Genetically predicted fatty liver disease and risk of psychiatric disorders: A mendelian randomization study

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)and alcohol-related liver disease(Ar-LD)constitute the primary forms of chronic liver disease,and their incidence is progressively increasing with changes in lifestyle habits.Earlier studies have do-cumented a correlation between the occurrence and development of prevalent mental disorders and fatty liver.AIM To investigate the correlation between fatty liver and mental disorders,thus ne-cessitating the implementation of a mendelian randomization(MR)study to elu-cidate this association.METHODS Data on NAFLD and ArLD were retrieved from the genome-wide association studies catalog,while information on mental disorders,including Alzheimer's disease,schizophrenia,anxiety disorder,attention deficit hyperactivity disorder(ADHD),bipolar disorder,major depressive disorder,multiple personality dis-order,obsessive-compulsive disorder(OCD),post-traumatic stress disorder(PTSD),and schizophrenia was acquired from the psychiatric genomics consor-tium.A two-sample MR method was applied to investigate mediators in signifi-cant associations.RESULTS After excluding weak instrumental variables,a causal relationship was identified between fatty liver disease and the occurrence and development of some psychia-tric disorders.Specifically,the findings indicated that ArLD was associated with a significantly elevated risk of developing ADHD(OR:5.81,95%CI:5.59-6.03,P<0.01),bipolar disorder(OR:5.73,95%CI:5.42-6.05,P=0.03),OCD(OR:6.42,95%CI:5.60-7.36,P<0.01),and PTSD(OR:5.66,95%CI:5.33-6.01,P<0.01).Meanwhile,NAFLD significantly increased the risk of developing bipolar disorder(OR:55.08,95%CI:3.59-845.51,P<0.01),OCD(OR:61.50,95%CI:6.69-565.45,P<0.01),and PTSD(OR:52.09,95%CI:4.24-639.32,P<0.01).CONCLUSION Associations were found between genetic predisposition to fatty liver disease and an increased risk of a broad range of psychiatric disorders,namely bipolar disorder,OCD,and PTSD,highlighting the significance of preven-tive measures against psychiatric disorders in patients with fatty liver disease.

A Brief Review of Artificial Intelligence Applications and Algorithms for Psychiatric Disorders

A number of brain research projects have recently been carried out to study the etiology and mechanisms of psychiatric disorders.Although psychiatric disorders are part of the brain sciences,psychiatrists still diagnose them based on subjective experience rather than by gaining insights into the pathophysiology of the diseases.Therefore,it is urgent to have a clear understanding of the etiology and pathogenesis of major psychiatric diseases,which can help in the development of effective treatments and interventions.Artificial intelligence(AI)-based applications are being quickly developed for psychiatric research and diagnosis,but there is no systematic review that summarizes their applications.For this reason,this study briefly reviews three main brain observation techniques used to study psychiatric disorders-namely,magnetic resonance imaging(MRI),electroencephalography(EEG),and kinesics-based diagnoses-along with related AI applications and algorithms.Finally,we discuss the challenges,opportunities,and future study directions of AI-based applications.

Optical neuroimaging:advancing transcranial magnetic stimulation treatments of psychiatric disorders

Transcranial magnetic stimulation(TMS)has been established as an important and effective treatment for various psychiatric disorders.However,its effectiveness has likely been limited due to the dearth of neuronavigational tools for targeting purposes,unclear ideal stimulation parameters,and a lack of knowledge regarding the physiological response of the brain to TMS in each psychiatric condition.Modern optical imaging modalities,such as functional near-infrared spectroscopy and diffuse optical tomography,are promising tools for the study of TMS optimization and functional targeting in psychiatric disorders.They possess a unique combination of high spatial and temporal resolutions,portability,real-time capability,and relatively low costs.In this mini-review,we discuss the advent of optical imaging techniques and their innovative use in several psychiatric conditions including depression,panic disorder,phobias,and eating disorders.With further investment and research in the development of these optical imaging approaches,their potential will be paramount for the advancement of TMS treatment protocols in psychiatry.

Surgical Treatment of Lung Cancer in Patients with Psychiatric Disorders: A Retrospective Study

Background: The purpose of this retrospective study was to examine the clinical outcomes of patients with concomitant lung cancer and psychiatric disorders who underwent pulmonary resection at our institution and develop a strategy for treating such patients in the future. Methods: We retrospectively reviewed 23 patients with psychiatric disorders who underwent pulmonary resection for lung cancer at our institution between January 1984 and December 2011. Results: The study population comprised 13 men and 10 women with an average age of 67.4 years. The histological types of lung cancer included adenocarcinoma in 14 patients, squamous cell carcinoma in 4, and other types in 5. Fifteen patients were classified as having pathological TNM stage I cancer, four as having stage II, three as having stage III, and one as having stage IV. The coexisting psychiatric disorders were neurosis in eight patients, depression in seven, schizophrenia in five, dementia in two, and oligophrenia in one. Three patients were admitted without a full understanding of the operation. There were no major complications with the exception of delirium, which was seen in eight patients. None of these patients’ coexisting psychiatric disorders worsened. No perioperative death occurred. Conclusions: At our institution, we cooperate closely with psychiatrists to care for surgical patients with psychiatric disorders. There is a possibility that such cooperation will reduce the frequency of previously reported complications.

Past,present,and future of deep transcranial magnetic stimulation:A review in psychiatric and neurological disorders

Deep transcranial magnetic stimulation(DTMS)is a new non-invasive neuromodulation technique based on repetitive transcranial magnetic stimulation technology.The new H-coil has significant advantages in the treatment and mechanism research of psychiatric and neurological disorders.This is due to its deep stimulation site and wide range of action.This paper reviews the clinical progress of DTMS in psychiatric and neurological disorders such as Parkinson’s disease,Alzheimer’s disease,post-stroke motor dysfunction,aphasia,and other neurological disorders,as well as anxiety,depression,and schizophrenia.

Progress in the application of molecular imaging inpsychiatric disorders

Psychiatric disorders have always attracted a lot of attention from researchers due to the difficulties in their diagnoses and treatments.Molecular imaging,as an emerging technology,has played an important role in the researchers of various diseases.In recent years,molecular imaging techniques including magnetic resonance spectroscopy,nuclear medicine imaging,and fluorescence imaging have been widely used in the study of psychiatric disorders.This review will briefly summarize the progression of molecular imaging in psychiatric disorders.

Increased Risk of Psychiatric Disorders in Women with Polycystic Ovary Syndrome in Southwest China

Background： Polycystic ovary syndrome （PCOS） and its characteristic symptoms have been associated with physical and psychological issues in women of reproductive age. The current study was conducted in response to the dearth of systematic research related to psychological functioning and quality of life in patients with PCOS in Southwest China, and to determine whether patients with PCOS exhibit poorer mental health （MH） compared to healthy women of the same age and living in the same region, without a PCOS diagnosis. Methods： We enrolled 120 outpatients with PCOS and 100 healthy controls in this study. Standardized questionnaires were administered to assess general MH conditions （General Health Questionnaire-12-item version）, anxiety （State-Trait Anxiety Inventory）, depression （Beck Depression Inventory）, as well as health-related quality of life （HRQoL） measured using the 36-item short-form health survey. The independent samples t-test was conducted for continuous study variables. For categorical variables, the Pearson Chi-square test, Fisher＇s exact test, and logistic regression were perlbrmed. Results： The prevalence of anxiety （13.3% vs. 2.0%） and depression （27.5% vs. 3.0%） was higher in patients with PCOS compared to the controls （both P 〈 0.05）. Patients with PCOS had decreased HRQoL. Patients with PCOS who had fertility requirements were more likely to be anxious and depressed than those without fertility requirements （anxiety： 22.6% [1 2/53] vs. 5.9% [4/67],Z： = 7.117, P = 0.008： depression： 37.7% （20/53） vs. 19.4% （13/67）, Х^2 = 4.988, P - 0.026）. Conclusions： PCOS and related synaptoms may be risk factors for depression and anxiety. Professionals should be concerned with the MH of women with PCOS, and psychological therapy should be considered.

Recent advances of deep learning in psychiatric disorders

Deep learning(DL)is a recently proposed subset of machine learning methods that has gained extensive attention in the academic world,breaking benchmark records in areas such as visual recognition and natural language processing.Different fromconventional machine learning algorithm,DL is able to learn useful representations and features directly from raw data through hierarchical nonlinear transformations.Because of its ability to detect abstract and complex patterns,DL has been used in neuroimaging studies of psychiatric disorders,which are characterized by subtle and diffuse alterations.Here,we provide a brief review of recent advances and associated challenges in neuroimaging studies of DL applied to psychiatric disorders.The results of these studies indicate that DL could be a powerful tool in assisting the diagnosis of psychiatric diseases.We conclude our review by clarifying the main promises and challenges of DL application in psychiatric disorders,and possible directions for future research.

Research progress of functional near-infrared spectroscopy in patients with psychiatric disorders

Functional near-infrared spectroscopy(fNIRS)is a technique of detecting cerebral cortical function by using near-infrared light,which is a multifunctional neuroimaging technique and provides a convenient and efficient detection method in neuroscience.In consideration of acceptability,safety,high spatial and temporal resolutions compared with electroencephalogram(EEG)and functional magnetic resonance imaging(fMRI),fNIRS is widely used to study different psychiatric disorders,most prominently affective disorders,schizophrenic illnesses,brain organic mental disorders and neurodevelopmental disorders,etc.The article focuses on the latest research progress and practical application of fNIRS in psychiatric disorders,especially traumatic brain,including studies on the characterization of phenomenology,treatment effects and descriptions of neuroimaging data.

Deep brain stimulation for psychiatric disorders: roleof imaging in identifying/confirming DBS targets,predicting, and optimizing outcome and unravellingmechanisms of action

Following the established application of deep brain stimulation(DBS)in the treatment of movement disorders,new non-neurological indications have emerged,such as for obsessive–compulsive disorders,major depressive disorder,dementia,Gilles de la Tourette Syndrome,anorexia nervosa,and addictions.As DBS is a network mod-ulation surgical treatment,the development of DBS for both neurological and psychiatric disorders has been partly driven by advances in neuroimaging,which has helped explain the brain networks implicated.Advances in magnetic resonance imaging connectivity and electrophysiology have led to the development of the con-cept of modulating widely distributed,complex brain networks.Moreover,the increasing number of targets for treating psychiatric disorders have indicated that there may be a convergence of the effect of stimulating dif-ferent targets for the same disorder,and the effect of stimulating the same target for different disorders.The aim of this paper is to review the imaging studies of DBS for psychiatric disorders.Imaging,and particularly connectivity analysis,offers exceptional opportunities to better understand and even predict the clinical out-comes of DBS,especially where there is a lack of objective biomarkers that are essential to properly guide DBS pre-and post-operatively.In future,imaging might also prove useful to individualize DBS treatment.Finally,one of the most important aspects of imaging in DBS is that it allows us to better understand the brain through observing the changes of the functional connectome under neuromodulation,which may in turn help explain the mechanisms of action of DBS that remain elusive.

Epigenetic Regulation of Serotonin Transporter in Psychiatric Disorders

SLC6A4 （solute carrier family 6, member 4） gene encodes a serotonin transporter （5-hydroxytryptamine transporter, HTT）, which transports synaptic serotonin into presynaptic terminal. SLC6A4 is known to be the target of antidepressants such as selective serotonin reuptake inhibitors （SSRIs）. Inhibition of HTT increases synaptic serotonin concentration and thereby exerts antidepressant efficacy. A large number of genetic studies suggest the contribution of genetic variations of SLC6A4 to various psychiatric disorders. The most studied genetic variation, HTT-linked polymorphic region （HTTLPR）,

Reduced homotopic interhemispheric connectivity in psychiatric disorders:evidence for both transdiagnostic and disorder specific features

There is considerable interest in the significance of structural and functional connections between the two brain hemispheres in terms of both normal function and in relation to psychiatric disorders.In recent years,many studies have used voxel mirrored homotopic connectivity analysis of resting state data to investigate the importance of connectivity between homotopic regions in the brain hemispheres in a range of neuropsychiatric disorders.The current review summarizes findings fromthese voxel mirrored homotopic connectivity studies in individuals with autism spectrum disorder,addiction,attention deficit hyperactivity disorder,anxiety and depression disorders,and schizophrenia,aswell as disorders such as Alzheimer’s disease,mild cognitive impairment,epilepsy,and insomnia.Overall,other than attention deficit hyperactivity disorder,studies across psychiatric disorders report decreased homotopic resting state functional connectivity in the default mode,attention,salience,sensorimotor,social cognition,visual recognition,primary visual processing,and reward networks,which are often associated with symptom severity and/or illness onset/duration.Decreased homotopic resting state functional connectivity may therefore represent a transdiagnostic marker for general psychopathology.In terms of disorder specificity,the extensive decreases in homotopic resting state functional connectivity in autism differ markedly from attention deficit hyperactivity disorder,despite both occurring during early childhood and showing extensive co-morbidity.A pattern of more posterior than anterior regions showing reductions in schizophrenia is also distinctive.Going forward,more studies are needed to elucidate the functions of these homotopic functional connections in both health and disorder and focusing on associations with general psychopathology,and not only on disorder specific symptoms.

Neurological and psychiatric effects of hepatitis C virus infection

Hepatitis C virus(HCV)infection is widespread and affects 71 million people worldwide.Although hepatic manifestations are the most frequent,ranging from chronic hepatitis to cirrhosis and hepatocellular carcinoma,it is also associated with several extrahepatic manifestations.Infected patients may present nonspecific neurological symptoms,regardless of the presence of liver cirrhosis.Several pathogenetic mechanisms underlying neurological symptoms have been hypothesized:neuroinvasion,immune-mediated damage,neurotransmitter alterations and cryoglobulinemia.Alterations of the central nervous system include cerebral vasculopathy,acute or subacute encephalopathy and inflammatory disorders.HCV infection may be responsible for neuropathies,of which the most frequent form is symmetrical axonal sensory or sensory-motor polyneuropathy which causes loss of leg sensitivity and weakness.Up to 50%of patients with HCV infection may experience cognitive decline and psychological disorders,such as depression and fatigue.HCV associated neurocognitive disorder is independent of the presence of liver cirrhosis and affects different domains than in patients with hepatic encephalopathy.It can be studied using specific tests that mainly explore executive functions,verbal learning and verbal recall.These disorders significantly reduce the quality of life.The new antiviral therapies improve the extrahepatic symptoms of HCV infection and their success depends on the achievement of sustained virological response.However,the effect of therapy may differ depending on the type of organ involved;neurological symptoms can be irreversible if there is organic liver damage.The aim of this review is to provide a critical overview of physiopathological mechanisms,diagnostic and therapeutic strategies of the neurological and psychiatric effects of HCV infection.

Vitamin D binding protein in psychiatric and neurological disorders:Implications for diagnosis and treatment

Vitamin D binding protein(VDBP)serves as a key transporter protein responsible for binding and delivering vitamin D and its metabolites to target organs.VDBP plays a crucial part in the inflammatory reaction following tissue damage and is engaged in actin degradation.Recent research has shed light on its potential role in various diseases,leading to a growing interest in understanding the implications of VDBP in psychiatric and neurological disorders.The purpose of this review was to provide a summary of the existing understanding regarding the involvement of VDBP in neurological and psychiatric disorders.By examining the intricate interplay between VDBP and these disorders,this review contributes to a deeper understanding of underlying mechanisms and potential therapeutic avenues.Insights gained from the study of VDBP could pave the way for novel strategies in the diagnosis,prognosis,and treatment of psychiatric and neurological disorders.

Psychiatric comorbidities in cancer survivors across tumor subtypes:A systematic review

BACKGROUND Psychiatric disorders are common but underdiagnosed in cancer survivors.Research suggests that tumor type has an effect on the prevalence of clinically relevant depression,anxiety,comorbid anxiety-depression and posttraumatic stress disorder(PTSD).AIM To identify studies that examined the prevalence of clinically relevant levels of depression,anxiety,comorbid anxiety-depression and PTSD for patients with one or more tumor sites and compare those prevalences between cancer subtypes.METHODS Four databases(PubMed,PsycInfo,PubPsych and the Cochrane Database)were searched and resulted in a total of 2387 articles to be screened.To be included,a study must have investigated cancer-free and posttreatment survivors using tools to assess clinically relevant levels of the listed psychiatric comorbidities.All articles were screened by two authors with a third author reviewing debated articles.RESULTS Twenty-six studies on ten different tumor types fulfilled all inclusion criteria and were included in the review.The studies showed heterogeneity regarding the study characteristics,number of participants,time since diagnosis,and assessment tools.Generally,all four comorbidities show higher prevalences in cancer survivors than the general population.Brain tumor survivors were reported to have a relatively high prevalence of both depression and anxiety.Studies with melanoma survivors reported high prevalences of all four psychiatric comorbidities.Regarding comorbidities,a wide range in prevalence existed across the tumor types.Within one cancer site,the prevalence also varied considerably among the studies.CONCLUSION Psychiatric comorbidities are more frequent in cancer survivors than in the general population,as reflected by the prevalence of depression,anxiety,comorbid anxiety-depression and PTSD across all tumor subtypes.Developing generalized screening tools that examine psychological distress in cancer survivors up to at least ten years after diagnosis could help to understand and address the psychological burden of cancer survivors.

Connecting brain and body:Transdiagnostic relevance of connective tissue variants to neuropsychiatric symptom expression

The mind is embodied;thoughts and feelings interact with states of physiological arousal and physical integrity of the body.In this context,there is mounting evidence for an association between psychiatric presentations and the expression variant connective tissue,commonly recognised as joint hypermobility.Joint hypermobility is common,frequently under-recognised,significantly impacts quality of life,and can exist in isolation or as the hallmark of hypermobility spectrum disorders(encompassing joint hypermobility syndrome and hypermobile Ehlers-Danlos syndrome).In this narrative review,we appraise the current evidence linking psychiatric disorders across the lifespan,beginning with the relatively well-established connection with anxiety,to hypermobility.We next consider emerging associations with affective illnesses,eating disorders,alongside less well researched links with personality disorders,substance misuse and psychosis.We then review related findings relevant to neurodevelopmental disorders and stress-sensitive medical conditions.With growing understanding of mind-body interactions,we discuss potential aetiopathogenetic contributions of dysautonomia,aberrant interoceptive processing,immune dysregulation and proprioceptive impairments in the context of psychosocial stressors and genetic predisposition.We examine clinical implications of these evolving findings,calling for increased awareness amongst healthcare professionals of the transdiagnostic nature of hypermobility and related disorders.A role for early screening and detection of hypermobility in those presenting with mental health and somatic symptoms is further highlighted,with a view to facilitate preventative approaches alongside longer-term holistic management strategies.Finally,suggestions are offered for directions of future scientific exploration which may be key to further delineating fundamental mind-body-brain interactions.

Schizophreniform Disorder after Onset of Menopause

Schizophrenia is one of the psychotic disorders that is a huge concern with prevalence increasing every year. In this case report, we are discussing the case of a 49-year-old female with no prior history of psychiatric illness and a recent diagnosis of menopause, presenting with signs and symptoms of schizophreniform disorder and menopause. After undergoing treatment with estrogen and risperidone, she experienced complete resolution of her delusions and hallucinations.

Major Depressive Disorder as a Post COVID Infection Sequela

COVID-19 has taken the world by storm, producing a multitude of concerning sequela in all genders and age groups. One surprising finding is the onset of depression post COVID recovery in patients with no past medical history of psychiatric illness. The following case report discusses a 52-year-old female with a past medical history of pneumonia secondary to COVID-19 in April 2021, who presented with recurrent falls and a syncopal episode. On review of systems, it was discovered that the patient has new onset depression since recovering from COVID related pneumonia. Patient has yet to follow up with an outpatient psychiatrist.

Depletion of microglia with PLX3397 attenuates MK-801-induced hyperactivity associated with regulating inflammation-related genes in the brain

Acute administration of MK-801(dizocilpine),an N-methyl-D-aspartate receptor(NMDAR)antagonist,can establish animal models of psychiatric disorders.However,the roles of microglia and inflammation-related genes in these animal models of psychiatric disorders remain unknown.Here,we found rapid elimination of microglia in the prefrontal cortex(PFC)and hippocampus(HPC)of mice following administration of the dual colony-stimulating factor 1 receptor(CSF1R)/c-Kit kinase inhibitor PLX3397(pexidartinib)in drinking water.Single administration of MK-801 induced hyperactivity in the open-field test(OFT).Importantly,PLX3397-induced depletion of microglia prevented the hyperactivity and schizophrenia-like behaviors induced by MK-801.However,neither repopulation of microglia nor inhibition of microglial activation by minocycline affected MK-801-induced hyperactivity.Importantly,microglial density in the PFC and HPC was significantly correlated with behavioral changes.In addition,common and distinct glutamate-,GABA-,and inflammation-related gene(116 genes)expression patterns were observed in the brains of PLX3397-and/or MK-801-treated mice.Moreover,10 common inflammation-related genes(CD68,CD163,CD206,TMEM119,CSF3R,CX3CR1,TREM2,CD11b,CSF1R,and F4/80)with very strong correlations were identified in the brain using hierarchical clustering analysis.Further correlation analysis demonstrated that the behavioral changes in the OFT were most significantly associated with the expression of inflammation-related genes(NLRP3,CD163,CD206,F4/80,TMEM119,and TMEM176a),but not glutamate-or GABA-related genes in PLX3397-and MK-801-treated mice.Thus,our results suggest that microglial depletion via a CSF1R/c-Kit kinase inhibitor can ameliorate the hyperactivity induced by an NMDAR antagonist,which is associated with modulation of immune-related genes in the brain.

Transdiagnostic considerations of mental health for the post-COVID era:Lessons from the first surge of the pandemic

BACKGROUND The Coronavirus disease 19(COVID-19)-related psychiatric burden partly results from prolonged social stress world-wide.Studies have examined the psychiatric impact of COVID-19 on Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM 5)and International Classification of Diseases 11th Revision(ICD-11)categories,implicating multiple diagnoses,complicating clinical management.AIM To verify whether COVID-19-related psychopathology spans multiple DSM-5 and ICD-11 diagnoses,but not in a random pattern.Consequently,empirical analysis of the multiple associated symptoms will better describe COVID-19-related psychopathology.METHODS We conducted a bi-national study during the first surge of the pandemic:an Italian sample(n=21217,studied March-April 2020);and three representative longitudinal samples from Israel(n=1276,1189,and 1432 respectively,studied May-July 2020).Data in Italy were collected by a national internet-based survey with an initially approached sample of about one million persons and in Israel by the Israeli Central Bureau of Statistics using probability-based national representative sampling.Data analysis focused on the frequency and patterns of reported multiple mental health symptoms.RESULTS Combinations with all symptoms were more prevalent than combinations with fewer symptoms,with no majorities-minorities differences in both countries,demonstrating the generalizability of the transdiagnostic pattern of mental health issues in both nations.A history of previous mental disorder(Italian study)and an increase in symptom prevalence over time(Israel study)were associated with an increased number of symptoms.Conclusions:Based on finding correlated symptom diversity spanning conventional diagnostic categories,we suggest that the pattern of mental health issues associated with the COVID-19 pandemic is transdiagnostic.CONCLUSION The findings have implications for improving prevention and treatment of COVID-19 related psychopathology and for post-pandemic times in conditions resulting from multiplicity of stressors with mixed symptomatology in the clinical picture.