INTRODUCTION:Catatonia is a neuropsychiatric syndrome associated with cognitive impairments, yet the neurocognitive performance of catatonia relative to other psychiatric disorders is poorly understood. This study characterised neurocognitive profiles in patients with a history of catatonia compared to schizophrenia spectrum (SSD), bipolar disorder (BD), and major depressive disorder (MDD) across a comprehensive battery of neuropsychological tests. METHODS:Sixty-seven adults who underwent neuropsychological assessment were classified into catatonia (n = 10), SSD (n = 23), BD (n = 19), and MDD (n = 15) groups. Composite z-scores were generated across six domains: language, visuospatial skills, memory, attention, processing speed, and executive functioning. RESULTS:Global neurocognitive functioning was similar, and approximated population norms, in BD and MDD, but significantly lower in catatonia (z = -1.63) and SSD (z = -1.14) groups. Significant differences emerged in overall neurocognitive scores (ηp2 = .47) and memory, attention, processing speed, executive functioning (ηp² = 0.30-0.41), but not language. Post hoc tests showed MDD and BD outperformed SSD and catatonia groups, with no differences within these pairs. Neurobehavioural examinations distinguished catatonia from SSD by increased affective blunting, withdrawal, psychomotor slowing, and slow mentation. CONCLUSIONS:Catatonia is associated with substantial neurocognitive impairment, most similar to SSD, but with distinct neurobehavioural features. Routine screening and targeted neurocognitive assessment may enhance diagnosis and understanding of catatonia.

Approximately 1 in 5 Canadians experience a mental health illness in any given year. While most individuals can be successfully treated within a primary care setting, a subset of individuals present with a severity and complexity requiring specialist care. Unfortunately, a shortage of psychiatrists (especially in rural regions) can result in wait times of months to years. We designed the Alberta Network for Community Health Outreach and Rural Mental Health. ANCHOR-MH is a 12-week program that includes a unique educational intervention, collaborative case conferencing, and a community of practice between family medicine (FM) physicians and psychiatrists. We enrolled two pilot cohorts of n=20 FM physicians each and measured participants’ confidence and comfort in diagnosing, managing, and treating psychiatric conditions. We also conducted qualitative analyses of their experience. Data from participants that completed both the pre- and post-program survey (n=34) showed increased confidence in screening for, diagnosing, and managing psychiatric issues, as well as increased comfort discussing mental health concerns with patients and families and reduced stigma towards certain psychiatric conditions. Qualitative thematic analysis (n=39) reflected this increased confidence, revealed an increased sense of connectedness to the mental healthcare landscape, and highlighted specific examples of practice changes. Participants broadly agreed that the program improved their ability to provide mental healthcare and would improve psychiatric outcomes within their practice. ANCHOR-MH improved FM physicians’ confidence and ability to deliver mental healthcare in their primary care settings. Increasing the reach of this program may improve mental healthcare in underserved communities.

Opioid use disorder (OUD) and overdose deaths are a public health crisis. One contributing factor is stigma towards people who use opioids. We developed and conducted a public-facing, half-day educational event designed to challenge misperceptions about OUD from a contemporary neuroscience perspective. Participants engaged with three different resources on the neurobiology of addiction, and, at the end of the event, they rated its effectiveness. We also collected and compared pre- and post-event composite OUD stigma scales. Participants rated our approach and the overall event as highly effective. Additionally, OUD stigma scores were lower immediately following the event, and this decrease was primarily driven by decreased internalized stigma. Here, we demonstrate an effective proof-of-concept that an accessible, public-facing, neuroscience education event may reduce OUD stigma in the community.

As the histories of psychiatry, neurology, and neuroimaging interweave through time, psychiatry has only recently started to recognize the need to embrace neuroimaging like its sibling specialty. While imaging in psychiatric research is well accepted, there is current clinical utility as well. Standards for psychiatry residency and board certification in the USA and abroad have carved out a place for neuroimaging, but the implementation is variable and sparse in the USA. The few publications that describe neuroimaging teaching to psychiatrists have barriers to widespread adoption, and no comprehensive curricular solution has been developed. In this context, we describe some of the barriers and propose solutions to shape the future of neuroimaging education for psychiatrists.

Department of Psychiatry, University of Illinois at Chicago, Chicago, IL [email protected]. The authors have no conflicts of interest or financial disclosures to report.

In 2016, Juan Pedro Franco made headlines as the world's heaviest man. At his peak, he weighed 595 kg. Pictures circulated on the internet as he was leaving his home for the first time in nearly a decade to seek treatment. But Franco wasn't born morbidly obese. As a child, he was described as playful, musically gifted, and part of a close-knit family. "He ate the same as his brothers," his mother said, but other difficulties set Franco apart from his siblings. He was seriously bullied as a child and stopped attending school at age 11; then, at age 17, a motor vehicle accident left him bedridden for a year.

Harvard Medical School, Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts. E-mail: [email protected]. Department of Psychiatry and Behavioral Sciences, Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee. Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois.