Complex psychiatry最新文献

{"title":"Association of Ptosis with Mental Health Conditions in Adults from a Large United States Research Database.","authors":"Jaffer Shah, Matthew Lin, Gabriella Schmuter, Kyle D Kovacs, Kyle J Godfrey","doi":"10.1159/000546894","DOIUrl":"10.1159/000546894","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the association between blepharoptosis (ptosis) and the prevalence of mental health disorders in adults, including anxiety, depression, bipolar disorder, schizophrenia spectrum disorders, and substance use/addictive disorders.</p><p><strong>Methods: </strong>Cross-sectional study using data from the National Institutes of Health's All of Us Research Program. The study included 4,411 adults diagnosed with ptosis and 4,411 propensity score-matched controls, matched by age, sex, race, education, and income. A 1:1 propensity score-matched analysis was performed, comparing adults with ptosis to matched controls. Logistic regression was used to adjust for potential confounders, including body mass index, elevated blood pressure, and blood glucose levels. Prevalence rates of anxiety, depression, bipolar disorder, schizophrenia spectrum disorders, and substance use/addictive disorders. The primary outcome was the association between ptosis and any mental health disorder.</p><p><strong>Results: </strong>Adults with ptosis exhibited significantly higher rates of mental health disorders compared to controls, including anxiety (46.8% vs. 28.9%), depression (44.9% vs. 27.8%), bipolar disorder (5.8% vs. 3.6%), schizophrenia spectrum disorders (1.8% vs. 1.1%), and substance use/addictive disorders (23.4% vs. 17.0%). The prevalence of any mental health disorder was significantly higher in the ptosis group (63.4% vs. 44.8%, <i>p</i> < 0.001). After adjustment, ptosis was associated with increased odds of any mental health disorder (aOR: 1.92, 95% CI, 1.76-2.10) and each specific mental health disorder.</p><p><strong>Conclusion: </strong>Ptosis is associated with a significantly higher prevalence of mental health disorders, suggesting it may be an independent risk factor. Mental health screenings and psychosocial support should be considered for patients with ptosis. Further research is needed to explore causal mechanisms and stratify risk based on ptosis etiology and severity. This study may be subject to Berkson's bias, wherein individuals with ptosis may have more frequent health care encounters, increasing the likelihood of being diagnosed with psychiatric conditions.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"11 1","pages":"94-98"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging Natural Language Processing for Psychiatric Phenotyping from Spanish Electronic Health Records: Enabling the Investigation of Transdiagnostic Symptom Profiles at Scale.","authors":"Juan F De La Hoz, Clara Frydman-Gani, Alejandro Arias, Maria Perez Vallejo, John Daniel Londoño Martínez, Laura Mena, Ariel Seroussi, Susan K Service, Ana M Diaz-Zuluaga, Ana M Ramirez-Diaz, Johanna Valencia-Echeverry, Mauricio Castaño, Victor I Reus, Alex A T Bui, Nelson B Freimer, Carlos Lopez-Jaramillo, Loes M Olde Loohuis","doi":"10.1159/000546480","DOIUrl":"10.1159/000546480","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical notes in electronic health records offer valuable insight into the symptom profiles and trajectories of patients with severe mental illness (SMI). However, systematically extracting symptoms at scale remains a challenge, especially in languages other than English. We developed a light, accurate, and interpretable natural language processing (NLP) algorithm to extract psychiatric phenotypes from Spanish clinical notes.</p><p><strong>Methods: </strong>We selected a set of 136 core psychiatric phenotypes and annotated 4,000 clinical note sections (e.g., Chief Complaint, Plan; called \"documents\") and 240 complete visit notes (called \"entries\") from two psychiatric hospitals in Colombia: Hospital Mental de Antioquia (HOMO) and Clínica San Juan de Dios Manizales (CSJDM). For phenotypes meeting frequency and inter-annotator reliability thresholds, we developed three NLP algorithms (HOMO, CSJDM, and COMBINED) for phenotype extraction and context labeling (e.g., negation, family history, uncertainty). We evaluated performance at the document and entry levels, as well as across hospitals.</p><p><strong>Results: </strong>Document-level performance at both hospitals was high (average F1 scores of 0.84 and 0.85). Moreover, on phenotypes meeting our document-level performance threshold of F1 ≥0.7, entry-level performance was high as well (average F1 of 0.75 and 0.78), as was the cross-hospital transportability of the algorithms (F1 of 0.75 HOMO-to-CSJDM and 0.77 CSJDM-to-HOMO). The COMBINED algorithm improved overall recall, without significantly decreasing precision (F1 of 0.78 and 0.77 on HOMO and CSJDM, respectively). The application of our algorithm for 50 high-performing phenotypes to the notes of 9,737 SMI patients highlighted the transdiagnostic nature of many core SMI phenotypes; 44/50 phenotypes were recorded in over 10% of patients across diagnoses. Multiple correspondence analysis further revealed variation in symptom space across diagnoses; while major depressive disorder and schizophrenia form distinct clusters, patients with bipolar disorder span the entire phenotypic spectrum.</p><p><strong>Conclusion: </strong>Our tool enables the systematic investigation of psychiatric symptoms from psychiatric notes, facilitating large-scale investigations in Spanish-speaking populations.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"11 1","pages":"99-112"},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescription Opioid Medication Survey: A Tool to Collect Deep Phenotypic Data on the Multifactorial Pathways to Opioid Use Disorder in Clinical and Population-Based Cohorts.","authors":"Natasia S Courchesne-Krak, Anirudh R Chandrasekaran, Jean Gonzalez, Sevim B Bianchi, Vinh Tran, Eric O Johnson, Vanessa Troiani, John M Hettema, Murray B Stein, Hilary Coon, Anna R Docherty, Wade H Berretini, James MacKillop, Harriet de Wit, Carla Marienfeld, Abraham A Palmer, Sandra Sanchez-Roige","doi":"10.1159/000546389","DOIUrl":"10.1159/000546389","url":null,"abstract":"<p><strong>Introduction: </strong>We are in the midst of an opioid epidemic. In the USA, more than a third of the country knows someone who has died from an opioid overdose. Prescription opioids (e.g., oxycodone, hydrocodone, and fentanyl) are commonly used and misused, and it has been estimated that approximately 8-12% of individuals who misuse opioids will subsequently develop an opioid use disorder (OUD). While emphasis has been placed on understanding OUD and the associated adverse effects, there remains a critical gap in systematically characterizing the multifactorial pathways (e.g., behavioral, clinical, genetic, and socio-demographic characteristics) that contribute to the transition from initial use to misuse to OUD.</p><p><strong>Methods: </strong>To address this gap, we introduce the Prescription Opioid Medication Survey (POMS), an online 120-item assessment that compiles multiple validated and standardized instruments. POMS is intended for individuals with any lifetime prescription opioid use. POMS captures various aspects of prescription opioid use including data on opioid use patterns, subjective effects (e.g., euphoria, nausea), problematic use, withdrawal, OUD, overdose, treatment history, and remission. It also addresses comorbid risk factors such as surgical history, chronic pain, other substance use disorders (SUD; e.g., nicotine, alcohol, cannabis, stimulants), other addictive behaviors (i.e., gambling, sexual behaviors, and gaming), and family history of SUD and other addictive behaviors. Mental health assessments, including screening for depression and anxiety, self-reports of eight psychiatric disorders (anxiety, depression, bipolar, schizophrenia, attention-deficit/hyperactivity disorder, post-traumatic stress disorder, obsessive-compulsive disorder, eating disorders), and related mental health conditions (e.g., loneliness, suicide, trauma) are included, along with data on personality traits (e.g., risk-taking, delay discounting, wisdom) and socio-demographic factors. POMS is intended to be administered in clinical settings and large population-based cohorts, facilitating data collection that can enable discoveries to inform better prevention and intervention strategies for OUD.</p><p><strong>Conclusion: </strong>POMS offers a comprehensive tool for systematically capturing the multifactorial risk factors associated with opioid misuse and OUD, providing insights that can inform prevention and intervention strategies.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"11 1","pages":"72-93"},"PeriodicalIF":0.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caffeine Consumption, Psychological Distress, and Insomnia in a Cohort of Individuals with Depression.","authors":"Harry A McIntosh, Aleah J Borgas, Nisreen Aouira, Brittany L Mitchell, Jacob J Crouse, Sarah E Medland, Ian B Hickie, Naomi R Wray, Nicholas G Martin, Christel M Middeldorp, Enda M Byrne","doi":"10.1159/000545393","DOIUrl":"https://doi.org/10.1159/000545393","url":null,"abstract":"<p><strong>Introduction: </strong>Caffeine is a widely consumed psychoactive compound that can cause anxiety and sleep difficulties, in part due to genetic variation. We investigated the association between caffeine consumption, psychological distress, and sleep difficulties in a genetically informative cohort of individuals with a history of depression.</p><p><strong>Methods: </strong>Survey data and genetic information were sourced from the Australian Genetics of Depression Study (AGDS [<i>n</i> = 20,689, %_female = 75%, mean age = 43 ± 15 years]). Associations between caffeine consumption and symptoms of distress and sleep disturbance, as well as 9 genetic variants associated with caffeine consumption behaviour, were assessed using linear regression.</p><p><strong>Results: </strong>The highest consumers of caffeine reported higher psychological distress measured by the Kessler 10 scale (β = 1.21, SE = 0.25, <i>p</i> = 1.4 × 10^-6) compared to the lowest consumers. Consumption was associated with 2 genetic variants with effect sizes ∼0.35 additional caffeinated drinks/day between opposite homozygotes (<i>p</i> < 0.005). A deletion near <i>MMS22L/POU3F2</i> was associated with 10% increased odds of reporting caffeine susceptibility (OR = 1.1 per deletion [95% CI: 1.04-1.17], <i>p</i> = 0.002).</p><p><strong>Conclusions: </strong>Higher rates of caffeine consumption were associated with higher levels of psychological distress, but not insomnia, in individuals with a history of depression. While the direction of causality is unclear, caffeine consumption may be a modifiable factor to reduce distress in individuals susceptible to mental health problems. Some of the previous findings of common variant associations with caffeine consumption and susceptibility were replicated.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"11 1","pages":"37-49"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory Analysis of Sleep Deprivation Effects on Gene Expression and Regional Brain Metabolism.","authors":"Lily Bai, Ramanuj Sarkar, Faith Lee, Joseph Chong-Sang Wu, Marquis P Vawter","doi":"10.1159/000545461","DOIUrl":"https://doi.org/10.1159/000545461","url":null,"abstract":"<p><strong>Introduction: </strong>Sleep deprivation affects cognitive performance and immune function, yet its mechanisms and biomarkers remain unclear. This study explored the relationships among gene expression, brain metabolism, sleep deprivation, and sex differences.</p><p><strong>Methods: </strong>Fluorodeoxyglucose-18 positron emission tomography measured brain metabolism in regions of interest, and RNA analysis of blood samples assessed gene expression pre- and post-sleep deprivation. Mixed model regression and principal component analysis identified significant genes and regional metabolic changes.</p><p><strong>Results: </strong>There were 23 and 28 differentially expressed probe sets for the main effects of sex and sleep deprivation, respectively, and 55 probe sets for their interaction (FDR-corrected <i>p</i> < 0.05). Functional analysis of genes affected by sleep deprivation revealed pathway enrichment in nucleoplasm- and UBL conjugation-related genes. Genes with significant sex effects mapped to chromosomes Y and 19 (Benjamini-Hochberg FDR <i>p</i> < 0.05), with 11 genes (4%) and 29 genes (10.5%) involved, respectively. Differential gene expression highlighted sex-based differences in innate and adaptive immunity. For brain metabolism, sleep deprivation resulted in significant decreases in the left insula, left medial prefrontal cortex (BA32), left somatosensory cortex (BA1/2), and left motor premotor cortex (BA6) and increases in the right inferior longitudinal fasciculus, right primary visual cortex (BA17), right amygdala, left cerebellum, and bilateral pons.</p><p><strong>Conclusion: </strong>Sleep deprivation broadly impacts brain metabolism, gene expression, and immune function, revealing cellular stress responses and hemispheric vulnerability. These findings enhance our understanding of the molecular and functional effects of sleep deprivation.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"11 1","pages":"50-71"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic Insights into Substance Use Disorder and Associated Psychiatric Conditions.","authors":"Ambrose Loc Ngo, Christopher M Ahmad, Niki Gharavi Alkhansari, Linda Nguyen, Huiping Zhang","doi":"10.1159/000544912","DOIUrl":"10.1159/000544912","url":null,"abstract":"<p><strong>Background: </strong>Substance use disorder (SUD) is closely associated with epigenetic modifications that significantly impact mental health outcomes. Alcohol and drug misuse induce widespread changes in the epigenome and transcriptome of the central nervous system, disrupting critical processes such as reward signaling and emotional regulation. These alterations in epigenetic regulation and gene expression often persist even after substance cessation, potentially contributing to the onset or worsening of psychiatric conditions, including schizophrenia, depression, stress, and anxiety.</p><p><strong>Summary: </strong>This review delves into key epigenetic mechanisms underlying SUD and its comorbid psychiatric disorders, with a focus on DNA methylation, histone modifications, and noncoding RNA regulation. Additionally, it examines the influence of environmental and biological factors on the epigenome and evaluates emerging epigenetic-based therapeutic strategies aimed at treating SUD and related psychiatric conditions.</p><p><strong>Key messages: </strong>Gaining a deeper understanding of the epigenetic mechanisms driving SUD and its associated psychiatric disorders is crucial for the development of effective therapeutic interventions. This review highlights the potential of epigenetic-based pharmacological strategies to mitigate the societal and personal burdens linked to SUD and its mental health complications.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"11 1","pages":"12-36"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, Genomic, and Neurophysiological Correlates of Lifetime Suicide Attempts among Individuals with an Alcohol Use Disorder.","authors":"Peter B Barr, Zoe Neale, Chris Chatzinakos, Jessica Schulman, Niamh Mullins, Jian Zhang, David B Chorlian, Chella Kamarajan, Sivan Kinreich, Ashwini K Pandey, Gayathri Pandey, Stacey Saenz de Viteri, Laura Acion, Lance Bauer, Kathleen K Bucholz, Grace Chan, Danielle M Dick, Howard J Edenberg, Tatiana Foroud, Alison Goate, Victor Hesselbrock, Emma C Johnson, John R Kramer, Dongbing Lai, Martin H Plawecki, Jessica Salvatore, Leah Wetherill, Arpana Agrawal, Bernice Porjesz, Jacquelyn L Meyers","doi":"10.1159/000543222","DOIUrl":"10.1159/000543222","url":null,"abstract":"<p><strong>Introduction: </strong>Research has identified multiple risk factors associated with suicide attempt (SA) among individuals with psychiatric illness. However, there is limited research among those with an alcohol use disorder (AUD), despite their disproportionately higher rates of SA.</p><p><strong>Methods: </strong>We examined lifetime SA in 4,068 individuals with an AUD from the Collaborative Study on the Genetics of Alcoholism (23% lifetime SA; 53% female; mean age: 38). We explored risk for lifetime SA across other clinical conditions ascertained from a clinical interview, polygenic scores for comorbid psychiatric problems, and neurocognitive functioning.</p><p><strong>Results: </strong>Participants with an AUD who attempted suicide had greater rates of trauma exposure, major depressive disorder, post-traumatic stress disorder, other substance use disorders (SUDs), and suicidal ideation. Polygenic scores for SA, depression, and PTSD were associated with increased odds of reporting an SA (ORs = 1.22-1.44). Participants who reported an SA also had decreased right hemispheric frontal-parietal theta and decreased interhemispheric temporal-parietal alpha electroencephalogram resting-state coherences relative to those who did not, but differences were small.</p><p><strong>Conclusions: </strong>Overall, individuals with an AUD who report lifetime SA experience greater levels of trauma, have more severe comorbidities, and carry increased polygenic risk for other psychiatric problems. Our results demonstrate the need to further investigate SAs in the presence of SUDs.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"11 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic Alterations in Post-Traumatic Stress Disorder: Comprehensive Review of Molecular Markers.","authors":"Elizaveta Golubeva, Angelina Zeltser, Yana Zorkina, Aleksandra Ochneva, Anna Tsurina, Denis Andreyuk, Georgiy Kostyuk, Anna Morozova","doi":"10.1159/000541822","DOIUrl":"10.1159/000541822","url":null,"abstract":"<p><strong>Background: </strong>Post-traumatic stress disorder (PTSD) can occur after a traumatic event. PTSD is characterized by nightmares, flashbacks and avoidance of stressors. It currently affects 2-8% of the population, with military personnel particularly susceptible. Studies show that environmental stressors can induce various epigenetic changes that shape the PTSD phenotype. Despite the significant impact of epigenetic factors on PTSD symptoms and susceptibility, they have not been widely discussed in the literature. This review focuses on describing epigenetic mechanisms in PTSD, especially DNA methylation, chromatin regulation, and noncoding RNA.</p><p><strong>Summary: </strong>The article includes relevant studies published from 2013 to 2023, excluding non-English-language studies or studies with insufficient data. This review investigated gene methylation changes in association with PTSD, including those related to the hypothalamic-pituitary-adrenal axis, brain-derived neurotrophic factor, neurotransmitters, and immune system functioning, as well as the role of histones and regulatory noncoding RNAs.</p><p><strong>Key messages: </strong>Epigenetic alterations play a crucial role in shaping PTSD susceptibility, symptomatology, and long-term outcomes, highlighting their potential as important markers and therapeutic targets. Understanding these alterations can aid in developing clinical strategies to better predict, prevent, and treat PTSD. However, further large-scale longitudinal studies are needed to establish the temporal relationship between epigenetic changes and the onset of PTSD, as well as to classify other potential epigenetic mechanisms.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"10 1-4","pages":"71-107"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Olfactory Epithelium Infection by SARS-CoV-2: Possible Neuroinflammatory Consequences of COVID-19.","authors":"Ana G Gutiérrez-García, Carlos M Contreras","doi":"10.1159/000540982","DOIUrl":"10.1159/000540982","url":null,"abstract":"<p><strong>Background: </strong>The loss of smell is a typical diagnostic symptom of coronavirus disease 2019 (COVID-19). This sensorial deprivation may be expressed as quantitative (anosmia or hyposmia) or qualitative (dysosmia) alterations as a consequence of anatomical disturbances of the nasal epithelium structure. The olfactory system sends direct neuronal connections to brain structures that are involved in emotional processing, including deep temporal nuclei. This anatomical and functional feature may be related to the occurrence of emotional disorders among COVID-19 patients.</p><p><strong>Summary: </strong>We identify a possible sequence of events, from typical olfactory dysfunction that is associated with COVID-19 and caused by olfactory epithelium damage to disturbances in the quality of life and emotional state of infected patients that is attributable to possible neuroinflammatory processes. Sensorial deprivation causes deleterious actions on mood, negatively affecting quality of life. Olfactory dysfunction that is associated with COVID-19 occurs concurrently with psychological distress, symptoms of anxiety, and depressive disorders and impinges on self-perceived quality of life.</p><p><strong>Key messages: </strong>Changes in mood are certainly associated with multiple factors, including the environment and isolation, but the observation that the virus may penetrate the central nervous system through the olfactory bulb and the connection between the olfactory system and prefrontal and orbitofrontal cortices and the amygdala-hippocampus do not allow one to discard neural factors that are involved in the pathophysiology of emotional symptoms in post-COVID-19 patients. Behavioral symptoms of COVID-19 involve local olfactory actions and the participation of central neuronal systems.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"10 1-4","pages":"59-70"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Contraceptives and the Risk of Psychiatric Side Effects: A Review","authors":"Julia Ciarcia, Laura M. Huckins","doi":"10.1159/000539515","DOIUrl":"https://doi.org/10.1159/000539515","url":null,"abstract":"Importance: Oral contraceptives (OCs) are an essential medicine used by millions of people every day. Given the widespread usage of these medicines, even a small increase in psychiatric risk could be of clinical significance. Although mood-related side effects are a common reason for OC hesitancy and discontinuation, studies investigating psychiatric responses to OC treatment have had inconsistent results. \u0000Observations: While OCs are beneficial for most users, there is evidence that a subgroup of users are susceptible to mood side effects. Randomized controlled trials have generally failed to find differences in mood symptoms between OC and placebo users, but observational studies comparing OC users to non-users have reported increases in symptoms of depression, anxiety, and eating disorders. Additionally, observational evidence suggests that OC users may be more likely to use prescription psychotropic medications and to attempt or die by suicide. However, responses to OC treatment are highly heterogeneous, and some users report mood improvement. A variety of factors may increase the likelihood of negative psychiatric side effects, including younger age, previous experience of side effects from OCs, and pre-existing psychiatric disorders. Progestin-only pills may confer a higher psychiatric risk than combination pills.\u0000Conclusions and Relevance: Further research investigating factors that contribute to susceptibility to the mood-related side effects of OCs is clearly warranted. Genomic approaches may provide insight as to why some users experience side effects while others do not. Research elucidating who is most at risk and why will be essential to addressing prevalent concerns about the psychiatric risk of OCs. \u0000","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"30 34","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141814025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}