Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder associated with increased risk for poor educational attainment and compromised social integration. Currently, clinical diagnosis rarely occurs before school-age, despite behavioral signs of ADHD in very early childhood. There is no known brain biomarker for ADHD risk in children ages 2–3 years-old.

The current study aimed to investigate the functional connectivity (FC) associated with ADHD risk in 70 children aged 2.5 and 3.5 years via functional near-infrared spectroscopy (fNIRS) in bilateral frontal and parietal cortices; regions involved in attentional and goal-directed cognition. Children were instructed to passively watch videos for approximately 5 min. Risk for ADHD in each child was assessed via maternal symptoms of ADHD, and brain data was evaluated for FC.

Higher risk for maternal ADHD was associated with lower FC in a left-sided parieto-frontal network. Further, the interaction between sex and risk for ADHD was significant, where FC reduction in a widespread bilateral parieto-frontal network was associated with higher risk in male, but not female, participants.

These findings suggest functional organization differences in the parietal–frontal network in toddlers at risk for ADHD; potentially advancing the understanding of the neural mechanisms underlying the development of ADHD.

To check whether the presence or not of free intervals between episodes could help differentiate subtypes of bipolar disorder, as suggested by the seminal controversy between Falret and Baillarger.

From 1090 bipolar I patients included in a French national study, 981 could be classified as with or without free intervals and assessed for demographic and illness characteristics.

Compared with patients with free intervals (n = 722), those without (n = 259) had an earlier age at onset, more episodes, suicide attempts, cyclothymic and irritable temperaments. The following independent variables were associated with no free intervals: being single or divorced, delay to mood stabilizer treatment, multiple hospitalizations, incongruent psychotic features, panic and generalized anxiety disorder.

“Folie à double forme” (without free intervals) and “folie circulaire” (with free intervals) may actually refer to early and later onset bipolar subtypes, insofar as most differences we found between them were previously evidenced between the latter two. We cannot, however, exclude that they might simply be two separate subtypes, whose main characteristics could be accounted for by different explanatory factors.

Therapeutic relationships are a central component of community treatment for psychosis and thought to influence clinical and social outcomes, yet there is limited research regarding the potential influence of professional characteristics on positive therapeutic relationships in community care. It was hypothesised that professionals’ relating style and attitudes toward their work might be important, and thus this exploratory study modelled associations between these characteristics and therapeutic relationships developed in community psychosis treatment.

Dyads of professionals and young patients with psychosis rated their therapeutic relationships with each other. Professionals also completed measures of attachment style, therapeutic optimism, outcome expectancy, and job attitudes regarding working with psychosis.

Professionals’ anxious attachment predicted less positive professional therapeutic relationship ratings. In exploratory directed path analysis, data also supported indirect effects, whereby anxious professional attachment predicts less positive therapeutic relationships through reduced professional therapeutic optimism and less positive job attitudes.

Professional anxious attachment style is directly associated with the therapeutic relationship in psychosis, and indirectly associated through therapeutic optimism and job attitudes. Thus, intervening in professional characteristics could offer an opportunity to limit the impact of insecure attachment on therapeutic relationships in psychosis.

To increase knowledge on the reproductive health of women who have been placed in a residential school, a child welfare facility for adolescents with severe psychosocial problems.

All women (n = 291) who lived in the Finnish residential schools on the last day of the years 1991, 1996, 2001 and 2006 were included in this study and compared with matched general population controls. Register-based information on induced abortions and births was collected until the end of the year 2011.

Compared to controls, women with a residential school history had more induced abortions. A higher proportion of their births took place when they were teenagers or even minors. They were more often single, smoked significantly more during pregnancy and had a higher risk of having a preterm birth or a baby with a low birth weight.

The findings have implications for the planning of preventive and supportive interventions that aim to increase the well-being of women with a residential school history and their offspring.

University life is stressful for the student, which is characterized by disturbed emotional regulation or alexithymia. To face these stressful events he must use certain coping strategies.

Studying the prevalence of alexithymia and exploring coping strategies among medical students, and establish the relationship between these parameters.

It was a cross-sectional study of 97 students in Sfax university medicine (Tunisia). We used:

– a questionnaire containing demographic and clinical data;

– Toronto alexithymia Scale (TAS-20): a score ≥61 indicates alexithymia;

– WCC (Ways of Coping Checklist-r Folkman) with 3 factors: problem-focused, emotion-focused and social support coping.

The average age of participants was 24.07 years (±2.71); the sex ratio (M/W) was 0.4. They were smoking in 36.1% and sedentary in 43.3% of case. They had a nibbling activity in 57.7%. The average score of TAS-20 was 50. 92 10.46 and alexithymia was found in 16.5% of students. Alexithymia was significantly correlated with smoking (P = 0.003) and physical inactivity (P = 0.025). Most students (72.2%) opted for problem-focused ways of coping with a highest score at WCC = 29.21. A significant correlation was found between alexithymia and coping strategy with emotion-focused (P = 0.02). The TAS score was significantly higher among students who resort to this ways of coping = 26.11. (P = 0.002).

This study explored the role of alexithymia in stress management ubiquitous in university life. A high level of alexithymia could be a detrimental factor in stress management. Psychological support aimed specifically alexithymic dimension is indispensable.

The authors have not supplied their declaration of competing interest.

Aberrant emotional reactivity is a putative endophenotype for bipolar disorder (BD), but the findings of behavioral studies are often negative due to suboptimal sensitivity of the employed paradigms. This study aimed to investigate whether visual gaze patterns and facial displays of emotion during emotional film clips can reveal subtle behavioral abnormalities in remitted BD patients.

Thirty-eight BD patients in full or partial remission and 40 healthy controls viewed 7 emotional film clips. These included happy, sad, and neutral scenarios and scenarios involving winning, risk-taking, and thrill-seeking behavior of relevance to the BD phenotype. Eye gaze and facial expressions were recorded during the film clips, and participants rated their emotional reactions after each clip.

BD patients showed a negative bias in both facial displays of emotion and self-rated emotional responses. Specifically, patients exhibited more fearful facial expressions during all film clips. This was accompanied by less positive self-rated emotions during the winning and happy film clips, and more negative emotions during the risk-taking/thrill-related film clips.

These findings suggest that BD is associated with trait-related abnormalities in subtle behavioral displays of emotion processing. Future studies comparing patients with BD and unipolar depression are warranted to clarify whether these differences are specific to BD. If so, assessments of visual gaze and facial displays of emotion during emotional film clips may have the potential to be implemented in clinical assessments to aid diagnostic accuracy.

ADHD is a neurodevelopmental disorder comprising brain structural and functional alterations, especially in default mode network (DMN), as MRI studies have recently shown. However, it is not clear in which extent medication for ADHD may influence the activity of these networks.

The main purpose is to look up published evidence about the effects of ADHD medication on the connectivity of DMN in patients as measured with functional-MRI.

A review was conducted with Pubmed, using search terms ‘default mode network’+ ‘ADHD’ + ‘medication’/‘methylphenidate’/‘atomoxetine’/‘stimulant’/‘lisdexanfetamine’. Original research studies in English using f-MRI to assess DMN connectivity in ADHD patients were included in a more comprehensive review.

The searches found 124 articles, 8 meeting the review criteria. A total size of 146 ADHD patients was comprised (mean size: 18.25 patients). Three studies used specific resting-state f-MRI. Seven were drug trials, 3 of them short-term, randomized and controlled ones. Six included methylphenidate, 2 atomoxetine, 1 lisdexanfetamine and 3 amphetamines. Two also assessed drugs clinical effects. Evidence seems heterogeneous, but mostly consistent with normalizing drug effects on DMN in patients (in some studies also compared with healthy controls), associated with a measured clinical improvement in one study with amphetamines and one with atomoxetine. One trial found little differences on DMN activity.

Psychostimulant drugs and atomoxetine are clinically effective medications; DMN connectivity may partially explain their action mechanisms and constitute a potential response predictor. Further f-MRI studies might more deeply assess the imaging-clinical relationships for each drug.

The authors have not supplied their declaration of competing interest.

Previous studies have provided evidence for Theory of Mind (ToM) impairment in bipolar disorder (BD). The aim of the study was to determine whether ToM impairment can be considered as a trait- marker or a state characteristic of BD.

ToM was assessed in 29 patients with bipolar-I during an episode and in remission as well as in 29 pair-matched for age, gender and education level healthy controls. Three different ToM tests were used (multilevel assessment): First Order False Belief Stories, Hinting Test, Faux Pas Recognition Test. Attention, memory, verbal learning ability, visuospatial ability, executive functions were also assessed using WAIS – Vocabulary, Block design, and Digit span, Stroop Test, Rey Auditory Verbal Learning Test, Trail Making Test, Wisconsin Card Sorting Test. Paired t-test was used to compare patients’ neuropsychological performance in episode and euthimic states and one-way ANOVA with post hoc Bonferroni corrections for the between groups comparisons.

Patients showed significant impairments on ToM tasks in the acute phase compared to the control group. ToM deficits did not persist beyond mood episode, except patients’ poor performance on Faux Pas. Dysfunction in verbal learning, working memory, visospatial ability was found during both the acute and the euthymic phases in relation to the comparison group. Poorer performance in attention, immediate verbal memory and executive function tasks was observed only in the acute phase of the illness.

Impairments in social cognition might reflect underlying general cognitive deficits and residual symptoms rather than representing a specific trait-marker in BD.

To study the prevalence of social anxiety problem and potential risk factors that may be associated with social anxiety among Malaysian medical undergraduate students.

Social Phobia Inventory (SPIN) and a questionnaire assessing gender, religion, number of siblings, type of previous school and partner status were given to 167 final year medical students at University Malaya.

There were 101 respondents of which 56% of the medical students scored > 19 in the Social Phobia Inventory (SPIN) suggesting that they may be having social anxiety. However, none of the variables analysed were significantly associated with social anxiety.

More than half of the medical students have significant social anxiety symptoms. Students with social anxiety symptoms may find clinical training difficult and this may lead to additional stress and anxiety. This may further decrease academic performance. There is also evidence to suggest that stress during undergraduate training may result in psychological or emotional impairment during professional life and therefore affect the quality of patient care. Furthermore, untreated social anxiety may lead to other complications such as depression and substance abuse. It may also affect their choice of future specialties and prevent them from pursuing what they really want. It is recommended that medical undergraduates be routinely screened for social anxiety in view of its high prevalence, and interventive measures can then be instituted.

Adverse childhood experiences (ACEs; e.g. violence, divorce) are associated with numerous negative health outcomes. Children with autism spectrum disorder (ASD) may be at risk for ACEs due to behavioral issues and financial/social/emotional stressors associated with their care. Yet, research on ACEs in children with ASD is limited.

Assess ACEs in youth with and without ASD.

To assess rates and associated characteristics of ACEs in children with and without ASD in the general population.

Data on 84,352 children (ages 2-17 years; 1,608 with ASD) were drawn from the 2011-2012 National Survey of Children's Health, a nationally representative CDC survey of households with children. The survey included questions about child emotional, developmental, and behavioral problems, socio-demographics and nine ACEs (neighborhood violence, discrimination, financial stress, domestic violence and parent separation, mental illness, substance abuse, death, or incarceration).

A history of multiple ACEs was reported by 34.4% of children with ASD compared with 24.4% of children without ASD. In survey-weighted logistic regression models controlling for age, sex, race, family structure and poverty, youth with ASD were 1.66 times (95% CI 1.18-2.34) more likely to have multiple ACEs compared with youth without ASD. Mediation analyses suggested that the increased rate of ACEs in ASD is driven by the greater co-occurrence of behavioral and emotional problems, but not ID, in ASD.

Although children with ASD experience ACEs at a higher frequency than children without ASD, this is explained by the increased co-occurrence of emotional and behavioral problems in ASD.

Schizophrenia spectrum disorders are among the most debilitating mental disorders and has complex pathophysiological underpinnings. There is growing evidence that brain-derived neurotrophic factor (BDNF) can play a role in its pathogenesis. The present study investigated the longitudinal variation of serum BDNF levels in a 24-month observational prospective cohort study of Sardinian psychotic patients and its relationship with psychopathological and cognitive changes. Furthermore, we examined whether genetic variation within the BDNF gene could moderate these relationships.

Every 6 months, 105 patients were assessed for their BDNF serum levels, as well as for a series of psychopathological, cognitive, and social measures. We performed a targeted analysis of four tag single nucleotide polymorphisms within the BDNF gene that were selected and analyzed using polymerase chain reaction. Longitudinal data were analyzed using mixed-effects linear regression models.

We observed a declining longitudinal trajectory of BDNF levels in psychotic patients in general, and in relation to the severity of depressive and negative symptoms. BDNF serum levels also declined in patients scoring lower in cognitive measures such as attention and speed of information processing and verbal fluency. The rs7934165 polymorphism moderated the significant association between verbal fluency and BDNF levels.

These findings in patients from real-world settings suggest a plausible role of peripheral BDNF levels as a marker of illness burden in schizophrenia spectrum disorders.

Waiting times for gender identity services, even before the Covid-19 pandemic, have been a cause of concern. Despite the waiting time standard for planned elective care in the NHS being a maximum of 18 weeks, the average waiting time for a first appointment with a gender identity clinic is 18 months. This study aims to analyse the effect that these timings have on the transgender community, and whether they impact the risk of developing mental health conditions such as depression or anxiety.

This study’s main aim is to analyse the correlation between waiting times and mental health burden in the transgender community.

A literature review and analysis on a transgender individual’s mental health and waiting times for Gender Identity Clinics; looking at any key themes and conclusions. Research papers were taken from MEDLINE, The International Journal of Transgender Health, Oxford Academic, SpringerLink and Emerald Insight, with studies publishing date ranging from 2014 – 2021.

The transgender population were found to have higher rates of suicidal ideation, depression and self harm compared to the general population. Longer waiting times were found to contribute to feelings of low mood and suicidal ideation, as well as decreasing overall quality of life.

Longer waiting times can decrease a transgender individual’s quality of life and impact their overall mental wellbeing: especially with the impact of COVID-19 and the rise in referrals.

No significant relationships.