Vol 2-4 Mini Review

Improving the Methodological Quality of Single-Case Experimental Design Meta-Analysis

Laleh Jamshidi1*, Lies Declercq1, John M. Ferron2, Mariola Moeyaert3, S. Natasha Beretvas4, and Wim Van den Noortgate1

1Faculty of Psychology and Educational Sciences & imec-Itec, KU Leuven (University of Leuven), Belgium

2University of South Florida, Tampa, Florida, USA

3University at Albany – State University of New York, New York, USA

4University of Texas at Austin, Texas, USA

Single-case experimental design (SCED) studies are becoming more prevalent in a variety of different fields and are increasingly included in meta-analyses (MAs) and systematic reviews (SRs). As MA/SR’s conclusions are used as an evidence base for making decisions in practice and policy, the methodological quality and reporting standards of SRs/MAs are of uttermost importance. One way to improve the reliability and validity of SCED MAs and therefore to provide more confidence in MA/SR findings to practitioners and clinicians to decide on a particular intervention is the use of high-quality standards when conducting and reporting MAs/SRs. In the current study, some existing tools for assessing the quality of SRs/MAs that might also be helpful for SCED MAs will be reviewed briefly. These tools and guidelines can help meta-analysts, reviewers, and users to organize and evaluate the quality and reliability of the findings.

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Vol 2-3 Mini Review

The Deep Evolutionary Roots of 'Addiction'

Moira J van Staaden1,2*, F Scott Hall1,3 and Robert Huber1,2

1Juvatech creative behavioral designs, Maumee, OH 43537, USA

2JP Scott Center for Neuroscience, Mind & Behavior, Department of Biological Sciences, Bowling Green State University, Bowling Green, OH 43403, USA

3Department of Pharmacology and Experimental Therapeutics, University of Toledo, Toledo, OH 43606, USA

Addiction is now recognized as a phenomenon with exceedingly deep evolutionary roots. Addictive plant alkaloids, as secondary metabolites, evolved primarily to counter insect herbivory. Although some views regard addiction as a human/mammal specific, cognitive phenomenon, we suggest that its roots are found in much more fundamental biological mechanisms for learning and motivation, mechanisms which are shared by taxa since the early evolution of bilateral metazoans. According to this view, addiction is fundamentally an invertebrate phenomenon and humans can be viewed as collateral damage in this coevolutionary arms race. Results from a variety of invertebrate preparations demonstrate behavioral and neural consequences of drug exposure, ranging from psychostimulant properties and sensitization, to conditioned cue learning and operant self-administration. This mini review focuses attention on our recent work in crayfish, but there is certainly evidence for the presence of addictionlike phenomena in more ancient invertebrate taxa.

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Vol 2-4 Mini Review

Is Schizophrenia Disappearing? The Rise and Fall of the Diagnosis of Functional Psychoses: an Essay

Per Bergsholm*

Department of Psychiatry, District General Hospital of Førde, Box 1000, 6807, Førde, Norway

The category diagnosis of functional psychoses builds on views of influential professionals. Until the second half of the 1800s, the conceptions of mania and melancholia from the Greek antiquity included largely all functional psychoses. Disturbed mood and energy were central symptoms, and the idea of unitary psychosis prevailed. From the 1900s this was followed by a dichotomy between schizophrenia and affective psychoses and broadening of the schizophrenia concept. Affective symptoms were strongly downgraded. Many psychoses with mixed features were described, and there have now long been four main categories of functional psychoses – affective, schizophrenic, schizoaffective/cycloid/reactive/polymorphic, and delusional/paranoid psychoses. The last three are included in “psychotic disorders”. The boundaries between categories have varied with time, place and professionals’ views. DSM-5 is updated with separate chapters for catatonia and psychotic symptoms, both unspecific, and removal of the subtypes of schizophrenia. However, time may be running out for categorical psychosis diagnoses, which may be replaced by continuum, spectrum, dimensional and research domain criteria. Affective symptoms are often difficult to acknowledge, diagnosis is often done on the basis of preconceptions, and patients’ affect characterized accordingly. Chronic mood disorders may appear as schizophrenic or paranoid psychosis, end-stages like heart failure in heart diseases. This underscores the importance of early and optimal treatment of mood disorders, which may be the most important cause of schizophrenia and other functional psychoses.

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Vol 2-4 Original Research Article

A Peer-Support Mental Health Response Training for LGBTQIA+ Adolescents

Megan Chernosky*

University in Louisville, Kentucky, USA

This paper will discuss the correlation between participation in a mental health peer-support training and adolescents’ self-reported feelings of preparedness to deal with mental health crises. The paper will focus on lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other non-heterosexual, non-cisgender youth (LGBTQIA+) between the ages of 13 and 21 years old. The study used a quantitative, written survey with eighteen questions before the intervention, and another with five questions after the intervention. The study originally involved eleven participants, but the number of participants decreased to seven dues to attrition. The intervention was administered to every participant. The data were analyzed to find the averages and standard deviations for each category. The results found that the average preparedness increased after the intervention. Due to lack of a control group, the researcher was not able to determine causation, but they were able to determine correlation. The researcher concluded that there was a short-term increase in feelings of preparedness to deal with crises in correlation with receiving the mental health training.

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Vol 2-4 Mini Review

Concept and Results of the German Research Network on Schizophrenia

Wolfgang Wölwer1*, Gerhard Buchkremer2, Heinz Häfner3, Joachim Klosterkötter4, Wolfgang Maier5, Hans-Jürgen Möller6, Wolfgang Gaebel1

1Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, LVR Klinikum Düsseldorf, Germany

2Department of Psychiatry and Psychotherapy, University Tübingen, Germany

3Research Group Schizophrenia Research, Central Institute of Mental Health Mannheim, Germany

4Department of Psychiatry and Psychotherapy, University Cologne, Germany

5Department of Psychiatry and Psychotherapy, University Bonn, Germany

6Department of Psychiatry and Psychotherapy, University Munich, Germany

Background: The German Research Network on Schizophrenia (GRNS) was funded by the Federal Ministry of Education and Research (BMBF) from 1999 to 2011. The aim was to obtain a better horizontal and vertical networking of German research and care facilities on schizophrenia, in order to investigate open research questions, to transfer the results into clinical practice and after all to improve care and quality of life in patients with schizophrenia.

Objectives / Methods: This paper describes the concept and functioning of the GRNS as well as its results on the basis of selected research projects.

Results: The GRNS comprised about 25 clinical trials of high practical relevance, which were closely interrelated regarding content, methodology and organization. The trials primarily served the development and evaluation of new and established diagnostic and therapeutic approaches, the assessment of the status quo of clinical care as well as its improvement, together with the investigation of basic scientific questions. Many substantial results to highly relevant issues could be obtained, which led or will lead to an improvement in mental health care.

Conclusions: Quantitative and qualitative evaluation parameters such as scientific publications and raising of additional grants, as well as promotion of young scientists, public relations activities, congress activities and foundation of the European Scientific Association on Schizophrenia and other Psychoses (ESAS) prove the successful work of the network. The successful grant raising will allow continuing cooperative schizophrenia research in Germany as initiated by the GRNS.

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Vol 2-4 Mini Review

"On the Economic Concept of Mental Health: A Probing Inquiry", an Author's Review

Pablo Levín*

Faculty of Economics, University of Buenos Aires (FCE/UBA), Argentina

Both this mini-review and the reviewed article were composed by this author (an economist), to probe into the ample but as yet hardly explored interface between two disciplines (Psychiatry and Political Economy) that have mostly grown heretofore with their backs turned to each other. In facing such a very large and complex almost newfound interdisciplinary field –itself a decisive step towards the integration of an all-encompassing philosophy of culture; a full systematic discussion is neither to be announced nor expected. At some point however our statements may appear apodictic in form and emphatic in tone; but please bear in mind that these excesses are just meant to make our point. Our purpose is to call for further discussion, with a serious caveat as to the danger entailed in interdisciplinary conversation, of begetting still another syncretic contraption.

We hopefully feel instead, that this abridged version comes closer than the earlier article; to the desideratum of a synthetic concept; potentially impinging upon: i.e., constituting; the vast area where these two disciplines overlap; by developing the concept of a "triple culture aporia (TCA)" -as a theoretical archetype for Ideology.

The TCA concept has to saddle over upon the interdisciplinary boundaries we’re here concerned with; shedding new light on the absolute originality of today’s human condition. To make this clearer, we should bring forth the concept of historical heteronomy, to wit, contemporary human’s self-inflicted incapacity for becoming our own full- fledged contemporaries. In a nutshell: chronologic contemporariness is given to us as a matter of fact; but prevailing institutionalized education falls short from –or indeed systematically precludes; preparing us to raise ourselves up to present historical contemporaneity; to confront its exigencies, to reap its high rewards; the latter being the utmost specifically human aspiration!

It is our deep conviction, that a (the?) main source of our individual distresses and sufferings –included those that bring us as patients to the psychiatrist’s office; are to be sought among our failures in our quest for Bildung; not constrained into its xviii enlightenment still incipient notion; but open to its urgently needed updated concept…which is what this review is about.

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Vol 2-4 Commentary

Commentary: Comparative Genomic Analysis of Ten Clinical Streptococcus pneumoniae Collected From a Malaysian Hospital Reveal 31 New Unique Drug-Resistant SNPs Using Whole Genome Sequencing

Hassan Mahmood Jindal1, Shamala Devi Sekaran2*

1Department of Medical Microbiology, University of Malaya, Kuala Lumpur, 50603, Malaysia

2Department of Microbiology, Faculty of Medicine, MAHSA University, 42610 Jenjarom, Selangor, Malaysia

Despite the effort and decades of research, S. pneumoniae remains a primary cause of infectious morbidity and mortality worldwide. Although Antibiotics are lifesaving medications that offer tremendous benefits to patients with infectious diseases. Yet, several reports have revealed that the overuse and misuse of these agents had led to antibiotic resistance. Our study utilized whole genome sequencing (WGS) to reveal the pattern of antibiotic-resistance among ten pneumococcal isolates with various degree of susceptibility to antibacterial drugs. The main purpose of our study was to explore genetic variations related to drug-resistance in those ten strains. The results indicated that pneumococcal strains with resistant profile were associated with greater number of SNPs compared to susceptible ones. Out of all the SNPs identified, 31 were unique and had not been reported before. Our data propose that these SNPs could possess an important role in modifying the degree of sensitivity to different antibacterial drugs. In this article we comment on the methodology and results of our study which previously published in Journal of Biomedical Science.

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Vol 2-4 Review Article

Risperidone Response in Schizophrenia: A Narrative Review of Pharmaco-Genetic Research

Jitender Aneja*

Department of Psychiatry, All India Institute of Medical Sciences, India

Background: The response to risperidone in patients with schizophrenia is influenced by many factors including the genetic ones. The innovations in biotechnology have provided essential tools for conduction of pharmaco-genetic research and subsequently a number of pharmaco-dynamic and pharmaco-kinetic studies delineating the response of anti-psychotics in schizophrenia have been conducted till date. So, we may prevision that pharmaco-genetic knowledge can provide us with the tools to personalize treatment in routine psychiatric clinical practice.

Purview of this article: This article is a narrative review of existing pharmaco-genetic research that has elicited relationship of various gene polymorphisms and response to risperidone monotherapy in patients with schizophrenia. The association of response to risperidone treatment and the genetic markers across the dopaminergic, serotonergic, and the metabolizing enzymes have been reported here. However, the pharmaco-kinetic aspects of the metabolizing enzymes and other genes are not reviewed in this paper.

Conclusions: Some of the genes coding for dopaminergic and serotonergic receptors and their mutations have been shown to predict risperidone response. Certain promising observations have been made for the association of DRD2 receptor genes (Ser311Cys, -141C Ins/Del), DRD3 (Ser9Gly), 5-HTR2A genes (102T>C), and COMT genes. Although, some positive association with some other genes have also been found, but the evidence is minimal. Despite the availability of such evidence, it is limited for clinical utilization in its present form. However, efforts shall be made at further exploration of genetic underpinnings of schizophrenia, refinement of study methods, and discovery of newer biomarkers to attain utilization of pharmaco-genetics in clinical practice.

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Vol 2-4 Review Article

Fetal Alcohol Spectrum Disorder and the Criminal Justice System: A Research Summay

Jacqueline Pei1,2, Katherine Flannigans1*, Sarah Keller2, Michelle Stewart1,2, Alexandra Johnson3

1Canada Fetal Alcohol Spectrum Disorder Research Network, PO Box 11364 Wessex PO, Vancouver, BC, Canada, V5R 0A4

2Department of Educational Psychology, University of Alberta, 6-102 Education North, Edmonton, AB, Canada, T6G 2G5

3Department of Justice Studies, University of Regina, 3737 Wascana Parkway, Regina, SK, Canada, S4S 0A2

Fetal Alcohol Spectrum Disorder (FASD) is a neurodevelopmental disability that occurs as a result of fetal exposure to alcohol. Such exposure can impact physical, cognitive, social-emotional, and behavioural development, which renders individuals with FASD vulnerable to a range of adverse life outcomes when adequate supports and services are not available. One of the common adverse outcomes associated with FASD is criminal justice system (CJS) involvement, and individuals with FASD are believed to be over-represented in forensic and correctional settings. The FASD population is an exceptionally heterogeneous and complex group, with varying life experiences, clinical profiles, and levels of functional ability. These factors likely impact how an individual with FASD might engage with the CJS, function within the system, and respond to justice-related supports and intervention initiatives. In this mini review, we provide a synopsis of the current state of the literature regarding the intersections between FASD and the CJS, including research on prevalence and screening, as well as profiles and perspectives of individuals with FASD who are justice-involved. Further, recommendations are put forward to guide our work with justice-involved individuals with FASD, keeping in mind that no two individuals will present in the same way.

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Vol 2-4 Commentary

Commentary: Using Electroencephalography Measurements and High-quality Video Recording for Analyzing Visual Perception of Media Content

Celia Andreu-Sánchez1*, Miguel Ángel Martín-Pascual1, 2, Agnès Gruart3, José María Delgado-García3

1Neuro-Com Research Group, Department of Audiovisual Communication and Advertising, Universitat Autònoma de Barcelona, Barcelona, Spain

2Instituto Radio Televisión Española, RTVE, Barcelona, Spain

3División de Neurociencias, Universidad Pablo de Olavide, Sevilla, Spain

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Vol 2-5 Mini Review

Gender Incongruence is No Longer a Mental Disorder

M. Fernández Rodríguez1,2*, M. Menéndez Granda3, Villaverde González4

1Mental Health Center I “La Magdalena” University Hospital San Agustín de Avilés. Health Area III, Asturias, Spain

2Gender Identity Treatment Unit of Principality of Asturias (UTIGPA), Spain

3Master of General Health Psychology, University of Oviedo, Asturias, Spain

4Intern Resident Psychologist, University Hospital San Agustín Avilés. Health Area III Asturias, Spain

The aim of this article is to highlight the historical path of transsexualism diagnosis since its inclusion to its elimination from the catalogue of mental disorders. We analyse the terminological changes that may account for this phenomenon in order to depathologise and just as the controversies raised by its location in the new Manual of International Statistical Classification of Diseases and Related Health Problems ICD-11.

ICD-11 drives out the term "Transsexualism" and replaces it with the term "Gender Incongruence" (GI). This new terminology will no longer be part of the chapter on mental disorders (Chapter 6) but a new chapter (Chapter 17) entitled "Conditions relating to sexual health" is created. These changes of ICD-11 represent a breakthrough and a great sense of freedom for trans people, since WHO has included the different variants of gender in normality by not being considered a mental disorder.

The aim of this paper is to highlight the historical development of the diagnosis of transsexualism from its inclusion to the elimination of the chapter of mental disorders. Terminological changes that can best reflect this phenomenon to depathologize and the controversies raised by its location in the new manual of ICD-11 are analyzed.

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Vol 2-5 Mini Review

A Two-Hit Model of The Biological Origin of Posttraumatic Stress Disorder (PTSD)

Apostolos P. Georgopoulos1,2,3,4,5*, Lisa M. James1,2,3,4, Peka Christova1,2,3, Brian E. Engdahl1,2,3,6

1 Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, USA

2 Department of Neuroscience, University of Minnesota Medical School, Minneapolis, Minnesota, USA

3 Center for Cognitive Sciences, University of Minnesota, Minneapolis, Minnesota, USA

4 Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA

5 Department of Neurology, University of Minnesota Medical School, Minneapolis, Minnesota, USA

6 Department of Psychology, University of Minnesota Medical School, Minneapolis, Minnesota, USA

Posttraumatic stress disorder (PTSD) is a debilitating disorder that can develop following exposure to a traumatic event. Although the cause of PTSD is known, the brain mechanisms of its development remain unknown, especially why it arises in some people but not in others. Most of the research on PTSD has dealt with psychological and brain mechanisms underlying its symptomatology, including intrusive memories, fear and avoidance (see ref.1 for a broad coverage of PTSD research)1. Here we focus, instead, on the origin of PTSD, namely on the neural mechanisms underlying its development. Specifically, we propose a two-hit model for PTSD development, with the following components. (a) The 1st hit is a neuroimmune challenge, as a preexisting condition, and the 2nd hit is intense glutamatergic neurotransmission, induced by the traumatic event; (b) the key molecule that mediates the effects of these two hits is intercellular adhesion molecule 5 (ICAM-5) which was found to be differentially expressed in PTSD2. ICAM-5 is activated by neuroimmune challenge3,4 and glutamatergic neurotransmission5,6, it further enhances glutamatergic transmission6, and exerts a potent effect on synapse formation and neural plasticity, in addition to immunoregulatory functions3,4,7; and (c) with respect to the neural network(s) involved, the brain areas most involved are medial temporal cortical areas, and interconnected cortical and subcortical areas8-10. We hypothesize that the net result of intense glutamatergic transmission in those areas induced by a traumatic event in the presence of ongoing neuroimmune challenge leads to increased levels of ICAM-5 which further enhances glutamatergic transmission and thus leads to a state of a neural network with highly correlated neural interactions, as has been observed in functional neuroimaging studies8-10. We assume that such a “locked-in” network underlies the intrusive re-experiencing in PTSD and maintains associated symptomatology, such as fear and avoidance.

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