Trainee emergency and resuscitation technicians are not prepared during their academic training to deal with their psychological reactions to the death of a patient, we wanted to describe their feelings and understand the aggravating factors and highlight the need for intervention.

Our study aims to describe the psychological reactions of traineesexposed to the death of a patient on the internship grounds and to demonstrate the usefulness of specific psychological counseling

It is a prospective interventional study carried out with 2nd and 3rd-year students of the emergency and resuscitation section, our collection was done using a self-administered questionnaire with a validated PDI scale before the training, and a satisfaction questionnaire with the same scale after the training.

Our population isyoung, with an averageage of 20.05 years, and ispredominantlyfemale, with a sex ratio of 0.12. Eighty-seven percent of the population statedthatthey were not prepared to deal with their feelings about the death of a patient, and thiseventharmed the quality of care for 68% of the students. According to the scores of the PDI scale in pre-training 77.33% of the students are at risk of developing PTSD, this percentage decreases to 30.67% according to the same scale in post-training.

it is important to take into consideration the suffering of traineesexposed to traumaticevents such as the death of patients and to prepare them psychologically to deal with these situations

No significant relationships.

Posttraumatic stress disorder (PTSD) is a psychiatric condition which can be developed following traumatic experience. Treatment guidelines have long considered psychotherapy as a first line treatment. Despite that, PTSD remains an illness with high rates of comorbidity. Therefore, exploring novel therapies is of utmost importance.

Clarifying methylenedioxymethamphetamine (MDMA)-assisted psychotherapy efficacy in symptom relief in people with PTSD. Explaining clinical MDMA mechanism of action. Assessing safety of MDMA clinical use.

PubMed database search, with “MDMA for PTSD” keyword expression. 12 Articles published in the last ten years were selected among the 112 best matches. Reference lists of articles were reviewed to identify additional articles.

Mithoefer et al. (2010) carried out the first controlled clinical study with MDMA-assisted psychotherapy in people with PTSD. Twenty patients with treatment-resistant PTSD were selected. They were given either placebo or two or three sessions of MDMA. 83% of the experimental group no longer met the criteria for PTSD (mean remission lasted 45 months without further MDMA doses) compared with 25% of the placebo group. Further studies were also suggestive of improvements in treatment-resistant PTSD patients undergoing MDMA-assisted psychotherapy. MDMA may increase exposure therapy effectiveness, allowing patients to stay emotionally involved while revisiting past traumas without being overwhelmed by anxiety and fear.

To date, MDMA-assisted psychotherapy studies demonstrated consistently positive results. However, they have been carried out with small groups of individuals. Therefore, larger trials should be conducted to assess MDMA’s efficacy and safety for it to become a licensed medicine.

No significant relationships.

PTSD is a chronic, debilitating condition with limited treatment efficacy. Accessing traumatic memories often leads to overwhelming distress, impacting treatment process. Current approved pharmacological treatments have exhibited small to moderate effects when compared with placebo. Evidence suggests 3,4,-methylene-dioxymethamphetamine(MDMA)-assisted psychotherapy as a viable option for refractory PTSD.

Comprehensive review of early clinical research, proposed mechanisms, safety and emerging therapeutic models.

Eligible studies will be identified through strategic search of MEDLINE.

Pre-clinical and imaging studies suggest memory reconsolidation and fear extinction as candidate psychological and neurological mechanisms, involving MDMA’s combined effects of increasing serotonergic activity, as well the release of oxytocin and brain-derived neurotrophic factor in key memory and emotional circuits. Resulting reduction in amygdala and insula activation and increasing connectivity between the amygdala and hippocampus may create a “tolerance window” of neuroplasticity for emotional engagement and reprocessing of traumatic memories during psychotherapy. Early clinical trials report impressive and durable reduction in PTSD symptoms, with a safety profile comparable to that of SSRIs. A recently completed randomized, double-blind, placebo-controlled phase 3 trial reported full remission of PTSD symptoms in 67% of patients at 2 months, with no increase in suicidality, cardiovascular events or abuse behavior. Emerging treatment models underline the importance of unmedicated therapeutic sessions for preparation for the experience and subsequent integration as essential for full benefit and safety of the clinical context.

The psychological impact associated with the COVID-19 pandemic is an reminder of the emotional and economic burden associated with PTSD. MDMA-assisted therapy may be a breakthrough approach meriting further multidisciplinary investment and clinical research.

No significant relationships.

Resilience is a multidimensional construct. Despite being quoted as protective against mental disorders, it remains largely unexplored in our context.

We attempted to explore the role of resilience in the development of various psychiatric symptoms as depression, anxiety and post-traumatic stress disorder following trauma in clinical population in a psychiatry outpatient of a university hospital.

We interviewed one hundred patients who sought treatment in psychiatry outpatient in a university hospital in Kathmandu, Nepal. We collected sociodemographic and trauma related information using semi-structured interview format. Other instruments used were the World Health Organization Composite International Diagnostic Interview version 2.1 for trauma categorization, the Post-Traumatic Stress Disorder Checklist-Civilian version to measure the post-traumatic stress disorder symptoms, and the 25-item Hopkins Symptom Checklist-25 to assess the level of depression and anxiety symptoms. We used Nepali adapted resilience scale derived from the original Wagnild and Young Resilience scale to measure resilience. We explored the associations between resilience scores and the scores on depression, anxiety and posttraumatic stress disorder using bivariate and multivariate analysis.

Resilience had negative correlations with depression, anxiety, and post-traumatic stress disorder symptoms after adjusting for other variables such as gender, marital status, employment status, socioeconomic status and trauma types which were observed to have significant association in the bivariate analysis.

There was inverse correlation between resilience scores and depression, anxiety, and post-traumatic stress symptoms. Resilience should be considered in studies involving trauma population.

No significant relationships.

Post-traumatic stress disorder (PTSD) is a psychiatric disorder characterized by symptoms from four clusters after exposure to a traumatic event: re-experiencing symptoms including flashbacks and nightmares, hyperarousal, avoidance of internal and external stimuli related to trauma, and negative alterations in mood and cognition. As a noninvasive intervention that uses induction of electromagnetic fields to modulate cortical circuitry, TMS has a substantial body of literature demonstrating safety, tolerability, and efficacy in depression and potentially PTSD.

Our aim is to perform a non-systematic review of the literature regarding TMS and PTSD

A semi-structured review was conducted on Pubmed concerning TMS and PTSD

The majority of studies utilize repetitive TMS targeted to the right dorsolateral prefrontal cortex (DLPFC) at low frequency (1 Hz) or high frequency (10 or 20 Hz), however others have used alternative frequencies, targeted other regions, or trialed different stimulation protocols utilizing newer TMS modalities such as theta-burst TMS (TBS). It is encouraging that were positive outcomes have been shown, and often sustained for up to -3 months, nevertheless there is a paucity of long-term studies directly comparing available approaches.

TMS appears safe and effective for PTSD, although important steps are needed to operationalize optimal approaches for patients.

No significant relationships.

Post-traumatic stress disorder frequently alters the quality of life.

Assess the quality of life in midwives who have post-traumatic stress disorder.

We conducted a cross-sectional study among midwives in a single university hospital centre using a self-administered questionnaire. We screened post-traumatic stress disorder using the Impact of event scale and the quality of life using 5 items Likert scale.

Our response rate was 82%. Out of 42 midwives who answered us, 18 had post-traumatic stress disorder symptoms (42.8%). They were all female. Their mean age was 45.6± 10.3 years. The traumatic event occurred mainly at work and was related to the death of a mother or a baby. Symptoms of post-traumatic stress disorder symptoms were severe in 5 midwives. The quality of life was altered in 38.8% of participants. Both post-traumatic stress disorder symptoms and alteration of the quality of life were more frequent in patients who don’t have leisure activities.

In conclusion, midwives are vulnerable to developing post-traumatic stress disorder. Encouraging sports and other leisure activities may protect them from having severe repercussions on their life.

No significant relationships.

Posttraumatic nightmares are one of the most frequent symptoms in posttraumatic stress disorder. Prevalence can be up to 96%. These nightmares evoke the experienced traumatic event, causing a negative impact. Besides, they are and independent risk for suicide. There are different pharmacological and non-pharmacological options for PTN, despite is no optimal treatment.

To analyse the different treatment options for PTN.

This was a narrative literature review.

The two main treatments for PTN nowadays are the Imagery Rehearsal Therapy (IRT) and prazosin. IRT is a cognitive-behavioral intervention, that helps the patient to change the content of the nightmare to a “happier ending”. Prazosin is an alpha-adrenergic receptor antagonist that blocks the stress response in the central nervous system receptors. Although it was a promising drug, significant differences compared to placebo have not been found. There is growing data that suggests nabilone, a synthetic cannabinoid, could be helpful in PTN treatment. A clinical trial made in Canada revealed that 72% of patients experienced a complete disappearance or at least an important reduction of PTN.

PTN is a very common and distressing symptom in patients presenting PTSD. Nevertheless, there is no treatment with enough evidence for this pathology. On this account, it is fundamental to do more research in order to find and suitable treatment that can improve the quality of life of these patients.

No significant relationships.

Post-traumatic stress disorder (PTSD) is associated with exposure to an actual death or serious injury threatening event , as is the example of an Intensive Care Unit (ICU) patient, and it is characterized by dissociative, avoidance, cognitive and mood symptoms. (1) It is known that ICU patients may develop PTSD with an incidence rate of 10%. (2)

Comprehend the correlation between PTSD development and ICU care and its risk factors and ways of prevention.

The authors conducted a literature review by searching the Pubmed database using the keywords PTSD; ICU; Risk Factors; Prevention.

The studies show that the risk factors are associated to: Intensive care like mechanic ventilation, sedation (like using midazolam, lorazepam or opioid); individual’s characteristics like being younger than 50 years old, personal history of depression, feminine gender and lower levels of cortisol, and experiencing cognitive alterations, as hallucinations, delirium, amnesia and delirant memory, or anxiety while under ICU care. (1,3,4,5) As a form of prevention non pharmacological measures are the most consensual. Pharmacologic hypothesis should be applied in the first 6 hours of trauma and could be hydrocortisone, as it is thought to be a protective factor for memory consolidation, but the conclusions are not consistent.(6)

There are a lot of people that develop PTSD in the ICU context who are not diagnosed and therefore not treated. In this way, it is necessary to identify the patients with more risk factors, apply the non-pharmacological measures and evaluate the person after discharge.

No significant relationships.

With the application of virtual reality (VR), tailored interventions can be created that mirror the traumatic experiences of veterans with post-traumatic stress disorder (PTSD). Visual elements can be mimicked, and auditory and other senses stimulated. In doing so, the degree of immersion can be adjusted to optimize the therapeutic process. Objectively measuring the sensory immersion is key to keep subjects within their personal window of tolerance. Based on this information the therapist can decide manipulate the sensory stimulation embedded in the treatment.

The objectives of this study are to explore the different immersive design aspects of VRET that can be modified to influence the experienced presence in veterans with PTSD, and to discuss possible methods of measuring the emotional response facilitated by immersive design aspects and experienced presence.

Four design aspects are discussed: system, sensory cues, narrative and challenge. We also report on a user experiment in three veterans that informed on quality and depth of immersion.

Believability of the neutral virtual environment was important for maintaining the veterans’ presence within the VR experience. The immersive design aspects that were personalized and supportive in the narrative of the veteran such as music and self-selected images appeared to have a strong influence on recall and reliving of the traumatic events.

Finally, in order to increase the therapeutic effect in veterans with PTSD, the highlighted design aspects should be recognized and tailored to maximize immersion in virtual reality exposure therapy.

No significant relationships.

About a decade ago, the idea of a Late-Onset Post Traumatic Stress Disorder (LO-PTSD) emerged, in order to characterize the later-life emergence of symptoms related to early-life warzone trauma among aging combat Veterans.

This paper provides a review of the changes happened during the onset of a late form of PTSD and how can mental health professionals intervene.

Review of the literature from 2015 to present, using search engines such as Pubmed and Google Schoolar, using the following keywords: Late-Onset Post Traumatic Stress Disorder, triggers, prevention, intervention

At first, there was hypothesized that aging-related challenges (role transition and loss, death of family members and friends, physical and cognitive decline) might lead to increased reminiscence, and possibly distress, among Veterans who had previously dealt successfully with earlier traumatic events. However, recent studies have proposed that in later life many combat Veterans confront and rework their wartime memories in an effort to find meaning and build coherence. Through reminiscence, life review, and wrestling with issues such as integrity versus despair, they intentionally reengage with experiences they avoided or managed successfully earlier in life, perhaps without resolution or integration. This process can lead positively to personal growth or negatively to increased symptomatology.

Therefore the role of preventive intervention in enhancing positive outcomes for Veterans who reengage with their wartime memories in later life should be reconsidered.

No significant relationships.

Digital technologies are used in the prevention of post-traumatic stress disorder (PTSD). There is no clear evidence for effective gender-sensitive preventive measures for PTSD. Using Tetris during the golden hour after trauma can reduce intrusive memories and thus reduce the likelihood of PTSD in the future.

Understand the features of gender differences after psychological interventions in patients in the acute period after a traumatic event. Video games that use visual-spatial efforts over a fixed time and frequency (Tetris) may reduce the likelihood of developing PTSD.

Main inclusion criteria was an exposure to traumatic event (time from traumatic event - 0-24 hours). Respondents were assessed by PTSD symptom scale (PCL-5), peritraumatic distress scale (PDS), peritraumatic dissociative experience scale (PDES) and global functioning scale (GFS), intrusion diary (intervals: week 0, week 4, week 8, week 12).

PTSD symptoms were more severe in female participants (p ≤ 0,05). Participants in the Tetris game group recorded significantly fewer intrusive memories during the first week after the traumatic event than participants in two other groups, with a mean effect size of 57 (M = 8.73 vs. M = 23.26, t (69) = 2.80, P = 0.005, d = 0.67, 95% CI: 0.18, 1, 14). After the first month of follow-up, members of the Tetris game group reported less stress from intrusive symptoms.

Tetris intervention may reduce intrusive memories of real trauma. Women had more severe PTSD symptoms. Due to the small number of samples, the study should be repeated.

No significant relationships.

It is important to determine those clinical factors that imply a greater risk of rehospitalization in psychotic patients

To determine the rate and predictors of rehospitalization in psychotic patients after their first hospitalization

We include all Psychotic patients admitted for first time in their life in our Psychiatric Unit between 2009 and 2019 (N=359) , including all diagnosed according DSM-IV of Schizophrenia or other Psychotic disorders -Multiple clinical, sociodemographic and biological variables of the basal hospitalization were recorded With the SPSS program we compared the variables between patients who needed any hospitalization in the follow-up until 31th December 2019 and those who do not. We use the Chi square ( qualitative variables) and the Student T ( quantitative variables)

109 psychotic inpatients had at least one rehospitalizations (30,4%). The qualitative variables significantly associated with rehospitalization were : cannabis in urine at admission (P<0.03), and treatment with risperidone (P<0.014). Instead treatment with long acting paliperidone was associated with absence of rehospitalization (P<0.005) .The quantitative variables relationed significantly with multiple rehospitalization were : lower age (P<0,015) lower HDL cholesterol levels (P<0.02) and higher years of follow-up after discharge (P<0.000)

1-More of 30% of psychotic patients need rehospitalization after their first hospitalization in a mean of follow up of 5,8 years 2-Lower age, longer follow-up period and treatment with risperidone are significantly associated with rehospitalization , instead treatment with long acting paliperidone are significantly associated with absence of rehospitalization

No significant relationships.

The comorbidity between cardiometabolic and psychotic disorders develops early. This is a crucial window of opportunity to reduce excess morbidity and mortality. Recently, a cardiometabolic risk prediction algorithm for young people with psychosis, the psychosis metabolic risk calculator (PsyMetRiC) was developed and externally validated in the UK. However, its international transportability is unknown.

We performed the first international validation study of PsyMetRiC in Lausanne, Switzerland, and examined whether additional variables (clinical and/or genetic) may improve the predictive performance of the algorithm

We included people aged 16-35y with psychosis from the PsyMetab cohort, who did not have MetS at baseline, and who had 1-6y follow-up data. The PsyMetRiC partial (age, sex, ethnicity, body mass index, smoking status, and prescription of a metabolically-active antipsychotic) and full (also including high-density lipoprotein and triglycerides) algorithms were applied. Predictive performance was assessed using measures of discrimination (C-statistic) and calibration (calibration plots). Recalibration steps included refitting the intercept and/or slope if necessary. Additional variables (e.g. speed of weight gain, polygenic risk scores) were added to the model and predictive performance was reassessed.

We included 545 participants. The discrimination performance of both PsyMetRiC algorithms was good (C>0.75), and calibration plots showed good agreement between observed and predicted risk. Additional analyses to be conducted.

PsyMetRiC is likely to be generalizable for use in Switzerland, suggesting that PsyMetRiC may also be suitable for use in other European populations. While additional international validations are required, these findings are an encouraging step toward an international cardiometabolic risk prediction algorithm for young people with psychosis.

No significant relationships.

The search for approaches to creating a precision personalized virtual reality for the treatment of mental disorders is urgent. (Belkasim, 2005; Park M.J. et all., 2019).

To develop a new approach to personalize the form of virtual reality content to the neurophysiological and anatomical parameters of the patient’s brain, to improve the quality of precision VR therapy for mental disorders.

The MRI study was carried out on a GE Optima 450w apparatus with a magnetic field induction of 1.5 Tesla. We used a radio frequency coil for the head. T1-weighted images were obtained with a field of view (FOV) of 24.4 x 14.8 cm and a slice thickness of 0.5 mm. Later, the images were built in three standard mutually perpendicular planes. Measurements were carried out using standard tools on an eFilm 4.0 WorkStation. FreeSurfer 4.5.0 was used to calculate the surface area of the cerebral hemispheres. To estimate the surface area of the room and the design of the shape in VR closed environment Autodesk AutoCAD 2018.

A new approach to personalization of the form of virtual reality content has been developed (Patent No. RU (11) 2 668 697 (13) C1, 2018;Patent No. RU (11) 2 753 234 (13) C1, 2020). It is based on the use a single morphometric indicator for a closed VR space and brain.

Research and applied analysis of the developed approach is required. The development of this area will make it possible to create precision products for the therapy and rehabilitation of mental disorders.

No significant relationships.

Anorexia nervosa (AN) is a chronic psychiatric disorder resulting from abnormal eating habits with a high prevalence (0.5%). AN involves genetic and epigenetic factors supporting that AN is a metabo-psychiatric disorder. One candidate gene for AN, validated by meta-analyzes, is BDNF which encodes the brain-derived neurotrophic factor. BDNF negatively modulates the central control of food intake and its injection in rodents induces weight loss and anorexia. In humans, we observed an association of its functional variant Val66Met/rs6265 and electrodermal response to images of thinness suggesting an association between rs6265 and a reward effect of weight loss in AN.

This work study the impact of the functional polymorphism at risk rs6265, epigenetic variations in DNA methylation of BDNF gene and consequences on the concentrations of BDNF in AN patients.

DNA was isolated from 24 AN patients and 48 controls. DNA methylation was measured for sites spanning the BDNF gene using Infinium HumanMethylation450 BeadChip technology. The genotyping of rs6265 was performed by Taqman-SNP assay. The BDNF was dosaged by ELISA from plasmas.

We observe that several sites are significantly hypermethylated in AN patients compared to controls. AN patients show significantly higher BDNF levels than controls. Finally, this BDNF concentration is significantly higher in AN carrying the risk Met66 allele.

This work demonstrates the effects of genetic and epigenetic variations of BDNF, which could constitute relevant diagnostic biomarkers of AN, and their likely consequences in the pathophysiology of AN. This work was supported by the Nestlé Foundation.

No significant relationships.

Cardiovascular disease (CVD) causes staggering losses in quality adjusted life years worldwide.1 Among patients in the Danish psychiatric hospital setting, heart disease is associated with a decrease in life expectancy of 5.1 years.2 The causes underlying this association are likely manifold. For example, severe mental illness is associated with unhealthy lifestyle.3 Furthermore, psychiatrists may focus predominantly on the treatment of mental illness and have less emphasis on detection and prevention of physical illness.4 If patients at elevated risk of CVD are pointed out automatically, this may lead to better preventive medicine.

To predict which patients develop cardiovascular disease using machine learning.

We obtained data on all psychiatric hospital contacts in the Central Denmark Region since the initiation of the current EHR system (MidtEPJ). These span from 2011 to 2021 and cover 120,000 patients, of which 3,000 patients developed severe CVD (stroke or coronary event) follow-up. We will train a variety of models (random forests, SVM, deep neural nets) to predict CVD within one year from a planned contact to hospital.

The modelling is currently underway, intermediary results are expected in January.

We explore whether predicting CVD is feasible using state-of-the-art technologies and a uniquely detailed dataset. This may pave the way for machine learning to act as a clinical support decision system, since we’re only training on data that is available in a live, clinical context.

References

1: Khan 2019

2: Erlangsen 2017

3: Scott 2011

4: Fagiolini 2009

No significant relationships.

The term “personalised therapy” refers to the use of genetic data to better treat or determine the predisposition to a specific genetic disease, with the ultimate goal of improving quality of life. Telepsychiatry and AI are key to support it..

Determine benefits of pharmacogenomic analysis (PGx) in CNS diseases regarding: - cost effectiveness - adverse drug reactions - reduced hospitalizations -drug interactions - efficacy - quality of life - “trial and error” approach avoidance

Questionnaires before and after the treatment provided using PGX tests Telepsychiatry for consultation along face to face sessions were conducted. Artificial intelligence in data analyses

Benefits of pharmacogenomic analysis (PGx) in CNS diseases: - cost effective savings - prediction and prevention of adverse drug reactions - reduced hospitalization due to ineffectiveness of medication - reduced risk of drug interactions - more effective treatments - better quality of life for the patient - with the analysis (PGx) the “trial and error” approach is avoided

In a number of studies in patients with mental disorders, pharmacogenomic analysis (PGx) has led to an increase in both clinical response and remission, better tolerated treatments, fewer side effects, and reduced treatment costs. In conclusion, pharmacogenomic analysis is ideal for patients with CNS diseases: a) Not responding to treatment b) Who in their history have many relapses and hospitalizations c) They show serious side effects d) Who do not comply with the treatment e) Taking many medications and suffering from serious illnesses f) Who are wary of taking psychotropic drugs

No significant relationships.

Cariprazine (CAR) is a D2, D3, 5HT1A receptor partial agonist and a 5HT2A, 5HT2B antagonist, used to treat Schizophrenia and Bipolar disorder. Interindividual variability in therapeutic and side effects of antipsychotics is difficult to predict, due to non-genetic and genetic factors. Single nucleotide polymorphisms (SNPs) are the main source of genetic variability, the ones in dopamine and serotonin receptors to which CAR binds are indeed likely to determine response to treatment.

The aim of the study is to define a relationship between CAR clinical efficacy and SNPs in dopamine and serotonin receptors genes of patients affected by schizophrenia and bipolar disorder.

We recruited 16 patients starting a monotherapy with CAR, evaluated at baseline and after 2, 4 and 8 weeks through BPRS rating scale. We selected a panel of SNPs in DR2, DR3, 5HT1A and 5HT2A receptors, with a frequency higher that 10% in Caucasians and functionally characterized. Cut-off for response to treatment was a 50% reduction of BPRS score. Statistical analysis was performed with one-way ANOVA followed by the test for linear trend between columns.

All subjects achieved response after 8 weeks of treatment, but 6 patients after 4 weeks. Early responders have a genetic profile associated with increased dopamine and serotonin receptor expression and/or binding affinity for their specific ligands. The association don’t reach statistical significance, probably due to low number of patients.

Preliminary results suggest that an array of dopamine and serotonin receptors SNPs could predict time to respond to CAR in schizophrenia and bipolar disorder.

The study is founded by Recordati AG, that commercialize the drug under study (Cariprazine) in Switzerland. Funding covers the costs for genetic analysis and other procedures of the study, no financial compensation is planned for investigators/authors.

Group-level studies showed cross-sectional and prospective between-person associations between circadian rest-activity rhythms (RAR), physical activity (PA), sleep, and depressive symptoms. However, whether these associations replicate at the within-person level remains unclear. Therefore, it is clinically relevant to investigate these associations within persons and study whether changes in depressive symptoms are related to changes in circadian rhythm and sleep variables.

To identify changes in circadian rhythm elements in proximity to a transition in depressive symptoms, whether changes are less frequent in individuals without compared to those with transitions, and whether there are individual differences in the direction of change of circadian rhythm variables.

Data of remitted individuals tapering antidepressants were used: 12 with and 14 without a transition in depressive symptoms. RAR, PA, and sleep variables were calculated as predictors from four months of actigraphy data. Transitions in depressive symptoms were based on weekly SCL-90 scores and evaluation interviews. Kernel Change Point analyses were used to detect change points (CPs) and CP timing in circadian rhythm variables for each individual separately.

In 67% of individuals with depressive symptoms transitions, CPs were identified in proximity to symptom transitions. CPs were detected less frequently in the no-transition group with 7 CPs in 14 individuals, compared to transition groups with 10 CPs in 12 individuals. For several RAR and sleep variables, consistent changes were detected in expected directions.

Circadian rhythm variables provide potentially clinically relevant information although their patterns around transitions are highly person-specific. Future research is needed to disentangle which variables are predictive for which patients.

No significant relationships.

Structural variations of DNA, such as copy number variations (CNVs), are important contributors to risk for human diseases. Several CNVs have been associated with an increased risk of early-onset neurodevelopmental disorders (NDD), adult-onset psychiatry disorders and physical comorbidities. While in Pediatrics the microarray is the first-line genetic analysis technique in the study of child onset NDD, its use in psychiatry care of young/adult onset NDD has been limited to research purposes.

Review of the diagnostic yield of the use of microarrays analysis in psychiatric clinical practice of severe mental disorder care in adults, according to the concept of a neurodevelopmental continuum.

An exploratory literature review on the topic in PubMed, including the terms: “copy number variants/CNVs” AND “neurodevelopmental delay/disorders, congenital anomalies/malformations, ADHD, autism/ASD, learning disabilities, epilepsy, Tourette, schizophrenia, bipolar, behaviour”.

The prevalence of carriers of pathogenic or likely pathogenic CNVs among the different NDD phenotypes investigated by microarray analysis ranged from 3-22.5%. The majority of studies in adult psychiatric populations examined schizophrenia. Intellectual disability, autism spectrum disorders, dysmorphic features and multiple NDD/psychiatric diagnoses were described as predictors of an increased diagnostic yield of microarray testing.

While CNV testing is frequent in early-onset NDD; microarray analysis has not been established in psychiatric clinical practice despite the evidence of a high prevalence of findings in adult-onset NDD. The potential benefits in the detection of CNV are associated with physical comorbidities detection, understanding of pathogenesis of disease or genetic counseling. High-quality research designs are required before a routine clinical use.

No significant relationships.