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Background Major depressive disorder (MDD) is often associated with suicidal attempt (SA). Therefore, predicting the risk factors of SA would improve clinical interventions, research, and treatment for MDD patients. This study aimed to create a nomogram model which predicted correlates of SA in patients with MDD within the Chinese population. Method A cross-sectional survey among 474 patients was analyzed. All subjects met the diagnostic criteria of MDD according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10). Multi-factor logistic regression analysis was used to explore demographic information and clinical characteristics associated with SA. A nomogram was further used to predict the risk of SA. Bootstrap re-sampling was used to internally validate the final model. Integrated Discrimination Improvement (IDI) and Akaike Information Criteria (AIC) were used to evaluate the capability of discrimination and calibration, respectively. Decision Curve Analysis (DCA) and the Receiver Operating Characteristic (ROC) curve was also used to evaluate the accuracy of the prediction model. Result Multivariable logistic regression analysis showed that being married (OR = 0.473, 95% CI 0.240 and 0.930) and a higher level of education (OR = 0.603, 95% CI 0.464 and 0.784) decreased the risk of the SA. The higher number of episodes of depression (OR = 1.854, 95% CI 1.040 and 3.303) increased the risk of SA in the model. The C-index of the nomogram was 0.715, with the internal (bootstrap) validation sets was 0.703. The Hosmer-Lemeshow test yielded a P-value of 0.33, suggesting a good fit of the prediction nomogram in the validation set. Conclusion Our findings indicate that the demographic information and clinical characteristics of SA can be used in a nomogram to predict the risk of SA in Chinese MDD patients.Introduction An important approach to improve the therapeutic effect of electroconvulsive therapy (ECT) may be to early characterize patients who are more likely to respond. Our objective was to explore whether baseline electroencephalography (EEG) settings before the beginning of ECT treatment can predict future clinical response to ECT in patients with depressive disorder. Methods We conducted a systematic search in the MEDLINE, EMBASE, PsycINFO, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify studies using EEG in adults with depressive disorder treated by ECT. To investigate the predictive value of baseline EEG on clinical outcomes of ECT, we extracted from the retrieved studies and qualitatively described the association between the baseline EEG markers characteristics and the rates of future responders and/or remitters to ECT. Results The primary search yielded 2,531 potentially relevant citations, and 12 articles were selected according to inclusion criteria. Most of the studies were prospective studies with small sample size. Sociodemographic and clinical characteristics of patients, ECT settings, EEG settings, and outcomes were heterogeneous. Event-related potential (ERP) paradigms were used in three studies, polysomnography was used in three studies, and the six other studies used EEG to measure cerebral connectivity and activity. Conclusions P300 amplitude, coherence, and connectivity measures were correlated with remission in patients with depression treated by ECT. Sleep EEG recordings seemed not to be correlated with remission after ECT. Further prospective studies with large sample size are needed to determine optimal EEG parameters associated with clinical response to ECT in depressive disorder. Systematic Review Registration PROSPERO CRD42020181978.Background The importance of physical health among persons with schizophrenia is well-established. Studies from developed and developing countries indicated a strong association between cardiovascular diseases and schizophrenia, while evidence from India is scattered and in its infancy. Hence, the aims of the study were to collate available studies from India on cardiovascular diseases among persons with schizophrenia, identify knowledge gaps and challenges, and discuss recommendations to improve clinical care and research on cardiovascular diseases among persons with schizophrenia in India. Materials and methods A comprehensive literature review of Indian studies on cardiovascular diseases and schizophrenia was conducted to collate and synthesise available knowledge. Results Several risk factors for cardiovascular disease predominated among persons with schizophrenia. Metabolic syndrome and obesity were the key factors that were reported. Knowledge gaps were identified with respect to the prevalence of cardiovascular diseases among persons with schizophrenia. Sparse research in interventions to prevent and reduce the impact of cardiovascular diseases among persons with schizophrenia was noted. Conclusion Targeted efforts are needed at the clinic, community, and policy levels to understand the impact of cardiovascular diseases among persons with schizophrenia. Robust and feasible interventions targeting cardiovascular diseases and its varied risk factors in persons with schizophrenia, that can be implemented in tertiary mental health services, need to be developed and tested.Background Polypharmacy and inappropriate prescription are frequent in vulnerable and multi-morbid populations. Adults with intellectual disability (ID) are at risk of being polymedicated because they often present with multiple comorbidities and challenging behaviors. Aim The objective of this study was thus to evaluate the prevalence of potentially inappropriate medications (PIM) and polypharmacy in a hospital unit dedicated to adults with ID. Methods A 10-month prospective observational study took place at a hospital unit specializing in the care of adults with ID in Geneva, Switzerland. Once a week, health and prescription data were collected and screened for PIM according to preset definitions. Results Fourteen patients consented to participate, leading to 20 hospitalization events assessed during the study. Hospitalizations lasted 12.8 weeks on average. Naphazoline supplier ID severities ranged from mild to profound, all degrees of severity being equally represented. One hundred percent of the patients were polymedicated (defined as five drugs or more prescribed simultaneously). A mean number of 9.4 drugs were prescribed per week, including 5.3 psychotropic drugs. The number of prescribed drugs remained stable throughout the hospitalizations. Antipsychotics were the most prescribed drug class (19% of all prescribed drugs), followed by benzodiazepines (13%) and laxatives (12%). link2 A total of 114 PIM were recorded with an average of 5.7 PIM per hospitalization. Conclusions This study showed that polypharmacy and inappropriate prescription are very common in adults with ID, even though the literature and expert positions advocate for deprescription in these patients. Specific prescribing and deprescribing guidelines are needed for that specific population.Background Antipsychotics are frequently used to treat delirium but often induce corrected QT (QTc) prolongation, which can be lethal by causing torsade de pointes. Nonetheless, the selection of antipsychotics to treat delirium patients with prolonged baseline QTc intervals remains unclear. We aimed to assess the utility of antipsychotics based on their effects on treatment outcomes and QTc intervals. Methods A clinical decision analysis was conducted using data on the effects of antipsychotics on treatment outcomes and QTc intervals from published network meta-analyses. We quantified the utility of six antipsychotics (amisulpride, haloperidol, olanzapine, quetiapine, risperidone, and ziprasidone) using a decision tree and the obtained effect sizes. Subsequently, we conducted sensitivity analyses using multiple utility settings and another dataset. We also performed a probabilistic sensitivity analysis using Monte Carlo simulation, in which the effects of antipsychotics were randomly sampled given the plausible range. Results Amisulpride showed the highest utility when the baseline QTc interval was 420 ms. Quetiapine showed the highest utility when the baseline QTc interval was ≥450 ms. The sensitivity analyses also showed the superiority of quetiapine when the baseline QTc intervals were prolonged. Conclusions Decision analysis suggests that quetiapine is the optimal antipsychotic drug for the treatment of patients with delirium and prolonged baseline QTc intervals.A large number of neuroimaging studies have detected brain abnormalities in first-episode schizophrenia both before and after treatment, but it remains unclear how these abnormalities reflect the effects of antipsychotic treatment on the brain. To summarize the findings in this regard and provide potential directions for future work, we reviewed longitudinal structural and functional imaging studies in patients with first-episode schizophrenia before and after antipsychotic treatment. A total of 36 neuroimaging studies was included, involving 21 structural imaging studies and 15 functional imaging studies. link3 Both anatomical and functional brain changes in patients after treatment were consistently observed in the frontal and temporal lobes, basal ganglia, limbic system and several key components within the default mode network (DMN). Alterations in these regions were affected by factors such as antipsychotic type, course of treatment, and duration of untreated psychosis (DUP). Over all we showed that (a) The striatum and DMN were core target regions of treatment in schizophrenia, and their changes were related to different antipsychotics; (b) The gray matter of frontal and temporal lobes tended to reduce after long-term treatment; and (c) Longer DUP was accompanied with faster hippocampal atrophy after initial treatment, which was also associated with poorer outcome. These findings are in accordance with previous notions but should be interpreted with caution. Future studies are needed to clarify the effects of different antipsychotics in multiple conditions and to identify imaging or other biomarkers that may predict antipsychotic treatment response. With such progress, it may help choose effective pharmacological interventional strategies for individuals experiencing recent-onset schizophrenia.Background Previous observational studies suggested a relationship between dietary fiber consumption and mental health, but the findings were conflicting. We evaluated the link between dietary fiber intake and prevalence of depression, anxiety, and psychological distress among a large population of Iranian adults. Methods A cross-sectional study among 3,362 Iranian adults working in 50 health centers was done. Data of dietary intakes were collected through a validated semiquantitative dish-based 106-item food frequency questionnaire (FFQ). Anxiety, depression, and psychological distress were defined based on the Iranian validated version of Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ). Results After adjustment for potential confounders, participants in the top quartile of total dietary fiber intake had a 33% and 29% lower risk of anxiety and high psychological distress [odds ratio (OR) 0.67; 95% CI 0.48, 0.95 and OR 0.71; 95% CI 0.53, 0.94, respectively] compared to the bottom quartile of intake.