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The Journal of Pharmacology and... Oct 2020Innate and adaptive immune mechanisms have emerged as critical regulators of CNS homeostasis and mental health. A plethora of immunologic factors have been reported to... (Review)
Review
Innate and adaptive immune mechanisms have emerged as critical regulators of CNS homeostasis and mental health. A plethora of immunologic factors have been reported to interact with emotion- and behavior-related neuronal circuits, modulating susceptibility and resilience to mental disorders. However, it remains unclear whether immune dysregulation is a cardinal causal factor or an outcome of the pathologies associated with mental disorders. Emerging variations in immune regulatory pathways based on sex differences provide an additional framework for discussion in these psychiatric disorders. In this review, we present the current literature pertaining to the effects that disrupted immune pathways have in mental disorder pathophysiology, including immune dysregulation in CNS and periphery, microglial activation, and disturbances of the blood-brain barrier. In addition, we present the suggested origins of such immune dysregulation and discuss the gender and sex influence of the neuroimmune substrates that contribute to mental disorders. The findings challenge the conventional view of these disorders and open the window to a diverse spectrum of innovative therapeutic targets that focus on the immune-specific pathophenotypes in neuronal circuits and behavior. SIGNIFICANCE STATEMENT: The involvement of gender-dependent inflammatory mechanisms on the development of mental pathologies is gaining momentum. This review addresses these novel factors and presents the accumulating evidence introducing microglia and proinflammatory elements as critical components and potential targets for the treatment of mental disorders.
Topics: Brain; Female; Humans; Male; Mental Disorders; Neuroimmunomodulation; Neurotransmitter Agents; Sex Characteristics
PubMed: 32661057
DOI: 10.1124/jpet.120.266163 -
European Child & Adolescent Psychiatry Jan 2024The siblings of children with mental disorders are more likely to experience mental health issues themselves, but there has been a lack of sibling studies on selective...
The siblings of children with mental disorders are more likely to experience mental health issues themselves, but there has been a lack of sibling studies on selective mutism (SM). The aim of this population-based study was to use national registers to examine associations between children with SM and diagnoses of various mental disorder in their siblings. All singleton children born in Finland from 1987 to 2009, and diagnosed with SM from 1998 to 2012, were identified from national health registers and matched with four controls by age and sex. Their biological siblings and parents were identified using national registries and the diagnostic information on the siblings of the subjects and controls was obtained. The final analyses comprised 658 children with SM and their 1661 siblings and 2092 controls with 4120 siblings. The analyses were conducted using generalized estimating equations. Mental disorders were more common among the siblings of the children with SM than among the siblings of the controls. The strongest associations were observed for childhood emotional disorders and autism spectrum disorders after the data were adjusted for covariates and comorbid diagnoses among SM subjects. The final model showed associations between SM and a wide range of disorders in siblings, with strongest associations with disorders that usually have their onset during childhood. Our finding showed that SM clustered with other mental disorders in siblings and this requires further research, especially the association between SM and autism spectrum disorders. Strong associations with childhood onset disorders may indicate shared etiologies.
Topics: Child; Humans; Mutism; Siblings; Neurodevelopmental Disorders; Mental Disorders; Comorbidity; Child Behavior Disorders
PubMed: 36422730
DOI: 10.1007/s00787-022-02114-3 -
Revista Medica de Chile Apr 2018There is no consensus amongst physicians, social security representatives and researchers about optimum sick leaves. This is an indication that should maximize positive... (Review)
Review
There is no consensus amongst physicians, social security representatives and researchers about optimum sick leaves. This is an indication that should maximize positive outcomes and minimize potential side effects, both for the patient and society. The use of sick leaves during the last decade rose steadily, particularly in the psychiatric field. The most important causes of this increase are: changes in public policies, overuse of psychiatric diagnosis to cover up unmet social needs, and modifications to labour structure. It is analysed the impact that this situation has implied for physician patient relationship as well as for health budget. Even though sick leave diminishes presentism associated to a psychiatric disorder, published evidence about the effect of prolonged sick leave shows that damage overruns potential benefits: augmented morbidity and mortality, workplace phobia, economic loss, among others.
Topics: Chile; Humans; Mental Disorders; Occupational Health; Practice Guidelines as Topic; Presenteeism; Sick Leave
PubMed: 29999125
DOI: 10.4067/s0034-98872018000400494 -
Dialogues in Clinical Neuroscience 2005Psychiatric disorders constitute 15.4% of the disease burden in established market economies. Many psychiatric disorders are associated with sleep disturbances, and the... (Review)
Review
Psychiatric disorders constitute 15.4% of the disease burden in established market economies. Many psychiatric disorders are associated with sleep disturbances, and the relationship is often bidirectional. This paper reviews the prevalence of various psychiatric disorders, their clinical presentation, and their association with sleep disorders. Among the psychiatric disorders reviewed are affective disorders, psychosis, anxiety disorders (including posttraumatic stress disorder), substance abuse disorders, eating disorders, and attention deficit/hyperactivity disorders. The spectrum of associated sleep disorders includes insomnia, hypersomnia, nocturnal panic, sleep paralysis, hypnagogic hallucinations, restless legs/periodic limb movements of sleep, obstructive sleep apnea, and parasomnias. The effects on sleep of various psychotropic medications utilized to treat the above psychiatric disorders are summarized.
Topics: Humans; Mental Disorders; Psychiatry; Sleep; Sleep Wake Disorders
PubMed: 16416705
DOI: 10.31887/DCNS.2005.7.4/vabad -
Deutsches Arzteblatt International May 2015About 17% of all children suffer from a mental disorder in early childhood, defined as the period up to the age of 6 years. (Review)
Review
BACKGROUND
About 17% of all children suffer from a mental disorder in early childhood, defined as the period up to the age of 6 years.
METHODS
This review is based on publications retrieved by a selective search in PubMed and the Web of Science, as well as on the authors' clinical and scientific experience.
RESULTS
In children up to age 2, disorders of emotional and motor regulation are common (ca. 7%), as are feeding problems (25%), which persist in 2% of children to meet the diagnostic criteria for a feeding disorder. Reactive attachment disorder, a serious mental illness, has a prevalence of about 1%: it is more common among children in situations of increased risk, e.g., orphanages and foster homes. Preschool children can develop anxiety disorder and depressive disorder, as well as hyperactivity and behavioral disorders (the latter two mainly in boys). Parent training and parent-child psychotherapy have been found to be effective treatments. There is no evidence that psychotropic drugs are effective in early childhood.
CONCLUSION
The diagnostician should act cautiously when assigning psychopathological significance to symptoms arising in early childhood but should still be able to recognize mental disorders early from the way they are embedded in the child's interactive relationships with parents or significant others, and then to initiate the appropriate treatment. Psychotherapy in this age group is still in need of validation by efficacy studies and longitudinal studies of adequate quality.
Topics: Child; Child Health; Child, Preschool; Evidence-Based Medicine; Female; Humans; Infant; Infant, Newborn; Male; Mental Disorders; Neurodevelopmental Disorders; Parent-Child Relations; Parents; Treatment Outcome
PubMed: 26149380
DOI: 10.3238/arztebl.2015.0375 -
Neurologic Clinics Feb 2011Aggression is a serious medical problem that can place both the patient and the health care provider at risk. Aggression can result from medical, neurologic, and/or... (Review)
Review
Aggression is a serious medical problem that can place both the patient and the health care provider at risk. Aggression can result from medical, neurologic, and/or psychiatric disorders. A comprehensive patient evaluation is needed. Treatment options include pharmacotherapy as well as nonpharmacologic interventions, both of which need to be individualized to the patient.
Topics: Aggression; Anticonvulsants; Antipsychotic Agents; Brain; Humans; Mental Disorders; Physical Examination; Seizures; Substance-Related Disorders
PubMed: 21172570
DOI: 10.1016/j.ncl.2010.10.006 -
Psychological Medicine Apr 2021Psychiatric disorders are studied at multiple levels, but there is no agreement on how these levels are related to each other, or how they should be understood in the... (Review)
Review
Psychiatric disorders are studied at multiple levels, but there is no agreement on how these levels are related to each other, or how they should be understood in the first place. In this paper, I provide an account of levels and their relationships that is suited for psychopathology, drawing from recent debates in philosophy of science. Instead of metaphysical issues, the focus is on delivering an understanding of levels that is relevant and useful for scientific practice. I also defend a pragmatic approach to the question of reduction, arguing that even in-principle reductionists should embrace pluralism in practice. Finally, I discuss the benefits and challenges in integrating explanations and models of different levels.
Topics: Heuristics; Humans; Mental Disorders; Philosophy; Psychopathology; Research
PubMed: 31549600
DOI: 10.1017/S0033291719002514 -
Psychological Medicine Oct 2023Despite being a relatively new concept, psychiatric comorbidity, i.e. the co-occurrence of two or more mental disorders, has become widespread in clinical practice and... (Review)
Review
Despite being a relatively new concept, psychiatric comorbidity, i.e. the co-occurrence of two or more mental disorders, has become widespread in clinical practice and psychiatric research. In this article, we trace the origin of the concept of psychiatric comorbidity, discuss the conceptual literature and point to basic problems concerning inadequate definition of the concept, differential diagnostic issues, and reification of mental disorders. We illustrate how these problems may have consequences for diagnostic assessment in current clinical practice and psychiatric research. To address some of the problems related to psychiatric comorbidity, we discuss potential principles for assessing psychiatric comorbidity. Inspired by Feinstein's original concept of comorbidity in general medicine and his differential diagnostic principles, we emphasize the importance of of mental disorders when assessing psychiatric comorbidity. We suggest that knowledge of . conditions and of the multitudinous clinical manifestations beyond what is captured in the diagnostic manuals may be helpful for assessing the independence of mental disorders and thus psychiatric comorbidity. We further argue that a more hierarchical diagnostic system and explicit exclusionary rules could improve clinical practice and research by reducing informational complexity and combating unwarranted psychiatric comorbidity.
Topics: Humans; Mental Disorders; Comorbidity
PubMed: 37264812
DOI: 10.1017/S0033291723001605 -
Alcohol Research : Current Reviews Oct 2019Given the high co-occurrence between alcohol use disorder (AUD) and mental health conditions (MHCs), and the increased morbidity associated with the presence of... (Review)
Review
Given the high co-occurrence between alcohol use disorder (AUD) and mental health conditions (MHCs), and the increased morbidity associated with the presence of co-occurring disorders, it is important that co-occurring disorders be identified and both disorders addressed in integrated treatment. Tremendous heterogeneity exists among individuals with co-occurring conditions, and factors related to both AUD and MHCs, including symptom type and acuity, illness severity, the chronicity of symptoms, and recovery capital, should be considered when recommending treatment interventions. This article reviews the prevalence of co-occurring AUD and MHCs, screening tools to identify individuals with symptoms of AUD and MHCs, and subsequent assessment of co-occurring disorders. Types of integrated treatment and current challenges to integrate treatment for co-occurring disorders effectively are reviewed. Innovative uses of technology to improve education on co-occurring disorders and treatment delivery are also discussed. Systemic challenges exist to providing integrated treatment in all treatment settings, and continued research is needed to determine ways to improve access to treatment.
Topics: Alcoholism; Combined Modality Therapy; Comorbidity; Delivery of Health Care, Integrated; Humans; Mental Disorders
PubMed: 31649837
DOI: 10.35946/arcr.v40.1.07 -
Neuropsychopharmacology : Official... Jan 2020
Topics: Humans; Mental Disorders; Sleep; Sleep Wake Disorders
PubMed: 31486776
DOI: 10.1038/s41386-019-0514-5