PSYCHOLOGICAL MEDICINE

Diagnostic profiles among suicide decedents with and without borderline personality disorder
Kaufman EA, Coon H, Shabalin AA, Monson ET, Chen D, Staley MJ, Keeshin BR, Docherty AR, Bakian AV and DiBlasi E
Borderline personality disorder (BPD) is a debilitating condition characterized by pervasive instability across multiple major domains of functioning. The majority of persons with BPD engage in self-injury and up to 10% die by suicide - rendering persons with this condition at exceptionally elevated risk of comorbidity and premature mortality. Better characterization of clinical risk factors among persons with BPD who die by suicide is urgently needed.
Predicting involuntary admission following inpatient psychiatric treatment using machine learning trained on electronic health record data
Perfalk E, Damgaard JG, Bernstorff M, Hansen L, Danielsen AA and Østergaard SD
Involuntary admissions to psychiatric hospitals are on the rise. If patients at elevated risk of involuntary admission could be identified, prevention may be possible. Our aim was to develop and validate a prediction model for involuntary admission of patients receiving care within a psychiatric service system using machine learning trained on routine clinical data from electronic health records (EHRs).
Exploring associations between ADHD symptoms and emotional problems from childhood to adulthood: shared aetiology or possible causal relationship?
You Y, Oginni OA, Rijsdijk FV, Lim KX, Zavos HMS and McAdams TA
ADHD symptoms are associated with emotional problems such as depressive and anxiety symptoms from early childhood to adulthood, with the association increasing with age. A shared aetiology and/or a causal relationship could explain their correlation. In the current study, we explore these explanations for the association between ADHD symptoms and emotional problems from childhood to adulthood.
The effect of vitamin D supplementation on depression: a systematic review and dose-response meta-analysis of randomized controlled trials
Ghaemi S, Zeraattalab-Motlagh S, Jayedi A and Shab-Bidar S
The impact of vitamin D supplementation on depressive symptoms remains uncertain. This study aimed to investigate the dose-dependent effects of vitamin D supplementation on depressive and anxiety symptoms in adults. We systematically searched PubMed, Scopus, and Web of Science up to December 2022 to identify randomized controlled trials evaluating the effects of vitamin D supplementation on depression and anxiety symptoms in adults. Using a random-effects model, we calculated the standardized mean difference (SMD) for each 1000 IU/day vitamin D supplementation. The GRADE tool assessed the certainty of evidence. Our analysis included 31 trials with 24189 participants. Each 1000 IU/day vitamin D supplementation slightly reduced depressive symptoms in individuals with and without depression (SMD: -0.32, 95% CI -0.43 to -0.22; GEADE = moderate). The effect was more pronounced in those with depressive symptoms (SMD: -0.57, 95% CI -0.69 to -0.44; = 15). The greatest reduction occurred at 8000 IU/day (SMD: -2.04, 95% CI -3.77 to -0.31). Trials with follow-up ⩽8 weeks (SMD: -0.45, 95% CI -0.70 to -0.20; = 8) and 8 to ⩽24 weeks (SMD: -0.47, 95% CI -0.70 to -0.24; = 15) showed stronger effects compared to those lasting 24 to ⩽52 weeks (SMD: -0.13, 95% CI -0.28 to 0.02; = 5) or longer than 52 weeks (SMD: 0.14, 95% CI -0.16 to 0.44; = 3) ( group difference <0.001). Vitamin D supplementation had no significant effects on anxiety symptoms. In summary, this study suggests that vitamin D supplementation may effectively reduce depressive symptoms in short term. Further high-quality trials are warranted for a conclusive assessment of its impact on anxiety.
Comparative efficacy of interpersonal psychotherapy and antidepressant medication for adult depression: a systematic review and individual participant data meta-analysis
Cohen ZD, Breunese J, Markowitz JC, Weitz ES, Hollon SD, Browne DT, Rucci P, Corda C, Menchetti M, Weissman MM, Bagby RM, Quilty LC, Blom MBJ, Altamura M, Zobel I, Schramm E, Gois C, Twisk JWR, Wienicke FJ, Cuijpers P and Driessen E
Interpersonal psychotherapy (IPT) and antidepressant medications are both first-line interventions for adult depression, but their relative efficacy in the long term and on outcome measures other than depressive symptomatology is unknown. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional meta-analyses. This IPD meta-analysis compared the efficacy of IPT and antidepressants on various outcomes at post-treatment and follow-up (PROSPERO: CRD42020219891). A systematic literature search conducted May 1st, 2023 identified randomized trials comparing IPT and antidepressants in acute-phase treatment of adults with depression. Anonymized IPD were requested and analyzed using mixed-effects models. The prespecified primary outcome was post-treatment depression symptom severity. Secondary outcomes were all post-treatment and follow-up measures assessed in at least two studies. IPD were obtained from 9 of 15 studies identified ( = 1536/1948, 78.9%). No significant comparative treatment effects were found on post-treatment measures of depression ( = 0.088, = 0.103, N = 1530) and social functioning ( = 0.026, = 0.624, = 1213). In smaller samples, antidepressants performed slightly better than IPT on post-treatment measures of general psychopathology ( = 0.276, = 0.023, = 307) and dysfunctional attitudes ( = 0.249, = 0.029, = 231), but not on any other secondary outcomes, nor at follow-up. This IPD meta-analysis is the first to examine the acute and longer-term efficacy of IPT . antidepressants on a broad range of outcomes. Depression treatment trials should routinely include multiple outcome measures and follow-up assessments.
Charting brain GABA and glutamate levels across psychiatric disorders by quantitative analysis of 121 H-MRS studies
Zhang J, Toulopoulou T, Li Q, Niu L, Peng L, Dai H, Chen K, Wang X, Huang R, Wei X and Zhang R
Psychiatric diagnosis is based on categorical diagnostic classification, yet similarities in genetics and clinical features across disorders suggest that these classifications share commonalities in neurobiology, particularly regarding neurotransmitters. Glutamate (Glu) and gamma-aminobutyric acid (GABA), the brain's primary excitatory and inhibitory neurotransmitters, play critical roles in brain function and physiological processes.
Effects of aerobic exercise on hippocampal formation volume in people with schizophrenia - a systematic review and meta-analysis with original data from a randomized-controlled trial
Roell L, Fischer T, Keeser D, Papazov B, Lembeck M, Papazova I, Greska D, Muenz S, Schneider-Axmann T, Sykorova E, Thieme CE, Vogel BO, Mohnke S, Huppertz C, Roeh A, Keller-Varady K, Malchow B, Stoecklein S, Ertl-Wagner B, Henkel K, Wolfarth B, Tantchik W, Walter H, Hirjak D, Schmitt A, Hasan A, Meyer-Lindenberg A, Falkai P and Maurus I
The hippocampal formation represents a key region in the pathophysiology of schizophrenia. Aerobic exercise poses a promising add-on treatment to potentially counteract structural impairments of the hippocampal formation and associated symptomatic burden. However, current evidence regarding exercise effects on the hippocampal formation in schizophrenia is largely heterogeneous. Therefore, we conducted a systematic review and meta-analysis to assess the impact of aerobic exercise on total hippocampal formation volume. Additionally, we used data from a recent multicenter randomized-controlled trial to examine the effects of aerobic exercise on hippocampal formation subfield volumes and their respective clinical implications.
Similarity and difference in large-scale functional network alternations between the behavioral addictions and substance use disorder: A comparative meta-analysis - CORRIGENDUM
Zeng X, Han X, Zheng D, Jiang P and Yuan Z
Association of cardiovascular-kidney-metabolic health and social connection with the risk of depression and anxiety
Huang X, Liang J, Zhang J, Fu J, Xie W and Zheng F
To explore the association of cardiovascular-kidney-metabolic (CKM) health with the risk of depression and anxiety and to investigate the joint association of CKM health and social connection with depression and anxiety.
Use and discontinuation of antipsychotic medication in 20 years following a first episode of schizophrenia: results from the OPUS trial
Hansen HG, Speyer H, Stürup AE, Hjorthøj C, Öngür D, Nordentoft M and Albert N
Short-term exposure to antipsychotics has proven to be beneficial. However, naturalistic studies are lacking regarding the long-term use of antipsychotics. This study aimed to investigate changes in use of antipsychotics over 20 years after a first-episode schizophrenia.
Functional gradient dysfunction in drug-naïve first-episode schizophrenia and its correlation with specific transcriptional patterns and treatment predictions
Yao G, Luo J, Li J, Feng K, Liu P and Xu Y
First-episode schizophrenia (FES) is a progressive psychiatric disorder influenced by genetics, environmental factors, and brain function. The functional gradient deficits of drug-naïve FES and its relationship to gene expression profiles and treatment outcomes are unknown.
Co-occurrence between mental disorders and physical diseases: a study of nationwide primary-care medical records
Hanna MR, Caspi A, Houts RM, Moffitt TE and Torvik FA
Mental disorders and physical-health conditions frequently co-occur, impacting treatment outcomes. While most prior research has focused on single pairs of mental disorders and physical-health conditions, this study explores broader associations between multiple mental disorders and physical-health conditions.
Adverse psychiatric effects of psychedelic drugs: a systematic review of case reports
Yildirim B, Sahin SS, Gee A, Jauhar S, Rucker J, Salgado-Pineda P, Pomarol-Clotet E and McKenna P
Psychedelic drugs are a focus of interest in the treatment of depression and other disorders but there are longstanding concerns about possible adverse psychiatric consequences. Because the relevant literature is largely informal, the seriousness of these risks is difficult to evaluate.
Associations among environmental unpredictability, changes in resting-state functional connectivity, and adolescent psychopathology in the ABCD study
Yang Y, Kong T, Ji F, Liu R and Luo L
Unpredictability is a core but understudied dimension of adversities and has been receiving increasing attention recently. The effects of unpredictability on psychopathology and the underlying neural mechanisms, however, remain unclear. It is also unknown how unpredictability interacts with other dimensions of adversities in predicting brain development and psychopathology of youth.
The effect of polygenic liability to mental disorders on COVID-19 outcomes in people with depression: the mediating role of anxiety
Monistrol-Mula A, Felez-Nobrega M, Byrne EM, Lind PA, Hickie IB, Martin NG, Medland SE, Colodro-Conde L and Mitchell BL
Genetic vulnerability to mental disorders has been associated with coronavirus disease-19 (COVID-19) outcomes. We explored whether polygenic risk scores (PRSs) for several mental disorders predicted poorer clinical and psychological COVID-19 outcomes in people with pre-existing depression.
Using machine learning to determine a functional classifier of reward responsiveness and its association with adolescent psychiatric symptomatology
Blair RJR, Bashford-Largo J, Dominguez A, Dobbertin M, Blair KS and Bajaj S
Machine learning (ML) has developed classifiers differentiating patient groups despite concerns regarding diagnostic reliability. An alternative strategy, used here, is to develop a functional classifier (hyperplane) (e.g. distinguishing the neural responses to received reward received punishment in typically developing (TD) adolescents) and then determine the functional integrity of the response (reward response distance from the hyperplane) in adolescents with externalizing and internalizing conditions and its associations with symptom clusters.
Regional neural functional efficiency across schizophrenia, bipolar disorder, and major depressive disorder: a transdiagnostic resting-state fMRI study
Yang J, Liu Z, Pan Y, Fan Z, Cheng Y, Wang F, Sun F, Wu G, Ouyang X, Tao H, Yang J and Palaniyappan L
Major psychiatric disorders (MPDs) are delineated by distinct clinical features. However, overlapping symptoms and transdiagnostic effectiveness of medications have challenged the traditional diagnostic categorisation. We investigate if there are shared and illness-specific disruptions in the regional functional efficiency (RFE) of the brain across these disorders.
A systematic review and meta-analysis comparing the severity of core symptoms of attention-deficit hyperactivity disorder in females and males
Young S, Uysal O, Kahle J, Gudjonsson GH, Hollingdale J, Cortese S, Sakalli-Kani A, Greer B, Cocallis K, Sylver N, Yilmaz UE, Semerci B and Kilic O
In the past decade, there have been substantial changes in diagnostic nomenclature. This study investigated sex differences in attention-deficit/hyperactivity disorder (ADHD) symptom severity based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV, DSM-IV(TR), and DSM-5 criteria, separating rating scale and clinical interview data in children and adults with ADHD. PubMed, PsycINFO, and Scopus were searched for published studies (1996-2021) reporting severity of attention, and hyperactivity/impulsivity in males and females. We compared data: (1) across the entire lifespan aggregating rating scale and clinical interview data (51 studies), (2) drawing solely on rating scale data (18 studies), and (3) drawing solely on clinical interview data (33 studies). Fifty-two studies met inclusion criteria comparing data for females ( = 8423) and males ( = 9985) with ADHD across childhood and/or adulthood. In total, 15 meta-analyses were conducted. Pooled data across the lifespan aggregating both rating scale and clinical diagnostic interview data, showed males had significantly more severe hyperactivity/impulsivity symptoms than females. Rating scale data were similar; boys had significantly more severe hyperactivity/impulsivity than girls. In adulthood, men were rated to have significantly more severe inattention than women with no difference in the hyperactivity/impulsivity dimension. All significant differences were of small effect size. No significant sex differences in the severity of symptoms emerged for clinical interview data for children or adults, in contrast. Possible reasons for the discrepancy in findings between rating scales and clinical diagnostic interviews are discussed.
Theory driven psychological therapy for persecutory delusions: trajectories of patient outcomes
Jenner L, Payne M, Waite F, Beckwith H, Diamond R, Isham L, Collett N, Emsley R and Freeman D
We aimed to identify the common types of outcome trajectories for patients with psychosis who take up specialist psychological therapy for persecutory delusions. Knowing the different potential responses to therapy can inform expectations. Further, determining predictors of different outcomes may help in understanding who may benefit.
Examining the mental health trajectories of children and adolescents: a cross-cohort analysis
McNicholas F, Gavin B, Sellers R, Ji I, Zhang X, Browne WV and Harold G
Epidemiological samples provide opportunity to understand the development of mental health trajectories to better understand whether such epidemiological data can help to plan and modify service delivery for youth mental health. Variation between countries is not well understood and thus applying evidence from other countries to national strategies limits support service policy and planning. We therefore examine developmental patterns of youth mental health across different countries using the Growing Up in Ireland (GUI) Cohorts, with comparison to existing UK longitudinal cohort data (Millennium Cohort Study, MCS; Growing up in Scotland, GUS).
Harsh parenting, amygdala functional connectivity changes across childhood, and behavioral problems
Koyama Y, Tiemeier H, Huang P, Chan SY, Sudo M, Kyeong Y, Meaney M, Setoh P and Tan AP
Harsh parenting in early childhood is related to offspring's adverse behavioral outcomes. Due to the scarcity of longitudinal neuroimaging data, few studies have explored the neurobiological underpinnings of this association, focusing on within-person variability. This study examined the temporal associations among harsh parenting, later behavioral problems, and the developmental trajectories of amygdala volume and amygdala resting-state functional connectivity (RSFC) profiles, using longitudinal neuroimaging data.