Prevention Of Mental Disorders Research Articles

Barriers to and Facilitators of Engaging With and Adhering to Guided Internet-Based Interventions for Depression Prevention and Reduction of Pain-Related Disability in Green Professions: Mixed Methods Study.

Internet-based interventions (IBIs) are effective for the prevention and treatment of mental disorders and are valuable additions for improving routine care. However, the uptake of and adherence to IBIs are often limited. To increase the actual use of IBIs, it is important to identify factors for engaging with and adhering to IBIs. We qualitatively evaluated barriers and facilitators regarding a portfolio of guided IBIs in green professions (farmers, gardeners, and foresters). Interview participants were selected from 2 randomized controlled trials for either the prevention of depression (Prevention of Depression in Agriculturists [PROD-A]) or the reduction of pain interference (Preventive Acceptance and Commitment Therapy for Chronic Pain in Agriculturists [PACT-A]) in green professions. The intervention group in PROD-A (N=180) participated in an IBI program, receiving access to 1 of 6 symptom-tailored IBIs. The intervention group in PACT-A (N=44) received access to an IBI for chronic pain. Overall, 41 semistructured qualitative interviews were conducted and transcribed verbatim. Barriers and facilitators were identified via inductive qualitative content analysis, with 2 independent coders reaching almost perfect intercoder reliability (Cohen κ=0.92). A quantitative follow-up survey (30/41, 73%) was conducted to validate the results. Subgroup analyses were performed based on intervention characteristics. We identified 42 barriers and 26 facilitators, which we assigned to 4 superordinate categories related to the intervention (20 barriers; 17 facilitators), work (4 barriers; 1 facilitator), individual (13 barriers; 8 facilitators), and technical (5 barriers; 0 facilitators) aspects. Key barriers (identified by at least 50% of the interviewees) were time-consuming work life (29/40, 73%) and time-consuming private life (23/40, 58%). Similarly, the most frequently identified facilitators included presence of motivation, curiosity, interest and perseverance (30/40, 75%), flexible time management at work (25/40, 63%), and support from family and friends (20/40, 50%). Although agreement with barriers in the quantitative follow-up survey was rather low (mean 24%, SD 11%), agreement with facilitators was substantially higher (mean 80%, SD 13%). Differences in agreement rates were found particularly between intervention completers and noncompleters. Completers agreed significantly more often that perceived IBI success; being motivated, curious, interested, and perseverant; and having a persisting level of psychological strain have been facilitating. Noncompleters agreed more often with experiencing the e-coach contact as insufficient and technical problems as hindering for intervention completion. Based on these results, strategies such as customization of modules for more flexible and adaptive use; video chat options with the e-coach; options to facilitate social support by family, friends, or other participants; or using prompts to facilitate training completion can be derived. These approaches could be evaluated in further quantitative research designs in terms of their potential to enhance intervention use in this occupational group. German Clinical Trials Register DRKS00014000, https://tinyurl.com/3bukfr48; German Clinical Trials Register DRKS0001461, https://tinyurl.com/ebsn4sns.

Mental health literacy among primary healthcare workers in South Africa and Zambia.

In developing countries, mental health literacy (MHL) still needs to be improved due to the high prevalence of mental disorders. It is widely recognized that MHL can improve health outcomes for both individuals and populations. Healthcare professionals' development in MHL is crucial to the prevention of mental disorders. The aim of this study was to assess MHL of primary healthcare (PHC) workers in South Africa (SA) and Zambia and determinants thereof. Limited evidence is available on the levels of MHL among PHC workers in the sub-Saharan Africa region, which faces a large burden of mental disorders. The study population for this cross-sectional survey comprised PHC workers (n=250) in five provinces of SA and Zambia. MHL was measured with the Mental Health Literacy Scale (MHLS). We conducted a multivariate analysis to explore determinants of MHL. Results showed moderate MHL among PHC professionals, but with a wide range from low to high MHL. Knowledge-related items had a greater dispersion than other attributes of MHL. PHC workers with more education showed a greater ability to recognize mental health-related disorders. Those who had experience in the use of mental health-related assessment scales or screening tools reported a higher total MHL. The results confirmed strong internal consistency for the MHLS. The results highlighted varying mental health perceptions and knowledge in PHC. Implementation of specifically developed formal training programs and interventions to improve MHL in PHC workers to strengthen their competence may help bridge the treatment gap.

Intra-individual impact of the COVID-19 pandemic on mental health and sleep in young adults.

The COVID-19 pandemic has posed unique academic, social, financial, and health-related challenges for young adults. While numerous studies have documented average increases in reported mental health issues in the general population, few have measured the magnitude of changes in mental health symptoms and sleep difficulties within individuals. Here, we measure the impact of the COVID-19 pandemic on mental health and sleep of university students pre- and mid-pandemic. Prior to the pandemic (Fall 2019), individuals (n = 23) were recruited to participate in an eight-day, comprehensive sleep study using Fitbit® actigraphy. Participants also completed detailed mental health and sleep surveys, including depression (BDI-II), anxiety (STAI), and sleep disturbance (PROMIS) surveys. One year later, these individuals repeated the study during the pandemic (Fall 2020); participants completed the original surveys and sleep study, in addition to a targeted survey on mental and sleep health due to the pandemic. Self-reported levels of anxiety, depression, and sleep disturbance, and sleep parameters, measured by actigraphy, were compared within the same individuals pre- and mid-pandemic. Self-report survey data revealed that three-quarters of participants experienced an increase in stress and anxiety due to the pandemic. In addition, intra-individual depression and anxiety symptoms increased to clinically significant levels within individuals from pre- to mid-pandemic. Over two-thirds of participants reported sleeping less, and more than half reported that their sleep health had worsened during the pandemic. Changes in sleep disturbance were positively associated with changes in depression and anxiety, reinforcing the robust relationship between poor sleep quality and mental health. Furthermore, individuals who reported greater sleep disturbance during the pandemic experienced lower relative proportions of both REM and deep sleep. The impact of the COVID-19 pandemic on university students is multi-faceted—mental health, sleep quality, and the amount of restorative sleep are negatively affected by the pandemic environment. These compounded effects exacerbate the health consequences of the pandemic and highlight a need for increased attention to the prevention and treatment of mental health disorders, particularly in vulnerable populations of young adults.

Maternal circadian rhythm and its implications for offspring health

This review presents data on the circadian system hierarchy and its unique reorganization at the onset of pregnancy, which plays a fundamental role in maintaining maternal homeostasis and creating optimal conditions for the implementation of the genetic program of fetal development. A particular emphasis is made on the protective mechanisms of the circadian rhythm of maternal melatonin, which is the primary messenger of biorhythms. This paper thoroughly discusses the mechanisms and consequences of maternal chronodisruption in pregnant women exposed to adverse environmental conditions (shift work, stress, irregular nutrition, etc.), as well as in those with chronodestruction-related diseases (obesity, diabetes mellitus, etc.). Elucidating the circadian system status in the patients and, in particular, whether they have a daily rhythm of melatonin production will determine a new approach to risk assessment and timely prevention of cardiovascular, metabolic, neuroendocrine and mental disorders in the offspring in later life.

Positive mental health and COVID-19 pandemic in Slovenia

Abstract Background The COVID-19 pandemic is having a major impact on mental health. In contrast to studies on mental disorders, our study contributes to the under-researched area of the impact of the pandemic on positive mental health. We compare the prevalence of positive mental health before and during the pandemic and identify factors associated with flourishing and languishing mental health during the pandemic. Methods We used data from two nationally representative cross-sectional surveys of Slovenian adults conducted in 2019 and 2021. Outcome included positive mental health (Mental Health Continuum - Short Form). Cross-sectional prevalence estimates were calculated and logistic regression assessed associations between positive mental health and the COVID-19 specific and other health-related factors. Results In 2021, 38.6% (95% CI, 37.0%-40.2%) had flourishing mental health, compared to 61,5% (95% CI, 60.5%-62.5%) before the pandemic. In contrast, the share of people in languishing mental health during the pandemic (8.0%; 95% CI, 7.1%-8.9%) was nearly two times higher than in 2019 (4,5%; 95% CI, 4.1%-4.9%). Both flourishing and languishing were significantly associated with changes in family relations, social interactions and dietary habits, resilience and COVID-19 literacy. Conclusions Positive mental health in Slovenia worsened drastically during the pandemic compared with before. Results indicate important role of family relationships, social interactions and dietary habits on positive mental health. Both prevention of mental disorders and mental health promotion need to be considered in order to address the full range of public mental health needs, with increased attention to strengthening resilience and health literacy. Key messages • We noted an substantial decline in flourishing and rise in languishing mental health during the pandemic. • Public health efforts need to address the impact of the pandemic on family relations and social interactions.

Direction of implementation of social adaptation of demobilized combatants with mental and behavioral disorders

(experience of implementation of the Strategy for the development of an effective system (rehabilitation of war veterans and members of their families, families of dead (deceased) war veterans of Kyiv region on the basis of the municipal non-profit enterprise of the Kyiv Regional Council "Kyiv Regional Mental Health Center")
 
 Introduction. The article examines the experience of implementing the Strategy of development of effective system rehabilitation of war veterans and members of their families deceased (killed) war veterans on the basis of a communal non-profit enterprise of the Kyiv Regional Council "Kyiv Regional Center of mental health".
 Objective. Dissemination of experience in implementing the Strategy for the development of an effective rehabilitation system for war veterans and their families, families members of fallen combatants in order to preserve their ability to work and increase a duration and quality of life.
 Materials and methods. A content analysis of the existing regulatory and legal framework on the organization of psychological and psychiatric assistance to combatants and members of their families. At the time when was using he bibliosemantic method, were studied sources of scientific and scientific-practical literature on the problematic issues. Also were used methods of system analysis, organizational experiment, statistical and structural-logical.
 Results and their discussion. The need to solve the problems of rehabilitation and psychological and psychiatric support for participants in military conflicts is one of the the most important issues of our time. Unfortunately for today, considering the events in the country, the issue of treatment, diagnosis and prevention of mental disorders associated with stressful events of wartime, has become very relevant for us.
 Conclusions. Thus, the actuality of the issues of treatment, diagnosis and the prevention of mental disorders associated with stressful events of wartime is growing, and not only for professionals about mental health, but also for doctors of all specialties without exception. Our research shows that the traumatic effect of stress on soldiers, who have not formed readiness to participate in combat operations, personal immaturity, infantilism, unformed volitional sphere, which in the future provoked the emergence of destructive personality changes, behavioral disorders.

The Mediterranean Diet and the Western Diet in Adolescent Depression-Current Reports.

Depression is one of the most common mental disorders in the world and a current and growing social and health problem. The growing scale of the problem not only concerns adults, but now it particularly affects children and adolescents. Prevention, early diagnosis and treatment of mood disorders in adolescence is crucial because adolescent depression is a risk factor for recurrence of depression later in life, as well as many other mental health disorders in adulthood. The purpose of this study was to analyze data on the dietary patterns and composition of the Mediterranean diet as a modifiable risk factor for depression, which would be a viable prevention strategy and a good target for early intervention and supportive treatment of depression. Research shows that the Mediterranean diet pattern can reduce the risk and symptoms of depression, while western eating styles can increase the risk and severity of depression in adolescents. The number of studies in adolescent populations continues to increase, but most longitudinal and clinical studies are still insufficient. Modification of the diet can be a helpful strategy for the prevention and treatment of depression in adolescents; therefore, the diet of young people should be considered a key and modifiable goal in the prevention of mental disorders.

Individual characteristics of adolescent psychiatric patients accessing psychotherapy in China

Most mental health problems develop during childhood and adolescence, so identifying the mental health needs and care pathways of adolescents is crucial to improving prevention. This study aimed to understand the characteristics of adolescent patients with mental disorders receiving psychotherapy in China. Data were collected retrospectively from the psychotherapy records of 116 patients at the Weifang Mental Health Centre. Information collected included demographics, stressors, duration of psychotherapy, and clinical diagnosis. Chi-square tests and negative binomial regression models were used to explore the relationship between demographic and clinical variables. The results showed that depression was the most common diagnosis, followed by anxiety and stress-related disorders and bipolar and related disorders. Rural patients were more likely to report family stress, while urban patients were more likely to report school stress. Female patients were more likely to report family stress and to be diagnosed with depression. Family stress, social stress, school stress, patient origin and economic conditions were all significant predictors of the duration of psychological treatment. This study helps to understand the characteristics and psychotherapeutic needs of adolescents with mental disorders who receive psychotherapy in China so that the positive role of psychotherapy in the prevention, treatment and rehabilitation of mental disorders can be better utilised.

Development and reliability of the coding system evaluating maternal sensitivity to social interactions with 34- to 36-week postmenstrual age preterm infants.

Maternal sensitivity (MS), the ability to perceive and synchronously respond to the social signals (SSs), is affected by prematurity. The development of early supportive psychotherapy to foster MS, before discharge of the infant from the neonatal intensive care unit (NICU) is a major challenge in the prevention of subsequent developmental and mental disorders in the child. There are currently no reliable methods for evaluating MS to social interactions with very to moderate preterm infants. We investigated the reliability of a newly developed procedure for assessing MS in interactions between the mother and her 34- to 36-week postmenstrual age (PMA) preterm infant: the Preterm Infant Coding System for Maternal Sensitivity (PRICOSMAS).MethodThis study encompassed three steps: testing of the capacity to videorecord SSs in very to moderate preterm infants, selection, by an expert committee, of the recordable and relevant SSs, and investigation of the internal consistency and interrater reliability. The synchronicity between infant and mother's SSs was determined on a 1 s period basis, using ELAN software. Preterm infants born after 25-weeks gestational age (GA) were included while being between 34- and 36-weeks PMA. A perinatal risk inventory score > 10 for the infant precluded from inclusion. Interrater reliabilities were assessed independently by two raters blind to the clinical situation of the mother and infant.ResultsThe resulting PRICOSMAS encompassed two four-item SS sections, one covering the preterm infant's SSs and the other, the mother's SSs. Reliability was assessed on a sample of 26 videorecorded observations for 13 mother-preterm infant dyads. Infants' mean age at birth was 30.4 ± 3.1-weeks GA (range: 26.4–35) and PMA at the time of the test was 34.7-weeks (±0.8). Internal consistency ranged from 0.81 to 0.89. Interrater reliability ranged from substantial to almost perfect (0.73–0.88).ConclusionThis study shows that the infants' SSs and MS can be reliably scored in preterm infants as young as 34- to 36-weeks PMA. Our findings suggest that the PRICOSMAS is sufficiently reliable for use, including in NICU, by healthcare professionals or researchers for coding early parent-infant interactions with 34- to 36-week PMA preterm infants.

Executive Functions and mental health

This research seeks to clarify the role that executive functions play in the treatment and prevention of psychiatric disorders. Mental health is a cornerstone for the development of societies, and it is affected to the problem of availability of an effective, lasting, and no-side effects treatment that help in mental disorder recovering which has been known to rise in terms of their forms and the number of sufferers around the world, especially in low to middle-income societies. This study, with an analytical descriptive approach, aims at shedding light on a recent trend in the treatment and prevention of mental disorders, especially in their early stages. The originality of this study lies in touching on functions that are rarely tackled in our societies, as a kind of prevention and treatment, by integrating them within the children’s school track, and developing training programs on them that take into account the local culture, intending to achieve a balanced psychological immunity in societies. This study has concluded the importance of the role of executive functions in the treatment of several mental disorders, in addition to the preventive role played by these abilities in limiting the emergence of some diseases despite the availability of genetic factors behind their emergence. Keywords: Executive Functions, Mental Health, Psychiatric Disorders, Cognitive Neuropsychology, Training programs

Effectiveness of Nurse-Led Interventions for the Prevention of Mental Health Issues in Patients Leaving Intensive Care: A Systematic Review.

This study aimed to evaluate the effectiveness of nurse-led interventions for the prevention of mental health disorders after intensive care unit discharge through a systematic review of the literature. The searches were conducted in the MEDLINE (via PubMed), CINAHL, PsycINFO, and Cochrane Library databases for studies pertaining to such interventions. Two independent reviewers analyzed the studies, extracted data, and assessed the quality of the evidence. Six eligible articles were identified, all of which were regarding post-traumatic stress disorder after intensive care unit discharge. Some of the interventions were conducted during the admission and some after the discharge. One study found that multimedia education during admission improved anxiety and depression one week after discharge. The remaining five studies concluded that nurse-led interventions did not prevent mental health disorders three months to one year after intensive care unit discharge. Our review revealed a paucity of research into the effectiveness of nurse-led interventions for the prevention of mental health disorders after intensive care unit discharge. The timing and the content of these interventions, and the adequate training of nurses, appear to be key factors. Therefore, multidisciplinary interventions are likely to be more effective than those led by nurses alone.

The impact of covid-19: Anxiety, depression, and wellbeing among medical students.

Medical students have been considered as a vulnerable group at higher risk of mental health issues during the COVID-19 outbreak. We set out to detect symptoms of depression and anxiety in medical students in St. Petersburg (Russia) during the first wave of COVID-19 outbreak and explore the associations between psychosocial factors related to the pandemic and students' psychological well-being. An anonymous online survey of medical students was conducted in May-June 2020. The Hospital Anxiety and Depression Scale (HADS) was used for screening anxiety and depression symptoms. The final sample consisted of 144 students (78.5% females). About 69.4% of respondents reported that COVID-19 pandemic and social restrictions were a new source of stress in their lives. More than one-third (38.9%) of respondents reported a need for psychological (emotional) support due to a change in their daily life during the COVID-19 pandemic, with the vast majority (83.9%) of these respondents indicated an increased need for support in this specific period. Symptoms of anxiety were reported by 55.8% of females (HADS score: 9.05 ± 4.69) and 48.4% of males (8.09 ± 5.0), and symptoms of depression were found in 38.9% of females (6.40 ± 3.57) and 41.9% of males (6.16 ± 3.21). These findings indicate that it is necessary to develop additional measures for the prevention and early diagnosis of mental disorders along with right levels of support for wellbeing and mental health of medical students in this ongoing pandemic.

Understanding Importance of Mental Health and Therapy in India

The research article has focused on understanding the importance of Mental Health and Therapy in India from the aspect of laws and regulations such as Mental Health Policy 2014 (MHP 2014) and The Mental Healthcare Act 2017 (MHCA 2017) regarding psychological aspects. Primary reason for working on this aspect is that mental health is an integral part of the health of people that goes beyond providing therapy for mental illness by encouraging people for effective functioning and well-being through rehabilitation, treatment, and prevention of mental disorders. The themes that have helped in working on this aspect include Paradigm Shift in The Medical Model Of Disability, Cost of Estimation of Mental Healthcare Act of 2017 in India, Mental Healthcare is a Justiciable right, and, Mental health of Child and Adolescent is a matter of Concern. This study has also discussed every aspect of the result collected from the journal articles in minute detail. Keyword : Mental Health, Mental Health Therapy, Therapy, India, Mental healthcare in India, Mental Healthcare Act, Awareness, and psychological law

Nutrition and mental health: A review of current knowledge about the impact of diet on mental health.

Applied psychopharmacotherapy and psychotherapy do not always bring the expected results in the treatment of mental disorders. As a result, other interventions are receiving increasing attention. In recent years, there has been a surge in research on the effects of nutrition on mental status, which may be an important aspect of the prevention of many mental disorders and, at the same time, may lead to a reduction in the proportion of people with mental disorders. This review aims to answer whether and to what extent lifestyle and related nutrition affect mental health and whether there is scientific evidence supporting a link between diet and mental health. A review of the scientific evidence was conducted based on the available literature by typing in phrases related to nutrition and mental health using the methodological tool of the PubMed database. The literature search yielded 3,473 records, from which 356 sources directly related to the topic of the study were selected, and then those with the highest scientific value were selected according to bibliometric impact factors. In the context of current changes, urbanization, globalization, including the food industry, and changes in people’s lifestyles and eating habits, the correlations between these phenomena and their impact on mental state become important. Knowledge of these correlations creates potential opportunities to implement new effective dietary, pharmacological, therapeutic, and above all preventive interventions. The highest therapeutic potential is seen in the rational diet, physical activity, use of psychobiotics, and consumption of antioxidants. Research also shows that there are nutritional interventions that have psychoprotective potential.

Multiple Composite Scenarios: A Game-Based Methodology for the Prevention of Mental Disorders

Prevalence and incidence of mental disorders are on the rise. However, in comparison, the number of experts capable of treating them is not growing at the same rate. To address those issues, we devised a game-based methodology for the prevention of mental disorders: the Multiple Composite Scenarios (MCS). To prevent, MCS follows guidelines from Prevention Interventions and Cognitive Behavioural Therapy (CBT). Based on the MCS methodology, we created Guardians of the Crystal, a serious game that aims to contribute to the prevention of Anorexia Nervosa (AN) in young girls. To observe the effects produced by a MCS-based game and to explore its therapeutic value, we tested Guardians in a randomised, controlled trial. As results suggest, Guardians can help reduce the effects produced by risk factors related to the onset of the disorder. In this work, we present our methodology, discuss its benefits and limitations, provide a brief guide of use, and talk about our future work.

In Case You Haven't Heard…

Despite the best efforts of clinicians and researchers for decades, there is still so much uncertainty about why some people develop mental disorders and others do not, the nonprofit journalism organization, The Conversation, reported Aug. 4. However, changes in the brain very likely offer the best clues to future mental health outcomes. The adolescent brain is particularly important in these predictions because brain changes during this time are rapid and dynamic, shaping a person's individual uniqueness. By monitoring and tracking brain changes as they happen, [researchers] contend that they can tackle emerging mental health problems in adolescence and target early treatment. The challenge is in accurately predicting the likelihood of a person developing a mental disorder before it happens. In a paper published recently in NeuroImage, study authors used data from the Australian Longitudinal Adolescent Brain Study that monitors changes in adolescents' brains. “We have been tracking adolescent brain development, using MRI scans, for several years,” stated researchers. “Our recent paper is the first to show [that] the uniqueness of an adolescent's brain (or their ‘brain fingerprint') can predict mental health outcomes. Brain fingerprinting could be the future of mental disorder prevention, allowing us to identify signs of concern in teenagers through brain imaging and intervene early, before illness develops.”

Coping with Stress in Neoplastic Diseases.

Introduction: Disease-related stress is a common phenomenon. It also occurs in neoplastic diseases. Since physical and mental health are interrelated, it is important to make sure that treatment covers these two areas. Therefore, it is essential to learn how patients with neoplastic diseases can cope with stress. Materials and Methods: The respondents are 306 patients suffering from neoplastic diseases, associated in patient advocacy groups. The method is the Brief-COPE (Coping Orientation to Problems Experienced) questionnaire. Results: The following stress management strategies were most commonly adopted by the patients: acceptance (median 2.25; 25–75% IQR 2.0–3.0), active coping (median 2.0; 25–75% IQR (interquartile range) 1.5–2.0), planning (median 2.0; 25–75% IQR 2.0–2.0), emotional support (median 2.0; 25–75% IQR 1.5–2.0), instrumental support (median 2.0; 25–75% IQR 2.0–2.0), self-distraction (median 2.0; 25–75% IQR 1.5–3.0), and venting (median 2.0; 25–75% IQR 1.5–3.0). A decision to adopt a particular stress management strategy by patients with neoplastic diseases was highly affected by demographic factors (p < 0.05), such as sex, education, age, place of residence and employment. Conclusions: Teaching stress management strategies should be a part of the education process among patients with neoplastic diseases. Before or in the course of treatment, an oncology patient should be educated on the prevention of mental health disorders. The ability to cope with stress is one of the key competences for the course of neoplastic diseases and it can affect the treatment process. Stress management in chronic diseases, including neoplastic diseases, should be approached not only at the level of an individual person but also at the level of the health system as a whole.

Challenges in the Adoption of eHealth and mHealth for Adult Mental Health Management-Evidence from Romania.

New methods of connecting physicians and patients have arisen. Technology is playing a crucial role and the concept of hybrid doctor–patient relationship is considered relevant for the competitive health management system. At the same time, the need for knowledge about implementing policies and best practices into the system is highly demanding. Digital tools, such as eHealth or mHealth can improve the traditional approach to consulting patients without requiring face-to-face interaction. However, due to the discussion surrounding the adoption of these technologies, the authors performed the study with two marketing research methods. The first is qualitative and is related to the opinions, attitudes, and beliefs of Romanian experts on the use of eHealth and mHealth for the prevention, detection, and treatment of mild mental disorders. The second method quantifies the opinions, attitudes, and behaviours of Romanian adults on their openness to adopt new technologies for mental health management. The main findings of the research highlight three factors that can increase the chances of adults using technology for health-related needs: (1) accessibility (2) data security, and (3) content. These are the main aspects that influence the well-being of both young and older adults, who both need support regarding mental health management.

Therapeutic and Prophylactic Effects of Amphotericin B Liposomes on Chronic Social Defeat Stress-Induced Behavioral Abnormalities in Mice.

Recently, innate immune system stimulants, such as lipopolysaccharide (LPS) and macrophage-colony stimulating factor (M-CSF), were reported to prevent and reverse chronic stress-induced behavioral abnormalities, suggesting that innate immune stimulation could be a potential strategy for the treatment and prevention of mental disorders. Amphotericin B liposome is a clinically available antifungal medication that can stimulate macrophages and microglia. We hypothesize that amphotericin B liposome may be used to prevent and reverse behavioral abnormalities triggered by chronic stress. As expected, our results showed that a single injection of amphotericin B liposome (1 mg/kg) immediately after stress cessation reversed the decrease in time spent in the interaction zone in the social interaction test (SIT) and the increase in immobility time in the tail suspension test (TST) and forced swimming test (FST) in mice caused by chronic social defeat stress (CSDS). In addition, a single injection of amphotericin B liposomes (1 mg/kg) 1 day before stress exposure was found to prevent the CSDS-induced decrease in time spent in the interaction zone in the SIT and the increase in immobility time in the TST and FST in mice. Pretreatment with minocycline to inhibit the innate immune response was able to abolish the reversal effect of post-stress injection of amphotericin B liposomes on CSDS-induced behavioral abnormalities and the prophylactic effect of pre-stress injection of amphotericin B liposomes on CSDS-induced behavioral abnormalities. These results demonstrate that amphotericin B liposomes have both therapeutic and prophylactic effects on chronic stress-induced behavioral abnormalities in mice by mobilizing the innate immune response.

Clinical high at-risk mental state in young subjects accessing a mental disorder prevention service in Italy

We aim to assess how functioning, depressive symptoms, and psychotic symptoms are associated with different numbers of Clinical High At-Risk Mental State (CHARMS) categories. In this cross-sectional study, we assessed 62 help-seeking subjects aged 15-24 with a drop in functioning, with Structured Clinical Interview for DSM-5, Social and Occupational Functioning Assessment Scale (SOFAS), Comprehensive Assessment of At-Risk Mental State to define risk for psychosis, Hamilton Depression Rating scale (HAM-D), Positive and Negative Symptoms Scale, 6 items (PANSS-6). CHARMS criteria were assessed via retrospective chart review. Overall, 30.6% did not meet any CHARMS component criteria at baseline (CHARMS-), 27.4%, 33.9% and 8.1% met one, two, and three or more CHARMS groups. Overall, 48.8% met criteria for ultra-high risk for psychosis (17.7% without other CHARMS categories), 25.8% risk of borderline personality disorder (3.2% alone), 35.5% mild depression (8.1% alone), 11.3% risk of bipolar disorder (1.6% alone). SOFAS score and HAM-D score worsened from CHARMS- to three or more CHARMS categories, whilst PANSS-6 score did not. In a multivariate regression only PANSS-6 (beta=-1.105, p<0.001) was associated with SOFAS (R2=0.385). Help-seeking youth with poor functioning present symptoms meeting CHARMS criteria. Meeting criteria for multiple CHARMS categories is associated with increased depressive, but not psychotic symptoms, while psychotic symptoms play a prominent role in determining functional impairment. Results should be interpreted within the limitations of the study including the small sample size and the cross-sectional design, and need further replications.