Mental Disorders Research Articles

Genomics-driven integrative analysis highlights immune-related plasma proteins for psychiatric disorders

Genomics-driven integrative analysis highlights immune-related plasma proteins for psychiatric disorders

Of strong swords and fine scalpels: Developing robust clinical principles to cut through heterogeneity.

This is an invited commentary article for the special issue. The main thesis is that an effective strategy for computational psychiatry to handle the (possibly intrinsic) heterogeneity of psychiatric disorders is to focus on developing clinical principles rather than solely precision medicine. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Neuro-pharmacological Assessment of Coleus forskohlii for Anti-compulsive Activity in Swiss Albino Mice

Background: Obsessive-Compulsive Disorder (OCD) is a common psychiatric illness characterized by obsessions or compulsions that significantly disrupt or impair daily functioning. Coleus forskohlii, a significant medicinal crop, has forskolin in its roots. It is utilized extensively as food and medicine all over the world. Coleus forskohlii has reputed medicinal uses, which include antidepressant, antiaggregant, cAMP-genic, anticancer, etc. Objective: This study used mice models of marble burying and nestlet shredding to assess the potential efficacy of Coleus forskohlii against obsessive-compulsive disorder. 8-hydroxy-2-(di-npropylamino) tetralin (8-OH-DPAT) induced compulsive checking can demonstrate OCD-like repetitive and obsessive behavior as well as neurotransmitter imbalance (serotonin). Methods: Each group had six mice, and the therapy was administered to the animals for a total of 15 days. On days 1, 7, and 14, the marble burying test was assessed for 30 minutes, and on days 2, 8 and 15, the nestlet shredding test was assessed for 30 minutes. The T-maze paradigm was used to assess anti-OCD activity. The brain histology and morphometry were also performed. Results: When compared to the control group, treatments with Coleus forskohlii (50 and 100 mg/kg, p.o.) significantly enhanced performance on both behavior tests. The SAB score is dramatically increased following the administration of the 8-OH-DPAT (2 mg/kg, i.p.) group. Coleus forskohlii (50 and 100 mg/kg, p.o.) and fluoxetine (15 mg/kg, p.o.) groups showed significantly lowered results. Animals treated with 8-OH-DPAT showed a considerable reduction in serotonin levels. Following Coleus forskohlii administration, the histology of the brain tissues showed normal morphological structure with no toxicity or abnormalities. Conclusion: The combination of all these findings points to Coleus forskohlii delivering a possible therapeutic option for the treatment of OCD. The identification and anticompulsive properties of the components from Coleus forskohlii should be the main aim of future studies.

Identifying childhood pesticide exposure trajectories and critical window associated with behavioral problems at 10 years of age: Findings from SMBCS

BackgroundPesticides may impact children’s neurodevelopment. As children’s metabolic function and neural plasticity change throughout their growth and development, the effects of pesticide exposure may also vary. ObjectivesWe aimed to identify the trajectories of combined pesticide exposure during childhood, and examine the associations of the exposure trajectories with children’s neurobehavior at the age of 10. MethodsWe involved repeated measurements of three pesticide metabolites [Pentachlorophenol (PCP), 3,5,6-Trichloro-2-pyridinol (TCPy), and Carbofuran phenol (CFP)], in urine samples collected from children in a cohort study at ages 1, 2, 3, 6, 7, 8, 9, and 10 years. The group-based multi-trajectory model (GBMT) and latent class analysis (LCA) were separately utilized to describe the distinct trajectories and patterns of pesticide mixture exposure during childhood. Meanwhile, the Strengths and Difficulties Questionnaire (SDQ) and attention deficit hyperactivity disorder (ADHD) Criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) list were applied to assess behavioral disorders in children. The associations between exposure trajectories and behavioral problem scores were then examined. ResultsThe GBMT model delineated three distinct trajectories of combined pesticide exposure among children: consistently low, higher levels in early childhood transitioning to lower levels during pre-school age, and lower levels in early childhood followed by higher levels in the middle childhood. The LCA model identified three similar longitudinal exposure patterns. Further, the children in the second trajectory group identified by GBMT, characterized by higher early childhood exposure levels, exhibited significantly elevated hyperactivity/inattention scores of the SDQ compared to the other two groups (β = 0.46, 95 %CI: 0.11, 0.81; β = 0.44, 95 %CI: 0.02, 0.86). ConclusionsOur study revealed that exposure to pesticides during early childhood (especially before the age of two), rather than other age periods, was linked to hyperactivity/inattention problems in children aged 10 years. We also provided a novel perspective on characterizing the fluctuation in repeated measurements of multiple environmental chemicals and identifying the potential critical windows.

Integrating threat conditioning and the hierarchical taxonomy of psychopathology to advance the study of anxiety-related psychopathology.

Theoretical and methodological research on threat conditioning provides important neuroscience-informed approaches to studying fear and anxiety. The threat conditioning framework is at the vanguard of physiological and neurobiological research into core mechanistic symptoms of anxiety-related psychopathology, providing detailed models of neural circuitry underlying variability in clinically relevant behaviors (e.g., decreased extinction, heightened generalization) and heterogeneity in clinical anxiety presentations. Despite the strengths of this approach in explaining symptom and syndromal heterogeneity, the vast majority of psychopathology-oriented threat conditioning work has been conducted using Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic categories, which fail to capture the symptom-level resolution that is afforded by threat conditioning indices. Furthermore, relations between fine-grained neurobehavioral measures of threat conditioning and anxiety traits and symptoms are substantially attenuated by within-category heterogeneity, arbitrary boundaries, and inherent comorbidity in the DSM approach. Conversely, the Hierarchical Taxonomy of Psychopathology (HiTOP) is a promising approach for modeling anxiety symptoms relevant to threat conditioning work and for relating threat conditioning to broader anxiety-related constructs. To date, HiTOP has had a minimal impact on the threat conditioning field. Here, we propose that combining the HiTOP and neurobehavioral threat conditioning approaches is an important next step in studying anxiety-related pathology. We provide a brief review of prominent DSM critiques and how they affect threat conditioning studies and review relevant research and suggest solutions and recommendations that flow from the HiTOP perspective. Our hope is that this effort serves as both an inflection point and practical primer for HiTOP-aligned threat conditioning research that benefits both fields. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Making the most of errors: Utilizing erroneous classifications generated by machine-learning models of neuroimaging data to capture disorder heterogeneity.

Within-disorder heterogeneity complicates mapping the neurobiological features of psychopathology to Diagnostic and Statistical Manual of Mental Disorders conceptualizations. The present study explored the patterns of diagnostic classification errors among disorders with commonly co-occurring features to examine this heterogeneity. Classification analyses were conducted with the University of California, Los Angeles Phenomics Study database using a support-vector classifier to differentiate disorders via whole brain task-based functional connectivity, predicting that model misclassifications would provide insight about brain connectivity characteristics shared across disorders. Whether symptoms and specific brain networks could account for misclassification rates was also explored. The classification model performed better than chance (44% accuracy, p = .01) and revealed that misclassification of schizophrenia (SCZ) as bipolar disorder (BD; 38%) and BD as SCZ (36%) was symmetrical. Attention-deficit/hyperactivity disorder (ADHD) was misclassified as BD at the highest rate (46%) and higher than the converse (17%). SCZ and ADHD were misclassified least (15% SCZ as ADHD and 22% ADHD as SCZ). Considerable variance in misclassification of SCZ as BD (R2 = .83) and BD as SCZ (R2 = .71) could be accounted for by symptoms of both SCZ and BD. Permutation testing revealed disorder- and network-specific effects, with certain networks improving classification accuracy and others hindering it for specific disorders. An approach focused on classification errors replicated known disorder overlap, producing errors in the expected configuration. Further, it identified clinical and neural features within and across diagnostic categories that contribute to disorder misclassification and within-disorder heterogeneity. This approach may facilitate neurobiologically informed phenotypic differentiation within diagnostic groups. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Fathers' impact on outcomes in the treatment of eating disorders: A scoping review.

Male caregivers' participation in eating disorder (ED) treatment for their affected children is less consistent than female caregivers', with unclear effects. To clarify the impact, this scoping review examined literature on male caregiver involvement in ED treatment, focusing on its impact on fathers, treatment processes, and their affected children. A search encompassing English and French peer-reviewed articles from 1990 to 2022 was conducted. Studies distinguishing between mothers and fathers, addressing Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases ED diagnoses, and involving active interventions were included. From 1651 initially identified articles, 251 were retained after abstract and title review, and 45 metall criteria. Documented outcomes indicated fathers' engagement in ED treatment improved their well-being and family functioning, but these gains were not consistently tied to treatment outcomes. Father attendance, improved caregiving skills, and their expectations of treatment correlated with better outcomes for their affected child. Father involvement in ED treatment remains under-explored. This review emphasises fathers' positive impact while highlighting the need to better understand the link with overall patient outcomes. We call for proactive exploration of how to surmount barriers to fathers' involvement and ensure that paternal contributions are optimised in ED treatment alongside those of female caregivers.

An evaluation of measurement invariance of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition borderline personality disorder criteria across heterosexual, lesbian, gay, and bisexual adults.

There is a robust, yet poorly understood relationship between nonheterosexual orientation and borderline personality disorder (BPD), with lesbian, gay, and bisexual individuals evidencing greater BPD symptoms compared to heterosexual individuals. Recent evidence suggests possible psychometric bias in BPD diagnostic criteria leading to greater endorsement among sexual minority individuals, which hinders researchers' ability to make valid group comparisons. The present study utilized an epidemiological sample of 35,995 men and women to evaluate the extent of differential item functioning (DIF) among BPD criteria across sexual orientation groups using a multiple indicators multiple causes approach. All criteria except affective instability and emptiness indicated DIF for at least one sexual minority focal group, although both demonstrated DIF in sensitivity analyses. DIF was most consistently indicated for suicidality, efforts to avoid abandonment, and impulsivity. Contrary to predictions, DIF was mostly nonuniform with greater item discrimination for sexual minority groups compared to their heterosexual counterparts. Finally, all estimated effect sizes were small, suggesting that DIF was not practically meaningful and unlikely to impact the validity of group comparisons for BPD criteria across heterosexual and nonheterosexual men and women. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Optimized psilocybin production in tryptophan catabolism-repressed fungi.

The high therapeutic potential of psilocybin, a prodrug of the psychotropic psilocin, holds great promise for the treatment of mental disorders such as therapy-refractory depression, alcohol use disorder and anorexia nervosa. Psilocybin has been designated a 'Breakthrough Therapy' by the US Food and Drug Administration, and therefore a sustainable production process must be established to meet future market demands. Here, we present the development of an invivo psilocybin production chassis based on repression of l-tryptophan catabolism. We demonstrate the proof of principle in Saccharomyces cerevisiae expressing the psilocybin biosynthetic genes. Deletion of the two aminotransferase genes ARO8/9 and the indoleamine 2,3-dioxygenase gene BNA2 yielded a fivefold increase of psilocybin titre. We transferred this knowledge to the filamentous fungus Aspergillus nidulans and identified functional ARO8/9 orthologs involved in fungal l-tryptophan catabolism by genome mining and cross-complementation. The double deletion mutant of A. nidulans resulted in a 10-fold increased psilocybin production. Process optimization based on respiratory activity measurements led to a final psilocybin titre of 267 mg/L in batch cultures with a space-time-yield of 3.7 mg/L/h. These results demonstrate the suitability of our engineered A. nidulans to serve as a production strain for psilocybin and other tryptamine-derived pharmaceuticals.

Sufficient sleep and physical activity can relieve the effects of long-term exposure to particulate matter on depressive symptoms among 0.31 million children and adolescents from 103 counties in China.

Although long-term exposures to air pollutants have been linked to mental disorders, existing studies remain limited and inconsistent. We investigated the relationship between exposure to particulate matter (PM) and depressive symptoms, as well as the potential role of sleep duration and physical activity. Using the surveillance data (2019 to 2022) of common diseases and risk factors among 312,390 students aged 10-25years, logistic regression, generalized liner model (GLM) and restricted cubic spline (RCS) were employed to investigate the relationship between long-term exposure to PM and depressive symptoms. Significant associations were found between PM1 (OR=1.21, 95% CI: 1.12-1.32), PM2.5 (OR=1.24, 95% CI: 1.19-1.38), and PM10 (OR=1.87, 95% CI: 1.69-2.07) and increased risks of depressive symptoms. Sleep duration and physical activity relieved these associations. The odds ratios (ORs) of PM1, PM2.5, and PM10 on depressive symptoms were lower in group with sufficient sleep (1.02 vs. 1.49, 1.20 vs. 1.80, 2.15 vs. 2.23), lower in group with high level MVPA (1.13 vs. 1.48, 1.14 vs. 1.58, 1.85 vs. 2.38), and lower in group with high level outdoor activity (1.19 vs. 1.55, 1.23 vs. 1.63, 1.83 vs. 2.72). Conclusions about causality remain speculative because of the cross-sectional design. Sufficient sleep duration and outdoor activity may mitigate the decline in mental health among adults in developing countries caused by long-term exposure to PM. This contribution enhanced our understanding of the mechanisms linking air pollution to mental health.

Virtual connection and real community: the qualitative experience of participating in a videoconferencing-based psychotherapy group for postpartum depression and anxiety

BackgroundGroup psychotherapy, an effective treatment for common postpartum mental disorders (e.g. depression, anxiety), has increasingly been delivered virtually since the pandemic. This study aims to understand experiential aspects of participating in videoconferencing-based group psychotherapy in the postpartum period.MethodsOur urban academic ambulatory hospital has delivered group psychotherapy for women (cis and trans) and non-binary individuals of female sex with postpartum depressive and anxiety symptomatology via videoconferencing since 2020. One therapist-facilitator conducts weekly 60-min group therapy sessions with 5-6 participants for eight weeks. Group participants were invited to complete a semi-structured qualitative interview on their experience. Using an interpretive description approach, we conducted reflexive thematic analysis to code anonymized transcripts and construct themes. Facilitator interviews were used for triangulation and additional context.ResultsOf 134 patients in video psychotherapy groups over 11 months, 14 completed an interview, as did all group facilitators (n = 3). Overall, participants felt the experience with videoconferencing group therapy was beneficial for their mental health. Three themes were constructed: (1) “Moving Towards a New Normal”: The group helped participants normalize feelings and experiences around transition to parenthood, and accessing health care virtually was now considered to be normal practice, although some wanted an element of choice. (2) “Virtual Connection, Real Community”: Connections were made virtually, yet participants felt a real sense of community. Facilitators played an important role fostering an environment in which participants could create lasting bonds. Participants noted challenges with feeling comfortable virtually and provided pragmatic and structural suggestions for enhancing the creation of community. (3) “Trade-offs to Virtual Engagement”: Participants made positive and negative trade-offs (e.g. no informal interactions, travel, isolation at home, childcare challenges) to maximize their experience and were able to be more authentic in their self-presentation to the group.ConclusionsPeople with postpartum depression and anxiety who participated in videoconferencing-based group psychotherapy appreciated the sense of community within their groups to normalize their experience transitioning to parenthood. Participants had to make trade-offs to access virtual groups, but felt the experience was worthwhile and helped improve their mental health. Findings will help inform continued delivery of virtual group mental health services.

The Causal Role of Thyroid Hormones in Bipolar Disorders: A Two-Sample Mendelian Randomization Study.

Bipolar disorder is a complex psychiatric condition with distinctions between clinical subtypes including Type 1 and 2 disorders. Several studies have proposed that thyroid hormones may be involved in the aetiology of bipolar disorders. This study employed a two-sample Mendelian randomization (MR) approach to investigate the causal relationships between six thyroid hormone metrics (TSH, FT4, FT3, TT3, FT3/FT4 and TT3/FT4) and bipolar disorder and Type 1 and 2 disorders, separately. Genome-wide association (GWAS) data from the ThyroidOmics Consortium (up to 271,040 individuals of European ancestry) were used for thyroid function metrics. Bipolar disorder GWAS data included 41,917 cases and 371,549 controls (25,060 Type 1 and 6,781 Type 2 cases). We applied inverse variance weighted (IVW) methods for primary MR analysis, with MR Egger, weighted median and weighted mode for sensitivity. Additional tests assessed horizontal pleiotropy and heterogeneity. Higher FT4 levels showed a protective causal effect against bipolar disorder (OR: 0.92, 95% CI: 0.86-0.97, p = 4.58 × 10-3) and a suggestive effect on Type 1 disorders (OR: 0.92, 95% CI: 0.86-0.99, p = 3.21 × 10-2). Elevated FT3 (OR: 1.18, 95% CI: 1.03-1.35, p = 1.55 × 10-2) and FT3/FT4 ratio (OR: 1.97, 95% CI: 1.02-3.82, p = 4.46 × 10-2) had suggestive harmful effects on Type 1 disorders. Sensitivity analyses showed consistent effects, with no significant horizontal pleiotropy or heterogeneity. These findings highlight the protective role of FT4 and the potentially harmful effect of elevated FT3 in Type 1 bipolar disorder, highlighting the need for further research on thyroid hormone levels as a potential treatment strategy for Type 1 bipolar disorder.

Interactions between pregnant women's nutrition habits, psychological well-beings, sleep quality and biochemical parameters.

Hormonal changes during pregnancy may cause various changes in biological, physiologic and psychosocial areas. The main objective of this study was to analyze the relationship between dietary habits, psychological well-being, sleep quality and biochemical parameters of pregnant women. The study was conducted on a total of 93 patients who applied to Ankara Koru Sincan Hospital Gynecology and Obstetrics Outpatient Clinic for routine pregnancy control between November-December 2023, were between the ages of 18-45, had a live singleton fetus, had no diagnosed psychiatric disease or chronic disease, and agreed to participate in the study. Anthropometric measurements and biochemical findings of the individuals were recorded with a questionnaire including the psychological well-being scale (PWBS) and Pittsburgh sleep quality index (PSQI). According to the study, PSQI scores during the second and third trimesters are significantly higher than the first trimester. It was observed that while individuals have bad sleep quality during the second and third trimesters, they have good sleep quality during the first trimester (χ2 = 14.736; P < 0.001). In the biochemical results, the thyroid-stimulating hormone (TSH) value in the second trimester was higher (P > 0.05). Weight gain during pregnancy, age and trimester have a negative effect on sleep quality. When the effects of lifestyles and eating habits of pregnant women on the process are considered, there is a relationship between smoking/alcohol consumption, less physical activity, poor eating habits, sleep quality and depressive symptoms. Factors such as age, educational background, trimester period and other basic sociodemographic variables are also involved.

Mental Health and Crime: Exploring the Link

This paper discusses the complex connection present in factors of mental health and criminality in people, or how various psychological disorders may shape the inclination towards crime and the manner in which crime is dealt with by the justice system. We critique and evaluate literature catered towards various aspects such as the extent of mental illness in offenders, the influence of mental conditions on making decisions and addressing the factors related to mental illnesses that may hinder rehabilitation such as stigma. To add on, we assess in what ways such sociocultural structures as socio- economic positioning, and availability of mental care, relation to crime and mental health. Using a transdisciplinary perspective, we seek to develop implementation strategies and proposals that would serve people with mental health illness in correctional facilities, in a way that would not compromise fairness and encourage rehabilitation. The data indicate that enhancing mental health services and embedding mental health care into the criminal justice system can minimize the rates of reoffending and beneficially impact individual’s lives as well as the overall society.

Implementasi Penegakan Hukum Undang-Undang Nomor 18 Tahun 2014 terhadap Perlindungan Hukum dan Kendalanya pada Orang dengan Gangguan Jiwa di Kota Semarang

The number of people with mental disorders in Semarang City continues to increase. The large number of people with mental disorders in Semarang needs to be addressed seriously to prevent causing discomfort in social activities. Therefore, the author compiled a journal titled "Implementation of Law Enforcement Law Number 18 of 2014 concerning Legal Protection and Constraints on People with Mental Disorders in Semarang City." This journal aims to uncover issues related to how the implementation of Law Number 18 of 2014 on law enforcement against legal protection for people with mental disorders in Semarang City and what factors cause people to experience mental disorders in Semarang City. The research method used in this study is a qualitative method with a socio-legal juridical approach. The data used in this study was obtained using data collection techniques through interviews conducted with Mrs. Lela Dwipayana, S.H. as the Social Rehabilitation Staff of the PMKS Guidance Service Sub-Coordinating Social Welfare Services. The results of this study found that Law Number 18 of 2014 on Mental Health has protected people with mental disorders by being handled by the Social Service in Semarang City.

The Role of Animal Assisted Therapy in the Rehabilitation of Mental Health Disorders: A Systematic Literature Review

Mental health disorders like depression, anxiety, post-traumatic stress disorder (PTSD), and schizophrenia significantly reduce the daily functioning and quality of life of individuals. Traditional treatments often fall short, thus opening interest in complementary therapies like animal assisted therapy (AAT) which encourages the human-animal bond and gives emotional and psychological support. This review evaluated the efficacy of AAT in treating mental health disorders, and understanding its mechanisms and benefits. A comprehensive literature review was conducted (using databases such as PubMed, Google Scholar, and ResearchGate) focused on peer-reviewed articles, systematic reviews and meta-analyses published in the last 2 decades. Studies indicated that AAT improved mental health outcomes for people with depression, anxiety, PTSD, and schizophrenia. Interaction with therapy animals reduced cortisol levels, increased oxytocin, lowered blood pressure, and increased social engagement and emotional regulation. Benefits included reduced symptoms of depression, anxiety, PTSD, and improved social functioning and quality of life. AAT offered a complementary treatment for mental health disorders, providing emotional comfort, improving mood, and serving as a nonpharmacological option for individuals. However, challenges such as individual preferences, allergies, ethical concerns for therapy animals, and logistical issues must be addressed. Future research should focus on the long-term effects and mechanisms involved to optimize the application of AAT in the clinical setting, and alternatives like robotic companion pets could also be explored.

Using Virtual Reality in Mental Health Nursing to Improve Behavioral Health Equity.

Nursing students often experience anxiety, stress, and fear during a clinical rotation in a mental health setting due to stressors and biases toward the setting as well as lack experience in caring for patients with mental health conditions. One in four people worldwide suffers from a mental disorder; therefore, it is critical that nurses feel confident interacting with these patients to provide equitable care. Undergraduate training is a critical period for changing students' attitudes toward this population. This study's goal was twofold. First, we offered students' exposure to common behaviors and symptoms displayed by a patient with mental illness through an engaging and immersive virtual reality simulation experience before taking care of patients in a clinical setting. Second, we aimed to determine if a virtual reality simulation will change students' attitude and stigma, favorably, toward patients with mental health conditions. We used a mixed-method comparative analysis to collect information and identify themes on undergraduate students' attitudes and stigma toward patients with mental health conditions. Our findings demonstrate that virtual reality simulations enhance awareness and sensitivity to the situations of others (empathy) while improving their communication skills. The use of virtual reality in a baccalaureate curriculum deepens the understanding of health equity in behavioral health for nursing students.

Breast Cancer and Mental Health: Incidence and Influencing Factors—A Claims Data Analysis from Germany

Background/Objectives: With breast cancer (BC) survival improving due to optimized therapy, enhancing quality of life has become increasingly important. Both diagnosis and treatment, with their potential side effects, pose risks to mental well-being. Our study aimed to analyze the incidence and potential risk factors for mental disorders in BC patients. Methods: This retrospective analysis used claims data from AOK Baden-Wuerttemberg, including 11,553 BC patients diagnosed via ICD code C50 between 2010 and 2020 and 31,944 age-matched controls. Patients with mental disorders in the 12 months prior to diagnosis were excluded. Mental disorders were categorized into eight groups based on ICD codes: anxiety, obsessive compulsive disorder, adjustment disorder, dissociative disorder, hypochondriac disorder, affective disorder, mania, and other neuroses. Results: Mental disorders were significantly more common in BC patients than in controls (64.2% vs. 38.1%, p &lt; 0.01, OR 2.91, 95%CI [2.79, 3.04]). In particular, hypochondriac, anxiety, affective, and adjustment disorders occurred significantly more often in BC patients. No differences were found for mania, bipolar disease, other neuroses, obsessive compulsive-, or dissociative disorders. Furthermore, endocrine therapy was associated with psychological comorbidities (OR 1.69, p &lt; 0.001, 95%CI [1.53, 1.86]), while primarily metastasized patients (stage C) had a lower risk than adjuvant patients in stage A (OR 0.55, p &lt; 0.0001, 95%CI [0.49, 0.61]). Regarding surgical treatment, mastectomy patients showed lower rates of mental illnesses (61.2%) than those with breast-conserving treatment (71.6%), or especially breast reconstruction (78.4%, p &lt; 0.01). Breast reconstruction was also associated with more hypochondriac (p &lt; 0.01) and adjustment disorders (p &lt; 0.01). Conclusions: So, BC patients experience significantly more mental disorders than controls, particularly when treated with endocrine therapy and breast reconstructive surgery.

Vedic astrological factors for human immunodeficiency virus transmission within male individuals with sexual orientation as homosexual

Background: For almost more than 70 years, the modern science had labeled homosexuality as a mental disorder and was part of DSM (Diagnostic and Statistical Manual of Mental Disorders) until the fifth edition was released in the year 2013 and homosexuality was removed from the mental disorder list. Despite of the removal of homosexuality along with all kind of sexual orientation from mental disorder, it is still being considered taboo in the society. From Sanatana Dharma perspective, homosexuality is very well mentioned in multiple scriptures. In Vedic Astrology as well, this homosexuality along with diseases due to sexual intercourse is being described. In this modern era, one of the most common disease due to sexual intercourse is HIV. Although, HIV is considered relatively new transmission due to its first scientific mention in the late twentieth century, the symptoms and overall nature of this disease is clearly described in Vedic Astrology. Finding: This research paper is an extension of the existing research paper in the field of Vedic Astrology especially in the field of Vedic Astrology focusing on HIV transmission. A total of 314 HIV positive samples was collected from 18 countries selected from Asia, Europe, North America, South America, Africa as well as Australia in order to have a coverage of all the continents. All these HIV positive people belong to LGBT community, to be very specific Gay (homosexuals) and have been identified as HIV transmission due to anal intercourse with another Gay partner. The Astrological Natal Chart were analyzed for all these 314 samples against the KIRAN sutra (5 thumb rules) to find the possibility of HIV based on the sutras i.e. rules. Out of 314 samples, 310 charts fit the criteria (KIRA sutra) mentioned in the KIRAN sutra for HIV transmission. 4 samples were not checked against the criteria (N) due to insufficient Nakshatra-Pada i.e. Constellation-Phase coverage along with the complex nature of the Nakshatra sutra i.e. N sutra of KIRAN sutra. The result indicates that the KIRAN sutra is very effective sutra even to identify the HIV transmission from male-to-male partner with an accuracy of 98.73% (310 cases out of 314 cases) using only 4 sutras i.e. KIRA. Conclusion: The research is an effort to raise awareness and to help males with homosexual orientation to identify whether they are highly prone to HIV or not using their Vedic Astrological Natal Chart so that they can take preventive action. A new yoga i.e. Samalaingika Yauna Sankramaṇa Yoga is being introduced in the field of Medical Astrology focusing on males with sexual orientation as homosexual, commonly known as Gay in LGBT community in order to support Gays living a HIV free life without judging their sexual orientation. Novelty/Originality of this article: This study introduces the application of the KIRAN sutra from Vedic Astrology as a predictive method for assessing HIV transmission risk in homosexual men, achieving an accuracy rate of 98.73%, along with the introduction of a new configuration, Samalaingika Yauna Sankramaṇa Yoga.

E-Learning Modules for the Care of Caregivers of Older Filipinos

As the population ages, so does the challenge to the care of older people with mental health problems. Geriatric syndromes such as delirium, dementia, and depression are amenable to medical management. Beyond care of the patient, however, is care for the caregiver. Behavioral and Psychological symptoms of Dementia (BPSD) such as agitation, aggression, and delusions increase the risk of caregiver stress. This may lead to strain of individual carers and household members, increasing the patient’s risk for poor care, abuse, or institutionalization. Caregiver education and skills training help reduce the level of caregiver stress. These are usually delivered face to face during clinic visits or training modules by dementia care professionals. However, remote alternatives for education, learning and counselling became essential during the COVID-19 pandemic. E-workbooks and online learning modules on dementia, delirium, and depression written by professionals in the Philippines and Asia Pacific are available. An example is the Dementia Community Toolkit in English and its Filipino adaptation. The latter was developed by the Institute on Aging, National Institutes of Health, University of the Philippines Manila, with support from the Mental Health Unit of WHO WPRO. Patient support groups such as the Alzheimer’s Disease Association of the Philippines likewise developed online learning materials. These were and are still freely available via their websites and the webinars have been uploaded in internet and social media sites. The efficacy and acceptability of remote education to reduce informal caregiver burden, negative mood, and quality of life was published in a Cochrane meta-analysis. The authors analyzed experimental trials on information, training, or support compared to usual treatment, waitlist, or attention controls. Following several eligibility criteria, they identified 26 studies with 2367 participants in their review. Although most studies were of low quality and had uncertain risks of bias, there was small evidence that training plus support modules resulted in an improvement of caregiver knowledge. Training alone had no benefit on knowledge. Furthermore, there was no significant effect on patient institutionalization, caregiver burden depression, or quality of life. The article on E-Learning on knowledge on the 3Ds of Geriatric Psychiatry is a good start in understanding the capacity of well-educated Filipino caregivers to improve their knowledge on the subject. Beyond individual knowledge, E-learning modules have the capacity to guide families and communities in reducing ageism and improve patient care for older people with dementia, depression, and delirium. Further experimental studies are needed using locally developed modules. The bigger challenge is accessibility and acceptability of remote learning materials for the greater majority of informal caregivers with lower levels of education and poor access to online resources.