Suicide is a leading cause of death in prisons worldwide. The objective of this study was to describe the sociodemographic, clinical and criminal characteristics of people incarcerated in France who died by suicide, as well as the circumstances surrounding each suicide. .

We included all cases of suicide by people incarcerated in France (i.e., European and overseas territories) over the period 2017-2021. The National Prison Service provided sociodemographic and criminal data, as well as data on the circumstances surrounding the suicides. Health data were collected by health units located in all the country's prisons using a standardized questionnaire.

We included 598 suicide cases in the study. Mental disorders were more prevalent during (63.7%) than before (47.8%, p < 0.001) incarceration. In the week before suicide, 60% of cases had visited their prison's health unit and a traumatic criminal-, prison-, familial- or health-related event was identified in 61% of all cases. Persons who died during the SARS-CoV2 pandemic were more likely to have children (77.7% vs 61.1%, p = 0.001). The overall suicide rate was 17.5 [CI_95% 16.1-18.9] per 10,000 person-years. It increased (p < 0.05) with age, was twice as high during pretrial incarceration and six times higher during the first week of imprisonment. In terms of gender, it was 9.9 [9.1-10.7] and 41.0 [27.0-59.7] times higher among men and women, respectively, than among their counterparts in the general population.

Suicide in prisons is a major health issue. Suicide prevention measures must be reinforced.

The colony-stimulating factor 1 receptor (CSF1R) inhibitor PLX5622 has been widely used to deplete microglia for functional characterization and therapeutic support. Although diverse outcomes have been described after PLX5622 treatment, whether these phenotypes solely reflect microglial functions remains to be determined. Here, we show that transgenic microglial depletion did not mimic the accelerated anesthetic arousal or the alleviated nicotine addiction withdrawal symptoms observed after PLX5622 treatment in mice. We further identify that PLX5622 potently activates the mouse constitutive androstane receptor (CAR), leading to prominent induction of hepatic enzymes. The induced enzymatic activity enhances the metabolism and clearance of anesthetics and nicotine, thereby contributing to anesthetic insensitivity and addiction relief. Inactivation of CAR abolished these effects of PLX5622, indicating that the impact of PLX5622 treatment cannot be attributed exclusively to microglial depletion. Our findings raise awareness in evaluating consequences of PLX5622 treatment and provide insights into the design of specific CSF1R inhibitors.

Depression is highly heterogeneous. Characteristics of previous depressive episodes, additional clinical difficulties, family history of depression and exposure to stressors are associated with poorer outcomes. However, the role of these factors has not been tested simultaneously to explain depression persistence.

Using longitudinal data from 337 adults with a history of recurrent MDD, we characterised depressive symptom trajectories over 13-years using growth mixture modelling. We tested two partially competing hypotheses as to why depression persists: a) persistent depression is aetiologically distinct from a less persistent course and/or b) persistent depression is largely explained by exposure to ongoing stressors.

Three trajectory classes were identified: low (64%), which showed minimal symptoms throughout the study period; intermediate (17%), which showed high baseline symptoms which lessened after the first assessment; and severe persistent (19%), which showed high depressive symptoms throughout the study period. Three variables differentiated the severe persistent class: history of a severely impairing episode, self-harm or suicide attempt at baseline and ongoing high perceived stress.

The sample consisted of primarily women therefore the results may not generalise to men. An 8-year period between the third and fourth assessment meant that estimates of depression may have been conservative.

Prior impairment, self-harm or suicide and perceptions of stress were associated with a persistent course. It may be helpful for practitioners to consider assessing these factors to identify adults at the greatest risk of developing persistent depression.

Adolescent obsessive-compulsive disorder (OCD) is a severe psychiatric condition, but its neurodevelopmental origin remains understudied. Structural neuroimaging findings in adolescents are inconsistent and rarely linked to specific symptom dimensions, particularly anhedonia.

We conducted voxel-based morphometry to investigate grey matter volume (GMV) in 38 adolescents with OCD and 31 healthy controls (HC), supplemented by exploratory surface-based morphometry and medication-based subgroup analyses. Clinical assessments included the Children's Yale-Brown Obsessive Compulsive Scale and the Children's Depression Inventory. We conducted between-group comparisons, correlation analyses with obsessive severity, and mediation analysis to test the role of the right putamen in anhedonia-obsession relationship.

Adolescents with OCD exhibited significantly increased GMV in limbic, paralimbic, and subcortical regions, including the left hippocampus/amygdala, bilateral insula, and right putamen, along with increased sulcal depth in the left precentral gyrus. GMV exhibited a graded decrease across the unmedicated OCD, medicated OCD, and HC groups. Importantly, right insular and putamen GMV were positively correlated with obsessive symptoms. Mediation analysis revealed that putamen GMV partially mediated the relationship between anhedonia and obsessive symptoms (indirect effect = 0.199, 95% CI: 0.067-0.380).

This study identifies a distinct pattern of increased GMV in adolescent OCD, implicating the regions involved in emotional processing, salience detection, and habit formation. The correlation between right insula/putamen structure and obsessive symptoms, and the mediation role of the putamen between anhedonia and obsession together suggested a novel neuroanatomical model linking reward processing deficits to core OCD symptomatology. Our findings highlight potential targets for future mechanism-based interventions.

Hepatogenous diabetes, a secondary form of diabetes arising from chronic liver disease, particularly cirrhosis, is a well-documented complication. However, diabetic ketoacidosis (DKA) in the context of hepatogenous diabetes has not been reported in the literature. We report the case of a 60-year-old male with alcoholic liver cirrhosis and no prior history of diabetes who presented with altered mental status and was diagnosed with DKA. Initial lab tests revealed severe hyperglycemia, high-anion gap metabolic acidosis, and an elevated HbA1C of 10.2%, a significant increase from 5.2% five months earlier. The patient was managed with insulin and lactulose, resulting in clinical improvement. Follow-up revealed normalization of HbA1C and a reduction in insulin requirements. This is the first documented case of DKA as the initial presentation of hepatogenous diabetes, emphasizing the need for heightened awareness and further research into its clinical manifestations and management.

DKA can be the first clinical manifestation of hepatogenous diabetes, even in patients with normal HbA1C and no prior diabetes history. HbA1C is an unreliable marker for diagnosing diabetes in cirrhotic patients due to shortened red blood cell lifespan; OGTT should be considered when hepatogenous diabetes is suspected despite normal glycemic markers. Subclinical infections can precipitate DKA in cirrhosis through stress-induced insulin resistance.

To evaluate the effectiveness, time to discharge, functioning, and tolerability of Risperidone-ISM^® in hospitalised patients with schizophrenia relapse.

Non-interventional, multicentre, prospective study of adults admitted for acute exacerbation of schizophrenia and treated with Risperidone-ISM^®. Effectiveness was assessed using the Clinical Global Impression-Severity scale (CGI-S) and 6-item Positive and Negative Syndrome Scale (PANSS-6) at days 8 (FU1), 28 (FU2), and 56 (FV). Functioning was evaluated with the Personal and Social Performance scale (PSP), patient satisfaction with the Medication Satisfaction Questionnaire (MSQ). Admission/discharge data and adverse events were recorded.

In 275 patients, significant reductions from baseline in CGI-S and PANSS-6 scores occurred as early as day 8, with continued improvement through day 56 (CGI-S: -1.4 and PANSS-6: -7.6; p < 0.0001), regardless of use of concomitant antipsychotics. Median discharge occurred 8 days after first Risperidone-ISM^® injection. PSP improved by 17.6 points at day 28. No new/unexpected safety information was reported; 4% discontinued due to related adverse events. At final visit, 78% reported satisfaction with treatment, and therapeutic alliance improved in 89.4% of participants.

Risperidone-ISM^® demonstrated rapid and sustained effectiveness, functional improvement, and favourable tolerability, enabling early stabilisation and discharge. Adding another antipsychotic provided no additional benefits. Results support Risperidone-ISM^® for treating acute schizophrenia relapse in real-world settings.

Little is known about leisure physical activity (PA) behavior among people with previous myocardial infarction. This cross-sectional study within a cohort compared leisure PA behavior between women and men ≤61-year post myocardial infarction, overall and by race. We also examined factors that explain low leisure PA by sex-race category.

We used data of participants from the second and third waves of the Myocardial Infarction and Mental Stress Study. Least squares means of the Baecke Habitual Physical Activity Questionnaire (leisure component) were estimated for 4 sex-race categories (Black Women, non-Black women, Black men, and non-Black men) using linear mixed-effects models. The final model adjusted for education, income, obesity status, stress, depression, heart failure, and cardiac rehabilitation. Relative importance analysis identified key correlates of low leisure PA for each sex-race group. Sensitivity analyses were conducted to enhance validity and robustness.

Participants (N = 619) had a mean age of 51 (SD: 7) years; 46% were female, and 59% were Black. Leisure PA was low among all participants, with Black women reporting the least PA overall and across all types (ie, walking, cycling, sports, gardening) compared with the other 3 groups. Correlates of low leisure PA differed by sex/race: depression (Black women), education (Black men, non-Black women), and body mass index (non-Black men).

Personalized PA interventions addressing these factors could be effective in clinical settings. At the policy level, infrastructure improvements are needed to expand PA opportunities.

Serious mental illnesses, such as schizophrenia, schizoaffective or bipolar disorder, often starts in late teens or twenties. Adherence to antipsychotic treatment for serious mental illness is often poor. Involving service users in decisions about their treatment leads to improved clinical outcomes and adherence. Shared decision-making is bilateral information sharing between clinician and service user where decision-making is shared between both parties. This study aimed to evaluate the lived experiences of young adults on how healthcare professionals involve them in decisions about antipsychotic medication.

Fifteen semi-structured interviews were conducted online using Zoom. Participants were selected using purposive sampling via patient recruitment platform, support groups relevant to psychosis and social media. Those included in the study were diagnosed with schizophrenia, schizoaffective or bipolar disorder and treated with antipsychotics between the ages of 18-30. Data was coded inductively and thematic analysis was used to analyse the data.

Four themes were identified. These were living with antipsychotics, influence of family and friends, gaining autonomy and consequences of young adulthood. Findings highlighted the range of side effects from antipsychotic medication and their impact on young adults, and how the choices made by health care professionals influenced the quality of shared decision-making. Health care professionals' decisions directly influence the quality of life for service users. Young adults with psychosis acknowledge the effectiveness of antipsychotics but see the side effects as significant obstacles in their lives.

The study found that health care professionals provided limited acknowledgement and support for antipsychotic side effects, which significantly impacted the young adults' lives. Young adults want to be fully informed of their medication and potential side effects but support from friends and family was a potential barrier. Changes in practice are needed including an adjustment in clinical language used by health care professionals, giving information to service users' post-psychosis and ensuring health care professionals are trained in shared decision-making.

Early identification of symptoms in schizophrenia spectrum disorders (SSD) may improve clinical outcomes, yet the temporal trajectory and prognostic relevance of initial symptom dimensions remain unclear. This study aimed to identify the earliest emerging symptoms among individuals with SSD and investigate their association with illness severity using a dimensional, data-driven approach.

We conducted a cross-sectional observational study including 160 adults with SSD, diagnosed using the via the Structured Clinical Interview for DSM-5 (SCID-5). Participants completed the Structured Clinical Interview for the Psychotic Spectrum - Self-Report (PSY-SR) PSY-SR questionnaire, which assesses lifetime psychotic spectrum symptoms across five domains: interpersonal sensitivity, paranoid traits, schizoid traits, misperceptions, and typical psychotic symptoms, with retrospective reporting of age at symptom onset. K-means clustering classified patients by severity based on total PSY-SR scores. Multinomial logistic regression identified factors linked to the more severe cluster.

Two clusters were identified: Cluster 1 (less severe; n = 91) and Cluster 2 (more severe; n = 69). Cluster 2 had higher PSY-SR scores (81.2 vs. 42.0) and earlier symptom onset, particularly for interpersonal sensitivity (15.7 vs. 18.8 years, p = 0.013) and typical psychotic symptoms, including hallucinations and delusions (22.0 vs. 26.5 years, p < 0.001). In contrast, age at onset of paranoid traits and misperceptions did not significantly differ between clusters. FGA use was associated with Cluster 2 membership, likely reflecting greater clinical severity. (OR = 5.10, p = 0.008). Later onset of interpersonal sensitivity and typical psychotic symptoms was associated with reduced severity, lowering the probability of Cluster 2 membership by around 50% per additional year.

In a cross-sectional sample of adults with SSD, earlier onset of interpersonal sensitivity and typical psychotic symptoms in SSD predicted worse outcomes. These findings support a dimensional understanding of symptom heterogeneity within SSD and suggest that systematic assessment of subthreshold and spectrum-level symptoms may contribute to improved early detection, risk stratification and more personalised interventions.