Journal of Neuropsychiatry and Clinical Neurosciences最新文献

{"title":"Cutoff Points for Commonly Used Instruments to Assess Mental Health Problems Among Adults With Tourette's Syndrome.","authors":"Rachael Nicholls, Tamara Pringsheim, Davide Martino, Chenhui Hao, Julian Fletcher, Natalia Szejko","doi":"10.1176/appi.neuropsych.20240226","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20240226","url":null,"abstract":"<p><strong>Objective: </strong>Attention-deficit hyperactivity disorder, obsessive-compulsive disorder, depression, and anxiety are highly comorbid in Tourette's syndrome. Cutoff points of screening instruments for these conditions have been validated in the general population. The authors assessed whether established cutoff points on the General Anxiety Disorder-7 (GAD-7) scale; Patient Health Questionnaire-9 (PHQ-9); PHQ-2; Adult ADHD Self-Report Scale, version 1.1 (ASRS v1.1); and Obsessive-Compulsive Inventory (OCI) need to be adjusted for adults with Tourette's syndrome.</p><p><strong>Methods: </strong>Thirty-six adults with Tourette's syndrome completed these instruments and a diagnostic psychiatric interview. Measures of diagnostic accuracy were calculated (area under the receiver operating characteristic curve [AUC], sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio) for each instrument at various cutoffs. Cutoffs for the sample of adults with Tourette's syndrome were suggested by the lowest value derived from a Euclidean distance method.</p><p><strong>Results: </strong>In this sample of adults with Tourette's syndrome, the optimal cutoff points were a GAD-7 score ≥13 (sensitivity, 67%; specificity, 91%; and AUC, 79%), a PHQ-9 score ≥15 (sensitivity, 67%; specificity, 73%; and AUC, 70%), a PHQ-2 score ≥3 (sensitivity, 67%; specificity, 67%; and AUC, 67%), an ASRS v1.1 score ≥14 (sensitivity, 83%; specificity, 77%; and AUC, 80%), and an OCI score ≥63 (sensitivity, 70%; specificity, 89%; and AUC, 79%). The best-performing instrument was the ASRS v1.1, followed by the GAD-7 and OCI; the PHQ-9 and PHQ-2 performed least well in this population.</p><p><strong>Conclusions: </strong>Further research is needed to adapt screening instruments for the assessment of comorbid conditions among patients with Tourette's syndrome.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20240226"},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninvasive Brain Stimulation for Neurodevelopmental Disorders: A Systematic Review.","authors":"Sergi López-Rodríguez, David R A Coelho, Christian Renet, Willians Fernando Vieira, Ümit Tural, Paolo Cassano, Joan A Camprodon","doi":"10.1176/appi.neuropsych.20240127","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20240127","url":null,"abstract":"<p><p>Neurodevelopmental disorders (NDDs) affect brain development, leading to diverse cognitive, social, behavioral, and affective impairments. Noninvasive brain stimulation (NIBS) techniques, such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and transcranial photobiomodulation (tPBM), have been investigated as potential treatments for NDDs. The authors of this systematic review evaluated the literature on NIBS in NDDs, including double-blind, sham-controlled, randomized controlled trials. Following PRISMA guidelines and a registered protocol, the authors conducted a comprehensive search in PubMed, Embase, Cochrane Central Register of Controlled Trials, PsycInfo, and Scopus, identifying 23 studies. TMS showed promise for addressing hyperactivity, inattention, and working memory deficits in attention-deficit hyperactivity disorder (ADHD), with outcomes influenced by coil type (H5 vs. H6) and stimulation site (right vs. left dorsolateral prefrontal cortex). tDCS showed potential for improving inattention and executive function in ADHD, with limited effects observed on reducing symptom severity in autism spectrum disorder (ASD) and dyslexia. tPBM offered specific therapeutic benefits in reducing irritability in ASD. Although NIBS generally showed mild, transient adverse effects, isolated seizure events, such as one during TMS in ADHD, highlight the importance of rigorous safety protocols, especially in NDDs with elevated epilepsy risk. This review identified potential benefits of certain NIBS protocols in NDDs; however, high variability in methodologies, sample size limitations, and bias concerns underscore the need for further research to clarify the therapeutic efficacy and safety of NIBS among patients with NDDs.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20240127"},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicidal Ideation in Spinocerebellar Ataxia.","authors":"Levi Peppel, Ruo-Yah Lai, Christian Rummey, Puneet Opal, Jeremy D Schmahmann, Christopher M Gomez, Henry Paulson, Theresa A Zesiewicz, Susan Perlman, George Wilmot, Sarah H Ying, Chiadi U Onyike, Khalaf O Bushara, Michael D Geschwind, Karla P Figueroa, Stefan M Pulst, Sub H Subramony, Antoine Duquette, Tetsuo Ashizawa, Ali G Hamedani, Marie Y Davis, Sharan R Srinivasan, Matthew R Burns, Nadia Amokrane, Lauren R Moore, Vikram G Shakkottai, Liana S Rosenthal, Sheng-Han Kuo, Chi-Ying R Lin","doi":"10.1176/appi.neuropsych.20250006","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20250006","url":null,"abstract":"<p><strong>Objective: </strong>Suicidal ideation has not been extensively studied in spinocerebellar ataxias (SCAs). The authors examined whether individuals with SCAs have increased suicidal ideation and related factors.</p><p><strong>Methods: </strong>The authors studied patients with genetically confirmed SCAs enrolled in the Clinical Research Consortium for the Study of Cerebellar Ataxia cohort, examining the percentages of patients with SCA subtypes 1, 2, 3, and 6 who reported suicidal ideation and comparing findings with nationally representative data from the National Survey on Drug Use and Health (NSDUH). Clinical characteristics that may contribute to suicidal ideation in SCAs, including age, disease duration, sex, ataxia severity, depression, and SCA subtype, were also studied.</p><p><strong>Results: </strong>Suicidal ideation was present among 12% of 769 patients with SCAs and 4.3% of individuals in the general population recorded in the NSDUH. Compared with individuals in the general population, SCA patients had higher odds of suicidal ideation (OR=2.72). Compared with patients with SCA without suicidal ideation, patients with SCA and suicidal ideation had a longer disease duration (mean±SD=13.1±8.2 years vs. 11.2±9.4 years), more severe ataxia (Scale for the Assessment and Rating of Ataxia mean score=15.9±8.6 vs. 12.9±7.6), and more severe depression. Having suicidal ideation at baseline significantly increased the odds of suicidality later in the disease course (OR=58.73, 95% CI=36.00-98.40).</p><p><strong>Conclusions: </strong>Suicidal ideation was more prevalent among patients with SCAs than in the general population. The findings of this study underscore the importance of continuous suicidal risk screening among individuals with SCAs and the need for effective depression management.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20250006"},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiamyloid Monoclonal Antibodies in Alzheimer's Disease, Part 1: Patient Selection.","authors":"James R Bateman, Tara C Carlisle, Yanghong Yang, Christian Lachner, Melissa D Stockbridge, Laura A Flashman, Zeina Chemali, Nasir Alzbeidi, Peter S Pressman, Anne-Marie Osibajo, Bradford D Bobrin, Carlos J Martinez-Menendez, Antonio L Teixeira, Kirk R Daffner","doi":"10.1176/appi.neuropsych.20240191","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20240191","url":null,"abstract":"<p><p>The availability of monoclonal antibodies directed against amyloid beta, for use as disease-modifying therapies for Alzheimer's disease (AD), represented a major shift in the field of AD research and treatment. U.S. Food and Drug Administration approvals for the monoclonal antibody-based medications lecanemab and, more recently, donanemab provide clinicians with two antiamyloid therapy (AAT) options for targeting early symptomatic AD. The emergence of AAT has made careful biomarker-informed diagnosis of AD paramount, which was once reserved for highly specialized centers and research settings. Patient selection is complex, and although appropriate-use recommendations have been published, clinicians caring for patients with AD across the United States face uncertainty when trying to align clinical trial criteria, appropriate-use recommendations, and real-world patients in the clinic. Practical issues in patient selection as well as health care and systemic challenges in the implementation of AAT are considered in part 1 and part 2, respectively, of this two-part Treatment in Behavioral Neurology & Neuropsychiatry commentary on these therapies from the American Neuropsychiatric Association Dementia Special Interest Group.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20240191"},"PeriodicalIF":2.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Features of Misdiagnosis of Primary Psychiatric Disorders Among bvFTD Patients.","authors":"Elvis-Raymond Mukwikwi, Sherri Lee Jones, Ana L Manera, Rebecca Salpeter, Giorgio Giulio Fumagalli, Dhamidhu Eratne, Matthew J Y Kang, Maxime Bertoux, Mira Didic, Kasper Katisko, Eino Solje, Alexander F Santillo, Robert Jr Laforce, Matthias L Schroeter, Jan Van den Stock, Mathieu Vandenbulcke, Alexandre Morin, Sterre de Boer, Yolande Pijnenburg, Simon Ducharme","doi":"10.1176/appi.neuropsych.20240238","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20240238","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies have reported misdiagnosis rates of nondegenerative primary psychiatric disorders of up to 50% among patients with behavioral variant frontotemporal dementia (bvFTD). The authors hypothesized that misdiagnosis rates have decreased over time because of an increased awareness and a better understanding of psychiatric prodromes of FTD.</p><p><strong>Methods: </strong>Retrospective data on past psychiatric trajectories of individuals with probable or definite bvFTD (N=609) were acquired from 12 sites of the Neuropsychiatric International Consortium on FTD. Symptom profiles, primary psychiatric disorder diagnoses, and treatment information were collected from medical records. The authors used descriptive statistics to characterize past diagnostic trajectories, chi-square and t tests to compare groups, and logistic regressions to determine risk factors for diagnostic errors.</p><p><strong>Results: </strong>Of 609 bvFTD patients, 33% received a primary psychiatric disorder diagnosis after the onset of bvFTD symptoms but before a formal bvFTD diagnosis. In 13% (N=80) of all bvFTD cases, the diagnosis was retrospectively considered erroneous. The most common misdiagnosis was major depressive disorder, followed by anxiety disorders and psychosis. The remaining cases were classified as psychiatric prodromes (N=68) and comorbid conditions (N=42). Patients with misdiagnoses were significantly younger, by about 5.5 years, than those without such diagnoses and had higher rates of depressed mood, dietary changes, stereotypy, somatization, and anxiety symptoms. Only younger age predicted erroneous diagnoses.</p><p><strong>Conclusions: </strong>The rate of patients who were misdiagnosed as having primary psychiatric disorders was much lower than in previous reports, suggesting improvements in the quality of diagnostic assessments. Misdiagnoses were more common among younger patients, with some psychiatric symptoms being overrepresented in such cases.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20240238"},"PeriodicalIF":2.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apathy in Parkinson's Disease: A Diagnostic Conundrum Explored in a Cohort Characterization Study.","authors":"Adrianna M Ratajska, Katie Rodriguez, Hannah Appleton, Rachel N Schade, Joshua Gertler, Lauren E Kenney, Gregory M Pontone, Dawn Bowers","doi":"10.1176/appi.neuropsych.20240227","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20240227","url":null,"abstract":"<p><strong>Objective: </strong>Apathy is a prevalent neuropsychiatric feature of Parkinson's disease (PD), marked by reduced goal-directed behavior. Apathy is distinct from depression and significantly affects daily functioning and quality of life. Despite this, the DSM-5 does not acknowledge apathy as its own diagnostic category. The authors sought to examine how individuals with PD who score high on a self-report apathy scale are diagnostically classified by psychiatrists within a clinical setting.</p><p><strong>Methods: </strong>Fifty-five individuals with \"pure apathy\" were identified from a larger clinical convenience sample of 458 patients with PD. The pure-apathy group consisted of patients who scored above the clinical cutoff on a self-report measure of apathy but whose symptoms were below the cutoffs for depression and anxiety measures. These patients also received a standard clinical psychiatric evaluation using DSM-5 criteria. The authors examined the diagnoses provided by psychiatrists who were unaware of results of the mood scales.</p><p><strong>Results: </strong>More than half (53%) of the pure-apathy group had received no psychiatric diagnosis. The remainder had received the following diagnoses: anxiety (27%), depression (5%), comorbid depression and anxiety (5%), and other psychiatric diagnoses (9%). The most common anxiety diagnoses were unspecified or other specified anxiety disorders and generalized anxiety disorder. The most common depression diagnoses were unspecified or other specified depressive disorders.</p><p><strong>Conclusions: </strong>This study highlights a gap in diagnosing psychiatric conditions in PD, specifically for individuals with primarily apathetic presentations. More than 50% of PD patients in the pure-apathy group had received no psychiatric diagnosis, possibly resulting in unmet clinical needs.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20240227"},"PeriodicalIF":2.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Mid- and Late-Life Physical Activities With New-Onset Depression and Anxiety Among Older Adults.","authors":"Janina Krell-Roesch, Jeremy A Syrjanen, Walter K Kremers, Bettina Barisch-Fritz, Jelena Krafft, DeJarra Johnson, Julie A Fields, Ronald C Petersen, Alexander Woll, Maria Vassilaki, Yonas E Geda","doi":"10.1176/appi.neuropsych.20240255","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20240255","url":null,"abstract":"<p><strong>Objective: </strong>The authors of this prospective cohort study sought to examine associations between mid- and late-life physical activities and incident clinical depression and anxiety among community-dwelling older adults.</p><p><strong>Methods: </strong>The sample included 2,630 adults to examine the outcome of clinical depression (median follow-up length=5.4 years) and 2,444 to examine clinical anxiety (median follow-up length=5.6 years). Participants were ages ≥70 years, were enrolled in the Mayo Clinic Study of Aging, and did not have dementia or the respective neuropsychiatric symptoms at baseline. Mid- and late-life physical activities were assessed as predictors with a validated questionnaire, and physical activity composite scores were calculated. Outcomes of interest were new onset of clinical depression and anxiety, measured with the Beck Depression Inventory (score >13) and Beck Anxiety Inventory (score >7), respectively. The authors used Cox proportional hazard models, adjusted for age (timescale), sex, education, apolipoprotein E ε4 genotype status, and comorbid medical conditions.</p><p><strong>Results: </strong>Higher overall physical activity in late life was associated with a decreased risk for incident clinical depression (hazard ratio [HR]=0.85, 95% CI=0.74-0.98, p=0.025). Higher late-life overall physical activity (HR=0.79, 95% CI=0.71-0.89, p<0.001) and moderate-to-vigorous physical activity (MVPA; HR=0.86, 95% CI=0.77-0.95, p=0.003) were associated with a decreased risk for incident clinical anxiety. Higher midlife overall physical activity (HR=1.16, 95% CI=1.05-1.28, p=0.003) and MVPA (HR=1.12, 95% CI=1.02-1.23, p=0.019) were associated with an increased risk for new-onset clinical anxiety but not depression.</p><p><strong>Conclusions: </strong>Engagement in late-life physical activity was associated with reduced risk for new-onset depression and anxiety among community-dwelling older adults without dementia.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20240255"},"PeriodicalIF":2.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posttraumatic Headache: A Possible Therapeutic Target of Transcranial Magnetic Stimulation.","authors":"Anika Balse, Christine N Smith, William Drew, Shahrokh Golshan, Hossein Ansari, Ameer Chaudry, Ananth Karanam, Mohammed Ahmed","doi":"10.1176/appi.neuropsych.20240030","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20240030","url":null,"abstract":"<p><strong>Objective: </strong>Persistent headache is the most common and debilitating chronic condition after traumatic brain injury (TBI), affecting mood and reducing quality of life. The investigators examined in a community-based setting whether repetitive transcranial magnetic stimulation (rTMS) for management of major depression among outpatients with TBI histories was associated with improvement in the functional impact of headache (FH) and whether improvements were related to treatment at a specific site in the dorsolateral prefrontal cortex (DLPFC).</p><p><strong>Methods: </strong>In the discovery phase (posttraumatic headache 1 [PTH-1] group, N=21), the association of rTMS treatment at DLPFC targets and improvement in headache and depression and anxiety were studied. Associations between functional connectivity of the patient-specific TMS treatment sites and changes in patients' FH were used to identify a target for simultaneous treatment of behavioral and headache symptoms. Patients in the translational phase (PTH-2 group, N=7) received TMS treatment at this target.</p><p><strong>Results: </strong>The patients in the PTH-1 group had significant improvements in depression and anxiety but not FH, and more than half had a reduction in FH and reported an improvement in headache severity and duration. Increased functional connectivity between TMS sites and a subregion in the left DLPFC and bilateral precuneus was related to improved FH. Unlike the PTH-1 group, the PTH-2 group exhibited significant reductions in FH after 4 weeks of treatment and in anxiety and depression after 1-2 weeks of treatment.</p><p><strong>Conclusions: </strong>TMS treatment targeting the left DLPFC coordinate identified in this study may help improve treatment for both FH and anxiety and depression among PTH patients.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20240030"},"PeriodicalIF":2.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Psychiatric Outcomes of Autoimmune Encephalitis.","authors":"Palak S Patel, Maria Pleshkevich, Chen Lyu, Ramy Gabarin, Sydney Lee, David F Tang-Wai, Doris Xia, Julien Hébert, Claude Steriade","doi":"10.1176/appi.neuropsych.20240122","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20240122","url":null,"abstract":"<p><strong>Objective: </strong>The authors aimed to characterize the long-term psychiatric outcomes and their predictors among survivors of autoimmune encephalitis (AE).</p><p><strong>Methods: </strong>In this retrospective cohort study, patients diagnosed as having AE between 2008 and 2023 at two academic medical centers (in New York City and Toronto) completed the Mini International Neuropsychiatric Interview 7.0.2 (MINI) and Profile of Mood States (POMS-2) to assess long-term psychiatric outcomes. Clinical characteristics were assessed for potential predictors of psychiatric outcomes. Bivariate analyses and univariate logistic regressions were conducted to assess the relationship between the predictors and the primary outcome.</p><p><strong>Results: </strong>Overall, 42 participants (female, N=26, 62%; median age=37.5 years, interquartile range [IQR]=32.8 years) were assessed a median of 4 years (IQR=6 years) after an AE diagnosis. AE subtypes included anti-<i>N</i>-methyl-d-aspartate (33%), anti-leucine-rich-glioma-inactivated 1 (24%), anti-glutamic acid decarboxylase 65 (14%), and antibody-negative encephalitis (29%). In total, 71% of participants who completed the MINI met criteria for a DSM-5 diagnosis, and 56% were diagnosed as having a mood disorder. Thirteen participants (31%) reported above-average total mood disturbance on the POMS-2. Mann-Whitney U tests revealed that participants diagnosed as having a mood disorder self-reported significantly higher levels of confusion and bewilderment (z=-2.04, p=0.04) and depression and dejection (z=-2.24, p=0.03) and lower levels of vigor and activity (z=-2.62, p=0.01).</p><p><strong>Conclusions: </strong>AE survivors have a high prevalence of psychiatric comorbid conditions, with most being diagnosed as having a mood disorder and a significant proportion endorsing ongoing mood disturbance. Patients with a psychiatric history may benefit from closer psychiatric follow-up.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20240122"},"PeriodicalIF":2.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicidality and Self-Harm Among Individuals With Traumatic Brain Injury: Risk and Protective Factors and Coping Mechanisms.","authors":"Amelia J Hicks, Kiara Corso, Jai Carmichael, Kate R Gould, Lisa Johnston, Gershon Spitz, Jennie L Ponsford","doi":"10.1176/appi.neuropsych.20240206","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20240206","url":null,"abstract":"<p><strong>Objective: </strong>The authors examined lived experience perspectives of suicidality and nonsuicidal self-injury (NSSI) after moderate-to-severe traumatic brain injury (TBI), risk and protective factors, and methods of coping.</p><p><strong>Methods: </strong>A record review of suicide risk assessments was completed as part of routine clinical risk management for a research study. The authors used a semistructured interview approach developed from existing clinical tools and extracted data from assessment records by using content analysis to categorize common responses.</p><p><strong>Results: </strong>Data were extracted from records of 68 participants (mean±SD age=45.9±14.4 years; 82% male) with a history of moderate-to-severe TBI (mean=10.7±9.1 years after TBI). Most participants (86%) were currently experiencing suicidal thoughts, and 50% had experienced NSSI thoughts in their lifetime. Fifteen participants (28%) reported a lifetime suicide attempt. The most common protective factors for suicidal ideation reported by participants were support from family (59%) and the personal attributes of openness and being optimistic (49%). The most common risk factors were emotional distress or presence of a psychiatric diagnosis (62%), TBI sequelae (such as fatigue; 49%), work-related stress (43%), and lack of family support (34%). Engaging with health professionals (62%) and seeking support from family (57%) were the most common healthy coping strategies, whereas substance use (38%) and social withdrawal (32%) were the most common unhealthy coping strategies.</p><p><strong>Conclusions: </strong>The findings of this study provide detailed insights into the lived experiences of suicidality and NSSI after moderate-to-severe TBI, how survivors conceptualize factors that may increase or attenuate risk, and common coping strategies.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20240206"},"PeriodicalIF":2.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}