The endogenous opioid system affects metabolism, including weight regulation. Evidence from preclinical and clinical studies provides a rationale for targeting this system to mitigate weight-related side effects of antipsychotics. This review describes the role of the opioid system in regulating weight and metabolism, examines the effects of opioid receptor antagonism on those functions, and explores the use of opioid antagonists to mitigate antipsychotic-associated weight gain and/or metabolic effects.

A PubMed literature search was conducted to identify representative opioid antagonists and associated preclinical and clinical studies examining their potential for the regulation of weight and metabolism.

The mu opioid receptor (MOR), delta opioid receptor (DOR), and kappa opioid receptor (KOR) types have overlapping but distinct patterns of central and peripheral expression, and each contributes to the regulation of body weight and metabolism. Three representative opioid antagonists (eg, naltrexone, samidorphan, and LY255582) were identified for illustration. These opioid antagonists differed in their receptor binding and pharmacokinetic profiles, including oral bioavailability, systemic clearance, and half-life, and were associated with varying effects on food intake, energy utilization, and metabolic dysregulation.

Preclinical and clinical data suggest that antagonism of the endogenous opioid system is a mechanism to address antipsychotic-associated weight gain and metabolic dysregulation. However, evidence suggests that the differing roles of MOR, DOR, and KOR in metabolism, together with the differences in receptor binding, pharmacokinetic, and functional activity profiles of the opioid receptor antagonists discussed in this review, likely contribute to their differential pharmacodynamic effects and clinical outcomes observed regarding antipsychotic-associated weight gain.

Panic disorder (PD) is a prevalent and impairing anxiety disorder with previous reports suggesting that the longer the condition remains untreated, the greater the likelihood of nonresponse. However, patients with PD may wait for years before receiving a guideline-recommended pharmacological treatment. The widespread prescription of benzodiazepines (BDZ) for managing anxiety symptoms and disorders might delay the administration of pharmacotherapy according to guidelines (eg, selective serotonin reuptake inhibitors, SSRIs). The present study aimed to determine the mean duration of untreated illness (DUI) in a sample of PD patients, to quantify and compare DUI-SSRI to DUI-BDZ, and to compare findings with those from previous investigations.

Three hundred and fourteen patients with a Diagnostic and Statistical Manual of Mental Disorders, fifth edition diagnosis of PD were recruited from an Italian outpatient psychotherapy unit, and epidemiological and clinical variables were retrieved from medical records. Descriptive statistical analyses were undertaken for sociodemographic and clinical variables, Wilcoxon matched-pair signed rank test was applied to compare the distribution of DUI-SSRI vs DUI-BDZ, and Welch’s t test was performed to compare findings with those from previous studies.

The mean DUI-SSRI of the total sample was 64.25 ± 112.74 months, while the mean DUI-BDZ was significantly shorter (35.09 ± 78.62 months; P < 0.0001). A significantly longer DUI-SSRI, compared to findings from previous studies, was also observed.

The present results confirm a substantial delay in implementing adequate pharmacological treatments in patients with PD, and highlight the discrepancy between recommendations from international treatment guidelines and common clinical practice in relation to BDZ prescription.

The aim of this study is to identify differentially methylated regions (DMRs) in the genomes of a sample of cognitively healthy individuals and a sample of individuals with LOAD, all of them nonagenarians from Costa Rica.

In this study, we compared whole blood DNA methylation profiles of 32 individuals: 21 cognitively healthy and 11 with LOAD, using the Infinium MethylationEPIC BeadChip. First, we calculated the epigenetic age of the participants based on Horvath’s epigenetic clock. DMRcate and Bumphunter were used to identify DMRs. After in silico and knowledge-based filtering of the DMRs, we performed a methylation quantitative loci (mQTL) analysis (rs708727 and rs960603).

On average, the epigenetic age was 73 years in both groups, which represents a difference of over 20 years between epigenetic and chronological age in both affected and unaffected individuals. Methylation analysis revealed 11 DMRs between groups, which contain six genes and two pseudogenes. These genes are involved in cell cycle regulation, embryogenesis, synthesis of ceramides, and migration of interneurons to the cerebral cortex. One of the six genes is PM20D1, for which altered expression has been reported in LOAD. After genotyping previously reported mQTL SNPs for the gene, we found that average methylation in the PM20D1 DMR differs between genotypes for rs708727, but not for rs960603.

This work supports the possible role of PM20D1 in protection against AD, by showing differential methylation in blood of affected and unaffected nonagenarians. Our results also support the influence of genetic factors on PM20D1 methylation levels.

Bipolar disorder refers to a type of mood disorder that includes both manic or mild manic episodes and depressive episodes in clinical practice. Compared with a single disease, comorbidities typically have characteristics such as severe symptoms, long course of disease, severe social function impairment, high risk of suicide, and poor prognosis. Minors are prone to engage in criminal behavior under the influence of bipolar disorder. This study will use group psychological counseling combined with criminal law protection education to intervene and treat underage patients.

80 underage bipolar disorder patients were selected and divided into two groups according to a random number table method: the control group received group psychological counseling for intervention, while the research group received group psychological counseling combined with communication training and nursing. The improvement of the condition, self-care ability, depression, mania, quality of life, medication compliance, and social adaptability scores of the two groups of patients were compared.

The results showed that before the intervention, there was no statistically significant difference in the improvement of the condition, self-care ability, depression, mania, quality of life, medication compliance, and social adaptation scores between the two groups. After 12 weeks of intervention, the improvement score of the study group’s condition and self-care ability score were higher than that of the control group.

The combination of group psychological counseling and criminal law protection education can enhance the treatment effect of underage bipolar disorder patients, improve their quality of life, alleviate negative emotions, and achieve better nursing outcomes.

To examine socioeconomic disparities in use of electroconvulsive therapy (ECT) among homeless or unstably housed (HUH) veterans with mental illness.

National data from medical records in years 2000 to 2019 on 4 to 6 million veterans with mental illness, including 140 000 to 370 000 homeless veterans served annually from the U.S. Department of Veterans Affairs (VA) healthcare system, were analyzed to examine ECT utilization and changes in utilization over time.

ECT utilization was higher among HUH veterans (58–104 per 1000) than domiciled veterans with mental illness (9–15 per 1000) across years with a trend toward increasing use of ECT use among HUH veterans over time. Among HUH and domiciled veterans who received ECT, veterans received an average of 5 to 9 sessions of ECT. There were great regional differences in rates of ECT utilization among HUH and domiciled veterans with the highest overall rates of ECT use at VA facilities in the Northeast and Northwest regions of the country.

ECT is commonly and safely used in HUH veterans in a comprehensive healthcare system, but geographic and local factors may impede access to ECT for veterans who may benefit from this treatment. Efforts should be made to reduce barriers to ECT in the HUH population.

The elevated prevalence of metabolic syndrome (MetS) in patients with depression has been associated with increased mortality. This post hoc analysis assessed the effect of treatment with lurasidone on risk of MetS in patients with bipolar depression.

Data used in the current analyses consisted of 3 double-blind (DB), placebo-controlled, 6-week studies in adults with bipolar I depression (N = 1192), consisting of 1 monotherapy, and 2 adjunctive trials (lithium or valproate). Also analyzed was a 6-month open-label (OL) extension study (monotherapy, N = 316; adjunctive therapy, N = 497); and a 5-month, OL, stabilization phase followed by randomization to a 28-week DB, placebo-controlled, adjunctive therapy study with lurasidone (N = 490). MetS was defined based on NCEP ATP III criteria (2005 revision).

The proportion of patients with new-onset MetS was similar for lurasidone vs placebo in the short-term studies (monotherapy, 13.9% vs 15.3%; adjunctive therapy, 13.6% vs 11.0%); and remained stable during both the 6-month extension phase study (monotherapy, 15.2%; adjunctive therapy, 16.9%), and the 5-month stabilization study (adjunctive therapy, 12.2%). After 28 weeks of DB treatment (following 5-month treatment in the stabilization study), new onset MetS was observed at endpoint (OC) in 26.2% of the lurasidone group, and 30.8% of the placebo group.

This post hoc analysis found that both short and long-term treatment with lurasidone was associated with a relatively low risk for the development of MetS in patients with bipolar I disorder. These findings are consistent with similar analyses in patients with schizophrenia.

The primary aim was to test the hypothesis that physical interpersonal violence is decreased during the lockdown period in comparison with comparable control periods. The secondary aims were to explore the effects of gender and alcohol consumption on the violence during the lockdown.

Nationwide records of hospitalizations secondary to an assault were analyzed using quasipoisson regression. Assault rates in two lockdown periods, defined as a national emergency state, were compared to baseline data between 2017 and 2020, controlling for seasonal fluctuations and pandemic-related effects other than lockdown. To validate the findings on independent data, differences between lockdown and baseline in Police records of violent criminality between 2017 and 2021 were examined using one-way ANOVA.

The rates of hospitalizations secondary to an assault decreased substantially during lockdowns (IRR = .43; P < .001) and the duration of lockdown did not affect assault rates (P = .07). The decrease in assault rates was more pronounced in males than females (IRR = .77; P < .05) and was weakened in patients with history of alcohol abuse (IRR = 1.83; P < .001). Violent crime rate decreased by 19% during the lockdowns compared to prepandemic baseline (P < .001).

We found that physical interpersonal violence decreased during the COVID-19 lockdown periods. The reduction is significantly greater in males. Emerging evidence suggests an increased risk of alcohol use and intoxication during the lockdowns. Violent crime rate decreased during the lockdown.

Despite frequent benzodiazepine use in anxiety disorders, the trajectory and magnitude of benzodiazepine response and the effects of benzodiazepine potency, lipophilicity, and dose on improvement are unknown.

We performed a meta-analysis using weekly symptom severity data from randomized, parallel group, placebo-controlled trials of benzodiazepines in adults with anxiety disorders. Response was modeled for the standardized change in continuous measures of anxiety using a Bayesian hierarchical model. Change in anxiety was evaluated as a function of medication, disorder, time, potency, lipophilicity, and standardized dose and compared among benzodiazepines.

Data from 65 trials (73 arms, 7 medications, 7110 patients) were included. In the logarithmic model of response, treatment effects emerged within 1 week of beginning treatment (standardized benzodiazepine-placebo difference = −0.235 ± 0.024, CrI: −0.283 to −0.186, P < .001) and placebo response plateaued at week 4. Doses <6 mg per day (lorazepam equivalents) produced faster and larger improvement than higher doses (P = .039 for low vs medium dose and P = .005 for high vs medium dose) and less lipophilic benzodiazepines (beta = 0.028 ± 0.013, P = .030) produced a greater response over time. Relative to the reference benzodiazepine (lorazepam), clonazepam (beta = −0.217 ± 0.95, P = .021) had a greater trajectory/magnitude of response (other specific benzodiazepines did not statistically differ from lorazepam).

In adults with anxiety disorders, benzodiazepine-related improvement emerges early, and the trajectory and magnitude of improvement is related to dose and lipophilicity. Lower doses and less lipophilic benzodiazepines produce greater improvement.

In the present study, we aimed to perform a systematic review evaluating the cognitive performance of patients with hoarding disorder (HD) compared with controls. We hypothesized that HD patients would present greater cognitive impairment than controls.

A systematic search of the literature using the electronic databases MEDLINE, SCOPUS, and LILACS was conducted on May 2020, with no date limit. The search terms were “hoarding disorder,” “cognition,” “neuropsychology,” “cognitive impairment,” and “cognitive deficit.” We included original studies assessing cognitive functioning in patients with HD.

We retrieved 197 studies initially. Of those, 22 studies were included in the present study. We evaluated 1757 patients who were 41 to 72 years old. All selected studies comprised case–control studies and presented fair quality. Contrary to our hypothesis, HD patients showed impairment only in categorization skills in comparison with controls, particularly at confidence to complete categorization tasks. Regarding attention, episodic memory, working memory, information-processing speed, planning, decision-making, inhibitory control, mental flexibility, language, and visuospatial ability, HD patients did not show impairment when compared with controls. There is a paucity of studies on social cognition in HD patients, although they may show deficits. The impact of emotion in cognition is also understudied in HD patients.

Except for categorization skills, the cognitive performance in HD patients does not seem to be impaired when compared with that in controls. Further work is needed to explore social cognition and the impact of emotion in cognitive performance in HD patients.

With the growth of age, various functions of the human body enter the aging stage. During this period, immunity and physique decline rapidly, making the elderly prone to various mental problems. The mental problems of the elderly mainly include schizophrenia, manic depression, etc. These mental problems may become worse after a period of time, leading to dementia, which seriously endangers the physical and mental health of the elderly. At the same time, the mental problems of the elderly will also lead to the difficulty in taking care of themselves, and they cannot independently complete simple life skills such as eating and dressing. In this case, some elderly people may also have such behaviors as excluding contact with others and not cooperating with medical personnel in treatment and nursing, which in turn makes it difficult to alleviate mental problems. Therefore, the corresponding nursing measures should be implemented from both psychological and physiological aspects to explore the effect of relieving the mental problems of the elderly.

100 elderly patients with mental problems admitted in our hospital from January 2021 to January 2022 were selected as the research objects, and they were randomly divided into the observation group and the control group, with 50 cases in each group. The experiment was conducted with the consent of patients or their families to ensure the smooth development of the study. The elderly patients in the control group were given routine nursing care, while the patients in the observation group were given targeted psychological counseling on the basis of routine nursing care, including encouraging patients to actively express their emotions and actively communicating with patients. After four weeks, the relief effect of the elderly care system integrating physiology and psychology was illustrated by statistics of the self-management ability of the two groups of elderly patients.

The self-management ability of the elderly in the two groups after four weeks is shown in Table 1. The results showed that the self-management abilities of the elderly patients with mental disorders in the observation group, such as self-living ability and psychological state expression, were stronger than those in the control group after the integration of physiological and psychological elderly care measures, i.e., the elderly under conventional care, with a statistically significant difference (P < 0.05).

The mental problems of the elderly have become an important factor hindering the improvement of their quality of life. The study integrated physiological and psychological nursing measures when treating the elderly with mental disorders. The results show that it not only improves the physical quality of the elderly physically, ensures the normal life of the elderly, but also relieves the mental problems of the elderly psychologically, and thus has good clinical promotion value.Table 1.

Self-management ability of the elderly in the two groups after four weeks

Evaluation project	Control group		Observation group		$ {x}^2 $	P
	Quantity	Percentage (%)	Quantity	Percentage (%)
Active reporting of physical discomfort	38	76	48	96	16.611	0.000
Expression of psychological state	30	60	47	90	24.000	0.000
Self-life ability training	34	68	45	90	14.587	0.001
Description of excretion	32	64	47	94	27.125	0.000
Experience of side effects of drugs	31	62	44	88	18.027	0.000
Knowledge of fall prevention	32	64	48	96	32.000	0.000

Bipolar affective disorder, as a common mental issue, is characterized by emotional abnormality and manic and depressive states. Traditional medicine has a long course of disease and generates slow poor therapeutic effects. The asynchronous teaching method takes the students’ self-consciousness as an observation perspective. It focuses on the intervention of students’ psychological conditions in a teaching situation of equality and mutual assistance. To explore the effect of asynchronous teaching method on students with bipolar disorder to help improve their mental health.

The research took the students with bipolar affective disorder as the experiment object. The control group applied basic nursing, medication guidance and other conventional nursing approach, while the experimental group was treated with asynchronous teaching method intervention on the basis of the control group, that is, the teacher used a six-stage teaching process to guide students’ personalized development and improvement of their self-consciousness, and timely guided students to pay attention to and examine their own psychological conditions. The intervention time was 3 months. The aggressive behavior and psychological status of the students were evaluated with the Modified Overt Aggression Scale (MOAS) and the Self-reporting Inventory (SCL-90). SPSS22.0 statistical software was used for classification analysis. Measurement data was expressed as (x ± s), and P<0.05 was defined as statistically significant.

After receiving nursing care, the students in the two groups all received improvement in their symptoms to varying degrees. The MOAS scores of the students in the experimental group after one month and three months of nursing care were (5.34 ± 0.83) and (0.31 ± 0.91), which were significantly better than those of the control group (5.42 ± 0.92) and the control group (2.08 ± 0.32), with statistical significance (P<0.05). After intervention, the SCL-90 scores of the two groups were significantly different (P<0.05).

Asynchronous teaching method intervenes students with bipolar affective disorder in a more equal way so that they can correctly and objectively view their own symptoms. The method proposed in this research has a better intervention effect on students’ psychological assessment and mental health status.

Binge eating disorder (BED) is the most common eating disorder, and is associated with significant comorbidity, with university students being particularly vulnerable. We aimed to assess associations of BED with a wide range of comorbidities and measures of impulsivity and compulsivity in university students, to gain better understanding of its prevalence, correlates and pathophysiology.

We carried out an internet-based survey, assessing presence of BED using a validated structured self-report diagnostic tool, demographics, substance use, impulsive behaviors, psychiatric history, and measures of impulsivity and compulsivity. Approximately 10 000 students were invited to take part. Group differences between students with current BED and students without BED were investigated.

A total of 3415 students completed the survey, with 83 (2.4%) screening positive for BED. BED was associated with female gender, hazardous/harmful alcohol use, depression and anxiety symptoms, low self-esteem, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, treatment for psychological/emotional problems (including prescribed medication) and trait impulsivity and compulsivity. However, the largest effect sizes were evident for associations with trait impulsivity and compulsivity.

The associations of BED with trait impulsivity and compulsivity implicate these latent phenotypes in its pathophysiology. The identified links between BED and a wide range of mental disorders highlight the need to screen for disordered eating in student populations, including when students present with other mental health conditions.

Student anxiety disorder is very common today. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), it includes phobia, panic disorder, obsessive compulsive disorder, generalized anxiety disorder and post-traumatic stress disorder. The emergence of collective psychotherapy in ideological education aims to use the auxiliary role of collective combination of ideological education to appease students’ anxiety, but it has not achieved good results. Aromatic plant essential oil combines aromatherapy, which can promote people’s physical and mental health through inhalation or massage. Therefore, the research will integrate aromatic plant essential oil into ideological education group therapy for clinical treatment.

In this experiment, a total of 50 patients were observed, half of them were male and half female. All 50 patients reached the standard of anxiety disorder. Anxiety disorder as a mental disease α Brain waves will change. When people are in anxiety, α Brain waves will decrease or even disappear, so the study used the ND-97 digital EEG to test the left and right occipital α Brain wave changes. The experiment was conducted twice, with an interval of 7 days between the two experiments. For α Brain wave changes, the results are shown in Figure 1.

The brain wave intensities of different subjects were different, while the brain wave intensities of left occipital region and right occipital region were basically consistent. But before and after smelling, the changes of brain wave are also different. In the first experiment, left and right occipital regions of 50 patients α 34 cases (68%) had enhanced brain wave; α Brain wave instability occurred in 5 cases, accounting for 10%; α the brain wave was weakened in 11 cases, accounting for 22%. After the second experiment α Brain waves were enhanced in 39 cases (78%); α Brain wave instability occurred in 7 cases, accounting for 14%; α Brain wave was weakened in 4 cases, accounting for 8%. In general, α the more patients with brain wave enhancement, it shows that the ideological education collective psychotherapy combined with aromatic plant essential oil has greatly alleviated the tension and anxiety disorders of patients, and has a certain effect.

Anxiety disorder is quite common among today’s student groups, and the traditional collective therapy of ideological education is limited for various reasons, therefore, its role in alleviating students’ anxiety disorder is not obvious. As a natural therapy, aromatherapy with aromatic plant essential oil can play a very effective role in relieving students’ anxiety disorder, and has a high acceptance rate for students.Figure 1.

Before and after the two experiments α Brain wave changes

Problems with cognitive flexibility have been associated with multiple psychiatric disorders, but there has been little understanding of how cognitive flexibility compares across these disorders. This study examined problems of cognitive flexibility in young adults across a range of psychiatric disorders using a validated computerized trans-diagnostic flexibility paradigm. We hypothesized that obsessive-compulsive spectrum disorders (eg, obsessive-compulsive disorder, trichotillomania, and skin-picking disorder) would be associated with pronounced flexibility problems as they are most often associated with irrational or purposeless repetitive behaviors.

A total of 576 nontreatment seeking participants (aged 18-29 years) were enrolled from general community settings, provided demographic information, and underwent structured clinical assessments. Each participant undertook the intra-extra-dimensional task, a validated computerized test measuring set-shifting ability. The specific measures of interest were total errors on the task and performance on the extra-dimensional (ED) shift, which reflects the ability to inhibit and shift attention away from one stimulus dimension to another.

Participants with depression and PTSD had elevated total errors on the task with moderate effect sizes; and those with the following had deficits of small effect size: generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), antisocial personality disorder, and binge-eating disorder. For ED errors, participants with PTSD, GAD, and binge-eating disorder exhibited deficits with medium effect sizes; those with the following had small effect size deficits: depression, social anxiety disorder, OCD, substance dependence, antisocial personality disorder, and gambling disorder.

These data indicate cognitive flexibility deficits occur across a range of mental disorders. Future work should explore whether these deficits can be ameliorated with novel treatment interventions.

Obsessive–compulsive disorder (OCD) is a chronic psychiatric disorder that results in significant disability and substantial compromise in the quality of life. Until now, the role of repetitive transcranial magnetic stimulation (rTMS) has been primarily explored in individuals with treatment-resistant OCD. In this study, we investigated the safety and efficacy of rTMS as an early augmentation strategy in drug-free patients with OCD.

This is a randomized double-blind, placebo-controlled study that involved the administration of a total of 20 sessions of rTMS (active/sham) to drug-naïve OCD patients using a standard protocol (1-Hz; 20 trains [80 pulses/train]; 1600 pulses per session at 100% resting motor threshold) at supplementary motor area. All patients (active and sham) were started on escitalopram 10 mg/d, which was subsequently increased to 20 mg/d after 10 days.

Out of the 24 patients, 13 received active and 11 received sham rTMS. At the end of rTMS therapy, there was a substantial reduction (P = .001) in total Yale-Brown Obsessive–Compulsive Scale, obsessions (P = .030) and compulsions (P = .001) between the groups. Only few patients (N = 8) reported mild side effect with rTMS, local pain, and headache being the commonest. The study revealed large effect size (Cohen’s d = 1.6) of rTMS as an early augmentation strategy in drug-free patients of OCD.

rTMS is a safe and effective early augmentation strategy in the management of OCD. Larger randomized controlled trials are required to establish the therapeutic role of rTMS as early augmentation in OCD.

The psychological pressure on college students is increasing day by day, and many universities have integrated ideological and political courses into their student management.

The study selected college students from a university as research subjects and divided them equally into a control group and a research group. The former was subjected to routine student management, and the latter was given ideological and political treatment based on routine management. The anxiety scale was used for comparative analysis, and SPSS22.0 was used for statistical analysis.

After a 4-month experiment, the score of the anxiety scale for college students in the control group changed from 62 points to 58 points. The score for the research group changed from 64 points to 45 points. In the research group, there was a significant difference in psychological stress among college students before and after the experiment (P<0.05). The experimental results indicate that integrating ideological and political education into the management of college students has a significant alleviating effect on the psychological pressure of college students.

The study of integrating ideological and political education into college student management has a positive impact on alleviating their psychological pressure. It also provides a reference for the student management of other university departments, promoting the innovation on student management work.

Dongying science development fund project (No. DJ2021029).

A blunted response of the hypothalamic-pituitary-adrenal axis immediately after exposure to traumatic events has been proposed as a risk factor for posttraumatic stress disorder (PTSD). Accordingly, administration of hydrocortisone in the aftermath of a traumatic event is indicated. This study consisted of a randomized, placebo-controlled, double-blind trial investigating whether a single intravenous dose of hydrocortisone administered within 6 hours after exposure to trauma would reduce the incidence of PTSD at the 13-month follow-up.

A total of 118 consented patients with acute stress symptoms were administered a single intravenous bolus of hydrocortisone/placebo within 6 hours of the traumatic event. Blood samples were taken before hydrocortisone administration.

At 13 months, the hydrocortisone group did not differ from the placebo group regarding PTSD prevalence or symptom severity. However, a significant interaction between time of the trauma (ie, night, when cortisol’s level is low) and treatment was found. Specifically, a lower prevalence of PTSD was found at the 13-month follow-up in the hydrocortisone night group.

Administration of hydrocortisone within 6 hours of the traumatic event was not effective in preventing PTSD compared to placebo. However, nocturnal administration (when cortisol levels are low) may suggest a new venue for research.