Psychiatric Diagnosis Research Articles

Evaluating the efficacy of support groups in the metaverse for Ukrainian refugees: a protocol for a randomized clinical trial

BackgroundThe Ukrainian crisis, sparked by the Russian invasion, has generated one of the most extensive refugee crises in modern history. Addressing the mental health challenges of Ukrainian refugees is critical to promoting their resilience and successful integration into host communities. Traditional support group interventions might be challenging to implement for geographically dispersed populations, making the metaverse an innovative and inclusive platform for providing much-needed support to such populations.Methods/designDisplaced Ukrainian refugee adults (18 years or older) without current psychiatric diagnoses or current involvement in therapeutic interventions are included in the study. Participants are randomized to one of three conditions: (1) Metaverse Support Groups, (2) In-Person Support Groups, or (3) Waitlist. Both intervention groups (Metaverse and In-Person) undergo 5 support group sessions, and data are collected at baseline, mid-intervention, post-intervention, and 3-month follow-up. Primary outcomes are depressive symptomatology and anxiety. Secondary outcomes are perceived social support, well-being, and gender-based violence awareness.DiscussionTo our knowledge, this is the first attempt to test the efficacy of support groups in the Metaverse for the Ukrainian refugee population. This study can thus add substantially to the body of knowledge on effective interventions and policies for refugees.Trial registrationClinicalTrials.gov Identifier: NCT06142032 (https://clinicaltrials.gov/study/NCT06142032). Registered on November 8, 2023.

Classification of Mental Disorders Using Modified Balanced Random Forest And Feature Selection

Classification of Mental Disorders Using Modified Balanced Random Forest And Feature Selection

Evaluation of Psychological Symptoms in Terms of Childhood Traumas, Spirituality, and Conflict Tactics in Sheltered Battered Women.

The aim of this study was to evaluate psychological symptoms in terms of childhood traumas, spirituality and conflict styles in women victims of violence staying in women's shelters. Violence against women is a major public health problem. Spiritual values and practices are especially important for women to cope with the negative effects of violence. The study was conducted in women's shelters in two provinces of the Ministry of Family and Social Policies in Türkiye. The sample consisted of 92 women who had been subjected to violence and stayed in a women's shelter for at least 15 days. The data were collected using the "Brief Symptom Inventory", "Conflict Tactic Scale", "Spiritual Well-Being Scale (SWBS)", "Childhood Abuse Experiences Scale Short Form", and "Introductory Information Form" created by the researcher, and the data obtained were evaluated in SPSS 22.0 program. Frequency, percentage, Pearson Product Moment correlation analysis, t-test, one-way analysis of variance (ANOVA) were used in the evaluation of the data. In all statistical analyses, p<0.05 was accepted as the significance level. It was found that 64.1% of the women in the study had at least one psychiatric diagnosis and major depression was in the first place (32.2%). According to the mean scores of the Brief Symptom Inventory, the relationships between all subdimensions except the somatization subdimension and the mean scores of the SWBS were found to be inversely significant at p<0.05 significance level. According to the mean scores of the SWBS, the relationships between all subdimensions except the transcendence subdimension and the mean scores of the Conflict Methods Scale were found to be inversely significant at the p<0.05 level of significance. According to the findings obtained from the study, it has been concluded that women should be encouraged to support them in order to be able to cope with the mental problems experienced in the psychiatric sense and to realize their spiritual beliefs and practices.

Factors that Influence Recovery From Concussion in Young Children and Preadolescents

Objective: To examine differences in the presentation and management of concussion in younger children (aged 4–8 years) versus preadolescents (9–12 years) and identify factors that influence recovery time. Design: Retrospective analysis of prospectively collected data. Setting: Pediatric sports medicine and orthopedics clinic. Patients: Three hundred seventy-five patients aged 4 to 12 years diagnosed with concussion between 2020 and 2022. Independent Variables: Age, gender, race/ethnicity, mechanism of injury (sport vs nonsport related), neurodevelopmental or psychiatric diagnosis, concussion history, Post-Concussion Symptom Scale (PCSS) score, and Vestibular Ocular Motor Screening (VOMS) overall change scores. Main Outcome Measures: Days since injury (DSI) to initial visit, total number of visits, recovery time (days). Results: Groups significantly differed in DSI (P = 0.01) and overall VOMS change score (P = 0.03). No differences were observed between groups on total number of visits or recovery time. Patients with fewer DSI [odds ratio (OR) = 1.15], less change in overall VOMS score (OR = 1.02), lower PCSS scores (OR = 1.02), and who were injured in sport were less likely to experience a protracted recovery. Conclusions: Younger children with concussion may be appropriately treated with a similar approach to preadolescent patients despite greater DSI and differences in VOMS change scores, without sacrificing overall recovery time. Consistent with research in older cohorts, protracted recovery was seen in nonsport patients, and patients seen sooner at a specialty concussion clinic were less likely to experience a protracted recovery, endorsed lower PCSS scores, and had lower overall VOMS change scores. Further research is needed to solidify a child-specific paradigm to concussion management.

International Swiss Primary Hypersomnolence and Narcolepsy Cohort Study (iSPHYNCS): the impact of psychiatric comorbidities on daily life in central disorders of hypersomnolence-a vicious circle.

Presence of psychiatric comorbidities is well documented in narcolepsy type-1 (NT1) but there are limited data on patients with 'other central disorders of hypersomnolence' (OCH). This study aimed to investigate frequency of psychiatric comorbidities in patients with NT1 and OCH, and to evaluate their impact on quality of life and sleep as an additive factor in combination with hypersomnolence-related symptoms. This study was conducted within the scope of the international Swiss Primary Hypersomnolence and Narcolepsy Cohort Study (iSPHYNCS), which aims to find new biomarkers in central disorders of hypersomnolence (CDH). Study participants underwent Mini International Neuropsychiatric Interview and completed questionnaires related to quality of life and sleep. Comparative analysis was conducted to investigate group differences, and multivariable regression models were used to reveal the impact of psychiatric comorbidities. Among a total of 90 patients, 26 were diagnosed with NT1 and 64 with OCH. In all, 38 patients showed at least one psychiatric disorder, 27% of NT1 and 48% of OCH, with female dominance (50% in females versus 23% in males, p < 0.02). Major depressive episodes (n = 29) were most common, followed by suicidality (n = 13). Patients with a psychiatric diagnosis were more fatigued (β = 0.70, p < 0.05), apathic (β = -5.41, p < 0.002), had more disturbed sleep (β = 0.55, p < 0.02), worse sleep (β = 1.89, p < 0.001) and general health (β = -12.55, p < 0.02) quality. Comorbid psychiatric disorders are frequent in patients with CDH and worsen the impact of hypersomnolence-related symptoms on daily activities regardless of the type of CDH. Psychiatric comorbidities may create a vicious circle with fatigue and avoidance of physical activities, which aggravates hypersomnolence-related symptoms.

"The efficiency of treatment practices in adolescents diagnosed with substance use disorder".

Substance abuse has been an increasingly common entity among youth, that has turned into one of the major concerns for almost all countries in the world. This study aimed to evaluate the efficiency of inpatient and outpatient treatment practises for adolescent diagnosed with susbtance use disorder (SUD). Participants included 30 adolescents with SUD in the outpatient unit, 30 in the inpatient unit, and a control group of 30 adolescents without psychiatric diagnoses. Measurements were taken at the beginning and end of an 8-week treatment program using CGAS and HoNOSCA scales. The 8-week treatment program significantly improved overall functioning and reduced psychiatric symptoms, with greater improvements observed in the inpatient group. Inpatient treatment resulted in better overall functioning and symptom improvement in adolescents with SUD. Long-term follow-up studies are needed.

Seven Identities Co-existing, A Noteworthy Manifestation of Complex Childhood Trauma: A Case Report

Background Childhood trauma increases the risk for psychiatric disorders such as Dissociative Identity Disorder (DID), Other Specified Dissociative Disorder (OSDD), Depersonalisation/Derealisation disorder (DDD), Post-Traumatic Stress Disorder Dissociative Type (D-PTSD), and Borderline Personality Disorder (BPD). Children who experience prolonged stress, trauma, or abuse during developmental years of growth and change have a wide range of outcomes. Case Presentation We report a case of a 22-year-old female with a significant history of physical abuse and sexual assault who initially presented to the hospital for suicidal ideation with a stated plan. During the patient’s stay at the hospital, we encountered two of the six alternate identities of the patient. The patient revealed she experiences all 7 identities (her true self plus 6 alters) in parallel, recalls the events of each alter, and can intermittently switch between identities; all rare features of dissociative disorders. Conclusion Given our patient’s extensive history of trauma, previous psychiatric diagnoses, and current dissociative presentation, we conclude that a diagnosis of OSDD and defence mechanisms of dissociation and regression may be appropriate. The patient was discharged with clomipramine for Obsessive-Compulsive Disorder and mood, lurasidone for mood, mirtazapine for mood, insomnia, and appetite stimulation, clonidine for nightmares and Postural Orthostatic Tachycardia Syndrome (POTS), fludrocortisone for POTS, gabapentin for Generalized Anxiety and fibromyalgia, and levothyroxine for hypothyroidism, and counselled to follow up with an outpatient therapist specialising in trauma. This case highlights the impact that childhood physical, sexual, and emotional trauma can have on one’s psychiatric presentation and the complexity of diagnosing dissociative presentations in an inpatient psychiatry setting.

Psychiatric Comorbidities in Pediatric Trichotillomania: AMulticenter Cohort Study.

Trichotillomania (TTM) significantly increases the risk of psychiatric comorbidities. Sparse research in pediatric populations necessitates larger studies to assess these risks. This study investigates the risk of developing psychiatric comorbidities in pediatric TTM patients. This case-control study assessed pediatric patients (< 18 years old) with TTM diagnosed between May 18, 2013, and January 1, 2024, using US-based data from the TriNetX global research network. TTM patients (ICD-10 diagnostic category F63.3) aged 18 years or younger at diagnosis and control patients (ICD-10 code Z00.129) matched for age, sex, race, and ethnicity were assessed. Propensity score matching yielded 16,590 patients in each cohort. The analysis assessed subsequent diagnoses of ADHD, conduct disorders, tic disorders, obsessive-compulsive disorder, anxiety disorders, dissociative, stress-related, and somatoform disorders, mood disorders, and suicide attempts compared to controls. TTM patients under 18 years exhibited significantly greater risks of subsequent diagnoses for ADHD (OR: 2.002; CI 1.841-2.178; p < 0.001), conduct disorders (OR: 3.668; 3.2-3.668; p < 0.0001), tic disorders (OR: 2.247; 1.826-2.765; p < 0.0001), obsessive-compulsive disorder (OR: 11.047; 8.822-13.832; p < 0.0001), anxiety disorders (OR: 3.583; 3.387-3.7; p < 0.0001), dissociative, stress-related, and somatoform disorders (OR: 6.179; 3.935-9.701; p < 0.0001), mood disorders (OR: 2.476; 2.288-2.68; p < 0.0001), and suicide attempts (OR: 1.81; 1.121-2.924; p = 0.0139) compared to controls. TTM patients had the greatest risk of psychiatric diagnosis 1 year postindex event. Pediatric TTM patients have higher psychiatric comorbidity risks, necessitating timely intervention and comprehensive management. Dermatologists can facilitate access to behavioral and pharmacological care, enhancing patient outcomes.

Adverse childhood experiences, brain function, and psychiatric diagnoses in a large adult clinical cohort.

Adverse childhood experiences (ACEs) are linked to higher rates of psychiatric disorders in adults. Previous neuroimaging studies with small samples have shown associations between ACEs and alterations in brain volume, connectivity, and blood flow. However, no study has explored these associations in a large clinical population to identify brain regions that may mediate the relationship between ACEs and psychiatric diagnoses. This study aims to evaluate how patient-reported ACEs are associated with brain function in adults, across diagnoses. We analyzed 7,275 adults using HMPAO SPECT scans at rest and during a continuous performance task (CPT). We assessed the impact of ACEs on brain function across psychiatric diagnoses and performed mediation analyses where brain functional regions of interest acted as mediators between patient-reported ACEs and specific psychiatric diagnoses. We further evaluated the risk of being diagnosed with specific classes of mental illnesses as a function of increasing ACEs and identified which specific ACE questions were statistically related to each diagnosis in this cohort. Increased ACEs were associated with higher activity in cognitive control and default mode networks and decreased activity in the dorsal striatum and cerebellum. Higher ACEs increased the risk of anxiety-related disorders, substance abuse, and depression. Several brain regions were identified as potential mediators between ACEs and adult psychiatric diagnoses. This study, utilizing a large clinical cohort, provides new insights into the neurobiological mechanisms linking ACEs to adult psychiatric conditions. The findings suggest that specific brain regions mediate the effects of ACEs on the risk of developing mental health disorders, highlighting potential targets for therapeutic interventions.

Patterns of abnormal activations in severe mental disorders a transdiagnostic data-driven meta-analysis of task-based fMRI studies.

Studies suggest severe mental disorders (SMDs), such as schizophrenia, major depressive disorder and bipolar disorder, are associated with common alterations in brain activity, albeit with a graded level of impairment. However, discrepancies between study findings likely to results from both small sample sizes and the use of different functional magnetic resonance imaging (fMRI) tasks. To address these issues, data-driven meta-analytic approach designed to identify homogeneous brain co-activity patterns across tasks was conducted to better characterize the common and distinct alterations between these disorders. A hierarchical clustering analysis was conducted to identify groups of studies reporting similar neuroimaging results, independent of task type and psychiatric diagnosis. A traditional meta-analysis (activation likelihood estimation) was then performed within each of these groups of studies to extract their aberrant activation maps. A total of 762 fMRI study contrasts were targeted, comprising 13 991 patients with SMDs. Hierarchical clustering analysis identified 5 groups of studies (meta-analytic groupings; MAGs) being characterized by distinct aberrant activation patterns across SMDs: (1) emotion processing; (2) cognitive processing; (3) motor processes, (4) reward processing, and (5) visual processing. While MAG1 was mostly commonly impaired, MAG2 was more impaired in schizophrenia, while MAG3 and MAG5 revealed no differences between disorder. MAG4 showed the strongest between-diagnoses differences, particularly in the striatum, posterior cingulate cortex, and ventromedial prefrontal cortex. SMDs are characterized mostly by common deficits in brain networks, although differences between disorders are also present. This study highlights the importance of studying SMDs simultaneously rather than independently.

Advancing psychiatric nosology through philosophical inquiry.

Here, we have utilised the concept of fuzzy logic and Karl Popper's notion of verisimilitude to advocate navigating the complexity of psychiatric nosology, emphasising that psychiatric disorders defy Boolean logic. We underscore the importance of embracing imprecision and collecting extensive data for a more nuanced understanding of psychiatric disorders, asserting that falsifiability is crucial for scientific progress. We encourage the advancement of personalised psychiatric taxonomy, urging the continual accumulation of data to inform emerging advancements like artificial intelligence in reshaping current psychiatric nosology.

Psychiatric Comorbidities in Women with Complete Androgen Insensitivity Syndrome or Müllerian Aplasia/Agenesis.

Understanding mental health issues facing individuals with disorders/differences of sex development (DSD) is crucial for optimizing evidence-based practices in this population. To compare the prevalence of psychiatric diagnoses among patients diagnosed with complete androgen insensitivity syndrome (CAIS) or Müllerian duct aplasia/agenesis (MA) to male and female reference groups. Retrospective cohort study. Three large integrated health systems. All individuals with confirmed CAIS or MA enrolled in one of three Kaiser Permanente healthcare systems between January 1, 1988, and January 31, 2017. For each DSD patient, age-, race/ethnicity- and health system-matched male and female referents with typical sex development were randomly selected. Mental health diagnoses and use of psychiatric medications. The prevalence of anxiety and depressive disorders in the CAIS and MA cohorts was approximately twice as high as in male referents without DSD, but the corresponding differences relative to female referents were less evident. A subgroup of MA patients with uterine agenesis had higher prevalence of bipolar disorder than either reference group, but these results were accompanied by wide confidence intervals. Women with CAIS and MA more frequently filled psychiatric medications compared to male but not female referents. On balance, these findings are reassuring, albeit requiring confirmation in other settings. Future studies using longitudinal designs and patient-reported outcomes are needed to evaluate changes in mental health status of CAIS and MA patients at different ages and different intervals following initial diagnosis.

Exploring the Relationship between Telomere Length and Cognitive Changes in Post-COVID-19 Subjects.

Emerging evidence suggests that patients suffering from COVID-19 may experience neurocognitive symptoms. Furthermore, other studies indicate a probable association between leukocyte telomere length (LTL) and neurocognitive changes in subjects with post-COVID-19 condition. Our study was designed to determine the correlation between telomere length and cognitive changes in post-COVID-19 subjects. This study included 256 subjects, categorized based on SARS-CoV-2 infection from 2020 to 2023. In addition, subjects with a psychiatric diagnosis were considered. Moreover, the MoCA and MMSE scales were applied. Telomere length was determined using a polymerase chain reaction, and statistical analysis was employed using ANOVA and X2 tests. We identified a decrease in LTL in individuals with post-COVID-19 conditions compared to those without SARS-CoV-2 infection (p ≤ 0.05). However, no association was found between LTL and cognitive impairment in the subjects post-COVID-19. The findings suggest that LTL is affected by SARS-CoV-2 infection. Nonetheless, this important finding requires further research by monitoring neurological changes in subjects with post-COVID condition.

Substance use and psychiatric phenotypes of youth experiencing homelessness: A cluster analysis.

Due to the complex interactions of psychopathology, psychosocial stressors, and risk behaviors, characterizing high-risk phenotypic groups of transitional-age youth experiencing homelessness (TAY-EH) for targeted interventions remains difficult. We aimed to uncover specific phenotypes of TAY-EH based upon psychiatric and substance use disorder (SUD) diagnoses, and to assess relationships between these phenotypes and negative outcomes including suicidality and high-risk behaviors. Participants (N = 140; 57% male, 54% Black) were individuals aged 16-25 years accessing support at a psychosocial agency in the U.S. Northeast. Data were gathered via structured assessment. Cluster analysis identified sub-groups of TAY-EH with differing diagnostic patterns. Bivariate analyses examined associations between cluster membership and target outcomes. A four-cluster solution was identified. Cluster 1 (Co-occurring; N = 33) was characterized by high levels of comorbidity (i.e., major depressive disorder (MDD), SUD, and notable levels of other diagnoses). Clusters 2 (MDD alone; N = 47) and 3 (SUD alone; N = 18) were characterized by single diagnoses. Cluster 4 (None; N = 42) was characterized by low levels of psychopathology. Clusters differed significantly on several variables including suicidality, adverse childhood experiences, and social connectedness. Comorbid MDD and SUD were most strongly associated with high-risk behaviors and suicidality. These results highlight the importance of diagnosis and targeted interventions for co-occurring MDD and SUD to address the crisis of early mortality and other negative outcomes among TAY-EH. This study is the first to identify specific high-risk psychiatric and psychosocial phenotypes among the highly complex group of TAY-EH based upon structured diagnostic assessments.

The link between childhood traumatic events and the continuum of premenstrual disorders.

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD), collectively known as Premenstrual Disorders (PMDs), cause significant distress and functional impairment, and premenstrual exacerbation (PME) affects a large proportion of women with psychiatric diagnoses. Childhood trauma is one factor that may contribute to PMD/PME risk. This study examines the relationship between childhood trauma and PMDs, PME, and non-PMD psychiatric illness. This study is a secondary analysis of data from a prospective cohort. Participants completed self-assessments on childhood trauma using the Childhood Traumatic Event Scale (CTE-S) and on premenstrual symptoms using the Premenstrual Symptoms Screening Tool (PSST). Psychiatric diagnoses were assessed through structured clinical interviews. Participants were divided into four groups based on their PSST scores and psychiatric illness status: (1) Premenstrual Disorders (PMDs; moderate to severe PMS and PMDD), (2) PME, (3) psychiatric controls (PC; individuals with psychiatric illness but no significant premenstrual symptoms), and (4) healthy controls (HC; individuals with no psychiatric illness and no significant premenstrual symptoms). Statistical analyses, including ANOVA, Tukey's HSD test, Fisher's exact test, and logistic regression, were conducted to examine differences among the groups. Data from 391 participants were analyzed. Participants with PME and PC reported a higher quantity and severity of childhood traumatic events compared to HCs (p <.05). There was a weak but significant correlation between childhood trauma and premenstrual symptom burden across all groups (R = .18, p <.001). Within-group analysis revealed moderate correlations between childhood trauma and premenstrual symptoms driven by the PMD group (R = .42, p = .01). The findings underscore the impact of childhood traumatic events on mental health and premenstrual symptoms and highlight the need for additional research to explore the underlying mechanisms linking childhood trauma to the continuum of premenstrual disorders, to improve the efficacy of trauma-focused interventions for affected individuals.

Characteristics of children and adolescents with recurrent mental health emergency visits and clinicians' intervention tendencies.

Mental disorders affect approximately 15%-20% of childhood. However, due to various factors, these individuals do not benefit sufficiently from mental health services. Therefore, psychiatry emergency services become a key system in the need of psychiatric care for these children. This study aims to reveal the factors that predict recurrent admissions in children and adolescents admitted to the emergency department of a psychiatric hospital and the tendencies of clinicians during management. In our study, the data of patients aged 0-18 years who applied to the emergency department between 1 March 2022 and 01 March 2023 were scanned retrospectively. Participants who applied once were included in the 'single applicant' group, whereas patients who applied two or more times were included in the 'repeated applicants' group. A total of 1563 emergency applications were recorded by 785 different patients. A total of 62.2% of the patients visited the emergency department once, while 37.8% applied two or more times. Non-suicidal self-injury, delusion/hallucination, irritability and depression were significantly higher in recurrent applicants (P < 0.05). Psychotic disorder, bipolar disorder, major depression and borderline personality traits were significantly frequent in these patients (P < 0.05). Additionally, it was determined that the number of psychiatric diagnoses, referral time, need for chemical restraint, having a diagnosis of psychotic disorder or borderline personality traits increased the likelihood of recurrence. Our results indicate some special risk factors that increase the likelihood of recurrent emergency admissions in children and adolescents. Further research with larger sample sizes may elucidate the unique needs of these children in order to use of community resources beneficially.

Risks of Long-Term Psychiatric Disease in Women with a History of Primary Infertility: A Historical Cohort Study.

To examine the risks of long-term de novo psychiatric disease in women with primary infertiltiy compared to age-matched referrent women. Retrospective, population-based cohort of 1,001 women with primary infertility and 1,001 age-matched (± 1year) referent women aged 18-50. The "index date" was date of first clinical note for infertility and included visits fromJanuary 1, 1980 to December 31, 1999. Baseline characteristics were collected by chart review. Outcome data was evaluated through December 31, 2020. Primary outcomes were baseline prevalence and de novo rates of subsequent psychiatric disorders including depression, anxiety, bipolar disorder, substance abuse, suicidality, and somatization evaluated by Coxproportional hazards modeling. Among women with primary infertility and referent women, the median duration of follow-up was 23.7years. The risk of de novo psychiatric disorders was not significantly different between groups. Additionally, the risk of de novo psychiatric disorders did not significantly differ between those with isolated male factor versus isolated female factor infertility. Among women with primary infertility, the cumulative incidence of de novo depression and anxietywas significantly higher among women diagnosed with primary infertility in the 1990s compared to the 1980s. Women with primary infertility, in a historical population-based cohort, do not have a significantly different long-term risk of de novo psychiatric diagnoses compared to age-matched referent women. Our findings support the notion that infertility diagnosis and treatment present an acute period of stress and for some psychologic distress, neither of which persist or increase the risk for development of future psychiatric disease.

Examining epigenetic aging in the post-mortem brain in attention deficit hyperactivity disorder.

Mathematical algorithms known as "epigenetic clocks" use methylation values at a set of CpG sites to estimate the biological age of an individual in a tissue-specific manner. These clocks have demonstrated both acceleration and delays in epigenetic aging in multiple neuropsychiatric conditions, including schizophrenia and neurodevelopmental disorders such as autism spectrum disorder. However, no study to date has examined epigenetic aging in ADHD despite its status as one of the most prevalent neurodevelopmental conditions, with 1 in 9 children having ever received an ADHD diagnosis in the US. Only a handful of studies have examined epigenetic age in brain tissue from neurodevelopmental conditions, with none focused on ADHD, despite the obvious relevance to pathogenesis. Thus, here we asked if post-mortem brain tissue in those with lifetime histories of ADHD would show accelerated or delayed epigenetic age, as has been found for other neurodevelopmental conditions. We applied four different epigenetic clocks to estimate epigenetic age in individuals with ADHD and unaffected controls from cortical (anterior cingulate cortex, N = 55) and striatal (caudate, N = 56) post-mortem brain tissue, as well as peripheral blood (N = 84) and saliva (N = 112). After determining which epigenetic clock performed best in each tissue, we asked if ADHD was associated with altered biological aging in corticostriatal brain and peripheral tissues. We found that a range of epigenetic clocks accurately predicted chronological age in all tissues. We also found that a diagnosis of ADHD was not significantly associated with differential epigenetic aging, neither for the postmortem ACC or caudate, nor for peripheral tissues. These findings held when accounting for comorbid psychiatric diagnoses, substance use, and stimulant medication. Thus, in this study of epigenetic clocks in ADHD, we find no evidence of altered epigenetic aging in corticostriatal brain regions nor in peripheral tissue. We consider reasons for this unexpected finding, including the limited sampling of brain regions, the age range of individuals studied, and the possibility that processes that accelerate epigenetic age may be counteracted by the developmental delay posited in some models of ADHD.

Interoceptive sensibility and alcohol craving in Polish prisoners: the role of alexithymia and emotional dysregulation.

Alcohol craving, characterized by a strong desire or compulsion to consume alcohol, is a prominent symptom of substance dependence syndrome. Research indicates that alcohol craving is a significant factor leading to the termination of abstinence. The mechanisms underlying the activation of alcohol craving remain not fully understood. The urge to reach for alcohol may be stimulated by emotions, memories, thoughts, or bodily sensations, as well as external factors. It has been postulated that individuals with high levels of interoceptive sensibility tend to exhibit a high degree of alexithymia and emotion dysregulation in the context of alcohol craving. Deficits in identifying and verbalizing emotions, along with an operational thinking style, facilitate alcohol consumption by impeding accurate insight into one's mental state, thereby hindering the comprehension of bodily states, emotions, and the regulation of self. This study involved 160 inmates incarcerated in a prison in Poland, awaiting participation in therapy for individuals with substance dependence following psychiatric diagnosis. Four questionnaires were used in the study: multidimensional Assessment of Interoceptive Sensibility (MAIA) for interoceptive sensibility, Toronto Alexithymia Scale (TAS-20) for alexithymia, Difficulties in Emotion Regulation Scale (DERS) for emotional dysregulation, and the Penn Alcohol Craving Scale (PACS) for alcohol craving assessment. The results of the study are as follows: the study findings indicated that alexithymia and emotional dysregulation significantly mediates the relationship between interoceptive sensibility and alcohol craving. The indirect effect for both factors was found to be significant, similar to the indirect effect observed for alexithymia as an mediator. However, in the case of emotional dysregulation, no significant indirect effect was observed. Our study provides insights into the potential contribution of interoceptive sensibility to the heightened risk of alcohol dependence. Specifically, impaired interoceptive sensibility may be associated with the development of alexithymia and emotional dysregulation, potentially rendering individuals more susceptible to alcohol craving. Interoceptive sensibility could serve as a prerequisite for the cultivation of positive emotional processing skills.

7955 Increased occurrence of psychiatric disorders and use of psychiatric-related medication in patients with congenital adrenal hyperplasia

Abstract Disclosure: M. Lind-Holst: None. D. Hansen: None. K.M. Main: None. A. Juul: None. M. Andersen: None. M. Dunø: None. Å.K. Rasmussen: None. N. Jørgensen: None. C.H. Gravholt: None. A. Berglund: None. Background: Clinical studies on psychiatric morbidity, quality of life and cognition in patients with congenital adrenal hyperplasia (CAH) imply impaired mental health. Epidemiological studies on psychiatric morbidity in CAH are, however, scarce. Methods: A registry study of hospital diagnoses and prescribed medication related to psychiatric disorders in a national cohort of patients (n=462) diagnosed with CAH from 1943 to 2018 compared to 100 randomly selected sex- and age-matched controls (n=44,527) from the general population. Psychiatric hospital diagnoses were available for in-patient contacts from 1968 and out-patient contacts from 1994. Medication data were available from 1995. Outcomes: CAH was associated with an increased risk of hospital contacts related to any psychiatric diagnosis (incidence rate ratio (IRR)=2.73, 95% CI 1.85-4.04), and this applied to both males (IRR=2.48, 95% CI 1.57-3.91) and females (IRR=3.20, 95% CI 1.58-6.50). Psychiatric disorders due to psychoactive substance use were more common among CAH males (IRR=3.55, 95% CI 1.58-7.96) and females (IRR=3.81, 95% CI 1.71-8.48). Males with CAH also had an increased risk of suicidal behaviour (IRR=10.66, 95% CI 3.74-30.42). By the age of 30 years, 23% of CAH females and 21% of CAH males had at least one diagnosis related to a psychiatric disorder while this was the case in 14% of female controls and 15% of male controls. Stratifying by sex and CAH phenotype there were important differences among groups. Prescription of medication related to psychiatric disorders was increased for CAH overall (HR=1.73, 95% CI 1.48-2.03) and males (HR=1.80, 95% CI 1.35-2.38) and females (HR=1.70, 95% CI1.36-2.38), separately. Age at the first prescription of any psychiatry-related medication was significantly earlier for patients than for controls (HR males=1.67, 95% CI 1.2-2.3; HR females=1.48, 95% CI 1.2-1.8). Thirty-five per cent (157/448) of CAH patients and 24% of controls had at least one prescription related to a psychiatric disorder within the study period. Interpretation: An increased risk of psychiatric morbidity, psychoactive substance use and use of medication related to poor mental health was seen in both males and females with CAH. The risk of suicidal behaviour was increased for patients with CAH, yet only significantly in CAH males. The study underlines the need for more attention and extension of psychological care and support for patients with CAH. Presentation: 6/1/2024