Current Psychiatry Research and Reviews - Volume 20, Issue 2, 2024

Depression is a mental disorder that affects 279 million people. Patients with depression will not only have an impact on themselves but can also have an impact on others. Provide an overview of the impact of depression on health workers, workers, students and patients, as well as the prevention of depression. Data on the impact of depression and its prevention using the Google Scholar and Pubmed search engine. Depression in healthcare workers can affect the occurrence of misdiagnosis of a patient's disease, reduce the quality of service, and increase the risk of suicide. Depression in other workers can result in lost productivity and income, absenteeism, presenteeism, and accidents in the workplace. Depression in students causes decreased student achievement, difficulties concentrating and social interactions, and absenteeism. In patients with physical illness, depression can increase the risk of mortality, re-hospitalization, higher costs, poor treatment adherence, and lost followup. Depression prevention can help lower the risk of depression by up to 21%. This prevention must be done as early as possible and starts from the scope of prevention at the family level. Then this prevention can be done individually, especially for those with a high risk of experiencing depression. The last prevention is universal prevention (population) which can be started by educating the community. Depression can happen to anyone and will have a detrimental impact on themselves and others. Prevention of depression should be done as early as possible to prevent the impacts of depression.

Atypical antipsychotic quetiapine (QTP) exhibits high pharmacokinetic variability and population pharmacokinetic (PopPK) analysis is one of the approaches used to characterize factors influencing QTP pharmacokinetic variability. Though QTP is not regarded as a narrow therapeutic index drug, knowledge of this area is of importance. Thus, this review was conducted to summarize significant predictors for QTP pharmacokinetic variability identified using a PopPK analysis and to explore any knowledge gaps to be investigated. PubMed, Scopus, and CINAHL Complete databases were searched for eligible studies, and 75 articles were identified. Of these, only five studies were included as they were conducted using a nonlinear mixed-effects approach. This review found that only limited predictors for QTP pharmacokinetics were identified, with body weight being a predictor for the volume of distribution and age and γ-glutamyl transpeptidase being predictors for QTP clearance. None of the studies included elderly patients aged >65 years, and thus factors associated with aging were not investigated. Also, most of the participants in the PopPK analyses were from clinical trials which might not reflect real-world patients e.g., the impacts of polypharmacy may not be available. Moreover, while a population pharmacokinetic-pharmacodynamic model explaining QTP exposure and clinical response using the scores of the Brief Psychiatric Rating Scale is available, knowledge relevant to the relationship between exposure and QTP side effects has not been explored. Based on this limited information, future PopPK research encompassing a wide range of patient characteristics is required.

Historically, formal thought disorder (FTD) has been considered one of the distinctive key symptoms of schizophrenia and is still regarded as an important early warning sign and a marker of illness severity with solid predictive value. Recent studies are able to found that the presence of FTD is predictive of the subsequent diagnosis of schizophrenia and often precedes the frank clinical picture by several months. Much effort has been put into developing scales that can reliably detect FTD and can be readily applied in routine clinical practice. This narrative review investigated the use of FTD as a screening tool to assess risk in first-degree relatives of patients with schizophrenia. The results show that the use of these scales in firstdegree relatives of schizophrenic individuals during clinical contact and counseling is still an exception, despite their uniquely heightened vulnerability profile. To our knowledge, this is the first time that the application of FTD screening methods in first-degree relatives of schizophrenic individuals has been reviewed in a structured way.

A large body of literature indicates that the novel coronavirus disease (COVI D-19) was, and still is, a stressful and traumatic experience for different groups of people. Exposure to unexpected deaths or fear of death increases the risk of developing post-traumatic stress disorder (PTSD) anxiety disorder. Understanding the relationship between PTSD and SARS-CoV- 2 infection can help reduce the risk of developing psychiatric diseases, especially anxiety disorders. Here, we used the central mega databases of PubMed, Google Scholar, Scopus, Springer, and Science Direct. We explored the articles based on keywords and related articles. Social isolation stress during quarantine and hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis via increased cortisol synthesis and release seems to be key findings in current literature. Evidence shows that induced neuroendocrine changes in patients with COVID-19 can cause psychiatric diseases related to fear and anxiety. Studies suspect that angiotensinconverting enzyme 2 (ACE2) expressed in the hypothalamus and pituitary gland can be targeted by the infection and thereby could be a player in inducing psychiatric disorders. Here, we discuss the relationship between Covid-19 and post-traumatic stress disorder from psychoneuroendocrine- immune aspects and highlight the pro-inflammatory cytokines as mediators in the CNS-related processes, hoping to provide insights into the pathophysiology of PTSD.

Within a decade the Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR/Cas9 system), an advanced gene-editing technology became one of the celebrated approaches in modern disease therapeutics and was reported to have a potential role in the alteration of non-coding RNAs segment which are the pivotal causes behind the several mental disorder such as Schizophrenia. In general, Schizophrenia is referred as a neurodevelopmental disorder and symptomatically exhibited by social deficit, cognitive dysfunction, apathy, delusions, hallucinations, etc. At a genomics level large number of loci are susceptible for genetic alteration in schizophrenia and are mostly located in the genome’s non-coding region. With the growing variants and mutations in ncRNA genes (miRNA and lncRNA) strongly associated with schizophrenia, the need to develop a genetic tool to help with the treatment and study of schizophrenia increases. Recently the use of CRISPR/cas9 technology in the productive alteration of non-coding RNAs genes such as miRNA; miR-291, miR-141, and miR-21, lncRNA, lncRNA-21A, AK023948, and LncRNA Rian has been reported. The Cas9 protein and guide RNA (gRNA) together form the CRISPR/Cas9 system is known to be highly specific and efficient for manipulating the impact of gene mutations linked to genomic DNA like ncRNA besides other inheritable genetic diseases. Copy number variations are also found to be linked with schizophrenia. The generation of reciprocal CNVs of 15q13.3 and 16p11.2 in humaninduced pluripotent stem cells (iPSCs) with the CRISPR/Cas 9 system has opened new possibilities. Still, there are some limitations and challenges yet to be defeated, like the blood-brain barrier poses an obstacle to treating mental disorders and ethical issues like genomic DNA manipulation of eggs and embryos. This review brings schizophrenia-associated ncRNAs and CRISPR gene-editing technology for the non-coding parts of the genomic DNA together and recent challenges.

Background: Borderline Personality Disorder (BPD) is a psychiatric condition that affects approximately 2% of the population worldwide. It can present many challenges and can therefore be difficult to treat successfully by mental health professionals. Aim: The aim of this systematic review was to detect whether repetitive Transcranial Magnetic Stimulation (rTMS) is an effective intervention for the management of BPD to the point where there would be a reduction of the BPD symptoms and challenging behaviour. Methods: A literature search was conducted systematically using the following databases: PROSPERO, PUBMED, GOOGLE SCHOLAR, WEB OF SCIENCE, COCHRANE LIBRARY, SCOPUS, EMBASE and CLINICALTRIALS.GOV. Included studies were primary research studies of adult patients with a diagnosis of BPD who received rTMS treatment. Results: Nine studies were identified which ranged from a case report to a randomised controlled trial (RCT). While rTMS improved certain symptoms of BPD patients, such as affective instability, impulsivity and outbursts of anger; overall, some results lacked statistical significance and, due to the lack of robust evidence, it is uncertain if rTMS is an effective intervention for BPD. Conclusions: rTMS treatment showed some promising results in reducing the severity of symptoms for a number of patients. Studies varied with regard to the location of the target stimulation site, including different prefrontal brain regions and the cerebellum, as well as other rTMS protocol characteristics. These methodological differences in the application of the intervention and their impact on BPD symptomatology need to be explored more systematically in future research. Higher quality studies with larger sample sizes are needed in order to assess further the effectiveness of rTMS interventions on BPD symptoms.

Introduction: Oxidative stress is an imbalance between an organism's reactive oxygen species (ROS) production and antioxidant defence capacity. Long-term oxidative stress contributes to cellular ageing and plays a role in the pathogenesis of several diseases. Several investigations indicated that oxidative stress has a role in the pathogenesis of ASD. Objectives: Present study was undertaken to record the association of GSTTT1 and GSTM1 null genotype among the autistic population of India. Methods: Genomic DNA was isolated from 108 autistic children along with healthy agematched control. The quality and quantity of the isolated genomic DNA were analysed. GSTT1 and GSTM1 null genotype was analysed using polymerase chain reaction with internal positive control. Statistical analysis was performed using SPSS 15.0. Results: Present study included 85 males and 23 females with a mean age of 11.7 ± 3.5 and 75 males and 33 females with a mean age of 11 ± 2.0 in the control group. 32 (29.6%) autistic cases showed null genotypes for GSTT1 and 21(19.4%) autistic children showed null genotypes for GSTM1. 3 (2.85%) control children showed a null genotype for GSTT1 and 5 (4.6%) control children showed a null genotype for GSTM1. The GSTT1 and GSTM1 null genotypes were observed to be significantly associated with the risk of autism (p value-0.0001, OR-14.73, 95% CI 4.35-49.90) and (p value-0.003, OR-4.731, 95% CI 1.71-13.08) respectively. Conclusion: The findings of our study suggested that GSTT1 and GSTM1 null genotype is one of the potential risk factors for autism through oxidative stress mechanism in our population.

Parental stress and depression are factors that significantly affect the exercise of the parental role and have an impact on the upbringing of children and their quality of life. The purpose of this study is to investigate the differences between the dependent variables of quality of life, anxiety and depression in relation to the demographic characteristics, as an independent variable, in the entire sample before the implementation of parent counseling. A sample of 160 parents was collected to participate. The psychometric tools have been used are: The Spielberger Stress Trait Anxiety Inventory (STAI), the Beck depression Inventory (BDI), and the Health and well-being Questionnaire (The RAND 36-Item Healthy Survey, SF-36, Version 1.0). It was found that men have better quality of life in both physical and emotional health, lower anxiety and depression. A positive correlation between age and emotional health was found. Younger parents have more anxiety, depression and generally poorer emotional health than older parents.

Background: Healthcare workers (HCWs) who are directly involved in the management of patients with SARS-CoV-2 infection are at higher risk of psychological disorders. Objective: In this study, we evaluated the risk factors related to mental health disorders in HCWs active in the management of the COVID-19 pandemic in Mashhad, Iran. Methods: This was a cross-sectional investigation performed between April 2020 and May 2020 at five referral centers in Mashhad, Iran. Patient Health Questionnaire (PHQ-9), 7-item Generalized Anxiety Disorder scale (GAD-7), Insomnia Severity Index (ISI), Impact of Event Scale–Revised (IESR), and VAS (for fear from COVID-19) to assess depression, anxiety, insomnia, distress and fear related to COVID-19 were filled. Risk factors were evaluated by the regression model. Results: Mean ± SD age of participants was 33.84 ± 7.03 years. Most were females (64.2%). Of 360 participants, 252 had some degree of an anxiety disorder (70%), 63.8% had depression, 55.8% had insomnia, and 72.8% had distress. Work experiences (OR: 0.94, 95% CI = 0.901- 0.983, p = 0.007), exposure to COVID-19 patients (OR: 2.54, 95% CI = 1.37-4.69, p < 0.001), and job status (OR: 1.40, 95% CI = 1.19 -1.54, p < 0.001) were significant predictors of anxiety. Age (OR: 1.15, 95% CI = 1.05-1.27, p = 0.002), exposure to COVID-19 patients (OR: 1.95, 95% CI = 1.04-3.64, p = 0.037), work experience (OR: 0.86, 95% CI = 0.78-0.93, p < 0.001), having children (OR: 0.58, 95% CI = 0.39- 0.87, p = 0.008), and being infected with COVID-19 (OR: 9.95, 95% CI = 1.92-51.64, p < 0.001) were the significant independent factors for depression in participants. Conclusion: COVID-19 could significantly affect HCWs mental health status, specifically depression. By targeting these predictors, health policymakers can reduce the burden of psychological disorders in HCWs.