Psychiatry Int., Volume 2, Issue 1 (March 2021) – 8 articles

Mutations in the genes coding for tryptophan-hydrolase-2 and the scaffold protein FKBP5 are associated with an increased risk of suicide. The mutation in both cases enhances the enzymatic activity of glycogen synthase kinase-3 (GSK3). Conversely, anti-suicidal medications, such as lithium, clozapine, and ketamine, indirectly inhibit the activity of GSK3. When GSK3 is active, it promotes the metabolic removal of the transcription factor NRF2 (nuclear factor erythroid 2-related factor-2), which suppresses the transcription of multiple genes that encode anti-oxidative and anti-inflammatory proteins. Notably, several suicide-biomarkers bear witness to an ongoing inflammatory process. Moreover, alterations in serum lipid levels measured in suicidal individuals are mirrored by data obtained in mice with genetic deletion of the NRF2 gene. Inflammation is presumably causally related to both dysphoria and anger, two factors relevant for suicide ideation and attempt. Preventing the catabolism of NRF2 could be a strategy to obtain novel suicide-prophylactic medications. Possible candidates are minocycline and nicotinic-α7 agonists. The antibiotic minocycline indirectly activates NRF2-transcriptional activity, whereas the activation of nicotinic-α7 receptors indirectly inhibits GSK3. Full article

Trait emotional intelligence (EI) may prove to be most valuable as an approach for dealing with others’ behaviours/emotions via its related psychological processes. Personality trait theory posits that an individual’s level of EI affects their cognitive-affective-behavioural reaction towards students with emotional behavioural disorders (EBDs) and influences the level of difficult behaviour. EI would be an essential element in fostering supportive interactions with students as a way of preventing and/or managing disruptive behaviours. The author explores which individuals are more predisposed to discriminate against EBD students using an attribution model framework and identifies the most effective and supportive EI traits. Two hundred and sixty-one teachers from 51 Victorian schools completed self-report questionnaires, including the Trait Emotional Intelligence Questionnaire. A quantitative survey methodology used vignettes (depicting a student with either mild or severe EBD symptoms), with 50/50 surveys randomly distributed. Teacher EI predicted the behaviour towards students with EBDs, whilst bypassing or biasing conscious thought processing. Combinations of EI traits were identified that produced the most desirable outcomes, demonstrating EI’s propensity to direct reactions towards a more effective or dysfunctional helping approach. The findings suggest that the most effective approaches towards helping EBD students are the innate dispositional reactions that establish the necessary psychological foundations for any successful interaction or outcome. The development of an assessment tool (Assessment Screen for Emotionally Intelligent Teachers (ASET)) lays a sound foundation for profiling teachers with these ideal qualities. Full article

Background: This study aimed to compare the severity of psychological impact, anxiety and depression between people from two developing countries, Iran and China, and to correlate mental health parameters with variables relating to the COVID-19 pandemic. Although China and Iran are developing countries based on the World Bank’s criteria, these two countries are different in access to resources and health care systems. We hypothesized that Iranians would show higher levels of depression, anxiety and stress as compared to Chinese. Methods: This study collected information related to the COVID-19 pandemic including physical health, precautionary measures and knowledge about the pandemic. We also used validated questionnaires such as the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21) to assess the mental health status. Results: There were a total of 1411 respondents (550 from Iran; 861 from China). The mean IES-R scores of respondents from both countries were above the cut-off for post-traumatic stress disorder (PTSD) symptoms. Iranians had significantly higher levels of anxiety and depression (p < 0.01). Significantly more Iranians believed COVID-19 was transmitted via contact, practised hand hygiene, were unsatisfied with health information and expressed less confidence in their doctors, but were less likely to wear a facemask (p < 0.001). Significantly more Iranians received health information related to COVID-19 via television while Chinese preferred the Internet (p < 0.001). Conclusions: This cross-country study found that Iranians had significantly higher levels of anxiety and depression as compared to Chinese. The difference in reported measures between respondents from Iran and China were due to differences in access to healthcare services and governments’ responses to the pandemic. Full article

The activation relationship refers to the emotional bond a child develops with a parent that helps ensure the regulation of risk-taking during child exploration of the surrounding environment. As a complement to Bowlby’s attachment theory, activation relationship theory provides a greater understanding of the impact of fathering on child development, focusing primarily on parental stimulation of risk-taking and control during child exploration. The overarching objective of this article is to better understand the association between children’s relationship quality with both parents, via the activation to father and the attachment to mother relationships, and child externalizing behaviors in a clinical sample. Fifty two-parent families (40 boys and 10 girls) were recruited at random from a population of children receiving treatment at the perinatal and early childhood psychiatry clinic. Results with 44 children (with complete cases) showed that overactivated preschoolers displayed more externalizing behaviors than did children with either an activated or an under-activated relationship with their father. Results also showed that children with a disorganized-controlling caregiving attachment to their mother marginally presented with higher levels of externalizing behavior. Full article

Many patients with schizophrenia seem relatively immune to physical pain while others complain of constant pain. This may result from disturbances or alterations of the sensory threshold for pain in populations with psychosis, a possibility for which there is some preliminary evidence. The inconsistency in pain perception may, in part, be explained by the treatments patients receive, but treatment-naïve patients also exhibit differences in response to pain. This suggests that decreased pain sensitivity may represent a specific psychosis endophenotype. Thus far, few experimental studies have investigated sensory thresholds, pain modalities, or other factors contributing to the perception or expression of physical pain in psychosis. A digital search for information on this topic was conducted in PubMed and Google Scholar. The result is a non-systematic, narrative review focusing on recent clinical and experimental findings of pain sensitivity in patients with psychosis. Importantly, physical and mental pain are closely connected constructs that may be difficult to differentiate. Our hope is that the review provides some clarity to the field in the specific context of schizophrenia. Full article

This study investigated the associations of imageability with fear reactivity. Imageability ratings of four word classes: positive and negative (i) emotional and (ii) propriosensitive, neutral and negative (iii) theoretical and (iv) neutral concrete filler, and fear reactivity scores—degree of fearfulness towards different situations (Total Fear (TF) score) and total number of extreme fears and phobias (Extreme Fear (EF) score), were obtained from 171 participants. Correlations between imageability, TF and EF scores were tested to analyze how word categories and their valence were associated with fear reactivity. Imageability ratings were submitted to recursive partitioning. Participants with high TF and EF scores had higher imageability for negative emotional and negative theoretical words. The correlations between imageability of negative emotional words and negative theoretical words for EF score were significant. Males showed stronger correlations for imageability of negative emotional words for EF and TF scores. High imageability for positive emotional words was associated with lower fear reactivity in females. These findings were discussed with regard to negative attentional bias theory of anxiety, influence on emotional systems, and gender-specific coping styles. This study provides insight into cognitive functions involved in mental imagery, semantic competence for mental imagery in relation to fear reactivity, and a potential psycholinguistic instrument assessing fear reactivity. Full article

Post-traumatic stress disorder (PTSD) increasingly burdens the health of many people, as indicated by the growing numbers of U.S. military veterans’ claims. An increased awareness of PTSD as a health concern necessitates a careful exploration of treatments. A range of current PTSD treatments and the need to more selectively utilize treatments is addressed. Studies indicate that recent PTSD treatment breakthroughs may offer promise and can be more effectively utilized. Assertions from organizations such as the U.S. National Center for PTSD contradict the commonly cited contention that there is no “cure” for PTSD. A review of PTSD literature reveals that: (1) the U.S. Veterans Administration is dispensing drugs (some of which have harmful side effects) that are not approved for use in treating PTSD by the U.S. Food and Drug Administration, (2) not aggressively exploring the use of novel approaches to PTSD treatment, and (3) not adequately funding research into PTSD treatment relatively to the funding of disability payments. Because of these factors the U.S. government is not optimally serving the interests of veterans. Full article

Nowadays, most of the patients affected by psychiatric disorders are successfully treated with psychotherapy and pharmacotherapy. Nevertheless, according to the disease, a variable percentage of patients results resistant to such modalities, and alternative methods can then be considered. The purpose of this review is to summarize the techniques and results of invasive modalities for several treatment-resistant psychiatric diseases. A literature search was performed to provide an up-to-date review of advantages, disadvantages, efficacy, and complications of Deep-Brain Stimulation, Magnetic Resonance-guided Focused-Ultrasound, radiofrequency, and radiotherapy lesioning for depression, obsessive-compulsive disorder, schizophrenia, addiction, anorexia nervosa, and Tourette’s syndrome. The literature search did not strictly follow the criteria for a systematic review: due to the large differences in methodologies and patients’ cohort, we tried to identify the highest quality of available evidence for each technique. We present the data as a comprehensive, narrative review about the role, indication, safety, and results of the contemporary instrumental techniques that opened new therapeutic fields for selected patients unresponsive to psychotherapy and pharmacotherapy. Full article