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Topic Review
Fibromyalgia Symptoms Overview
Fibromyalgia syndrome (FMS) can be conceptualized as a chronic disorder characterized by widespread musculoskeletal pain and other accompanying symptoms such as fatigue, insomnia, depression, anxiety and cognitive impairments. The etiology of FMS remains unknown, being one of the most accepted hypothesis the presence of central sensitization to pain and impairments in endogenous pain inhibitory mechanisms. The history of the development of FMS concept reveals how other symptoms -apart from pain- has become also relevant in FMS diagnosis and treatment. The central symptom of FMS is pain. FMS patients generally report high levels of clinical pain, which are related to greater impairments in health related quality of life, cognitive abilities and disease course. Fatigue and sleeping difficulties are also common symptoms of FMS. Fatigue have shown positive associations with pain, stiffness, sleep problems, increased body mass index, FMS severity, tenderness, disability, cognitive complaints, anxiety and depression. The majority of FMS patients report poor sleep quality, take longer to fall asleep, generally wake up during the night, sleep fewer hours, and usually wake up unrefreshed. Emotional disturbances (i.e., depression, anxiety) are also frequent in FMS. In fact, depression and anxiety disorders have showed a negative impact on the clinical course and work capacity of FMS patients. Cognitive impairments are also a relevant symptom in FMS. The most common complaints among FMS patients are executive function deficits, attention problems, forgetfulness, concentration difficulties, and mental slowness. Regarding the most frequent treatments for FMS, these can be classified as non-psychological and psychological. The former includes analgesic drugs, adjuvant drugs (i.e., antidepressants, benzodiazepines, anticonvulsants, etc.), nerve blocks, electrostimulation at different levels, infiltrations, etc. The psychological therapies with the most evidence are cognitive-behavioral, acceptance and commitment therapy and mindfulness. FMS is associated with a severe reduction of health related quality of life and psychosocial impairments. It is necessary to take all FMS symptoms and its relations into account in order to provide a more tailored and effective treatment, as well as, to improve the health related quality of life of FMS patients.
  • 795
  • 26 Oct 2020
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. 
  • 766
  • 13 Jun 2021
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. 
  • 751
  • 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.
  • 709
  • 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.
  • 653
  • 29 Sep 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. 
  • 650
  • 16 Dec 2021
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.
  • 642
  • 10 Jun 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. 
  • 627
  • 05 Jan 2022
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. 
  • 585
  • 22 Nov 2021
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.
  • 552
  • 05 Nov 2021
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