Indoor tanning bed use and risk of food addiction based on the modified Yale Food Addiction Scale

The popularity of indoor tanning may be partly attributed to the addictive characteristics of tanning for some individuals.We aimed to determine the association between frequent indoor tanning,which we view as a sunogate for tanning addiction,and food addiction.A total of 67,910 women were included from the Nurses＇ Health Study II.In2005,we collected information on indoor tanning during high school/college and age 25-35 years,and calculated the average use of indoor tanning during these periods.Food addiction was defined as ≥3 clinically significant symptoms plus clinically significant impairment or distress,assessed in 2009 using a modified version of the Yale Food Addiction Scale.Totally 23.3%（15,822） of the participants reported indoor tanning at high school/college or age 25-35 years.A total of 5,557（8.2%） women met the criteria for food addiction.We observed a dose-response relationship between frequency of indoor tanning and the likelihood of food addiction（P_（trend）〈 0.0001）,independent of depression,BMI,and other confounders.Compared with never indoor tanners,the odds ratio（95%confidence interval） of food addiction was 1.07（0.99-1.17） for average indoor tanning 1-2 times/year,1.25（1.09-1.43） for 3-5times/year,1.34（1.14-1.56） for 6-11 times/year,1.61（1.35-1.91） for 12-23 times/year,and 2.98（1.95-4.57） for 24 or more times/year.Frequent indoor tanning before or at early adulthood is associated with prevalence of food addiction at middle age.Our data support the addictive property of frequent indoor tanning,which may guide intervention strategies to curb indoor tanning and prevent skin cancer.

Psychiatric and substance use disorders co-morbidities and hepatitis C: Diagnostic and treatment implications

Chronic hepatitis C virus(HCV) viral infection is the most common blood-borne viral infection and approximately 2%-3% of the world's population or 170-200 million people are infected. In the United States as many as 3-5 million people may have HCV. Psychiatric and substance use disorders(SUDs) are common co-morbid conditions found in people with HCV and are factors in predisposing people to HCV infection. Also, these co-morbidities are reasons that clinicians exclude people from antiviral therapy in spite of evidence that people with HCV and co-morbid psychiatric and SUD can be safely and effectively treated. Furthermore, the neuropsychiatric side effects of interferon(IFN), until recently the mainstay of antiviral therapy, have necessitated an appreciation and assessment of psychiatric co-morbidities present in people with HCV. The availability of new medications and IFNfree antiviral therapy medication combinations will shorten the duration of treatment and exposure to IFN and thus decrease the risk of neuropsychiatric side effects. This will have the consequence of dramatically altering the clinical landscape of HCV care and will increase the number of eligible treatment candidates as treatment of people with HCV and co-morbid psychiatric and SUDs will become increasingly viable. While economically developed countries will rely on expensive IFN-free antiviral therapy, less developed countries will likely continue to use IFN-based therapies at least until such time as IFNfree antiviral medications become generic. The current manuscript discusses the efficacy and viability of treating HCV in people with psychiatric and SUDs comorbidities, the treatment of the neuropsychiatric side effects of IFN-based therapies and the impact of new medications and new treatment options for HCV that offer the promise of increasing the availability of antiviral therapy in this vulnerable population.

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.

A randomized double-blinded sham-controlled trial of electroencephalogram-guided transcranial magnetic stimulation for obsessive-compulsive disorder

Background Obsessive-compulsive disorder （OCD） is a highly prevalent and devastating psychiatric condition.Repetitive transcranial magnetic stimulation （rTMS） is a potential and non-invasive treatment for OCD.Diverse efficacies of rTMS have been reported in different locations or frequencies of the stimulation.The main objective of this study was to assess the treatment effect for OCD with alpha electroencephalogram （αEEG）-guided TMS over dorsal Iateral prefrontal cortex bilaterally.Methods There were 25 OCD patients in the αTMS treatment group and 21 OCD patients in the sham control group.Each subject received 10 daily treatment sessions （5 days a week）.The αTMS group had significant reduction in scores of Yale-Brown Obsessive Compulsive Scale and Hamilton Rating Scale for Anxiety （HAMA） compared with the control group at the end of 2-week treatment and 1-week follow-up.Analysis of variance with repeated measures was used to test the effects between the two groups.Results Significant difference in scores of obsession and HAMA were found between the two groups after treatment.No significant difference in scores of Hamilton Rating Scale for Depression was found between the two groups after the treatment,but statistical significance was shown at the end of 1-week follow-up.Conclusions αEEG-guided TMS may be an effective treatment for OCD and related anxiety.Delayed response to αTMS in depression suggests that it might be secondary to the improvement of primary response in OCD and anxiety.

Traumatic brain injury induced by exposure to blast overpressure via ear canal

Exposure to explosive shockwave often leads to blast-induced traumatic brain injury in military and civilian populations.Unprotected ears are most often damaged following exposure to blasts.Although there is an association between tympanic membrane perforation and TBI in blast exposure victims,little is known about how and to what extent blast energy is transmitted to the central nervous system via the external ear canal.The present study investigated whether exposure to blasts directed through the ear canal causes brain injury in LongEvans rats.Animals were exposed to a single blast(0–30 pounds per square inch(psi))through the ear canal,and brain injury was evaluated by histological and behavioral outcomes at multiple time-points.Blast exposure not only caused tympanic membrane perforation but also produced substantial neuropathological changes in the brain,including increased expression of c-Fos,induction of a profound chronic neuroinflammatory response,and apoptosis of neurons.The blast-induced injury was not limited only to the brainstem most proximal to the source of the blast,but also affected the forebrain including the hippocampus,amygdala and the habenula,which are all involved in cognitive functions.Indeed,the animals exhibited long-term neurological deficits,including signs of anxiety in open field tests 2 months following blast exposure,and impaired learning and memory in an 8-arm maze 12 months following blast exposure.These results suggest that the unprotected ear canal provides a locus for blast waves to cause TBI.This study was approved by the Institutional Animal Care and Use Committee at the University of Mississippi Medical Center(Animal protocol#0932 E,approval date:September 30,2016 and 0932 F,approval date:September 27,2019).

初级保健中对情绪困扰患者进行短暂行为干预的诊疗策略

一位离异多年的中年妇女,因关节炎、体重增加和间歇性偏头痛而到全科医生处复诊。她看起来压力很大,也很疲惫。经询问,她说自己很紧张、疲劳、睡眠不好、焦虑。她与母亲同住,母亲患有老年痴呆症,需要照顾。同时,她还要适应女儿的家人(女儿的丈夫因失业和三个年幼的孩子搬来与她同住)。