A photonic pH sensor based on photothermal spectroscopy.

Although the determination of pH is a standard laboratory measurement, new techniques capable of measuring pH are being developed to facilitate modern technological advances. Bio-industrial processing, tissue engineering, and intracellular environments impose unique measurement requirements on probes of pH. We describe a fiber optic-based platform, which measures the heat released by chromophores upon absorption of light. The optical fibers feature fiber Bragg gratings (FBG) whose Bragg peak redshifts with increasing temperature. Using anthocyanins (pH-sensitive chromophores found in many plants), we are able to correlate visible light absorption by a solution of anthocyanins to heat released and changes in FBG signal over a pH range of 2.5 to 10. We tested the ability of this platform to act as a sensor coating the fiber within a layer of crosslinked polyethylene glycol diacrylate (PEG-DA). Incorporating the anthocyanins into the PEG, we find that the signal magnitude increases over the observed signal at the same pH in solution. Our results indicate that this platform is viable for assessing pH in biological samples and point at ways to optimize performance.

Mental Health in the Cree Peoples of Northern Quebec: Relationships Among Trauma, Familial Psychological Distress, and Mood or Anxiety Disorders.

OBJECTIVE: This study examined the physical and mental health of Cree adults, as well as the personal, clinical, and environmental factors associated with the presence of lifetime anxiety and mood disorders. METHODS: Mental health was assessed using the computerised version of the Diagnostic Interview Schedule (CDIS-IV), and standardised instruments were used to assess physical health, addiction severity, and psychological distress in 506 randomly selected participants from 4 Northern Cree communities in Quebec. RESULTS: Overall, 46.1% of participants reported chronic medical problems, 42.1% were current smokers and 34.5% met the DSM-IV criteria for an anxiety or mood disorder. Individuals with an anxiety or mood disorder were younger, predominantly female, and with higher educational levels, and a large proportion (47.7%) met the lifetime criteria for substance dependence. Hierarchical regression determined that anxiety or mood disorders were associated with serious problems getting along with parents, a history of physical and sexual abuse, and a lifetime diagnosis of substance dependence. Overall, 29.7% of Cree adults reported sexual abuse, 47.1% physical abuse, and 52.9% emotional abuse. CONCLUSIONS: This study highlights the high rates of physical and mental health problems in Cree communities and the association among parental history of psychological problems, history of abuse, and psychological distress. Participants expressed a desire for additional medical and psychological treatments to address the patterns of abuse, trauma, and mental disorders that are burdening the Cree communities in Northern Quebec.

The Social and Psychological Impacts of Gambling in the Cree Communities of Northern Québec.

A detailed survey of gambling, addiction and mental health was conducted with randomly selected respondents (n = 506) from four Cree communities of Northern Quebec. The study examined the current patterns of gambling in relation to demographic, social, and psychological factors. Instruments included the Canadian Problem Gambling Index, Addiction Severity Index, Beck Depression Inventory and the computerized Diagnostic Interview Schedule for psychiatric diagnoses. Overall, 69.2 % of the total sample participated in any gambling/gaming activities over the past year; 20.6 % of this group were classified as moderate/high risk gamblers, and 3.2 % were classified in the highest "problem gambling" category. Considering the entire sample, the overall prevalence of problem gambling was 2.2 %. Women were significantly more likely to play bingo (56.6 %) compared to men (35.1 %) and they played more frequently; 20.8 % of women versus 3.8 % of men played once/week or more often. Compared to the no/low risk gamblers, a greater proportion of moderate/high risk gamblers were cigarette smokers (44.8 vs. 56.3 %), they were more likely to meet DSM-IV diagnostic criteria for alcohol dependence (21.2 vs. 46.2 %), and they were more likely to report moderate to severe depressive symptoms in the past month. Risk factors for problem gambling included traumatic life events (physical and emotional abuse), anxiety and depression, as well as drug/alcohol abuse. The high rates of comorbidity between problem gambling, tobacco dependence, substance abuse and other psychological problems demonstrate that gambling among some Cree adults is part of a pattern of high-risk factors for negative long-term health consequences. The results also have implications for treatment, suggesting that interventions for gambling disorders should not focus on gambling alone but rather the constellation of high-risk behaviours that pose a risk to recovery and well-being.

Poorer Drinking Outcomes with Citalopram Treatment for Alcohol Dependence: A Randomized, Double-Blind, Placebo-Controlled Trial.

BACKGROUND: Previous research on the use of selective serotonin reuptake inhibitors (SSRIs) as a treatment for alcohol dependence has yielded mixed results. Depression has been shown to be a predictor of relapse and poor outcome following treatment, and it has been hypothesized that SSRIs would be beneficial in reducing drinking in depressed alcohol-dependent individuals. This randomized, double-blind, placebo-controlled trial was designed to test the effects of citalopram on treatment outcomes among alcohol-dependent individuals with and without depression. METHODS: Two hundred and sixty-five patients meeting criteria for a DSM-IV diagnosis of alcohol abuse or dependence were randomly assigned to receive placebo or citalopram 20 mg per day for the first week, followed by 40 mg per day from weeks 2 through 12. All patients received a standard course of treatment consisting of weekly individual and group psychotherapy. Participants were reassessed at 12 weeks, including dropouts from both treatment groups to determine rates of abstinence, changes in alcohol use, addiction severity, depressive symptoms, and psychiatric status. RESULTS: Citalopram provided no advantage over placebo in terms of treatment outcomes, and for some measures, citalopram produced poorer outcomes. Patients in the citalopram group had a higher number of heavy drinking days throughout the trial, and smaller changes in frequency and amount of alcohol consumption at 12 weeks. There was no influence of depression severity on outcomes in either medication group. Survival analyses also indicated no differences between depressed and nondepressed patients in the citalopram group for time to first slip or relapse. A diagnosis of personality disorder was associated with poorer treatment responses overall, regardless of treatment condition. CONCLUSIONS: This trial does not support the use of citalopram in the treatment of alcohol dependence. The results suggest that the use of SSRIs among depressed and nondepressed alcohol-dependent individuals early in recovery, prior to the onset of abstinence, may be contraindicated.

Short-term Outcomes of a Randomized Pilot Trial of 2 Treatment Regimens of Transcutaneous Tibial Nerve Stimulation for Fecal Incontinence.

BACKGROUND: Fecal incontinence is a socially disabling condition that affects ≤15% of adults. Neuromodulatory treatments for fecal incontinence are now well established. Less invasive, cheaper, and more ambulatory forms of neuromodulation are under exploration. OBJECTIVE: The purpose of this study was to assess the acceptability and safety of a new ambulatory tibial nerve stimulation device and to determine clinical effect size for 2 differing regimens of therapy. DESIGN: This was a randomized, investigator-blinded, parallel-arm, 6-week pilot trial. SETTINGS: The study was conducted at 7 United Kingdom trial centers. Patients were initially reviewed in the trial center, with subsequent applications of the device performed in the patients home setting. PATIENTS: A total of 43 eligible patients (38 women) who failed conservative management of fecal incontinence were included in the study. INTERVENTION: The study intervention involved twice-weekly, 1- versus 4-hour transcutaneous tibial nerve stimulation for 6 weeks (total of 12 treatments). MAIN OUTCOME MEASURES: Standard fecal incontinence outcome tools (bowel diary, symptom severity score, and generic quality-of-life instruments) were used to collect data at baseline and at 2 weeks posttreatment cessation. RESULTS: A total of 22 patients were randomly assigned to the 1-hour group and 21 to the 4-hour group. Improvements in fecal incontinence outcomes were observed for both groups, including median urge incontinence episodes per week at baseline and posttreatment (1-hour group 2.0 to 0.5 versus 4-hour group 4.0 to 1.0) and deferment time (1-hour group 2.0 to 2.0 minutes versus 4-hour group 0.5 to 5.0 minutes). Accompanying changes were observed in physical functioning domains of quality-of-life instruments. There were no adverse events, and the treatment was highly acceptable to patients. LIMITATIONS: Limitations included the pilot design and lack of control arm in the study. Future trials would need to address these limitations. CONCLUSIONS: This pilot study provides evidence that transcutaneous tibial nerve stimulation with a new ambulatory device is safe and acceptable for the management of fecal incontinence. Additional study is warranted to investigate clinical effectiveness.

The design and initial patient evaluation of an integrated care pathway for faecal incontinence: a qualitative study.

BACKGROUND: Faecal incontinence is a common, distressing and debilitating condition which remains largely hidden, leading to social isolation and loss of confidence. Patients with faecal incontinence experience delays in accessing appropriate treatment services due to embarrassment and lack of enquiry from primary care health professionals. Despite the publication of three government documents related to continence services in the last decade, these services are still fragmented with asynchronous delivery and poor inter-professional integration. The aim of the study was to describe a novel integrated care pathway for the management of faecal incontinence and examine the experiences of patients with faecal incontinence in relation to this pathway. METHODS: A focus group (eight participants) and narrative, qualitative individual interviews (five participants) were used to explore the views of patients with faecal incontinence, relating to access and quality of incontinence services and the new integrated care pathway. Emerging themes were identified from the transcribed focus group and interviews via the thematic analysis method. RESULTS: The concept of an integrated care pathway is attractive for increasing accessibility, streamlining of the patient pathway and providing a dedicated service for the management of faecal incontinence. Patients' initial experiences of the pathway are positive. DISCUSSION: A new ICP was developed and the initial patient evaluation of it was positive. Service users made various suggestions how the FI pathway could have been improved. The issues that patients were most concerned about were access to continence services, GP awareness of continence services and prompt, effective management of their condition. This service was set up within the pelvic floor dysfunction unit with BFNS and an integrated community continence team. The authors are aware that this is not a standard service setup across the country. The fact that it may be uncomfortable for patients to talk about their condition may have led to potential bias when discussing their beliefs or experiences. As with most qualitative studies, our aim was to identify a range of experiences rather than define our participant sample as being representative. Our participant sample was diverse in the key characteristics but a longitudinal study may reveal further important aspects of an ICP for FI. CONCLUSIONS: An integrated care pathway for faecal incontinence appears to have potential to address the long-standing service delivery issues that have blighted continence services historically.

Corresponding decrease in neuronal markers signals progressive parvalbumin neuron loss in MAM schizophrenia model.

Alteration in normal hippocampal (HPC) function attributed to reduced parvalbumin (PV) expression has been consistently reported in schizophrenia patients and in animal models of schizophrenia. However, it is unclear whether there is an overall loss of interneurons as opposed to a reduction in activity-dependent PV content. Co-expression of PV and the constitutively expressed substance P (SP)-receptor protein has been utilized in other models to ascertain the degree of cell survival, as opposed to reduction in activity-dependent PV content, in the HPC. The present study measured the co-expression of PV and SP-receptors in the dentate and dorsal and ventral CA3 subregions of the HPC in the methylazoymethanol acetate (MAM) rat neurodevelopmental model of schizophrenia. In addition, these changes were compared at the post-natal day 27 (PND27) and post-natal day 240 (PND > 240) time points. Brains from PND27 and PND > 240 MAM (n = 8) and saline (SAL, n = 8) treated offspring were immunohistochemically processed for the co-expression of PV and SP-receptors. The dorsal dentate, dorsal CA3 and ventral CA3 subregions of PND27 and PND > 240 MAM rats demonstrated significant reductions in PV but not SP-receptor expression, signifying a loss of PV-content. In contrast, in the ventral dentate the co-expression of PV and SP-receptors was significantly reduced only in PND > 240 MAM animals, suggesting a reduction in cell number. While MAM-induced reduction of PV content occurs in CA3 of dorsal and ventral HPC, the most substantial loss of interneuron number is localized to the ventral dentate of PND > 240 animals. The disparate loss of PV in HPC subregions likely impacts intra-HPC network activity in MAM rats.

Chronic methylphenidate treatment during early life is associated with greater ethanol intake in socially isolated rats.

BACKGROUND: Methylphenidate (MPH) is a stimulant prescribed to treat attention-deficit/ hyperactivity disorder. Its primary mechanism of action is in the dopamine system, alterations of which are associated with vulnerability to alcohol abuse. There are concerns that juvenile MPH treatment may influence adult drinking behavior. This study examined the interaction of MPH treatment and environmental rearing conditions, which are known to independently influence ethanol (EtOH) drinking behavior, on anxiety-like behavior and vulnerability to alcohol abuse in a juvenile rodent model. METHODS: Male Sprague-Dawley rats were housed in enriched, standard, or isolated conditions for 4 weeks, starting at postnatal day 21. Rats were concurrently treated with 8 mg/kg/d MPH or saline, delivered via osmotic minipump. Anxiety-like behavior was determined at the end of the treatment session, and 5 weeks later. After MPH treatment, rats were exposed to a 2-bottle choice EtOH drinking procedure that lasted 3 weeks. RESULTS: Early life chronic MPH treatment was associated with greater EtOH intake and greater EtOH preference, but only in socially isolated animals. Isolated animals had greater levels of anxiety-like behavior than standard-housed or enriched animals after 4 weeks of exposure to the housing conditions, a difference that persisted even after all animals had been individually housed for an additional 5 weeks and exposed to EtOH. CONCLUSIONS: These results suggest that early life MPH treatment may increase vulnerability to EtOH drinking in adulthood in a subset of the population. Additionally, this study highlights the importance of early rearing condition for establishing long-lasting behavioral phenotypes. Environmental histories should be considered when prescribing MPH treatment to young children.

Differential effects of acute and repeated stress on hippocampus and amygdala inputs to the nucleus accumbens shell.

The basolateral amygdala (BLA) and ventral subiculum (vSub) of the hippocampus convey emotion and context information, respectively, to the nucleus accumbens (NAc). Using in vivo extracellular recordings from NAc neurons, we examined how acute and repeated restraint stress alters the plasticity of the vSub and BLA afferent pathways. High-frequency (HFS) and low-frequency (LFS) stimulation was applied to the vSub to assess the impact on NAc responses to vSub and BLA inputs. In addition, iontophoretic application of the dopamine D2-antagonist sulpiride was used to explore the role of dopamine in the NAc in mediating the effects of stress on plasticity. Acute and repeated restraint caused disparate effects on BLA- and vSub-evoked responses in the NAc. Following repeated restraint, but not after acute restraint, HFS of the vSub failed to potentiate the vSub­NAc pathway while instead promoting a long-lasting reduction of the BLA­NAc pathway and these effects were independent of D2-receptor activity. In contrast, LFS to the vSub pathway after acute restraint resulted in potentiation in the vSub­NAc pathway while BLA-evoked responses were unchanged. When sulpiride was applied prior to LFS of the vSub after acute stress, there was a pronounced decrease in vSub-evoked responses similar to control animals. This work provides new insight into the impact of acute and repeated stress on the integration of context and emotion inputs in the NAc. These data support a model of stress whereby the hippocampus is inappropriately activated and dominates the information processing within this circuit via a dopaminergic mechanism after acute bouts of stress.

Auditory function in children with Charcot-Marie-Tooth disease.

The peripheral manifestations of the inherited neuropathies are increasingly well characterized, but their effects upon cranial nerve function are not well understood. Hearing loss is recognized in a minority of children with this condition, but has not previously been systemically studied. A clear understanding of the prevalence and degree of auditory difficulties in this population is important as hearing impairment can impact upon speech/language development, social interaction ability and educational progress. The aim of this study was to investigate auditory pathway function, speech perception ability and everyday listening and communication in a group of school-aged children with inherited neuropathies. Twenty-six children with Charcot-Marie-Tooth disease confirmed by genetic testing and physical examination participated. Eighteen had demyelinating neuropathies (Charcot-Marie-Tooth type 1) and eight had the axonal form (Charcot-Marie-Tooth type 2). While each subject had normal or near-normal sound detection, individuals in both disease groups showed electrophysiological evidence of auditory neuropathy with delayed or low amplitude auditory brainstem responses. Auditory perception was also affected, with >60% of subjects with Charcot-Marie-Tooth type 1 and >85% of Charcot-Marie-Tooth type 2 suffering impaired processing of auditory temporal (timing) cues and/or abnormal speech understanding in everyday listening conditions.

Antipsychotic drugs rapidly induce dopamine neuron depolarization block in a developmental rat model of schizophrenia.

Repeated administration of antipsychotic drugs to normal rats has been shown to induce a state of dopamine neuron inactivation known as depolarization block, which correlates with the ability of the drugs to exhibit antipsychotic efficacy and extrapyramidal side effects in schizophrenia patients. Nonetheless, in normal rats depolarization block requires weeks of antipsychotic drug administration, whereas schizophrenia patients exhibit initial effects soon after initiating antipsychotic drug treatment. We now report that, in a developmental disruption rat model of schizophrenia [methyl-azoxymethanol acetate (20 mg/kg, i.p.) injected into G17 pregnant female rats, with offspring tested as adults], the extant hyperdopaminergic state combines with the excitatory actions of a first- (haloperidol; 0.6 mg/kg, i.p.) and a second- (sertindole; 2.5 mg/kg, i.p.) generation antipsychotic drug to rapidly induce depolarization block in ventral tegmental area dopamine neurons. Acute injection of either antipsychotic drug induced an immediate reduction in the number of spontaneously active dopamine neurons (cells per electrode track; termed population activity). Repeated administration of either antipsychotic drug for 1, 3, 7, 15, and 21 d continued to reduce dopamine neuron population activity. Both acute and repeated effects on population activity were reversed by acute apomorphine injections, which is consistent with the reversal of dopamine neuron depolarization block. Although this action may account for the effects of D2 antagonist drugs on alleviating psychosis and the lack of development of tolerance in humans, the drugs appear to do so by inducing an offsetting deficit rather than attacking the primary pathology present in schizophrenia.

Different stressors produce excitation or inhibition of mesolimbic dopamine neuron activity: response alteration by stress pre-exposure.

Stressors can exert a wide variety of responses, ranging from adaptive responses to pathological changes; moreover, recent studies suggest that mild stressors can attenuate the response of a system to major stressful events. We have previously shown that 2-week exposure to cold, a comparatively mild inescapable stressor, induced a pronounced reduction in ventral tegmental area (VTA) dopamine (DA) neuron activity, whereas restraint stress increases DA neuron activity. However, it is not known if these stressors differentially impact the VTA in a region-specific manner, if they differentially impact behavioral responses, or whether the effects of such different stressors are additive or antagonistic with regard to their impact on DA neuron firing. To address these questions, single-unit extracellular recordings were performed in anesthetized control rats and rats exposed to chronic cold, and tested after delivery of a 2-h restraint session. Chronic cold stress strongly attenuated the number of DA neurons firing in the VTA, and this effect occurred primarily in the medial and central VTA regions that preferentially project to reward-related ventral striatal regions. Chronic cold exposure also prevented the pronounced increase in DA neuron population activity without affecting the behavioral sensitization to amphetamine produced by restraint stress. Taken together, these data show that a prolonged inescapable mild stressor can induce plastic changes that attenuate the DA system response to acute stress.

Update on the clinical use of buprenorphine: in opioid-related disorders.

OBJECTIVE: To review the current evidence on buprenorphine-naloxone for the treatment of opioid-related disorders, with a focus on primary care settings. QUALITY OF EVIDENCE: MEDLINE and the Cochrane Database of Systematic Reviews were searched. Evidence is mainly level I. MAIN MESSAGE: Buprenorphine is a partial µ-opioid agonist and κ-opioid antagonist with a long half-life and less abuse potential than methadone. For detoxification, buprenorphine is at least equivalent to methadone and is superior to clonidine. For maintenance treatment, buprenorphine is clearly superior to placebo. Methadone has a slight advantage in terms of retention in treatment, but a stepped approach with initial use of buprenorphine-naloxone is as efficacious. Use of buprenorphine in the primary care setting is feasible, safe, and effective. Authorization to prescribe buprenorphine can be obtained after completing online training. CONCLUSION: Buprenorphine is a safe and effective agent for detoxification from opioids. It can be used as a first-line agent in maintenance programs, owing to its lower abuse potential relative to other opioids. Its effectiveness in primary care settings makes it a useful therapeutic tool for family physicians.

Smartphone-based mobility metrics capture daily social motivation and behavior in schizophrenia.

Impaired social functioning contributes to reduced quality of life and is associated with poor physical and psychological well-being in schizophrenia, and thus is a key psychosocial treatment target. Low social motivation contributes to impaired social functioning, but is typically examined using self-report or clinical ratings, which are prone to recall biases and do not adequately capture the dynamic nature of social motivation in daily life. In the current study, we examined the utility of global positioning system (GPS)-based mobility data for capturing social motivation and behavior in people with schizophrenia. Thirty-one participants with schizophrenia engaged in a 60-day mobile intervention designed to increase social motivation and functioning. We examined associations between twice daily self-reports of social motivation and behavior (e.g., number of social interactions) collected via Ecological Momentary Assessment (EMA) and passively collected daily GPS mobility metrics (e.g., number of hours spent at home) in 26 of these participants. Findings suggested that greater mobility on a given day was associated with more EMA-reported social interactions on that day for four out of five examined mobility metrics: number of hours spent at home, number of locations visited, probability of being stationary, and likelihood of following one's typical routine. In addition, greater baseline social functioning was associated with less daily time spent at home and lower probability of following a daily routine during the intervention. GPS-based mobility thus corresponds with social behavior in daily life, suggesting that more social interactions may occur at times of greater mobility in people with schizophrenia, while subjective reports of social interest and motivation are less associated with mobility for this population.

Heterogeneous processing of amygdala and hippocampal inputs in the rostral and caudal subregions of the nucleus accumbens.

The nucleus accumbens (NAc) receives converging input from a number of structures proposed to play a role in affective disorders. In particular, the basolateral amygdala (BLA) provides an affective input that overlaps with context-related information derived from the ventral subiculum of the hippocampus (vSub). We examined how stimulation of the BLA is modulated by, and in turn affects, vSub inputs to this region. In-vivo extracellular recordings were performed in the NAc of anaesthetized rats. The effect of high-frequency (theta-burst) stimulation (HFS) of the BLA on both BLA and vSub-evoked responses was tested. In addition, the involvement of dopamine D2 receptors in BLA-induced plasticity in the NAc was examined by pre-treatment with sulpiride (5 mg/kg i.v.). Finally, tetrodotoxin (TTX) was used to inactivate the vSub and the effect on BLA-evoked responses was assessed. We found that HFS of the BLA causes hetereogeneous patterns of plasticity, depression and potentiation, respectively, in the rostral and caudal subregions of the NAc that are disrupted following D2 receptor antagonist treatment. In addition, inactivating the vSub with TTX attenuates the ability of the BLA to drive spike firing in the NAc. Thus, the vSub is required for activation of the NAc by the BLA. These data support a model whereby the amygdala can coordinate reward-seeking and fear-related behaviours via its differential regulation of NAc output. In addition, the hippocampus inappropriately dominates information processing within this circuit, potentially contributing to the overwhelming focus on internal emotional states in disorders such as depression.

A new general approach for the stereocontrolled synthesis of functionalised γ- and δ-lactams.

A new flexible approach for the stereoselective synthesis of substituted 1H-pyrrol-2(5H)-ones and 3,6-dihydro-1H-pyridin-2-ones has been developed. The general strategy employed the stereoselective reduction of a series of α,ß-unsaturated ketones under chelation control to give the corresponding allylic alcohols. Overman rearrangement to install the key C-N bond followed by conversion to either prop-2-enoyl or but-3-enoyl derivatives and a ring closing metathesis reaction gave the target unsaturated γ- and δ-lactams. The synthetic utility of these compounds as building blocks was demonstrated by the preparation of the N-Boc derivative of (-)-coniine.

"Skip the Small Talk" Virtual Event Intended to Promote Social Connection During a Global Pandemic: Online Survey Study.

BACKGROUND: Social distancing measures meant to prevent the spread of COVID-19 in the past year have exacerbated loneliness and depression in the United States. While virtual tools exist to improve social connections, there have been limited attempts to assess community-based, virtual methods to promote new social connections. OBJECTIVE: In this proof-of-concept study, we examined the extent to which Skip the Small Talk (STST)-a business dedicated to hosting events to facilitate structured, vulnerable conversations between strangers-helped reduce loneliness in a virtual format in the early months of the 2020 COVID-19 pandemic. We predicted that participants who attended STST virtual events would show a reduction in loneliness, improvement in positive affect, and reduction in negative affect after attending an event. We were also interested in exploring the role of depression symptoms on these results as well as the types of goals participants accomplished by attending STST events. METHODS: Adult participants who registered for an STST virtual event between March 25 and June 30, 2020, completed a survey before attending the event (pre-event survey; N=64) and a separate survey after attending the event (postevent survey; n=25). Participants reported on their depression symptoms, loneliness, and positive and negative affect. Additionally, participants reported the goals they wished to accomplish as well as those they actually accomplished by attending the STST event. RESULTS: The four most cited goals that participants hoped to accomplish before attending the STST event included the following: "to make new friends," "to have deeper/better conversations with other people," "to feel less lonely," and "to practice social skills." A total of 34% (20/58) of participants who completed the pre-event survey reported depression symptoms that indicated a high risk of a major depressive episode in the preceding 2 weeks. Of the 25 participants who completed the pre- and postevent surveys, participants reported a significant reduction in loneliness (P=.03, Cohen d=0.48) and negative affect (P<.001, Cohen d=1.52) after attending the STST event compared to before the event. Additionally, depressive symptoms were significantly positively correlated with change in negative affect (P=.03), suggesting that the higher the depression score was prior to attending the STST event, the higher the reduction in negative affect was following the event. Finally, 100% of the participants who wished to reduce their loneliness (11/11) or feel less socially anxious (5/5) prior to attending the STST event reported that they accomplished those goals after the event. CONCLUSIONS: Our preliminary assessment suggests that the virtual format of STST was helpful for reducing loneliness and negative affect for participants, including those experiencing depression symptoms, during the COVID-19 pandemic. While encouraging, additional research is necessary to demonstrate whether STST has benefits when compared to other social events and interventions and whether such benefits persist beyond the events themselves.

Distinct alterations in resting-state electroencephalogram during eyes closed and eyes open and between morning and evening are present in first-episode psychosis patients.

Abnormalities in resting-state electroencephalogram (rs-EEG) activity have been previously reported in schizophrenia. While most rs-EEG recordings were performed in patients with chronic schizophrenia during eyes closed (EC), only a handful of studies have investigated rs-EEG activity during both EC and eyes open (EO) conditions. It is also unknown whether EC and EO rs-EEG alterations are present at illness onset, and whether they change during the day. Here, we performed EC and EO rs-EEG recordings in the morning (AM) and evening (PM) in twenty-six first-episode psychosis (FEP) patients and seventeen matched healthy controls (HC). In AM/EC rs-EEG, a widespread reduction was found in low alpha power in FEP relative to HC. In PM/EC, the FEP group demonstrated a trend toward decreased theta power in parietal regions, while decreased high alpha power in frontal and left parietal regions was present during PM/EO. Moreover, reduced low alpha power during AM/EC was associated with worse positive symptoms. Altogether, those findings indicate that rs-EEG alterations are present in FEP patients at illness onset, that they are linked to the severity of their psychosis, and that distinct RS abnormalities can be detected in different conditions of visual alertness and time of the day. Future work should therefore account for those factors, which will help reduce variability of rs-EEG findings across studies and may serve as monitoring biomarkers of illness severity in schizophrenia and related psychotic disorders.

Preliminary Outcomes of an Ecological Momentary Intervention for Social Functioning in Schizophrenia: Pre-Post Study of the Motivation and Skills Support App.

BACKGROUND: People with schizophrenia and other serious mental illnesses often lack access to evidence-based interventions, particularly interventions that target meaningful recovery outcomes such as social functioning and quality of life. Mobile technologies, including smartphone apps, have the potential to provide scalable support that places elements of evidence-based interventions at the palm of patients' hands. OBJECTIVE: We aim to develop a smartphone app-called Motivation and Skills Support-to provide targeted social goal support (eg, making new friends and improving existing relationships) for people with schizophrenia enrolled in a stand-alone open trial. METHODS: In this paper, we presented preliminary outcomes of 31 participants who used the Motivation and Skills Support app for 8 weeks, including social functioning pre- to postintervention, and momentary reports of treatment targets (eg, social motivation and appraisals) during the intervention. RESULTS: The findings suggest that the intervention improved self-reported social functioning from baseline to treatment termination, particularly in female participants. Gains were not maintained at the 3-month follow-up. Furthermore, increased social functioning was predicted by momentary reports of social appraisals, including perceived social competence and the extent to which social interactions were worth the effort. CONCLUSIONS: The implications of these findings and future directions for addressing social functioning in schizophrenia using mobile technology have been discussed. TRIAL REGISTRATION: ClinicalTrials.gov NCT03404219; https://clinicaltrials.gov/ct2/show/NCT03404219.

Personality disorders among alcoholic outpatients: prevalence and course in treatment.

OBJECTIVE: To determine the prevalence of concurrent personality disorders (PDs) among alcoholic men and women seeking outpatient treatment, and to examine their effect on the course of alcohol treatment. METHOD: Patients with alcohol use disorders (n = 165) were assessed by clinical and semi-structured interviews, as well as self-report scales, to measure levels of psychological distress, impulsivity, social functioning, and addiction severity at treatment intake. PD diagnoses were assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Personality Disorder (SCID-II). Course in treatment was monitored prospectively for 12 weeks. RESULTS: Using the results of the SCID-II (n = 138), the sample was divided into 3 groups-that is, no PD 41% (n = 57), Cluster B PD 32% (n = 44), and other PD 27% (n = 37). The 3 groups did not differ in their alcohol use severity at intake. However, the Cluster B PD group achieved alcohol milestones at a younger age. Subjects with a PD had more severe psychological and social problems at intake. The Cluster B PD group showed significantly higher levels of impulsivity at intake, greater likelihood of early treatment dropout, and quicker times to first slip and to relapse. CONCLUSIONS: This study supports the high prevalence of concurrent PDs, particularly Cluster B PDs, among treatment-seeking alcoholics. The relation between observed high levels of impulsivity and worse course in early alcohol treatment among people with a Cluster B PD merits further investigation.