Statistical Manual Of Mental Disorders Research Articles

Anorexia nervosa: A narrative review of diagnostic criteria, pathophysiology, and innovative management approaches

This narrative review delves into the complexities of anorexia nervosa (AN), focusing on its unique manifestations within diverse contexts, particularly in cancer patients. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic approach was employed via electronic databases such as PubMed, Scopus, and Google Scholar. AN has been explored in the context of cancer-related anorexia‒cachexia syndrome, aging, and autoimmune disorders. The diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are outlined, emphasizing severe disturbances in eating behavior and self-imposed starvation. A thorough examination of the physiological, psychological, and social aspects of AN provides a comprehensive understanding of its multifactorial nature. This review outlines diverse management strategies for AN, encompassing nutritional rehabilitation, psychotherapeutic interventions, and potential pharmacological treatments. Various studies have summarized emerging signaling pathways in cancer-related AN, the bidirectional associations between AN and autoimmune disorders, and potential therapeutic modalities such as acupuncture. Emphasis is placed on the importance of family support, psychoeducation, and early intervention in cancer patients with AN, highlighting the integral role of a comprehensive approach in improving outcomes. In conclusion, this narrative review offers valuable insights into the intricate nature of AN, providing a basis for future research and clinical efforts to refine targeted interventions, particularly within the context of cancer patients. The article provides a broad overview of AN, serving as a resource for those interested in understanding its diverse manifestations.

ADHD detection based on human action recognition

Attention Deficit Hyperactivity Disorder (ADHD) is a highly prevalent human neurobehavioral and neurodevelopmental disorder worldwide. Recently, deep learning-based techniques have been exploited in ADHD detection and diagnosis due to their outstanding performance. However, the majority of these methods relying on fMRI and EEG data suffer from the limitation of requiring expensive equipment and incurring high operational costs. Therefore, inspired by the fact that the symptoms of ADHD may manifest in actions and daily behaviors (as stated in the Medical Statistical Manual of Mental Disorders, Fifth Edition (DSM-V)), we introduce a novel ADHD detection system based on human action recognition. We design a novel hyperactivity test for capturing ADHD features and record a real multimodal ADHD dataset (M-ADHD) for the first time. The proposed system detects ADHD symptoms based on acquired action characters from raw RGB videos from the M-ADHD. Our system outperforms conventional competitors in terms of accuracy and AUC on the real multimodal ADHD dataset. Our proposed method, based on simple, non-wearable sensors, has the advantages of being cost-efficient and easy to operate. It is widely applicable for remote ADHD screening and further applies to understanding, treating, and preventing brain disorders.

A Systematic Review of Treatment for Children with Autism Spectrum Disorder: The Sensory Processing and Sensory Integration Approach.

The prevalence of the diagnosis of autism spectrum disorder (ASD) has been increasing globally, necessitating updates to the Diagnostic and Statistical Manual of Mental Disorders with respect to ASD diagnosis. It is now recognised that ASD is related to sensory processing disorder, and sensory integration is considered a suitable intervention for treating children diagnosed with ASD. This paper provides a systematic review on a timeline from 2013 to 2023, based on the PRISMA model. Evidence was sought in the academic search engines Pubmed, Scielo, Eric, Dialnet, Springer, Base Search and Google Scholar, which produced 16 articles according to the inclusion criteria. According to the results of this review, intervention with sensory integration in infants with ASD meets the criteria to be considered an evidence-based practice. The studies reviewed focused mainly on clinical settings and, therefore, we highlight the urgent need for further research to evaluate the effectiveness of sensory integration interventions in naturalistic settings such as homes and schools. This will help to obtain more representative data on how these interventions affect the daily lives of children with ASD.

The Modern Concept of Schizoaffective Disorder: A Narrative Review.

Schizoaffective disorder (SAD) is one of the most complex and controversial diagnoses in clinical psychiatry. Despite the significant changes that have occurred in the conceptualization of SAD in modern classifications and the publications of recent years, many unresolved issues remain regarding the disease, from the point of view of clinical psychiatry and basic neuroscience. The purpose of this paper is to summarize published data on the concept of SAD, its clinical characteristics, cognitive profile, potential biomarkers, as well as the place of the disease in the following modern international classifications: the International Classification of Diseases (ICD) 9th, 10th and 11th revisions, and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). We undertook a review of the scientific studies in the relevant bibliographic systems and databases (eLIBRARY, PubMed) of the past 15 years. The descriptive analysis method was used to summarize the collected information. A total of 70 publications were selected for review, including different versions of international classifications of diseases (ICD and DSM-5). There has been some improvement in the inter-rater reliability of SAD criteria in modern classifications, but this has not yet led to a clearer understanding among mental health specialists, while the various subtypes of SAD identified so far fail to account for the heterogeneity in the clinical presentation of the disorder. The dimensional approach to diagnosing SAD, according to which the intensity of psychotic and affective symptoms can fluctuate over time and they can influence one another, more accurately reflects the disease's ability to embody different forms. Basic research does not support the identification of a distinct cognitive, neuroimaging, or immunological SAD endophenotype that differs qualitatively from schizophrenia and affective psychoses. The conceptualization of SAD remains incomplete, and new approaches rooted in neuroscience are needed to better understand the coexistence of affective and psychotic symptoms.

Active suicidal ideation in an adolescent with autism spectrum disorder receiving methylphenidate: a case report

BackgroundMethylphenidate is a psychostimulant treatment widely prescribed in children and adolescents with attention deficit hyperactivity disorder. Although published studies are reassuring regarding the safety and tolerability of this treatment in the short and long term, there are case studies that have reported the possibility of serious adverse effects following methylphenidate initiation in children and adolescents.Case presentationIn the present study, we illustrate the case of a 13-year-old adolescent, who was diagnosed with autism spectrum disorder, attention deficit hyperactivity disorder, and other psychiatric comorbidities. The patient developed active suicidal ideation a few weeks after initiating methylphenidate. He also presented irritability accentuation, insomnia, decreased appetite, and an increase in temper tantrums after initiation of this treatment. Psychiatric evaluation, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), did not reveal major psychiatric disorders that could explain them, particularly mood disorders. The risk of suicide was assessed as high indicating a hospitalization and the immediate discontinuation of this treatment. The evolution was marked by a disappearance of suicidal thoughts 2 days after discontinuation of methylphenidate and a clear decrease in symptoms of poor tolerance. The authors were unable to establish a cause-and-effect link between the prescription of methylphenidate and the appearance of suicidal thoughts in this patient, but the results of studies already published seem to provide clues that could explain this link.ConclusionsThe purpose of this work is to alert clinicians to the possibility that young people who have multiple neurodevelopmental disorders may experience suicidal thoughts after starting methylphenidate even in the absence of mood disorders. The link between the prescription of this treatment and the onset of suicidal ideation is not as clear and requires more controlled studies. This suggests particular attention, such as informing the young people and their families beforehand and planning rigorous psychiatric evaluations after the prescription.

Investigating the Prevalence of Eating Disorders, Factors Contributing to Eating Disorders and Weight Control Methods: A Cross-Sectional Study on the Residents of Qassim Region, Saudi Arabia.

Background:Eating disorders significantly affect quality of life, body image, self-esteem, and relationships. Previous studies have mainly focused on Western populations, leaving a gap in our understanding of the cultural, social, and environmental factors in non-western populations. This cross-sectional study aimed to investigate the prevalence of eating disorders and its risk factors and examine the common methods for weight control used by affected individuals within the Qassim region of Saudi Arabia. Materials and methods:Recognizing the importance of understanding the landscape of eating disorders in this population, we used diagnostic criteria from the validated Arabic version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to assess the severity and patterns of eating disorders. Data were collected remotely over one year using a self-administered questionnaire distributed at schools, colleges, parks, and malls. The questionnaire covered demographics, weight control methods, and diagnostic criteria. This study included 404 undiagnosed cases (n = 404) to provide a comprehensive overview of the prevalence and severity of eating disorders in this region. Statistical significance was set at p < 0.05. Results:Of the participants, 12 (2.9%) reported having a diagnosed eating disorder, and the severity levels varied across different disorders. Anorexia nervosa exhibited predominantly moderate severity (264, 65.3%), with lower percentages classified as low (119, 29.5%) or high severity (21, 5.2%). Avoidant/restrictive food intake disorder demonstrated a varied distribution, with 131 (32.4%) classified as high severity, whereas bulimia nervosa was predominantly of low severity (242, 59.9%). Binge eating disorders were observed in a significant proportion of patients with moderate severity (203, 50.2%). Conclusion:There is an urgent need for heightened awareness, early detection, and intervention strategies tailored to the diverse spectrum of eating disorders in this region. Furthermore, understanding commonmethods that affect individuals' utilization of food and the severity and distribution of different disorders provides valuable insights into tailored interventions and support systems that promote healthier relationships between food and body image within the community.

Are Suicide-Specific Interventions Required to Reduce Suicidal Ideation? An Empirical Examination in a Clinical Sample of Eating-Disorder Participants

In this research, we examined whether non-suicide-specific treatments effectively reduced suicidal ideation (SI) among a clinical sample of eating-disorder (ED) patients ( N = 3,447, of whom 50.9% presented with SI). All participants met criteria for a current ED diagnoses based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and were administered a combination of evidence-based treatments in inpatient, residential, partial hospitalization, and intensive outpatient ED treatment facilities. Mediation analyses tested whether SI at discharge decreased specifically through standardized residual change scores in ED symptoms. Both SI and ED symptoms decreased over the course of treatment without clinically meaningful differences by ED diagnosis. ED symptom improvement partially mediated the relationship between SI at admission and discharge, suggesting that treating ED symptoms with evidence-based treatments can be an effective way to reduce SI, at least partially, for many patients. These findings demonstrate the importance of facilitating evidence-based-treatment referrals for specific disorders as a component of broad-based suicide outreach and prevention strategies.

7618 Thyroid Nodules, Normal Thyroid Levels, and Chronic Anxiety: A Case for Sub-Clinical Toxic Multinodular Goiter

Abstract Disclosure: C.M. Barrera: None. Introduction: Chronic anxiety and panic disorders, as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), are the most common psychiatric conditions. Hyperthyroidism is a known cause of both chronic anxiety and panic disorder. Case 1: A 36-year-old overweight Latin female is referred for evaluation of multiple thyroid nodules. The thyroid ultrasound was heterogeneous, with multiple bilateral nodules. In her history, the patient has chronic anxiety with panic attacks resulting in frequent emergency room visits. The TSH and T4 levels were TSH 0.59 mIU/L (0.40-4.5) and T4 10.7 mcg/dL (5.1-11.9). An I[1]23- Thyroid Scan showed a hot nodule with mild suppression and an uptake of 31.8% (The top limit is 35%). The patient started methimazole 2.5 mg daily, and after two months, her chronic anxiety and panic attacks resolved. Post-methimazole TSH rose to 1.18 mIU/L, and T4 10.0 mcg/dL and she has weaned off anxiety medications. Case 2: A 49-year-old overweight Latin female is referred for increased thyroid nodules. She complained of six months of tachycardia and anxiety. The TSH and T4 levels were TSH of 0.828 mIU/L (0.40-4.5) and T4 of 7.9 mcg/dl (4.5-12.0). An I[1]23-Thyroid Scan showed no dominant hot or cold nodules, with an uptake of 36.4% (The top limit is 35%, within normal error limits). She started methimazole 5 mg daily, resolving her tachycardia and anxiety within five weeks. Post-methimazole TSH was 1.64 mIU/L (0.45-4.5), and T4 6.7 mcg/dL (4.5-12.0). Case 3: A 60-year-old overweight Latin female is referred for evaluation of multiple thyroid nodules of ten years. She complained of chronic anxiety and panic attacks for two years. The TSH and T4 were normal at TSH 0.36 mIU/L (0.35- 5.50) and T4 9.7 mcg/dL (4.5-10.9). The thyroid ultrasound showed multiple bilateral nodules. An I[1]23-Thyroid Scan showed a suspected hot nodule without appreciable suppression and an uptake of 33% (The top limit is 35%). The patient started methimazole 5 mg daily. After eight weeks, she reported the resolution of most of her chronic anxiety with post-methimazole TSH 2.39 mIU/L and T4 7.1 mcg/dL (4.5-12.0). Discussion: The normal range of TSH, typically from 0.4-4.5 mIU/L, is calculated by measuring the TSH levels among a normal population. The group range then determines the laboratory reference range. This contrasts with individual values, which have a narrower range, suggesting that each person has a unique thyroid level. This suggests that TSH levels at the extremum, associated with hyperfunctioning nodules contributing to a rise in uptake, may not be normal for that patient and may explain the anxiety and other symptoms. Learning Points: Evolving multiple autonomous thyroid nodules lowers TSH levels while raising thyroid uptake. Symptoms of chronic anxiety and panic attacks can predate abnormal thyroid levels and resolve with low-dose methimazole. Presentation: 6/1/2024

Major considerations in neurotic skin excoriations and psychiatric disorders: a systematic review

Introduction: Among psychiatric dermatoses, neurotic excoriation is characterized by the patient's confession of causing lesions on the skin itself, without presenting a basic dermatological disease. The theme has been gaining prominence since the incorporation of the diagnosis in the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5, APA 2014). Objective: The present study addressed the main clinical findings in research studies on neurotic excoriation, in addition to valuing the importance of psychological aspects in etiopathogenesis. Methods: The research and development of the work were carried out from June to July 2024 in the Scopus, PubMed, Science Direct, and Scielo databases, using the main scientific articles on nutrigenomics, and following the PRISMA rules. The quality of the studies was based on the GRADE and AMSTAR-2 instruments, and the risk of bias by the Cochrane instrument (Funnel Plot). Results and Conclusion: 18 studies were included out of a total of 115. According to the GRADE instrument, most studies presented homogeneity in their results, with X2=89.5%&gt;50%. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 26 studies with a high risk of bias and 25 studies that did not meet the GRADE and AMSTAR-2 criteria. it was found that the subject has been scarcely addressed in the literature since not all cases are diagnosed and this pathology has more than one denomination (excoriation disorder, pathological palpation of the skin, neurodermatitis, dermatothilomania, and psychogenic excoriation). Therefore, the present study addressed the main clinical findings in research studies, through a systematic review, on neurotic excoriation, in addition to valuing the importance of psychological aspects in etiopathogenesis.

Current approaches to the identification and management of gambling disorder: a narrative review to inform clinical practice in Australia and New Zealand.

Gambling disorder is a recognised psychiatric disorder in the Diagnostic and statistical manual of mental disorders (DSM-5) and is classified as an addiction alongside alcohol and substance use disorders. The DSM-5 describes a past-year timeframe, episodic or persistent specifiers, early or sustained remission specifiers, and three gambling disorder severity specifiers (mild, moderate and severe). Although anyone can develop gambling disorder, there are known risk factors. In studies involving general adult populations, the likelihood of developing the disorder varies with the type of gambling, and is particularly high for internet gambling, casino table games and poker machines. Australia and New Zealand have shifted the focus of gambling disorder to the identification of gambling harm, in recognition that efforts targeting the prevention of harm may be more effective as they potentially influence a larger segment of the population. Temporal categories of gambling harm (crisis harms versus legacy harms) affect help-seeking and need for treatment. Crisis harms often motivate people to change their behaviour or seek help, whereas treatment addresses legacy harms, which emerge or continue to occur after gambling behaviour ceases. The evidence base and clinical guidelines recommend cognitive behavioural therapy and motivational interviewing but there are many gaps in our understanding of treatment for gambling disorder, including an absence of high quality evaluations that assess treatment effectiveness over the longer term, especially for treatment delivered in community settings. There is also an urgent need to understand how, why and for whom treatment works so that interventions can be optimised to individual needs, thereby facilitating client engagement. Because of limited access to health care and poor retention in treatment, in recent years there has been an increase in treatment choices in the form of internet therapies and smartphone applications.

Validating the Fluctuating Mental Status Evaluation in Neurocritically Ill Patients With Acute Stroke.

Neurocritically ill patients are at high risk for developing delirium, which can worsen the long-term outcomes of this vulnerable population. However, existing delirium assessment tools do not account for neurologic deficits that often interfere with conventional testing and are therefore unreliable in neurocritically ill patients. We aimed to determine the accuracy and predictive validity of the Fluctuating Mental Status Evaluation (FMSE), a novel delirium screening tool developed specifically for neurocritically ill patients. Prospective validation study. Neurocritical care unit at an academic medical center. One hundred thirty-nine neurocritically ill stroke patients (mean age, 63.9 [sd, 15.9], median National Institutes of Health Stroke Scale score 11 [interquartile range, 2-17]). None. Expert raters performed daily Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-based delirium assessments, while paired FMSE assessments were performed by trained clinicians. We analyzed 717 total noncomatose days of paired assessments, of which 52% (n = 373) were rated by experts as days with delirium; 53% of subjects were delirious during one or more days. Compared with expert ratings, the overall accuracy of the FMSE was high (area under the curve [AUC], 0.85; 95% CI, 0.82-0.87). FMSE scores greater than or equal to 1 had 86% sensitivity and 74% specificity on a per-assessment basis, while scores greater than or equal to 2 had 70% sensitivity and 88% specificity. Accuracy remained high in patients with aphasia (FMSE ≥ 1: 82% sensitivity, 64% specificity; FMSE ≥ 2: 64% sensitivity, 84% specificity) and those with decreased arousal (FMSE ≥ 1: 87% sensitivity, 77% specificity; FMSE ≥ 2: 71% sensitivity, 90% specificity). Positive FMSE assessments also had excellent accuracy when predicting functional outcomes at discharge (AUC, 0.86 [95% CI, 0.79-0.93]) and 3 months (AUC, 0.85 [95% CI, 0.78-0.92]). In this validation study, we found that the FMSE was an accurate delirium screening tool in neurocritically ill stroke patients. FMSE scores greater than or equal to 1 indicate "possible" delirium and should be used when prioritizing sensitivity, whereas scores greater than or equal to 2 indicate "probable" delirium and should be used when prioritizing specificity.

Gender bias of antisocial and borderline personality disorders among psychiatrists.

Antisocial Personality Disorder (ASPD) and Borderline Personality Disorder (BPD) challenge mental health professionals with similar maladaptive behaviors. However, these two disorders differ regarding available evidence-based treatments. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been criticized as being gender-biased diagnostic construct. The present study aimed to determine the gender bias of ASPD and BPD among Turkish psychiatrists. Three case vignettes were randomly presented as male or female to the psychiatrists online. The first case was a patient with schizophrenia case to confirm the participant's ability to diagnose. The second case was a patient with ASPD, and the third one was a patient with BPD. Two hundred fifty participants diagnosed the first case correctly (n = 250). The results with statistical significance demonstrated that a female case with ASPD was 5.1 times more likely to get misdiagnosed than a male case with ASPD (p˂0.0001). Categorical classification of personality disorders in DSM leads to gender bias in in the diagnosis of ASPD and BPD. The present study shows that female cases with ASPD are misdiagnosed as BPD which may result in treatment attempts without evidence.

Initial development of a digitally based comprehensive child mental health questionnaire.

The present report describes the item development and initial validation of a comprehensive child mental health questionnaire through a series of four studies. To maximize clinical utility, the questionnaire was developed to directly reflect Diagnostic and Statistical Manual of Mental Disorders, fifth edition psychiatric criteria and diagnoses, cover all mental health conditions that present in youth, and capitalize on the benefits of digital administration, particularly tiered branching logic. Study 1 describes the item generation and development of a tiered item structure. Study 2 established internal consistency and discriminant validity in a representative community sample of 1,000 youth aged 7-17 and a parent. Study 3 examined the acceptability of the questionnaire's content and structure to families and made indicated text revisions. Finally, Study 4 cross validated the internal consistency and tiered structure of a revised version of the questionnaire in a second representative normative sample of 1,000 parent and child dyads. The four studies resulted in a questionnaire consisting of one general mental health question (parent-report only), 16 items (for both parent and child) on a diagnostic category checklist, and 40 scales with screener and follow-up items reflecting DSM-5 criteria for specific disorders (371 parent items and 326 child items). The data support the potential of the questionnaire to efficiently assess the breadth of youth psychiatric symptoms efficiently. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Relationship Between Brain-Derived Neurotrophic Factor and Serotonin in Major Depressive and Bipolar Disorders: A Cross-Sectional Analysis.

Background Mood disorders like major depressive disorder (MDD) and bipolar disorder (BD) involve complex interactions between brain-derived neurotrophic factor (BDNF) and serotonin. While extensive research has explored these factors individually, their combined effects and interactions in these disorders are less understood. This study uniquely addresses this gap by examining how BDNF and serotonin interact and relate to mood disorder severity, providing new insights into their joint role in MDD and BD. Objectives The objective of this study was to examine the correlation between serum BDNF and plasma serotonin levels and to assess how these correlations relate to the severity of symptoms and overall disease severity in MDD and BD. Methodology This cross-sectional study, conducted at the Khyber Medical University, Peshawar, from January to September 2023, examined the correlation between BDNF and serotonin in individuals with MDD and BD. Participants (n = 63) aged 18-65 were recruited based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, excluding those with neurological disorders, substance abuse, or severe medical illness. A control group of 21 healthy individuals was matched by age and gender. Data collection involved demographic details, clinical history, and comorbid diagnoses assessed using the Mini International Neuropsychiatric Interview (MINI). Mood disorder severity was measured using the Hamilton Depression Rating Scale (HAM-D) for MDD and the Young Mania Rating Scale (YMRS) for BD, along with additional assessments (Beck Depression Inventory, Global Assessment of Functioning). Serum BDNF and serotonin levels were analyzed using enzyme-linked immunosorbent assay (ELISA) kits. Statistical analyses included t-tests, Mann-Whitney U tests, Pearson correlations, and subgroup analyses to assess relationships between biomarkers, mood disorder severity, and influencing factors. Results BDNF levels were found to be 20.1 ± 5.3 ng/mL in MDD, 18.5 ± 4.7 ng/mL in BD, and 25.9 ± 6.2 ng/mL in controls. Serotonin levels were 45.8 ± 12.6 ng/mL in MDD, 43.2 ± 11.4 ng/mL in BD, and 52.1 ± 14.3 ng/mL in controls. In the MDD group, significant negative correlations were observed between BDNF levels and mood disorder severity (r = -0.32, p = 0.045), whereas serotonin levels did not show significant correlations (r = -0.21, p = 0.23). In the BD group, BDNF levels also showed a significant negative correlation with manic symptoms (r = -0.28, p = 0.048), but serotonin levels showed no significant correlation. Subgroup analyses revealed that participants under 40 years had higher BDNF levels (22.8 ± 5.6 ng/mL) compared to those aged 40 and above (19.7 ± 4.3 ng/mL). Females showed higher BDNF levels (24.5 ± 6.3 ng/mL) than males (19.3 ± 3.8 ng/mL). Participants not on medication had higher BDNF levels (23.6 ± 5.1 ng/mL) compared to those on medication (17.9 ± 4.2 ng/mL). Those without comorbidities also had higher BDNF levels (23.8 ± 5.9 ng/mL) than those with comorbidities (18.2 ± 4.5 ng/mL), while serotonin levels varied similarly across these subgroups. Conclusion Lower BDNF levels are associated with mood disorders and symptom severity, indicating their potential as a biomarker.

Comparative analysis of the identification efficacy of the bipolarity index and diagnostic and statistical manual of mental disorders, 5th edition, for bipolar disorder screening among college students

ObjectiveThis study aims to explore the differences in the identification efficacy of the Bipolarity Index (BPX) and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), as screening approaches for bipolar disorder (BD). MethodsA total of 150 college students with depressive episodes who underwent outpatient and inpatient treatment at Central China Normal University Hospital and the Renmin Hospital of Wuhan University between January 2021 and December 2022 were selected as research participants. We used a self-developed general data questionnaire to collect comprehensive demographic and clinical data from all participants. This questionnaire covered various aspects including gender, age, occupation, education level, drinking habits, age at onset, disease duration, frequency and duration of the current episode, comorbidities, family history of genetic conditions, diagnosis and prognosis. Participants were evaluated using the BPX, the DSM-5 and the International Classification of Diseases, 10th Revision (ICD-10). Clinical diagnosis based on the ICD-10 served as the standard against which the BPX and DSM-5 were compared for sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV). Additionally, we conducted a multivariate logistic regression analysis to evaluate risk factors associated with BD. ResultsThe sensitivity, specificity, accuracy, PPV and NPV were 85.34%, 81.90%, 84.00%, 87.21% and 79.69% for the BPX screening, and 72.73%, 90.32%, 80.00%, 91.43% and 70.00% for the DSM-5 screening, respectively. The study also identified significant clinical characteristics that differentiated those who screened positive for BD using the BPX. These characteristics included a younger average age at onset, a higher prevalence of atypical depression and more frequent prior affective episodes compared with those who did not meet the BPX criteria for BD. Risk factors associated with BD included atypical depression, history of suicide attempts, four or more previous affective episodes, borderline personality disorder, mixed states and a family history of BD. ConclusionIn conclusion, our findings suggest that the BPX exhibits superior sensitivity in screening for BD among college students compared with the DSM-5. Additionally, the study identifies significant risk factors (e.g., atypical depression, history of suicide attempts and multiple previous affective episodes), which are crucial for early detection and management.

Suicidal thoughts and behaviors in adults with hoarding disorder

BackgroundHoarding disorder (HD) is characterized by difficulty discarding possessions and clutter that impairs daily functioning. Previous research has demonstrated a high correlation between hoarding behaviors and suicidal thoughts and behaviors; however, there is limited research on suicidal thoughts and behaviors in individuals meeting Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for HD. Our aim in this study was to report our findings about suicidal thoughts and behaviors in a HD sample. MethodsWe used existing data from participants meeting DSM-5 criteria for HD (n = 99). Data about suicidal thoughts and behaviors was collected using a structured instrument, the Columbia-Suicide Severity Rating Scale (C-SSRS). ResultsAmong the 99 participants, 49.5 % and 26.3 % had passive and active suicidal ideation (SI), respectively. Of those with active ideation, 11 participants endorsed thinking about overdose during their most severe SI. 13 participants reported attempting suicide at least once in their lifetime. ConclusionsTo our knowledge, this is the first study examining suicidal thoughts and behaviors in HD using the structured assessment C-SSRS. In this HD data set, participants reported suicidal thoughts and behaviors at higher rates than the general U.S. population. Our study highlights the importance of screening for suicidal thoughts and behaviors in individuals with HD.

Improving the DSM-5 approach to cognitive impairment: Developmental prosopagnosia reveals the need for tailored diagnoses.

The Diagnostic Statistical Manual of Mental Disorders (DSM-5) recommends diagnosing neurocognitive disorders (i.e., cognitive impairment) when a patient scores beyond -1 SD below neurotypical norms on two tests. I review how this approach will fail due to cognitive tests' power limitations, validity issues, imperfect reliabilities, and biases, before summarizing their resulting negative consequences. As a proof of concept, I use developmental prosopagnosia, a condition characterized by difficulties recognizing faces, to show the DSM-5 only diagnoses 62-70% (n1 = 61, n2 = 165) versus 100% (n1 = 61) through symptoms alone. Pooling the DSM-5 missed cases confirmed the presence of group-level impairments on objective tests, which were further evidenced through meta-analyses, thus validating their highly atypical symptoms. These findings support a paradigm shift towards bespoke diagnostic approaches for distinct cognitive impairments, including a symptom-based method when validated effective. I reject dogmatic adherence to the DSM-5 approach to neurocognitive disorders, and underscore the importance of a data driven, transdiagnostic approach to understanding patients' subjective cognitive impairments. This will ultimately benefit patients, their families, clinicians, and scientific progress.

Prevalence and Risk Factors of PTSD, Depression, and Grief Among Survivors of 2023 Türkiye Earthquake.

This study investigated the prevalence and risk factors of probable posttraumatic stress disorder (PTSD), depression, and complicated grief among 529 adults residing in a container city, 4 months after the 2023 earthquakes in Türkiye. Participants were assessed using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, the Hamilton Depression Scale, and the Inventory of Complicated Grief. The prevalence rates of probable PTSD, depression, and complicated grief were 21.4%, 15.9%, and 64.7%, respectively. Logistic regression analyses indicated that PTSD was significantly associated with the loss of a loved one, fear of future earthquakes, and decreased perceived life control. Similarly, depression was associated with being trapped under debris, experiencing fear during the earthquake, and reduced perceived life control. These findings suggest that individuals presenting these risk factors warrant closer follow-up for potential psychological issues. Additionally, the impact of fear related to the earthquake and the role of perceived life control emerge as crucial considerations for psychological interventions.

Prevalence of Attention Deficit Hyperactivity Disorder among Primary School Children in Hyderabad, South India

Purpose: Attention deficit hyperactivity disorder (ADHD) is among the most prevalent neurodevelopmental disorders in childhood, and its incidence has increased in recent years. However, the frequency of ADHD varies significantly across different countries and regions. This study aimed to determine the prevalence of ADHD among primary school children in Hyderabad, India, as well as to raise awareness about ADHD among teachers.Methods: This descriptive cross-sectional study included 700 school-aged children between 5 and 12 years old, selected according to specific inclusion and exclusion criteria. The teachers' version of the Vanderbilt Assessment Scale, a rating scale grounded in Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria, was employed to diagnose ADHD. Results: The prevalence of ADHD in this study was 9.57% (67 out of 700), with a mean age of 8.9 years. ADHD was more prevalent in boys than in girls, with a sex ratio of 3:1. The combined type of ADHD was the most common (52.3%), followed by the attention deficit type (29.8%) and the hyperactive-impulsive type (17.9%). Conclusion: The prevalence of ADHD among schoolchildren in middle-income countries, such as India, is sufficiently high to impose a significant societal burden. Therefore, it is imperative that all elementary school teachers receive training on how to screen for indicators of ADHD.

Cyberbullying and Internet Gaming Disorders in Pakistan: Strategies for Mitigation

Dear Editor,Cyberbullying and internet gaming disorders (IGDs) have emerged as significant concerns in Pakistan, particularly among adolescents. This editorial explores the prevalence, impacts, and potential interventions for these issues, drawing on recentresearch and literature. The need for a multifaceted approach involving parents, educators, communities, and government is emphasized to protect vulnerable populations and promote a healthier digital environment. The advent of widespread internet access in Pakistan has brought numerous benefits, yet it has also introduced challenges such as cyberbullying andinternet gaming disorders (IGDs). These phenomena have serious implications for the mental health and well-being of adolescents. Given the relative novelty of these issues in the local context and the paucity of research, it is crucial to develop a comprehensive understanding and effective strategies for mitigation. According to a met analysis of earlier research, Asianyouth have a high IGD prevalence 1 Defining Cyberbullying and IGDs Cyberbullying lacks a universally accepted definitiondue to its complexity. Alipan and Skues provide a useful framework, describing it as behavior that intentionally harms victims using information and communication technology, perceived as harmful by victims, and witnessed by bystanders as negative2 . IGDs are recognized in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a condition warranting further study. Vulnerability of Adolescents Adolescents are particularly susceptible to cyberbullying and IGDs due to the developmental changes they experience. The American Academy of Pediatrics recommends against providing personal mobile phones to children under 13 years old, highlighting their vulnerability to risky behaviors3. The prefrontal cortex, responsible for decision making and impulse control, is not fully developed in adolescents, making them prone to impulsive and risky behaviors, including cyberbullying and excessive gaming.