Rates Of Psychopathology Research Articles

Fleeing the war: A socio-ecological perspective on the mental health of internally displaced and refugee children and adolescents living in the Kurdistan region of Iraq

Over the past decade, the number of children forced to flee their homes worldwide has increased twofold. The accumulative experiences of war, displacement, and flight can have a devastating impact on the mental health of affected minors. Although more than half of all displaced minors are internally displaced within their countries of origin, little is known about the psychopathology of these displaced children living in regions of ongoing or recent conflict. Employing a socio-ecological perspective, this study aims to identify risk factors contributing to psychopathology among internally displaced and refugee minors living in camps for displaced families in the Kurdistan region of Iraq. A total of 332 displaced children and adolescents, aged between 8 and 16 years, were interviewed by trained paraprofessionals in a cross-sectional study in 2019. Trauma and mental health symptoms, including posttraumatic stress disorder, depression, and internalizing and externalizing problems, were assessed. The findings highlighted elevated rates of trauma exposure and psychopathology among the participating minors. Using multiple linear regression analyses we identified risk factors across all mental health outcomes at the individual level (e.g., higher age, greater trauma exposure) and the family level (e.g., greater family violence). Moreover, an analysis at the community level, dividing the study sample by legal status (internally displaced vs. refugee) revealed significantly higher rates of trauma exposure and psychopathology among internally displaced minors. These findings have implications for developing appropriate support for the healthy development of forcibly displaced children and adolescents living in areas of ongoing conflict. Prevention and intervention strategies should take into account various socio-ecological levels, including trauma-focused psychotherapy at the individual level, measures to prevent violence at the family level, and community-level actions that consider context-specific responses, such as adapting camp conditions to meet the needs of vulnerable displaced children.

Doctors with mental health difficulties and ADHD.

There is growing interest in understanding neurodevelopmental disorders such as Attention-deficit/hyperactivity disorder (ADHD) among doctors. However, the current understanding of ADHD and its association with mental well-being in doctors is limited. This study investigated the significance of ADHD among doctors with mental health difficulties accessing a national mental health service for doctors in England. Electronic records from 2877 doctors seeking mental health care through the National Health Service Practitioner Health service were analysed. Demographic data, psychopathology scales (PHQ-9 for depression, GAD-7 for anxiety, Core-10 for psychological well-being) and ADHD screening using ADHD Self-Report Scale (ASRS) were examined. Analyses were conducted to explore associations between ADHD screening, demographic variables and co-existing mental health disorders. The study revealed that over one-third (35%) of doctors in this study sample screened positive for ADHD using the ASRS questionnaire. The male-to-female ratio for screened positive was 1.1:1. The number of doctors screening positive for ADHD reduced with age. A substantial portion of doctors who screened positive for ADHD also exhibited symptoms of co-existing mental health disorders such as anxiety and depression. This study highlights that assessments for ADHD among doctors presenting with mental health difficulties can be important and relevant. Validated screening tools can be used in this process. The high rate of psychopathology among those who screened positive for ADHD in this study sample indicates the need for detailed assessments to understand the complex dynamic of ADHD symptoms and psychiatric disorders. Recognizing ADHD is important as treatments are different to other psychiatric disorders.

Three-Month Polysubstance Use Patterns Among People Enrolled in Outpatient Treatment for Methamphetamine Use

Background Polysubstance use is common among people who use methamphetamine. This prospective study examined the three-month polysubstance use profiles among people enrolled in outpatient treatment for methamphetamine use and associated substance use, mental health, and treatment correlates. Method The present study used routinely collected client-reported outcome measures data from N = 1,507 clients enrolled in outpatient treatment who reported methamphetamine as their primary drug of concern (Mean age = 34.48; SD = 8.68; 56% male). Past-month substance use was assessed at baseline, one-, and three-months. Findings Repeated measures latent class analyses revealed four classes: (1) high and decreasing methamphetamine + stable moderate alcohol + stable high cannabis and daily tobacco (n = 474, 31.45%); (2) stable high methamphetamine + stable high alcohol and daily tobacco (n = 346, 22.96%); (3) low and decreasing methamphetamine + stable moderate daily tobacco (n = 322, 21.37%); (4) stable high methamphetamine + stable moderate daily tobacco (n = 365, 24.22%). Probability of using substances other than methamphetamine remained relatively stable for each class across time. Classes 1 and 4 had greatest severity of methamphetamine involvement at baseline and three-months. Class 1 had greater odds of experiencing moderate-to-severe depression and anxiety, and PTSD and psychosis, compared to class 3. Conclusion Individuals enrolled in outpatient treatment who report methamphetamine as their primary drug of concern report distinct substance use patterns, although daily tobacco use was mostly ubiquitous. Polysubstance use was widespread, with 79% of participants having moderate-to-high probability of polysubstance use at all timepoints. Clients with the most severe polysubstance use had the highest rates of co-occurring psychopathology.

Results of a Multicenter Clinical Study on Adaptation and Validation of the Russian Version of the Clinical Assessment Interview for Negative Symptoms (CAINS)

The aim of the study is to adapt and validate the Russian version of the Clinical Assessment Interview for Negative Symptoms (CAINS).Material and methods. From 2018 to 2024, 89 people were examined: 42 men (47.2%) and 47 women (52.8%), average age 37±9.8 years. Among them, 82 patients (92.1%) were diagnosed with F20.0 according to ICD-10, 5 patients (5.6%) with F21, and 2 patients (2.3%) with F23.1. The mean duration of the mental disorder was 18 [1-42] years, with an average number of hospitalizations of 12 [1-28] times. The CAINS manual and questionnaire text, translated into Russian by a group of young psychiatrists from the RSP YPC, were utilized for assessment.Results: The Cronbach’s alpha for the total score of the questionnaire was 0.91. Convergent validity was demonstrated by a significant positive correlation between CAINS scores and the Marder PANSS factor. Confirmatory factor analysis indicated the preservation of the questionnaire’s two-factor model, explaining 55.8% of the total variance. Discriminant validity was evidenced by the more frequent absence of correlations between CAINS scores and positive and general psychopathological PANSS ratings. Inter-rater reliability was established by a sufficient level of agreement, with Cohen’s kappa coefficient, among independent raters for the majority (91%) of clinical assessments using the CAINS questionnaire.Conclusion: The obtained results demonstrate that the Russian adaptation of the Clinical Assessment Interview for Negative Symptoms (CAINS) is a valid and effective psychometric clinical interview. It can be utilized for both clinical research and everyday clinical practice when working with patients suffering from psychotic disorders within the schizophrenia spectrum.

Are long-term meditators more psychologically resilient, more mindful, less psychologically distressed and have enhanced perceived quality of life? <em>A comparative preliminary analysis from Sri Lanka</em>

Background: Meditation practices are currently being incorporated in psychotherapeutic interventions to address globally increasing rates of psychopathology. Meditation has been a common practice in Sri Lanka since early times. However, the integration of meditation as practiced in a Sri Lankan context, into psychotherapeutic interventions require rigorous empirical exploration. Objectives: The primary objective of this preliminary study was to explore the differences between meditators and non-meditators in terms of several psychological parameters. This study aimed to understand patterns, trends, and relationships in psychological variables such as mindfulness, psychological resilience, perceived quality of life, and psychological distress (namely, depression, anxiety, and stress)Methods: This study involved 15 long-term meditators (with a practice of 5-25 hours per week and 3.5-25 years of experience) from Sri Lankan meditation centers headed by Buddhist monks/nuns, and a matched control group of 15 non-meditating participants from a Sri Lankan community sample. Participants were matched for their age, gender and education. Self-reported levels of mindfulness, psychological resilience, perceived quality of life, and psychological distress were assessed using culturally adopted and validates psychometric measures.Results: The long-term meditators showed significantly higher scores on three dimensions of mindfulness (observing, non-reactivity, and acting with awareness) and total mindfulness, as well as higher psychological resilience and perceived psychological and environmental quality of life. Furthermore, the meditators reported significantly low levels of depression compared to their non-meditating controls.Conclusion: These findings suggest that a meditation-based lifestyle in a Sri Lankan context may be characteristic of higher levels of mindfulness, psychological resilience, and quality of life, as well as lower levels of depression, when compared to individuals who do not engage in regular meditation. The results provide direction for further empirical investigation and potential integration of meditation practices into psychotherapeutic interventions.

Prevalence of neurocognitive deficits in patients with first-episode schizophrenia in an African sample and its relationship with dimensions of psychopathology and psychosocial outcome

BackgroundCurrent evidence supports the idea that neurocognitive deficits (NCD) constitute a core dimension of schizophrenia. Studies on longitudinal changes in neurocognition among neuroleptic-naive first-episode schizophrenia (FES) from Africa are uncommon. We aimed to highlight the prevalence of, and changes in NCD among FES on naturalistic treatment follow-up for 8 weeks, and the relationship with psychopathological and psychosocial outcomes.MethodsConsecutive FES and Healthy Control (HC) were recruited. Diagnosis of schizophrenia was based on ICD-10 criteria. The HC (n = 86) consisted of nursing students in the same facility, recruited purposely to match the cases in age and gender. After the baseline assessment, 82 FES were followed up 4-weekly for changes in NCD, psychopathological and psychosocial ratings for a period of 8 weeks, using the 3 alternate forms of the Screen for Cognitive Impairment in Psychiatry (SCIP), the Wisconsin Card Test, the Mini Mental State Examination, as well as the Brief Psychiatric Rating Scale, the WHO Disability Assessment Scale, and the Global Assessment of Functioning scale. The control group was tested only once, and their scores were utilized for comparison with the patients’ scores only at week 8. The prevalence of neurocognitive deficits in the two groups was described using percentages and 95% confidence interval. Predictors of cognitive function was determined using multivariate linear regression.ResultsThe prevalence of any NCD among FES at 8 weeks and HC was 62.9% (95% CI: 51.5%, 74.2%) and 1.2% (95% CI: 0.0%, 6.6%), respectively. With treatment, there was a significant improvement in cognitive function at each interval of follow-up. At week 8, the prevalence of any NCD among patients in remission was 55.1%. Total SCIP scores at week 8 had significant inverse moderate relationship with the dimensions of psychopathology. Conversely, total SCIP score was strongly positively correlated with functioning (rhos= 0.71, p < 0.001) at week 8. At week 8, the baseline predictors of total SCIP score were, duration of untreated psychosis (β = -0.33, p = 0.01, variance = 19.8%), negative symptoms (β = -0.35, p = 0.03, variance = 4.9%) and positive symptoms (β = -0.43, p = 0.01, variance = 4.8%).ConclusionThe high prevalence of NCD when patients were in remission indicates that they are enduring and merit consideration as a domain of psychopathology.

Is the diagnosis and treatment of depression gender-biased? Evidence from a population-based aging cohort in Sweden

BackgroundAs compared to men, older women´s higher rates of depression diagnosis and antidepressant use are widely reported. We aimed to: a) explore whether there is a potential gender bias in the clinical diagnosis of depression and antidepressant prescription in an older population from Stockholm; and 2) analyze if such gender bias differs by patients’ age and socioeconomic status.MethodsWe used data from the Swedish National Study on Aging and Care in Kungsholmen, SNAC-K (N = 2,941). We compared gender differences in: (a) clinical diagnosis of depression according to the Swedish National Patient Register (ICD-10 codes F32-F34; F412) (“register-based diagnosis”); (b) SNAC-K-based diagnosis of depression, partially gender-blind, using the Comprehensive Psychopathological Rating Scale (CPRS) and the DSM-IV-TR (“SNAC-K based diagnosis); and (c) antidepressant use (ATC code N06A). To analyze the magnitude of the gender bias in the register-based diagnosis of depression and in antidepressant use, and the role of potential moderating factors, prevalence ratios (PR) were calculated using Poisson regression models. Models were run separately by age and social class.ResultsWomen had a 63% higher probability of having a register-based diagnosis of depression (PR = 1.63[1.23–2.15]) and a 79% higher probability of using antidepressants (PR = 1.79[1.34–2.40]). No gender differences were observed in the SNAC-K-based diagnosis of depression. The gender differences in the register-based diagnosis were narrowed, although remained significant, after considering age, depressive symptoms, and health services use (PR = 1.44[1.10–1.88]), as well as the register-based diagnosis in the case of antidepressant use (PR = 1.31[1.04–1.64]). This gender bias was larger among the younger-old and the most advantaged social class.ConclusionA gender-bias was identified in the diagnosis and treatment of depression in older adults within the Swedish healthcare setting, which could imply that health services may be contributing to the medicalization of women’s mental health. Gender-sensitive clinical and public health interventions are essential to reduce gender disparities in mental healthcare, also in old age.

Long-term psychopathology rates of children and adolescents and associated factors in the worst-sticken area of 2023 Kahramanmaras earthquake

Introduction Earthquakes are natural disasters that can have significant psychological impacts on individuals, particularly children. While physical injuries are often the immediate focus following an earthquake, the psychological effects can be long-lasting and profound. Understanding the psychiatric effects of traumatic experiences in children following earthquakes is crucial for developing effective interventions and support systems. Method One hundred fifty three children and adolescents who experienced the earthquake were evaluated in the first year of the earthquake. Depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms were measured using standardized assessment tools. Factors that may be related to psychopathology, such as sleep disturbance, the extent of trauma, and where one lived after the earthquake, were also evaluated. The anxiety, depression and stress levels of the mother and father separately and their relationship with the child’s psychopathology were evaluated. Results The frequency of depression risk among participants was found to be 24.8%, while the frequency of anxiety risk was 62.8%. The frequency of PTSD risk was 97.4%. Children who migrated to another province after the earthquake had higher scale scores. Parental depression anxiety stress level was positively correlated with children’s scale scores. Disruption in sleep patterns increased the risk of depression by 2.38 times. Experiencing the loss of friends in the earthquake increased PTSD score by 6.27. Discussion The findings of this study highlight the importance of addressing the psychiatric needs of children following earthquakes. Psychosocial support and access to appropriate treatment should be prioritized to mitigate the long-term psychological effects of traumatic experiences in children.

Personality and Psychoneuroimmunology: A Systems Biology Perspective.

Research in psychoneuroimmunology (PNI) underscores the intricate connections within the "whole mind-body system." Personality plays a pivotal role, with specific traits linked to stress influencing neural behavior and psychophysiological disorders. Gene expression networks associated with personality affect neuronal plasticity, epigenetic processes, and adaptive behaviors, highlighting the importance of systems biology mechanisms. Systemic inflammation correlates with key personality traits. Understanding the roles of inflammatory and oxidative biomarkers in personality traits and disorders can help identify diagnostic and therapeutic targets for various diseases. Neurobiological features contribute to our understanding of personality disorders and related conditions. Personality traits are linked to distributed neuroendocrine networks, particularly the hypothalamic-pituitary-adrenal (HPA) axis, rather than localized brain areas. Correlations have also been identified between personality traits and thyroid hormones. Disrupted hypothalamic-pituitary-thyroid (HPT) axis functions may be associated with disease severity, depression, and distress, highlighting the need for comprehensive endocrinological and psychopathological evaluations. The gut-brain axis influences personality traits, emotions, stress, and social behaviors. Altered gut microbiota is common in psychiatric conditions, suggesting potential treatments targeting the microbiota. Chronic stress impacts cognitive functions and correlates with personality and mental health, emphasizing the need for comprehensive, multi-dimensional patient profiles for effective prevention and therapy. A biopsychosocial model integrating personality traits will advance personalized and systems medicine.

Echoes of Childhood: Gender and Coping Strategies as Moderators of Social Anxiety in Survivors of Maltreatment

The relationship between child maltreatment and elevated rates of psychopathology is widely recognized with research showing that the survivors of child abuse are more likely to experience higher levels of social anxiety than those in the general population. Studies confirm gender differences, with females generally exhibiting higher rates of social anxiety than males. Research suggests that coping styles may influence the connection between adverse childhood experiences and subsequent impacts, with evidence indicating that the use of specific coping strategies may vary between genders. This study examined the effects of coping styles and gender in moderating the relationship between childhood maltreatment severity and social anxiety in a sample of 200 students from the University of Tirana. Participants completed three self-reporting questionnaires: The Childhood Questionnaire-Short Form (CTQ-S), the Social Phobia and Anxiety Inventory Short Version (SPAI-18), and the Coping Inventory for Stressful Situations Short Form (CISS-21). Data analysis employed hierarchical multiple regression for moderator analyses and multivariate analysis of variance (MANOVA). Results indicated that emotion-oriented coping significantly moderated the relationship between maltreatment and social anxiety, while task-oriented and avoidance coping did not. Gender also moderated this relationship, with females demonstrating greater sensitivity to maltreatment's effects. Additionally, females scored higher on emotion-oriented coping, though no significant gender differences were found for the other coping styles. These findings highlight the nuanced roles of coping styles and gender in understanding the impact of childhood maltreatment on social anxiety. Received: 10 August 2024 / Accepted: 31 October 2024 / Published: 05 November 2024

Psychiatric and functional correlates of stigma associated with cognitive impairment in schizophrenia

Schizophrenia is the most strongly stigmatized psychiatric diagnosis, with negative stereotypes including assumptions of incompetence and inability to recover. Individuals with cognitive impairment associated with schizophrenia (CIAS) have reported stigma experiences, suggesting that CIAS carries stigma in addition to the stigma associated with schizophrenia as a diagnostic label. While research has established that mental illness stigma more generally is linked with poor psychiatric and functional outcomes, no research has explored correlates of CIAS stigma. This study evaluated cognitive, psychiatric, and functional correlates of CIAS stigma among 54 individuals with schizophrenia spectrum disorders participating in a cognitive remediation trial. Participants with greater estimated cognitive decline reported higher levels of CIAS stigma experiences. Participants who reported higher levels of CIAS stigma also scored higher on a measure of depressive symptom severity. No significant associations were found between CIAS stigma and positive and negative psychosis symptoms or general psychopathology ratings. CIAS stigma was not associated with performance-based functional capacity or ratings of community functioning. Findings suggest that CIAS stigma is linked with the degree of cognitive decline and depressive symptom severity among individuals with schizophrenia spectrum disorders. Additional research is needed to elucidate directionality and the relationship between CIAS stigma and functioning outcomes.

The influence of hope and optimism on trajectories of COVID-19 stress, health anxiety, and wellbeing during the COVID-19 pandemic.

The COVID-19 pandemic posed a threat to public health and psychological functioning, with early studies documenting higher rates of psychopathology within the United States and globally. Hope and optimism promote adjustment and are associated with positive physical and mental health outcomes. Thus, individual differences in hope and optimism may also foster resilience during a global health crisis. The current study examined how hope and optimism influenced longitudinal health-focused distress and wellbeing during the pandemic. Data were collected from 788 American adults across three periods during Spring-Summer 2020 using MTurk. Latent growth curve modeling examined whether hope and optimism predicted COVID stress, health anxiety, and wellbeing trajectories. COVID stress and health anxiety decreased after the onset of the pandemic, whereas wellbeing was stable. Individually, hope and optimism predicted lower initial COVID stress and health anxiety, along with greater initial wellbeing. When examining the combined influence of hope and optimism, optimism was more strongly related to health-focused distress, though both were strong predictors of wellbeing. These findings indicate that Americans were resilient and positive expectancies, particularly optimism, predicted better initial adjustment to the early phases of the pandemic. Thus, positive expectancies appear to be protective during a global health crisis.

Behaviour and Psychopathology in Preschool Children with William Syndrome and the Effects of Age, Sex and Cognition.

The current study compared the prevalence of cognitive and psychopathological impairments among 24 preschool children with Williams syndrome (WS) (aged 2.20 to 5.97years) and 53 controls without WS and screened for developmental or psychological diagnoses (aged 2.21 to 5.89years) matched on chronological age and sex distribution. Associations between sex, chronological age, early development and psychopathology were also investigated. The Child Behavior Checklist-Preschool Version (CBCL) and the Mullen Scales of Early Learning were administered. Higher reported rates of Attention Problems, Emotional Reactivity, Somatic Complaints, Withdrawal, Affective Problems and Total Problems were found in preschool children with WS. There were no significant group differences in prevalence rates of all other CBCL domains. Attention Problems were the most prevalent psychopathology in preschool children with WS (33% falling in the clinically significant range), followed by Affective Problems (29% in clinically significant range), then Anxiety Problems (17%) or Attention Deficit/Hyperactivity Problems (17%). Among children without WS, the highest prevalence rates of psychopathology were for Attention Problems (4% falling in the clinically significant range), Aggressive Behaviour (4%), Sleep Problems (4%) and Oppositional Defiant Problems (4%). There were no significant associations between sex or chronological age and CBCL-reported psychopathology for either group. In addition, there were no significant relationships between CBCL ratings and verbal ability, nonverbal ability or overall developmental level in either group. Findings highlight variations in the pattern of psychopathology among preschool children with WS compared to those without WS, which needs to be considered in clinical management and future research.

Psychopathological Correlates and Psychosocial Functioning in Children and Adolescents with Syncope: A Systematic Review.

Syncope is defined as a spontaneous and transient loss of consciousness and postural tone due to brief and reversible cerebral hypoperfusion. This review aimed to summarize the research findings regarding the psychological correlates associated with pediatric syncope. Moreover, the study aimed to deepen the understanding of the relationship between psychological disorders and the onset of syncopal episodes in childhood, focusing on clinical features and different clinical classifications. A systematic review was carried out from inception to January 2023, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, using the CINAHL Plus, APA PsycArticles, APA PsycInfo, MEDLINE, and Psychology and Behavioral Sciences Collection databases. The study search and selection were based on the Population Intervention Comparison Outcome Study Design (PICOS) strategy and the Quality Assessment was carried out using Critical Appraisal Skills Programme (CASP) scales. A combination of keywords related to a) syncope; b) psycho*; and c) child* (Subjects) was used. Studies concerning epilepsy-related syncope were excluded. Overall, 912 records were identified. After excluding non-English, non-original, and duplicate studies, 579 records were selected for the title screening, 88 for the abstract screening, 37 full-text articles were assessed for eligibility and a total of 14 were included. The Risk of Bias in the included studies was assessed and 78,6% of the studies satisfied robustness quality criteria. The findings highlighted that children and adolescents with syncope showed a higher rate of psychopathology as compared to the healthy and clinical controls. Furthermore, patients reported social withdrawal and poor quality of life. The findings suggest that there is a robust relationship between psychopathology and syncope. Children and adolescents with syncope frequently report clinical symptoms related to emotional, relational, and psychosomatic dysregulation. Psychological assessment should be routinely included in the integrated care to identify potential targets for treatment and improve early differential diagnosis.

B - 13 Effects of Individual and Community-Level Adverse Childhood Experiences and Current Psychopathology among Monolingual Spanish-Speaking Adult Neuropsychology Referrals

Abstract Objective The link between adverse childhood experiences (ACEs) and higher rates of psychopathology in adulthood has been well-established, though far less analogue research has examined this relationship among Latinx patients. This study assessed the relationship between ACEs and symptoms of anxiety, depression, and perceived stress among monolingual Spanish-speaking neuropsychology referrals. Method Data were culled from 27 adult neuropsychology referrals (mean age = 61.70; mean education = 8.59) neuropsychological referrals administered the ACE Questionnaire, Beck Depression Inventory (BDI-II), Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), and Perceived Stress Scale (PSS). Linear regression analyses examined the effect of exposure to individual (e.g., emotional, physical, sexual abuse, neglect, domestic violence) and community-level ACEs on depression, anxiety, and perceived stress symptom endorsement. Results Endorsement of more individual ACEs predicted higher levels of anxiety (R2 = 0.281; p = 0.009) and depression (R2 = 0.127; p = 0.075) symptoms, but not perceived stress levels (R2 = 0.037; p = 0.365. By contrast, endorsement of more community-level ACEs marginally predicted higher anxiety symptoms (R2 = 0.124; p = 0.071), but not depression symptoms (R2 = 0.020; p = 0.568) or perceived stress levels (R2 = 0.045; p = 0.319). Conclusions Experiencing more individual-level ACEs predicted greater anxiety and, to a lesser extent, depressive symptoms, whereas community-level ACEs did not predict similar levels of endorsement of active psychopathology among monolingual Spanish-speaking adults referred for neuropsychological evaluation. Findings emphasize the need of neuropsychologists to consider routinely assessing patient’s childhood trauma history and current psychopathology symptoms during evaluation to improve diagnostic accuracy and recommendations for Latinx patients.

Mental health and timing of gender-related events among transgender and gender-diverse children and adolescents seeking gender-affirming consultation and care

Transgender and gender-diverse (TGD) youth encounter unique challenges affecting their mental health, largely related to societal stigma and gender dysphoria. Limited research considers the specific needs of TGD youth. This study examined demographic and developmental factors, including the ages at which gender-related events occur, and their relationship to mental health among TGD youth seeking gender-affirming consultation and care (GACC). We examined the medical records of 674 TGD children and adolescents, comparing demographics, gender-related events, and mental health across gender groups. The total sample comprised 261 patients assigned male at birth, and 413 patients assigned female at birth. Non-binary individuals reported higher rates of psychopathology compared to binary transgender patients, with transgender boys exhibiting higher rates than transgender girls. Seeking GACC at a more advanced pubertal stage and older age was associated with an increased likelihood of psychopathology. Later recollection of first gender incongruence memory was correlated with higher rates of depression and anxiety. Finally, socioeconomic status was linked to GACC healthcare-seeking behaviors. These findings underscore the importance of recognizing the diverse experiences and needs of TGD youth seeking GACC services, highlighting that early identification and access to care may be crucial for improving mental health outcomes.

Efficacy and acceptability of long-acting antipsychotics in acutely ill individuals with schizophrenia-spectrum disorders: A systematic review and network meta-analysis

To assess the effect of Long-acting injectable (LAI) antipsychotics in acutely ill patients, we systematically searched major databases for randomized controlled trials (RCTs) comparing LAIs with other LAIs, oral antipsychotics, or placebo in acutely symptomatic adults with schizophrenia-spectrum disorders. Data were analyzed with a random-effects network meta-analysis. Co-primary outcomes were efficacy (mean change in psychopathology rating scales) and acceptability (all-cause discontinuations) at study endpoint.Of 25 RCTs, 19 studies tested second-generation LAIs (SGA-LAIs) and six first-generation LAIs (FGA-LAIs). Due to a disconnected network, FGA-LAIs were analyzed separately, with poor data quality. The SGA-LAIs network included 8,418 individuals (males=63%, mean age=39.3 years). All SGA-LAIs outperformed placebo in reducing acute symptoms at study endpoint (median follow-up=13 weeks). They were more acceptable than placebo with the only exception of olanzapine, for which no differences with placebo emerged. Additionally, we distinguished between different LAI formulations of the same antipsychotic to explore potential pharmacokinetic differences. Most formulations outperformed placebo in the very short-term (2 weeks or less), regardless of the need for initial oral supplementation.SGA-LAIs are evidence-based treatments in acutely ill individuals with schizophrenia-spectrum disorders. Findings support the use of SGA-LAIs to manage psychopathology and improve adherence right from the acute phases of illness.

The impact of age-related differences in emotion dysregulation on refugee mental health and social outcomes.

The refugee experience is typically characterized by exposure to numerous premigration traumatic events and postmigration stress in the resettlement environment. Refugees' experiences can lead to elevated rates of psychopathology, including posttraumatic stress disorder (PTSD) and depression. Emotion regulation is a key mechanism contributing to mental health outcomes among refugees. This study examined the impact of age on the association between emotion regulation and critical social outcomes relevant to refugee resettlement, such as social engagement and functional impairment. Participants were 1,081 Arabic-, Farsi-, Tamil- and English-speaking adult refugees. Premigration trauma exposure, postmigration stressors, PTSD symptoms, depressive symptoms, emotion regulation, social engagement, and functional impairment were measured. A series of hierarchical regression and Poisson regression analyses revealed emotion dysregulation as a significant predictor of functional impairment, β =.36, p <.001, and social engagement, Exp B = 0.99, p =.002. A significant interaction between age and emotion dysregulation was associated with both PTSD, β =.05, p =.048 and depressive symptoms, β =.06, p =.010, suggesting a stronger positive association between emotion dysregulation and both PTSD and depressive symptom severity for older individuals. Postmigration stressor exposure, emotion dysregulation, and older age are important factors that may negatively impact social engagement and functional impairment in the resettlement environment. Additionally, higher levels of trauma exposure may negatively impact social engagement. These findings have implications for public health and social services in the context of resettled refugee communities.

Nutraceuticals and phytoceuticals in the treatment of schizophrenia: a systematic review and network meta-analysis "Nutra NMA SCZ".

Sub-optimal response in schizophrenia is frequent, warranting augmentation strategies over treatment-as-usual (TAU). We assessed nutraceuticals/phytoceutical augmentation strategies via network meta-analysis. Randomized controlled trials in schizophrenia/schizoaffective disorder were identified via the following databases: PubMed, MEDLINE, EMBASE, Scopus, PsycINFO, CENTRAL, and ClinicalTrials.gov. Change (Standardized Mean Difference = SMD) in total symptomatology and acceptability (Risk Ratio = RR) were co-primary outcomes. Secondary outcomes were positive, negative, cognitive, and depressive symptom changes, general psychopathology, tolerability, and response rates. We conducted subset analyses by disease phase and sensitivity analyses by risk of bias and assessed global/local inconsistency, publication bias, risk of bias, and confidence in the evidence. The systematic review included 49 records documenting 50 studies (n = 2384) documenting 22 interventions. Citicoline (SMD =-1.05,95%CI = -1.85; -0.24), L-lysine (SMD = -1.04,95%CI = -1.84; -0.25), N-acetylcysteine (SMD = -0.87, 95%CI = -1.27; -0.47) and sarcosine (SMD = -0.5,95%CI = -0.87-0.13) outperformed placebo for total symptomatology. High heterogeneity (tau2 = 0.10, I2 = 55.9%) and global inconsistency (Q = 40.79, df = 18, p = 0.002) emerged without publication bias (Egger's test, p = 0.42). Sarcosine improved negative symptoms (SMD = -0.65, 95%CI = -1.10; -0.19). N-acetylcysteine improved negative symptoms (SMD = -0.90, 95%CI = -1.42; -0.39)/general psychopathology (SMD = -0.76, 95%CI = -1.39; -0.13). No compound improved total symptomatology within acute phase studies (k = 7, n = 422). Sarcosine (SMD = -1.26,95%CI = -1.91; -0.60), citicoline (SMD = -1.05,95%CI = -1.65;-0.44), and N-acetylcysteine (SMD = -0.55,95%CI = -0.92,-0.19) outperformed placebo augmentation in clinically stable participants. Sensitivity analyses removing high-risk-of-bias studies confirmed overall findings in all phases and clinically stable samples. In contrast, the acute phase analysis restricted to low risk-of-bias studies showed a superior effect vs. placebo for N-acetylcysteine (SMD = -1.10, 95%CI = -1.75,-0.45), L-lysine (SMD = -1.05,95%CI = -1.55, -0.19), omega-3 fatty acids (SMD = -0.83,95%CI = -1.31, -0.34) and withania somnifera (SMD = -0.71,95%CI = -1.21,-0.22). Citicoline (SMD = -1.05,95%CI = -1.86,-0.23), L-lysine (SMD = -1.04,95%CI = -1.84,-0.24), N-acetylcysteine (SMD = -0.89,95%CI = -1.35,-0.43) and sarcosine (SMD = -0.61,95%CI = -1.02,-0.21) outperformed placebo augmentation of TAU ("any phase"). Drop-out due to any cause or adverse events did not differ between nutraceutical/phytoceutical vs. placebo+TAU. Sarcosine, citicoline, and N-acetylcysteine are promising augmentation interventions in stable patients with schizophrenia, yet the quality of evidence is low to very low. Further high-quality trials in acute phases/specific outcomes/difficult-to-treat schizophrenia are warranted.

Effects of weight loss intervention on anxiety, depression and quality of life in women with severe obesity and polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women that is associated with an increased risk of anxiety and depression and with a lower health-related quality of life (HRQoL). PCOS is closely associated with obesity, which per se can lead to symptoms of anxiety and depression and lower HRQoL. The first-line treatment for PCOS is weight loss through lifestyle intervention, which has been shown to improve all symptoms of the syndrome. The aim of this study was to investigate symptoms of anxiety and depression and HRQoL in women with severe obesity (BMI ≥ 35) with and without PCOS, and to evaluate the effect of a one-year structured weight loss intervention. A total of 246 women with severe obesity (PCOS n = 63, non-PCOS n = 183) were included. The comprehensive psychopathological rating scale self-rating scale for affective symptoms (CPRS-S-A) and the short form-36 (SF-36) were used to assess symptoms of anxiety and depression and HRQoL. In total 72 women of the 246 women with severe obesity completed a one-year weight loss programme and were followed up and compared with baseline data. In women with severe obesity, there were no differences in symptoms of anxiety and depression and HRQoL between women with and without PCOS at baseline. Clinically relevant anxiety symptoms were present in 71.3% (PCOS) and 65.6% (non-PCOS), and depression symptoms were present in 56.4% (PCOS) and 52.2% (non-PCOS). Significant weight loss improved physical HRQoL in all women, but reduced symptoms of anxiety and depression only in women without PCOS. There were no differences when comparing the changes between the groups. Women with severe obesity are severely affected by symptoms of anxiety and depression, independent of PCOS. Weight loss improved symptoms of anxiety and depression in women without PCOS, but there were no differences between groups in change from baseline to follow-up.Trial registration number: Clinical trial.gov: NCT01319162, March 18, 2011. Date of registration and enrolment of the first subject September 2011.