Risk Of Psychiatric Disorders Research Articles

Psychiatric disorders in adolescent and young adult cancer survivors in Korea.

Although adolescent and young adult (AYA) cancer survivors have an increased risk of psychiatric disorders, limited evidence has been suggested. We aimed to determine the risk of psychiatric disorders among AYA cancer survivors. A retrospective population-based cohort study based on the Korea National Health Insurance Service database was carried out. All men and women aged 15-39 years diagnosed with cancer between 2006 and 2019 (N= 88 965) were included and matched with controls (1 : 4). The prevalence ratios (PRs) of psychiatric disorders were calculated in cancer patients and compared with those in the control group every 6 months before and after cancer diagnosis. The mean age of the participants was 32.2 years and the majority were 30-39 years of age (72.9%). There was no difference in the PRs of psychiatric disorders between AYA cancer patients and the control group before cancer diagnosis, but it increased sharply after cancer diagnosis [PR 2.50, 95% confidence interval (CI) 2.42-2.58 in the first 6 months]. During a median follow-up of 6.5 years, 54 733 participants developed psychiatric disorders. The overall risk of psychiatric disorders among AYA cancer survivors compared with the control group had a sub-distribution hazard ratio of 1.42 (95% CI 1.39-1.45) after considering competing risks. Our study confirmed a 42% increased risk of psychiatric disorders among AYA cancer survivors compared with controls across various cancer types. Our findings suggest that AYA cancer survivors require long-term psychological support following their cancer diagnosis.

Exercise as a mediator between childhood adversity and psychological distress: Can BDNF moderate the mediating effect?

Adverse childhood events (ACEs) have been associated with an increased risk of psychiatric disorders in young adulthood. To identify at-risk individuals and potential strategies to combat the negative impacts of ACE, this study investigated the mediating role of exercise in the relationship between psychological distress and ACEs. Further, we examined the moderating effect of the BDNF polymorphism in the mediation relationship. Participants (N=750, Mage=20.1 years) completed questionnaires assessing ACEs divided into adverse environment (AE) and childhood maltreatment (CM), exercise, and psychological distress. Salivary genomic DNA was used for genotyping. The significance of the moderated mediation model was assessed using bootstrapping. There was a significant association between ACEs and psychological distress mediated by exercise. After addition of BDNF polymorphism, we found that the effect of ACEs on psychological distress through exercise was moderated by the BDNF polymorphism (index of moderated mediation=-0.19, [-0.48, -0.04], p-value ≤0.05). Further dividing ACE into AE and CM, the moderated mediation relationship remains significant only with AE (index of moderated mediation=-0.41, [-0.99, -0.10], p-value ≤0.05). The interaction between BDNF polymorphism and exercise may be a suitable target for interventions in ACEs-experienced individuals for the prevention or reduction of psychological distress.

Emotion regulation repertoires predict the risk of major depressive disorder.

Few studies explored emotion regulation (ER) repertoires (the tendency to utilize multiple ER strategies in different contexts) in patients with Major Depressive Disorder (MDD). It remains unclear to what extent emotion regulation (ER) repertoires can assess the risk of MDD and other psychiatric disorders. Three subsamples including 1397 non-clinical individuals, 135 MDD patients, and 127 healthy controls (HCs) were combined to explore ER repertoires. We further built classifiers of ER repertoires to distinguish MDD patients from HCs, and additionally examined its performance based on published studies (total N = 4918). Adaptive, average, maladaptive, and intensely maladaptive repertoires were identified. The classifier based on ER repertoires can effectively distinguish MDD patients from HCs, demonstrating an AUC of 0.803 (SD = 0.067). Additionally, the classifier exhibited discriminatory power for various psychopathologies in published studies, including depression, anxiety, eating disorders, PTSD, and personality disorders (AUC: 0.616-0.779). Future studies should investigate the longitudinal influence of ER repertoires on the development of psychopathologies. Our findings suggest that an individual's ER repertoire is a critical psychopathological risk that can serve as a valuable indicator for assessing risk and imply the potential utility of reforming ER repertoire.

Causal associations between iron levels in subcortical brain regions and psychiatric disorders: a Mendelian randomization study

Despite observational studies linking brain iron levels to psychiatric disorders, the exact causal relationship remains poorly understood. This study aims to examine the relationship between iron levels in specific subcortical brain regions and the risk of psychiatric disorders. Utilizing two-sample Mendelian randomization (MR) analysis, this study investigates the causal associations between iron level changes in 16 subcortical nuclei and eight major psychiatric disorders, including schizophrenia (SCZ), major depressive disorder (MDD), autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder, bipolar disorder, anxiety disorders, obsessive-compulsive disorder, and insomnia. The genetic instrumental variables linked to iron levels and psychiatric disorders were derived from the genome-wide association studies data of the UK Biobank Brain Imaging and Psychiatric Genomics Consortium. Bidirectional causal estimation was primarily obtained using the inverse variance weighting (IVW) method. Iron levels in the left substantia nigra showed a negative association with the risk of MDD (ORIVW = 0.94, 95% CI = 0.91–0.97, p < 0.001) and trends with risk of SCZ (ORIVW = 0.90, 95% CI = 0.82–0.98, p = 0.020). Conversely, iron levels in the left putamen were positively associated with the risk of ASD (ORIVW = 1.11, 95% CI = 1.04–1.19, p = 0.002). Additionally, several bidirectional trends were observed between subcortical iron levels and the risk for psychiatric disorders. Lower iron levels in the left substantia nigra may increase the risk of MDD, and potentially increase the risk of SCZ, indicating a potential shared pathogenic mechanism. Higher iron levels in the left putamen may lead to the development of ASD. The observed bidirectional trends between subcortical iron levels and psychiatric disorders, indicate the importance of the underlying biomechanical interactions between brain iron regulation and these disorders.

Exploring itch in hidradenitis suppurativa with lessons from atopic dermatitis and psoriasis.

Itch is a prominent symptom in many cutaneous disorders, including atopic dermatitis (AD), prurigo nodularis, and psoriasis. Itch is also a common but overlooked concern in patients with hidradenitis suppurativa (HS). Currently, the mechanisms underlying itch in HS remain unclear. To gain a better understanding, we reviewed the literature on pruritus in HS and other itch-predominant disorders, AD, and psoriasis. In HS, psoriasis, and AD, we found that itch often co-localized with pain and occurred more frequently at night. Furthermore, itch was found to negatively affect sleep and increase the risk for comorbid psychiatric disorders in HS, psoriasis, and AD. However, HS-, psoriasis-, and AD-related itch differ in temporality. Itch in AD is often described as chronic, while itch in HS and psoriasis is often described as episodic. HS-associated itch is likely multifactorial, and several mechanisms have been proposed including peripheral sensitization, central sensitization, and neuroinflammation. Prior studies in HS highlight enhanced IgE production and a dense infiltration of mast cells, along with a variety of cytokines and chemokines. Furthermore, alterations in the skin microbiome may contribute to itch in HS. To date, few therapies have been studied to treat itch in HS. Given the efficacy of several biologics and small molecules in treating itch in AD and psoriasis, similar agents may be explored in future HS studies. Alternative therapies to target neurological and psychiatric contributions to itch may include anticonvulsants, cannabinoids, and nonpharmacological treatments. In conclusion, pathomechanisms of itch in HS remain to be fully elucidated. However, we can draw on lessons from other pruritic disorders to begin addressing the symptom of it and identify important questions for future study.

Risk of psychiatric neurodevelopmental disorders after meningitis in childhood: a nationwide, population-based cohort study

Background Few studies have investigated the risk of psychiatric neurodevelopmental disorders (PNDD) after childhood meningitis. Methods Nationwide population-based cohort study (Denmark, 1995–2021) of children with positive cerebrospinal fluid for bacteria or enterovirus, stratified on age as young infants (0 to <90 days, n = 637) or older children (≥90 days to <17 years, n = 1,218). We constructed a comparison cohort from the general population (n = 18,550), and cohorts of siblings of participants. As risk estimates of PNDD we calculated age- and sex-adjusted hazard ratios (aHRs) with 95% confidence intervals (95%CI). Results Children with bacterial meningitis had increased risks of PNDD, especially learning and intellectual developmental disorders (young infants: aHR 4.2, 95%CI: 2.4–7.1; older children: aHR 1.5, 95%CI: 1.0–2.3), attention deficit disorder (ADHD) (young infants: aHR 2.8, 95%CI: 1.5–5.2; older children: 1.4, 95%CI: 0.9–2.2) and redemption of ADHD medication (young infants: aHR 2.2, 95%CI: 1.0–4.7; older children: 1.5, 95%CI: 1.0–2.3). Young infants with bacterial meningitis additionally had increased risks of autism spectrum disorders (aHR 1.9, 95%CI: 0.9–4.1) and behavioural and emotional disorders (aHR 2.0, 95%CI: 1.0–3.9). In young infants, the excess risk of PNDD was especially observed in premature children. Siblings of older children with bacterial meningitis also had increased risks of PNDD. Children with enteroviral meningitis at any age did not have increased risks of PNDD or redemption of ADHD medication. Conclusions Bacterial meningitis in childhood is associated with subsequent diagnosis of PNDD, while enteroviral meningitis is not. The association appears to be partly explained by prematurity and familial and socioeconomic factors.

The risk for psychiatric disorders in offspring from thrombosis-prone pedigrees in Sweden: a nationwide family study

The risk for psychiatric disorders in offspring from thrombosis-prone pedigrees in Sweden: a nationwide family study

Relationship among depression, fatigue, and sleep after traumatic brain injury: The role of physical exercise as a non-pharmacological therapy.

Traumatic brain injury (TBI) is a burdensome condition frequently associated with an increased risk of psychiatric disorders. Although the exact molecular signaling pathways have not yet been fully defined, the compromised integrity of functional brain networks in regions such as the prefrontal cortex and anterior cingulate cortex has been linked to persistent symptoms, including depression, fatigue, and sleep disorders. Understanding how TBI affects neural physiology enables the development of effective interventions. One such strategy may be physical exercise, which promotes neural repair and behavioral rehabilitation after TBI. However, there are caveats to consider when interpreting the effects of physical exercise on TBI-induced mental health issues. This review will highlight the main findings from the literature investigating how different physical exercise protocols affect the progression of TBI-induced depression, fatigue, and sleep disturbances. Furthermore, we aim to explore potential neurobiological pathways that explain how physical exercise influences depression, fatigue, and sleep following TBI.

The mediating role of accelerated biological aging in the association between household air pollution from solid cooking fuels and neuropsychiatric disorders

BackgroundThe role of biological aging in the relationship between household air pollution (HAP) from polluting cooking fuels and neuropsychiatric diseases remains unclear. MethodsThis nationwide cohort study enrolled 8,550 participants aged 45-80 from 2011 to 2020. Biological age based on Klemera−Doubal method (KDM-BA) was derived from 11 clinical biomarkers. The associations of switching cooking fuels with KDM-BA acceleration (KDM-BAA) and neuropsychiatric diseases were elucidated by generalized linear models and Cox proportional hazard models, respectively. The mediating effects of KDM-BAA on associations between polluting cooking fuel and neuropsychiatric diseases were further examined. We also evaluated the potential of leisure engagement in attenuating KDM-BAA associated with polluting cooking fuels. ResultsCompared to consistent use of cleaner fuels, consistent solid fuel use was associated with a 0.12 (95% CI: 0.05, 0.18) year increase in KDM-BAA, a 25% higher risk of neurological disease (HR = 1.25, 95% CI: 1.03, 1.54), and a 34% increased risk of psychiatric disorders (HR = 1.34, 95% CI: 1.02, 1.78). Mediation analysis revealed that KDM-BAA significantly mediated the association between solid cooking fuel and neuropsychiatric diseases, with mediated proportions of 5.96% (P = 0.006) for neurological disease and 5.71% (P = 0.024) for psychiatric disease. Leisure engagement demonstrated stable benefits in attenuating KDM-BAA independently of cooking fuel use. ConclusionOur findings illuminate the pathways connecting HAP from solid fuel consumption with biological aging and neuropsychiatric disorders, and highlight the role of leisure engagement and expanding access to cleaner fuels in mitigating these adverse effects.

Psychiatric disorders in children and adolescents with temporal lobe epilepsy: A narrative review.

People with epilepsy (PWE) are at higher risk of psychiatric disorders (PD), disability, and reduced quality of life than the general population, especially in childhood and adolescence and when seizures originate from the temporal lobe. Temporal Lobe Epilepsy (TLE) is the most common type of focal epilepsy and can be due to structural abnormalities, or non-lesional causes, such as genetic variants. The prevalence of PD is approximately 20%-30% in people with epilepsy in general, and from 40% up to 80% in people with TLE. A higher rate of anxiety and depression disorders has been observed in association with TLE than with extra-temporal epilepsy, or idiopathic generalized epilepsy, or other chronic diseases such as diabetes. However, while the association between psychopathology and TLE has been extensively assessed in adults, only a few studies have focused on its expression in children and adolescents. In this review, we describe the prevalence, characteristics, and risk factors for PD in people with epilepsy in general and with TLE, with a specific focus on the pediatric age. In addition, we provide insights into the current knowledge of the pathophysiological bases of psychiatric symptoms in children and adolescents with TLE. PLAIN LANGUAGE SUMMARY: This review examines the frequency and characteristics of psychiatric disorders in people with temporal lobe epilepsy, with a focus on children and adolescents. Similarly to adults, younger people with epilepsy have higher rates of psychiatric disorders, such as depression and anxiety, than healthy peers or children with other chronic illnesses such as diabetes and asthma. Contributing risk factors include epilepsy duration and severity, and the effects of antiseizure medications, as well as psychological challenges, sociocultural influences, and family dynamics. Psychiatric disorders associated with temporal lobe epilepsy are relatively frequent, probably in relation to the critical role that some limbic structures in the temporal lobe, such as the amygdala and hippocampus, play in regulating emotions and behavior.

Assessing the benefit-risk profile of newer glucose-lowering drugs: A systematic review and network meta-analysis of randomized outcome trials.

To comprehensively evaluate the benefits and risks of glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl peptidase 4 inhibitors (DPP4i), and sodium-glucose cotransporter 2 inhibitors (SGLT2i). A systematic search of PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to November 2023 to identify randomized cardiovascular and kidney outcome trials that enrolled adults with type 2 diabetes, heart failure, or chronic kidney disease and compared DPP4i, GLP-1RAs, or SGLT2i to placebo. Twenty-one outcomes (e.g., major adverse cardiovascular events [MACE], stroke, and hospitalization for heart failure [HHF]) were assessed. Data were pooled using population-averaged odds ratios (ORs) with 95% CIs. Twenty-six trials enrolling 198 177 participants were included. GLP-1RAs were most effective in lowering the risks of MACE (OR, 0.85, [95% CI, 0.79 to 0.92]) and stroke (0.84 [0.77, 0.91]), but increased the risk of thyroid cancer (1.58 [1.36, 2.50]). SGLT2i showed the greatest benefits in reducing the risk of HHF (0.68 [0.64, 0.73]) and improving composite renal outcomes (0.67 [0.58, 0.77]), but increased the risk of genital infections (3.11 [2.15, 4.50]). DPP4i were associated with a lower risk of certain psychiatric disorders, Parkinson's disease (0.54 [0.32, 0.92]), and amputation (0.70 [0.86, 0.93]), but an increased risk of neuropathy (1.10 [1.02, 1.18]) and pancreatitis (1.63 [1.40, 1.91]). The weighted origami plot suggested that GLP-1RAs were more suitable for reducing macrovascular and microvascular outcomes, while DPP4i might be better for neurodegenerative diseases and cancer concerns. Given the distinct benefit-risk profiles, the selection of glucose-lowering drugs should be individualized based on patient characteristics and risk factors.

The adolescent dysregulation profile and its association with educational, occupational, and substance use outcomes in emerging adulthood

The dysregulation profile (DP) in youth is characterized by severe emotional, cognitive, and behavioral dysregulation and is associated with an increased risk for psychiatric disorders. Adolescent self-regulation has important implications for adulthood outcomes, yet this association is understudied in the context of the DP in emerging adults. Using a Canadian adolescent sample ( N = 662; Mage = 15.52), a dimensional approach to the DP was taken and associations between adolescent DP scores and educational, occupational and substance use outcomes in emerging adulthood ( Mage = 25.77) were examined. Latent profile analysis revealed: a highly problematic group with elevated DP scores ( n = 59; 8.9%); an average problems group with average DP scores ( n = 285; 43.1%); and a low problems group with below average DP scores ( n = 318; 48%). The highly problematic group reported the lowest occupational statuses, and the highest prevalence of unemployment and substance dependencies. These results demonstrate the impact of subthreshold adolescent DP scores on emerging adulthood outcomes.

The Risk of Hospital Admission for an Acute-Onset Psychiatric Disorder in Adolescents and Adults Treated with Isotretinoin: A French, Nationwide, Population-Based, Case-Time-Control Study

Introduction: Oral isotretinoin is the only effective treatment for severe acne without an alternative. Isotretinoin has been linked to the occurrence of acute psychiatric disorders outside suicidal behaviors. There are few large-scale epidemiological studies in this area, and the putative associations are unclear. Our objective was to determine whether adolescents and young adults have an elevated risk of acute-onset psychiatric disorder requiring hospital treatment within 2 months of starting isotretinoin treatment. Methods: Our data source was the French national health insurance database (Système National des Données de Santé, SNDS), 2010–2015. We performed a case-time-control study nested in an exhaustive, nationwide cohort of all French adolescents and young adults aged 10–25 years treated with isotretinoin. The outcome was an acute-onset psychiatric disorder requiring hospitalization (including anxiety, depressive, mood, adjustment, and psychotic disorders). A conditional logistic model was used to estimate odds ratios (ORs) with their 95% confidence interval (CI) for acute psychiatric events. Results: 2,284 acute-onset psychiatric disorder requiring hospitalization were recorded for the study population of 262,786 patients. Among the patients with at least one psychiatric event, 88 had started taking isotretinoin in the risk period (0–2 months before the date of the event), versus 81 in the reference period (2–4 months before the event). A comparison with the 383 and 355 time-trend matched controls who started taking isotretinoin in the risk and reference periods, respectively, yielded a case-time-control OR (95% CI) of 1.01 (0.72–1.41). Conclusion: Psychiatric events managed outside the hospital system were not recorded. Our findings are reassuring for clinicians concerning the risk of severe acute-onset psychiatric events after isotretinoin initiation.

Linking Genome-Wide Association Studies to Pharmacological Treatments for Psychiatric Disorders

Large-scale genome-wide association studies (GWAS) should ideally inform the development of pharmacological treatments, but whether GWAS-identified mechanisms of disease liability correspond to the pathophysiological processes targeted by current pharmacological treatments is unclear. To investigate whether functional information from a range of open bioinformatics datasets can elucidate the relationship between GWAS-identified genetic variation and the genes targeted by current treatments for psychiatric disorders. Associations between GWAS-identified genetic variation and pharmacological treatment targets were investigated across 4 psychiatric disorders-attention-deficit/hyperactivity disorder, bipolar disorder, schizophrenia, and major depressive disorder. Using a candidate set of 2232 genes listed as targets for all approved treatments in the DrugBank database, each gene was independently assigned 2 scores for each disorder-one based on its involvement as a treatment target and the other based on the mapping between GWAS-implicated single-nucleotide variants (SNVs) and genes according to 1 of 4 bioinformatic data modalities: SNV position, gene distance on the protein-protein interaction (PPI) network, brain expression quantitative trail locus (eQTL), and gene expression patterns across the brain. Study data were analyzed from November 2023 to September 2024. Gene scores for pharmacological treatments and GWAS-implicated genes were compared using a measure of weighted similarity applying a stringent null hypothesis-testing framework that quantified the specificity of the match by comparing identified associations for a particular disorder with a randomly selected set of treatments. Incorporating information derived from functional bioinformatics data in the form of a PPI network revealed links for bipolar disorder (P permutation [P-perm] = 7 × 10-4; weighted similarity score, empirical [ρ-emp] = 0.1347; mean [SD] weighted similarity score, random [ρ-rand] = 0.0704 [0.0163]); however, the overall correspondence between treatment targets and GWAS-implicated genes in psychiatric disorders rarely exceeded null expectations. Exploratory analysis assessing the overlap between the GWAS-identified genetic architecture and treatment targets across disorders identified that most disorder pairs and mapping methods did not show a significant correspondence. In this bioinformatic study, the relatively low degree of correspondence across modalities suggests that the genetic architecture driving the risk for psychiatric disorders may be distinct from the pathophysiological mechanisms currently used for targeting symptom manifestations through pharmacological treatments. Novel approaches incorporating insights derived from GWAS based on refined phenotypes including treatment response may assist in mapping disorder risk genes to pharmacological treatments in the long term.

Editor's Spotlight/Take 5: Do Children With Accidental Gunshot-related Fractures Experience Greater Risk of Mental Illness and Psychiatric Disorders? A Propensity-matched Study.

Editor's Spotlight/Take 5: Do Children With Accidental Gunshot-related Fractures Experience Greater Risk of Mental Illness and Psychiatric Disorders? A Propensity-matched Study.

Stress-Related Disorders Among Young Individuals With Surgical Removal of Tonsils or Adenoids

Studies have suggested an increased risk of psychiatric disorders and suicidal behavior among individuals who have undergone tonsillectomy. However, little is known about stress-related disorders. To investigate whether surgical removal of tonsils or adenoids is associated with a subsequent risk of stress-related disorders. This cohort study used Swedish nationwide population and health registry data of all individuals born between January 1, 1981, and December 31, 2016. Individuals who had undergone surgical removal of tonsils or adenoids (ie, exposed persons) were compared with unrelated unexposed individuals individually matched by sex, birth year, and calendar date at the start of follow-up (population-matched cohort) and with their unexposed full siblings (sibling-matched cohort). The analysis was performed between December 15, 2023, and October 11, 2024. Surgical removal of tonsils or adenoids. The Swedish Patient Register was used to identify stress-related disorders, including posttraumatic stress disorder (PTSD), acute stress reaction, and adjustment disorder or other stress reaction. In the population-matched cohort, a Cox proportional hazards regression model was used to assess the association of tonsillectomy with the risk of stress-related disorders, conditioned on sex, birth year, and calendar date at the start of follow-up and adjusted for parental educational attainment and history of stress-related disorders. To address potential familial confounding, analyses were replicated using the sibling-matched cohort. The population-matched cohort included 83 957 exposed and 839 570 unexposed persons (median [IQR] age at the start of follow-up, 14.4 [6.5-18.6] years; 55.2% female), and the sibling-matched cohort included 51 601 exposed persons (median [IQR] age at start of follow-up, 14.9 [6.9-18.7] years, 55.8% female) and 75 159 unexposed full siblings (median [IQR] age at start of follow-up, 13.3 [6.9-19.5] years; 52.6% male). Compared with the unexposed population reference, exposed persons exhibited a higher subsequent risk of stress-related disorders (hazard ratio [HR], 1.43; 95% CI, 1.38-1.48), especially PTSD (HR, 1.55; 95% CI, 1.43-1.69). These results were replicated in the sibling-matched cohort (any stress-related disorder: HR, 1.34 [95% CI, 1.25-1.44]; PTSD: HR, 1.41 [95% CI, 1.18-1.69]). An increased risk was consistently noted regardless of sex, age at surgery, time since surgery, parental educational attainment, or parental history of stress-related disorders and was mainly noted for a surgery due to adenotonsillar diseases or sleep and respiratory abnormalities. In this cohort study, the findings suggest that early-life surgical removal of tonsils or adenoids is associated with a higher future risk of stress-related disorders and highlight a need to understand the role of adenotonsillar diseases or associated health conditions in the development of stress-related psychiatric disorders.

Mental Health Care Needs and Access to Care for Adults With Intellectual Disabilities.

Adults with intellectual disabilities (IDs) are at greater risk for psychiatric disorders than the general population. Yet, they have limited access to mental health services. To examine the prevalence of psychiatric disorders in adults with ID. To describe evidence-based interventions for this population, their access to mental health care, and outline opportunities for improved access. This manuscript summarizes literature regarding psychiatric disorders in adults with ID and their access to behavioral health care. We considered articles referencing mental health care for adults with ID. PubMed and a variety of search terms were used. Studies published in English from 2010 to the date of the searches were included. Quantitative and qualitative study designs, review articles, program descriptions, and opinion papers were considered for inclusion. Additional references from the selected articles were also considered. We identified 2864 records. One hundred two records were included, consisting of work commenting on mental health and ID and access to care in the United States. The articles describe increased psychiatric comorbidities in adults with ID. They highlight the few evidence-based interventions for psychiatric comorbidities and the limited access to care. Our mental health care providers generally have minimal training and experience with people with ID, limiting access to appropriate care for these individuals. Improved access could be created by increasing education and experiences with these populations for mental health providers. Aligning policies, financing, and adequate insurance reimbursement to develop a continuum of care will be critical for these individuals.

PsyRiskMR: a comprehensive resource for identifying psychiatric disorders risk factors through Mendelian randomization

BackgroundPsychiatric disorders pose an enormous economic and emotional burden on individuals, their families and society. Given that the current analysis of the pathogenesis of psychiatric disorders remains challenging and time-consuming, elucidating the modifiable risk factors becomes crucial for the diagnosis and management of psychiatric disorders. However, inferring the causal risk factors in these disorders from disparate data sources is challenging due to constraints in data collection and analytical capabilities. MethodsBy leveraging the largest available genome-wide association studies (GWAS) summary statistics for ten psychiatric disorders and compiling an extensive set of risk factor datasets, including 71 psychiatric disorders-specific phenotypes, 3,935 brain imaging traits, and over 30 brain tissue/cell-specific xQTL datasets (covering 6 types of QTLs), we performed comprehensive Mendelian randomization (MR) analyses to explore the potential causal links between various exposures and psychiatric outcomes using genetic variants as instrumental variables. ResultsAfter Bonferroni correction for multiple testing, we identified multiple potential risk factors for psychiatric disorders (including phenotypic level and molecular level traits), and provided robust MR evidence supporting these associations utilizing rigorous sensitivity analyses and colocalization analyses. Furthermore. we have established the PsyRiskMR database (http://bioinfo.ahu.edu.cn/PsyRiskMR/), which serves as an interactive platform for showcasing and querying risk factors for psychiatric disorders. ConclusionsOur study offered a user-friendly PsyRiskMR database for the research community to browse, search, and download all MR results, potentially revealing new insights into the biological etiology of psychiatric disorders.

Threat sensitivity mediates the association between perceived safety and anxiety in adolescents from urban communities

PurposeDespite the prevalence of violence exposure (VE) among youth and its link to increased risk for anxiety and related psychiatric disorders, few studies have examined potential mediators. The present study investigated the relationships among lifetime VE, perceived safety, threat sensitivity, and anxiety symptoms in adolescents from an urban minority community (Detroit, MI). MethodsA sample of 54 adolescents (ages 14–18, 55.6% female) self-reported on VE, safety, threat sensitivity, and anxiety symptoms in an online survey. Linear regression analyses were conducted to examine the associations among these variables. ResultsResults indicated that perceived safety, but not VE, was significantly associated with lower anxiety and threat sensitivity. Furthermore, threat sensitivity mediated the association between perceived safety and anxiety symptoms. DiscussionThe findings of the present study highlight (1) the potential protective role of perceived safety and (2) threat sensitivity as a potential target for disrupting anxiety-related pathways in adolescents with VE.

Prenatal exposure to maternal hypertension and higher body mass index and risks of neurodevelopmental and psychiatric disorders during childhood.

Hypertensive disorders of pregnancy (HDP) or prepregnancy overweight/obesity are independently associated with the risk for certain neurodevelopmental and psychiatric disorders in offspring. These two conditions often co-exist but the risk from combined exposure is unknown. We investigated whether specific subtypes of maternal HDP, along with prepregnancy overweight/obesity, were associated with the distinct risk of neurodevelopmental and psychiatric disorders in offspring during childhood. This prospective, population-based cohort study used data from 652 732 singleton children born alive in Finland between 2004 and 2014 and followed until 2018. The Cox proportional hazards model was used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (95% CI). Children exposed to both chronic hypertension and obesity exhibited a 2.4-3.5-fold higher risk for mood disorders, specific developmental disorder, autism spectrum disorders, and attention-deficit/hyperactivity disorders. Similarly, exposure to both gestational hypertension and overweight increased the risk for anxiety disorders and attention-deficit hyperactivity disorders by 2.4-fold. Meanwhile, combined exposure to preeclampsia and overweight increased the risk of mood and anxiety disorders, specific developmental disorders, and other behavioral disorders, by 1.8-2.2-fold. The effect size of combined exposure to HDP and overweight/obesity was greater than that of the individual exposure to HDP subtypes or overweight/obesity. Furthermore, overweight/obesity synergistically modified these associations between the HDP subtype exposure and offspring mental disorders, except for specific developmental disorders. Our findings suggest that combined exposure to different subtypes of HDP and higher prepregnancy BMI have distinct impacts on the mental health of offspring. Notably, a more pronounced effect was observed in cases where chronic hypertension and obesity coexisted. Future research should focus on exploring dose-related relationships rather than amalgamating maternal HDP for investigating the offspring outcomes.