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.

We examined the levels of Glu, combined glutamate and glutamine (Glx), and GABA across psychiatric disorders by pooling data from 121 1H-MRS studies and further divided the sample based on Axis I disorders.

Statistically significant differences in GABA levels were found in the combined psychiatric group compared with healthy controls (Hedge's g = −0.112, p = 0.008). Further analyses based on brain regions showed that brain GABA levels significantly differed across Axis I disorders and controls in the parieto-occipital cortex (Hedge's g = 0.277, p = 0.019). Furthermore, GABA levels were reduced in affective disorders in the occipital cortex (Hedge's g = −0.468, p = 0.043). Reductions in Glx levels were found in neurodevelopmental disorders (Hedge's g = −0.287, p = 0.022). Analysis focusing on brain regions suggested that Glx levels decreased in the frontal cortex (Hedge's g = −0.226, p = 0.025), and the reduction of Glu levels in patients with affective disorders in the frontal cortex is marginally significant (Hedge's g = −0.172, p = 0.052). When analyzing the anterior cingulate cortex and prefrontal cortex separately, reductions were only found in GABA levels in the former (Hedge's g = − 0.191, p = 0.009) across all disorders.

Altered glutamatergic and GABAergic metabolites were found across psychiatric disorders, indicating shared dysfunction. We found reduced GABA levels across psychiatric disorders and lower Glu levels in affective disorders. These results highlight the significance of GABA and Glu in psychiatric etiology and partially support rethinking current diagnostic categories.

Population-wide restrictions during the COVID-19 pandemic may create barriers to mental health diagnosis. This study aims to examine changes in the number of incident cases and the incidence rates of mental health diagnoses during the COVID-19 pandemic.

By using electronic health records from France, Germany, Italy, South Korea and the UK and claims data from the US, this study conducted interrupted time-series analyses to compare the monthly incident cases and the incidence of depressive disorders, anxiety disorders, alcohol misuse or dependence, substance misuse or dependence, bipolar disorders, personality disorders and psychoses diagnoses before (January 2017 to February 2020) and after (April 2020 to the latest available date of each database [up to November 2021]) the introduction of COVID-related restrictions.

A total of 629,712,954 individuals were enrolled across nine databases. Following the introduction of restrictions, an immediate decline was observed in the number of incident cases of all mental health diagnoses in the US (rate ratios (RRs) ranged from 0.005 to 0.677) and in the incidence of all conditions in France, Germany, Italy and the US (RRs ranged from 0.002 to 0.422). In the UK, significant reductions were only observed in common mental illnesses. The number of incident cases and the incidence began to return to or exceed pre-pandemic levels in most countries from mid-2020 through 2021.

Healthcare providers should be prepared to deliver service adaptations to mitigate burdens directly or indirectly caused by delays in the diagnosis and treatment of mental health conditions.

Ketamine is an effective short-term treatment for a range of psychiatric disorders. A key question is whether the addition of psychotherapy to ketamine treatment improves outcomes or delays relapse.

To identify all studies combining psychotherapy with ketamine for the treatment of psychiatric disorders to summarise their effects and make recommendations for future research.

The review protocol was prospectively registered with PROSPERO (registration number CRD42022318120). Potential studies were searched for in MEDLINE, Embase, PsycINFO, SCOPUS, the Cochrane library and Google Scholar. Eligible studies combined ketamine and psychotherapy for the treatment of psychiatric disorders and did not use case reports or qualitative designs. Key findings relating to psychotherapy type, diagnosis, ketamine protocol, sequencing of psychotherapy and study design are reported. Risk of bias was assessed using modified Joanna Briggs critical appraisal tools.

Nineteen studies evaluating 1006 patients were included in the systematic review. A variety of supportive individual and group, manualised and non-manualised psychotherapies were used. The majority of studies evaluated substance use disorders, post-traumatic stress disorder and treatment-resistant depression. Ketamine protocols and sequencing of ketamine/psychotherapy treatment varied substantially between studies. Outcomes were largely positive for the addition of psychotherapy to ketamine treatment.

The combination of psychotherapy and ketamine offers promise for the treatment of psychiatric disorders, but study heterogeneity prevents definitive recommendations for their integration. Larger randomised controlled trials using manualised psychotherapies and standardised ketamine protocols are recommended to clarify the extent to which the addition of psychotherapy to ketamine improves outcomes over ketamine treatment alone.

Previous studies underline the importance of internalising disorders as risk factors of nonsuicidal self-injury (NSSI), meanwhile only a few research draw the attention to the role of externalising disorders. The possible association between NSSI and pathological internet use (PIU) is also understudied.

The purpose of this study was: 1) to investigate the frequency of NSSI among adolescents with different psychopathology and in different internet user groups of adolescents, 2) to understand the mediator role of psychiatric disorders between NSSI and PIU.

Adolescents were enrolled from a clinical (Vadaskert Child Psychiatric Hospital, Budapest, Hungary) and a school based population (high schools in Budapest, Hungary). The used measurements were: Strengths and Difficulties Questionnaire (SDQ), Deliberate Self-Harm Inventory, Young Diagnostic Questionnaire for Internet Addiction, Mini International Neuropsychiatric Interview Kid.

There was significant difference in the frequencies of NSSI in SDQ subgroups (U=2127.000; z=-6.170; p <0.001). There was also significant difference in NSSI frequency between normal- and pathological internet users (U=2020.000; z=-2,501; p <0.017 p=0.012). According to the mediator model there was no direct association between PIU and NSSI, however it was mediated by different psychiatric disorders (affective disorders, anxiety disorders, attention deficit/hyperactivity disorder, conduct disorder, opposition defiant disorder, psychoactive substance abuse/dependence, psychotic disorders, suicidal behavior).

The results strengthen that both internalising- and externalising psychopathology are associated with NSSI. Moreover this study underlines the importance of careful screening and treating of comorbid disorders with PIU, which can have a role in the prevention of NSSI and suicide as well.

No significant relationships.

The estimation of the percentage of mentally ill among prisoners and of the most severe psychiatric disorders has been the subject of few studies in Tunisia.

To study in a general way the extent of psychiatric disorders among prisoners. To describe the socio-demographic and judicial characteristics of prisoners. To describe the clinical, evolutionary and therapeutic characteristics of the main psychiatric disorders.

This is a cross-sectional and descriptive study, carried out over a period of 4 months (February 2021-May 2021) on one hundred and twelve inmates of the civil prison of Mahdia followed in psychiatry. Data were collected using a pre-established questionnaire. It is made up of 30 items.

The prevalence of mental disorders in prison was 9.03%. The descriptive study revealed an average age of 37.57 years, a majority having a single marital status (62.5%), the professional activity before imprisonment were workers in 61.6%, a history of imprisonment more than twice in 62.5% of cases and 50.89% declared having been victims of physical acts, psychological or sexual abuse during their childhood. Murder, armed robbery, drug trafficking and rape were the most frequent offenses with respective rates of 25.2; 17.07; 13.82 and 9.75%. Anxiety was noted in 53.57% of cases, of the respondents, depressive syndrome was in 28.57% of cases, schizophrenia was reported in 18, 75% of cases and substance-related disorders were noted in 21.42% of cases.

Longitudinal studies should, in the coming years, try to understand the impact of imprisonment on the onset and evolution of psychiatric disorders.

No significant relationships.

The Research Domain Criteria (RDoC) approach proposes a novel psychiatric nosology using transdiagnostic dimensional mechanistic constructs. One candidate RDoC indicator is delay discounting (DD), a behavioral economic measure of impulsivity, based predominantly on studies examining DD and individual conditions. The current study sought to evaluate the transdiagnostic significance of DD in relation to several psychiatric conditions concurrently.

Participants were 1388 community adults (18–65) who completed an in-person assessment, including measures of DD, substance use, depression, anxiety, posttraumatic stress disorder, and attention-deficit hyperactivity disorder (ADHD). Relations between DD and psychopathology were examined with three strategies: first, examining differences by individual condition using clinical cut-offs; second, examining DD in relation to latent psychopathology variables via principal components analysis (PCA); and third, examining DD and all psychopathology simultaneously via structural equation modeling (SEM).

Individual analyses revealed elevations in DD were present in participants screening positive for multiple substance use disorders (tobacco, cannabis, and drug use disorder), ADHD, major depressive disorder (MDD), and an anxiety disorder (ps < 0.05–0.001). The PCA produced two latent components (substance involvement v. the other mental health indicators) and DD was significantly associated with both (ps < 0.001). In the SEM, unique significant positive associations were observed between the DD latent variable and tobacco, cannabis, and MDD (ps < 0.05–0.001).

These results provide some support for DD as a transdiagnostic indicator, but also suggest that studies of individual syndromes may include confounding via comorbidities. Further systematic investigation of DD as an RDoC indicator is warranted.

Elevated prevalence of somatic disorders (SD) in patients with mental diseases is well recognized and studied since latest years. However, their detection remains too late, which darken the prognosis of both diseases, and complicate the therapeutic management.

We aimed to determine the prevalence of SD in psychiatric inpatients, and to assess relationships between the two diseases.

We analyzed retrospectively the medical records of 94 male patients hospitalized for the first time in psychiatry “B” department, Hedi Chaker hospital (Sfax, Tunisia), in the period from January 1st until December 31st, 2019.

The mean age of patients was 36.88 years. Among them, 22.3% used cannabis and 37.2% consumed alcohol. Schizophrenia (41,5%) and bipolar disorders (20.2%) were the most common psychiatric diagnoses. During their hospitalization, at list one SD was noted in 53.2%: cardiovascular diseases 21.3% (electrocardiographic anomalies 19,1%); infections 9.6% and hepatic pathologies 8.5 %. The SD was comorbid with psychiatric disease in 90%, and represented a side effect of psychotropics in 10% of patients with SD. Older Patients were more likely to present SD during hospitalization, without a significant association. Patients with schizophrenia were significantly more likely to present infections (p=0.031). Repolarization disorders are more common in patients with cannabis use (p = 0.006).

Our study pointed the high prevalence of SD in patients with mental illnesses, especially in those with schizophrenia and cannabis use. Thus, the somatic assessment should be a systematic practice to identify patients at risk for somatic complications and ensure timely their transfer to a specialized setting.

Altered expression of the complement component C4A gene is a known risk factor for schizophrenia. Further, predicted brain C4A expression has also been associated with memory function highlighting that altered C4A expression in the brain may be relevant for cognitive and behavioral traits.

We obtained genetic information and performance measures on seven cognitive tasks for up to 329 773 individuals from the UK Biobank, as well as brain imaging data for a subset of 33 003 participants. Direct genotypes for variants (n = 3213) within the major histocompatibility complex region were used to impute C4 structural variation, from which predicted expression of the C4A and C4B genes in human brain tissue were predicted. We investigated if predicted brain C4A or C4B expression were associated with cognitive performance and brain imaging measures using linear regression analyses.

We identified significant negative associations between predicted C4A expression and performance on select cognitive tests, and significant associations with MRI-based cortical thickness and surface area in select regions. Finally, we observed significant inconsistent partial mediation of the effects of predicted C4A expression on cognitive performance, by specific brain structure measures.

These results demonstrate that the C4 risk locus is associated with the central endophenotypes of cognitive performance and brain morphology, even when considered independently of other genetic risk factors and in individuals without mental or neurological disorders.

Despite a sizable minority of persons with serious mental illness (SMI) acting aggressively toward family members, little is known about this topic. The objectives of the present analyses are to examine the association of offenders' SMI status with offender behaviors and victim outcomes and to compare the immediate contextual characteristics of incidents involving offenders with and without SMI.

Using a cross-sectional design, all incidents of domestic violence to which police were called between adult children and their parents in Philadelphia, PA, in 2013 (N = 6191) were analyzed. Additionally, incidents in which the offender was indicated to have SMI (n = 327) were matched with a sample of incidents in which the offender was not indicated to have SMI (n = 327).

Offenders having SMI was not associated with using a bodily weapon or gun, threatening victims, or damaging property. Offenders having SMI was associated with a decreased risk of offenders using a non-gun external weapon and victims being observed to have a complaint of pain or visible injuries. When offenders had SMI, conflict was less likely to focus on family issues and more likely to focus on offenders' behaviors and to involve contextual characteristics related to mental illness.

Efforts to prevent gun and other violence between non-intimate partner family members should target factors more strongly associated with violence than SMI (e.g. history of domestic violence, substance abuse). Intervening in family aggression by persons with SMI likely requires addressing unique circumstances these parties experience.

To date, nearly all research of subtype differences in ADHD has been performed in children and only two studies, with conflicting results, have covered this subject in adults with ADHD.

This study examined subtype differences in the clinical presentation of ADHD-symptoms, related psychopathological features, psychosocial functioning and comorbid psychiatric disorders in adults with ADHD.

One hundred and eighteen adults with ADHD, diagnosed according to DSM-IV criteria, and a population based control group underwent diagnostic evaluations with clinical interviews for ADHD, DSM-IV disorders and demographic features. Comparisons were made between ADHD combined type (n = 64), predominantly inattentive type (n = 30) and predominantly inattentive type, anamnestically combined type (n = 24), relative to each other and to a community control group (n = 70).

The four groups did not differ in age and gender composition. All ADHD groups had significantly less education, were significantly more often unemployed and reported significantly more lifetime psychiatric comorbidity than controls. In comparison to each other, the three ADHD groups differed mainly in core symptoms and the pattern of comorbid psychiatric disorders, whereas no prominent differences in associated psychopathological features and most of the assessed psychosocial functions could be found. Patients with ADHD combined type and inattentive, anamnestically combined type both presented with significantly more hyperactive symptoms and also showed more impulsive symptoms than those with the predominantly inattentive type. With a similar overall lifetime psychiatric comorbidity in the three groups, patients with ADHD combined type and inattentive, anamnestically combined type suffered significantly more from lifetime substance use disorders than patients with predominantly inattentive type.

Our results clearly show impaired psychosocial adjustment and elevated risk for additional psychiatric disorders in adults with all subtypes of ADHD, compared to healthy controls. They provide preliminary evidence that in adult ADHD there might be a subgroup of patients, which is classified as predominantly inattentive subtype according to current diagnostic criteria, but which in its clinical presentation is in between ADHD combined and inattentive type. Further studies are needed to evaluate this finding and to gain a clear picture of its validity.

To investigate the relationship between heavy daily smoking and suicidality among adolescent psychiatric inpatients in Finland.

Data were collected from 411 patients (age 12–17 years) admitted to inpatient psychiatric hospitalization between April 2001 and July 2005. The number of daily cigarettes (>15) and the time of first cigarette after waking up (within 30 min) were used as indicators of heavy daily smoking.

After adjusting for psychiatric diagnoses an over twofold risk for suicide attempts was found among adolescents who smoked over 15 cigarettes a day. Additionally, if an adolescent also smoked the first cigarette immediately after waking up the risk was over threefold. Suicidal ideation was not associated with smoking behaviour.

Among adolescents with severe psychiatric illnesses, heavy daily smoking may increase the risk of suicidal behaviour independently of current psychiatric diagnosis. The degree of nicotine dependence of an adolescent should therefore be carefully assessed as part of psychiatric evaluation.

To examine the relationship between self-esteem and psychiatric disorders in adolescents.

Seventy-six adolescents (mean age: 16.02 years; range: 12-20) treated in an inpatient unit and presenting with DSM-IV psychotic disorder, depressive disorder, anxious disorder, anorexia nervosa, personality disorder, or conduct disorder were compared with a control group of 119 adolescents drawn from a normal population. All the subjects were assessed with the French translation of the Coopersmith self-esteem inventory (SEI).

Self-esteem was significantly higher in the control than in the clinical population (P = 0.0001). Female patients showed significantly lower SEI scores than male patients. Self-esteem increased significantly after 12 weeks in patients with a first psychotic episode who responded successfully to antipsychotic drug treatment. In the clinical group, a history of suicide attempts and sexual abuse was associated with significantly lower SEI scores. Lack of boy- or girlfriend, dropping out of school, and social withdrawal were also associated with lower self-esteem.

The presence of a psychiatric disorder in adolescents is associated with decreased self-esteem. This decrease in self-esteem varies according to the psychiatric disorder. Appropriate treatment can enhance self-esteem in adolescent patients.

A growing body of evidence suggests that the glial cell line-derived neurotrophic factor (GDNF) is involved in the aetiopathology of mood disorders. GDNF is a neurotrophic factor from the transforming growth factor-β-family, playing a role in cell development and function in the limbic system. This is the first study to examine GDNF concentration in different brain regions of patients with depressive disorder (DD).

We used sandwich-ELISA-technique to ascertain GDNF concentration and Lowry assay for overall protein levels in post-mortem brain tissue of 7 patients with recurrent depressive disorder and 14 individuals without any neurological or psychiatric diagnoses. We included cortical regions as well as limbic area's (hippocampus, entorhinal cortex) basal ganglia (putamen, caudate nucleus), thalamus and cingulated gyrus.

We found a significant increase in GDNF concentration in the parietal cortex of patients with DD compared to the control group. In other regions the trend of an increased GDNF concentration did not reach statistical difference.

This proof of concept study supports previous findings of an alteration of the GDNF in patients with depressive disorder. However, for the first time a significant increase of GDNF in a cortical brain area was found in DD.