2.

This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.

ObjectiveAssessing the potential of serotonin challenge for altering executive functions in OCD, OCD relatives and controls.BackgroundExecutive planning and response inhibition problems are common in OCD, yet the role of serotonin in these is unclear. Pharmacological challenge can elicit an u2018endophenotypeu2019 existing in patients and relatives. Therefore, we assessed the potential of serotonin challenge for altering specific executive functions in OCD patients, relatives and controls.Materials and MethodsA randomized crossover study assessed effects of single-dose escitalopram / placebo on executive planning and response inhibition in 24 patients, 13 relatives and 28 controls. One-touch Stockings of Cambridge (OTS) and Stop-Signal Task (SST) performances were assessed. ResultsOn executive planning, there was a significant effect of group (p=0.05) and a trend towards significant group x treatment interaction (p=0.07). Post hoc tests showed: (i) patients and relatives were impaired versus controls (p=0.04, p=0.03); (ii) escitalopram was associated with improved executive planning in OCD (p=0.01), but not in other groups (both p>0.1). There were no main effect of group or group x treatment interactions for response inhibition (both p>0.1). ConclusionsExecutive planning did not differ between OCD patients and relatives while differences between these two groups and controls were significant. Escitalopram challenge normalized executive planning dysfunction in OCD, providing support for SSRIu2019s potential role in normalizing planning deficits of fronto-striatal circuitry typical of OCD. Lack of effects on response inhibition is consistent with a role for other neurochemical systems in this function, notably noradrenaline, as found in non-OCD work.

Genome-wide association studies (GWAS) have identified common pancreatic cancer susceptibility variants at 13 chromosomal loci in individuals of European descent. To identify new susceptibility variants, we performed imputation based on 1000 Genomes (1000G) Project data and association analysis using 5,107 case and 8,845 control subjects from 27 cohort and case-control studies that participated in the PanScan I-III GWAS. This analysis, in combination with a two-staged replication in an additional 6,076 case and 7,555 control subjects from the PANcreatic Disease ReseArch (PANDoRA) and Pancreatic Cancer Case-Control (PanC4) Consortia uncovered 3 new pancreatic cancer risk signals marked by single nucleotide polymorphisms (SNPs) rs2816938 at chromosome 1q32.1 (per allele odds ratio (OR) = 1.20, P = 4.88x10 -15), rs10094872 at 8q24.21 (OR = 1.15, P = 3.22x10 -9) and rs35226131 at 5p15.33 (OR = 0.71, P = 1.70x10 -8). These SNPs represent independent risk variants at previously identified pancreatic cancer risk loci on chr1q32.1 ( NR5A2), chr8q24.21 ( MYC) and chr5p15.33 ( CLPTM1L- TERT) as per analyses conditioned on previously reported susceptibility variants. We assessed expression of candidate genes at the three risk loci in histologically normal ( n = 10) and tumor ( n = 8) derived pancreatic tissue samples and observed a marked reduction of NR5A2 expression (chr1q32.1) in the tumors (fold change -7.6, P = 5.7x10 -8). This finding was validated in a second set of paired ( n = 20) histologically normal and tumor derived pancreatic tissue samples (average fold change for three NR5A2 isoforms -31.3 to -95.7, P = 7.5x10 -4-2.0x10 -3). Our study has identified new susceptibility variants independently conferring pancreatic cancer risk that merit functional follow-up to identify target genes and explain the underlying biology.

Bill & Melinda Gates Foundation and Public Health England.

Mild to severe depressive symptoms during pregnancy/postpartum were common among this South African cohort. Interventions to treat women with severe chronic depressive symptoms with co-occurring psychosocial issues are urgently needed.

The discipline of global mental health has emphasized the importance of the treatment gap in mental disorders, and of addressing this gap via changes in health policy, an emphasis on human rights, and innovations such as task-shifting. Although global mental health research has focused on both common mental disorders such as depression, and serious mental disorders such as schizophrenia, it has paid relatively little attention to obsessive-compulsive and related disorders (OCRDs). Nevertheless, international collaborations have recently paid a good deal of attention to the nosology and neurobiology of OCRDs, and given the prevalence and morbidity of these conditions, further work along these lines should be encouraged. This article provides a brief overview of recent international collaborations on OCRDs, and outlines future directions for such work.

The purpose of the current study is to explore the regulatory effects of a novel, brief feelings-focused intervention called Tracking a Feeling (TAF) on psychophysiological and self-reported variables following a laboratory-induced stressful experience. The sample included 18- to 35 year-old men and women of varying ethnic backgrounds (TAF, N=30; Control, N=19; 84% women). In a laboratory setting, subject's blood pressure (BP) and heart rate (HR) was assessed every two minutes throughout the four phases of study protocol (baseline, stressor, intervention, recovery), while the PANAS was completed between each phase. Contrary to our predictions, results revealed no significant effect of TAF intervention on physiological markers. However, TAF participants reported significantly more PA at the post-intervention phase, which was consistent with our hypothesis, and continued to report higher levels of PA after a 10-minute recovery period when compared to the control. Results provide evidence to support TAF as an effective emotion regulation strategy that can support health by mitigating the stress response via increasing PA. Keywords: experiential therapy, emotion regulation, brief intervention, reactivity, recovery, affective intervention

Zinc plays a central role in skin integrity via barrier and immune mechanisms and may also be relevant in the pathogenesis of atopic dermatitis (AD). However, little is known about the relationship between zinc and AD. We performed a systematic review to determine (i) the association between zinc levels or zinc deficiency and AD and (ii) the efficacy of oral zinc supplementation in the treatment of AD. We searched PubMed, Scopus, Web of Science and article references for observational studies on zinc levels or zinc deficiency in participants with AD vs. controls and for randomized control trials (RCTs) on zinc supplementation in AD. For observational studies, we calculated pooled standardized mean differences (SMDs) or odds ratios (ORs) along with 95% confidence intervals (CIs) using a random effects model. We included 14 observational studies and two RCTs. The pooled SMD demonstrated significantly lower serum (SMD 0.66, 95% CI 0.21-1.10, P = 0.004), hair (SMD 0.95, 95% CI 0.38-1.52, P = 0.001) and erythrocyte (SMD 0.95, 95% CI 0.38-1.52, P = 0.001) zinc levels in participants with AD compared to controls. Pooled unadjusted data from three studies showed a non-significant increased odds of AD in those with zinc deficiency compared with those without zinc deficiency (OR = 1.50, 95% CI 0.71-3.16, P = 0.28). One RCT of oral zinc supplementation among AD patients with zinc deficiency showed improvement in extent and severity of AD, while another RCT among all AD patients showed no significant improvement. All the studies were of low or moderate quality. We conclude that low serum, hair and erythrocyte zinc levels are associated with AD. However, the poor quality of included studies makes interpretation of these results problematic. High-quality observational studies are needed to confirm the association between low zinc levels and AD, and RCTs are required to evaluate the merit of zinc supplementation for the treatment or prevention of AD.

Antenatal maternal psychological distress is common in LMIC settings and was found to be associated with key psychosocial measures during pregnancy, as well as with adverse birth outcomes, in our study population. These associations highlight the potential value of screening for antenatal maternal psychological distress as well as of developing targeted interventions.

Several modifiable risk factors including food insecurity, smoking, and alcohol consumption during pregnancy were identified as associated with negative birth outcomes, all of which are amenable to public health interventions. Interventions to address key exposures influencing birth outcomes are needed to improve maternal and child health in low-middle income country settings.

This first large survey shows that, compared to the DSM-IV, the DSM-5 identifies a substantial group of new cases with AG, while the prevalence rate remains stable at 1.5%. Severity and comorbidity are higher in individuals meeting DSM-5 AG criteria compared with individuals meeting DSM-IV AG criteria only.

Background Obsessive-compulsive disorder (OCD) places individuals at risk for suicidality. Inconsistencies regarding the associated features of suicidality and OCD remain. Methods Regression analysis determined the extent to which psychiatric comorbidity, illness severity, OCD symptom dimensions, childhood trauma history, and the Val66Met (rs6265) polymorphism of the brain-derived neurotrophic factor (BDNF) gene predict lifetime suicidal ideation and attempts in adults with OCD. Results Among the 496 participants, 51.8% reported suicidal ideation and 16.5% reported ≥1 suicide attempts. Females and individuals with borderline personality disorder (BPD) were at higher risk of presenting with suicide attempts (female: odds ratio [OR] = 2.75; 95% confidence interval [CI], 1.28 to 5.94; BPD: OR = 7.35; 95% CI, 3.25 to 16.61). Major depressive disorder (MDD), BPD, and avoidant personality disorder (AVPD) were significant predictors of suicidal ideation (MDD: OR = 2.4; 95% CI, 1.5 to 3.86; BPD: OR = 2.8; 95% CI, 1.36 to 5.73; AVPD: OR = 1.96; 95% CI, 1.02 to 3.75). No significant association was observed between BDNF Val66Met and suicidality. Conclusions Suicidality is common among patients with OCD. Several variables were associated with risk, including female sex, depression, and personality pathology. Further research into the underlying mechanisms is warranted. Emphasis is placed on assessment of suicidality risk and addressing modifiable features associated with suicidality to ensure better outcomes.

Following approval of the ICD-11 by the World Health Assembly in May 2019, World Health Organization (WHO) member states will transition from the ICD-10 to the ICD-11, with reporting of health statistics based on the new system to begin on January 1, 2022. The WHO Department of Mental Health and Substance Abuse will publish Clinical Descriptions and Diagnostic Guidelines (CDDG) for ICD-11 Mental, Behavioural and Neurodevelopmental Disorders following ICD-11's approval. The development of the ICD-11 CDDG over the past decade, based on the principles of clinical utility and global applicability, has been the most broadly international, multilingual, multidisciplinary and participative revision process ever implemented for a classification of mental disorders. Innovations in the ICD-11 include the provision of consistent and systematically characterized information, the adoption of a lifespan approach, and culture-related guidance for each disorder. Dimensional approaches have been incorporated into the classification, particularly for personality disorders and primary psychotic disorders, in ways that are consistent with current evidence, are more compatible with recovery-based approaches, eliminate artificial comorbidity, and more effectively capture changes over time. Here we describe major changes to the structure of the ICD-11 classification of mental disorders as compared to the ICD-10, and the development of two new ICD-11 chapters relevant to mental health practice. We illustrate a set of new categories that have been added to the ICD-11 and present the rationale for their inclusion. Finally, we provide a description of the important changes that have been made in each ICD-11 disorder grouping. This information is intended to be useful for both clinicians and researchers in orienting themselves to the ICD-11 and in preparing for implementation in their own professional contexts.