Tobacco Use Disorder (TUD) is a health problem of the first order in the world population, affecting a vulnerable population, such as people with other mental disorders, whose morbidity and mortality ...are increased as a result.
Mental illness is alarmingly on the rise, and circadian disruptions linked to a modern lifestyle may largely explain this trend. Impaired circadian rhythms are associated with mental disorders. The ...evening chronotype, which is linked to circadian misalignment, is a risk factor for severe psychiatric symptoms and psychiatric metabolic comorbidities. Resynchronization of circadian rhythms commonly improves psychiatric symptoms. Furthermore, evidence indicates that preventing circadian misalignment may help reduce the risk of psychiatric disorders and the impact of neuro-immuno-metabolic disturbances in psychiatry. The gut microbiota exhibits diurnal rhythmicity, as largely governed by meal timing, which regulates the host's circadian rhythms. Temporal circadian regulation of feeding has emerged as a promising chronotherapeutic strategy to prevent and/or help with the treatment of mental illnesses, largely through the modulation of gut microbiota. Here, we provide an overview of the link between circadian disruption and mental illness. We summarize the connection between gut microbiota and circadian rhythms, supporting the idea that gut microbiota modulation may aid in preventing circadian misalignment and in the resynchronization of disrupted circadian rhythms. We describe diurnal microbiome rhythmicity and its related factors, highlighting the role of meal timing. Lastly, we emphasize the necessity and rationale for further research to develop effective and safe microbiome and dietary strategies based on chrononutrition to combat mental illness.
Abstract Background Cocaine dependence is a public health problem affecting 2 million individuals in USA. Craving is a predictor of subsequent cocaine use and is related to changes in brain activity ...in networks involving the prefrontal cortex. Methods We investigated the efficacy of one session of high frequency repetitive transcranial magnetic stimulation (rTMS) to reduce craving in cocaine addicted subjects. Six patients underwent two sessions of 10 Hz rTMS over left or right dorsolateral prefrontal cortex (DLPFC). Before, immediately after and 4 h after rTMS we measured craving using visual analogue scales. Results Right, but not left, DLPFC stimulation significantly reduced craving over time ( F (2,10) = 11.07, p = 0.0029). The reduction was 19% (13.4–24.6%) from baseline and disappeared after 4 h. The interaction of time by site of stimulation for craving was also significant ( F (2,25) = 6.13, p = 0.0068). Conclusion One session of 10 Hz rTMS over right, but not left, DLPFC transiently reduces craving in cocaine dependent individuals. These results highlight the potential of non-invasive neuromodulation as a therapeutic tool for cocaine addiction.
•Adults with ADHD often have impairments in self -regulation.•Different subgroups of adults with ADHD could be identified according to pattern in the self-regulation.•Latent profile analysis revealed ...three ADHD classes: normalized, moderate and severe impairments.•Problems with self-regulation are associated with different functional outcomes.
Adults with diagnosis of childhood attention-deficit hyperactivity disorder (ADHD) experience impairments in self-regulation (SR). This study examined whether subgroups of these impairments can be established based on differentiable patterns. The relationships between these subgroups and a group without ADHD were then analyzed, focusing on functional outcomes. Executive functions, effortful control, and emotional lability, in addition to self-concept, quality of life, and different comorbidities, were evaluated in 61 adults with a childhood diagnosis of ADHD and 54 adults without ADHD. Latent profile analysis (LPA) revealed three ADHD classes based on different self-regulation indicators: “Normalized” (49.18%), “Moderate impairments” (27.86%), and “Severe generalized impairments” (22.96%), who were compared with a Non-ADHD group on different functional measures. The “Normalized” profile showed significantly less dysfunctionality than the other two profiles, and it only exhibited significant differences with respect to the Non-ADHD group on the Hyperactivity index. By contrast, the “Severe generalized impairments” group, with the lowest self-regulatory skills, was impaired on all the functional outcomes. Self-regulatory skills could be a key target in interventions for adults with ADHD.
Background
Understanding the developmental trajectories of children with autism spectrum disorder (ASD) with and without comorbid ADHD is relevant to tailor care plans. This prospective study ...assessed, for the first time, cognitive, emotional, behavioral, and learning outcomes in adolescence of children with ASD−ADHD and in those with ASD+ADHD in childhood. Possible predictors of severity of ASD core symptoms in adolescence were also evaluated.
Methods
Forty‐five adolescents without intellectual disability, 26 diagnosed in childhood with ASD−ADHD and 19 with ASD+ADHD, were evaluated at baseline (mean age: 8.6 ± 1.3) and at 5‐year follow‐up (mean age: 12.9 ± 0.9). Parents and teachers completed questionnaires on executive functions, theory of mind (ToM), emotional/behavioral difficulties (EBD), and learning style at both time points..
Results
Overall different developmental trajectories for the two groups were found. In general, deficits in metacognition processes, ToM skills, EBD, and learning abilities were more pronounced in the ASD+ group. Over time, the ASD+ADHD group, but not the ASD−ADHD, tended to improve in EBD and metacognition but their level of development continued to be lower compared with ASD+ADHD. EBD in childhood were significant predictors of autism core symptoms of adolescents.
Conclusions
Our findings highlight the importance of an early identification of comorbid ADHD symptoms in ASD to offer treatment strategies based on specific developmental trajectories.
Patients with gambling disorder (GD) frequently present other mental disorders, such as substance use disorder (SUDs), attention deficit/hyperactivity disorder (ADHD), mood disorders, and ...impulse-control disorders. We propose that GD should not be conceptualized as a single nosological entity, but rather as a gambling dual disorder (GDD). This study aims to provide further evidence of the co-occurrence of GD and other mental disorders in routine clinical practice and to identify different clinical profiles of severity. This descriptive, cross-sectional, and observational study included 116 patients with GD who were undergoing treatment in a specialized center. The MULTICAGE-CAD 4 and South Oaks gambling screen questionnaires confirmed the presence of GD in 97.4% and 100% of the patients, respectively. Other addictive behaviors such as compulsive spending, Internet, video games, or SUD (59.5%, 27.6%, 11.2%, and 13.8%, respectively) were also identified. The most used substances were tobacco (42.2%) and alcohol (5.2%). Half of the patients suffered from ADHD, 30.2% showed moderate or severe depression, and 17.2% suffered from a social anxiety problem. The majority (76.7%) also presented a phenotype with high impulsiveness. The cluster analysis identified two different clinical profiles of severity in patients with GDD. One profile showed higher severity of other mental disorders (ADHD, depression, anxiety, SUD, or insomnia), impulsivity, general psychopathological burden, and disability. In conclusion, our study provides further evidence on the co-occurrence of GD and other mental disorders supporting the GDD existence, shows impulsiveness as a vulnerability factor for GD, and identifies two clinical severity profiles.
— Failure to complete treatment during alcohol detoxification is a major complication of effective clinical management. We determined the socio-demographic characteristics, the pattern of alcohol and ...drug use, the hepatitis C status and the psychiatric state of these patients, using retrospective data on 470 first admissions to a specialist alcohol in-patient unit. The 316 patients (67.2%) who had a planned discharge (PD group) were compared with the 154 patients (32.8%) who had unplanned discharges (UPD group). Patients in the UPD group were younger on admission, had higher Alcohol Problems Questionnaire scores, had started to drink heavily at a younger age, were more likely to have previously used cocaine, amphetamines and heroin, and to have smoked cannabis in the 30 days prior to admission. They were more likely to be positive for markers of hepatitis C infection, to have a borderline personality disorder, antisocial personality disorder, or to have concurrent opiate or benzodiazepine dependence. PD was associated with depressive disorder. Early identification can be made of alcohol-dependent individuals at risk of premature drop-out during in-patient treatment. Interventions to retain patients at risk of premature UPD should be developed.
Limited studies have evaluated the effectiveness of vortioxetine in real-world settings, and none of them has involved patients with dual depression (major depressive disorder MDD and substance use ...disorder SUD). The objective of the study was to describe the effectiveness of vortioxetine in clinical practice and determine its effect on affective symptoms, cognitive function, quality of life, and substance use in patients with MDD and SUD.
Post-authorization, retrospective, multicenter, descriptive, and observational study in 80 patients with MDD and SUD receiving a maintenance treatment with vortioxetine for six months between January 2017 and April 2021.
Compared with baseline, scores significantly decreased after 3 and 6 months of treatment in the Montgomery-Åsberg Depression Rating Scale total (from 28.9 to 17.7 and 12.0), and global functional impairment of the Sheehan Disability Inventory (from 26.3 to 19.1 and 16.7). The number of correct answers in the symbol digit modalities test significantly improved during vortioxetine treatment (from 40.4 to 43.8 and 48.4). Regarding the clinical global impression scale, the score for disease severity significantly decreased from 3.8 to 3.0 and 2.4. Compared with baseline, there was a significant reduction in consumption of practically all substances, especially of alcohol, cannabis, and cocaine.
Vortioxetine was effective in clinical practice for alleviating depressive symptoms and functional impairment, and in improving cognitive and executive functions and disease severity in patients with MDD and SUD. Moreover, the treatment with vortioxetine favored a reduction in substance use and the severity of the SUDs.
The persistent nature of attention deficit hyperactivity disorder (ADHD) and the role of behavioral factors in its continuity have been widely documented in the literature. However, less is known ...about the role of early family and neuropsychological factors in predicting later adaptive functioning and quality of life in individuals with ADHD. This study aimed to analyze the contribution of early family, behavioral, and neuropsychological factors to long-term functional outcomes in young adults with ADHD. Family (parental mood disorders, family risk index, parenting stress, coherence), behavioral (oppositionism, inattention, emotional lability, hyperactivity), and cognitive factors were examined at baseline. Twelve years later, daily life functioning, quality of life, and executive and behavioral functioning were also evaluated in 61 young adults with a childhood diagnosis of ADHD. Results revealed significant correlations between most of the family and behavioral factors at baseline and the long-term functional outcomes. Specifically, multiple regressions showed that mothers’ depression and laxness predicted later quality of life, executive functioning, and the hyperactivity index, and mothers’ depression and parenting stress at baseline also significantly predicted the hyperactivity index. Oppositionism behavior and inhibition were also significant predictors of the hyperactivity index. Therefore, understanding the family, behavioral, and neuropsychological factors that can contribute to later quality of life, daily functioning, and behavioral and executive functions is a particularly critical issue in detecting and planning efficacious ADHD interventions.
Agitation is a heterogeneous concept without a uniformly accepted definition, however, it is generally considered as a state of cognitive and motor hyperactivity characterized by excessive or ...inappropriate motor or verbal activity with marked emotional arousal. Not only the definition but also other aspects of agitated patients' care are still unsolved and need consensus and improvement. To help the discussion about agitation among experts and improve the identification, management, and treatment of agitation, the 1st International Experts' Meeting on Agitation was held in October 2016 in Madrid. It was attended by 20 experts from Europe and Latin America with broad experience in the clinical management of agitated patients. The present document summarizes the key conclusions of this meeting and highlights the need for an updated protocol of agitation management and treatment, the promotion of education and training among healthcare professionals to improve the care of these patients and the necessity to generate clinical data of agitated episodes.
PDF
