Critical Overview of Patriarchy, Its Interferences With Psychological Development, and Risks for Mental Health.

The systemic oppression of women and gender-based discrimination has deep roots in human civilization. As evident in both written texts and widespread practices, conscious and unconscious biases associated with patriarchy have been and continue to be interlaced with power struggles, control, and conformity enforced by the male-dominant cultures of the time. Brought into bold relief in this pandemic, recent dramatic events (the tragic murder of George Floyd and the overturning of Roe v. Wade, for example) have heightened social outrage against bias, racism, and bigotry and have also brought us to an inflection point demanding our better understanding of the pernicious and long-term mental health effects of patriarchy. There are compelling grounds to further expand their construct, but efforts to do so in psychiatric phenomenology have, until now, failed to gain momentum and substantive attention. The resistance may in part lie in misconceptions that patriarchy is supported by archetypal endowments of the collective unconscious constitutive of shared societal beliefs. While many continue to live with the adverse experiences associated with patriarchy within the current times, critics have argued that our concepts about patriarchy are not empirical enough. Empirically supported deconstruction is necessary to debunk misinformed notions that undermine women's equality.

Integrating Psychosocial Risks With Emerging Evidence for Borderline Personality Disorders in Adolescence: An Update for Clinicians.

Borderline personality disorder (BPD) has seen significant advances in the knowledge of its developmental phenomenology during late childhood and adolescence. Various genetic, neurobiological, psychological, and social factors are implicated in the etiology of BPD. With emerging evidence on BPD development in adolescence, the review focused on recent literature to understand the role of psychosocial risk factors. The effects of adverse familial environment, physical, emotional, verbal, and sexual abuse, intergenerational transmission of psychopathological traits, maternal neglect and rejection, low socioeconomic status, bullying victimization, and dating violence were reviewed to understand their role in the development of BPD. BPD is a highly complex, serious, and enduring mental illness that has now been widely accepted to have symptoms that onset in early adolescence and could be diagnosed as early as age 12. BPD symptoms are stable, phenomenologically distinct from externalizing and internalizing disorders, and often present with co-occurring disorders, which during assessment could not explain impairments associated with BPD. New measures like the Difficulties in Emotion Regulation Scale (DERS), detailed developmental histories, understanding of psychosocial risks, shared decision-making, and psychoeducation could assist in early diagnosis and improvement of long-term outcomes. The implementation of evidence-based treatments is a challenge given higher costs and access to services; therefore, modifications in the treatment based on the core principles of these strategies should be considered. It is imperative to screen for psychosocial factors early in higher-risk groups. The assessment of familial factors, parental histories of psychopathologies, and histories of childhood abuse is important in context with impairing symptoms of clinical presentation and dimensional aspects of self-functioning. The role of family therapies, parental psychoeducation, and the integration of trauma-informed care approaches are important for clinical outcomes. Also, coordinated efforts with multiple stakeholders like school awareness programs, anti-bullying policies, legislation, and enforcement of existing laws might be instrumental in addressing issues related to victimization by peers.

Gut Biome and Mental Health: Do Probiotics Work?

Mental health conditions have been linked closely to an imbalance of microbiota in the gut, leading to disruption of the microbiome (dysbiosis). Several neurotransmitters, such as GABA (gamma-aminobutyric acid), serotonin, and glutamate, are produced in the gut, which are associated with anxiety and depressive symptoms. Mental health and the gut have been linked closely, and many mental illnesses have been associated with gut dysbiosis. Probiotics are marketed to improve gut health, act as mood enhancers, and be effective in reducing stress as unregulated over-the-counter supplements. Given healthcare disparities and patient-doctor gaps across the globe, this review aims to appraise the literature on probiotics for the prevention and treatment of mental disorders. PubMed and Google Scholar databases were searched till March 2023 using the MeSH words "prebiotics," "probiotics," "synbiotics," and "psychobiotics." Out of 207 studies, 26 studies met the inclusion criteria and were included in the review. Studies suggest probiotics could be an effective and economical adjunct therapy; however, due to weak study design and low power, the results are inconclusive. Their use is not without risks, and healthcare providers need close supervision until more robust longitudinal studies are conducted to appraise their efficacy and safety profiles.

Parkinson's Disease: Diagnostic Challenges Amidst Transdiagnostic and Overlapping Mental Health Symptoms.

Parkinson's disease (PD) is a complex neurodegenerative disorder with heterogeneous clinical presentations. Given the ambiguity of its overlapping symptomatology and concomitant atypical motor and neuropsychological symptoms its early diagnosis is clinically challenging. It is often missed since low mood, anhedonia, lack of motivation, and psychomotor retardation are commonly reported in individuals with PD. When alexithymia is the predominant symptom, the knowledge to discriminate between apathy, anhedonia, and alexithymia is critical to avoid misdiagnosis.

Play Therapy As Effective Options for School-Age Children With Emotional and Behavioral Problems: A Case Series.

As a type of psychotherapy, play therapy entails using play and creative activities as a means to help children express their thoughts and emotions, and to work through their challenges. A wide range of issues can be addressed through play therapy, including behavioral issues, anxiety, depression, trauma, and difficulties in relationships. Through this case report, we aim to discuss the history and evolution of play therapy concepts. We will review the core principles of child-centered therapy (CCT), non-directive child-centered play (NDCCP), and cognitive behavior play therapy. We will discuss clinically helpful approaches and the evidence supporting the efficacy of play therapy in anxiety, depression, trauma, and other behavioral difficulties in children.

Effects of Escitalopram on Autonomic Function in Posttraumatic Stress Disorder Among Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF).

OBJECTIVE: Posttraumatic stress disorder is a chronic, debilitating condition that has become a growing concern among combat veterans. Previous research suggests that posttraumatic stress disorder disrupts normal autonomic responding and may increase the risk of cardiovascular disease and mortality. Measures of heart rate variability and QT interval variability have been used extensively to characterize sympathetic and parasympathetic influences on heart rate in a variety of psychiatric populations. The objective of this study was to better understand the effects of pharmacological treatment on autonomic reactivity in posttraumatic stress disorder. DESIGN: A 12-week, Phase IV, prospective, open-label trial of escitalopram in veterans with combat-related posttraumatic stress disorder and comorbid depression. SETTING: An outpatient mental health clinic at a Veterans Affairs Medical Center. PARTICIPANTS: Eleven male veterans of Operations Enduring Freedom and Iraqi Freedom diagnosed with posttraumatic stress disorder and comorbid depression. MEASUREMENTS: Autonomic reactivity was measured by examining heart rate variability and QT interval variability. Treatment safety and efficacy were also evaluated pre- and post-treatment. RESULTS: We observed a reduction in posttraumatic stress disorder and depression symptoms from pre- to post-treatment, and escitalopram was generally well tolerated in our sample. In addition, we observed a decrease in high frequency heart rate variability and an increase in QT variability, indicating a reduction in cardiac vagal function and heightened sympathetic activation. CONCLUSION: These findings suggest that escitalopram treatment in patients with posttraumatic stress disorder and depression can trigger changes in autonomic reactivity that may adversely impact cardiovascular health.