Suicidal Tendencies Research Articles

Inclusion of nutritional counseling and mental health services in HIV/AIDS management: A paradigm shift.

Human immunodeficiency virus (HIV) infection is a public health challenge that can degenerate into acquired immunodeficiency syndrome (AIDS) if not properly managed. HIV infection shortens life expectancy to about 5 to 10 years compared to noninfected individuals. People living with HIV/AIDS (PLWHA) are prone to several health challenges as a result of a deranged immune system culminating in high morbidity and mortality. Depression is a common feature of PLWHA. Depression heightens the emergence of opportunistic infections in HIV-infected individuals, accelerates the progression to AIDS, and increased suicidal tendencies, morbidity, and mortality. Food insecurity with its resultant undernutrition contributes to HIV/AIDS-related deaths. Undernourished PLWHA are more prone to opportunistic infections due to poor immunity. Interestingly, proper diet intake can boost immunity, slow the progression of AIDS and opportunistic infections, enhance body weight, and retard depression tendencies. Undernutrition can also be ameliorated by incorporating nutritional counseling and oral nutrient supplementation in routine HIV/AIDS checkups. Therefore, to increase HIV/AIDS management outcomes, the integration of nutrition counseling, dietary supplements, and mental health services should be embraced. Thus, HIV/AIDS care centers should amplify these services. In this article, we isolated relevant studies from various databases, illuminated the interwoven relationship between HIV/AIDS, depression, and undernutrition, and also reemphasized the need for adequate nutritional intervention in the battle against HIV/AIDS. Thus, this study provides a reawakening call to focus on incorporating nutritional guides and mental health care in HIV/AIDS management protocols.

A - 27 Early-Onset Alzheimer's Disease: Indications of Psychosis Severity and Disease Progression.

Early-onset Alzheimer's disease (EOAD) comprises about 5% of ad cases and is associated with delays in diagnosis and aggressive course. Psychotic symptoms are frequent in ad and often include delusions of infidelity and hallucinations. When present, ad with psychosis is accompanied by elevated levels of depression and greater functional impairment. This case expands upon the existing literature on EOAD through the timeline of a complex psychosis presentation accompanied by rapid cognitive decline. 63-year-old, Hispanic, woman with progressive cognitive changes (e.g., confusion, forgetfulness, word-finding difficulties, disorganization) that emerged 5years prior to seeking neurological consultation. Psychosis symptoms (i.e., auditory/visual hallucinations, delusions), in the context of real events (i.e., husband's previous infidelity), developed simultaneously. These pervasive symptoms have contributed to social withdrawal, persistent suicidal tendencies, and impaired IADLs. Neuroimaging suggested hypometabolism in the parietotemporal regions with precuneus and posterior cingulate gyri involvement. The evaluation revealed fairly generalized cognitive decline. Basic attention, working memory, visual abstract reasoning, and phonemic fluency were intact. Visual integration/visuoconstruction were reduced. Impairments emerged in processing speed, rapid cognitive flexibility, cognitive inhibition, conceptualization, visuospatial orientation, semantic fluency, confrontation naming, and visual and verbal encoding and retention (with rapid forgetting). She endorsed moderately elevated symptoms of depression and anxiety. The pattern of cognitive and functional deficits are all suggestive of an ad process. Her age, sex, significant neuroimaging findings, report of earliest cognitive symptoms, and family history reinforce an EOAD etiology. Significant behavioral changes are often associated with increased cognitive impairment and in turn, may mark the progression/stage of the disease.

Depression and Suicide Risk Among Nursing Staff at a Honduran National Hospital.

Depression and suicide risk among nursing staff have become increasingly concerning, especially given the demanding nature of their profession. The World Health Organization identifies depression as a primary factor contributing to global disability and suicide deaths. A descriptive, non-experimental, cross-sectional cohort study was conducted, encompassing the eligible personnel (n=82) out of a total of 102 nurses at the Mario Catarino Rivas Hospital in San Pedro Sula, Honduras, from October to November 2022. The study utilized the Okasha assessment tool to gauge the prevalence of suicidal risk and the Beck Depression Inventory-II (BDI-II) instrument to analyze the extent and severity of depression. In addition, the participants completed a demographic survey. Results: The average age of participants was 34.91 years, with a majority (86.6%) being female. In terms of work assignments, 54.9% were employed in the inpatient area. Regarding the mental health of the nursing staff, 78% displayed no or minimal depression, 9.7% presented mild depression, 7.3% showed moderate depression, 4.8% displayed severe depression, and 14.6% exhibited a suicide risk. Young adults had the highest prevalence of all three levels of depression, and the emergency department and inpatient area had the most at-risk individuals for suicidal tendencies. The study offers a comprehensive insight into the demographics, work environment, and mental health of the nursing staff at the Honduran National Hospital. The results highlight the importance of specialized measures and strong support systems to safeguard the mental health of nursing staff.

MARY SHELLEY’NİN MATHILDA ADLI ESERİNİN EKOFEMİNİST ANALİZİ: KENDİ TABU KURGUSUNU YAZAN KADIN ANLATICI

Re-reading Mary Wollstonecraft Shelley’s novelette, Mathilda, in the twenty-first century from an ecofeminist perspective sheds a new light on contemporary criticism, opening up multifaceted perspectives. There was a critical moment in British literary history when Elizabeth Nitchie transcribed Mathilda from the microfilm of the manuscript and published it in 1959, which unveiled this piece of revolutionary taboo fiction suppressed for over a century by the author’s male relatives, chiefly Shelley’s father, William Godwin. Written in 1819-1820, Mathilda is the only work completed during Shelley’s lifetime. It is an artfully crafted epistolary work depicting the traumatic confessions and suicidal tendencies of the protagonist, Mathilda, a woman who isolated herself from society by integrating herself with nature due to her father’s confession for his incestuous passion towards her. Regarded as an underrated work, Mathilda has often been interpreted from biographical and incest-related perspectives by literary critics, which relegates its literary merits although it is in accordance with feminist and ecological theories and feminine writing. This paper, avoiding biographical accounts and the author’s life experiences and with theories consistent with those of ecofeminism, intends to show how nature functions as an effective instrument for the female writer to fictionalize her taboo story. By blending ecofeminism with feminine writing, this paper also investigates the interplay between woman and nature, and navigates how a female character courageously relocates her taboo story on a textual level from a feminist perspective in a natural setting, challenging the male-dominant Romantic tradition of the nineteenth century.

Network Analysis of Depression Using Magnetoencephalogram Based on Polynomial Kernel Granger Causality.

Depression is a psychiatric disorder characterized by anxiety, pessimism, and suicidal tendencies, which has serious impact on human's life. In this paper, we use Granger causality index based on polynomial kernel as network node connectivity coefficient to construct brain networks from the magnetoencephalogram (MEG) of 5 depressed patients and 11 healthy individuals under positive, neutral, and negative emotional stimuli, respectively. We found that depressed patients had more information exchange between the frontal and occipital regions compared to healthy individuals and less causal connections in the parietal and central regions. We further analyzed the topological properties of the network revealed and found that depressed patients had higher average degrees under negative stimuli (p = 0.008) and lower average clustering coefficients than healthy individuals (p = 0.034). When comparing the average degree and average clustering coefficient of the same sample under different emotional stimuli, we found that depressed patients had a higher average degree and average clustering coefficient under negative stimuli than neutral and positive stimuli. We also found that the characteristic path lengths of patients under negative and neutral stimuli significantly deviated from small-world network. Our results suggest that the analysis of polynomial kernel Granger causality brain networks can effectively characterize the pathology of depression.

The meaning of lithium and naltrexone pharmacotherapy in the treatment of borderline personality disorder – a narrative review

Introduction: Borderline personality disorder (BPD) affects approximately 1%-3% of the population. As the most common personality disorder, BPD features behavioural, emotional and social dysfunctions. It often co-occurs with self-harm, suicidal tendencies and substance abuse. To date, pharmacological treatment does not provide sufficient therapeutic effects. The aim of our study is to analyse the neurobiological, genetic and environmental components in the aetiopathogenesis of BPD and to collect data on the innovative use of lithium and naltrexone in the therapy of BPD. Methods: Basing on PubMed and Google Scholar databases using the following keywords: borderline, lithium, naltrexone for papers published from 1979 to 2022. Results: Difficult childhood, and emotional, sexual and physical abuse are the strongest predictors of BPD development. The core symptoms of BPD may be related to dysfunction of the serotonin, dopaminergic, endogenous system and opioid systems. Variation in 5-HTT, COMT, FKBP5 and oxytocin receptor genes may influence the course of BPD. Imaging studies have shown structural and functional abnormalities in the prefrontal cortex, amygdala and hippocampus. Lithium reduces impulsivity, aggression, suicidal tendencies and self-harm in BPD. Naltrexone may effectively reduce self-harm without suicidal tendencies, impulsivity, substance abuse and suicidality. Conclusions: No unified model has been developed to account for environmental, genetic and neurobiological components in the pathogenesis of BPD. Understanding the mechanisms is a crucial step towards personalising treatment. The use of lithium and naltrexone may have positive therapeutic effects. Randomised clinical trials are required to establish the efficacy and safety of both drugs in long-term treatment. Keywords: borderline, lithium, naltrexone

Folate and Its Significance in Depressive Disorders and Suicidality: A Comprehensive Narrative Review.

Depressive disorders pose significant challenges to global public health, necessitating effective prevention and management strategies. Notably, the occurrence of suicide frequently coincides with depressive episodes. Suicide is as a paramount global health concern that demands efficacious preventive strategies. Current psychiatric approaches heavily rely on pharmacological interventions but have had limited success in addressing the global burden of mental health issues. Suboptimal nutrition, with its impact on the neuroendocrine system, has been implicated in the underlying pathology of depressive disorders. Folate, a group of water-soluble compounds, plays a crucial role in various central nervous system functions. Depressed individuals often exhibit low levels of serum and red blood cell folate. Multiple studies and systematic reviews have investigated the efficacy of folic acid and its derivative, L-methylfolate, which can cross the blood-brain barrier, as stand-alone or adjunct therapies for depression. Although findings have been mixed, the available evidence generally supports the use of these compounds in depressed individuals. Recent studies have established links between the one-carbon cycle, folate-homocysteine balance, immune system function, glutamate excitation via NMDA (N-methyl-D-aspartate) receptors, and gut microbiome eubiosis in mood regulation. These findings provide insights into the complex neurobiological mechanisms underlying the effects of folate and related compounds in depression. Through a comprehensive review of the existing literature, this study aims to advance our understanding of the therapeutic potential of folic acid and related compounds in depression treatment. It also seeks to explore their role in addressing suicidal tendencies and shed light on the neurobiological mechanisms involved, leveraging the latest discoveries in depression research.

EVALUATION OF SELF-HARM AND SUICIDAL ATTEMPTS AMONG UNIVERSITY STUDENTS

Self–harm and suicidal attempts are very important public health concerns and emerging issues affecting millions globally, especially young and adults. Suicidal attempts and self–harm are essential predictors of suicide in future and intolerable suffering. Assessment in this domain is challenging as no agreement is observed to conceptualize the behaviors. Our study aims to assess the prevalence rate of suicidal attempts and thoughts and self–harm thoughts in young adults. This cross-sectional study was conducted at Shaheed Mohtarma Benazir Bhutto Medical University for 6 months. An online questionnaire was prepared and circulated among young adults. Informed consent was obtained from all participants. The questionnaire included many demographic questions, including age, gender, living status, and relationship status. The data was analyzed using SPSS 24.0. For all qualitative variables, frequencies and percentages were measured. A total of 401 responses were collected. The number of female participants was more (66.6%) than male participants (33.4%). The majority of participants (70.3%) were aged between 18-23 years, followed by 24-29 years (23.7%) and 30-35 years (6%). In questions regarding self–harm and suicidal thoughts, 27.2% of respondents said that they had serious thoughts about suicide but never attempted it, 17.2% responded that they had such thoughts before attending university, and 11.7% said that they tried to attempt suicide in some manner. Thoughts of suicide and self–harm were observed among university students. Various factors influence students' mental health, including parental help, home environment, and university workload. Stress–free environment and social support to students may decrease the prevalence of suicidal tendencies among students.

Risk Factors of Suicidal Ideation in Iraqi Crystal Methamphetamine Users.

Crystal methamphetamine, a potent psychostimulant, presents a complex clinical landscape. However, insights into the predisposing factors for suicidal tendencies among Iraqi users remain limited. Our study delves into these risks among 165 patients. Rigorous multivariable analysis was conducted, employing binary logistic regression, drawing from patients from Baghdad Medical City and Ibn-Rushd Teaching Hospital. Most participants were in their third decade (26.62 ± 0.53 years). Regarding suicidal ideation, our model demonstrated robust accuracy, supported by the Hosmer-Lemeshow goodness-of-fit test (NagelKerke's R2 = 0.49, accuracy = 79.4%, p = 0.885). Notably, chronic methamphetamine use exceeding a year (OR = 6.15, p = 0.001), absence of psychological trauma (OR = 4.58, p = 0.006), and incidence of visual hallucinations (OR = 4.52, p = 0.001) rendered users more susceptible to suicidal ideation. Furthermore, our investigation unveiled risk factors tied to psychotic features and withdrawal manifestations. The study underscores pivotal predictors of suicidal ideation, warranting interdisciplinary vigilance from psychiatrists, clinical psychologists, and social workers. By monitoring at-risk individuals, progression toward the intricate spectrum of suicide can be potentially averted. These findings illuminate the urgency of tailored interventions for crystal methamphetamine users, contributing to enhanced holistic care.

The Psychosocial Profile of Women Who Defaulted Option B+ HIV Treatment: An Interpretive Phenomenological Analysis Study.

The study explored the psychosocial profile of women who defaulted Option B+ HIV treatment at Chitungwiza Municipality clinics in Zimbabwe. Option B+ is a strategy to prevent mother-to-child transmission (PMTCT) of HIV to reduce MTCT rate to less than or equal to 5%. An interpretive phenomenological analysis (IPA) design was used. Data were collected from 04 September to 12 October 2020 on twelve purposively selected HIV-positive breastfeeding women aged 18 to 40 years, who defaulted Option B+ HIV treatment. Unstructured individual face-to-face interviews were utilised. Data were analysed thematically using the interpretive phenomenological analysis framework for data analysis. The study findings revealed that participants experienced the following: psychosocial and emotional challenges due to HIV positive results, shown emotional distress and suicidal tendencies which affected their mental health. Their relationship was derailed due to abuse, infidelity, partner's high-risk behaviour and to lack of support stemming from their partners and family members. Strengthening adherence support interventions and effective counselling on HIV-positive status disclosure and male partner involvement is important for retaining women in care and for improving their quality of life. Comprehensive, integrated, and tailor-made interventions should be adopted. Couple HIV counselling and testing should be encouraged. Psychosocial and mental health should be encouraged. Furthermore, community sensitization, risk reduction behaviour, education on purpose and side effects of ART as well as the benefits of Option B+ to new enrolments should be intensified and strengthened to minimize defaulting of treatment and LTFUP. Vigorous patient tracing and visit reminders help retain women in care.

Traitements pharmacologiques dans le trouble de stress post-traumatique : la nécessité d’une stratégie globale

International guidelines indicate that trauma-focused psychotherapeutic treatments are the recommended approach for first line treatment of post-traumatic stress disorder (PTSD). However, the guidelines concerning drug-focused treatment are less consistent and contradictory. Although trauma-focused therapy combined with cognitive-behavioral therapy is effective in treating PTSD, many patients do not respond adequately to this treatment, which stresses the need to develop effective adjuvant therapeutic treatments. In addition, most randomized controlled trials investigating psychological treatments for PTSD exclude patients with psychosis, addiction, bipolar disorder, and suicidal thoughts, and it is crucial to offer effective treatments for these patients. Off-label medication is frequently used in treating these populations, but there is a need to clarify these practices. We thus propose an evidence-based algorithm for the management of PTSD, based on current international literature and taking into consideration suicidal tendencies, the presence of psychiatric disorders (psychotic disorders, bipolar disorders, borderline personality disorders) or addictive disorders, the severity of PTSD, and resistance to treatment.

A Discourse Analysis of Suicide Tendency in Photographer Lu Dawson’s Posts on Public Acconts: An Approach of Non-real World and Real World

With the number of diagnoses of depression increasing each year and the high frequency of suicides, depression has become a challenge in the fields of neurology and psychology due to its complex etiology and pathogenesis difficult to trace. However, research has demonstrated that language use patterns can reflect the mental state and psychological characteristics of the user (Huang Guanlan and Zhou Xiaolu, 2021). Therefore this paper, based on Kugrerberg and Gliat's (2012) discourse differentiation between "reality orientation" and "non-reality orientation " analyzes the discourse posted by the photographer Lu Dawson on his Weibo and Xiaohongshu accounts before his suicide, adopting the DSM diagnostic criteria for depression as the discourse differentiation method. in terms of vocabulary and syntax. As is revealed, the content of Weibo accounts with more followers expressed suicidal tendencies in a more direct way. At the lexical level, the first person singular, negative words and a large number of vaguely restricted adverbs are employed; at the syntactic level, a large number of rhetorical questions and apologetic sentences are utilized, demonstrating the blogger's disappointment and guilt, which is highly consistent with the symptoms of depression as defined by neurology. This study may provide a reference for identifying the help-seeking signals and life-ending intentions of those who suffer from depression in hope to reduce the occurrence of tragedies.

Impact of emotional state and suicidal intentions on suicide attempts among Korean adolescents with household financial difficulties following the outbreak of COVID-19: A cross-sectional study.

The recent prolonged coronavirus disease-2019 pandemic has brought an economic crisis to various households, leading to negative mental health such as depression, anxiety, traumatic distress, and suicide risk among adolescents. Adolescents with household financial difficulties due to the coronavirus disease-2019 pandemic show high suicidal tendencies and attempts such as suicidal ideation and plans, their suicidal ideation and plans increase the risk of suicide attempts in South Korea. The purpose of this study was to determine the effects of emotional state and suicidal tendencies on suicide attempts among adolescents with household financial difficulties in early pandemic. This was a secondary data analysis study using statistical data from the 16th (2020) Korea Youth Risk Behavior Web-based Survey. Among 54,948 who participated in the survey, 16,839 (30.6%) adolescents who had household financial difficulties were included in final analysis. Descriptive statistics, chi-squared test, and logistic regression analysis were conducted to analyze data. The strengthening the reporting of observational studies in epidemiology checklist was used for reporting this study. 16,839 adolescents (mean age 15.68 ± 1.76 years; 8709, 51.7% male) who experienced household financial difficulties in the prior year revealed 3 percent (508) had attempted suicide. Suicide attempts differed according to several characteristics and were significantly associated with sex, residence type, drinking experience, depressive mood, perceived happiness, suicidal ideation, and suicide planning. The findings indicate high-risk adolescents with household financial difficulties need a multi-dimensional safety network, suicide screening, and emotional interventions during the pandemic.

Self-injury and Its Criminal Correlates among Hungarian Juvenile Offenders

Self-injury is an important problem in incarcerated populations worldwide. This behaviour may be explained by circumstantial factors as incarceration per se may trigger stress responses that result in suicide and other forms of self-harming. On the other hand, certain psychiatric disorders are associated with an increased risk of self-injury and recent findings suggest that psychiatric disorders are highly prevalent in prison and reformatory populations. As a first attempt to study this issue in Hungarian underage criminals, we investigated the prevalence of self-injury and suicidal ideation in reformatory institutions. These were established in 84 incarcerated male juvenile offenders by the MINI KID structured psychiatric inventory. The study lasted 2 years. About one sixth (16.66%) of offenders had a suicidal history. More than half showed self-harming behaviour (N = 47, 55.95%) and 5 subjects reported suicidal ideation at the time of the assessment (5.95%). The suicidal tendency did not reach the level of actual life-threatening condition in any participant. These findings show that self-harming behaviour is rather frequent in the correctional system and requires further research, e.g. studies on the psychiatric antecedents of this behaviour. The findings of such studies may be applicable both in practice and in the education of law enforcement professionals.

Does the Human Right to Healthcare Apply Universally? A Contribution from a Trauma Therapeutic Perspective.

Access to the best possible healthcare is a fundamental human right. However, the provision of medical treatment is not only dependent on the actual treatment options available and the type of illness to be treated but is significantly influenced and restricted by structural and legal conditions. This is particularly evident in the case of refugees and other groups such as the so-called "paperless", whose access to medical treatment is de facto seriously impeded or denied altogether. At the same time, these individuals are particularly vulnerable to the development of mental illness for a variety of reasons. Refugees in particular often suffer from trauma sequelae, resulting in a broad range of impairments. Based on a case study of a refugee woman living in her host country, the interactions between mental illness and limited psychiatric/psychotherapeutic treatment options due to legal restrictions are analyzed from a medical perspective. Her initially only medically oriented treatment was insufficient to mitigate the consequences of these restrictions. As it was a protracted treatment process, the legal aspects of her case therefore also had to be decisively considered. This case study shows that the human right to the best possible healthcare can be considerably restricted by structural requirements, which, in the case of sequential traumatization and severe illnesses with suicidal tendencies, can be labelled as structural violence.

Return to Work Assessment in A Financial Analyst with Major Depressive Disorder: A Case Report

Background: More than half of the global population are workers, and depression and anxiety result in the loss of 12 billion working days per year, costing the global economy around $1 trillion.1 Depression is a widespread mood disorder that can lead to self-harm and suicide.2,3 Work eligibility assessments are essential to ensure that workers can perform their duties safely and effectively. This case report discusses the fitness-to-work assessment of a financial analyst with major depressive disorder with psychotic features. Objective: To explore factors affecting the fit-to-work status of a patient with major depressive disorder and assess the fit-to-work status of the patient.Case Presentation: A 27-year-old female with a history of depression and trauma worked as a financial analyst. She had a psychiatric evaluation revealing major depressive disorder with psychotic features, moderate stressors, narcissistic personality disorder, and problematic workplace relationships.Discussion: PERDOKI has a seven-step process for evaluating fitness to work and return-to-work programs. These steps involve assessing the patient’s medical condition, disability, job demands, risks, and tolerance to determine the appropriate work status. In this case, the patient is declared fit to work with a note.Conclusion: The role of occupational medicine in workers with major depressive disorder is very important, in-depth interviews regarding workload and other factors that are stressors for workers must be carried out. Support from the inner circle, family and workplace is very important for workers with major depressive disorder. Clinical symptoms of delusions, hallucinations and suicidal tendencies are the main criteria for determining return to work in addition to other influential factors.

Use of lithium in psychiatric, viral and neurological disorders - a review

Introduction: Lithium is one of the longest used drugs in psychiatry and is currently a mainstay in the long-term prophylaxis of bipolar disorder, preventing recurrent manic and depressive episodes. It also remains an important drug in the treatment of acute episodes of mania and depression. Out of the normothymic drugs, lithium has the greatest effect in preventing suicidal behavior. It also exhibits antiviral activity and in recent years evidence has also accumulated of the drug's neuroprotective properties. 
 Aim of the study: The aim was to collect and analyze publications on the use of lithium in affective disorders, dementia and viral diseases, as well as its effect on reducing suicidal tendencies.
 Materials and Methods: The literature available in the PubMed database was reviewed, using the key words: "lithium"; "bipolar disorder"; "mania", "depression"; "suicidal risk", "side effects".
 Results: Chronic use of lithium in patients with bipolar disorder has an effect on preventing recurrence of manic and depressive episodes and can successfully last for 40 years or longer. Studies support the theory that long-term lithium pharmacotherapy has a significant impact on preventing suicidal tendencies among patients with affective disorders. In recent years, the antiviral and neuroprotective properties of the drug have also become known. Despite the rather high risk of overdose, as well as the occurrence of numerous side effects, lithium is still very often used in the treatment of affective disorders due to its high efficacy.
 Conclusions: Lithium has been one of the mainstays of psychopharmacology for several decades and is a precursor to mood-stabilizing drugs. In recent years evidence has also been collected for its potential use in non-psychiatric conditions. Conducting further research on lithium will certainly allow for wider use of the drug and a more thorough understanding of its mechanism of action.

Babies Having Babies: Incarcerated Adolescent Parents and Their Emotional Well-Being

Adolescent parents have been the subject of scrutiny for decades, with a great deal of research focused on how these young parents adjust to their new roles. There is one group of adolescent parents about which we know next to nothing, though: incarcerated adolescent parents. To fill this gap, the current study examines whether parental status affects the emotional well-being (e.g., mental health diagnoses and suicidal tendencies) of incarcerated adolescent parents. We also consider whether these effects are gendered. Results suggest that adolescent parents, especially young mothers, have worsened mental health during incarceration. This effect was most pronounced for suicidal tendencies. These results underscore the importance of providing additional supports for young parents within juvenile facilities. Doing so could not only improve the safety and security of these confinement facilities but improve the long-term outcomes of these young parents and their offspring.

Correlation analysis between sleep quality and the mental health status of female sex workers during the COVID-19 pandemic in Hubei Province.

Female sex workers (FSWs) in entertainment venues are subject to condemnation and rejection by their families and the outside world. As a result, they are prone to psychological problems, including anxiety and even suicidal tendencies. The aim of the current study was to understand the sleep and mental health status of local FSWs and to identify associated risk factors, so as to provide a scientific basis for improving the social recognition of FSWs and establishing effective psychological interventions. A stratified cluster random sampling method was used to select women engaged in commercial sex in bathing, sauna, karaoke halls and other entertainment venues. A self-designed questionnaire assessing mental health-related factors was administered face-to-face with the respondents. 90 participants were randomly selected for blood tests to analyze the relationship between biological indicators and sleep quality. The rates of depression, anxiety and somnipathy among FSWs were 32.7%, 43.1% and 8.6%, respectively. The correlation coefficients (r) between sleep quality and depression, anxiety and social support were 0.07, 0.09 and -0.09, respectively. Divorce or widowhood, technical secondary school education, alcohol consumption and exercise were independent risk factors for depression in FSWs (p< 0.05) while living in urban areas and counties and having a sense of social support were protective factors (P< 0.05). Quarantining due to the pandemic and exercise were independent risk factors for anxiety in FSWs (P< 0.05) while living in counties and having a sense of social support were protective factors (P< 0.05). Quarantining due to the pandemic was an independent risk factor for somnipathy in FSWs (P< 0.05) while being married was a protective factor (P< 0.05). NE/NA was a protective factor for sleep disorders (OR=0.042, P=0.05), with an AUC of 0.87. FSWs should appropriately adjust their work form during the pandemic period, maintain a positive and optimistic attitude, establish long-term stable social relationships, and seek a greater sense of social support. The government should provide comprehensive bio-psycho-social interventions to address the mental and physical health status of this population.

Co-Aggregation and Parallel Aggregation of Specific Proteins in Major Mental Illness.

Disrupted proteostasis is an emerging area of research into major depressive disorder. Several proteins have been implicated as forming aggregates specifically in the brains of subsets of patients with psychiatric illnesses. These proteins include CRMP1, DISC1, NPAS3 and TRIOBP-1. It is unclear, however, whether these proteins normally aggregate together in the same individuals and, if so, whether each protein aggregates independently of each other ("parallel aggregation") or if the proteins physically interact and aggregate together ("co-aggregation"). Post mortem insular cortex samples from major depressive disorder and Alzheimer's disease patients, suicide victims and control individuals had their insoluble fractions isolated and tested by Western blotting to determine which of these proteins are insoluble and, therefore, likely to be aggregating. The ability of the proteins to co-aggregate (directly interact and form common aggregate structures) was tested by systematic pairwise expression of the proteins in SH-SY5Y neuroblastoma cells, which were then examined by immunofluorescent microscopy. Many individuals displayed multiple insoluble proteins in the brain, although not enough to imply interaction between the proteins. Cell culture analysis revealed that only a few of the proteins analyzed can consistently co-aggregate with each other: DISC1 with each of CRMP1 and TRIOBP-1. DISC1 was able to induce aggregation of full length TRIOBP-1, but not individual domains of TRIOBP-1 when they were expressed individually. While specific proteins are capable of co-aggregating, and appear to do so in the brains of individuals with mental illness and potentially also with suicidal tendency, it is more common for such proteins to aggregate in a parallel manner, through independent mechanisms. This information aids in understanding the distribution of protein aggregates among mental illness patients and is therefore important for any future diagnostic or therapeutic approaches based on this aspect of mental illness pathology.