Medication adherence is poor among individuals with serious mental illness (SMI). Few studies demonstrated the effectiveness of remote medication dispensing and adherence monitoring interventions among individuals with SMI.

To understand medication dispensing rates associated with the use of remote medication dispensing and adherence monitoring device and identify associated demographic and clinical characteristics.

In this cohort study, individuals' characteristics were measured at the baseline and dispensing records were followed from their enrollment and subsequent device installation as early as January 2019 until June 2023. Individuals were eligible to participate if they were had a diagnosis of serious and persistent mental illness, age 18-64, were currently being prescribed psychiatric medications, and receiving mental health services from a participating community mental health agency (CMHA). Participants were recruited through a combination of self-selection and referrals from agency staff. Our intervention was the use of the remote medication dispensing and adherence monitoring device. Our measure was participants' daily medication dispensing.

The final sample consisted of 99 participants. The mean age of the participants was 49 years (SD=12.08), with 64% identified as men, and 41% as Black/African American. The average dispensing rate was 92.9%, with 90 individuals having dispensing rates greater than 80%. The results of the hierarchical Bayesian logistic regression model showed that participants adhered better to evening doses compared to morning doses (IRR=1.11, 95% CI=1.06-1.16). Dispensing adherence was poorer on weekends compared to weekdays (IRR=0.87, 95% CI=0.83-0.91). For every additional year on using the device, the rate of adherence increased by 1% (IRR=1.01, 95% CI=1.00-1.01). The rate of dispensing dropped by 22% after the onset of the COVID-19 pandemic (IRR=0.78, 95% CI=0.71-0.86) and African Americans had a 29% lower rate of dispensing compared to whites (IRR = 0.71, 95% CI = 0.55-0.90). The rate of dispensing did not differ by age, sex, and educational attainment, or the level of sadness, emotional and behavioral dyscontrol, cognitive function or psychotic symptoms at the baseline.

The high adherence rate observed, regardless of baseline psychopathology levels, highlights the potential of remote medication dispensing and adherence monitoring devices to address adherence challenges in SMI populations. Observed variation in dispensing behavior by dose timing and contextual factors suggests opportunities for intervention, including aligning dosing schedules with patient routines, providing additional support during periods of disruption (e.g., weekends or major life events), and tailoring strategies to address disparities across patient groups. These findings highlight the role of targeted, context-aware approaches to improve adherence in community-based SMI care. The findings support the integration of digital adherence monitoring within mental health services, especially in settings where traditional adherence support may be challenging.

nCT03775044.

Prader-Willi syndrome (PWS) is highly associated with psychiatric comorbidity.

This article investigates the prevalence of mental disorders in PWS, explores their association with neurobiological foundations, and outlines the resulting clinical recommendations.

An evaluation of the scientific literature in the context of clinical experience from the special outpatient clinic for mental health in rare syndromic disorders at Hannover Medical School.

Psychiatric manifestations are present in 44-89% of PWS patients, with disruptive behavior, skin picking, psychosis, compulsive symptoms, and affective disorders being the most common. PWS psychosis differs from schizophrenic psychosis and can be difficult to treat in some cases. Treatment approaches exist for disruptive behavior, affective symptoms, and compulsive symptoms.

Knowledge of the neurobiological basis of PWS is necessary for the adequate treatment of psychiatric disorders. In addition to pharmacological therapies, behavioral interventions and environmental control should also be included.

BackgroundInflammation is implicated in the pathogenesis of dementia. However, its role in the vascular cognitive burden and the clinical stage of Alzheimer's disease (AD) remains controversial.ObjectiveThis study aimed to explore the association of plasma inflammatory proteins with vascular cognitive burden and clinical stage of AD by using a multi-method approach.MethodsWe included 330 individuals with complete plasma protein profiles, Hachinski Ischemia Scale scores, and cognitive function status between September 13, 2005, and October 24, 2007. We employed generalized linear models, restricted cubic splines, and the inverse variance weighting (IVW) method for two-sample Mendelian randomization (MR) to investigate the correlation between inflammatory biomarkers and dementia. We employed the random forest algorithm to build predictive models and utilized SHapley Additive exPlanations (SHAP) analysis for feature importance and interpretability.ResultsAD clinical stage exhibited significant associations with cortisol, C-peptide, tumor necrosis factor receptor-2 (TNFR-2) and interleukin-16 (IL-16, all p < 0.05). Similarly, the vascular cognitive burden was significantly correlated with C-peptide, carcinoembryonic antigen and TNFR-2 (all p < 0.05). These observational findings were corroborated by SHAP analysis. Subsequent MR analysis further revealed a weak negative causal relationship between AD and IL-16 (p_IVW = 0.003; OR_IVW = 0.981; 95% CI: 0.969-0.994).ConclusionsOur study identified several inflammatory proteins correlated with the vascular cognitive burden and AD clinical stage, providing exploratory evidence for future mechanistic and interventional research.

Temporal expectations are considered as implicit timing, which is different from explicit timing. Furthermore, temporal expectations could be divided into exogenous and endogenous temporal expectations. However, it is still unclear about the neural activation under temporal expectations.

In the present study, an experimental paradigm was designed for eliciting the related brain activation under exogenous temporal expectations. Three conditions were used for the exogenous temporal expectations task. In order to compare the exogenous temporal expectations related activations to the endogenous', a proper endogenous temporal expectations task was used. Brain activations were obtained by using functional magnetic resonance imaging (fMRI).

Exogenous temporal perception-related regions, including TPJ, MTG, thalamus, IFG, caudate, cuneus, SOG, calcarine, FEF, and SPL have a good agreement with previous studies. Furthermore, it shows that the precuneus, PCC, Brodmann area 8 (BA8), ACC, and BA10 were also activated, which overlap with regions of the mesial of the so-called "default mode network". Negative correlated activations to exogenous temporal expectations task (use an endogenous temporal expectations task as an analysis baseline) were also evaluated.

We found that the sum of exogenous and endogenous temporal expectations related cerebral regions was almost the same when compared to resting-state networks (RSNs). We propose that the cerebrum could activate in two modes for cognition: one is based on endogenous temporal expectations, and another is based on exogenous temporal expectations.

Congenital adrenal hyperplasia (CAH) is a genetic condition caused by enzymatic defects of adrenal steroidogenesis. The physical manifestations of CAH are well recognised but the effects on health-related quality of life (HRQoL) are unclear. We sought to explore the factors impacting the HRQoL of individuals with CAH.

Phenomenological qualitative study of lived experience.

In-depth, timeline-assisted, semi-structured interviews were undertaken virtually with participants recruited via the Living with CAH patient support group. Participants, purposively selected until data saturation, were adults (≥18 years) with CAH and parents/partners of adults with CAH. Interviews were audio-recorded, transcribed verbatim and analysed using Framework Analysis.

Twenty-three participants were interviewed (20 classic, 1 non-classic, 2 mothers). Most participants (n=19) were female. CAH has a profound physical, psychological and psychosocial impact on individuals. The psychological wellbeing of women was compromised by trauma from childhood medical examinations and lack of agency in treatment decision. Poor self-esteem, shame and negative body image impaired female social functioning. Female sexual dysfunction from genital malformation/surgery and psychosexual issues negatively impacted intimate relationships. Fertility and reproductive choices were a concern to both sexes. Complex family dynamics with dependent relationships was evident.

This study identified a breadth of factors impacting HRQoL in CAH - domains overlooked by an existing measure which predominantly focus on physical symptoms. Further work is needed to develop a sensitive, comprehensive disease-specific HRQoL measure which reflects the lived experience of individuals with CAH to facilitate delivery of patient-centred care and improved patient outcomes.

Suicide rates in Mexico have been rising, and because suicidal behavior has a genetic component, several pharmacogenes potentially linked with suicide risk have been investigated. This review aims to summarize articles addressing pharmacogenes, their relationship with suicidal behavior phenotypes, and their role in pharmacological treatment response. Among the identified pharmacogenes, variants in genes such as ATP-binding cassette subfamily B member 1 Gene (ABCB1) and FKBP Prolyl Isomerase 5 Gene (FKBP5) have been repeatedly observed across suicide attempt and completed suicide phenotypes. With these we could hypothesize that there is a possibility of finding shared genetic mechanisms among suicide phenotypes. When studying the response to treatment, the presence of certain variants may result in reduced drug response, yielding no benefit and possibly worsening symptoms, potentially culminating in suicidal behavior. Moreover, overlapping variants have been identified between suicidal behavior and altered response to psychotropic drugs in pharmacogenes involved in different functional pathways such as neurotransmission, hypothalamic-pituitary-adrenal (HPA) regulation and neuroinflammation, so this combination could lead to an increased genetic vulnerability to suicidal behavior. In summary, although data on pharmacogenes related to suicide exist, further research is required to replicate findings in the Mexican population. The insights presented in this review may support the inclusion of other pharmacogenes or variants in existing pharmacogenomic panels to advance precision medicine approaching suicide prevention.

This study evaluated the periodontal status of psychiatric patients and its association with demographic and behavioral factors.

A cross-sectional study was conducted among 65 psychiatric patients attending a mental health center in Saudi Arabia. Periodontal health was assessed using plaque control record (PCR), bleeding on probing (BoP), probing pocket depth, and clinical attachment loss (CAL). Sociodemographic data, psychiatric diagnoses, medication use, and oral hygiene practices were recorded.

Participants had a mean age of 33.7 years, with schizophrenia being the most common diagnosis (70.8%). Most patients reported irregular oral hygiene (86.2%) and 32.3% were current smokers. Only 9.2% had good plaque control, while 41.5% showed poor control. Moderate BoP prevalence was 67.7%, and CAL was observed in 69.2% of patients. Smoking, poor oral hygiene, and longer medication use were significantly associated with adverse periodontal outcomes (P < 0.01).

Psychiatric patients demonstrated a high burden of periodontal disease. Behavioral factors and treatment duration, rather than socioeconomic variables, were the main predictors of poor oral health. Integration of dental care into psychiatric management is essential to improve patients' quality of life.

Dietary preference and childhood eating behaviour influence the mental health of children. Nutrition plays an important role in physical and mental health by supporting the development, normal functioning, and overall well-being of the body.

To study the nutritional status of children with mental illness admitted at a tertiary care psychiatric centre, Bangalore.

The cross-sectional study was conducted among 100 children admitted to the tertiary care psychiatric centre, Bangalore. Nutritional status and eating behaviour were assessed by anthropometric measurements and the Child Eating Behaviour Questionnaire (CEBQ). The children's mental health was assessed by using the CGAS scale (Children's Global Assessment Scale).

The study revealed that the average age of the children was 10.17 years. The majority of children are 49% normal weight. A significant correlation was found between nutritional status and some of the domains of eating behaviour like food responsiveness, enjoyment eating, and satiety responsiveness and child mental health at P value < 0.001. Additionally, significant associations were found between child eating behaviour with specific clinical variables, like duration of illness, diagnosis of children at P value < 0.001.

Study findings reveal a significant correlation between nutritional status and eating behaviour, indicating that the nutritional status of children with mental illness is closely linked to their eating behaviour. Parents of children with mental illness are facing various eating behavioural challenges to meet the nutritional requirements of the children.

Vitamin A signals through retinoic acid receptors and may influence neurodevelopment and the expression of clock genes. However, the biological pathway linking vitamin A status to sleep disturbance in ASD remains insufficiently defined. This study aimed to examine associations between vitamin A status and sleep problems, core symptoms, and clock genes in children with ASD, and to explore the mechanistic role of RARβ in regulating core clock genes.

This observational study included 361 children with ASD. Clinical symptoms were assessed using the Children's Sleep Habits Questionnaire (CSHQ); the Childhood Autism Rating Scale (CARS) and the Social Responsiveness Scale (SRS). Peripheral blood mononuclear cell (PBMC) mRNA levels of RARβ and clock genes (BMAL1 and CLOCK) were quantified by qPCR. RARβ expression was knocked down in mice by stereotaxic injection of adeno-associated virus.

Children with lower vitamin A levels exhibited more severe sleep problems and autistic symptoms. Vitamin A levels showed a weak positive correlation with the expression of RARβ and BMAL1. RARβ knockdown reduced the expression of RARβ and clock genes in mouse brain tissue. Chromatin immunoprecipitation quantitative PCR (ChIP-qPCR) confirmed RARβ occupancy at a predicted CLOCK regulatory region.

This study provided evidence that vitamin A status was linked to sleep problems, symptom severity, and expression of clock genes in the morning in ASD. We also found that RARβ signaling may regulate the expression of clock genes. This finding provides new insights into the mechanisms underlying sleep disturbances in ASD, but further functional studies are needed to confirm these findings.