Lumateperone (LUMA) is an FDA-approved antipsychotic to treat schizophrenia and depressive episodes associated with bipolar I or bipolar II disorder. An open-label study (Study 303) evaluated the safety and tolerability of LUMA in outpatients with stable schizophrenia who switched from previous antipsychotic (AP) treatment. This post hoc analysis of Study 303 investigated the safety and tolerability of LUMA stratified by previous AP in patients who switched to LUMA treatment for 6 weeks.

Adult outpatients (≥18 years) with stable schizophrenia were switched from previous AP to LUMA 42 mg once daily for 6 weeks followed by switching to another approved AP for 2 weeks follow-up. Post hoc analyses were stratified by most common previous AP: risperidone or paliperidone (RIS/PAL); quetiapine (QET); aripiprazole or brexpiprazole (ARI/BRE); olanzapine (OLA). Safety analyses included adverse events (AE), vital signs, and laboratory tests. Efficacy was assessed using the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impressions-Severity (CGI-S) scale.

The safety population comprised 301 patients, of which 235 (78.1%) were previously treated with RIS/PAL (n=95), QET (n=60), ARI/BRE (n=43), or OLA (n=37). Rates of treatment-emergent AEs (TEAEs) while on LUMA were similar between previous AP groups (44.2%-55.8%). TEAEs with incidences of ≥5% in any AP group were dry mouth, somnolence, sedation, headache, diarrhea, cough, and insomnia. Most TEAEs were mild or moderate in severity for all groups. Rates of serious TEAEs were low and similar between groups (0%–7.0%).

Statistically significant (P<.05) decreases from baseline were observed in the OLA group that switched to LUMA in total cholesterol and low-density lipoprotein cholesterol with significant decreases thereafter on LUMA. Statistically significant decreases in prolactin levels were observed in both the RIS/PAL (P<.0001) and OLA (P<.05) groups. Patients switched from RIS/PAL to LUMA showed significant (P<.05) decreases for body mass index, waist circumference, and weight. At follow-up, 2 weeks after patients switched back from LUMA to another AP, none of the decreases in laboratory parameters or body morphology observed while on LUMA maintained significance.

Those switching from QET had significant improvements from baseline at Day 42 in PANSS Total score (mean change from baseline −3.47; 95% confidence interval [CI] −5.27, −1.68; P<.001) and CGI-S Total score (mean change from baseline −0.24; 95% CI, −0.38, −0.10; P<.01).

In outpatients with stable schizophrenia, LUMA 42 mg treatment was well tolerated in patients switching from a variety of previous APs. Patients switching from RIS/PAL or OLA to LUMA had significant improvements in cardiometabolic and prolactin parameters. These data further support the favorable safety, tolerability, and efficacy of LUMA in patients with schizophrenia.

Intra-Cellular Therapies, Inc.

The study attempts to integrate Civic and Political Psychoeducation to optimize the teaching content of traditional mathematics courses in colleges and universities, in order to alleviate college students’ anxiety in the process of mathematics learning, as the difficulty of mathematics courses in colleges and universities increases.

As subjects for this study, 120 students majoring in Mathematics Applications at one of China’s universities were chosen. The 120 college students were randomly and equally divided into two groups, the control group and the experimental group, with 60 students in each group. The students in the experimental group were taught utilizing the Civic Psychology intervention in their mathematics courses, whereas the students in the control group were taught using the usual mathematics lecture approach. The trial ran for a semester. After one semester, the students’ anxiety psychological ratings under various instructional approaches were compared. The data changes during the experiment were recorded and analyzed using SPSS23.0.

The study’s findings demonstrate that after one semester of mathematics instruction, the average anxiety level of the experimental group dropped from 28.56 to 5.21, whereas the average anxiety score of the control group did not change appreciably. It can be demonstrated that the experimental group’s teaching style can more successfully ease college students’ anxiety during the arithmetic learning process.

A college mathematics teaching strategy that mixes ideological and psychological education can successfully reduce college students’ anxiety during the mathematics learning process.

Sleep is an important behavioral biomarker for patients with serious mental illness (SMI). The ability to accurately quantify sleep in a real-world setting could thus provide insight into patient well-being. In this study, patients in a sleep lab wore a patch that is part of a digital medicine system (aripiprazole with sensor (AS)) designed to provide objective records of medication ingestion. The patch provided accelerometer and electrocardiogram (ECG) data; polysomnography (PSG) data was collected to be used as the gold standard for sleep stage classification. The accelerometer and ECG data were used to build machine learning classification models to distinguish periods of wake from periods of sleep. To optimize these models for a real-world environment, different data sampling paradigms and methodologies were explored, and resultant model performances were analyzed.

Data was collected for a total of 220 nights, across 73 unique subjects—42 subjects had a diagnosed SMI (schizophrenia, bipolar disorder I, or major depressive disorder) and 31 subjects were healthy volunteers. PSG data, which provides a sleep stage designation at 30-second intervals, was combined into 5-minute windows, labeled as either “Sleep” or “Wake” based on which class comprised the majority of the 30-second intervals within the window. Accelerometer and ECG features were derived for each 5-minute window. Models were trained with three learning methodologies: a light gradient boosting machine (LGBM), a conditional random field (CRF), and a long short-term memory (LSTM) network. Model performance was tested with the full complement of accelerometer and ECG data, as well as down-sampled subsets of data. Additionally, ECG data from the PSG system was incorporated to test the effect of other ECG sampling strategies.

CRF models produced the best classification performance (AUC = 0.91) with the full patch dataset. Down-sampling to include less than half of the accelerometer data did begin to degrade the specificity of the model. Down-sampling to include less frequent ECG collection did not have a significant effect on model performance; however, changing the sampling paradigm to continuous ECG collection from a block sampling paradigm did lead to more robust classification of when a patient was awake.

Accurately recording sleep in a logistically simple way can provide insights into the well-being of SMI patients. Combining these insights with the objective medication ingestion records provided by AS would be of great value to SMI patients, as well as their caregivers and physicians. This research explores what amount of sensor data is required to accurately quantify sleep and some of the machine learning strategies that can ameliorate data limitations, providing guidance for the optimization of digital device design.

Otsuka Pharmaceutical Development & Commercialization, Inc.

Most FDA-approved ADHD treatments increase norepinephrine (NE) and dopamine (DA); however, our prior preclinical studies of the non-stimulant ADHD treatment viloxazine ER (Qelbree®) demonstrated that viloxazine also increases serotonin (5-HT). A prior microdialysis study showed increases in NE, DA, and 5-HT in the rat prefrontal cortex (PFC); however, the 50 mg/kg dose resulted in supratherapeutic plasma concentrations. Viloxazine is a moderate affinity selective NE reuptake inhibitor, structurally different than traditional SSRI antidepressants. Viloxazine has negligible activity at the serotonin reuptake transporter (SERT), suggesting viloxazine has a different mechanism of 5-HT PFC elevation than SSRIs. The current microdialysis study was undertaken to further characterize if viloxazine affects 5-HT and its 5-HIAA metabolite at therapeutically relevant plasma concentrations. Results are compared to similar microdialysis studies of SSRIs.

Rats were implanted with I-shaped microdialysis probes connected to a microperfusion pump, delivering artificial cerebrospinal fluid, in the PFC. After a 2-hour baseline period, viloxazine (1, 3, 10, or 30 mg/kg) was administered (ip). Dialysate samples were collected from the interstitial fluid (ISF) of the PFC before and after dosing. LC-MS/MS was used to determine the dialysate concentrations of viloxazine and viloxazine-induced changes in NE, 5-HT, and their respective metabolites, DHPG and 5-HIAA. Viloxazine plasma concentrations were also measured.

Animal research was approved by the Institutional Animal Care and Use Committee and conducted in accordance with the National Research Council’s Guide for the Care and Use of Laboratory Animals.

Viloxazine administration resulted in significant dose-dependent increases in ISF NE levels and corresponding decreases in DHPG (NE metabolite) at all doses tested, reflecting viloxazine’s activity as a NET inhibitor. Viloxazine treatment also resulted in a dose-dependent elevation of ISF 5-HT levels in the PFC. Of the doses tested, 30 mg/kg was found to be clinically relevant as it induced ISF concentrations approximating unbound plasma concentrations in pediatric ADHD patients. At this dose, 5-HT levels were significantly increased over baseline and higher than vehicle levels. Coincident changes in 5-HIAA concentrations were not observed, reaffirming viloxazine’s lack of activity as a SERT inhibitor.

Viloxazine induced dose-dependent increases in NE and 5-HT in the PFC, a critical target region for ADHD therapies. At clinically relevant viloxazine plasma concentrations, 5-HT was increased in the PFC. Unlike SSRIs, which correspondingly decrease the 5-HT metabolite in the PFC (indicating serotonin reuptake inhibition), viloxazine did not affect 5-HIAA levels. Thus, viloxazine increases cortical 5-HT levels by a different mechanism than SSRIs. Whether 5-HT effects aid in viloxazine therapeutic efficacy in ADHD is yet unknown.

Supernus Pharmaceuticals, Inc.

In response to the phenomenon of autism and autism in the socialization process of students in higher education, this study attempted to combine Civic Education and Cognitive Psychological Intervention Therapy (CPIT) with the aim of alleviating the symptoms associated with students with autism.

Thirty students with autism from five colleges and universities in a city were selected as subjects for this study. The 30 autistic students were randomly and equally divided into the control group and the intervention group. The students in the intervention group were treated with Civic Education combined with Cognitive Psychological Intervention Therapy, and the students in the control group were treated with Civic Education only. The whole course of treatment lasted for 3 months. The data generated during the experiment were analyzed and recorded using SPSS23.0. Self-made autistic psychological scale was used for assessment, and the higher the score of the scale, the more serious the autistic psychology of the students.

After 3 months of treatment, the mean Autism Psychological Scale score of the students in the intervention group decreased from 9.85 to 2.35, while the mean Autism Psychological Scale score of the students in the control group decreased from 9.24 to 8.65.

In conclusion, it can be concluded that Civic Education combined with Cognitive Psychological Intervention Therapy can be more effective in alleviating students’ autism.

Aiming at the current situation of employment anxiety disorder of students in higher vocational colleges and universities, this study integrates the idea of integration of production and education into the ideological education of higher vocational colleges and universities, so as to optimize students’ employment anxiety.

In a higher education setting, 100 students with employment anxiety disorder were chosen as study participants. The 100 participants in the study were randomly divided into two groups: the integrated teaching group and the standard teaching group. Civics education was combined with the integration of business and education for students in the integrated teaching group, while only Civics education was used for students in the traditional teaching group. A self-made employment anxiety scale was used to assess each student’s level of anxiety following a month of teacher training. Using SPSS23.0, all experimental data for this investigation were statistically evaluated.

After one month of training, 32 students in the integrated group changed from severe to mild anxiety, and 18 were no longer anxious. In contrast, only five students in the traditional teaching group changed from severe to mild anxiety, while the others still had severe employment anxiety.

Integrating the idea of integration of production and education into the ideological education of higher vocational colleges and universities can effectively alleviate students’ employment anxiety.

Aripiprazole 2-month ready-to-use 960 mg (Ari 2MRTU 960) is a new long-acting injectable (LAI) antipsychotic formulation for gluteal administration every 2 months, intended for the treatment of schizophrenia and maintenance monotherapy treatment of bipolar I disorder (BP-I). This 32-week trial evaluated the safety, tolerability, and pharmacokinetic profile of multiple-dose gluteal administration of Ari 2MRTU 960 in clinically stable adult patients with a diagnosis of schizophrenia or BP-I, versus that of aripiprazole once-monthly 400 mg (AOM 400; an LAI indicated for the treatment of schizophrenia and maintenance monotherapy treatment of BP-I).

This was an open-label, multiple-dose, randomized, parallel-arm trial conducted at 16 sites in the US. Eligible patients (N=266) were randomized to receive Ari 2MRTU 960 every 56±2 days (n=132; 4 injections in total) or AOM 400 every 28±2 days (n=134; 8 injections in total). Safety and tolerability were evaluated throughout the study; assessments included adverse event reporting, patient reporting of injection site pain, and monitoring of extrapyramidal symptoms.

In the Ari 2MRTU group, 102 patients (77.3%) completed the study; in the AOM 400 group, 92 patients (68.7%) completed the study. The overall incidence of treatment-emergent adverse events (TEAEs) was similar between Ari 2MRTU 960 and AOM 400 (71.2% versus 70.9%, respectively). The most frequently reported TEAEs were increased weight (22.7% for Ari 2MRTU 960 versus 20.9% for AOM 400) and injection site pain (18.2% for Ari 2MRTU 960 versus 9.0% for AOM 400), none of which were assessed as serious or severe by the investigators. All injection site pain events in the Ari 2MRTU 960 group were assessed as mild or moderate in severity; most (15.9%) coincided with the first injection and resolved within 5 days. Extrapyramidal symptom scores remained unchanged in both treatment groups.

Multiple-dose administration of Ari 2MRTU 960 was generally well tolerated in patients with schizophrenia or BP-I and did not show any new safety concerns.

Otsuka Pharmaceutical Development & Commercialization, Inc. (Princeton, NJ, USA) and H. Lundbeck A/S (Valby, Denmark)

In patients with bipolar disorder, depression symptoms are associated with greater reduction in function and quality of life than hypomania/mania symptoms. Lumateperone (LUMA), is an FDA-approved antipsychotic to treat schizophrenia and depressive episodes associated with bipolar I or bipolar II disorder.

In a recent phase 3 clinical trial (Study 404, NCT03249376) in people with bipolar depression, LUMA 42 mg monotherapy significantly improved symptoms of depression compared with placebo (PBO). This analysis of Study 404 investigated the effects of LUMA on functional disability and quality of life as measured using the secondary outcome measure, the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF).

Patients (18–75 years) with bipolar I or bipolar II disorder experiencing a major depressive episode (Montgomery-Åsberg Depression Rating Scale [MADRS] Total score ≥20 and Clinical Global Impression Scale-Bipolar Version-Severity [CGI-BP-S] score ≥4) were randomized to LUMA 42 mg or PBO orally, once daily in the evening for 6 weeks. The primary endpoint was the change from baseline to Day 43 in MADRS Total score, analyzed using a mixed-effects model for repeated measures (MMRM) approach in the intent-to-treat population (ITT). This post hoc analysis evaluated the mean change from baseline to Day 43 in the Q-LES-Q-SF individual item scores using an analysis of covariance with last observation carried forward (ANCOVA-LOCF) in the ITT. Categorical shifts in individual items were also analyzed.

The ITT comprised 376 patients (LUMA 42 mg, 188; PBO, 188). Patients in the LUMA 42 mg group had significantly greater improvement on MADRS Total score change from baseline to Day 43 compared with PBO (least squares mean difference vs PBO [LSMD], −4.585; 95% CI, −6.344 to −2.826; effect size vs PBO [ES], −0.56; P<.0001). LUMA 42 mg treatment significantly improved Q-LES-Q-SF Total score from baseline to Day 43 compared with PBO (LSMD, 2.9; 95% CI, 1.15 to 4.59; P=.001).

The Q-LES-Q-SF items with the lowest mean scores at baseline in both groups were mood, leisure time activities, and sexual drive, interest, and/or performance. By Day 43, LUMA 42 mg treatment significantly improved 8 of the 14 items in the Q-LES-Q-SF (P<0.05). Overall life satisfaction also significantly improved with LUMA treatment (P=.0016). The largest improvements with LUMA 42 mg compared with PBO (ES>0.3,) were seen for the ability to function in daily life, family relationships, household activities, leisure time activities, and mood (all LSMD=0.3; all P<.01).

In patients with bipolar depression, treatment with LUMA 42 mg compared with PBO significantly improved patient quality of life and functional impairment. These results support LUMA 42 mg as treatment of MDEs associated with bipolar I or bipolar II disorder in adults.

Intra-Cellular Therapies, Inc.

Anxiety disorders are a common mental health problem, especially in highly stressful work environments, such as librarians, who need to cope with large amounts of information and the population. Librarians are important players responsible for organizing and managing library resources, and they face many challenges, including handling complex tasks, meeting user needs, and interacting with different individuals. Because of these professional characteristics, librarians may face persistent stress and anxiety.

Librarians who met the study criteria were recruited from different libraries as study participants, and participants were randomized into the experimental group and the control group. The experimental group received behavioral psychology and Morita treatment intervention, while the control group received conventional treatment or waiting treatment. Finally, the effects of behavioral psychology and Morita treatment on anxiety levels were analyzed using the SPSS 23.0 software.

The analysis found that the incidence of anxiety disorders decreased by 45.87% after receiving the behavioral psychology intervention and Morita therapy intervention. 73.23% of the patients showed significant disease improvement. In the control group, only 22.36% of participants with anxiety disorders improved. It was 20.87% lower than the experimental group.

During the treatment, the therapist works with the librarian to develop an individualized treatment plan and provide support and guidance. This integrated treatment approach can help librarians establish healthier mental states and coping mechanisms. Through cognitive reconstruction, exposure exercises, behavioral experiments and other methods, they can gradually face and deal with anxiety triggers and develop more positive and adaptive coping strategies.

Although physical education is considered to be beneficial for attention deficit disorder students in general, the therapeutic role of physical education models based on red sports culture optimization for this group has not been extensively studied. Therefore, it is important to further explore the physical education model optimized by red sports culture for the therapeutic effect of students with attention deficit disorder.

The study first let a proportion of participants receive the physical education model intervention under red sports culture optimization. The intervention includes the following aspects, individualized exercise program selection, individual guidance and coaching, focus training, emotion regulation skills, etc. The intervention can be conducted through classroom teaching, group activities, individual instruction, and other forms. Control participants received the traditional physical education mode, and the data were analyzed using 3D-CAM during the experiment.

The analysis found that the participants had different degrees of improvement in their attentional control, motor coordination and emotional regulation after receiving the physical education model intervention under the red sports culture optimization. Meanwhile, the results showed that 84.3% of attention deficit disorder students improved their social skills.

This study provides guidance and reference for improving and optimizing the physical education model to better meet the needs of students with attention deficit disorder. The findings will provide practical application value to educators, medical professionals and parents to help them better support and promote the development and adaptability of students with attention deficit disorder

The scientific research fund of Inner Mongolia University for nationalities, No. NMDYB20013.

While seen in patients with bipolar disorder due to NMS, antipsychotic side effects, or substance use, rhabdomyolysis resulting from behaviors seen in mania has not been reported in recent literature. We present a case of a patient with rhabdomyolysis due to exertion during a manic episode.

A 29-year-old male with a history of bipolar disorder type 1 was brought to the ED in June 2022 after he was found on the roof of a local theater sharing excerpts from a book he had written. Temperatures outside were 100–102 Fahrenheit. On presentation, the patient had rapid, pressured speech and demonstrated flight of ideas. He was religiously preoccupied. He had been previously admitted to Psychiatric Emergency Services in April 2022 for mania and was discharged with lithium and lamotrigine. He had been titrating these medications with his outpatient psychiatrist.

The patient’s labs showed an elevated creatinine of 1.49, up from his baseline of 1.09. Further workup revealed an elevated CK of 3,538. Additional abnormalities included an AST of 70, calcium of 10.6, total bilirubin of 1.6, and WBC of 15.5. He was afebrile, oriented, and had no obvious signs of infection. The patient received 2 liters of Lactated Ringers (LR) and was admitted to Internal Medicine. Later, he was agitated overnight and received 10mg olanzapine and 2mg lorazepam. Lithium level following fluid resuscitation was 0.6.

On interview the next day, the patient described working on a creative religious piece that he wanted to share with others, leading to him climbing on the roof. He had been hyper-focused on this work, with 1–4 hours of sleep nightly. He also had been frequently doing gymnastics, walking long distances, and climbing other buildings. He endorsed diffuse muscle pain, but this was not reproducible on exam.

150mL/hr of LR was started, and PO fluid intake was encouraged. He agreed to resume his medications and was started on lithium 900mg and lamotrigine 50mg. His CK continued to downtrend. WBC count decreased and was 12.9 at discharge. Lamotrigine was titrated up to home dose of 100mg. His mania improved, and he was ultimately discharged home with outpatient follow-up.

Rhabdomyolysis results from the release of toxic cellular compounds from muscle fibers. Complications include acute renal failure, hyperkalemia, and compartment syndrome. Causes include substance use, medications, trauma, seizures, ischemia, overexertion, and dehydration. Recently reported cases of mania-associated rhabdomyolysis involve iatrogenic causes, such as neuromuscular malignant syndrome (NMS) and non-NMS antipsychotic side effects.Other causes include high-risk drug use during mania. Rhabdomyolysis due to behavioral manifestations of mania have been documented more rarely in older reports, similarly, addressing excessive exercise and dehydration. Therefore, our case represents a reminder of the medical sequalae resulting from actions undertaken during acute mania. This highlights the importance of implementing effective treatment to prevent such episodes.

No Funding

Accurate assessment of disability associated with Parkinson’s Disease Psychosis (PDP) is essential and has been poorly studied. Patients often have poor insight on impact of PDP on daily function. This phase 4 study is the first to evaluate the impact of pimavanserin on activities of daily living (ADL) in PDP patients.

Eligible PDP patients entered a 16-week single-arm, open-label study of oral pimavanserin (34 mg) taken once daily. Primary endpoint (modified Functional Status Questionnaire [mFSQ]) and secondary endpoints (MDS-UPDRS I & II; Schwab and England ADL; CGI-S, CGI-I, and PGI-I) were measured as change from baseline to Week 16 using mixed-effects model for repeated measures (MMRM) and least-squares means (LSM).

29 patients were treated with pimavanserin, of which 24 (82.8%) completed the study. Treated patients demonstrated significant improvements in LSM (SE) mFSQ score change from baseline to Week 12 (11.5 [2.44]) and Week 16 (14.0 [2.50]; both p<0.0001). Significant improvements (p<0.05) were also observed for all secondary outcomes at Week 16 (MDS-UPDRS Part I: -6.3 [0.97]; MDS-UPDRS Part II: -2.6 [0.98]; CGI-S: -1.5 [0.25]; CGI-I: 1.9 [0.17]; PGI-I: 2.0 [0.22], except for Schwab and England ADL. No new safety signals were observed.

Functional outcomes and psychosis measures improved in PDP patients treated with pimavanserin, with safety findings consistent with previous studies. Our findings highlight the positive effect of pimavanserin in improving ADLs in patients with PDP.

Acadia Pharmaceuticals Inc.

Social anxiety disorder is a common mental disorder characterized by concerns about being evaluated, denied, or embarrassed in social situations. In recent years, with the increasing number of college students born in the 2000s, social anxiety disorder has shown an upward trend, which has a negative impact on their mental health and social function.

In order to better help the post-00s college students to deal with social anxiety disorders, the research combines intelligent social mode and cognitive psychology. Intelligent social networking mode uses computer and Internet technology to provide a virtual social environment to simulate real social situations. Cognitive psychology intervention focuses on individual thinking, beliefs and cognitive strategies, and helps to reduce social anxiety by adjusting negative thinking patterns and establishing positive self-evaluation.

According to SPSS23.0 analysis, intelligent social mode can provide students with safe and controllable practice opportunities for those with social anxiety disorder, and reduce fear and discomfort in real social situations. In addition, 68 percent of the participants believed that the cognitive psychology intervention can help them adjust their negative thinking and increase their confidence.

Intelligent social model combined with cognitive psychology intervention method can not only relieve participants’ anxiety in social situations, but also promote their self-growth and mental health development. The results show that this method can help promote the mental health development of “post-00 s” college students, help them better adapt to and integrate into the social environment, and improve their quality of life and happiness.

2021 Guangdong University Ideological and political education project (No. 2021GXSZ040).

The core symptoms of Autism Spectrum Disorder (ASD) are impaired social communication and restricted repetitive behavior. The diagnosis of autism is extremely complex and affects the judgment of differences in autism groups. With the attention paid to female patients with autism, research adopted psychological intervention therapy and combined female images in Japanese literature to attach importance to the diagnostic tools of female autistic population.

Firstly, 80 patients with autism were selected and randomly divided into two groups with 40 cases in each group. The observation group received psychological intervention treatment using female images from Japanese literary works, while the control group only received psychological intervention treatment. Three months later, the two groups were scored on the Autism Rating Scale (ARS) and the Positive and Negative Affect Scale (PANAS). Finally, SPSS23.0 was used for data analysis and t-test.

After 3 months, the positive emotion score on the PANAS scale in the observation group was higher than that in the control group (t=4.412, P<0.001), the negative emotion score (t=-2.552, P<0.05), and Autism Treatment Evaluation Scale (ATCE) score (t=4.183, P<0.001). The degree of reduction in various indicators of the control group is much greater than that in the control group. Indicating the effectiveness and feasibility of its treatment.

More attention should be paid to female patients with autism, and the development and changes of female images in literary works should be analyzed for auxiliary treatment, in order to promote the development of patients’ mental health and improve their quality of life.

Valbenazine is a once-daily VMAT2 inhibitor approved for the treatment of tardive dyskinesia (TD), a persistent and potentially disabling movement disorder associated with prolonged exposure to antipsychotics, antiemetics, and other dopamine receptor blocking agents. The efficacy, safety, and tolerability of valbenazine has been established in several phase 3 trials, including a long-term study (KINECT 4 [NCT02405091]) in which participants received open-label valbenazine (40 or 80 mg) for 48 weeks. Post hoc analyses of KINECT 4 data were conducted to assess patterns of treatment response.

Data from KINECT 4 treatment completers (participants who reached the Week 48 visit and had the longest duration of treatment) were analyzed post hoc. TD was assessed using the Abnormal Involuntary Movement Scale (AIMS) total score (sum of items 1–7, as rated by the study investigator), the Clinical Global Impression of Change-Tardive Dyskinesia (CGI-TD), and the Patient Global Impression of Change (PGIC). Analyses were conducted at Week 8 (first study visit after the valbenazine dose-optimization period) and Week 48 using the following definitions of response: ≥50% and ≥70% improvement from baseline in AIMS total score; rating of “much improved” or “very much improved” (score ≤2) on the CGI-TD and PGIC.

Of the 167 participants who entered KINECT 4, 103 (62%) were treatment completers and included for analysis. Of these 103 participants, 39% and 86% met the ≥50% AIMS response threshold at Weeks 8 and 48, respectively. The percentages of participants who met the highly rigorous AIMS ≥70% response threshold at Weeks 8 and 48 were 17% and 52%, respectively. Of the 40 participants with AIMS ≥50% total score improvement at Week 8, 95% also met this threshold at Week 48 (“sustained response”). Of the 63 participants with <50% AIMS improvement at Week 8, 81% achieved the ≥50% response threshold by end of treatment at Week 48. The proportion of participants meeting the threshold for CGI-TD response also increased over time, from 50% at Week 8 to 92% at Week 48. PGIC results were similar, with response rates of 53% and 88% at Weeks 8 and 48, respectively.

Post hoc analyses of data from a 48-week, open-label study of once-daily valbenazine showed that the proportion of participants meeting rigorous treatment response thresholds increased over time. By the end of treatment at Week 48, >80% of participants demonstrated robust improvements in TD, as assessed using the AIMS (≥50% improvement), CGI-TD (score ≤2), and PGIC (score ≤2).

Neurocrine Biosciences, Inc.

Currently, there are relatively few intervention models for ideological and political education in response to issues such as mood disorders caused by high mental stress among college students. The usual way is through exercise and art therapy. The use of red culture education as an intervention and treatment method can provide an exploratory model for the treatment of psychological disorders among college students.

Firstly, six college students were selected for intervention treatment. The second experiment lasted for 6 weeks, once a week for 90 minutes, and the Chinese version of the Self Rating Anxiety Scale (SAS), Chinese version of the Self Rating Depression Scale (SDS), Hamilton Depression Scale (HAMD), and Hamilton Anxiety Scale (HAM-A) were used to collect data for evaluation before and after intervention. Finally, SPSS23.0 statistical software is used to input data and t-test.

Comparing the significance of the four quantitative testing results before and after intervention, data of SAS (t=1.308, P>0.1), SDS (t=2.529, P<0.05), HAMA (t=11.931, P<0.001), and HAND (t=6.771, P<0.001) were obtained. This indicates that its treatment intervention model is more suitable for the treatment of obstacles in college students.

The Intervention of Red Culture and Ideological Education can help promote college students’ self-awareness and inner emotional organization, effectively alleviate anxiety, depression, and physical health problems. It provides technical guidance for various intervention and treatment plans.

Research result of Jiangxi Province graduate innovation project (No. YC2019_B025); Phased research results of Jiangxi Province Education Science Planning Project 2021 (No. 21YB231).

Delayed access to mental health services (MHS) has become a crisis in the United States. Children have the highest disproportionate rates of delayed psychiatric services in comparison to adults. There are greater demands for mental health professionals than the workforce can supply. Social workers (SW) have been identified as essential stakeholders for children needing access to mental health services. The shortage of social workers is more profound than nurses, especially in rural and underserved areas. Therefore, the Institute of Medicine (IOM) has recommended all educational institutions incorporate telemental health (TMH) training into interprofessional students’ curriculums.

The delays in MHS are directly related to the shortage of mental health professionals especially for nursing but is it is more apparent in social work. The United States Health Resource and Service Administration (HRSA) have projected there is a greater demand for mental health clinicians than the workforce is able to supply. Social workers are essential providers for navigating our nation’s mental health system. They can also train to become licensed mental health therapists. HRSA predicts by 2025 the demand for SWs will be 157,760. However, the estimated supply will be 147,500 resulting in a shortage of approximately 10,260 social workers. Children have the greatest risk for lack of access amongst mental health patients in the U.S. An estimated 13–20 % of children in the United States have a diagnosable mental illness. Twenty-one percent of that amount are children who reside in rural or underserved areas. Strikingly, only 7% of children living in rural or underserved areas will receive a mental health appointment.

The purpose of the George Mason University initiative was to develop a telemental health training model that would be incorporated into social work students’ curriculum and meet the IOMs’ recommendation. The GMU Population Health Center Initiative sought to identify how SW students, trained as TMH providers could be the resolution to the workforce shortage crisis.

This project design was a quality improvement initiative to assess social work students’ perception of the telemental health training. The CTiBS framework was used to determine the level of competency SW students achieved upon completion of the TMH training. The Activity Theory was used as the methodological framework to assess social work students’ readiness of change, engagement, and TMH technology.

After reviewing quantitative data, 70% participants (n=7) declared novice competency. The remaining 30% (n=3) affirmed proficiency (SD= 0.46, V=0.21). Sixty percent (n=6) participants declared they would consider becoming TMH providers. Sixty percent (n=6) of the trainees stated they were satisfied with the training and would consider providing TMH services upon graduation (SD= 0.49, V=0.24). Ninety percent (n=9) of trainees stated they could successfully conduct a TMH visit and would consider working in rural and underserved areas (SD= 0.30, V=0.09). One hundred percent (n=10) of the participants stated the TMH training was a beneficial skill for their profession.

One hundred percent of the participants found TMH training beneficial and ninety percent would use it to conduct visits for children upon graduation. The workforce crisis will not improve unless the IOM recommendations are adapted by educational institutions. A telemental health-prepared labor force will help to reduce the rates of mental health disparities in children.

No Funding

The prevalence of depression is increasing due to the tremendous pressure of life and study. Depression may lead to excessive depression, thinking disorder, cognitive dysfunction, other problems, and extreme behaviors such as suicide. To improve the treatment effect of depression, to study the auxiliary treatment of art appreciation teaching on the psychological influence of patients with depression.

Twenty depressed college students who received art appreciation teaching were selected as the experimental group, and 20 other depressed college students were selected as the control group. The 17-item version of the Hamilton Depression Scale (HAM-D) was used to collect data from the two groups of college students. Five art appreciation courses were taken as a cycle, and five courses were taken as a course of treatment. In each process, the two groups of college students were tested for depression scores until the end of three courses.

The average scores of the experimental and control groups were 20 and 25 after one session and 15 and 23 after three sessions, respectively. The experimental group significantly improved psychological adjustment and emotion management, while the control group had no significant change.

Learning and appreciating artworks can change negative emotions, improve self-awareness and cognition, and cultivate positive emotional experiences. Therefore, colleges and universities should pay attention to and strengthen the teaching of art appreciation and provide effective psychological intervention and aesthetic education help for college students with depression.

Naloxone use has increased in recent years in response to the nation’s opioid crisis. Once only available to health care professionals, it is now obtainable by prescription for persons at risk for substance overdose and their families. Increasing its availability is seen by some as an “over-the-counter solution” to the opioid problem. However, while naloxone has been viewed as relatively safe, with a low side effect profile when appropriately dosed and monitored, it is not without safety concerns that may go unrecognized or misattributed to other causes.

Here we present a case study of a 41-year-old female who presented to our medication-assisted treatment (MAT) clinic complaining of sudden onset weight gain, shortness of breath, upper and lower extremity peripheral edema, tachycardia, insomnia, and nocturnal enuresis. These symptoms made it difficult for her to work at her housekeeping job, resulting in missed workdays. She had seen a primary care provider for her symptoms and been prescribed a rescue inhaler for her shortness of breath. This patient had previously been treated for opioid use disorder with buprenorphine/naloxone and experienced similar symptoms, which disappeared when she relapsed on opioids. However, symptoms reappeared upon resuming her prescribed treatment.

The patient was identified as experiencing side effects to naloxone, causing noncardiogenic edema. Her MAT medication was switched to buprenorphine. Within two weeks her heart rate had returned to normal, she had lost weight, and she no longer had nocturnal enuresis or needed the rescue inhaler. Her peripheral edema resolved so she was able to walk better and resume work. At the same time, buprenorphine continued to relieve her cravings.

There is a dearth of information related to naloxone-induced edema. Our patient had not received a formal evaluation of pulmonary edema, but her pulmonary and cardiac symptoms were consistent with that diagnosis. Although pulmonary edema is mentioned in the product literature, peripheral edema is not. A literature search indicates that the number of case studies on naloxone-induced pulmonary edema have increased since 2018, but only one other case of naloxone-induced peripheral edema was discovered.

Naloxone is used in a variety of settings by differing types of health care providers. As the number of persons treated with naloxone increases, there will likely be a corresponding increase in incidences of pulmonary and/or peripheral edema as side effects. Providers and patients who are not aware of these manifestations and their relationship to naloxone treatment may easily attribute presenting symptoms to cardiogenic or other causes, as this case illustrates. It is important for providers in all settings to consider new onset shortness of breath and edema within the context of the person’s whole health and to be aware of their implications for mental as well as physical health.

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