Posttraumatic stress disorder (PTSD) during pregnancy is associated with adverse consequences and has an estimated prevalence of 3% in community samples. The prevalence of current PTSD among pregnant women with opioid use disorder (OUD), a population at increased risk of adverse birth outcomes and other mental disorders, has been estimated at 16%-37% based on 3 small studies. We used the Centers for Disease Control and Prevention's MATernaL and Infant clinical NetworK (MAT-LINK) surveillance network to (1) further examine current PTSD prevalence among pregnant women with OUD and (2) compare characteristics of those with and without PTSD.

PTSD prevalence estimates during the current pregnancy were based on (1) presence of an ICD-9/10-CM code indicating PTSD (ie, extracted); (2) documentation of a PTSD diagnosis in abstracted data (ie, abstracted); and (3) PTSD identified by either source.

Of 3315 pregnancies among women with OUD, estimated current PTSD prevalence was 14.7% (95% CI: 13.5-15.8) based on extracted data alone, 23.3% (95% CI: 22.0-24.6) based on abstracted data alone, and 25.9% (95% CI: 24.1-27.7) when based on either data source. Those with PTSD had a higher prevalence of most substance use and mental health disorders examined compared with those without.

These estimates underscore the substantial prevalence of PTSD among pregnant women with OUD and emphasize the need to screen for and treat PTSD and other mental health disorders in this population. Given that evidence-based treatments for PTSD have not been systematically evaluated in pregnant women, more research is sorely needed.

Poor diet quality can negatively affect postsecondary students' physical health, mental well-being, and academic performance. This cross-sectional study examined personal, social, structural, and environmental correlates of diet quality among 1,118 postsecondary students aged 17-25 years enrolled in a postsecondary institution across Ontario, Canada. Participants completed an online survey and the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24). Diet quality was assessed using the Healthy Eating Index (HEI)-2015 total score. Multiple regression showed that higher diet quality was associated with a more positive attitude towards healthy eating (p < 0.001), greater nutrition knowledge (p < 0.001), more frequent dinner preparation (p < 0.001), and living in the family home (p < 0.05). Lower diet quality was linked to not following a special diet (e.g. vegetarian; p < 0.01) and experiencing frequent food insecurity (p < 0.01). These findings suggest that initiatives to improve student diet quality should promote positive attitudes towards healthy eating, enhance nutrition knowledge, and address food insecurity.

Anandamide (AEA), an endogenous cannabinoid, is thought to exert an inhibitory role in the basolateral amygdala complex (BLA), dampening hypothalamus-pituitary-adrenal (HPA) axis activation and reducing stress-related fear and anxiety behaviors. Stress-induced reductions in AEA mediated signaling have been associated with amygdala hyperexcitability contributing to the reinstatement of cocaine-seeking behavior. Fatty acid-binding protein 5 (FABP5) serves as the major intracellular transporter of AEA, facilitating its degradation by fatty acid amide hydrolase (FAAH). In vivo studies demonstrate that FABP5 enhances AEA uptake and hydrolysis. Given the established role of AEA signaling in modulating stress reactivity through the amygdala, changes in FABP5 expression may influence drug seeking in response to stressful stimuli. In the current study we investigated the behavioral impact of viral vector induced FABP5 overexpression in the BLA. Male C57BL/6N mice received a bilateral intracranial injection into the BLA with either an AAV5-GFP control virus or an AAV5-FABP5 construct. Following transfection, mice were assessed for cocaine-seeking behavior using the conditioned place preference (CPP) paradigm. In addition, mice were assessed for a stress-induced reinstatement of cocaine CPP. Surprisingly, upregulation of FABP5 in the BLA was found to reduce stress-induced reinstatement of cocaine-seeking behavior. These findings mirror previous observations of FAAH overexpression in the BLA and suggest a complex role of FABP5 in regulation of stress responses, potentially via modulation of GABAergic and glutamatergic neurotransmission. Further work is warranted to elucidate the mechanisms by which FABP5 influences stress reactivity and reward-related behaviors through its modulation of endocannabinoid signaling in the BLA.

Advanced glycation end products (AGEs) are a heterogeneous group of glycation-derived compounds that accumulate under metabolic stress and contribute to age-related and chronic diseases. Pentosidine (PEN), a well-characterized fluorescent AGE, increases during aging under certain pathological conditions. In particular, increased PEN levels have been observed in a subset of patients with schizophrenia and are associated with more severe clinical outcomes. Glucuronic acid (GlcA) has previously been identified as a metabolic precursor of PEN, and impaired GlcA metabolism due to reduced aldo-keto reductase family 1 member A1 (AKR1A1) activity may underlie PEN accumulation. In the present study, to investigate the neurobiological impact of endogenous PEN accumulation, we examined neurobehavioral consequences using Akr1a knockout (KO) mice, which exhibit impaired GlcA metabolism. These mice exhibited significantly elevated PEN levels in both the plasma and prefrontal cortex (Pfc), a brain region critically involved in higher-order cognitive and behavioral regulation, accompanied by increased aggression and hyperactivity-behavioral domains relevant to patients with schizophrenia. Notably, aggression measures were positively correlated with PEN concentrations, whereas PEN levels were associated with novelty-driven exploratory locomotion but not with sustained baseline locomotor activity. Transcriptomic analysis of Pfc revealed altered expression of genes involved in guanylate cyclase signaling, cytoskeletal organization, and the immune response. Cyclic guanosine monophosphate (cGMP) levels were significantly reduced, suggesting impaired downstream signaling. Together, these findings demonstrate that GlcA-driven PEN accumulation induces molecular and behavioral alterations in the brain and provides a dimensional mouse model linking glycation-related metabolic stress to aggression and hyperactivity relevant to schizophrenia.

Pediatric disorders of gut-brain interaction (DGBI) often co-occur with a variety of mental health conditions. This analysis examines the impact of a brief cognitive behavioral program (ADAPT; Aim to Decrease Anxiety and Pain Treatment) targeting pain and anxiety in youth with DGBI and comorbid mental health diagnoses.

This secondary analysis of a clinical trial includes participants between the ages of 9-14 with DGBI, randomized to ADAPT plus medical treatment as usual (TAU), or TAU alone. Participants completed the Anxiety Disorder Interview Schedule for DSM-IV, Child Version (ADIS-IV-C) to determine if they met criteria for a mental health diagnosis at baseline and at post assessment 8 weeks later. Analysis of Covariance (ANCOVA)-style logistic regression models were used to assess whether ADAPT+TAU had an impact on mental health diagnoses compared to TAU alone.

ADAPT+TAU was associated with a lower posttest rate of generalized anxiety disorder (GAD) compared to TAU (26.4% vs 46.1%, OR = 3.11, 95% CI = [1.03, 9.41].) Although additional diagnoses trended in similar directions, no other rates of diagnoses across other mental health conditions met the threshold for significance at post-test.

ADAPT is associated with reductions in GAD diagnoses in youth with DGBI. Although not a target of ADAPT, there appeared to be a generalization of treatment effects on other mental health conditions, but larger controlled studies are needed.

Intrinsic capacity (IC), which reflects the combined physical and mental reserve of an individual, is a key indicator of healthy ageing. While genetic and environmental factors influence IC, the interaction effects between them remain poorly understood. This study investigated the independent and interaction effects of polygenic scores for IC (PGS-IC), socioeconomic status, and lifestyle factors on IC. Baseline data from the Canadian Longitudinal Study on Aging (CLSA; N = 13,112) were analysed. Associations with IC (outcome) and interaction effects of PGS-IC and socioeconomic factors or lifestyle measures-including composite physical activity and diet scores-were examined using linear regression models. All models were adjusted for age and sex, and additionally for five genetic principal components in models involving PGS-IC. Higher IC was associated with higher education, income, physical activity, and healthier diet patterns. Lower IC was observed among previous and current smokers and those with short (<7h) or long (>9h) sleep durations. PGS-IC was positively associated with the IC score. Significant gene-environment interactions were identified between PGS-IC and; Mediterranean diet (β = -0.003, 95% CI: -0.006, -0.0002), education in younger adults (β = -0.109, 95% CI: -0.211, -0.007), and sleep duration (younger adults: long sleep, β = 0.198, 95% CI: 0.023, 0.373; older adults: short sleep, β = -0.095, 95% CI: -0.153, -0.036). This study provides preliminary evidence of gene-environment interactions influencing IC, with implications for future research to determine how genetic and modifiable factors can inform strategies for maintaining IC and promoting healthy aging.

ABSTRACTBackground: Structural and functional changes in stress-related gray matter (GM) regions have been found in trauma-exposed individuals. However, the nature of underlying neurobiological abnormalities in individuals following stress, particularly acute stress, is unclear.Methods: In this study, thirty-two motor vehicle accident (MVA) survivors and thirty-one nonexposed controls were recruited. MVA survivors were scanned and received trauma-specific clinical assessments within one week of their accident. Mean diffusivity (MD), fractional anisotropy (FA), and GM volume (GMV) were measured as indicators of GM structural changes in the medial orbitofrontal cortex (mOFC), amygdala, hippocampus, insula, and anterior cingulate cortex (ACC) bilaterally. In these regions with significant structural changes in the MVA group, sex differences were assessed. Functional connectivity (FC) analysis was conducted to explore the brain network effect of these structural alterations. Correlation analyses were performed to explore the association between the resultant GM structure and anxiety symptoms.Results: Significantly lower fractional anisotropy (FA) in the mOFC and ACC was detected in the MVA group. In these regions, females in the MVA group had lower MD in the right ACC, but no sex-by-stress interactions were found. Compared with controls, the MVA group had less connectivity between the right mOFC and the left inferior OFC. No significant association was found between GM structure and anxiety symptoms.Conclusion: MVA survivors showed potential GM microstructure alterations which may affect functional consequences shortly after acute stress. These findings may contribute to informing future strategies for timely interventions after acute stress.

Background: About a decade after the 2014 ISIS genocide in Shingal, Iraq, the effects of mass trauma and displacement continue to be felt among the Yazidi population. In particular, the long-term interplay between psychological distress and biological stress regulation remains poorly understood.Objective: The present study aimed to investigate the prevalence and severity of PTSD, depression, anxiety, somatic symptoms, and perceived stress among displaced Yazidi participants. It also aimed to explore how these psychological indicators relate to chronic physiological stress, as measured by hair cortisol and cortisone concentrations.Method: A total of 264 Yazidi adults residing in internally displaced person (IDP) camps in Duhok, Iraq, underwent structured interviews by trained psychologists. Standardized Kurdish versions of the PCL-5, HSCL-25, PHQ-15, PSS-14, and War and Adversity Checklist-26 were administered. Hair cortisol and cortisone were analyzed by liquid chromatography tandem mass spectrometry (LC-MS). Data were evaluated using multiple regressions and latent profile analysis (LPA).Result: Severe mental health burden was evident: 93.2% reached the cutoff for PTSD, 83.7% for anxiety, and 87.5% for depression (HSCL-25 subscales). LPA revealed three classes of PTSD symptoms - low, moderate, and high - along with four symptom classes reflecting various distress patterns. Compared to men, women exhibited significantly higher levels of psychological distress and somatic symptoms (p < .01, d = 0.60-0.70). Hair cortisol related moderately to all symptom scales (r = .17-.25, p < .01), indicating cumulative HPA axis activation. Cross-class correlations suggest that PTSD, anxiety, and depression represent, at least partly, independent symptom dimensions.Conclusions: Findings stress the long-lasting psychobiological effects of genocide-related trauma among Yazidi IDPs. This finding is further underlined by the integrated psychometric and biological data, which point to the urgent need for long-term, culturally sensitive, and gender-responsive interventions.

Urine drug testing (UDT) is an important laboratory tool utilized in various healthcare settings to identify drug or toxic exposures. It has wide clinical applications, including but not limited to detecting substance misuse, monitoring treatment effectiveness and compliance, and identifying substances in affected patients. Depending on the clinical care setting and patient population, the UDT service model and practice are important decisions by the clinical laboratory to meet the needs of the healthcare providers. In addition, clinical laboratories must appreciate the testing process and unique aspects of this toxicology test, from specimen collection and integrity, testing methods, to the result reporting and interpretation. Each phase has specific quality requirements to ensure the accuracy and appropriate interpretation of results. This review aims to summarize the preanalytical, analytical, and postanalytical considerations of clinical laboratories when implementing the test or providing support to clinicians in point-of-care settings. To bring awareness of the limitations inherent to different analytical methodologies, this review discusses important considerations and presents the current gaps, opportunities, and recommendations for quality improvement and standardization. This article may serve as a framework for clinical laboratory directors and other laboratory professionals to review their current provision of UDT and provide recommendations on various important aspects when considering changes to the test service models to meet their local clinical needs, including when introducing new test methods. It may also help physicians and healthcare providers appreciate the complexities of UDT and recognize the challenges in clinical interpretation.

Excessive housing costs significantly affect household financial stability and overall well-being. This study investigated the impact of South Korea's housing allowance programme on the physical and mental health of household heads, utilising data from the Korea Welfare Panel Study (2009-2021). To overcome selection bias, we employed propensity score matching to construct a comparable control group. We then estimated a two-way fixed effects event study model to assess the dynamic health impacts following the programme's significant reform in 2015. Our analysis confirms the absence of pre-existing differential trends, supporting the validity of our research design. The results indicate that the policy's positive effects were not immediate but emerged over time. A statistically significant reduction in depression appeared approximately four years post-reform. For physical health, a consistent and statistically significant improvement was observed from 2017 onwards, highlighting a delayed but sustained positive impact. The findings, validated by a rigorous quasi-experimental design, emphasise the critical role of housing welfare policies in promoting health equity and suggest the benefits of such policies may accumulate over time.