OBJECTIVE:Maternal infections during pregnancy have been implicated in offspring neurodevelopmental disorders, but evidence regarding influenza infection, and antiviral treatments remains limited. This study examined the associations between maternal influenza infection and prenatal oseltamivir exposure with attention-deficit/hyperactivity disorder (ADHD) in offspring. METHOD:We conducted a nationwide population-based birth cohort study in Taiwan including 2,231,264 mother-child dyads born between 2004 and 2015. Maternal influenza infection during pregnancy was identified from medical records and categorized by trimester. ADHD in offspring was ascertained using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Tenth Revision, Clinical Modification (ICD-10-CM) codes. We employed Cox proportional hazards models and sibling-comparison analyses to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs), adjusting for maternal characteristics, comorbidities, and child-specific factors. RESULTS:During the follow-up period, of the mothers, 116,080 (5.2%) were diagnosed with influenza during pregnancy. In addition, 102,717 children in the unexposed group (4.86%) and 6,620 children in the exposed group (5.36%) were diagnosed with ADHD. In the partially adjusted model, any trimester of maternal influenza exposure showed a small but statistically significant association with offspring ADHD (aHR 1.04, 95% CI 1.02-1.06). However, in the sibling-comparison analysis, which accounts for shared familial and genetic factors, this association was no longer significant (aHR 1.02, 95% CI 0.96-1.08). Prenatal exposure to oseltamivir among influenza-infected mothers was not significantly associated with an increased risk of ADHD in offspring in the sibling-comparison model (aHR 0.46, 95% CI 0.08-2.67). CONCLUSION:Our initial analyses suggested a very small though statistically significant association between maternal influenza infection during pregnancy and offspring ADHD , but sibling-comparison analysis revealed no significant risk, pointing to familial confounding. Additionally, prenatal oseltamivir exposure may not increase ADHD risk, supporting the safety of antiviral management during pregnancy.

Introduction: The connection between human parvovirus B19 (B19V) infection and various illnesses has been established; however, its impact on cancer patients remains poorly understood. This study assesses the psychological and immunological impacts of B19V infection in breast cancer patients. Healthy controls (BH) and breast cancer patients before chemotherapy (BB) and after chemotherapy (BA) were recruited. Methods: B19V antibodies and B19V DNA were evaluated for B19V infection. Socio-demographics, psychological status, and cytokine levels were evaluated using SAS 9.4 for all statistical analyses. Results: The BA group displayed higher anxiety and depression scores on both the Hospital Anxiety and Depression Scale (HADS) (p = 0.008) and the Patient Health Questionnaire (PHQ) (p = 0.001). Those positive for B19V-IgG among BA individuals showed higher PHQ sums (p = 0.028) and lower Fact-sums (p = 0.039). In BH, TNF-alpha levels were significantly lower in B19V IgG + subjects (p = 0.018). Overall, breast cancer patients (BB + BA) had higher PHQ scores; however, B19V infection was associated with lower PHQ scores (p = 0.0363 for B19V IgG). Conclusions: The impact of B19V infection on cognitive function and depression prognosis in breast cancer patients suggests potential consequences.

Purpose Glymphatic dysfunction is linked to various neurological conditions, yet its longitudinal role in Major Depressive Disorder (MDD) and suicidal ideation remains unclear. This study used the non-invasive Diffusion Tensor Image Analysis Along the Perivascular Space (DTI-ALPS) index to evaluate the association between glymphatic function and suicidal ideation over time. Methodology In this prospective longitudinal study, we enrolled 85 patients (31 male and 54 females) comprising 26 healthy controls (HC; mean age: 40.04±10.4 years [95% CI: 35.85–44.22]) and 59 patients with MDD. The patient cohort was categorized by clinical trajectory into three groups: non-suicidal (NS, n=28; 44.75±10.1 [40.82–48.68]), suicidal ideation (SI, n=18; 38.56±11.6 [32.81–44.30]), and improved (IM, n=13; 42.15±13.1 [34.21–50.10]), the latter of which transitioned from an SI to a non-suicidal state between timepoints. Clinical assessments, including the Hamilton Depression Rating Scale (HAM-D), Ruminative Responses Scale (RRS), Hospital Anxiety and Depression Scale–Anxiety (HADS-A), and Beck Scale for Suicide Ideation (BSS), were analyzed alongside diffusion MRI. Research is structured for a longitudinal study that includes (1) healthy controls at two time points, (2) depression without suicidal ideation at two time points, (3) depression with suicidal ideation at two time points, and (4) depression with suicidal ideation converting to depression without suicidal ideation. By calculating the DTI-ALPS index, we aim to obtain estimates of glymphatic activity and its association with clinical assessment. All patients, including healthy controls, were also rescanned at TP2. Key Results At TP1, a significant difference in the DTI-ALPS index (b=1500) was observed between the SI and IM groups, suggesting its potential as a predictor of treatment response. Over two years, the IM group was characterized by a stabilization of glymphatic activity. Notably, differential analysis revealed a significant negative correlation between the DTI-ALPS index and HADS-A scores at follow-up. This inverse relationship indicates that maintained glymphatic function is associated with the reduction of anxiety and depressive symptoms. Conclusions The DTI-ALPS index is closely associated with anxiety-related measures in MDD. These findings highlight glymphatic activity as a potential biological marker for monitoring clinical improvement and the impact of treatment on suicidal ideation.

Background Suicide risk fluctuates during the Christmas holidays, suggesting a role for social integration in suicide prevention. In Taiwan, the Lunar New Year is the longest and most culturally significant family holiday. This study examines gender-specific suicide risks during the Lunar New Year and Western New Year holidays. Methods Daily suicide data between 2012 and 2022 were obtained from national cause-of-death data. A Poisson regression model compared the suicide risk seven days before and after the Lunar and Western New Year’s Day with that of the remainder of the year, stratified by gender and marital status. A moderation analysis by gender was conducted. Results Suicide risks in married and divorced men decreased before Lunar New Year’s Day, but the risk was elevated in divorced men a few days after both the Lunar and Western New Year’s Days. Compared to men, divorced women had a higher suicide risk on Lunar New Year’s Day. Divorced women had a lower suicide risk after the Lunar New Year holiday, whereas married women had a higher suicide risk. Conclusion The differential suicide risk by marital status and gender offers important implications for suicide prevention, particularly concerning temporal landmarks, social integration, and caregiving burdens during holidays.

Psychostimulants have been recommended as first-line therapy for attention-deficit/hyperactivity disorder (ADHD), and safety concerns related to cardiovascular events in psychostimulant users have attracted increasing attention. However, evidence remains limited regarding the cardiovascular risks associated with methylphenidate use in children and adolescents who have heart disease or a family history of cardiovascular conditions. We conducted a self-controlled case series (SCCS) study using Taiwan’s nationwide insurance database (2004–2021), which links data from births registered in the National Health Insurance system. A total of 2,493 individuals with ADHD, at least one methylphenidate prescription, and incident cardiovascular disease (CVD) were enrolled. A stratified Cox regression model adjusted for time-varying confounders was used to estimate the relative risks (RRs) of arrhythmias, ischaemic heart disease, and cerebrovascular disease during methylphenidate exposure compared with those during unexposed periods. Effect modification by congenital heart disease and family history of CVD was also assessed. We found a significantly increased risk of arrhythmias during both the exposed period (RR: 1.41, 95

Background: Chemotherapy-related cognitive impairment (CRCI), commonly known as "chemobrain," frequently occurs during breast cancer treatment and has been linked to altered brain function. This resting-state functional magnetic resonance imaging study examined chemotherapy-related changes in functional brain activity, network connectivity, and associations with cognitive outcomes. Methods: Twenty-eight patients with breast cancer were assessed prechemotherapy (BB) and postchemotherapy (BBF), alongside 27 healthy controls of comparable age at baseline (BH) and follow-up (BHF). Mean fractional amplitude of low-frequency fluctuations (mfALFF) and mean regional homogeneity (mReHo) quantified functional brain activity. Graph theoretical analysis (GTA) assessed network topology; network-based statistics (NBS) evaluated interregional connectivity. Cognitive performance was evaluated through standardized assessments. Results: Postchemotherapy patients exhibited reduced anxiety and lower FACT-Cog scores. Voxel-wise analyses showed increased mfALFF in frontal regions and mReHo in superior temporal and inferior frontal gyri, alongside decreases in postcentral, lingual, and parahippocampal areas. Healthy controls showed increased activity in medial frontal and cingulate regions, with reductions in the temporal lobe and putamen. GTA revealed higher global efficiency and reduced modularity, path length, and network complexity in the BBF group compared with BHF. NBS showed weaker structural connectivity in motor and occipital regions prechemotherapy and decreased parietal and insular connectivity postchemotherapy. Multiple regression showed brain-behavior correlations: declines in FACT-Cog, Digit Symbol Substitution, and mood scores were linked to altered activity in frontal, parietal, cingulate, and occipital areas, while positive correlations suggested compensatory activation. Conclusions: Chemotherapy was associated with longitudinal alterations in brain activity, network organization, and connectivity in breast cancer survivors. Brain-behavior associations suggest disrupted neural networks may underlie CRCI.

Abstract Background A few studies reported the associations between ADHD and precocious puberty. Based on animal studies, Methylphenidate (MPH) can alter the timing of puberty and the change varies by sex. Aims & Objectives We conducted a cohort study to investigate the association between ADHD, MPH, and precocious puberty, with considering of the potential moderating effects by different neuropsychiatric disorders and sex. Method To compare the risk of precocious puberty between ADHD and non-ADHD cases, we conducted Cox regression analysis with ADHD as exposure and time-to-precocious puberty as outcomes adjusting for sex, ASD, tics, obsessive– compulsive disorder, anxiety disorder, intellectual disability, and epilepsy. We performed moderation analyses to examine the potential moderating effects by sex and comorbidities. To compare the risk of precocious puberty between MPH uesrs and non-MPH users in patients with ADHD, we conducted Cox regression analysis with MPH as exposure and time-to-precocious puberty as outcomes adjusting for sex and the six neuropsychaitric comorbidities. We also performed a moderation analysis to examine the potential moderating effects by sex. Results Patients with ADHD had a significantly greater risk of precocious puberty than patients without ADHD, with an aHR of 2.01 (95% CI 1.91, 2.11). In the sex-stratified analysis, precocious puberty was still significantly more prevalent in ADHD group than in non-ADHD group in either stratum of males or females, with aHRs of 2.05 and 1.99, respectively. Regarding the effect modification, sex, specifically female, moderated the association between ADHD and precocious puberty, with a relative excess risk due to interaction (RERI) 8.56 (95% CI 7.48,9.64). Tics also served as an effect modifier on either additive (RERI -1.24, 95% CI -1.78, -0.70) or multiplicative scale (aHR -0.70, 95% CI -1.02, -0.38). Similar findings were found when intellectual disability was set as an effect modifier, with RERI -0.70 (95% CI -1.02, - 0.38) and value of ratio on multiplicative scale being 0.62 (95% CI 0.50, 0.77). This means that ADHD has a greater impact on the risk of precocious puberty in patients without tics or without intellectual disability than in patients with tics or with intellectual disability. No significant effect modification was found for the other comorbidities within the scope of additive effect modification. While comparing the effect of MPH on risk of precocious puberty in patients with ADHD, MPH users had significantly lower rate of precocious puberty than non-MPH users, with aHR 0.63 and 95% CI 0.57-0.70. If considering the moderation analysis of sex, being female was served as an effect modifier on both additive (RERI -4.38, 95% CI -5.51, -3.25) and multiplicative scales (aHR 0.54, 95% CI 0.43, 0.67). It means that the preventive effect of MPH on precocious puberty in patients with ADHD was greater in females than in males. Discussion & Conclusion Patients with ADHD are at greater risk for precocious puberty, regardless of sex. Girls with ADHD are at particularly high risk of developing precocious puberty. Comorbid tics or intellectual disability appear to have an antagonistic effect on the association between ADHD and precocious puberty. Treatment with MPH lower the risk of precocious puberty in ADHD, especially in girls with ADHD.

BACKGROUND AND AIMS:In recent years, the study of brain structural changes in individuals experiencing suicidal ideation and depression has attracted increasing interest. This study investigated changes in gray and white matter volumes among different groups. We recruited 86 patients, including 26 healthy controls (HCs), 29 with depression (NS), 18 with suicidal ideation (SI), and 13 improved (IM), to further understand the impact of treatment on suicidal ideation. MATERIALS AND METHODS:We used MRI to analyze four groups of participants at two time points over one-year intervals. Additionally, evaluations were conducted using clinical assessment scales (HAM-D, HADS-A, BSS, RRS). RESULTS:Repeated measures Analysis of Covariance (ANCOVA) and paired t tests revealed significant changes in brain volume across different groups at two time points. Notable differences were observed in regions such as the cingulate gyrus, corpus callosum, insula, amygdala, and hippocampus, indicating dynamic structural changes related to suicidal ideation and its treatment. CONCLUSIONS:Our findings highlight the potential value of brain structural changes in evaluating depression and suicidal ideation, supporting the effectiveness of early interventions in improving mental health. The observed alterations in gray and white matter emphasized the importance of targeted treatments for better patient outcomes.

BACKGROUND:The suicide risk on Chinese Valentine's Day and its potential risk factors have not been examined. This study assessed whether the suicide rates around Chinese and Western Valentine's Days differed from the rest of the year in Taiwan, and the roles of various genders and marital statuses. METHODS:This study analyzed daily suicide data from Taiwan's Cause of Death Statistics between January 2012 and December 2022. We compared the suicide rate of each day in the week before and after Chinese and Western Valentine's Days with those of the remainder of the year using Quasi-Poisson regression models stratified by gender and marital status. We then performed a moderation analysis to explore whether the effect of Valentine's Day on suicide differed by gender. RESULTS:Married women reported a higher suicide risk on the third day after Chinese Valentine's Day than married men did. Although a similar trend was observed in Western Valentine's Day between married women and men, it did not reach statistical significance. CONCLUSION:Suicide rates for certain days in the week before or after Chinese and Western Valentine's Days were different from other days of the year, and these differences were gender- and marital status-specific.

Background We aimed to investigate whether changes in levels of chosen cytokines were associated with contemporaneous changes in cognitive function from before to after chemotherapy, adjusting for baseline characteristics such as body mass index, age, or education years, and changes in anxiety, depression, or fatigue into consideration. Methods Adult patients with breast cancer stages I to III without brain metastasis were invited to participate in this longitudinal follow up study. A multidimensional neuropsychological examination was administered at two timepoints evaluating multiple subjective and objective cognitive domains, depression, anxiety, or fatigue before and at least 3 months after chemotherapy, and baseline demographic information. Cytokine levels were taken at the same times. Stepwise multivariate Generalized Linear Mixed Model was used to examine changes in cytokines and associations with changes in cognitive function. Results Over a mean interval of 10.5 months Event-based prospective memory (p < 0.001), Word list immediate (p < 0.001) or delayed recall (p = 0.024), and self- perceived cognitive impairment (p = 0.026) significantly improved following chemotherapy. Unit changes in log values of IL-2 (Estimates (SE) = 1.22(0.59), p = 0.04) and IL-12p70 (1.05(0.19), p = 0.03) were positively associated with improvements in Event-based prospective memory over that period. Discussion Improvements in Event-based prospective memory were positively associated with changes in IL-2 and IL-12p70. Our finding may not only reduce BC patients’ concerns about chemotherapy-related cognitive adverse effects, but also exhibit the possible roles or interactions of systemic cytokines and inflammation and cognitions.

BACKGROUND:Scarce research has investigated associations between suicidal ideation and the gut microbiota. We aimed to explore variations in the gut microbiome associated with suicidal ideation and major depressive disorder (MDD). METHOD:A case-control study compared abundances of fecal microbiota and biomarkers of gut permeability among patients with MDD, with or without suicidal ideation, and healthy volunteers without depression. Information on demographic variables and assessments of suicidal ideation (Beck Suicidal Ideation Scale), depression (Hamilton Depression Scale, Patient Health Questionnaire, Hospital Anxiety and Depression Scale- Depression), as well as anxiety (Hospital Anxiety and Depression Scale- Anxiety), were obtained. Univariate and multivariate regression model was performed to explore the possible predictors of suicidal ideation. RESULTS:Among the 140 participants, significant differences in Beta diversity were found between MDD patients with (n = 43) or without suicidal ideation (n = 34), and healthy volunteers (n = 42) (all p < 0.001). The strain of g-Phascolarctobacterium was found to have significant positive associations with scores of BSSI and BSSI Part 1 (suicidal ideation), particularly in MDD patients with suicidal ideation, after controlling for demographic and mood covariates. Mediation analyses revealed that g-Phascolarctobacterium may be a partial mediator between depression and suicidal ideation; however, it is also possible that the association between g-Phascolarctobacterium and suicidal ideation was partially mediated by the level of depression. CONCLUSION:We found different compositions, diversities, and possible mediating of the gut microbiome associated with suicidal ideations. Potential mechanisms need further investigation to establish whether this reflects a biological process that might be the focus for intervention development. SYNOPSIS:Our objective was to investigate whether the diversities and abundances of the gut microbiome varied in people with or without suicidal ideation and with or without MDD after considering possible demographic and mood confounders.

Objective:A high tendency to boredom and delay aversion are commonly observed traits among children and adolescents diagnosed with ADHD. However, the interplay between boredom, delay aversion, and ADHD symptoms remains unclear. It is unknown, for example, whether a predisposition to boredom predicts difficulties in sustaining attention because of susceptibility to delay aversion. This study investigated the potential mediating role of delay aversion in the relationship between boredom and inattentive behaviors in children with and without ADHD. Methods:Parent- and self-ratings of boredom proneness, delay aversion, and inattention symptom severity of 93 children with ADHD and 90 typically developing controls (aged 9-16 years) were included in analysis. Results:Both parent- and self-ratings showed that children with ADHD had significantly elevated levels of trait boredom, delay aversion, and inattention compared to controls. Trait boredom, delay aversion, and inattention were inter-correlated. The parent-ratings showed that children with a higher level of trait boredom tended to be more inattentive, and this effect was partially explained by the mediating role of delay aversion. Conclusions:Our findings suggest that the relation between boredom and inattention may be at least partially explained by the mediating role of delay aversion in children within and without ADHD.

Suicidal ideation (SI) is an important predictor of suicide attempts, yet SI is difficult to predict. It is also important to understand the associations between network function and SI (or the absence of suicidal ideation, NS) in patients with depression. We recruited 83 participants and divided them into four groups: 25 healthy controls (HCs), 27 depressed patients without suicidal ideation (NS), 18 depressed patients with suicidal ideation (SI), and 13 depressed patients whose SI was converted to NS (improved). All subjects underwent resting-state fMRI at baseline (TP1) and one year later (TP2) after receiving therapy. Patients also underwent four clinical assessments that yielded scale scores. We used the mean amplitude of low-frequency fluctuations (mfALFF) and mean regional homogeneity (mReHo) to compare the function of each brain region at TP1 and TP2. Graph theoretical analysis and network-based statistic analysis were performed to assess changes in connectivity from TP1 to TP2. Multiple regression analysis was also used to examine the association between brain function alterations and clinical assessment changes in each group. Post-treatment, significant functional activity differences were observed: in the cuneus and cingulate for NS; inferior parietal lobule and frontal regions for SI; and parahippocampus and thalamus for the improved group. Increased functional interconnections were noted among frontal, occipital, and temporal lobes. Several connectivity changes correlated with clinical assessment variations (HAM-D, HADS-A, BSS, RRS) across groups, including the caudate, precuneus, and cingulate. We deliberated on the impact of treatment on distinct cerebral regions within the NS and SI cohorts across various conditions. Within the improved group, discernible alterations in brain function following treatment amelioration were identified among the same cohort of individuals, encapsulating modifications in both pathological conditions and cerebral functionality. These findings contribute to our understanding of the neural correlates of depressive disorder and suicidal ideation and highlight the potential impact of therapeutic interventions on brain function in these populations.

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are both common neurodevelopmental disorders (NDDs), but their association between maternal thyroid dysfunction and NDDs in offspring remains equivocal. This study aimed to evaluate the association between maternal thyroid dysfunction, related medications, and neurodevelopmental disorders in offspring. This population-based retrospective birth cohort study included children born between 2004 and 2020, with surveillance continuing through 2021. Maternal thyroid dysfunction during pregnancy was identified by any outpatient or inpatient diagnosis of hyperthyroidism or hypothyroidism. Medications for hyperthyroidism during pregnancy, including propylthiouracil (PTU) and methimazole (MMI), as well as levothyroxine for hypothyroidism, were also examined. Associations between maternal thyroid dysfunction with medication use and child NDDs were modeled using Cox proportional hazards regression. The study cohort consisted of 3,175,328 live-born children. Among them, 39,294 (1.2%) were born to mothers with hyperthyroidism, and 14,630 (0.5%) had mothers with hypothyroidism. A higher risk of ADHD was noted in children whose mothers had thyroid dysfunction, whether they had hyperthyroidism (adjusted HR, 1.19; 95% CI,1.14-1.24) or hypothyroidism (adjusted HR,1.28; 95% CI,1.19-1.37), and a similarly increased risk of ASD was observed in association with maternal hyperthyroidism (adjusted HR, 1.14; 95% CI, 1.03-1.27) or hypothyroidism (adjusted HR, 1.34; 95% CI, 1.19-1.51). For medications in treating hyperthyroidism during pregnancy, continuous propylthiouracil (PTU) use was associated with a lower risk of ADHD (adjusted HR, 0.91; 95% CI, 0.83-0.99) or ASD (adjusted HR, 0.80; 95% CI, 0.67-0.96). This study identified the association between maternal thyroid dysfunction during pregnancy and offspring ADHD. Moreover, we observed that continuous use of PTU for treating maternal hyperthyroidism during pregnancy may be associated with a reduced risk of childhood ADHD.

ObjectiveBreast cancer was the most prevalent type of cancer and had the highest incidence rate among women worldwide. The wide use of adjuvant chemotherapy might have a detrimental effect on the human brain and result in chemotherapy-related cognitive impairment (CICI) among breast cancer patients. Furthermore, prior to chemotherapy, patients reported cancer-related cognitive impairment (CRCI), which might be due to physiological factors or mood symptoms. The present longitudinal study aimed to investigate microstructural and macroscale white matter alterations by generalized q-sampling imaging (GQI).MethodsThe participants were categorized into a pre-chemotherapy group (BB) if they were diagnosed with primary breast cancer and an age-matched noncancer control group (HC). Some participants returned for follow-up assessment. In the present follow up study, 28 matched pairs of BB/BBF (follow up after chemotherapy) individuals and 28 matched pairs of HC/HCF (follow up) individuals were included. We then used GQI and graph theoretical analysis (GTA) to detect microstructural alterations in the whole brain. In addition, we evaluated the relationship between longitudinal changes in GQI indices and neuropsychological tests as well as psychiatric comorbidity.FindingsThe results showed that disruption of white matter integrity occurred in the default mode network (DMN) of patients after chemotherapy, such as in the corpus callosum (CC) and middle frontal gyrus (MFG). Furthermore, weaker connections between brain regions and lower segregation ability were observed in the post-chemotherapy group. Significant correlations were observed between neuropsychological tests and white matter tracts of the CC, MFG, posterior limb of the internal capsule (PLIC) and superior longitudinal fasciculus (SLF).ConclusionThe results provided evidence of white matter alterations in breast cancer patients, and they may serve as potential imaging markers of cognitive changes. In the future, the study may be beneficial to create and evaluate strategies designed to maintain or improve cognitive function in breast cancer patients undergoing chemotherapy.

Hypertension has been associated with risk of cognitive impairments. The American Heart Association recommended the use of the harmonized neuropsychological protocol suggested by the National Institute of Neurologic Disorders and Stroke and the Canadian Stroke Network (NINDS-CSN) for studying related cognitive impairments. Initially designed for vascular cognitive impairment, empirical data of results from NINDS-CSN protocol has not been well-established in hypertension. The present study recruited 58 adults diagnosed with hypertension and 44 normotensive controls. Tests from the NINDS-CSN protocol were given in three lengths, including neuropsychological tests and neuropsychiatric inventories. The results showed higher proportions of hypertensive adults with impairments on tests of memory and executive functions and that they performed worse as a group on several tests from the 30-minute protocol, but not on the other additional tests in the full-length version, nor on cognitive screening test in the 5-minute protocol such as the Mini-Mental State Examination or the Montreal Cognitive Assessment. There was no significant group difference on neuropsychiatric symptoms. These findings suggested that the 30-minute version of the NINDS-CSN protocol with the two supplemental tests was able to reveal selective cognitive deficits in hypertensive adults and provide a practical solution for related studies, balancing between the requirement of sensitivity, domain variety, and brevity.

Limited knowledge is available about the association between autistic spectrum disorder (ASD) and precocious puberty. Our study examined the association between the two medical conditions and effect modification by sex and neuropsychiatric comorbidities in a nationwide population. To compare the risk of precocious puberty between ASD and non-ASD cases, we conducted a Cox regression analysis using ASD as the exposure and time to precocious puberty as the outcome. We adjusted for sex, attention-deficit/hyperactivity disorder (ADHD), tic disorder, obsessive–compulsive disorder (OCD), anxiety disorder, intellectual disability, and epilepsy. We performed a moderation analysis to examine the potential moderating effects of sex and comorbidities. Patients with ASD were prone to have precocious puberty, with an adjusted hazard ratio (aHR) of 1.80 (95% CI: 1.61–2.01). For effect modification, sex, specifically females, moderated the association between ASD and precocious puberty, with a relative excess risk due to interaction (RERI) of 7.35 (95% CI 4.90–9.80). No significant effect modification was found for any of the comorbidities within the scope of additive effect modification. We found that patients with ASD were prone to precocious puberty, regardless of sex or comorbid neuropsychiatric disorders. Girls with ASD are at a particularly higher risk of developing precocious puberty.

Exposure to illicit substances during pregnancy may have long-term impacts on children’s neurodevelopment. This study explores subsequent risks for intellectual disability, autistic disorders, and attention deficit and hyperactivity disorders in children born to mothers exposed to illicit substances before or during pregnancy. We identified women with illicit drug use by linking the police records from the “Substance Abuse Control Databases” and Taiwan Birth Registration and Birth Notification records from 2004 to 2014. Children whose mothers that had exposed to illicit substances during pregnancy identified from the police records were the “substance-exposed cohort.” A 1:1 ratio exact-matched comparison cohort based on child’s gender, child’s birth year, mother’s birth year, and child’s first use of the health insurance card, as well as a “propensity score (PS)-matched” comparison cohort of children born by substance-unexposed mothers, was established. Multivariate Cox regression analyses with competing risk models were performed. Higher incidences of intellectual disability (adjusted hazard ratio (aHR) = 2.41, 95

Objective: Major depressive disorder (MDD) is an important psychiatric illness worldwide. We developed the Chen Depression Scale (CDS) based on the criteria of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition. In this study, we intended to evaluate the psychometric properties of the CDS. Methods: The sample consisted of 135 adult participants aged between 20 and 64 years, including 85 individuals with MDD recruited at a teaching hospital, and 50 community-based non-MDD controls. Depressive symptoms were assessed using CDS and the Chinese version of the Patient Health Questionnaire 9 (C-PHQ-9). We investigated the psychometric properties of CDS, including test–retest reliability, internal consistency reliability, sensitivity and specificity, convergent validity, discriminant validity, and construct validity. Results: The result showed that the CDS had excellent internal reliability (Cronbach’s α = 0.957) and test–retest reliability (intraclass correlation coefficient = 0.843). Construct validity was examined with confirmatory factor analyses to verify the factor structure of the CDS and convergent validity with C-PHQ-9 with a statistically high correlation with Pearson’s r with p < 0.001. When evaluating the impairment criterion for identifying individuals with MDD, those who reported impairment in MDD symptoms and scored a CDS of 17 or above exhibited a sensitivity of 0.86 and a specificity of 0.96 for CDS. Conclusion: The CDS has good psychometric properties, including excellent reliability and sensitivity and diagnostic properties at cutoff point 17. It serves effectively as a screening tool for both clinical diagnosis and academic study of depression.

The lymphocyte-related ratios, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) are new measures of inflammation within the body. Few studies have investigated the inflammatory response of patients with methamphetamine-induced psychotic disorder. Clinically, the psychotic symptoms and behavioural manifestation of methamphetamine-induced psychotic disorder are often indistinguishable from paranoid schizophrenia. We aimed to determine the differences in these inflammatory markers between patients with methamphetamine-induced psychotic disorder, patients with schizophrenia and healthy individuals. A total of 905 individuals were recruited. The NLR and MLR were found to be higher in both patients with methamphetamine-induced psychotic disorders and patients with schizophrenia compared with healthy controls. There was no significant difference between the three groups in PLR. When compared with the control group, the methamphetamine-induced psychotic disorder group was significantly higher in NLR 27% (95%CI = 11 to 46%, p = 0.001), MLR 16% (95%CI = 3% to 31%, p = 0.013) and PLR 16% (95%CI = 5% to 28%, p = 0.005). NLR of the group with methamphetamine-induced psychotic disorder was 17% (95%CI = 73% to 94%, p = 0.004) less than the group with schizophrenia, while MLR and PLR did not differ significantly between the two groups. This is the first study that investigated the lymphocyte-related ratios in methamphetamine-induced psychotic disorder when compared with patients with schizophrenia and healthy individuals. The results showed that both patients with methamphetamine-induced psychotic disorder and patients with schizophrenia had stronger inflammatory responses than the healthy control. Our finding also indicated that the inflammatory response of methamphetamine-induced psychotic disorder was between those of patients with schizophrenia and healthy individuals.