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Topic Review
HPA Axis and Allopregnanolone
Under stressful conditions, the hypothalamic-pituitary-adrenal (HPA) axis acts to promote transitory physiological adaptations that are often resolved after the stressful stimulus is no longer present. In addition to corticosteroids (e.g., cortisol), the neurosteroid allopregnanolone (3α,5α-tetrahydroprogesterone, 3α-hydroxy-5α-pregnan-20-one) participates in negative feedback mechanisms that restore homeostasis. Chronic, repeated exposure to stress impairs the responsivity of the HPA axis and dampens allopregnanolone levels, participating in the etiopathology of psychiatric disorders, such as major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). MDD and PTSD patients present abnormalities in the HPA axis regulation, such as altered cortisol levels or failure to suppress cortisol release in the dexamethasone suppression test. Herein, we review the neurophysiological role of allopregnanolone both as a potent and positive GABAergic neuromodulator but also in its capacity of inhibiting the HPA axis. The allopregnanolone function in the mechanisms that recapitulate stress-induced pathophysiology, including MDD and PTSD, and its potential as both a treatment target and as a biomarker for these disorders is discussed. 
  • 927
  • 13 Jun 2021
Topic Review
Sexual Dysfunction in Schizophrenia
Psychiatric disorders, in general, have a high prevalence of sexual problems, whether from the psychopathology of the disorder itself, pre-existing or co-morbid sexual disorder or from side effects of the treatment for mental disorders. Many patients report an already existing sexual dysfunction at the onset of diagnosis. The risk association for developing sexual dysfunction in patients with schizophrenia includes antipsychotic use and resulting hyperprolactinemia, age, gender, and disease severity. Medication side effects lead to nonadherence, and relapses lead to structural changes in the brain, treatment resistance, and worsening of symptoms. Findings in certain studies propose serum prolactin and thyroid-stimulating hormone measurement as a tool for assessing patients with schizophrenia for sexual dysfunction. Regarding specific symptoms, females especially reported decreased desire at baseline and galactorrhea after treatment.
  • 920
  • 18 Jan 2022
Topic Review
Role of Oligodendrocytes in Autism
Autism Spectrum Disorder (ASD) is an early neurodevelopmental disorder that involves deficits in interpersonal communication, social interaction, and repetitive behaviors. Although ASD pathophysiology is still uncertain, alterations in the abnormal development of the frontal lobe, limbic areas, and putamen generate an imbalance between inhibition and excitation of neuronal activity. Interestingly, recent findings suggest that a disruption in neuronal connectivity is associated with neural alterations in white matter production and myelination in diverse brain regions of patients with ASD. 
  • 901
  • 06 Feb 2021
Topic Review
Crisis-focused Psychological Interventions
Public safety personnel (PSP) and frontline healthcare professionals (FHP) are frequently exposed to potentially psychologically traumatic events (PPTEs), and report increased rates of post-traumatic stress injuries (PTSIs). Despite widespread implementation and repeated calls for research, effectiveness evidence for organizational post-exposure PTSI mitigation services remains lacking.
  • 894
  • 10 Dec 2020
Topic Review
Obsessive–Compulsive Personality Disorder
Obsessive–compulsive personality disorder (OCPD) is a cluster C personality disorder marked by an excessive need for orderliness, neatness, and perfectionism. Symptoms are usually present by the time a person reaches adulthood, and are visible in a variety of situations. The cause of OCPD is thought to involve a combination of genetic and environmental factors, namely problems with attachment. This is a distinct disorder from obsessive–compulsive disorder (OCD), and the relation between the two is contentious. Some studies have found high comorbidity rates between the two disorders but others have shown little comorbidity. Both disorders may share outside similarities—rigid and ritual-like behaviors, for example. Attitudes toward these behaviors differ between people affected with either of the disorders: for people with OCD, these behaviors are egodystonic, unwanted and involuntary, being the product of anxiety-inducing and involuntary thoughts. On the other hand, for people with OCPD, they are egosyntonic; the person perceives them as rational and wanted, being the result of, for example, strong adherence to routines, a desire for control, or a need for perfection. OCPD is highly comorbid with other personality disorders, autism spectrum, eating disorders, anxiety, mood disorders, and substance use disorders. The disorder is the most common personality disorder in the United States, and is diagnosed twice as often in males as in females, however, there is evidence to suggest the prevalence between men and women is equal.
  • 840
  • 29 Sep 2022
Topic Review
Psychological Symptoms in COVID-19 Patients
There is growing evidence of studies associating COVID-19 survivors with increased mental health consequences. Mental health implications related to a COVID-19 infection include both acute and long-term consequences. Here we discuss COVID-19-associated psychiatric sequelae, particularly anxiety, depression, and post-traumatic stress disorder (PTSD), drawing parallels to past coronavirus outbreaks. A literature search was completed across three databases, using keywords to search for relevant articles. The cause may directly correlate to the infection through both direct and indirect mechanisms, but the underlying etiology appears more complex and multifactorial, involving environmental, psychological, and biological factors. Although most risk factors and prevalence rates vary across various studies, being of the female gender and having a history of psychiatric disorders seem consistent. Several studies will be presented, demonstrating COVID-19 survivors presenting higher rates of mental health consequences than the general population. The possible mechanisms by which the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the brain, affecting the central nervous system (CNS) and causing these psychiatric sequelae, will be discussed, particularly concerning the SARS-CoV-2 entry via the angiotensin-converting enzyme 2 (ACE-2) receptors and the implications of the immune inflammatory signaling on neuropsychiatric disorders. Some possible therapeutic options will also be considered. 
  • 839
  • 05 Jan 2022
Topic Review
Misophonia
Misophonia is a complex neurophysiological and behavioral disorder of multifactorial origin and is characterized by an increased physiological and emotional response produced by intolerance to specific auditory stimuli.
  • 824
  • 10 Jun 2022
Topic Review
Virtual Reality Therapy for Social Anxiety Disorder Treatment
Virtual reality (VR) is a three-dimensional environment generated by the computer, in which subjects interact with the environment as if they were really inside it. The most used VR tools are the so-called HMD (head-mounted display) which make it possible to achieve what theorists define “direct mediated action”. The most common treatment for social anxiety disorder is represented by “in vivo exposure therapy” (iVET). Virtual reality therapies proved to be a valid alternative to the acquisition of social skills suitable for improving the symptoms of SAD. Although there has not been a significant difference between VRET and iVET, the low costs and flexibility of VRET open up new scenarios for achieving greater psychophysical well-being. 
  • 816
  • 16 Dec 2021
Topic Review
Yoga: A Complementary Treatment of Mental Health Concerns
Yoga is a broad umbrella term for a variety of philosophical tenets and lifestyle practices, the most common of which in biomedical cultures is hatha yoga. Yoga has been tested mostly as a complementary treatment to standard psychiatric and psychotherapeutic approaches. Findings from efficacy trials largely support the notion that yoga is helpful in reducing symptoms of many psychiatric conditions, including anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms, above and beyond the effects achieved by standard pharmacological treatments alone. 
  • 776
  • 22 Nov 2021
Topic Review
Progression of the Learning Models for Anorexia Nervosa
Anorexia nervosa (AN), a serious and often treatment-refractory mental illness characterized by distorted body perception and pathological weight loss due to sustained attempts to restrict food intake, can be understood and addressed through the lens of learning theory; which provides a coherent framework of integrated constructs and principles that describe, explain, and predict how organisms learn and how this learning is translated into behavior.
  • 722
  • 15 Feb 2023
Topic Review
Waste Clearance in the Brain and Neuroinflammation
Alzheimer’s disease (AD) is a multifactorial disease with a heterogeneous etiology. The pathology of Alzheimer’s disease is characterized by amyloid-beta and hyperphosphorylated tau, which are necessary for disease progression. Many clinical trials on disease-modifying drugs for AD have failed to indicate their clinical benefits. Recent advances in fundamental research have indicated that neuroinflammation plays an important pathological role in AD. Damage- and pathogen-associated molecular patterns in the brain induce neuroinflammation and inflammasome activation, causing caspase-1-dependent glial and neuronal cell death. These waste products in the brain are eliminated by the glymphatic system via perivascular spaces, the blood-brain barrier, and the blood–cerebrospinal fluid barrier. Age-related vascular dysfunction is associated with an impairment of clearance and barrier functions, leading to neuroinflammation. The proteins involved in waste clearance in the brain and peripheral circulation may be potential biomarkers and drug targets in the early stages of cognitive impairment.
  • 695
  • 15 Mar 2022
Topic Review
Mental Disorders after Terrorist Attacks
There is no widely agreed upon definition of terrorism. In general terms, it is defined as an act of violence that is used to further a political goal by instilling fear into the public. Though acts that could be defined as “terrorism” have occurred since the Roman Empire, the term was coined during the French Revolution. Since the terrorist attack in New York City on 11 September 2001 (9/11), it is difficult to imagine a topic that has shaped global discourse as much as terrorism. It is a violent act that has been shown to have longstanding effects on the mental health of those who witness it.
  • 684
  • 05 Nov 2021
Topic Review
MS-Based Proteomics for Bipolar Disorder Potential Biomarkers Assessment
Bipolar disorder (BD) is a clinically heterogeneous condition, presenting a complex underlying etiopathogenesis that is not sufficiently characterized. Without molecular biomarkers being used in the clinical environment, several large screen proteomics studies have been conducted to provide valuable molecular information. Mass spectrometry (MS)-based techniques can be a powerful tool for the identification of disease biomarkers, improving prediction and diagnosis ability.
  • 664
  • 27 May 2022
Topic Review
Food Addiction in Eating Disorders
Food addiction (FA) has been mentioned as a potential subtype of obesity, and has been associated with Eating Disorders (ED). A first approach of a phenotypic characterization of food addiction (FA) found three clusters (dysfunctional, moderate and functional). 
  • 661
  • 16 Mar 2022
Topic Review
Biomarkers for Pediatric Depressive Disorders
Depressive disorder in childhood and adolescence is a highly prevalent mood disorder that tends to recur throughout life. Untreated mood disorders can adversely impact a patient’s quality of life and cause socioeconomic loss. Thus, an accurate diagnosis and appropriate treatment is crucial. However, until now, diagnoses and treatments were conducted according to clinical symptoms. Objective and biological validation is lacking. This may result in a poor outcome for patients with depressive disorder. Research has been conducted to identify the biomarkers that are related to depressive disorder. Cumulative evidence has revealed that certain immunologic biomarkers including brain-derived neurotrophic factor (BDNF) and cytokines, gastrointestinal biomarkers, hormones, oxidative stress, and certain hypothalamus-pituitary axis biomarkers are associated with depressive disorder.
  • 655
  • 09 Oct 2021
Topic Review
Dipeptidyl Peptidase-4 Inhibitors
The pharmacologic action of DPP-4 inhibitors is similar to that of GLP-1R agonists. The major therapeutic effects of DPP-4 inhibitors protect against degradation of the substrates GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), which are physiological substrates that affect insulin and glucagon secretion in a glucose-dependent manner.
  • 640
  • 13 May 2021
Topic Review
Recovery Model
The recovery model, recovery approach or psychological recovery is an approach to mental disorder or substance dependence that emphasizes and supports a person's potential for recovery. Recovery is generally seen in this model as a personal journey rather than a set outcome, and one that may involve developing hope, a secure base and sense of self, supportive relationships, empowerment, social inclusion, coping skills, and meaning. Recovery sees symptoms as a continuum of the norm rather than an aberration and rejects sane-insane dichotomy. William Anthony, Director of the Boston Centre for Psychiatric Rehabilitation developed a quaint cornerstone definition of mental health recovery in 1993. "Recovery is a deeply personal, unique process of changing one's attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one's life as one grows beyond the catastrophic effects of mental illness." The use of the concept in mental health emerged as deinstitutionalization resulted in more individuals living in the community. It gained impetus as a social movement due to a perceived failure by services or wider society to adequately support social inclusion, and to studies demonstrating that many people do recover. A recovery approach has now been explicitly adopted as the guiding principle of the mental health or substance dependency policies of a number of countries and states. In many cases practical steps are being taken to base services on a recovery model, although a range of obstacles, concerns and criticisms have been raised both by service providers and by recipients of services. A number of standardized measures have been developed to assess aspects of recovery, although there is some variation between professionalized models and those originating in the psychiatric survivors movement.
  • 631
  • 28 Sep 2022
Topic Review
Substance Use Disorder
Substance use disorder (SUD) is the persistent use of drugs (including alcohol) despite substantial harm and adverse consequences. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as chronic guilt; an inability to reduce or stop consuming the substance(s) despite repeated attempts; driving while intoxicated; and physiological withdrawal symptoms. Drug classes that are involved in SUD include: alcohol; cannabis; phencyclidine and other hallucinogens, such as arylcyclohexylamines; inhalants; opioids; sedatives, hypnotics, or anxiolytics; stimulants; tobacco; and other or unknown substances. In the Diagnostic and Statistical Manual of Mental Disorders 5th edition (2013), also known as DSM-5, the DSM-IV diagnoses of substance abuse and substance dependence were merged into the category of substance use disorders. The severity of substance use disorders can vary widely; in the DSM-5 diagnosis of a SUD, the severity of an individual's SUD is qualified as mild, moderate, or severe on the basis of how many of the 11 diagnostic criteria are met. The International Classification of Diseases 11th revision (ICD-11) divides substance use disorders into two categories: (1) harmful pattern of substance use; and (2) substance dependence. In 2017, globally 271 million people (5.5% of adults) were estimated to have used one or more illicit drugs. Of these, 35 million had a substance use disorder. An additional 237 million men and 46 million women have alcohol use disorder as of 2016. In 2017, substance use disorders from illicit substances directly resulted in 585,000 deaths. Direct deaths from drug use, other than alcohol, have increased over 60 percent from 2000 to 2015. Alcohol use resulted in an additional 3 million deaths in 2016.
  • 627
  • 12 Oct 2022
Topic Review
Ketamine for Eating Disorders
Eating disorders (EDs) are serious, life-threatening psychiatric conditions associated with physical and psychosocial impairment, as well as high morbidity and mortality. Given the chronic refractory nature of EDs and the paucity of evidence-based treatments, there is a pressing need to identify novel approaches for this population. The noncompetitive N-methyl-D-aspartate receptor (NMDAr) antagonist, ketamine, has recently been approved for treatment-resistant depression, exerting rapid and robust antidepressant effects. It is now being investigated for several new indications, including obsessive–compulsive, post-traumatic, and substance use disorder, and shows transdiagnostic potential for EDs, particularly among clinical nonresponders.
  • 617
  • 07 Apr 2022
Topic Review
Trauma in Rapes and Assaults
This entry describes that psychological trauma in rapes and assaults is a serious public health issue. 
  • 616
  • 14 Dec 2021
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