Chronic stress, anxiety, and depression can interfere with young adults’ everyday function, academic achievement, and interpersonal relationships. Interventions aimed at preventing the deterioration or possibly onset of these mental disorders among young people are timely.

To assess the impact of a supportive text messaging program (Text4Hope) on the psychological well-being of young adults.

This study adopted both longitudinal and naturalistic controlled trial designs. Longitudinal study: compared baseline and 6th week outcomes in the same group of young adult subscribers. Naturalistic controlled study: compared clinical parameters in two groups of Text4Hope young adult subscribers: (i) intervention group (IG), subscribers who received once-daily supportive text messages for 6-weeks and completed 6th-week evaluation between 26 April and 12 July 2020, and (ii) control group (CG), subscribers who joined Text4Hope the same time frame, completed a baseline survey and were yet to receive text messages. The prevalence and severity of moderate-high stress, anxiety, and depression was measured using standardized scales. Inferential statistics, including the t-test, McNemar test, chi-square, and binary logistic regression analyses, were used to evaluate the differences in the prevalence and severity of the psychological symptoms.

Longitudinal study: subscribers who completed both the baseline and 6th-week surveys, had significant reduction in the prevalence of moderate-high stress (8%) and likely GAD (20%) from baseline to six weeks. The largest reduction in mean scores was for the GAD-7 scale (18.4%). Naturalistic study: significantly lower prevalence for likely Moderate Depressive Disorder (25.2%) and suicidal thoughts/thoughts of self-harm (48.4%), with a small effect size in the IG compared to CG.

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TheText4Hope program has been demonstrated as an effective e-mental health tool for mental health support for young adult subscribers. This is particularly encouraging, as young adults have already adapted to SMS text messaging and texting. Therefore, this mode of intervention can be used to supplement existing treatments for psychological problems impacting young adults. In addition, the cost effectiveness and easy scalability of supportive text message interventions mean that policymakers and governments can quickly implement similar programs as part of national youth suicide prevention strategies.

None Declared

Blood-based biomarkers represent a scalable and accessible approach for the detection and monitoring of Alzheimer’s disease (AD). Plasma phosphorylated tau (p-tau) and neurofilament light (NfL) are validated biomarkers for the detection of tau and neurodegenerative brain changes in AD, respectively. There is now emphasis to expand beyond these markers to detect and provide insight into the pathophysiological processes of AD. To this end, a reactive astrocytic marker, namely plasma glial fibrillary acidic protein (GFAP), has been of interest. Yet, little is known about the relationship between plasma GFAP and AD. Here, we examined the association between plasma GFAP, diagnostic status, and neuropsychological test performance. Diagnostic accuracy of plasma GFAP was compared with plasma measures of p-tau181 and NfL.

This sample included 567 participants from the Boston University (BU) Alzheimer’s Disease Research Center (ADRC) Longitudinal Clinical Core Registry, including individuals with normal cognition (n=234), mild cognitive impairment (MCI) (n=180), and AD dementia (n=153). The sample included all participants who had a blood draw. Participants completed a comprehensive neuropsychological battery (sample sizes across tests varied due to missingness). Diagnoses were adjudicated during multidisciplinary diagnostic consensus conferences. Plasma samples were analyzed using the Simoa platform. Binary logistic regression analyses tested the association between GFAP levels and diagnostic status (i.e., cognitively impaired due to AD versus unimpaired), controlling for age, sex, race, education, and APOE e4 status. Area under the curve (AUC) statistics from receiver operating characteristics (ROC) using predicted probabilities from binary logistic regression examined the ability of plasma GFAP to discriminate diagnostic groups compared with plasma p-tau181 and NfL. Linear regression models tested the association between plasma GFAP and neuropsychological test performance, accounting for the above covariates.

The mean (SD) age of the sample was 74.34 (7.54), 319 (56.3%) were female, 75 (13.2%) were Black, and 223 (39.3%) were APOE e4 carriers. Higher GFAP concentrations were associated with increased odds for having cognitive impairment (GFAP z-score transformed: OR=2.233, 95% CI [1.609, 3.099], p<0.001; non-z-transformed: OR=1.004, 95% CI [1.002, 1.006], p<0.001). ROC analyses, comprising of GFAP and the above covariates, showed plasma GFAP discriminated the cognitively impaired from unimpaired (AUC=0.75) and was similar, but slightly superior, to plasma p-tau181 (AUC=0.74) and plasma NfL (AUC=0.74). A joint panel of the plasma markers had greatest discrimination accuracy (AUC=0.76). Linear regression analyses showed that higher GFAP levels were associated with worse performance on neuropsychological tests assessing global cognition, attention, executive functioning, episodic memory, and language abilities (ps<0.001) as well as higher CDR Sum of Boxes (p<0.001).

Higher plasma GFAP levels differentiated participants with cognitive impairment from those with normal cognition and were associated with worse performance on all neuropsychological tests assessed. GFAP had similar accuracy in detecting those with cognitive impairment compared with p-tau181 and NfL, however, a panel of all three biomarkers was optimal. These results support the utility of plasma GFAP in AD detection and suggest the pathological processes it represents might play an integral role in the pathogenesis of AD.

Craft story recall test in the National Alzheimer’s Coordinating Center Uniformed Data Set 3 (NACC UDS3) neuropsychological battery has been employed to assess verbal memory and assist clinical diagnosis of mild cognitive impairment (MCI) and dementia. While a Chinese version of the test was adapted, no existing literature has examined the diagnostic validity of the test in Chinese Americans. This study aimed to evaluate the predictive validity of both immediate and delayed recall.

The Chinese version of Craft Story was administered in to 78 Chinese participants per their language preference of Mandarin or Cantonese. Outcome measures were verbatim and paraphrase recall of the story immediately and after a 20-minute delay. A multiple linear regression was performed to investigate the association of each outcome measure with age, education, gender, age when moved to the U.S., years in the U.S., and testing language. To assess its diagnostic value, cutoff standard deviation scores of -1.5 and -2.0 from the mean of the clinically cognitive normal participants were generated for MCI and dementia diagnoses, respectively. Due to the small sample size, a normative group fitting the mean age (73 years), years of education (12 years), and the majority gender (female) of the current sample were used to identify standard cut points. A receiver-operating characteristic analysis was used to compare predicted diagnosis with actual clinical diagnosis obtained through patients’ overall performance and a consensus meeting by licensed clinicians.

Younger age (p < 0.05) and being tested in Mandarin (p < .01) were positively associated with immediate and delayed recall. Strong positive correlations between each measure were observed (all p < .001), indicating a significant relationship between information encoded and retained. Among all the participants, 15 (19.2%) were diagnosed with MCI and 22 (28.2%) with dementia. For MCI diagnosis, the standard cutoff scores demonstrated adequate sensitivity (verbatim=82%, paraphrase=91%) but low specificity (verbatim=44%, paraphrase=67%) in all outcome measures. For dementia diagnosis, delayed recall showed strong sensitivity (100%) and adequate specificity (75%) in both verbatim and paraphrasing scores. Immediate recall paraphrase (sensitivity = 95%, specificity = 50%) showed a better sensitivity but lower specificity than verbatim scoring (sensitivity = 86%, specificity = 58%). The accuracy was higher in delayed recall for both MCI and dementia diagnosis. A preliminary analysis on the optimal cut points indicated higher cutoff scores to distinguish MCI and dementia from clinically cognitive normal population, and from each other (e.g., the optimal cut point for delayed verbatim in distinguishing MCI from normal is 8.0 (sensitivity=89%, specificity=73%, AUC=84.3%)).

Consistent with previous literature, Craft Story delayed recall served as a more accurate diagnostic tool for both MCI and dementia compared to immediate recall in older Chinese Americans. However, poor specificity might increase the chance of following false positive subjects in clinical trials. In addition, testing language appeared to impact performance on verbal memory recall of constructed information. Thus, future studies should focus on developing normative scores that address both the overall cultural differences of Chinese Americans and the heterogeneity within this population.

Blood-based biomarkers offer a more feasible alternative to Alzheimer’s disease (AD) detection, management, and study of disease mechanisms than current in vivo measures. Given their novelty, these plasma biomarkers must be assessed against postmortem neuropathological outcomes for validation. Research has shown utility in plasma markers of the proposed AT(N) framework, however recent studies have stressed the importance of expanding this framework to include other pathways. There is promising data supporting the usefulness of plasma glial fibrillary acidic protein (GFAP) in AD, but GFAP-to-autopsy studies are limited. Here, we tested the association between plasma GFAP and AD-related neuropathological outcomes in participants from the Boston University (BU) Alzheimer’s Disease Research Center (ADRC).

This sample included 45 participants from the BU ADRC who had a plasma sample within 5 years of death and donated their brain for neuropathological examination. Most recent plasma samples were analyzed using the Simoa platform. Neuropathological examinations followed the National Alzheimer’s Coordinating Center procedures and diagnostic criteria. The NIA-Reagan Institute criteria were used for the neuropathological diagnosis of AD. Measures of GFAP were log-transformed. Binary logistic regression analyses tested the association between GFAP and autopsy-confirmed AD status, as well as with semi-quantitative ratings of regional atrophy (none/mild versus moderate/severe) using binary logistic regression. Ordinal logistic regression analyses tested the association between plasma GFAP and Braak stage and CERAD neuritic plaque score. Area under the curve (AUC) statistics from receiver operating characteristics (ROC) using predicted probabilities from binary logistic regression examined the ability of plasma GFAP to discriminate autopsy-confirmed AD status. All analyses controlled for sex, age at death, years between last blood draw and death, and APOE e4 status.

Of the 45 brain donors, 29 (64.4%) had autopsy-confirmed AD. The mean (SD) age of the sample at the time of blood draw was 80.76 (8.58) and there were 2.80 (1.16) years between the last blood draw and death. The sample included 20 (44.4%) females, 41 (91.1%) were White, and 20 (44.4%) were APOE e4 carriers. Higher GFAP concentrations were associated with increased odds for having autopsy-confirmed AD (OR=14.12, 95% CI [2.00, 99.88], p=0.008). ROC analysis showed plasma GFAP accurately discriminated those with and without autopsy-confirmed AD on its own (AUC=0.75) and strengthened as the above covariates were added to the model (AUC=0.81). Increases in GFAP levels corresponded to increases in Braak stage (OR=2.39, 95% CI [0.71-4.07], p=0.005), but not CERAD ratings (OR=1.24, 95% CI [0.004, 2.49], p=0.051). Higher GFAP levels were associated with greater temporal lobe atrophy (OR=10.27, 95% CI [1.53,69.15], p=0.017), but this was not observed with any other regions.

The current results show that antemortem plasma GFAP is associated with non-specific AD neuropathological changes at autopsy. Plasma GFAP could be a useful and practical biomarker for assisting in the detection of AD-related changes, as well as for study of disease mechanisms.

Internalising disorders are highly prevalent emotional dysregulations during preadolescence but clinical decision-making is hampered by high heterogeneity. During this period impulsivity represents a major risk factor for psychopathological trajectories and may act on this heterogeneity given the controversial anxiety–impulsivity relationships. However, how impulsivity contributes to the heterogeneous symptomatology, neurobiology, neurocognition and clinical trajectories in preadolescent internalising disorders remains unclear.

The aim was to determine impulsivity-dependent subtypes in preadolescent internalising disorders that demonstrate distinct anxiety–impulsivity relationships, neurobiological, genetic, cognitive and clinical trajectory signatures.

We applied a data-driven strategy to determine impulsivity-related subtypes in 2430 preadolescents with internalising disorders from the Adolescent Brain Cognitive Development study. Cross-sectional and longitudinal analyses were employed to examine subtype-specific signatures of the anxiety–impulsivity relationship, brain morphology, cognition and clinical trajectory from age 10 to 12 years.

We identified two distinct subtypes of patients who internalise with comparably high anxiety yet distinguishable levels of impulsivity, i.e. enhanced (subtype 1) or decreased (subtype 2) compared with control participants. The two subtypes exhibited opposing anxiety–impulsivity relationships: higher anxiety at baseline was associated with higher lack of perseverance in subtype 1 but lower sensation seeking in subtype 2 at baseline/follow-up. Subtype 1 demonstrated thicker prefrontal and temporal cortices, and genes enriched in immune-related diseases and glutamatergic and GABAergic neurons. Subtype 1 exhibited cognitive deficits and a detrimental trajectory characterised by increasing emotional/behavioural dysregulations and suicide risks during follow-up.

Our results indicate impulsivity-dependent subtypes in preadolescent internalising disorders and unify past controversies about the anxiety–impulsivity interaction. Clinically, individuals with a high-impulsivity subtype exhibit a detrimental trajectory, thus early interventions are warranted.

Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.

To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.

Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.

Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.

AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.

Given the aging population of people with HIV (PWH), along with increasing rates of binge drinking among both PWH and the general older adult population, this study examined the independent and interactive effects of HIV, binge drinking, and age on neurocognition.

Participants were 146 drinkers stratified by HIV and binge drinking status (i.e., ≥4 drinks for women and ≥5 drinks for men within approximately 2 h): HIV+/Binge+ (n = 30), HIV−/Binge+ (n = 23), HIV+/Binge− (n = 55), HIV−/Binge− (n = 38). All participants completed a comprehensive neuropsychological battery measuring demographically-corrected global and domain-specific neurocognitive T scores. ANCOVA models examined independent and interactive effects of HIV and binge drinking on neurocognitive outcomes, adjusting for overall alcohol consumption, lifetime substance use, sex, and age. Subsequent multiple linear regressions examined whether HIV/Binge group moderated the relationship between age and neurocognition.

HIV+/Binge+ participants had worse global neurocognition, processing speed, delayed recall, and working memory than HIV−/Binge− participants (p’s < .05). While there were significant main effects of HIV and binge drinking, their interaction did not predict any of those neurocognitive outcomes (p’s > .05). Significant interactions between age and HIV/Binge group showed that HIV+/Binge+ participants demonstrated steeper negative relationships between age and neurocognitive outcomes of learning, delayed recall, and motor skills compared to HIV−/Binge− participants (p’s < .05).

Results showed adverse additive effects of HIV and binge drinking on neurocognitive functioning, with older adults demonstrating the most vulnerability to these effects. Findings support the need for interventions to reduce binge drinking, especially among older PWH.

To evaluate age-related differences in the independent/combined association of added sugar intake from soda and body adiposity with hyperuricaemia in gender-stratified US adults.

Consumption of added sugar from soda was calculated from 24-h dietary interviews and categorised into none, regular and excessive consumption. Hyperuricaemia was defined as serum uric acid levels >417 mmol/l in men and >357 mmol/l in women. Multiple regression models with interaction terms and logistic models adjusted for covariates were conducted under survey-data modules.

National Health and Nutrition Examination Survey during 2007–2016.

15 338 adults without gout, failing kidneys, an estimated glomerular filtration rate < 30 or diabetes were selected.

The age-stratified prevalence rate of hyperuricaemia was 18·8–20·4 % in males and 6·8–17·3 % in females. Hyperuricaemia prevalence of approximately 50 % was observed in young and middle age males who consumed excessive added sugar from soda. Excessive added sugar intake was observed to be associated with 1·5- to 2·0-fold and 2·0- to 2·3-fold increased risk of the probability of hyperuricaemia in young and middle age males and middle age females, respectively. Study participants, regardless of age or gender, who were obese and consumed excessive added sugar from soda had the highest risk of having hyperuricaemia.

Our study revealed that the association between hyperuricaemia and consumption of excessive added sugar from soda may vary by age and gender. Obese adults who consumed excessive added sugar from soda had the highest risk of hyperuricaemia, a finding that was found across all age-specific groups for both genders.

This study assessed the relationships between different perpetrator-victim roles in intimate partner violence (IPV), emotion regulation (ER) and mental health problems among men who have sex with men (MSM) in China.

From April to June 2019, 1233 participants were approached via gay-friendly non-governmental organisations in 15 cities across mainland China.

Of the total, 578 eligible participants completed an anonymous online survey. All participants provided informed consent and information about their violent perpetrator-victim role and mental health status. The results revealed a high prevalence of IPV in this study sample, with 32.7% of participants reporting IPV victimisation and 32.5% of participants reporting IPV perpetration during their lifetime. A total of 81 (14.0%) participants were suicidal, 309 (53.5%) participants reported poor general mental health and 208 (36.0%) had significant depressive symptoms. Adjusted logistic regression models revealed that both physical victimisation (adjusted odds ratio [ORa] = 3.22, 95% confidence interval [CI] = 1.11–9.32) and sexual victimisation (ORa = 2.90, 95% CI = 1.39–6.05) had positive associations with suicidality, and unidirectional and bidirectional psychological perpetration were associated with poor general mental health and significant depressive symptoms. Although high cognitive reappraisal showed a negative association with poor general mental health (ORa = 0.89，95% CI = 0.86–0.92), the correlation with victims of IPV was weaker than it was with non-victims.

This study revealed that different perpetrator-victim roles in different IPV situations should be considered comprehensively in research, prevention and intervention. ER is not enough to buffer the effects of IPV on the mental health of MSM victims.