Mental Health Research Institute

Athlete burnout is increasingly reported as impacting esports players' wellbeing and performance. This study examined the psychometric properties of the Athlete Burnout Scale (ABO-S) in esports. The ABO-S assesses three burnout dimensions: physical exhaustion, reduced sense of accomplishment, and negative feelings toward sport. The study focused on item discrimination and difficulty parameters to establish optimal raw cut-off scores indicating levels of burnout risk. Participants were 453 adult esports players proficient in English, ranked in the top 40% of one of seven major esports. The sample included 372 males, 74 females, and seven nonbinary participants from 66 countries. Item Response Theory was used to assess the ABO-S's psychometric properties. The GRM provided a superior fit, with all but one item showing sufficient discrimination and difficulty levels. Items reflecting weariness, lacking energy, and physical exhaustion demonstrated high levels of information and reliability across a range of burnout levels. A provisional diagnostic cut-off score of ≥ 63 (+2 SD) was established, identifying 2% of participants at high burnout risk. Additional raw score thresholds of ≥ 47 (+0.5 SD) and 52 (+1 SD) were also identified. The ABO-S is a robust instrument for assessing burnout in esports players, with specific items effectively identifying varying levels of burnout. The establishment of cut-off scores aids in identifying players at high risk of burnout, contributing to better support and intervention strategies in the esports community. These findings further the understanding of burnout in esports, highlighting the scale's utility in monitoring and addressing player wellbeing.

Youth depression disrupts the social and vocational transition into adulthood. Most depression burden is caused by recurring or chronic episodes. Identifying young people at risk for relapsing, recurring, or chronic depression is critical. We systematically reviewed and meta-analyzed the literature on prognostic factors for relapsing, recurrent, and chronic depression in young people. We searched the literature up (MEDLINE, PsycINFO, CINAHL, Embase, CENTRAL, WHO ICTRP, ClinicalTrials.gov, bioRxiv, MedRxiv) to March 6, 2024, and included cohort studies and randomized trials that assessed any prognostic factor for relapse, recurrence, or chronicity of depression in young people (aged 10-25 years at baseline) with a minimum of a 3-month follow-up. We assessed individual study risk of bias using the QUIPS tool and the certainty of evidence via the GRADE approach. We conducted random-effects meta-analyses with Hartung-Knapp-Sidik-Jonkman adjustment when 3 or more estimates on the same prognostic factor were available. Qualitative synthesis was conducted to identify promising prognostic factors that could not be meta-analyzed. A total of 76 reports of 46 studies (unique cohorts or trials) were included that tested 388 unique prognostic factors in 7,488 young people experiencing depression. The majority of the reports were at high risk of bias (87%). We conducted 22 meta-analyses on unadjusted, and 7 on adjusted, prognostic factors of a poor course trajectory (ie, combined relapse, recurrence, and chronicity). Female sex (adjusted; odds ratio [95% CI] = 1.49 [1.15, 1.93], p = .003), higher severity of depressive symptoms (unadjusted; standardized mean difference [95% CI] = 0.53 [0.33, 0.73], p < .001), lower global functioning (unadjusted; standardized mean difference [95% CI] = -0.35 [-0.60, -0.10], p = .005), more suicidal thoughts and behaviors (unadjusted; standardized mean difference [95% CI] = 0.52 [0.03, 1.01], p = .045), and longer sleep-onset latency (unadjusted; mean difference [95% CI] = 6.96 [1.48, 12.44] minutes, p = .013) at baseline predicted a poor course trajectory of depression. The certainty of the evidence was overall very low to moderate. Promising prognostic factors that could not be meta-analyzed included relational/interpersonal factors (friend relationships and family relationships/structure). Our findings demonstrate the prognostic value of demographic and clinical factors for poor course trajectories of depression in young people. More research is needed to confirm the potential value of relational/interpersonal factors in predicting poor depression course. Limitations of the literature include the high risk of bias of included studies, which indicates that future studies should include large sample sizes and wider diversity of prognostic markers (eg, genetic and neurobiological) in multivariable models. The critical next step is to combine the identified prognostic factors and to evaluate their clinical value in identifying individuals at risk for a poor course trajectory of depression during youth, a life stage in which most of the disability and burden attributable to depression can be averted. This systematic review and meta-analysis summarized the evidence for factors that can be used to identify relapsing, recurrent, and chronic depression in young people. Data from 76 reports of 46 unique cohorts, including a total of 7,488 young people experiencing depression, found that female sex, more severe depressive symptoms, suicidal thoughts and behaviors, lower global functioning, and longer sleep-onset latency were predictive of a poor course trajectory of depression. This information has the potential to identify youth at risk for a poor course of depression, a life stage in which most of the disability and burden attributable to depression can be averted. Prognostic factors for relapsing, recurrent or chronic depression in youth: a systematic review with meta-analysis; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023458646.

This brief narrative review describes the limitations of traditional categorical diagnostic systems, such as the ICD and DSM, when used to form homogeneous groups for biological research and application of the findings to address clinical challenges. As an alternative, the Hierarchical Taxonomy of Psychopathology (HiTOP) is proposed. This taxonomy is based on a hierarchical principle, where the clinical picture is considered a multi-level system: the top level features a general psychopathology factor (the p-factor); the middle level consists of psychopathological domains or spectra, formed by more specific phenotypic manifestations such as depressiveness, cognitive impairments, impulsivity, and psychoticism; and the lower level is represented by individual symptoms characteristic of a specific case but not defining the overall clinical picture, such as insomnia or suicidality. The system separately assesses the degree of a patient's maladaptation due to a symptom, as well as the influence of external factors on both the severity of symptoms and the degree of maladaptation. To illustrate the rationale of this approach, knockout models of two domains—cognitive and anxiety—are presented. Using examples of gene knockouts (KMO, Gabrb2, GRM2/3, mGlu1, PLCB1, TAAR1, DISC1, SLC6A4, 5-HT1A, 5-HT2C, Slitrk5), it is demonstrated how specific genetic impairments lead to various behavioral and cognitive phenotypes that do not fit into existing diagnostic frameworks but correspond better to clinical reality. The possibilities of applying the HiTOP approach and genetic data for personalizing therapy and creating more accurate biological models of mental disorders are discussed.

Affective disorders are polyetiological conditions arising from the complex interplay of adverse genetic, epigenetic, and environmental factors, whose interaction leads to the development of structural (including molecular and cellular) and functional alterations in the brain. Contemporary research has established that changes in regulation of immune system function are a key component of the etiology, pathopsychology, and pathogenesis of affective disorders, particularly depression. The existence of reciprocal interactions among the nervous, endocrine, and immune systems, together with the high degree of comorbidity between depression and autoimmune, infectious, and chronic inflammatory diseases, supports the hypothesis of shared immune-mediated pathogenetic mechanisms underlying these pathological processes. The high prevalence and relentless rise in incidence of depression, severe clinical manifestations, limited efficacy of therapeutic correction methods, and the substantial social and economic burden collectively elevate the issue of effective treatment and prevention of depression to one of the most urgent challenges of modern medicine. Pharmacological treatment of depression is associated with several limitations, including delayed onset of action of antidepressants, substantial adverse effects, and insufficient therapeutic efficacy, all of which reduce patient adherence to treatment. Therefore, the development of novel, more effective, pathogenetically substantiated strategies for the pharmacotherapy of depression is an urgent objective in modern psychopharmacology. This review presents an analysis of data on the immunomodulatory properties of various antidepressants, the clinical experience with nonsteroidal anti-inflammatory drugs (selective cyclooxygenase-2 inhibitors), cytokine inhibitors, and epigenetic modulators, as well as the potential prospects for the application of cell-based technologies in the immunotherapy of depression. The incorporation of immunotherapy into treatment protocols for patients with depression opens new opportunities for correcting pathological changes in this patient population, thereby enhancing the effectiveness of pharmacotherapy, improving quality of life and social adaptation, preserving occupational functioning, and reducing the burden on the healthcare system and society in general.

Despite efforts to uncover genome variability confined to the human brain, genome composition of neurons remains a matter of conjecture in health and disease. Still, somatic neurogenomics continuously gives further insights into understanding of mechanisms for devastative psychiatric and neurological disorders. For instance, since somatic genetic mosaicism and genome instability affecting the brain dynamically change during the ontogeny, these phenomena are able to shape individual features of disease manifestation, course, and outcome. This review is dedicated to the involvement of genome instability in the pathogenesis of brain diseases. Genome/chromosome instability and somatic mosaicism mediating brain dysfunction may produce specific (personalized) manifestations and course of a brain disorder via genetic-environmental interactions. Consequently, genome instability in the brain has to be taken into account during the development of personalized therapeutic interventions in a wide spectrum of psychiatric and neurological disorders. Among the latters, the most striking are schizophrenia, Alzheimer’s diseases, and chromosome instability syndromes. Still, neurodevelopmental diseases (e.g., autism and intellectual disability) are to be investigated in the context of brain-specific genome instability.

With increasing use of AI in public life, various technological tools like ChatGPT are being used for psychotherapy. Psychiatrists face unique ethical challenges in understanding their use. Clinicians have an obligation to advise policymakers and to update scope of practice laws related to the mental health workforce and technology. Coordinating therapeutic interventions with patient use of ChatGPT or other applications, the need for data storage, the maintenance of patient confidentiality, and medico-legal responsibilities of clinicians are discussed.

IntroductionSchizophrenia is a severe psychiatric disease caused by genetic and environmental factors or their interactions that can contribute across multiple disease domains, including negative symptoms (NS), a core feature of schizophrenia.ObjectivesTo study the association between season of birth (SOB), a well-replicated risk factor for schizophrenia, and NS domains avolition/apathy (AA) and diminished expression (DE) and to search for an interaction effect of SOB and rs2794521 genetic variants of the inflammatory marker C-reactive protein (CRP) on these domains.MethodsThe study included 2475 patients with schizophrenia. Patients born during the months of December to February were considered to be winter-born (n=636) and patients born in other months were considered to be non-winter-born (n=1839). Genotypes for CRP rs2794521 were obtained for 2437 patients. NS factors were calculated based on the Positive and Negative Syndromes Scale.ResultsThere was a significant effect of SOB on AA scores (p=0.009), which remained after adjustment for sex and illness duration. Patients born in winter had higher scores compared with those born in other seasons. No significant effect of SOB on DE scores was observed. An association between the CRP rs2794521 G-allele and AA scores was found (p=0.044) in the winter-born group, with the carriers of the G-allele having higher scores. There was no effect of the G allele on DE scores in this group and on AA or DE scores in the non-winter group.ConclusionsThe results provide new evidence about the effect of SOB and SOB/CRP gene interaction on schizophrenia NS domains.Disclosure of InterestNone Declared

IntroductionIt is necessary to know how the pharmacokinetics of psychotropic drugs changes in the body of patients during their long-termuse.ObjectivesTo study the pharmacokinetic parameters of the anticonvulsant galodif in experimental rats at different times of drug administration.MethodsGalodif (meta-chlorobenzhydryl urea, 100 mg/kg) was administered in rats (in suspension, intragastrically) for: 1, 5 and 15 days. Galodif was determined in the microsomal fraction of rat liver. Pharmacokinetic parameters were calculated by a model-independent method of statistical moments. The statistical significance of differences was assessed using the Kolmogorov-Smirnov λ-test at p<0.05.ResultsA single administration of galodif to rats is accompanied by a slowdown in its elimination from the body: the values of T1/2 (18.82±6.25h), MRT (22.41±7.07h), MET (10.64±2.84h), AUC (15.01±4.86 mcg/ml) increase, indicating the retention of galodif in the body tissues. A 5-fold administration of galodif stimulates the elimination of the drug: T1/2 (2.22±0.52*h), AUC (3.68±0.79*mcg/ml), MRT (2.95±0.73*h), MET (3.00±0.65*h) decrease. The pharmacokinetic parameters of the drug indicate a pronounced tissue availability of galodif molecules. With a 15-fold administration of galodif, the elimination of the drug from the body slows down somewhat, remaining accelerated relative to a single administration: T1/2 (10.79±2.90*h), MRT (3.97±1.03*h), MET (12.05±4.10*h), AUC (19.28±7.13*mcg/ml). The revealed changes in kinetic parameters during long-term administration of galodif to rats stimulate the elimination of the drug by inducing the microsomal liver oxidative system.ConclusionsThe choice of a drug that combines anticonvulsant and detoxifying properties is of great importance in long-term therapy of paroxysmal disorders, epilepsy and alcoholism.Disclosure of InterestNone Declared

IntroductionIt is indisputable that against the background of the popularity of various chemical addictions among patients with schizophrenia, it is relevant to study the joint clinical and pathomorphological deformation of two nosological phenomena of paranoid schizophrenia and dependence on modern, increasingly popular drugs, synthetic cannabinoids in various ethno-territorial groups. It is important to consider issues of mutual deformation of mental disorders, their progression, behavioral characteristics and adaptation.Objectivesto study the ethno-territorial features of paranoid schizophrenia comorbid with abuse of synthetic cannabinoids, clinical dynamics, behavior and adaptations.Methodsfollow-up, clinical-psychopathological methods (PANS, SANS, CGI, MMPI, CGI, STAI, LSI, TPA, ICD-10), statistical (Python 3.11.0).Results193 men (aged 18 to 35 years) were examined: 142 patients with paranoid schizophrenia dependent on synthetic cannabinoids F20.xx+F12.2xx and 51 - F20.xx without drug addiction. The study took place from 2018 to 2024 on the basis of psychiatric institutions in Russia - Tomsk Region, St. Petersburg, Noyabrsk and Nizhnevartovsk. The phenomenon of abuse of synthetic cannabinoids leads to the development of diseases. Persistent exogenous visual and delirious disorders are included in the complex of symptoms of exacerbation of schizophrenia; A new symptom of pseudohallucinoids appears - thought disorders of an associative (fantasy) disease that arose against the background of long-term exogenous (toxic) effects of the drug on the subject type, usually against the background of a primary endogenous schizophrenic process.ConclusionsThe leading position among patients with schizophrenia who use synthetic cannabinoids in the temperate continental climate zone of Russia was occupied by the following ethnic groups, taking into account the hierarchy: Russians, Tatars; Uzbeks; Germans; Azerbaijanis and Armenians.Disclosure of InterestNone Declared

IntroductionFor over 50 years, there has been based on Vladimir Hudolin method a family preventive program for the addicted of psychoactive substances and actions (Zoricic 2006; 42(1) 35). Family therapeutic communities (family sobriety clubs) exist in many countries in Europe and the world, in Russia there are over 50 clubs. In Russian clubs, a change in the lifestyle of rehabilitants is accompanied by a transformation of value systems and semantic formations into traditions of religious worldview.ObjectivesTo study the dynamics of changes in value systems and religious beliefs among family sobriety club members during rehabilitation, which includes a spiritually-oriented component.Methods50 Russian patients with alcohol addiction who participated in rehabilitation in a community setting were examined: 25 (“participants” group) - with remission from several months to two years, 25 (“leaders”) – with remission over two years were also the heads of family sobriety clubs. There were used psychometrical (Schwartz Value Survey – SVS, Religions Orientation Scale - ROS) and statistical methods.ResultsLeading values among “participants” are “kindness”, “safety” and “conformality”, the most significant values among “leaders” are “kindness”, “traditions” and “universalism” (р<0,05). Benchmarking: self-transcedence values prevail among “leaders”, high levels of self-raising among “participants”. Analysis of variance (ANOVA): increasing the significance of values of kindness (p = 0.025) and tradition (p = 0.009) at the level of ideals, tradition (p = 0.0003) and safety (p = 0.04) at the level of priorities at remote stages of rehabilitation. The cohesion of values among “leaders” is higher than among “participants” (conformity (p = 0.03) and kindness (p = 0.09)). Over time a detailing of spiritual ideas takes place, rehabilitants identify themselves as believers and aim to change their lifestyle according to religious Faith values. According to ROS, there is a more meaningful religiosity among “leaders” than among “participants,” the predominance of internal religiosity over external religiosity at long stages of assistance.ConclusionsChange in value orientations correlates with the duration of rehabilitation, their greater cohesion is noted, values are more consistent with the normative for the population as a whole. Religious idias become more harmonious, a transformation of dysfunctional manifestations of external religiosity into adaptive forms of internal religiosity is noted, which is associated with the increase of overall meaningfulness of life.Disclosure of InterestNone Declared