Mutation of GPR143 Associated With Ocular Albinism Type 1, Intellectual Disability, and Schizophrenia: The Complex Biological and Social Interactions Between Genetic Syndromes and Mental Illness.

Copy number variations, which manifest primarily as deletions and duplications, contribute significantly to the genetic risk of schizophrenia. Specific syndromes associated with copy number variations, exemplified by the 22q11 deletion syndrome, confer both congenital abnormalities and an elevated risk of schizophrenia. We report the case of a patient with a deletion of exons 2 through 8 of GPR143. In addition to having the ophthalmologic disorder ocular albinism type 1 (OA1), a well-established consequence of mutations of GPR143, the patient is also intellectually impaired and impulsive, and he developed schizophrenia at age 15. Psychiatric manifestations of OA1 have not previously been reported, yet remain plausible, as the GPR143 protein is widely distributed in the brain and may function as an L-DOPA receptor. However, the patient described here also had a family history of psychiatric disorders independent of OA1, in utero exposure to heroin and cocaine, and challenging family circumstances. We suggest that the relationship between his GPR143 mutation and his psychiatric disorders is complex. The mutation may have directly contributed to his cognitive and psychiatric disorders, but we also suspect that OA1, present in multiple family members, contributed to multigenerational familial instability. Further, OA1 likely exacerbated our patient's cognitive and social impairment by interfering with his education, while his neuropsychiatric status frequently interfered with the assessment and treatment of his OA1. We conclude that the psychiatric and nonpsychiatric manifestations of a genetic syndrome are best managed in parallel and that psychiatrists and other mental health providers may be in the best position to assure that patients receive appropriate genetic and medical care.

Violent behavior, perceived safety, and assault experiences among adolescents: results from the Brazilian National Adolescent School-based Health Survey

Objective To investigate factors associated with violent behavior in a large nationally representative sample of Brazilian adolescents. Methods The data were derived from the 2015 National Adolescent School-based Health Survey (Pesquisa Nacional de Saúde do Escolar [PeNSE]). The independent variables of interest included feelings of safety while on the way to and at school. The outcome was violent behavior, including bullying. Logistic regression models were developed to examine the relationship between violent behavior and each independent and control variable. Results In the adjusted regression model, male sex (aOR: 1.75; 95%CI 1.65-1.86), being assaulted by a family member (aOR: 1.74; 95%CI 1.59-1.90), and being assaulted in the past year (aOR: 1.70; 95%CI 1.57-1.85) all increased the chance of violent behavior. Feeling safe on the way to school (aOR: 0.82; 95%CI 0.74-0.92) and at school (aOR: 0.82; 95%CI 0.73-0.92) reduced the chance of violent behavior. Conclusion This study extends the body of literature on violent behavior among adolescents, demonstrating a correlation between school, domestic, family, or community violence and violent behavior. Our research supports the idea that adolescents who experience violence act violently with greater frequency. This finding has significant implications for pediatricians, child psychiatrists and psychologists, other health care professionals, school professionals, and other professionals involved in adolescent health. School professionals must be prepared to identify adolescents with violent behavior due to its potential consequences for their mental and physical health.

Substance use among older adults: a review of the literature.

OBJECTIVES: To explore studies that have examined the effectiveness of possible interventions to reduce the substance use among older adults. METHODS: From the search, 295 abstracts were identified and 200 were excluded. Ninety-five remaining articles were reviewed, and 90 were excluded after full text review. Nine articles were included after reviewing bibliographic references on the topic. A total of 14 articles, which all met the inclusion criteria, were considered in the review. RESULTS: All 14 studies found that pharmacological and non-pharmacological interventions can reduce substance use (alcohol, cocaine, nicotine and benzodiazepines) among older adults (mean age 45 years or older). CONCLUSIONS: There are promising possibly pharmacological and non-pharmacological interventions that can be used to reduce substance use among older adults. In addition, other studies are needed to expand the therapeutic arsenal in this population.

Violent behavior, perceived safety, and assault experiences among adolescents: results from the Brazilian National Adolescent School-based Health Survey.

OBJECTIVE: To investigate factors associated with violent behavior in a large nationally representative sample of Brazilian adolescents. METHODS: The data were derived from the 2015 National Adolescent School-based Health Survey (Pesquisa Nacional de Saúde do Escolar [PeNSE]). The independent variables of interest included feelings of safety while on the way to and at school. The outcome was violent behavior, including bullying. Logistic regression models were developed to examine the relationship between violent behavior and each independent and control variable. RESULTS: In the adjusted regression model, male sex (aOR: 1.75; 95%CI 1.65-1.86), being assaulted by a family member (aOR: 1.74; 95%CI 1.59-1.90), and being assaulted in the past year (aOR: 1.70; 95%CI 1.57-1.85) all increased the chance of violent behavior. Feeling safe on the way to school (aOR: 0.82; 95%CI 0.74-0.92) and at school (aOR: 0.82; 95%CI 0.73-0.92) reduced the chance of violent behavior. CONCLUSIONS: This study extends the body of literature on violent behavior among adolescents, demonstrating a correlation between school, domestic, family, or community violence and violent behavior. Our research supports the idea that adolescents who experience violence act violently with greater frequency. This finding has significant implications for pediatricians, child psychiatrists and psychologists, other health care professionals, school professionals, and other professionals involved in adolescent health. School professionals must be prepared to identify adolescents with violent behavior due to its potential consequences for their mental and physical health.

An Exploration of the Link Between Bullying Perpetration and Substance Use: A Review of the Literature.

Bullying and substance use are serious public health concerns. The aim of this article is to review empirical studies that examined the association between bullying perpetration and substance use among adolescence in various countries. Research studies that found a correlation between bullying perpetration and substance use in children and adolescents were reviewed. From the search, 7,844 abstracts were identified and 7,795 were excluded. Fifty-four remaining articles were reviewed, and 23 were excluded after full text review. A total of 31 articles, which all met the inclusion criteria, were considered in the review. Findings from the review suggest that children who engaged in bullying are more likely to be involved in alcohol, tobacco, and illicit drug use. Substance use prevention efforts require an examination of peer dynamics and peer relationships. In addition, bullying and substance use prevention require family dynamics and how they may increase the risk of bullying and drugs abuse.

Prescription psychostimulants for the treatment of stimulant use disorder: a systematic review and meta-analysis.

RATIONALE: Agonist-based pharmacologic intervention is an accepted approach in treatment of opioid and tobacco use disorders. OBJECTIVES: We conducted a systematic review and meta-analysis to evaluate usefulness of an agonist approach as treatment of (psycho)stimulant use disorder (PSUD). METHODS: We reviewed PubMed/Medline, LILACS, and ClinicalTrials.gov databases searching for randomized, double-blind, placebo-controlled, parallel-design studies evaluating outcomes of individuals treated for cocaine- or amphetamine-type substance use disorder. We combined results of all trials that included the following prescription psychostimulants (PPs): modafinil, methylphenidate, or amphetamines (mixed amphetamine salts, lisdexamphetamine, and dextroamphetamine). The combined sample consisted of 2889 patients. Outcomes of interest included the following: drug abstinence (defined as 2-3 weeks of sustained abstinence and the average maximum days of consecutive abstinence), percentage of drug-negative urine tests across trial, and retention in treatment. We conducted random-effects meta-analyses and assessed quality of evidence using the GRADE system. RESULTS: Thirty-eight trials were included. Treatment with PPs increases rates of sustained abstinence [risk ratio (RR) = 1.45, 95% confidence interval (CI) = (1.10, 1.92)] and duration of abstinence [mean difference (MD) = 3.34, 95% CI = (1.06, 5.62)] in patients with PSUD, particularly those with cocaine use disorder (very low-quality evidence). Prescription amphetamines were particularly efficacious in promoting sustained abstinence in patients with cocaine use disorder [RR = 2.44, 95% CI = (1.66, 3.58)], and higher doses of PPs were particularly efficacious for treatment of cocaine use disorder [RR = 1.95, 95% CI = (1.38, 2.77)] (moderate-quality evidence). Treatment with prescription amphetamines also yielded more cocaine-negative urines [MD = 8.37%, 95% CI = (3.75, 12.98)]. There was no effect of PPs on the retention in treatment. CONCLUSION: Prescription psychostimulants, particularly prescription amphetamines given in robust doses, have a clinically significant beneficial effect to promote abstinence in the treatment of individuals with PSUD, specifically the population with cocaine use disorder.

Childhood trauma and adolescent psychotic experiences in a community-based cohort: The potential role of positive attributes as a protective factor.

OBJECTIVE: To investigate how a set of positive social and personality characteristics called 'positive attributes' affects the emergence and persistence of Psychotic Experiences (PE) in adolescence. METHOD: We used data from a community-based Brazilian High-Risk Cohort (HRC). 2511 6-12 year-old children were evaluated at baseline, and 80.05% completed a 3-year follow-up interview. At baseline, childhood trauma was assessed using parent- and self-report, and positive attributes were assessed by parent-report. Trained psychologists rated self-reported PE at both time points. Linear models evaluated the effect of childhood trauma and positive attributes on PE at follow-up. Mediation models tested i.) the indirect effect of positive attributes on the association between childhood trauma and follow-up PE and, ii.) the indirect effect of childhood trauma and positive attributes on the relationship between PE at baseline and follow-up. RESULTS: Higher levels of baseline PE (B = 0.157, p < .001) and higher childhood trauma (B = 0.110, p < .001) were associated with increased follow-up PE. Higher positive attributes predicted lower PE after 3 years, adjusting for the prevalence of baseline PE and childhood trauma (B = -0.042, p < .022). Positive attributes partially mediated the relationship between childhood trauma and follow-up PE. The indirect pathway of childhood trauma and positive attributes mediated the association between baseline and follow-up PE. CONCLUSIONS: Higher levels of positive social and behavioral traits in childhood may diminish the subsequent emergence of PE. As these attributes can be promoted, our findings suggest that positive attributes may represent a novel target for preventive interventions in children at risk of developing PE.