Autism spectrum disorders (ASD) are a group of neurodevelopmental conditions characterized by impairments in social interaction, communication (both verbal and non-verbal), and repetitive behaviors. The global prevalence of ASD has increased significantly, with an estimated 28.3 million cases worldwide. Although many individuals with ASD have normal cognitive and language skills, difficulties with social interactions and understanding nonverbal cues can interfere with their ability to form romantic and sexual relationships, potentially leading to inappropriate behaviors and a distorted experience of sexuality.

This paper aims to review the literature on sexuality in individuals with ASD, focusing on typical sexual behaviors, sexual preferences, as well as hypersexuality and paraphilic fantasies and behaviors within this population.

A non-systematic literature review was conducted, with article selection from PubMed using the keywords: “autism spectrum disorders”, “sexuality”, “hypersexuality” and “paraphilia”.

Studies have shown that adolescents with ASD experience higher rates of inappropriate sexual behaviors and gender dysphoria compared to neurotypical peers. Variants in sexual orientation, including homosexuality, asexuality, and bisexuality, are more prevalent in this population. Recent research indicates that sexual experiences, both alone and with others, are common among individuals with high-functioning ASD, with one study revealing that 47% expressed interest in having a romantic partner. Despite this, adults with ASD, especially men, are generally less likely to be in romantic relationships. They also exhibit more hypersexual and paraphilic fantasies and behaviors than neurotypical individuals. Hypersexual behaviors are predominantly observed among male ASD individuals, while paraphilias, such as voyeurism and fetishism, are frequently reported among both ASD men and women. Sadistic and masochistic fantasies and behaviors are also common in this group.

The results indicate that individuals with ASD have a higher prevalence of sexual orientation variants and inappropriate behaviors compared to their peers. Although they have sexual interests and desires for relationships, their ability to express sexuality in a healthy way is hindered by communication deficits, social interaction challenges, and an unsupportive environment, exacerbated by inadequate sexual education. These challenges prevent many from fully embracing their sexuality. Specialized, evidence-based sexual education addressing the unique needs of individuals with ASD is essential for promoting healthier sexual behaviors and improving psychosocial well-being.

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Studies that have investigated the relationship between testosterone and psychiatric disorders in women report inconsistent results. Some studies suggesting that female depression patients have lower serum testosterone levels than healthy controls while others report higher serum testosterone levels in female depression patients. Testosterone has also been found to modulate depression and anxiety symptoms. Social research suggests high androgen levels cause aggressive behavior in men and women and as a consequence may cause depression and possible results with more often hospitalization.

The purpose of this study was to determine whether there is a link between the intensity of psychological symptoms that required hospital psychiatric treatment and the level of testosterone in the blood.

The research is prospective and includes female patients with established diagnoses of depressive disorder, anxiety-depressive disorder, bipolar disorder (depressive episode) aged 18-65. The patients had their laboratory parameters determined, including sex hormones (testosteron, estrogen, progesterone, FSH, LH and prolactin), filled out a demographic questionnaire and questionnaires: The Suicide Behaviors Questionnaire-Revised (SBQ-R), Generalised Anxiety Disorder Assessment (GAD-7), Patient Health Questionnaire (PHQ-9), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), Matthey Generic Mood Question, Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Rating Scale (HAMA) i Hamilton Depression Rating Scale (HAMD).

The preliminary data of the prospective study showed that there was a statistically significant proportion of patients in whom higher testosterone levels are linked with higher number of hospitalizations (rho=0.511, p=0.036).

Preliminary results show an association between testosterone levels and frequent psychiatric hospitalizations.

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The widespread use of electronic cigarettes (e-cigarettes) among adolescents and young adults has become a significant public health concern. With the rise of social media, exposure to content promoting e-cigarette use, including endorsements by influencers, has become increasingly pervasive. This overlap between social media and vaping culture may contribute to the normalization and growing use of e-cigarettes among this vulnerable population.

This article aims to systematically examine the influence of social media use and endorsements by influencers on e-cigarette use among adolescents and young adults, identifying patterns of exposure and consumption across various platforms and providing insights for future prevention and intervention strategies.

This systematic review aims to explore the impact of social media use and influencers on e-cigarette use among adolescents and young adults. A PRISMA model review was conducted across four databases: PubMed, Science Direct, Google Scholar, and Scopus. Medical Subject Heading (MeSH) terms and keywords (vape, e-cigarette, smoking, social media, influencer, adolescent) were used to search for full-text studies published in English from the last five years. The studies included focused on human subjects aged 10-21 and met predefined eligibility criteria.

Of the 1,064 articles initially identified, 37 were included after screening and removing duplicates.

Thirty-seven articles met the eligibility criteria. The analysis focused on five key social media platforms: TikTok, Instagram, YouTube, Twitter, and Facebook. However, significant methodological limitations were noted in the studies.

The research highlights a strong link between social media use and youth e-cigarette consumption. Exposure to vaping content, ads, and peer influence on social media increases the risk, particularly among younger and vulnerable groups. Social media enables both direct marketing and peer-to-peer promotion. Stricter regulations on online ads and enhanced parental controls are necessary to mitigate these risks and reduce youth vaping rates.

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Substance Use can be a lifelong issue. Recovery is not necessarily easy and not necessarily predictable. Treatment can be expensive and is potentially offset by other influences.

We wanted to predict the likelihood of returning to use for Indigenous clients being treated for Substance Use Disorders in the United States.

We interviewed 35 people who had been diagnosed with a Substance Use Disorder and had been treated in a conventional detox program followed by 30 to 120 days of residential treatment. The participants were obtained by word of mouth referrals, posters and flyers announcing the studiekeeeeeeWe gathered their life stories using a modification of the Northwestern University Life Story Interview which we called the Maine Life Story Interview. We correlated elements from the life story with the likelihood of return to use. By virtue of where the authors worked (Clinics providing services to Indigenous people), all the clients were Indigenous, though we did not aim for that at the outset. Logistic regression methods were used to predict return to use.

The combination of an ACE Score of 5 or greater, a history of substance use for 4 or more years, couipled with returning to the environment of the original substance abuse (physical and/or human) was associated with a 100% probability of return to use regardless of substance used and despite treatment received., With an ACE score of less than 5, the probability of return to use dropped to 80%. The length of treatment before returning to community did not matter. Adverse Childhood Events were measured using the ACE score and resiilience was assessed using a qualitative rating that has been shown to be reliable. Logistic regression confirmed the above -- that the most powerful predictors were returning to the community in which the abuse began and returning to the same social network of people who abused. These variables predicted 84% of the variance. Treatment type or duration did not emerge as significant.

For Indigenous clients, returning to the environment of substance abuse and to the people with whom substance have been used is a powerful factor that overrides the effects of treatment. The higher the ACE score, the more likely the return to use. The length of treatment (ranging from 10 to 130 days) did not seem to matter. Based upon this data, one could argue that tretment should take place in the community from which the person came and be oriented toward changing social networks and eliminating environmental cues. If this is not possible, returning to community appears frought with peril, though inevitable for Indigenous people who need to come home again. Resilience was not a predictive factor once one had returned to the social and environmental locale of the original substance use.

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There are recent studies examining the cognitive functions, depressive symptoms, social cognitive characteristics (Terms of Theory of Mind) and acute symptoms of patients with substance-induced psychosis, as well as varying effects of different substances on development of psychosis (Beckmann et al. Child Adolesc Psychiatr CNA.2020;131-143).

It was aimed to examine sociodemographic characteristics, clinical symptoms in acute psychotic period, cognitive functions, social cognition characteristics of hospitalized patients diagnosed with substance related psychosis; compare the severity of clinical symptoms, improvement in acute period symptoms with treatment, cognitive functions and social cognitions according to substance (methamphetamine, cannabis, polydrug).

34 hospitalized patients in acute psychotic episode diagnosed with Substance-Induced Psychosis according to DSM-5 were included in study. Socidemographic Data Form, Reading the Mind in the Eyes Test, Stroop Test, Calgary Schizophrenia Depression Scale and every 3 days during the treatment PANSS (Positive Negative Syndrome Scale) were administered.

Statistical analyses done with R program. Kruskal-Wallis test was used to compare numerical variables between groups. For the significant differences between groups, Bonferroni correction was applied in post hoc analyses. P-value of less than 0.05 was considered statistically significant for all analyses. Chi-square test was used to analyze categorical variables.

It was determined that drug-induced psychosis patients were mostly male, unemployed, young adults, started using drugs before the age of 18, lived in irregular urban areas. Methamphetamine, cannabis and polydrug-related psychosis were compared; There was no difference in cognitive functions and social cognition characteristics between all groups. At the end of treatment, it was observed that the rate of improvement in positive and negative symptoms and the decrease in PANSS scores were greatest in methamphetamine group, there was no difference between cannabis and polydrug groups. We found that PANSS and negative symptom severity before starting treatment were not different between methamphetamine and cannabis, and initial positive symptoms were more severe in methamphetamine than cannabis.

Methamphetamine group showed greater improvements in positive and negative symptoms and total PANSS scores compared to cannabis and polydrug. The fact that there was less improvement in cannabis group than in methamphetamine group supports the data in the literature identifying the relationship between cannabis and chronic psychosis (D’Souza et al, The World Journal of BP, 2022, 719–742).

No difference was found between social cognitions and cognitive functions of 3 groups.

Drug Induced Psychosis, Methamphetamine, Cannabis, Theory of Mind.

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Bipolar disorder, like other severe mental illnesses, is considered to be a condition with an increased risk of unsafe sexual practices [1]. Unsafe sex in bipolar disorder has been empirically linked to manic episodes due to symptoms of hypersexuality, cognitive impairment and substance and alcohol abuse.

Unprotected sex poses health risks for both sexes in terms of sexually transmitted diseases, but for women it also means a risk of unplanned pregnancy. Unplanned pregnancies can have negative consequences for the health, social and psychological lives of women and children [2].

Translated with DeepL.com (free version)

To assess reproductive health and unplanned pregnancies in patients with bipolar disorder followed and hospitalised at the Arrazi psychiatric hospital in Salé.

This was a descriptive cross-sectional study using a questionnaire including sociodemographic and clinical criteria as well as questions on the sex life of patients with bipolar disorder type I or II, questions on contraception, and on pregnancies and their outcomes.

Inclusion criteria: women with bipolar disorder type I or II.

Exclusion criteria: psychosis, intellectual disability.

The average age of the participants was 33 years. 68% were married and 57% had children. The majority were unemployed (87%). 85% had a substance use disorder. 61% had type I bipolar disorder and 44% were hospitalised, with the remainder receiving outpatient treatment. Almost all the patients were sexually active at the time of the study, and 88% had only one sexual partner. 77% were using contraception, mainly the pill. The average age of first pregnancy was 22 years. 66% of pregnancies were unplanned. 89% gave birth and 11% had abortions.

Bipolar disorder, like other serious mental illnesses, is considered to be a condition with an increased risk of unsafe sexual practices. Female patients with bipolar disorder have an early age of onset of sexual activity. This leads to frequent unplanned pregnancies. These unplanned pregnancies can have negative consequences for the health, social and psychological life of women and children. Clinicians must be aware of reproductive health and take steps to improve access to family planning when treating young women with bipolar disorder, in order to avoid negative consequences.

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Bipolar Disorder (BD) is a severe and chronic psychiatric condition, with complicated course and substantially reduce psychosocial functioning. Alterations in immune response are considered to be one of the major factors underlying the etiopathogenesis of BD, causing alterations in neurotransmitter systems, neuroendocrine systems, neurotrophic factors, and producing oxidative stress. Inflammatory cytokines have potential value for the clinical diagnosis and prognosis of BD.

The primary aim of the study was to assess the effect of disease course and clinical-characteristics on alterations of transforming growth factor-beta (TGF-beta), in BD.

This cross-sectional study included 82 patients with BD in remission. Multivariate linear regression with TGF-beta value as an outcome, and duration of illness, number of hospitalizations, residual symptoms estimated as Brief Psychiatric Rating Scale (BPRS) score, gender, and age, was used to produce the model.

The explored linear regression model was significant, explaining 39.4% of the variance (p<0.001). Higher TGF-beta was predicted by less previous hospitalizations (p<0.001) and lower BPRS score (0.034), while longer duration of illness was almost significant predictor (p=0.054). Age and gender showed no predictive effect in the model.

The study points out to the better course of BD characterized by less episodes and less residual symptoms in determining the TGF-beta levels, potentially creating a more favorable immunological state. The importance of neuroprotective and neurodegenerative balance of immune mediators, their interplay and relation to chronicity and severity of BD should be further explored.

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Mood disorders with mixed features, characterized by the concurrent presence of manic and depressive symptoms, represent a complex and significant area in psychiatric research. Historically, the recognition of such mixed states traces back to ancient Greek scholars, with evolving understanding through the 19th century. This evolution reflects substantial contributions from early thinkers to modern psychiatric frameworks.

1. 1. To trace the historical development of the concept of mixed mood states from ancient Greece to the 19th century.

2. 2. To analyze the contributions of key figures such as Areteo of Cappadocia, Wilhelm Griesinger, Jean-Pierre Falret, Emil Kraepelin, and Wilhelm Weygandt in shaping the understanding of mixed states.

3. 3. To evaluate the impact of Kraepelin’s and Weygandt’s work on contemporary classifications of mood disorders.

A historical review of primary and secondary sources, including classical texts and psychiatric literature, was conducted. The analysis focused on the contributions of significant historical figures, examining their theories and classifications of mood disorders. Key publications, such as Kraepelin’s treatises and Weygandt’s monographs, were scrutinized to assess their influence on modern psychiatric nomenclature.

The study highlights the foundational observations of mixed mood states by ancient Greek scholars, particularly Areteo, who first proposed that mania and melancholia were facets of the same condition. The 19th-century revival of interest in these states saw important contributions from Griesinger and Falret, with Kraepelin’s systematic framework in his 1899 treatise integrating mixed states into a unified concept of manic-depressive insanity. Weygandt’s 1899 monograph further refined the understanding of mixed states, reflecting a collaborative intellectual effort with Kraepelin.

The historical evolution of mixed mood states demonstrates a significant advancement in psychiatric theory. Kraepelin’s comprehensive framework, supported by Weygandt’s detailed analysis, laid the groundwork for contemporary classifications of mood disorders. Recognizing the collaborative nature of these developments underscores the importance of shared intellectual contributions in the advancement of psychiatric science.

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Lithium is a widely used treatment for mood disorders, particularly bipolar disorder, but its narrow therapeutic range often leads to toxicity. A major complication is lithium-induced neurotoxicity, which is generally reversible with dose adjustment or discontinuation. However, symptoms persisting beyond two months after cessation are deemed irreversible and may result in permanent neurological damage(Verdoux et al. Encephale 1991;17:221-4). The permanent sequelae, first recognized in the 1980s, are known as “Syndrome of Irreversible Lithium-Effectuated Neurotoxicity” (SILENT). SILENT is marked by irreversible neurological damage, including cerebellar dysfunction, dementia, parkinsonian syndromes, choreoathetosis, brainstem syndromes and peripheral neuropathies (Farouji et al. Cureus 2023;15).

This case report aims to highlight the rare SILENT syndrome and underscore the importance of early diagnosis and management of lithium-induced neurotoxicity.

Case 1: A 61-year-old male with a long-standing diagnosis of bipolar disorder, managed since age 18, presented in 2022 with speech and gait disturbances while on lithium therapy. His lithium level was elevated (2.31 mmol/L), and he underwent emergency hemodialysis after the suspected interaction of NSAIDs with lithium. Despite normal brain imaging, the patient experienced persistent symptoms of postural instability, ataxic gait, dysarthria and tremor over two years. Subsequent imaging revealed cerebral atrophy and ischemic white matter changes. Neuropsychological testing showed frontal-type memory deficits, leading to a diagnosis of Syndrome of Irreversible Lithium-Effectuated Neurotoxicity.

Case 2: A 71-year-old male with a 40-year history of bipolar disorder presented with tremors, bradykinesia, dysarthria and anorexia. Blood tests showed renal impairment (creatinine 2.3 mg/dL) and elevated lithium levels (1.7 mmol/L), likely secondary to chronic kidney disease. Lithium was discontinued, and valproate was initiated. Nine weeks later, he returned with increased energy, insomnia, impulsivity, auditory hallucinations, temporal disorientation, perseverative speech, and gait instability. Examination revealed agitation, a blank stare, mild dysarthria and gait imbalance despite normal routine blood tests.

Lithium poisoning is a common clinical issue. Elevated lithium levels can result from excessive intake, impaired excretion or drug interactions. SILENT syndrome, a rare complication of lithium therapy, leads to permanent neurological damage, including cerebellar dysfunction, ataxia, dysarthria and tremor (Konieczny et al. Alpha Psychiatry 2024; Mar.).

This emphasizes the importance of monitoring for drug interactions and conducting regular neurological assessments to detect and manage lithium-related complications early. The case underscores the need for heightened clinical awareness to prevent permanent lithium neurotoxicity.

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People with severe mental illness die 10-20 years earlier than the general population. This is largely due to non-communicable diseases (NCDs) such as hypertension, diabetes and hypercholesterolaemia increasing the risk of cardiovascular disease, which is the greatest contributor to the excess mortality seen. The effect of these NCDs is likely to be greater in low-and middle-income countries such as Bangladesh, India and Pakistan due to additional barriers to health care access, lack of resources and other sociodemographic variables.

Our study aimed to estimate the proportion of individuals with SMI in Bangladesh, India, and Pakistan who were screened for NCDs and offered health risk modification advice. Furthermore, we also explored socio-demographic factors associated with the likelihood of being screened for NCDs within this demographic.

This cross-sectional study gathered data from three national mental health institutions in South Asia. Participants aged ≥18 years diagnosed with SMI were included. Data collection involved face-to-face interviews based on the World Health Organisation Stepwise (WHO-STEPS) approach to NCD risk factor surveillance, supplemented by anthropometric measurements and blood tests to confirm NCDs. The prevalence of screening, diagnosis, health risk modification advice, and treatment for diabetes, hypertension, and high cholesterol was assessed. A logistic regression model assessed the associations of sociodemographic characteristics with NCD screening.

3,989 participants were recruited. Screening prevalence varied by country and disease, with hypertension being the most commonly screened NCD (Bangladesh = 52.5% [50.0-55.1], India = 43.1% [40.3-45.9], Pakistan = 60.9% [58.2-63.5]), and cholesterol was the least common (Bangladesh = 4.1% [3.2-5.2], India = 14.8% [12.9-17.0], Pakistan = 9.6% [8.1-11.3]). Characteristics such as BMI, age and education level were positively associated with screening, and females were more likely to be screened than males. The provision of health risk modification advice was most common in India (diet = 66.7% [62.1-71.1], physical activity = 71.5% [67.0-75.6], smoking = 17.1% [13.8-21.0]), and least common in Bangladesh (diet = 17.8% [15.8-20.0], physical activity = 12.0% [10.3-13.8], smoking = 9.8% [8.3-11.5]).

There is a consistent gap in the screening of NCDs among individuals with SMI in South Asia, with marked sociodemographic disparities. There is a pressing need for standardised screening protocols and health risk modification interventions tailored to South Asian populations. Improving health literacy and implementing culturally sensitive, cost-effective prevention strategies could mitigate the increased risk of NCDs in South Asian individuals with SMI.

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Attention Deficit Hyperactivity Disorder (ADHD) is a lifetime co-diagnosis of one or more psychiatric disorders in 70-80% of cases. In adults, ADHD is associated with anxiety, MDD, bipolar disorder and substance use disorder. (Faraone, S.V. et al., Nature Reviews Disease Primers (2024)). The aim of this study was to examine the relationship between ADHD and MDD symptoms in young adults and the mediation of mood and anxiety disorder symptoms on this relationship.

In this study, we examined the explainability of the relationship between ADHD and MDD symptoms in young adults through mood and generalized anxiety disorder scales. The aim was to reveal the relationships between different psychiatric dimensions in young adults presenting with these symptoms and to present the necessary treatment approaches.

Between September 2019 and September 2022, 935 students who applied to Koç University Psychological Counseling and Psychotherapy Center were examined. Sociodemographic information and data were collected using the Adult ADHD Self-Report Scale (ASRS-v1.1), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) and Mood Disorder Questionnaire (MDQ). Data were evaluated with descriptive statistics and Pearson correlation analysis. The effect of ASRS on PHQ-9 and the mediating effect of GAD-7 and DSQ scores were analyzed with Process macro model 4. The study was approved by Koç University Ethics Committee (Protocol No: 2024.291.IRB2.124).

82.8% of the students were classified as ADHD positive according to the ASRS 24 cut-off score. According to PHQ-9, the rate of depression was 78.1%. The rate of ADHD and depression positives was 70% according to ASRS24, 57.6% according to ASRS30 and 22.8% according to ASRS44. In the mediation analysis in which ASRS, PHQ9, GAD7 and MDQ scales were evaluated, the model explained 52% of the variance (p<0.00001). The direct effect of ASRS on PHQ9 (β: 0.35; p<0.00001; 95% CI: 0.29-0.39) was higher than the indirect effects via GAD7 (β: 0.21; 95% CI: 0.175-0.245) and DBQ (β: 0.025; 95% CI: 0.0027-0.048); the effect of MDQ was minimal.

The study shows that ADHD symptoms are frequently associated with depression and that anxiety and mood disorder symptoms may strengthen this association. The possible bidirectional relationship between disorders should be considered in young adulthood assessment and should be followed up with longitudinal studies. The strengths of the study are its large sample size and focus on a significant age range; limitations are its cross-sectional nature and reliance on self-report scales.

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Gender dysphoria (GD) and Autism Spectrum Disorder (ASD) are two complex conditions that can significantly impact an individual’s identity and well-being. Emerging research suggests a notable overlap between these two conditions, yet the nature and implications of this relationship remain underexplored. This paper aims to investigate the intersection of gender dysphoria and autism, considering both psychological and social dimensions.

The primary objectives of this study are to: (1) analyze the prevalence of gender dysphoria among individuals with autism, (2) explore the psychosocial factors contributing to the co-occurrence of GD and ASD, and (3) examine the implications for treatment and support strategies.

A comprehensive literature search was conducted across multiple databases, including PubMed and Google Scholar, focusing on studies published between 2000 and 2024. Inclusion criteria centered on peer-reviewed articles that discuss the relationship between GD and ASD. Data were extracted and analyzed to identify common themes, prevalence rates, and psychosocial factors.

Preliminary findings indicate that individuals with ASD may experience higher rates of gender dysphoria compared to the general population. Factors such as social communication difficulties, rigid thinking patterns, and heightened sensitivity to social norms appear to influence the experience of gender identity. Qualitative data reveal that many individuals navigate significant challenges in accessing appropriate support and validation, often feeling marginalized within both the autistic and gender-diverse communities.

This study highlights a critical intersection between gender dysphoria and autism, emphasizing the need for tailored support systems that acknowledge the unique experiences of individuals at this intersection. Increased awareness and understanding among healthcare providers can lead to more effective interventions and improved outcomes for those navigating both gender identity and autism. Future research should continue to explore this relationship to inform policy and practice, ultimately fostering a more inclusive environment for all individuals.

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Emotional dysregulation (ED) is highly heterogeneous in its definition, presentation, and classification. It manifests in a variety of ways, including emotional impulsivity, heightened emotional intensity (both positive and negative), and emotional lability. This pattern of emotional experience and expression is seen in several psychiatric disorders, such as Attention-Deficit Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD). Methylphenidate (MTH) has been extensively studied for its efficacy in treating ED in patients with ADHD, but it has been less studied for specific dimensions of BPD, such as impulsivity and executive dysfunction, and even less studied for ED in patients with comorbid ADHD and BPD.

This retrospective observational study evaluates the efficacy of MTH in reducing ED in patients with a dual diagnosis of BPD and ADHD. Specifically, we report the efficacy of MTH on emotional impulsivity, emotional lability, and emotional intensity (both positive and negative).

Patients with a dual diagnosis of ADHD and BPD treated with MTH were evaluated. Descriptive statistics were used to assess the presentation of the comorbidity. The Negative Emotion Dysregulation (NED) subscale of the Reactivity, Intensity, Polarity, and Stability Questionnaire (RIPoSt-40) was used to measure emotional lability and emotional intensity (both positive and negative). In addition, the C-T-Score representing ‘Impulsivity/Emotional Lability’ from the Conners’ Adult ADHD Rating Scales-Self Report: Short Version (CAARS-S:S), was assessed at baseline, week 2, and week 4. A repeated measures ANOVA test was used to assess mean differences.

Of the 24 patients (37.5% female, median age = 24, IQR: 21-37), 23 participants (96%) in the cohort had attention deficits, 9 participants (38%) had hyperactivity, and 19 participants (79%) had impulsivity. Most participants had overlapping symptom profiles (Figure 1). The median dose of MTH was 20 mg [10-30 mg], and the median duration of treatment was 4 months [3-10 months]. Statistically significant reductions in both NED and C-T-Score were observed from baseline to week 2 and from week 2 to week 4 (Table 1, Figure 2).Table 1

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ED is a core symptom of BPD and an important aspect of ADHD psychopathology. Targeting this pattern is complex because it encompasses multiple dimensions such as emotional impulsivity, lability, and intensity. In our study, MTH demonstrated efficacy in reducing these aspects in a real-world population with a dual diagnosis of ADHD and BPD, suggesting a possible role in improving ED, but further controlled studies are needed to confirm these findings.

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The variety and efficacy of biomarkers available that may be used objectively to diagnose Major Depressive Disorder (MDD) in adults are unclear. This systematic review aims to identify and evaluate the variety of objective markers used to diagnose MDD in adults.

This systematic review aims to identify and evaluate the variety of objective markers used to diagnose MDD in adults.

The search strategy was applied via PubMed and PsycINFO over the past 10 years (2013-2023) to capture the latest available evidence supporting the use of biomarkers to diagnose MDD. Papers were excluded if they were published in a non-peer-reviewed journal and/or not published in English; featured non-primary study designs (e.g. systematic review, meta-analysis, literature review); included children or adolescents in the study population; featured participants without a clinical diagnosis of MDD; featured participants with a diagnosis of other forms of MDD such as treatment resistant depression, vascular depression, remitted depression. Data was reported through narrative synthesis.

42 studies were included in the review. Findings were synthesised based on the following measures: blood, neuroimaging/neurophysiology, urine, dermatological, auditory, vocal, cerebrospinal fluid and combinatory – and evaluated based on its sensitivity/specificity and area under the curve (AUC) values. The best predictors of blood (MYT1 gene), neuroimaging/neurophysiological (5-HT1A auto-receptor binding in the dorsal and median raphe), urinary (combined albumin, AMBP, HSPB, APOA1), cerebrospinal fluid-based (neuron specific enolase, microRNA) biomarkers were found to be closely linked to the pathophysiology of MDD.

A large variety of biomarkers were available to diagnose MDD, with the best performing biomarkers intrinsically related to the pathophysiology of MDD. Potential for future research lies in investigating the joint sensitivity of the best performing biomarkers identified via machine learning methods and establishing the causal effect between these biomarkers and MDD.

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Non-invasive brain stimulation (NIBS) is emerging as a promising option for the treatment of psychiatric diseases, including major depressive disorder (MDD). In this context intermittent white light at a specified frequency holds high promise. We have previously shown that 60Hz stimulation in mice induces selective brain entrainment associated with microglia-mediated remodeling of the perineuronal nets (Venturino et al., Cell Reports 2021).

Here, we extend our previous findings with 60Hz stimulation to assess behavioral effects in mice and EEG response in healthy volunteers.

For the preclinical data, we exposed C57Bl6/J mice to a battery of behavioral tests to assess anxiety level, learning capability, and response to various stress paradigms after 60Hz light (2h per day/5 days) compared to constant light. Weight change, water and food intake were recorded. For human studies, a cohort of 12 healthy volunteers (6M, 6F) was recruited; their EEG response was investigated with an 8-channel EEG setup following acute (same day), short (5 days), and intermediate (3 weeks) stimulation with 60Hz entrainment (n=6) or sham light (n=6).

Preliminary data from the preclinical behavior studies indicate that 60Hz treatment improves the social interaction of socially defeated mice compared to sham light stimulation. Furthermore, the animals showed less anxiety-related behavior when exposed to the elevated plus maze. No differences were noticed in weight change, water and food intake following 60Hz stimulation.

In healthy volunteers, we observed robust and widespread entrainment at 60Hz after acute 60Hz stimulation; the entrainment spread beyond the visual cortex and reached the frontal cortex. The normalized power of the 60Hz component slightly declined over time but remained significant as compared to sham stimulation at three weeks, indicating sustained EEG response. The stimulation was very well tolerated overall, without major side effects.

60Hz intermittent light induces strong and sustained neuronal response in mice and humans, is well tolerated, and ameliorates depressive-like symptoms in the social defeat model in mice. 60Hz might represent a novel NIBS for the treatment of psychiatric disorders, including MMD.

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Depression is commonly treated with psychotherapy or antidepressants, but predicting which intervention will work best for a given patient remains a challenge. This pilot trial compared the feasibility, acceptability, and effectiveness of psychotherapy based on behavioral activation (Healthy Activity Program, HAP) and antidepressant medication (fluoxetine) in a primary care setting in India.

The trial had three key objectives: (1) assess the feasibility and acceptability of a randomized pilot trial comparing HAP and fluoxetine; (2) collect outcome data to refine study instruments and the baseline assessment; and (3) evaluate the preliminary comparative effectiveness of psychotherapy versus medication.

The pilot trial was conducted at eight primary health care centres in Madhya Pradesh (India) from August 2023 to February 2024. Eligible participants (aged 18+, PHQ-9 score ≥10) with moderate to severe depression were randomized to receive either HAP or fluoxetine. Feasibility was assessed by recruitment, retention, and adherence to study procedures. Acceptability was measured by adherence to interventions. Preliminary efficacy, as a secondary outcome, was assessed through changes in depressive symptoms (PHQ-9) from baseline to the 3-month follow-up.

76 participants were randomized, with primary endpoint data available for 63 (83%). Retention rates and study assessment completion were acceptable across both arms. Intervention adherence was high, with 79% (30/38 in HAP and ADM groups) completing the treatment per protocol (≥6 HAP sessions or 70% medication adherence). PHQ-9 scores improved significantly, with an average reduction from 15.02 at baseline to 6.73 at the 3-month follow-up, with no statistically significant differences between treatments. Full remission (PHQ-9 < 5) was achieved by 45.16% (28/62) of participants. Additionally, the pilot study identified logistical challenges and facilitators that will help refine the protocol for the larger trial.

This pilot trial successfully demonstrated the feasibility and acceptability of the study design, procedures, and interventions. The preliminary data suggest that both HAP and Fluoxetine are viable treatments for moderate to severe depression in primary care settings in India. The findings will be instrumental in informing the design and implementation of a larger precision trial.

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Depression affects 57 million people in India and is often linked to neurodegeneration (10-90% of cases). However, there’s insufficient evidence comparing the effectiveness of SSRIs and SNRIs in managing neurodegeneration symptoms.

This prospective observational study aims to compare the effects of SSRI and SNRI monotherapy on neurodegeneration, neuroplasticity, and social cognition.

This prospective observational study aims to compare the effects of SSRI and SNRI monotherapy on neurodegeneration, neuroplasticity, and social cognition.

Treatment-naïve patients with unipolar depression were evaluated for treatment response using the Hamilton Depression Rating Scale (HDRS) and neurodegeneration parameters at enrollment and after six weeks of antidepressant treatment. Neurodegenerative serum biomarkers [indoleamine-2,3-dioxygenase (IDO), neurofilament light chain protein (NLCP), brain derived neurotrophic factor (BDNF)] were assessed using ELISA. Social cognition was assessed using Social Cognition Rating tools in Indian setting (SOCRATIS). Neuroplasticity was assessed by resting state MRI.

A total of 150 patients of unipolar depression were enrolled, out of these n=126 patients were prescribed SSRI and 24 patients were prescribed SNRI. Both SSRI and SNRI group have significant reduction in HDRS score at 6-week compared to baseline (both p<0.001), but no intergroup difference. Overall treatment responder rate (HDRS score reduction >50%) was 11.33%, but SSRI group has more responder (12.69%) compared to SNRI (4.16%). After 6 weeks of follow-up, serum IDO in SSRI group and NLCP levels in both groups were significantly decreased when compared to baseline (p<0.001) and BDNF levels were significantly increased in SSRI group when compared to baseline (p<0.01). As per SOCRATIS, after 6 weeks treatment, SSRI and SNRI didn’t show any significant difference. fMRI assessment of depression patients showed significant decrease in cortical thickness of inferiortemporal, parsopercularis and precuneus regions of brain (p<0.05) in comparison with healthy controls. But there was no significant difference/increase in cortical thickness after 6 weeks of follow-up when compared to baseline.

After six weeks of antidepressant treatment, the treatment responder rate among all depression patients was 11.33%, with better outcomes observed in the SSRI group compared to the SNRI group. Likewise, in the assessment of social cognition and neurodegeneration-related biomarkers, the SSRI group showed superior performance over the SNRI group.

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Social media is now known as a vital aspect of the younger generation’s existence, significantly impacting their emotional and psychological growth. In contrast to prior generations, Generation Z has been raised in an environment of continuous digital connectivity, which poses distinct issues with body image, emotional health, and sleep quality. Platforms such as Instagram, TikTok, and Snapchat have been increasingly associated with mental health conditions, including eating disorders, anxiety, depression, and insomnia. Considering the ubiquity of these platforms, it is imperative for psychiatrists, public health practitioners, and educators to comprehend the mental health ramifications associated with social media participation.

This study attempts to examine the relationship between social media exposure and mental health disorders in Generation Z, specifically emphasizing eating disorders, anxiety, depression, and sleep disturbances.

Relevant studies and existing research on social media usage patterns and their effects on mental health in Gen Z were reviewed. Attention was given to how different platforms contribute to the development of body dissatisfaction, social comparison, and sleep difficulties. The analysis included an exploration of platform-specific features and user behavior, focusing on Instagram’s image-centric nature, TikTok’s short-form, high-stimulation content, and Snapchat’s emphasis on transient communication.

The analysis indicated that Instagram, being predominantly a visual medium, exacerbates body dissatisfaction and increases the likelihood of eating disorders by consistently advocating unattainable beauty ideals and trends such as “thinspiration” and “fitspiration.” TikTok, although promoting mental health awareness, may also induce anxiety and attention deficits because to its intensely stimulating, rapid content. Snapchat’s design, that encourages continuous monitoring of temporary content, seems to exacerbate anxiety stemming from the fear of missing out (FOMO). Cyberbullying has surfaced as a substantial factor exacerbating mental health conditions across all platforms, particularly with anxiety and desperation, along with severe instances associated with suicidal ideation.

Social media has a complex influence on the mental health of Generation Z, with each platform uniquely affecting conditions such as eating disorders, anxiety, depression, and insomnia. Instagram’s emphasis on aesthetics, TikTok’s rapid content consumption, and Snapchat’s addictive interaction present unique mental health issues. These findings underscore the necessity for medical professionals to integrate social media practices into their evaluations and therapies for Generation Z, while public health professionals and educators are encouraged to work together to promote better online habits.

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In Moldova, telemedicine has emerged as a pivotal intervention in addressing the persistent disparities in mental health care. Geographic isolation, coupled with socio-economic constraints, severely limits access to essential mental health services. The prevalence of mental health disorders is alarming, with approximately 17.34% of the population affected, particularly by anxiety and depression among vulnerable populations. This underscores the urgent need for innovative, scalable solutions. Telemedicine harnesses advanced technology to enhance the availability and continuity of mental health support, particularly in rural areas where traditional services are often inaccessible.

This study investigates the transformative potential of telemedicine in tackling the unique mental health challenges faced by the Moldovan population. It specifically examines how high rates of anxiety and depression, exacerbated by socio-political factors and historical trauma, can be addressed through telemedicine strategies tailored to the local context.

A comprehensive literature review was conducted utilizing PubMed, focusing on studies and systematic reviews published since 2020. This analysis aimed to identify global best practices in telemedicine and evaluate their applicability within Moldova’s socio-cultural and economic landscape. The synthesis of these findings will inform future telemedicine initiatives aimed at improving mental health outcomes.

The findings indicate that telemedicine has significantly enhanced access to mental health services, facilitating timely interventions while reducing the stigma often associated with seeking help. The implementation of remote consultations during the COVID-19 pandemic has been particularly illuminating, demonstrating the effectiveness of telemedicine in maintaining continuity of care for individuals in remote areas who struggle to access traditional mental health services. Furthermore, telemedicine has led to significant reductions in treatment costs, thereby making mental health support more accessible to at-risk populations.

As telemedicine solidifies its role within Moldova’s mental health framework, it promises to enhance public health outcomes and promote a more equitable healthcare environment. Future policy initiatives must prioritize the integration of telemedicine into routine mental health practices. This includes fostering partnerships between healthcare providers, policymakers, and community organizations to ensure that telemedicine solutions are both sustainable and tailored to meet the diverse needs of all patients, particularly those in underserved regions.

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Digital interventions are increasingly popular in addressing various issues, including mental health problems, executive functions, and social cognitive skills in clinical and non-clinical populations. Previous studies have revealed that neurotypical individuals with elevated autistic traits may be more susceptible to other mental health conditions such as anxiety disorders, mood disorders, internet addiction, substance abuse, and suicidal risk. While there is no definitive explanation for this susceptibility, social and cognitive impairments may be contributing factors, including problems with executive functions and social cognitive skills.

The main goal of this research is to develop an online social cognitive training program and conduct a pilot study to assess its feasibility within the current sample.

36 participants (randomly assigned to 16 for the experimental group and 20 for the control group) were recruited for the pilot study and the experimental group completed 6 weeks of an online intervention program, while the control group was assigned to the waiting list. Autism Quotient, Depression Anxiety Stress -21, Patient Health Questionnaire -9, and Generalized Anxiety Questionnaire– 7 were used to assess mental health symptoms. Executive functions were evaluated using the Wisconsin Card Sorting Task, N-back Task, and Go/No-Go task. At the same time, social cognition was assessed through the Interpersonal Reactivity Index, The Eyes test, and the Self-Assessment Manikin.

2 x 2 mixed repeated measure ANOVA was conducted. The main effect of time and group was significant for mental health symptoms and working memory (p < 0.5). However, the interaction of time and group was not significant (p > .05). Communication and attention switching (two components of autistic traits) have significant impacts on the scores (p < 0.5).

This pilot study demonstrated significant improvements in mental health scores, laying a solid foundation for further development and efficacy testing of the digital intervention program. This suggests that the intervention holds promise, particularly in targeting mental health improvements. Attention switching and communication contribute to the overall main effects highlighting the program’s potential in addressing key aspects of mental health.

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