Statistical Manual Of Mental Disorders Research Articles

Mapping the evolution of gender dysphoria research: a comprehensive bibliometric study

AbstractThe definition of gender dysphoria has been the subject of extensive scientific debate in various fields. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V) characterizes gender dysphoria as a psychological condition due to a discrepancy between perceived and assigned gender. The scientific community has engaged in an extensive debate over the years regarding the classification of gender dysphoria, initially characterizing it as a gender identity disorder and subsequently removing it from the category of mental disorder. This paper aims to use bibliometric techniques to analyze scientific productivity and study the evolution of content on gender dysphoria from 1991 to 2022. It provides to map the scientific research production in this field through the science mapping approach highlighting the changes that have taken place over the past three decades.

Yoga Exercises as a Therapeutic Approach for Adults with Insomnia to Promote better Sleep: A Randomized Control Trial

Background: Insomnia is a prevalent sleep disorder that significantly impacts the quality of life and is associated with various health complications, including high blood pressure, heart disease, diabetes, anxiety, and depression. Traditional treatments for insomnia often involve pharmacological interventions, but there is growing interest in alternative therapies such as yoga. This study investigates the efficacy of yoga as a therapeutic approach to improving sleep quality in adults with insomnia. Objective: The objective of this study was to evaluate the effects of a structured yoga program on sleep quality and sleep latency in adults diagnosed with insomnia. Methods: The study employed a cross-sectional design conducted at multiple healthcare facilities, including the Physiotherapy Outpatient Department at Holy Family Hospital, Benazir Bhutto Hospital, and District Headquarters Hospital in Rawalpindi. The study duration was four months, involving 54 participants selected through random sampling techniques. Inclusion criteria included adults aged 18 to 65 years diagnosed with insomnia according to the International Classification of Sleep Disorders (ICSD) or the Diagnostic and Statistical Manual of Mental Disorders (DSM). Exclusion criteria included severe medical or psychiatric disorders, substance abuse, pregnancy, or recent changes in sleep medication. Participants in the intervention group engaged in a standardized yoga program consisting of gentle yoga postures, controlled breathing techniques, and mindfulness meditation, conducted twice weekly for eight weeks, with each session lasting 60 minutes. The control group received standard care for insomnia. Data collection involved subjective assessments of sleep quality using validated questionnaires and objective measures through polysomnography. Statistical analysis was performed using SPSS version 25.0, with independent sample t-tests comparing means between groups and repeated measures ANOVA for within-group analysis. Results: The yoga group showed significant improvements in subjective sleep quality and sleep latency. The mean sleep quality score improved from 2.18 ± 0.66 pre-intervention to 0.92 ± 0.37 post-intervention (p=0.0001), while the control group showed a less marked improvement from 2.37 ± 0.48 to 2.03 ± 0.18 (p=0.0012). Sleep latency in the yoga group decreased from 3.00 ± 0.00 to 1.29 ± 0.40 (p=0.0002), whereas the control group showed a reduction from 2.44 ± 0.49 to 2.11 ± 0.31 (p=0.0013). ANOVA results confirmed the statistical significance of these findings, with an F-value of 69.897 for sleep quality (p=0.0001) and 361.947 for sleep latency (p=0.0002). Conclusion: The findings indicate that a structured yoga program significantly improves sleep quality and reduces sleep latency in adults with insomnia. Yoga appears to be an effective non-pharmacological intervention for managing insomnia, offering a viable alternative to traditional treatments.

Comparing the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, personality disorder models scored from the same interview.

The alternative model of personality disorders (AMPD) traits were designed to maintain continuity with the Section II personality disorder (PD) diagnoses by retaining the same clinical information. Whether the AMPD traits achieve this is not well established. Prior work testing incremental validity of AMPD traits and Section II diagnoses is limited by the fact each model was measured by a different instrument or rater, making it unclear whether discrepancies are due to the constructs or methods. Here, we compare the incremental validity of AMPD traits versus Section II PDs assessed by the same instrument and rater. Participants (N = 311, 50% received past-year mental health treatment) completed a clinical interview, baseline self-reports, and 14-day ambulatory assessment protocol. Interviewers rated AMPD domains, facets, and Section II criteria from the same interview (Structured Interview for DSM-IV Personality). We used hierarchical regression models to evaluate the variance predicted in 17 clinically relevant cross-sectional and momentary variables by the AMPD traits and Section II PDs. Incremental R² showed that Section II PDs account for little variance in outcomes over and above the AMPD domains/facets, whereas the AMPD facets were generally more predictive of outcomes than the Section II PDs. Results add novel evidence that dimensional PD traits-not a particular assessment method-are equivalent or superior to PD categories for predicting social, emotional, and behavioral functioning. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Association of categorical diagnoses and psychopathologies with quality of life in patients with depression, anxiety, and somatic symptoms: A cross-sectional study

ObjectiveMajor depressive disorder (MDD), anxiety disorders, and somatic symptom disorder (SSD) are associated with quality of life (QoL) reduction. This cross-sectional study investigated the relationship between these conditions as categorical diagnoses and related psychopathologies with QoL, recognizing their frequent overlap. MethodsWe recruited a total of 403 clinical patients and healthy individuals, administering diagnostic interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. QoL and psychopathologies were assessed using the WHO Quality of Life-BREF (WHOQOL-BREF) and several self-administered questionnaires, respectively. Multiple linear regression analyses examined the associations between psychiatric diagnoses, psychopathologies, and QoL. ResultsSSD and MDD were independently associated with impaired global (β = −0.318 and − 0.287) and all QoL domains (β = −0.307, −0.150, −0.125, and − 0.133, in physical, psychological, social, and environmental domains respectively for SSD; β = −0.278, −0.344, −0.275, and − 0.268 for MDD). The Beck Depression Inventory-II score showed pervasive associations with QoL (β = −0.390, −0.408, −0.685, −0.463, and − 0.420, in global, physical, psychological, social, and environmental domains). The Patient Health Questionnaire-15 and Health Anxiety Questionnaire scores were associated with global (β = −0.168 and − 0.181) and physical (β = −0.293 and − 0.121) QoL domain, while the Cognitions About Body and Health Questionnaire score was only associated with environmental QoL domain (β = −0.157). ConclusionSSD and MDD were independently associated with QoL impairment. Depressive symptoms were associated with all QoL domains, whereas somatic symptom burden and health anxiety primarily affected the physical QoL domain. Clinicians should consider concomitant psychopathologies when managing patients with depression, anxiety, or somatic symptoms.

ICD-11 and DSM-5-TR prolonged grief symptoms and quality of life: A criterion validity test.

Two similar but distinct versions of prolonged grief disorder (PGD) have recently been included in the International Classification of Diseases eleventh edition (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders - fifth edition, Text-Revision (DSM-5-TR). This study provides a criterion validity test of both new criteria sets of PGD, by examining concurrent and longitudinal associations of ICD-11 and DSM-5-TR prolonged grief symptoms with quality of life (QOL). Bereaved adults completed a survey assessing ICD-11 and DSM-5-TR prolonged grief symptoms, depressive symptoms, insomnia symptoms and QOL at baseline and 6-month follow-up. Both ICD-11 and DSM-5-TR prolonged grief symptoms related negatively to QOL concurrently, while controlling for insomnia and depressive symptoms. ICD-11 prolonged grief symptoms, but not DSM-5-TR prolonged grief symptoms, predicted QOL at 6-month follow-up, while controlling for baseline QOL and insomnia and depression symptoms. Results provide consistent evidence for the criterion validity of ICD-11 PGD, but mixed evidence for the criterion validity of DSM-5-TR PGD. Study results can help guide attempts to optimize and harmonize future PGD criteria.

The screening of cannabis addiction using machine learning, MoCA, and anxiety/depression tests

A new cannabis addiction screening approach is developed based on the use of Machine Learning (ML) alongside with psychological and cognitive assessment tests. The Hospital Anxiety and Depression (HAD) test is used to determine the Absence of Anxiety and Depression “No Disorder” or the presence of “Anxiety Only”, “Depression Only”, and both “Anxiety and Depression”. These features are considered to evaluate the psychological effects of cannabis use. In addition to that, the Montreal Cognitive Assessment (MoCA) test is chosen as a feature to assess the cognitive state of the participants. Also, the Age of First Cannabis Use (AFCU) is included as a feature to incorporate participants with no prior cannabis use alongside with those who have used cannabis before. The portion of participants with prior experience consuming cannabis comprises a subset containing passive users and a subset of users that have developed cannabis addiction. This 6-month study was conducted in Marrakech, Morocco in a center affiliated to the National Association of Drug-Risk Reduction of Morocco known as RdR-Maroc with the participation of 146 subjects. The participants in this study are grouped into two groups of 73 participants each. Both case and control groups were clinically assessed by a professional. In this paper, the classical statistical data analysis for the AFCU (M=15.6; SD=2.4), MoCA (M=25.0; SD=2.4), and HAD (58 cases with no disorder, 88 cases with disorder) failed to separate between the two classes. Also, the feature selection for modeling is performed using Spearman correlation, Kendall correlation, and the Odds Ratio (OR). These statistics showed that the selected features were associated to addiction except for “Anxiety Only”. Moreover, ML models such as Logistic Regression (LR), Support Vector Machine (SVM), Artificial Neural Network (ANN), kth-Nearest Neighbor (KNN), and Decision Tree (DT) were used to classify participants into two categories (Addict vs. Non-Addict) based on the selected features mentioned earlier. The Receiver Operating Characteristic (ROC) curve is used to overview the quality of the models and showed that they all captured the nonlinearities underlined in the data. On the other hand, the Area Under the Curve (AUC) allowed the ranking of these models and indicated that the SVM model outperformed all other models with an AUC of 0.97. After that, the SVM model was compared to the Cannabis Use Disorder (CUD) based screening method issued by the fifth edition of the Diagnostic and Statistical Manual of mental disorders (DSM-5). The SVM model's accuracy of 96.6 % outperformed the CUD questionnaires accuracy of 87.7 %. The validity of the proposed approach was investigated where the SVM model presented high validity characteristics (sensitivity=1, specificity=0.93) compared to the CUD questionnaire (sensitivity=0.75, specificity=1). Hence, the proposed approach provided satisfactory results compared to current adopted CUD based screening test. Our findings expand current research on the development of simple and powerful tools for cannabis addiction screening with the purpose of early detection in order to establish preventive and therapeutic strategies that could potentially mitigate the prevalence of cannabis addiction.

Prevalence of insomnia in a general adult population cohort using different diagnostic criteria: The seventh survey of the Tromsø study 2015–2016

Insomnia disorder is a subjective complaint of sleep dissatisfaction including both night-time and daytime symptoms. Currently there are three commonly used diagnostic manuals each with their own set of criteria, which is often credited for the wide range in insomnia prevalence reported by population-based studies, especially those with self-reported insomnia. However, there are limited studies directly comparing different criteria and little is known about associations with health outcomes. Thus, the aim of this study was to compare the most commonly used diagnostic criteria for insomnia from the literature and to explore the associations with a range of physical and mental health outcomes. We used data from 21,083 women and men from the seventh survey of the population-based Tromsø Study which included adults aged 40–99 years. A revised version of the Bergen Insomnia Scale was used to define insomnia based on the 4th (revised) and 5th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR and DSM5), the 10th edition of the International Classification of Diseases (ICD-10), and the 3rd edition of the International Classification of Sleep Disorders (ICSD-3). We found the following prevalence of insomnia: DSM-IV-TR 23.6 %, DSM5 8.5 %, ICD-10 9.9 % and ICSD-3 20.0 %. When looking at each symptom, we found over half the participants classified as having insomnia using the DSM-IV-TR and ICSD-3 criteria did not report having impaired daytime functioning at least three days per week. Overall, participants with DSM5 and ICD-10 insomnia appeared to have worse health profiles, based on a higher percentage meeting the cut-off for possible anxiety or depression, reporting a psychological problem or chronic pain, and using antidepressants, painkillers or sleeping pills. However logistic regression models showed largely the same health factors had the same association with the odds for being classified as having insomnia disorder from each set of criteria. Overall, this study suggests that insomnia prevalence may be overestimated if daytime symptoms are not adequately included in accordance with current guidelines.

Opioid Use Disorder among Hospitalized Adults in North Carolina: Analysis from the 2000-2020 NC State Inpatient Database.

Opioid use disorder (OUD) is characterized as a chronic condition that was first outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and now the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. It encompasses frequent opioid usage, cravings, the development of tolerance, withdrawal symptoms upon discontinuation, unsuccessful attempts to quit or reduce use, and recurrent use even when faced with negative consequences. Both national- and state-level data show that overdose deaths associated with prescription opioids are increasing at an alarming rate. The increasing overdose deaths from illicitly manufactured fentanyl and other synthetic opioids compound this epidemic's burden. The present study sought to determine the prevalence and potential factors associated with OUD in North Carolina. Using the State Inpatient Database, a retrospective cross-sectional study was conducted to identify OUD-related discharges between 2000 and 2020. Descriptive statistics and rates of OUD per 1000 discharges were calculated. Simple and multivariable logistic regression models were used to identify factors associated with increased odds of having an opioid use disorder diagnosis at discharge. The deviance-Pearson goodness of fit statistic was also used. Variables were identified using International Classification of Diseases, Ninth Revision, Clinical Modification, and International Classification of Diseases, Tenth Revision, Clinical Modification, codes in the discharge records. Of 19,370,483 hospitalizations that occurred between 2000 and 2020 in North Carolina, 483,250 were associated with OUD, a prevalence rate of 24.9 cases per 1000 discharges. The highest OUD rates were seen among adults who self-paid for their hospitalization, those with Medicaid, and those with other types of payors such as Workers' Compensation and the Indian Health Service; individuals between 25 and 54 years old; tobacco and alcohol users; Native American patients; patients located in urban areas; patients with lower household income; White patients; and female patients. OUD also was associated with increased odds of having one or more comorbid psychiatric disorders when controlling for other factors. Although preventive measures are crucial, including policies that discourage prescribing opioids for noncancer pain and those that target the manufacturing and distribution of synthetic opioids, providing integrated care for patients with OUD and co-occurring psychiatric and/or physical disorders is equally important. These findings suggest the need for a system-wide public health response focused on the expansion of primary prevention and treatment efforts, including crisis services, harm reduction services, and recovery programs.

The abnormalities of lipid metabolism in children and adolescents with major depressive disorder and relationship with suicidal ideation and attempted suicide

BackgroundMajor depressive disorder (MDD) is a widespread health issue in many countries, which has an extremely negative impact on the health of children and adolescents in particular. In the context of depression and metabolic disorders, dyslipidemia and metabolism-related problems become more prominent comorbidities. However, they continue to be the main barrier to the successful recovery of the clinical progress. In this study we investigated the rate of dyslipidemia, additional risk factors among Chinese children and adolescents with MDD, and association of the suicidal behavior with lipid levels. MethodsThe study took 756 people from the Third People's Hospital of Fuyang between January 2020 and December 2021, aged between 8 and 18, with major depressive disorders diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). We determined the FBG (fasting blood glucose) and lipid parameters in all subjects and also investigated the history of suicidal ideation, the cases of attempted suicide, and the scores of depressive symptoms. Sociodemographic and clinical data were gathered and analyzed using the SPSS-23.0 version. ResultsThe prevalence of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C were 5.42% (41/756), 10.58% (80/756), 3.84% (29/756) and 5.42% (41/756) respectively. For hypercholesterolemia and hypertriglyceridemia, they were positive associated with suicidal ideation and suicide attempts, and the positive correlation is shown between low HDL-C levels and suicide attempts. Nevertheless, non-ideation and inversely suicidal attempts were not discovered among high-LDL-C subjects. Logistic analysis showed that high levels of FBG (OR=2.86, 95% CI: 1.31-6.25, P=0.008) and worse LDL-C (OR=357.82, 95% CI: 66.16-1935.10, P<0.001) are the independent associated factors for hypercholesterolemia. More hospitalizations (OR=1.89, 95% CI: 1.07-3.35, P=0.028), obesity (OR=2.55, 95% CI: 1.25-5.18, P=0.010), high levels of TC (OR=2.15, 95% CI: 1.03-4.48, P=0.042), and higher doses of antidepressants (OR=1.02, 95% CI: 1.00-1.04, P=0.029) were independently associated factors for hypertriglyceridemia, while high levels of HDL-C (OR=0.11, 95% CI: 0.04-0.31, P<0.001) were protective factors. In addition, high levels of TC (OR=113.94, 95% CI: 20.01-648.85) were statistically different (P<0.001) and suggested that the factor was significantly related to high LDL-C. Meanwhile, older age (OR=1.25, 95% CI: 1.02-1.52, P=0.030) and high levels of TG (OR=3.00, 95% CI: 1.98-4.55, P<0.001) were independent factors contributing to low HDL-C. ConclusionThe high prevalence of dyslipidemia in childhood and adolescence among children and adolescents with depressive disorder has become a public health issue. Hypercholesterolemia and hypertriglyceridemia showed a positive correlation with suicidal thoughts and suicidal attempts. Monitoring the incidence of suicidal thoughts and attempts among them would carry some predictor meaning in therapy and for jumping back to health.

Suicidal attempt in a patient with gambling disorder: A rare case report

Background: Gambling disorder is characterized by a compulsive, repetitive and maladaptive pattern of gambling that results in significant distress. It is now classified into the “Substance-Related and Addictive Disorders'' group in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Some participants do present with psychiatric complications ranging from mood, substance use, abnormal personality traits and even suicidality. This comorbidities complicates both presentation and treatment. Methods: In this report, we presented a case of a 32 year old civil servant who presented with repeated engagement in online sport gambling with ensuing accrued debts, strained interpersonal relationships, depressive symptoms and subsequent suicidal attempt by hanging himself in a closed room at night. This was a rare case of pathological gambling that was complicated by a severe depressive episode and suicidal attempt with a fatal means (hanging) in a patient with family history of gambling and psychotic illness. Conclusion: Pathological gambling is an addictive behavior with far reaching consequences such as mood disorders, suicidal behaviors and subsequent affectation of functioning of the individuals involved. Early detection and prompt intervention is essential to prevent further complications.

Development and initial validation of Personality Disorder Syndrome scales for the MMPI-3.

The purpose of the present study was to revise and update the MMPI-2-RF personality disorder (PD) syndrome scales for the Minnesota Multiphasic Personality Inventory-3 (MMPI-3). Study 1 describes the development of the MMPI-3 PD syndrome scales in three separate samples of community participants (n = 1,591), university students (n = 1,660), and outpatient mental health patients (n = 1,537). The authors independently evaluated each of the 72 new MMPI-3 items and rated them for appropriateness for scale inclusion and used various statistical procedures for final item selection. Ultimately, all 10 scales were revised, with nine incorporating items that were new to the MMPI-3. In Study 2, we subsequently validated the new MMPI-3 PD Syndrome scales against measures of traditional PD measures, trait measures of the Alternative Diagnostic and Statistical Manual of Mental Disorders, fifth edition-5 model of personality disorders (AMPD) and the five-factor model (FFM) of personality, and specific criterion measures of externalizing, psychopathy, narcissism, emotional dysregulation, and self-harm, in two samples of university students (ns = 489 and 645). With some exceptions, the results were generally supportive of the convergent and discriminant validities of the MMPI-3 PD Syndrome scales. The Histrionic PD scale in particular was associated with questionable results and diverged most strongly from the theoretical construct it was originally meant to reflect. Further continuous validation of the scales is needed, especially in clinical samples, but the findings to date are promising. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Assessment of the Internet Addiction Disorder and its Association with Anxiety and Depression in Young Indian Adults: A Cross Sectional Study

The phenomenon of involuntary engagement with internet devices, accompanied by a sense of emptiness in their absence, characterizes internet addiction disorder. A comprehensive meta-analysis spanning 80 studies worldwide from 1996 to 2012, involving 89,281 participants across 31 countries, revealed a 6% prevalence of this disorder among young individuals globally. A separate study funded by the Indian Council of Medical Research (ICMR) investigated 2,755 participants aged 18-65 in India, finding a prevalence rate of 1.3% for internet addiction. Notably, this disorder has not yet been recognized as Internet Addiction Disorder (IAD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Numerous studies have examined the prevalence of internet addiction in the Indian population. This current study aimed to assess the prevalence, impact, and available treatment options for internet addiction among Indian adults. Utilizing a cross-sectional, close-ended online survey questionnaire distributed among the general public and experts, a total of 303 responses were collected. The findings revealed that 33.3% of Indian adults were addicted to the internet, with varying degrees of severity: severely (1.7%), moderately (10.2%), and mildly (20.8%) addicted. Notably, most severely addicted individuals (80%) fell within the 26-35 years age range. Male participants exhibited a higher prevalence of internet addiction compared to females (57.1% vs. 42.9%), with males also displaying a greater propensity for addiction (71.9% vs. 28.1%). Further analysis indicated that 11.2% of addicted individuals experienced symptoms of anxiety and/or depression, with males affected at a rate 50% higher than females.

Provider-patient relationships and trauma among pregnant patients with opioid-use disorder.

The provider-patient relationship is integral to medical practice and health outcomes, particularly among vulnerable patient populations. This study compared the provider-patient relationship among pregnant patients with opioid-use disorder (OUD), who did or did not have a history of moderate to severe trauma. This was an exploratory data analysis of 119 patients enrolled in the Support Models for Addiction Related Treatment trial. Probable posttraumatic stress disorder (PTSD) was determined by a score ≥ 31 on the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The provider-patient relationship was assessed at 26 ± 4 weeks of pregnancy using the Kim Alliance Scale (KAS). Multivariable regression was used to examine the association of KAS with probable PTSD among pregnant people with OUD. The mean KAS score for pregnant participants without probable PTSD (N = 88) was 61.4 (SD ± 2.8) and for pregnant participants with probable PTSD (N = 31) was 59.6 (SD ± 3.7). Results demonstrated significant differences in KAS scores between those with and without probable PTSD after adjusting for demographic variables. Adjusted mean total KAS scores and scores on Empowerment and Communication subscales were significantly lower among those with probable PTSD compared to those without (p = .04 and 0.02, respectively) but did not differ significantly on Collaboration and Integration subscales. Analyses show an association between probable PTSD and provider-patient relationship among pregnant patients with OUD, with those with probable PTSD having a worse alliance with obstetric providers. This novel finding helps characterize the provider-patient relationship among a uniquely vulnerable population and can inform efforts to integrate trauma-informed practices into prenatal care.

Mental disorders in antiphospholipid syndrome patients: association with clinical and immunological manifestations of the disease

The aim of this work is to clarify the association between the clinical and psychopathological features of mental disorders (MD) and the clinical and immunological features of antiphospholipid syndrome (APS).Material and methods. The study included 107 patients (34 (31.8%) men and 73 (68.2%) women) aged 18 to 69 years (40.6±10.4 years (M±SD)), 54 (50.5%) – with primary APS (PAPS), established according to the international criteria of 2006 and 53 (49.5%) patients – with reliable diagnosis of systemic lupus erythematosus (SLE), according to the European Alliance of Associations for Rheumatology/American College of Rheumatology (EULAR/ ACR) 2019 criteria, with a secondary APS. Risk of thrombosis in APS was assessed by the GAPSS (Global Anti-Phospholipid Syndrome Score). MD were diagnosed by a psychiatrist in accordance with 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and Diagnostic and Statistical Manual of mental disorders, 5th edition (DSM-5).Results. Mental disorders are detected in the vast majority of patients with APS (98 (91.6%)), predominantly in anxiety-depressive spectrum disorders (ADSD; 90 (84.1%)). Depressive disorders are not associated with a high risk of thrombosis according to the GAPSS, but more severe variants of depression are more common in patients with high anti-β2 -glycoprotein I (anti-β2 GP1) and low/moderate anti cardiolipin (aCL) antibodies. Anxiety disorders were diagnosed only in patients with a high risk of thrombosis according to GAPSS, high aCL and IgG anti-β2 GP1. Schizotypal disorder was identified only in patients with a high risk of thrombosis and positive anti-phosphatidylserine/prothrombin complex antibodies (aPS/PT) regardless of class, and also more often in patients with high IgG anti-β2 GP1. Epilepsy was observed only in patients with positive aPS/PT, regardless of class. Cognitive impairment (CI), mostly mild and moderate, was found in the vast majority of patients with APS (102 (95.3%)). Dementia was detected in 7 (6.5%) patients, and only in those who had acute or transient cerebrovascular accident. When compared with the general population, dementia developed at an earlier age (up to 65 years). For patients with a high risk of thrombosis, moderate CI is more typical. CI and their severity are not associated with the duration of APS, but are associated with positivity for IgG aPS/PT, acute or transient cerebrovascular accident and the duration of comorbid ADSD.Conclusion. A high frequency of MD in patients with APS revealed. Associations of MD with clinical and immunological manifestations of APS were determined. CI in patients with APS is heterogeneous and are associated with both clinical and immunological manifestations of APS and MD. Identification of CI and determination of their characteristics should be confirmed by clinical, psychopathological and pathopsychological methods in order to personalize their correction within the partnership model of care.

Estimating the prevalence of depression in people with acute coronary syndromes: A systematic review and meta-analysis.

The epidemic of acute coronary syndromes (ACS) poses a great challenge to depression. However, the prevalence of depression among ACS patients has not been fully determined. This meta-analysis aimed to provide an estimation of the global prevalence of depression among ACS patients (ACS depression). Online databases including PubMed, Cochrane Library, Web of Science, and Scopus were searched for all relevant studies that reported the prevalence of ACS depression through March 2023. Pooled prevalence of ACS depression with 95% confidence interval (CI) was estimated by the random-effect model. All statistical analyses were performed using comprehensive meta-analysis software. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42023409338). A total of 28 studies (17 cohort studies, 9 cross-sectional studies, and 2 case-control studies) were included. The overall pooled prevalence of depression in ACS, derived from 28 studies, was 28.5% (95% CI: 0.28-0.29, P = .000, I2 = 99%). 21 included studies showed a prevalence of 20.3% (95% CI: 0.20-0.21, P = .000, I2 = 96%) in men, and the prevalence in women was 13.6% (95% CI: 0.13-0.14, P = .000, I2 = 95%). Subgroup analysis showed the lowest prevalence in Europe (20.7%, 95% CI: 0.20-0.22, P = .000, I2 = 98%); On different diagnostic criteria, the diagnostic and statistical manual of mental disorders (DSM-IV) (36.8%, 95% CI: 0.35-0.38, P = .000, I2 = 96%) has the highest prevalence. In terms of end year of data collection, the prevalence of ACS depression was lower for studies that ended data collection after 2012 (25.7%, 95% CI: 0.25-0.27, P = .000, I2 = 99%) than in studies before 2012 (30%, 95% CI: 0.29-0.31, P = .000, I2 = 98%). This systematic review and meta-analysis suggest high global prevalence of depression among ACS patients, underlining the necessity of more preventive interventions among ACS patients especially in Asian and North American regions.

Eating Disorders Among Saudi Dietitians: Prevalence and Analysis

Eating disorders (EDs) involve persistently disturbed eating and related behaviors that result in altered consumption or absorption of food with potential physical or psychological function impairment. There are four major types of EDs: anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorders not otherwise specified. This investigation aimed to study the prevalence of EDs by assessing the nutritional status of nutrition students and dietitians from multiple provinces in Saudi Arabia. A cross-sectional study included 175 male and female nutrition students and dietitians. EDs were diagnosed using the Eating Attitudes Test – 26 item (EAT-26) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Dietary intake was estimated using repeated 24-hour recall records. Diets were analyzed using food processor nutrition and fitness software. The intakes were compared with the recommended dietary allowances (RDA). The mean participant age was 24.62 ± 4 years. According to EAT-26 diagnostic criteria, the prevalence of EDs was 15.4%. The ED participants had normal body mass index values of 23.6 ± 3.47kg/m2. The diet analysis showed that these subjects had a lower intake of energy, macronutrients, and micronutrients but higher intakes of other micronutrients than the RDA. Nine (33.3%) of the subjects were students and 18 (66.7%) were dietitians. l EDs were more prevalent among dietitians than students. The EDs included a high number of other specified feeding or eating disorders and unspecified eating disorder cases. Subjects with ED had an unbalanced diet and poor nutrition. Our investigation concluded that the prevalence of EDs in Saudi Arabia was 15.4% among nutrition students and dietitians. Moreover, EDs were more prevalent in some provinces of Saudi Arabia. Intakes of energy, macronutrients, and some micronutrients were low, while those of other micronutrients were higher than the RDA.

Clonidine Patch for Tourette Syndrome With Attention-Deficit/Hyperactivity Disorder.

To explore the efficacy and safety of clonidine adhesive patch in Tourette syndrome (TS) patients with comorbid attentiondeficit/hyperactivity disorder (ADHD). This study was conducted on a sample of children and adolescents with TS who had comorbid ADHD between May 2012 and March 2015. The patients were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, and were randomly assigned to four different dose groups: 1.0 mg/week, 1.5 mg/week, 2.0 mg/week and placebo group, and the symptom was evaluated by Swanson, Nolan, and Pelham Rating Scale, Version IV (SNAP-IV) and Yale Global Tic Severity Scale scales every 2 weeks. The primary outcome was tic disorders (TD) effective rate at week 8. One hundred and twenty-seven TS patients with comorbid ADHD in 2.0 mg/week (n=35), 1.5 mg/week (n=27), 1.0 mg/week (n=36) and placebo groups (n=29) were included in this subgroup analysis. The TD effective rate of the 2.0 mg, 1.5 mg, and 1.0 mg groups at week 8 were significantly better than that in placebo group (85.7%, 81.5%, and 86.1% vs. 20.7%, all p<0.0001). All groups demonstrated significant improvements in SNAP-IV total scale scores compared to baseline (p=0.0004), with treatment groups showing only a trend for better performance compared to placebo group at week 8, without statistical differences (22.1±15.41, 21.3±11.96, and 21.2±12.48 vs. 26.0±13.37, p=0.3385). A total of 9 adverse reactions occurred, all recovered spontaneously without additional medication. Clonidine adhesive patch could safely and effectively reduce the tic symptoms of TS patients with comorbid ADHD, and might be potentially helpful in the ADHD symptoms control.

The relationship of the methylation status and polymorphism of glucocorticoid receptor gene (NR3C1) with attempted suicide or non-suicidal self-injury patients in schizophrenia.

We aim to investigate the methylation of NR3C1 gene promotor and NR3C1 BclI polymorphism in schizophrenia (SCZ) patients with attempted suicide or non-suicidal self-injury (NSSI). A sample of 112 patients with SCZ was included in the study. Structured Clinical Interview for Diagnostic and Statistical Manual-Fourth Edition Axis I Disorders was used to confirm the diagnosis according to The Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision criteria. The patients were evaluated by data forms that had sociodemographic, suicidal behavior, and NSSI information. Methylation-specific polymerase chain reaction (PCR) was used to identify the methylation of the NR3C1 gene. The analysis of the BclI polymorphism of the NR3C1 gene was evaluated by using the PCR restriction fragment length polymorphism. Our results revealed that although the NR3C1 gene methylation was not statistically significantly different, there was a significant difference in NR3C1 genotype distribution among the SCZ groups with and without attempted suicide. SCZ patients carrying the CC genotype had a lower risk of attempted suicide (Odds Ratio [OR]: 0.421; 95% Confidence Interval [CI]: 0.183-0.970; p = 0.040), while having the GG genotype in SCZ patients was associated with a higher risk of attempted suicide (OR: 3.785; 95% Cl: 1.107-12.945; p = 0.042). Additionally, due to NSSI in SCZ patients, there were no significant differences in NR3C1 gene methylation and NR3C1 genotype distribution among the groups. We propose that the NR3C1 BclI polymorphism may be associated with attempted suicide in Turkish patients diagnosed with SCZ.

Being an Anorectic versus Having Anorexia: Should the DSM Diagnostic Criteria Be Modified?

The Diagnostic and Statistical Manual of Mental Disorders classifies “anorexia nervosa” as a mental disorder, yet individuals with anorexia often characterize it as an identity. The author describes the identity of being an anorectic and compares it with what it takes to have anorexia in the diagnostic sense. This furthers the existing scholarship on anorexia and identity, most notably by revealing a disconnect between being an anorectic and having anorexia: Some individuals inhabit the identity of being an anorectic but do not have anorexia because they do not have a significantly low body weight. The author explores whether expanding the diagnostic criteria for anorexia would be beneficial for anorectics by examining the implications of classifying the identitive phenomenon of being an anorectic in terms of a medical concept of mental disorder. In the short term, the answer depends on whether being an anorectic calls for interventions that require a diagnosis. Either way, it would be beneficial to develop nonmedical frameworks for understanding anorexia that facilitate interventions that do not require a diagnosis. Understanding being an anorectic as an identity lays the scaffolding for a nonmedical way of conceptualizing anorexia that illuminates innovative approaches to assisting anorectics.

The Effectiveness and Tolerability of an Intensive Outpatient Trauma Treatment Program for Adolescents With PTSD

Following the promising effects of an intensive trauma treatment for adults, the question arises whether adolescents suffering from posttraumatic stress disorder (PTSD) can also benefit from a similar treatment program. The objective of this study was to assess the effectiveness and tolerability of an intensive trauma treatment program combining two evidence-based, trauma-focused therapies—prolonged exposure (PE) and eye movement desensitization and reprocessing (EMDR)—with psychoeducation and physical activity for adolescents suffering from PTSD in an outpatient clinic. We used a multiple-baseline study design. Fifteen adolescents aged 12–18 years old with aDiagnostic and Statistical Manual of Mental Disorders(5th ed.) diagnosis of PTSD were included. Participants were randomized to wait 2, 3, or 4 weeks between the start of baseline and the start of the intervention. In the 2-week intervention period, participants received daily PE, EMDR, and physical activity. The social network of adolescents was involved for support. PTSD symptoms and treatment tolerability were assessed daily. PTSD diagnosis was assessed at baseline and at 1 month and 3 months after completion of treatment. In addition, semistructured interviews were conducted after treatment to determine the tolerability. After treatment, we found a diagnostic PTSD remission of 58%–62% and a decrease in PTSD severity compared with baseline. The effects were maintained at 1-month and 3-month follow-ups. The dropout rate was 13%. Participants reported good treatment tolerability. This study provides initial evidence that an intensive outpatient trauma treatment including PE, EMDR therapy, psychoeducation, and physical activity is effective and tolerable for adolescents with PTSD and is associated with low dropout rates.