Search Results (11,440)

Background/Objectives: Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with an increased risk of obesity and disordered eating behaviors. This study compared weight status and eating behaviors among drug-naïve ADHD children, those on stimulant monotherapy, those on combined stimulant and antipsychotic treatment, and healthy controls. Methods: This cross-sectional study included 547 children aged 6–12 years from four Turkish provinces: 361 with ADHD (152 drug-naïve, 156 on stimulants, and 53 on combined therapy), and 186 healthy controls. Anthropometric measurements, psychiatric assessments, and eating behavior evaluations were conducted using standardized tools. Results: Drug-naïve ADHD children had the highest obesity rate (13.8%), while those on stimulant monotherapy had the lowest (4.5%) compared to controls. Combined treatment group obesity rates were similar to controls (7.5% vs. 8.6%). The drug-naïve and combined treatment groups showed increased food approach behavior and desire to drink, with the combined treatment group also showing increased emotional overeating. Conclusions: This study reveals a complex relationship between ADHD, its pharmacological management, and the risk of obesity. Stimulant monotherapy may mitigate the risk of obesity, while combined stimulant and antipsychotic treatment may lead to problematic eating behaviors. These findings emphasize the importance of monitoring weight status and eating behaviors in ADHD children, especially those receiving pharmacological interventions. Full article

Objectives. There is a significant correlation between EEG microstate and the neurophysiological basis of mental illness, brain state, and cognitive function. Given that the unclear relationship between network dynamics and different microstates, this paper utilized microstate, brain network, and control theories to understand the microstate characteristics of short-term memory task, aiming to mechanistically explain the most influential microstates and brain regions driving the abnormal changes in brain state transitions in patients with schizophrenia. Methods. We identified each microstate and analyzed the microstate abnormalities in schizophrenia patients during short-term memory tasks. Subsequently, the network dynamics underlying the primary microstates were studied to reveal the relationships between network dynamics and microstates. Finally, using control theory, we confirmed that the abnormal changes in brain state transitions in schizophrenia patients are driven by specific microstates and brain regions. Results. The frontal-occipital lobes activity of microstate D decreased significantly, but the left frontal lobe of microstate B increased significantly in schizophrenia, when the brain was moving toward the easy-to-reach states. However, the frontal-occipital lobes activity of microstate D decreased significantly in schizophrenia, when the brain was moving toward the hard-to-reach states. Microstate D showed that the right-frontal activity had a higher priority than the left-frontal, but microstate B showed that the left-frontal priority decreased significantly in schizophrenia, when changes occur in the synchronization state of the brain. Conclusions. In conclusion, microstate D may be a biomarker candidate of brain abnormal activity during the states transitions in schizophrenia, and microstate B may represent a compensatory mechanism that maintains brain function and exchanges information with other brain regions. Microstate and brain network provide complementary perspectives on the neurodynamics, offering potential insights into brain function in health and disease. Full article

Background: In recent years, there has been growing interest in the evaluation of autism spectrum disorder (ASD) and autistic traits in prison populations and offenders. Due to misleading headlines and highly publicized criminal cases, the belief that autistic individuals are more prone to commit crimes has spread among the general population, also leading to increasing research on this matter. Aims: In this context, this narrative review aimed to analyze the available scientific literature on the bi-directional link between ASD and criminal behaviors and to assess the key characteristics of eventual ASD offenders, including sociodemographic data, comorbidities, crime-related features, and interactions with the criminal justice system. Results: Our review highlighted that the available studies lack methodological rigor and present controversial results. Overall, the current state of research does not support any definitive correlation between ASD or autistic traits and the predisposition to engage in criminal conduct. Further studies are needed to confirm or reject this hypothesis. Full article

Deprivation of sleep (DS) and its effects on circadian rhythm gene expression are not well understood despite their influence on various physiological and psychological processes. This study aimed to elucidate the changes in the expression of circadian rhythm genes following a night of sleep and DS. Their correlation with sleep architecture and physical activity was also examined. The study included 81 participants who underwent polysomnography (PSG) and DS with actigraphy. Blood samples were collected after PSG and DS. Expression levels of brain and muscle ARNT-like 1 (BMAL1), circadian locomotor output cycles kaput (CLOCK), neuronal PAS domain protein 2 (NPAS2), period 1 (PER1), cryptochrome 1 (CRY1) and nuclear receptor subfamily 1 group D member 1 (NR1D1) were analyzed using qRT-PCR. DS decreased the expression of CLOCK and BMAL1 while increasing PER1. PER1 expression correlated positively with total sleep time and non-rapid-eye-movement (NREM) sleep duration and negatively with sleep latency, alpha, beta and delta waves in the O1A2 lead. Physical activity during DS showed positive correlations with CLOCK, BMAL1, and CRY1. The findings highlight the role of PER1 in modulating sleep patterns, suggesting potential targets for managing sleep-related disorders. Further research is essential to deepen the understanding of these relationships and their implications. Full article

Pharmacogenomic (PGx) testing can help personalise psychiatric prescribing and improve on the currently adopted trial-and-error prescribing approach. However, widespread implementation is yet to occur. Understanding factors influencing implementation is pertinent to the psychiatric PGx field. Normalisation Process Theory (NPT) seeks to understand the work involved during intervention implementation and is used by this review (PROSPERO: CRD42023399926) to explore factors influencing PGx implementation in psychiatry. Four databases were systematically searched for relevant records and assessed for eligibility following PRISMA guidance. The QuADS tool was applied during quality assessment of included records. Using an abductive approach to codebook thematic analysis, barrier and facilitator themes were developed using NPT as a theoretical framework. Twenty-nine records were included in the data synthesis. Key barrier themes included a PGx knowledge gap, a lack of consensus in policy and guidance, and uncertainty towards the use of PGx. Facilitator themes included an interest in PGx use as a new and improved approach to prescribing, a desire for a multidisciplinary approach to PGx implementation, and the importance of fostering a climate for PGx implementation. Using NPT, this novel review systematically summarises the literature in the psychiatric PGx implementation field. The findings highlight a need to develop national policies on using PGx, and an education and training workforce plan for mental health professionals. By understanding factors influencing implementation, the findings help to address the psychiatric PGx implementation gap. This helps move clinical practice closer towards a personalised psychotropic prescribing approach and associated improvements in patient outcomes. Future policy and research should focus on the appraisal of PGx implementation in psychiatry and the role of pharmacists in PGx service design, implementation, and delivery. Full article

Endometrial Cancer (EC) is one of the most common gynecological malignancies. Despite its prevalence, molecular pathways, such as the Sonic Hedgehog (SHH) pathway, have not been extensively studied in the context of EC. This study aims to explore the clinical implications of SHH expression in EC, potentially uncovering new insights into the disease’s pathogenesis and offering valuable insights for therapeutic strategies in EC. We utilized data from The Cancer Genome Atlas (TCGA) to divide the dataset into ‘High SHH’ and ‘Low SHH’ groups based on a gene signature score derived from SHH pathway-related genes. We explored the clinical and tumor characteristics of these groups, focusing on key cancer hallmarks, including stemness, proliferation, cytolytic activity, tumor micro-environment, and genomic instability. ‘High SHH’ tumors emerged as a distinct category with favorable clinical and molecular features. These tumors exhibited lower proliferation rates, reduced angiogenesis, and diminished genomic instability, indicating a controlled and less aggressive tumor growth pattern. Moreover, ‘High SHH’ tumors displayed lower stemness, highlighting a less invasive phenotype. The immune micro-environment in ‘High SHH’ tumors was enriched with immune cell types, such as macrophage M0, monocytes, B cells, CD8 T cells, CD4 T cells, follicular helper T cells, and natural killer cells. This immune enrichment, coupled with higher cytolytic activity, suggested an improved anti-tumor immune response. Our study sheds light on the clinical significance of Sonic signaling in EC. ‘High SHH’ tumors exhibit a unique molecular and clinical profile associated with favorable cancer hallmarks, lower grades, and better survival. These findings underscore the potential utility of SHH expression as a robust prognostic biomarker, offering valuable insights for tailored therapeutic strategies in EC. Understanding the SHH pathway’s role in EC contributes to our growing knowledge of this cancer and may pave the way for more effective treatment strategies in the future. Full article

Mechanical bowel preparation (MBP) is essential for visualisation of the colon during colonoscopy. Previous studies have identified changes in gut microbiota composition after MBP and colonoscopy. Considering the gut microbiota is increasingly implicated in psychiatry, we explored the potential impact of this intervention on mood and the microbiota–gut–brain axis. We conducted a pre–post intervention study in adults, with timepoints of one week before and one month after MBP and colonoscopy. Our primary outcome was change in average Hospital Anxiety and Depression Scale depression sub-scores. We examined changes in average anxiety, stress, and quality of life scores and gut microbiota composition using 16S rRNA sequencing. We further explored associations between changes in depressive symptoms and gut microbiota and conducted post hoc analyses to explore potential effect modifiers. Average depressive symptom scores decreased one month post-procedure compared to baseline (n = 59; adjusted β = −0.64; 95%CI: −1.18, −0.11). Irritable bowel syndrome (IBS) appeared to moderate this relationship (β = 1.78; 95%CI: 0.292, 3.26); depressive symptoms increased in those with, and decreased in those without, IBS. Reduced alpha diversity, modest effects on beta-diversity, and increases in health-associated genera were observed one month post-procedure. Increases in the CLR-transformed abundances of Ruminococcaceae UCG-009 were associated with improvements in depressive symptoms. There is preliminary evidence of a potential mental health effect of MBP and colonoscopy, particularly for those with IBS, which may be associated with changes to the gut microbiota. Further research is required to confirm these findings and their clinical relevance. Full article

Objectives: Adverse childhood experiences (ACEs) are linked to a heightened risk of depression. We explored the relationship between ACEs and both depression and mental distress among cancer survivors. Methods: This was a cross-sectional analysis using the 2022 Behavioral Risk Factor Surveillance System database of cancer survivors aged ≥18 (n = 14,132). The primary outcome was self-reported history of depression, and the secondary outcome was mental distress. The exposure variable was the number of ACEs, classified as 0, 1–2, and ≥3. Weighted multivariable logistic regression models assessed the association between the number of ACEs and depression and mental distress while adjusting for covariates. Results: Approximately 22% of respondents reported experiencing ≥3 ACEs. The prevalence of depression was 21.8%, and mental distress was 15.4%. Compared with cancer survivors who had experienced 0 ACEs, those who had experienced ≥3 (aOR = 3.94; 95% CI, 3.04–5.10) or 1–2 (aOR = 1.85; 95% CI, 1.47–2.32) ACEs had a higher likelihood of reporting depression. Compared with cancer survivors who had experienced 0 ACEs, those who had experienced ≥3 (aOR = 0.67; 95% CI, 0.48–0.93) had a lower likelihood of reporting mental distress. Conclusions: This study highlights the impact of ACEs on depression in adulthood among cancer survivors. Full article

Background: Long COVID-19 is an emerging chronic illness of significant public health concern due to a myriad of neuropsychiatric sequelae, including increased suicidal ideation (SI) and behavior (SB). Methods: This review provides a concise synthesis of clinical evidence that points toward the dysfunction of astrocytes, the most abundant glial cell type in the central nervous system, as a potential shared pathology between SI/SB and COVID-19. Results: Depression, a suicide risk factor, and SI/SB were both associated with reduced frequencies of various astrocyte subsets and complex proteomic/transcriptional changes of astrocyte-related markers in a brain-region-specific manner. Astrocyte-related circulating markers were increased in depressed subjects and, to a less consistent extent, in COVID-19 patients. Furthermore, reactive astrocytosis was observed in subjects with SI/SB and those with COVID-19. Conclusions: Astrocyte dysfunctions occurred in depression, SI/SB, and COVID-19. Reactive-astrocyte-mediated loss of the blood–brain barrier (BBB) integrity and subsequent neuroinflammation—a factor previously linked to SI/SB development—might contribute to increased suicide in individuals with long COVID-19. As such, the formulation of new therapeutic strategies to restore astrocyte homeostasis, enhance BBB integrity, and mitigate neuroinflammation may reduce SI/SB-associated neuropsychiatric manifestations among long COVID-19 patients. Full article

Major depressive disorder (MDD) is a complex mental health condition with a multifaceted and incompletely elucidated pathophysiology. MicroRNAs (miRNAs) have emerged as potential biomarkers due to their role in gene regulation and the observed dysregulation in MDD. The aim of this study is to detect the presence of specific molecular diagnostic biomarkers in major depressive disorder. This cross-sectional study analyzed plasma miRNA expression in ten MDD patients and eight healthy controls using real-time PCR. Differentially expressed miRNAs were identified using independent t-tests, and their diagnostic potential was assessed with ROC curve analysis. Fifteen miRNAs exhibited significant dysregulation in MDD patients. Notably, hsa-miR-29c-3p, hsa-miR-376a-3p, hsa-miR-532-5p, and hsa-miR-339-5p showed excellent discriminatory power (AUC > 0.8). This study identifies differentially expressed plasma miRNAs in MDD, suggesting their potential for improved diagnosis and personalized treatment. However, further validation in larger cohorts and investigation into their functional roles are warranted. Full article

Objective: Examine the effect of an 8-week teacher-guided active play intervention on preschoolers’ body composition and fundamental motor skills. Methods: Participants were from two local preschool centers randomly assigned to either the intervention (n = 25, 3.91 ± 0.53 years) or the control group (n = 25, 3.69 ± 0.81 years). All measures were assessed at baseline (week 0), post-intervention (weeks 9–11), and follow-up (weeks 30–33). Bioelectrical Impedance assessed body composition (fat mass (FM) and fat-free mass (FFM)). The Peabody Developmental Motor Scales, Second Edition (PDMS-2) assessed fundamental motor skills (gross motor quartile (GMQ)). Results: A significant Group × Time interaction for GMQ at post-intervention (p = 0.03), with the intervention group scoring significantly higher on GMQ. A significant main effect of Time (p < 0.001) indicated that GMQ increased in both groups across the 33-week period. For FM, a significant main effect of Time at both post-intervention (p < 0.05) and follow-up testing (p < 0.001) indicated that participants increased FM over the 33-week period. Lastly, there was a significant main effect of Time for FFM at post-intervention (p = 0.003) and follow-up (p < 0.001). Interestingly, there was a significant Group × Time interaction (p < 0.05) at follow-up testing showing that FFM increased over time but significantly more for the control group. Conclusions: Results indicate that active play interventions might be a successful pathway to improve gross motor skills in young children. Further research is needed to understand the effect that active play interventions have on body composition in preschoolers. Full article

Healthcare researchers are increasingly utilizing smartphone sensor data as a scalable and cost-effective approach to studying individualized health-related behaviors in real-world settings. However, to develop reliable and robust digital behavioral signatures that may help in the early prediction of the individualized disease trajectory and future prognosis, there is a critical need to quantify the potential variability that may be present in the underlying sensor data due to variations in the smartphone hardware and software used by large population. Using sensor data collected in real-world settings from 3000 participants’ smartphones for up to 84 days, we compared differences in the completeness, correctness, and consistency of the three most common smartphone sensors—the accelerometer, gyroscope, and GPS— within and across Android and iOS devices. Our findings show considerable variation in sensor data quality within and across Android and iOS devices. Sensor data from iOS devices showed significantly lower levels of anomalous point density (APD) compared to Android across all sensors (p  <  1 × 10⁻⁴). iOS devices showed a considerably lower missing data ratio (MDR) for the accelerometer compared to the GPS data (p  <  1 × 10⁻⁴). Notably, the quality features derived from raw sensor data across devices alone could predict the device type (Android vs. iOS) with an up to 0.98 accuracy 95% CI [0.977, 0.982]. Such significant differences in sensor data quantity and quality gathered from iOS and Android platforms could lead to considerable variation in health-related inference derived from heterogenous consumer-owned smartphones. Our research highlights the importance of assessing, measuring, and adjusting for such critical differences in smartphone sensor-based assessments. Understanding the factors contributing to the variation in sensor data based on daily device usage will help develop reliable, standardized, inclusive, and practically applicable digital behavioral patterns that may be linked to health outcomes in real-world settings. Full article

Our understanding of chronic pain has evolved significantly, shifting from a focus on peripheral damage to recognizing the central mechanisms underlying pain perception. This perspective article explores the concept of nociplastic pain, a term introduced by the International Association for the Study of Pain (IASP) in 2017, which describes pain arising from altered pain modulation within the central nervous system, without clear evidence of tissue damage or inflammation. The historical progression from fibrositis to fibromyalgia, and now to nociplastic pain, underscores the complexity of chronic pain syndromes and the need for a multidisciplinary approach to management. Nociplastic pain is characterized by central sensitization, leading to heightened pain sensitivity and often accompanied by comorbidities such as fatigue, sleep disturbances, and cognitive difficulties. Advances in neuroimaging have revealed altered connectivity within key brain networks, such as the default mode and salience networks, in patients with nociplastic pain, providing insights into the neural underpinnings of this condition. The article also addresses controversies surrounding the role of small fiber neuropathy and autonomic dysfunction in nociplastic pain, highlighting the ongoing debates in the field. The practical importance of recognizing nociplastic pain across various medical disciplines—including primary care, orthopedics, neurology, psychiatry, and rheumatology—is emphasized, with recommendations for integrating this knowledge into clinical practice. Emerging therapies, such as neurofeedback, hyperbaric oxygen therapy, and neuromodulation, offer new avenues for treatment, particularly for patients who do not respond to conventional approaches. The article calls for continued research into the mechanisms of nociplastic pain, the development of reliable diagnostic tools, and the exploration of novel therapeutic strategies to improve patient outcomes. The recognition and management of nociplastic pain are crucial for advancing the care of patients with chronic pain, necessitating interdisciplinary collaboration and a patient-centered approach. Full article

Hidradenitis suppurativa (HS) is a chronic skin disease characterized by painful, recurrent abscesses, nodules, and scarring, primarily in skin folds. The exact causes of HS are multifactorial, involving genetic, hormonal, and environmental factors. It is associated with systemic diseases such as metabolic syndrome and inflammatory bowel disease. Genetic studies have identified mutations in the γ-secretase complex that affect Notch signaling pathways critical for skin cell regulation. Despite its high heritability, most reported HS cases do not follow a simple genetic pattern. In this article, we performed whole-exome sequencing (WES) on a cohort of 100 individuals with HS, and we provide a comprehensive review of the variants known to be described or associated with HS. 91 variants were associated with the γ-secretase complex, and 78 variants were associated with other genes involved in the Notch pathway, keratinization, or immune response. Through this new genetic analysis, we have added ten new variants to the existing catalogs. All variants are available in a .vcf file and are provided as a resource for future studies. Full article

Background/Objectives: There is evidence of overtreatment in patients with subclinical hypothyroidism (SCH). We aimed to identify the proportion of patients treated for SCH and the determinants of thyroid hormone therapy initiation. Methods: We included a random sample of adult Veterans diagnosed with SCH from 1 January 2016 to 31 December 2018 and conducted univariate and multivariable logistic regression to identify factors associated with levothyroxine initiation. Results: Out of 229 Veterans with SCH [90.0% male, 87.2% White, 99.1% non-Hispanic, median age (interquartile range; IQR) 68 (17) years], 27.5% were treated with levothyroxine. The treated group had a higher proportion of White patients (95.2% vs. 84.2%, p = 0.039), a higher thyrotropin level [median (IQR), 6.98 (2.06) mIU/L vs. 6.14 (1.10) mIU/L, p = 0.0002], a higher proportion of patients with thyrotropin level ≥ 10 mIU/L (11.1% vs. 3.0%, p = 0.021), a lower frequency of confirmatory thyroid testing before initiating levothyroxine (49.2% vs. 97.0%, p < 0.0001), and a similar frequency of thyroid autoimmunity testing (3.2% vs. 0.6%, p = 0.18) compared to the untreated group. In a multivariable logistic regression analysis, White race (OR = 4.50, 95% CI 1.19 to 17.08, p = 0.026) and index thyrotropin level [OR = 1.71, 95% CI 1.24 to 2.35, p = 0.001; for every SD increase (1.6 mIU/L)] were associated with higher odds of treatment. Conclusions: Three in 10 Veterans with SCH received levothyroxine, often based on a single abnormal thyroid test without autoimmunity assessment. White race and higher thyrotropin level were linked to increased odds of starting treatment, indicating potential disparities and the influence of SCH severity on decision-making. Full article