1,721,540 research outputs found
5HTTLPR Polymorphism, stressful events, neuropsychological performance and brain connectivity in eating disorders
Full text linkAbstract Introduction. Low functioning variants of 5HTTLPR have been associated to an increased risk of depression in subjects who experienced stressful events, to altered cognitive functioning and decisional processes, and functional and structural neural patterns. Contrasting evidence is available up to now in Eating Disorders (ED), and no study has evaluated the polymorphism effect on brain connectivity according to graph theory in Anorexia Nervosa (AN). Methods. We recruited up to 735 patients with life-time history of AN or bulimia nervosa (BN) according to DSM-IV criteria and up to 241 healthy controls (HC) for the assessment of the association between 5HTTLPR polymorphism and ED. We merged our Biobank data from BIO.Ve.D.A. and meta-analyzed 22 former studies. Patients underwent a structured diagnostic interview for present or life-time ED, an interview for presence and severity of stressful events, Edinburgh Handedness Inventory, Wisconsin Card Sorting Test, Trail A making test, Trail B making test, Iowa Gambling Task, Cognitive Bias Task, psychopathology rating scales for ED and general symptoms. Finally patients with AN and HCs underwent a Magnetic Resonance; their brains’ connectivity integration and segregation measures were then measured with Graph Analysis Toolbox, according to 5HTTLPR polymorpshim. Results. Our results from a meta-analysis including data from BIO.Ve.D.A. and 22 previous studies, suggest that 5HTTLPR polymorphism does not have a role per se in determing ED onset. However it may moderate the effect of SEs in increasing the risk of ED onset, and the influence of SEs on ED severity, anxious, depressive and obsessive symptoms. When we tested both a multiplicative and an additive model, which is considered to be more representative of a real-world gene by environment interaction, such a 5HTTLPR by SE interaction was not confirmed instead. S allele was associated with worse performance at Cognitive Bias Task and Trail Making B, and with increased ED psychopathology, general psychopathology, anxious, depressive, and obsessive symptoms. Finally S allele was associated with decreased segregation measures at brain connectivity analysis according to graph theory compared with L allele in AN; this was an opposite association compared with healthy controls who had higher modularity associated with S allele instead. Conclusions. 5HTTLPR polymorphism does not seem to be a causal factor of ED per se, but it seems to play a role in moderating the role of stressful events in increasing ED risk. Such a moderation however did not reflect a gene by environment interaction according to either a multiplicative or additive model. S allele was associated with higher psychopathology scores, and worse neuropsychological functions in AN, and with a disrupted segregation measures of brain signal connectivity compared to HCs
Editorial Perspective: COVID-19 related publications on young people’s mental health – What have been the key trends so far and what should come next?
No full textIn this Editorial Perspective, we take a systematic look at the overall nature of the Covid-19 related research on mental health in children and young people, to gain insight into the major trends in this area of research and inform future lines of investigation, clinical practices, and policies. By means of state-of-the-art scientometric approaches, we identified 3,692 relevant research outputs, mainly clustering around the following themes: (a) mental health consequences of the Covid-19 pandemic in children and young people; (b) impact of the pandemic on pre-existing psychiatric disorders; (c) family outcomes (i.e., family violence and parental mental health); and (d) link between physical and mental conditions. Only 23% of the retrieved publications reported new data, the remaining ones being reviews, editorials, opinion papers, and other nonempirical reports. The majority of the empirical studies used a cross-sectional design. We suggest that future research efforts should prioritise: (a) longitudinal follow-up of existing cohorts; (b) quasi-experimental studies to gain insight into causal mechanisms underlying pandemic-related psychopathology in children and young people; (c) pragmatic randomised controlled trials (RCTs) to test evidence-based intervention strategies; and (d) evidence-based guidelines for clinicians and policymakers
Physical exercise as a treatment for anxiety and depression in children and adolescents? The devil is in the details
No full textCommentary: the impact of Covid‐19 on psychopathology in children and young people worldwide – reflections on Newlove‐Delgado et al. (2023)
No full textIn the past 3 years, since the beginning of the Covid-19 pandemic, there has been an impressive flourishing body of publications on the impact of the pandemic and related restrictions on the mental health of children and young people. It was about time for a rigorous quantitative evidence synthesis of this large body of research. Newlove-Delgado et al. (J Child Psychol Psychiatry, 2022) took on this challenge by completing a systematic review with meta-analysis of epidemiological studies on the impact of Covid-19 on psychopathology in children and adolescents, featured in the 2023 Annual Research Review series of the Journal. Overall, this meta-analysis shows that the relationship between mental health and Covid-19 pandemic in children and adolescents is complex and, as such, it ought to be addressed by studies using rigorous methods and advanced analytic strategies. Collectively, as a field, we should and could do better with regards to the scope and quality of the studies in this area.</p
Understanding placebo mechanisms to reduce attrition in psychiatric trials
No full textPlacebo responses in psychiatric trials are clinically significant and variable.1 When placebo response is large, the assay sensitivity of a clinical trial can be impacted, meaning that it can potentially result in a failure to detect efficacy for an active treatment.2 The constituent effects that combine to produce a placebo response are multiple and include both specific placebo mechanisms (eg, expectation effects) and nonspecific effects (eg, regression to the mean).1,3 An additional factor that might impact estimates of both treatment and placebo response is missing data
Global and risk-group stratified well-being and mental health during the COVID-19 pandemic in adults: results from the international COH-FIT Study
No full textInternational studies measuring wellbeing/multidimensional mental health before/ during the COVID-19 pandemic, including representative samples for >2 years, identifying risk groups and coping strategies are lacking. COH-FIT is an online, international, anonymous survey measuring changes in well-being (WHO-5) and a composite psychopathology P-score, and their associations with COVID-19 deaths/restrictions, 12 a-priori defined risk individual/cumulative factors, and coping strategies during COVID-19 pandemic (26/04/2020-26/06/2022) in 30 languages (representative, weighted non-representative, adults). T-test, χ2, penalized cubic splines, linear regression, correlation analyses were conducted. Analyzing 121,066/142,364 initiated surveys, WHO-5/P-score worsened intra-pandemic by 11.1±21.1/13.2±17.9 points (effect size d=0.50/0.60) (comparable results in representative/weighted non-probability samples). Persons with WHO-5 scores indicative of depression screening (<50, 13% to 32%) and major depression (<29, 3% to 12%) significantly increased. WHO-5 worsened from those with mental disorders, female sex, COVID-19-related loss, low-income country location, physical disorders, healthcare worker occupations, large city location, COVID-19 infection, unemployment, firstgeneration immigration, to age=18-29 with a cumulative effect. Similar findings emerged for P-score. Changes were significantly but minimally related to COVID-19 deaths, returning to near-pre-pandemic values after >2 years. The most subjectively effective coping strategies were exercise and walking, internet use, social contacts. Identified risk groups, coping strategies and outcome trajectories can inform global public health strategies
Stigma and attitudes towards restrictive practices in Psychiatry among Psychology students: a network and path analysis study in an Italian sample
No full textSystematic review and meta-analysis: reporting and representation of race/ethnicity in 310 randomized controlled trials of attention-deficit/hyperactivity disorder medications
No full textObjective: to evaluate the reporting of race/ethnicity data in randomized controlled trials (RCTs) of attention-deficit/hyperactivity disorder (ADHD) medications. Secondary objectives were to estimate temporal trends in the reporting, and to compare the pooled prevalence of racial/ethnic groups in RCTs conducted in the US to national estimates.Method: we drew on, adapted, and updated the search of a network meta-analysis by Cortese et al. (2018) up to March 2022. We calculated the percentage of RCTs reporting data on race/ethnicity of participants in the published article or in related unpublished material. Temporal trends were estimated with logistic regression. The pooled prevalence of each racial/ethnic group across US RCTs was calculated using random-effects model meta-analyses.Results: we retained 310 RCTs (including 44,447 participants), of which 231 were conducted in children/adolescents, 78 in adults, and 1 in both. Data on race/ethnicity were reported in 59.3% of the RCTs (75% of which were conducted in children/adolescents and 25% in adults) in the published article, and in unpublished material in an additional 8.7% of the RCTs. Reporting improved over time. In the US RCTs, Asian and White individuals were under- and overrepresented, respectively, compared to national estimates in the most recent time period considered.Conclusion: more than 30% of the RCTs of ADHD medications retained in this review did not include data on race/ethnicity in their published or unpublished reports, and more than 40% in their published articles, even though reporting improved over time. Results should inform investigators, authors, editors, regulators, and study participants in relation to efforts to tackle inequalities in ADHD research.Diversity & Inclusion Statement: one or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work
Lamotrigine Induces Hair Loss in a Patient With Treatment-Resistant Major Depressive Disorder
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