hoped that this resource will support PCPs in managing ED patients in British Columbia and there may be a potential scope for use across Canada with adaptations to local guidelines and resources.

Door de ogen van de patiënt: tele- en zelfmonitoring voor zwangere vrouwen met een verhoogd risico op hypertensie

Through the patient’s eyes: remote monitoring and patient self-measurement for women at risk of gestational hypertensive disorders Remote monitoring (RM) and patient self-measurement (PSM) are new technologies that enable blood pressure monitoring at home for pregnant women at risk of gestational hypertensive disorders (GHD). As patient satisfaction is increasingly considered as an indicator of the quality of care, this study aimed to compare patients’ perceptions on RM and PSM with those on conventional care for women at risk of GHD. The data collection was part of a multicentric RCT with 2 intervention groups (RM and PSM) and 1 control group. 254 participants completed the survey, determining the patients’ perceptions regarding the care they received at 4 measurement points. Linear probability models were used to assess the impact of RM and PSM on patients’ perceptions. Women at risk of GHD were significantly more likely to be satisfied with the care outcomes, to feel confident about their role as a mother and to be satisfied with their delivery after a follow-up by RM than after a follow-up by conventional care. In addition, they were significantly less likely to be concerned about their general health. The perceptions of women in the PSM group were not significantly better than those of the control group. The positive perceptions of patients regarding RM may be partly explained by the reduction in complications and the role of the study midwife as ‘advanced midwifery practitioner’.

Development and validation of a nomogram for sleep disorders among stroke patients

BackgroundPrecisely identifying high-risk sleep disorder patients and implementing suitable measures are important for decreasing the incidence of sleep disorders. In this study, a nomogram method was adopted to construct a tool to predict sleep disorders in stroke based on four factors: individual characteristics, treatment-related factors, psychological factors, and family-related factors. MethodsA total of 450 stroke patients were continuously diagnosed at the Affiliated Hospital of Nantong University, and the data on participants were randomly distributed into a training set (n = 315) and a validation set (n = 135). Within the training set, using LASSO regression and random forest methods, five optimal predictors of sleep disorders were identified. Five optimal predictors were used to develop a model. The calibration, discrimination, generalization, and clinical applicability of the model were evaluated using calibration curves, receiver operating characteristic (ROC) curves, internal validation, and decision curve analysis (DCA). ResultsWe found that the place of residence, average daily infusion time, the Hospital Anxiety and Depression Scale (HADS), the Type D Personality Scale-14 (DS14), and the Fatigue Severity Scale (FSS) were crucial factors associated with sleep disorders. The validation data showed an area under the curve (AUC) of 0.903 compared to 0.899 in the training set. There was an approach to the diagonal in the calibration curve of this model, and the results of DCA noted that it is clinically beneficial across a range of thresholds from 5 % to 99 %. ConclusionA model was developed to predict sleep disorders among stroke patients to help hospital staff evaluate the risk among patients and screen high-risk patients.

Abnormal functional lateralization and cooperation in bipolar disorder are associated with neurotransmitter and cellular profiles

BackgroundHemispheric lateralization and cooperation are essential for efficient brain function, and aberrations in both have been found in psychiatric disorders such as schizophrenia. This study investigated alterations in hemispheric lateralization and cooperation among patients with bipolar disorder (BD) and associations with neurotransmitter and cell-type density distributions to identify potential molecular and cellular pathomechanisms. MethodsSixty-seven BD patients and 127 healthy controls (HCs) were examined by resting-state functional MRI (rs-fMRI). Whole-brain maps of the autonomy index (AI) and connectivity between functionally homotopic voxels (CFH) were constructed to reveal BD-specific changes in brain functional lateralization and interhemispheric cooperation, respectively. Spatial associations of regional AI and CFH abnormalities with neurotransmitter and cell-type density distributions were examined by correlation analyses. ResultsBipolar disorder patients exhibited higher AI values in left superior parietal gyrus, cerebellar right Crus I, and cerebellar right Crus II, and these regional abnormalities were associated with the relative densities (proportions) of oligodendrocyte precursor cells and microglia. Patients also exhibited lower CFH values in right inferior parietal gyrus, bilateral middle occipital gyrus, left postcentral gyrus, and bilateral cerebellar crus II, and these regional abnormalities were associated with the densities of serotonin 1A and dopamine D2 receptors, oligodendrocyte precursor cells, astrocytes, and neurons. ConclusionsThese findings indicate that abnormal functional lateralization and cooperation in BD with potential molecular and cellular basis.

Association between olfactory function and metabolic syndrome in bipolar disorder patients: a cross-sectional study

BackgroundOlfactory function is closely related to mood and the endocrine system. However, the role of olfactory function in bipolar disorder combined with metabolic syndrome remains unclear. The purpose of this study was to explore the associations among olfactory function, tumor necrosis factor alpha (TNF-α), and metabolic syndrome and its components in patients with bipolar disorder.MethodsNinety-six bipolar disorder patients were divided into two groups with and without metabolic syndrome. We also included 46 healthy controls. Olfactory function was assessed using the Sniffin’ Sticks test. Blood samples were collected to measure metabolic indicators and serum TNF-α levels.ResultsSignificant differences in olfactory function were found among the three groups. Compared with the healthy controls, the bipolar disorder without metabolic syndrome group showed poorer olfactory identification ability (P < 0.001) and the bipolar disorder with metabolic syndrome group showed impaired olfactory sensitivity (P = 0.003) and olfactory identification (P < 0.001). Moreover, the bipolar disorder with metabolic syndrome group had poorer olfactory identification ability than the bipolar disorder without metabolic syndrome group (P = 0.015). Both bipolar disorder groups showed lower TNF-α levels than healthy controls. However, there was no significant difference between the two patient groups. Correlation analysis showed that, in the bipolar disorder with metabolic syndrome group, olfactory identification was negatively correlated with systolic blood pressure (r = − 0.424, P = 0.031), and serum TNF-α level was negatively correlated with body mass index (BMI; r = − 0.398, P = 0.049), triglyceride (r = − 0.503, P = 0.010), total cholesterol (r = − 0.491, P = 0.013), low-density lipoprotein-cholesterol (r = − 0.491, P = 0.013), and high-density lipoprotein-cholesterol (r = − 0.454, P = 0.023).ConclusionsThe olfactory identification ability of patients with bipolar disorder is worse than that of healthy controls, and the occurrence of metabolic syndrome will further aggravate the olfactory identification impairment of those patients. Furthermore, there may be a stronger link between serum TNF-α level and multiple metabolic indicators in bipolar disorder patients with metabolic syndrome than in bipolar disorder patients without metabolic syndrome.

Impact of comorbid sleep-disordered breathing on escitalopram treatment in patients newly diagnosed with generalized anxiety disorder: A 12-week prospective observational study

We aimed to evaluate the presence of sleep-disordered breathing (SDB) in generalized anxiety disorder (GAD) patients and its impacts after 12-week of escitalopram treatment. In this prospective observational study, GAD patients were followed up to determine whether comorbid SDB affects their treatment response. They underwent a home sleep apnea test (HSAT), and oxygen desaturation index ≥5 was considered indicative of SDB. All participants were treated with escitalopram 5 mg in the first 2 weeks and 10 mg in the remaining 10 weeks. They underwent assessments of heart rate variability and completed questionnaires for sleep, mood, attention, and daytime sleepiness on the day of enrollment, and 2 weeks, 4 weeks, and 12 weeks later. A total of 45 GAD participants (mean age, 56.2 years) were included in the study. Of these, 53.3% had comorbid SDB. Participants with GAD and SDB had higher baseline Beck Anxiety Inventory (BAI) and STOP-BANG scores. Both groups of participants with GAD showed overall improvement in anxiety, depression, and insomnia symptoms after 12 weeks of escitalopram treatment. Additionally, there were no statistically significant differences in the changes in BAI, Beck Depression Inventory, and Epworth Sleepiness Scale scores between the two groups at the Week 2, Week 4, and Week 12 assessments compared to baseline. However, the GAD group with comorbid SDB seemed to have a lower tendency for improvement in depressive symptoms than the group with non-comorbid SDB. Compared with the GAD group without comorbid SDB, the GAD group with comorbid SDB exhibited more severe anxiety symptoms at baseline and tended to show less improvement in depressive symptoms after 12 weeks of escitalopram treatment.

Amygdala self-neuromodulation capacity as a window for process-related network recruitment.

Neurofeedback (NF) has emerged as a promising avenue for demonstrating process-related neuroplasticity, enabling self-regulation of brain function. NF targeting the amygdala has drawn attention to therapeutic potential in psychiatry, by potentially harnessing emotion-regulation processes. However, not all individuals respond equally to NF training, possibly owing to varying self-regulation abilities. This underscores the importance of understanding the mechanisms behind successful neuromodulation (i.e. capacity). This study aimed to investigate the establishment and neural correlates of neuromodulation capacity using data from repeated sessions of amygdala electrical fingerprint (Amyg-EFP)-NF and post-training functional magnetic resonance imaging (fMRI)-NF sessions. Results from 97 participants (healthy controls and post-traumatic stress disorder and fibromyalgia patients) revealed increased Amyg-EFP neuromodulation capacity over training, associated with post-training amygdala-fMRI modulation capacity and improvements in alexithymia. Individual differenaces in this capacity were associated with pre-training amygdala reactivity and initial neuromodulation success. Additionally, amygdala downregulation during fMRI-NF co-modulated with other regions such as the posterior insula and parahippocampal gyrus. This combined modulation better explained EFP-modulation capacity and improvement in alexithymia than the amygdala modulation alone, suggesting the relevance of this broader network to gained capacity. These findings support a network-based approach for NF and highlight the need to consider individual differences in brain function and modulation capacity to optimize NF interventions. This article is part of the theme issue 'Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation'.

Cannabis-Related Disorders Are Associated with Increased Early Postoperative Opioid Prescriptions and Delayed Emergency Department Visits Following Open Carpal Tunnel Release.

The effect of cannabis on pain management following open carpal tunnel release (CTR) surgery is unknown. The purpose of this study is to compare outcomes for patients with cannabis-related disorder (CRD) undergoing open CTR to a propensity-matched cohort of patients without CRD (no cannabis-related disorder [NCRD]). The TriNetX Research Network was queried to identify patients undergoing primary open CTR between January 2010 and December 2022. Patients with CRD were propensity matched to a NCRD cohort in a 1:1 ratio based on 7 characteristics. Rates of postoperative opioid prescriptions, emergency department (ED) services, and outpatient appointments were reported at 0-2, 2-6, and 6-12 weeks postoperatively. A total of 925 CRD patients were propensity matched to 925 NCRD patients undergoing open CTR. Within 0-2 weeks postoperatively, CRD patients received significantly greater rates of opioid prescriptions compared to NCRD patients (30.9% and 25.6%, P = .011). No cannabis-related disorder (NCRD) patients presented for outpatient follow-up at significantly higher rates than CRD patients within 6 weeks postoperatively. CRD patients presented to the ED at significantly higher rates between 6 and 12 weeks postoperatively (11.0% vs. 8.0%, respectively, P = .027). Cannabis-related disorder (CRD) is associated with lower rates of outpatient follow-up but higher rates of postoperative opioid prescriptions and ED presentations following open CTR compared to a propensity-matched cohort of NCRD patients. Cohort Study; Level III.

The Dysregulation of the Glymphatic System in Patients with Psychosis Spectrum Disorders Minimally Exposed to Antipsychotics: La dérégulation du système glymphatique en présence de troubles psychotiques chez des patients peu exposés à des antipsychotiques.

The pathophysiological mechanisms influencing psychosis spectrum disorders are largely unknown. The glymphatic system, which is a brain waste clearance pathway, has recently been implicated in its pathophysiology and has also been shown to be disrupted in various neurodegenerative and vascular diseases. Initial studies examining the glymphatic system in psychosis spectrum disorders have reported disruptions, but the findings have been confounded by medication effects as they included antipsychotic-treated patients. In this study, we used diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) as a technique to measure the functionality of the glymphatic system in a sample of antipsychotic-minimally exposed patients with psychosis spectrum disorders and healthy controls. The study included 13 antipsychotic-minimally exposed (2 weeks antipsychotic exposure in the past 3 months/lifetime) patients with psychosis spectrum disorders and 114 healthy controls. We quantified water diffusion metrics along the x-, y-, and z-axes in both projection and association fibres to derive the DTI-ALPS index, a proxy for glymphatic activity. Between-group differences were analyzed using two-way ANCOVA controlling for age and sex. Partial correlations were used to assess the association between the ALPS index and clinical variables. Analyses revealed that antipsychotic-minimally exposed psychosis spectrum disorder patients had a lower DTI-ALPS index value than healthy controls in both hemispheres and the whole brain (all P < 0.005). Significant differences were also observed between the x and y projections/associations between patients and healthy controls (P < 0.001). Furthermore, we did not find any significant correlations (all P > 0.05) between the DTI-ALPS index with age, body mass index, symptomatology, and metabolic parameters. This study shows that the glymphatic system is dysregulated in antipsychotic-minimally exposed patients with psychosis spectrum disorders. Understanding the mechanisms that influence the glymphatic system may help to understand the pathophysiology of psychosis spectrum disorders as proper waste clearance is needed for normal brain functioning.

Identify of Preoperative and Postoperative Complication of Planned Management and Emergency Management of Patients with PAS Disorder

Background: Placenta accreta spectrum (PAS) often results in significant blood loss and peripartum hysterectomy; the mother may not survive. In many cases, timely prenatal diagnosis allows for careful birth planning in a specialized facility with a highly qualified multidisciplinary team. This has been shown to reduce maternal morbidity. Scheduled deliveries are associated with lower rates of bleeding and emergency procedures when compared to emergency deliveries. Objective: The aim of this study is to identify the preoperative and postoperative complication of planned management and emergency management of patients with PAS disorder. Methods: The cross-sectional comparative study was conducted in the Department of Obstetrics &amp; Gynaecology, Dhaka Medical College Hospital, Dhaka from 18th January 2020 to 17th July 2020. A total of 84 patients diagnosed as a case of PAS disorder (antenatally and peroperative diagnosed) and scheduled for planned management or emergency management of PAS were included according to inclusion and exclusion criteria. 42 planned management of PAS disorder patients as Group A and 42 emergency management of PAS disorder patients as Group B. The questionnaire was pretested, corrected and finalized. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, mean ± SD of age was calculated 26.3 ± 4.3 years for Group – A and 28.1 ± 3.2 years for Group – B. Urban population were predominant in group-A. About 30 (70.0%)) patients in group-A and 10 (23.8%) patients in group-B came from urban. Large number of respondents 22 (52.4%) and 10 (50.0%) were housewife in both groups. Among the patients, the lower class 18 (42.9%) and 23 (54.8%) comprised the major percentage of the patients in both groups. More participants in Group-A 29 (69.00%) received ANC regularly than Group B 10 (23.80%), the difference was statistically significant (p&lt;0.05). In group-A maximum patients presented with only USG findings of PAS disorders and with APH or without APH 26 (61.8%). In group-B, PPH and internal haemorrhage 10 (23.8) was noted predominantly. The mild anemia was more in 23 (54.8%) patients in group A and 16 (38.1%) patients in group B which was statistically significant (p &lt; 0.001). More participants in Group-B 26 (61.9%) required early termination, whereas majority of group A 35 (83.3%) was terminated at 35-36 weeks. There was a statistically significant difference between groups. Maximum patients were managed by peripartum hysterectomy 35 (82.0%) and 31 (73.8%) in group A &amp; B respectively. Presence of multidisciplinary team was arranged in 38 (90.4%) in group A and 18 (42.9%) in group B. General anesthesia and CV line was given in 36 (85.7%) patients in group-A and 27 (64.3%) patients in group-B. Massive blood transfusion was needed in 23 (54.8%) patients in Group B &amp; only 3 (7.1%) patients in Group A. Placenta acreta was present 11 (26.2%) patients in group A and 7 (16.7%) patients in group B. Placenta percreta with bladder invasion and peroperative bladder injury was higher in group-B patients. More than 3 L blood was transfused 3 (7.1%) patients in group A and 23 (54.8%) patients in group B. PPH, Sepsis, Re-exploration, DIC and ICU admission were the significant complication in Group-B patients, reported 41 (95.0), 4 (9.5%), 8 (19.0%), 9 (21.4%) and 21 (50.0%) of women and in less complication in Group A 13 (31.0), 0%, 0%, 1 (2.3) and 4 (9.5). In this study mortality rate was 2 (4.8%) in group-B (due to irreversible shock &amp;DIC). Poor outcomes were significantly higher in group-B. NICU admission for prematurity was required in 9 (21.4%) of the babies in group-A and 23 (54.8%) babies of group-B. Birth asphyxia was observed in 4 (9.5%) of the babies in group-A and 13 (31.0%) in Group-B. Conclusion: Prenatal diagnosis and placenta preservation may be linked to lower rates of morbidity in mothers. For morbidly adherent placenta linked with placenta previa, we advise hysterectomy as the preferred course of therapy following extremely thorough prenatal counseling. Maternal problems and fetal outcomes may be improved by early risk factor identification and proactive management.

Transient CSF1R inhibition ameliorates behavioral deficits in Cntnap2 knockout and valproic acid-exposed mouse models of autism

Microglial abnormality and heterogeneity are observed in autism spectrum disorder (ASD) patients and animal models of ASD. Microglial depletion by colony stimulating factor 1-receptor (CSF1R) inhibition has been proved to improve autism-like behaviors in maternal immune activation mouse offspring. However, it is unclear whether CSF1R inhibition has extensive effectiveness and pharmacological heterogeneity in treating autism models caused by genetic and environmental risk factors. Here, we report pharmacological functions and cellular mechanisms of PLX5622, a small-molecule CSF1R inhibitor, in treating Cntnap2 knockout and valproic acid (VPA)-exposed autism model mice. For the Cntnap2 knockout mice, PLX5622 can improve their social ability and reciprocal social behavior, slow down their hyperactivity in open field and repetitive grooming behavior, and enhance their nesting ability. For the VPA model mice, PLX5622 can enhance their social ability and social novelty, and alleviate their anxiety behavior, repetitive and stereotyped autism-like behaviors such as grooming and marble burying. At the cellular level, PLX5622 restores the morphology and/or number of microglia in the somatosensory cortex, striatum, and hippocampal CA1 regions of the two models. Specially, PLX5622 corrects neurophysiological abnormalities in the striatum of the Cntnap2 knockout mice, and in the somatosensory cortex, striatum, and hippocampal CA1 regions of the VPA model mice. Incidentally, microglial dynamic changes in the VPA model mice are also reported. Our study demonstrates that microglial depletion and repopulation by transient CSF1R inhibition is effective, and however, has differential pharmacological functions and cellular mechanisms in rescuing behavioral deficits in the two autism models.

Appearance-enhancing masticatory muscle exercises and their potential impact on masticatory muscle symptoms: A netnographic study and scoping review

ABSTRACT Objective Videos containing exercises for masticatory muscles to enhance esthetic appearance are published on social media platforms. The aim of the study was to find out the nature of the exercises and whether they could have an impact on the health of the masticatory muscles. Method For the netnography, social media videos of jaw area exercises were collected as material and reviewed. The literature review investigated the effect of voluntary masticatory muscle exercises. Results 71 videos were collected, with none referring to scientific evidence. Muscle exercises found by netnography were isometric exercise of the masseter muscles. The scoping review revealed isometric exercise of the masticatory muscles can cause symptoms in the masticatory system in temporomandibular disorder patients. Conclusion Non-professional masticatory muscle exercises should be considered in the etiology of muscle-related TMD. Dental professionals should to explore social media platforms to be aware of content about dental issues.

The relationship between emotion regulation difficulties and eating disorder outcomes: a longitudinal examination in a residential eating disorder treatment facility

ABSTRACT Eating disorders (EDs) are associated with numerous comorbidities and deleterious outcomes (e.g. medical complications, high rates of death by suicide). The complexities of EDs are further compounded by treatment dropout, poor treatment outcomes, and relapse. One way to better understand these complexities is to investigate broad, transdiagnostic risk factors that contribute to the etiology and maintenance of EDs, such as emotion regulation (ER) difficulties. We longitudinally tested the relationship between ER difficulties and ED outcomes in a sample of 101 female ED patients in a southeastern U.S. residential ED treatment facility. Consistent with hypothesis, there were significant improvements in both ER difficulties and eating pathology from admission to discharge. Further, improvement in ER difficulties was associated with improvements in eating pathology. These findings further substantiate the role of ER difficulties in eating disorders and provide further evidence for the relationship between ER difficulties and eating pathology among residential eating disorder patients.

CONTINUOUS SCORING OF AUTISM SPECTRUM DISORDER PATIENTS BY ANALYZING THEIR EEG SIGNALS

Clinical manifestations and standard psychological tests have been widely used to diagnose autism spectrum disorder (ASD) patients and evaluate their severity level. The gold-standard criterion to diagnose ASD patients is the childhood autism rating scale (CARS), which is a qualitative questionnaire that is filled out through a systematic interview while no physiological test/record is performed to determine this score. To make the diagnosis process quantitative, electroencephalography (EEG) signals have been repeatedly analyzed to differentiate healthy subjects from ASD patients. However, the precise relationship between the abnormal behavior of EEG signals and different ASD severity levels is not well investigated. Here, we use CARS to qualitatively determine the severity level of 14 autistic children, who voluntarily enrolled in our study. We recorded their EEG signals from 19 scalp channels when they were awake in the idle state and elicited three informative features including approximation entropy, multiscale entropy and sample entropy in successive time frames. Among the three measures of entropy, the last one exhibits the highest sensitivity, where its correlation coefficient (CC) exceeds 0.7, on the electrode positions T6 (CC [Formula: see text] 0.74), P4 (CC [Formula: see text] 0.76) and Cz (CC [Formula: see text] 0.75). Results of sample entropy in channels Cz-versus-Pz and P4-versus-FP2 show that a simple K-nearest neighbor classifier can provide 93% classification accuracy among patients with mild, moderate and severe ASD levels. Comparing the proposed method to the conventional ones, we also extracted power spectral density features from the channels but they failed to identify the ASD severity level with an acceptable accuracy.

Factors associated with seasonal affective disorder: Findings from the bipolar disorder course and outcome study from India (BiD-CoIN study)

BackgroundThere is a lack of information on the long-term course and outcomes of bipolar disorder (BD) patients with seasonal affective disorder (SAD). AimTo compare the demographic and clinical profile of BD patients with and without SAD. MethodologyData from 773 BD patients with an illness duration of at least 10 years were collected from 14 tertiary care centers. SAD was defined according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Participants with and without SAD were compared for demographic and clinical features. ResultsThe prevalence of SAD was 9.44 %. BD patients with SAD spent more time in episodes (p < 0.001), had a higher number of lifetime episodes (p < 0.001), and more episodes per year of illness in the lifetime. They also spent more time in depressive episodes (p < 0.001), had higher depressive (p < 0.001) and manic (p = 0.01) affective morbidity indices, shorter durations of current remission (p < 0.001), higher levels of residual depressive and manic symptoms, higher levels of disability, and received more medications (p < 0.001). Patients with SAD were also more likely to have BD-II (p = 0.01), rapid cycling (p < 0.001), a first-lifetime episode of depressive polarity (p = 0.01), a history of breakthrough episodes (p < 0.001), self-discontinuation of pharmacoprophylaxis, and relapses due to poor medication adherence. They were more often receiving lithium, antipsychotics, and antidepressants. However, a lower proportion of those with SAD had been hospitalized, received electroconvulsive therapy, or were receiving valproate. ConclusionPatients with SAD, in general, have more severe BD, and differ from those without SAD on many clinical parameters.

How to motivate adolescents who are afraid of treatment?

Motivation has long been considered key to sending substance use disorder (SUD) patients in the direction of recovery. But how do you motivate an adolescent, to whom motivational approaches may feel like a call to battle — or even worse, an excuse for running away? Lauren Sbarbaro, Ph.D., a psychologist licensed in alcohol and drug treatment who trained at Hazelden, shared some insights with attendees at the Cape Cod Symposium on Addictive Disorders (CCSAD) in Hyannis, Massachusetts last week.