Adolescents with major depressive disorder (MDD) often show reduced prefrontal functional connectivity with the subcortical regions than healthy controls (HC) (Tang et al., 2018). However, relatively little is known about longitudinal effects of antidepressant (AD) treatment on resting state functional connectivity (RSFC) in the prefrontal cortex (PFC).

This study aimed to investigate abnormal PFC RSFC in MDD adolescents compared to HC and longitudinal effects of AD on PFC RSFC.

This study included 59 adolescents with MDD and 43 HC. MDD adolescents were treated with escitalopram in an 8 week, open-label trial. The treatment outcome was assessed by Children’s Depression Rating Scale (CDRS-R) and patients showing at least a 40% improvement in CDRS-R scores from baseline to week 8 were defined as “responders”. Functional and T1 images collected before and after treatment were processed using AFNI and Freesurfer. Our seed was the lateral PFC (LPFC, BA46). T-tests and repeated measures ANCOVAs, controlling for age and IQ, were conducted to examine abnormal PFC RSFC and longitudinal effects of AD on LPFC RSFC.

Relative to HC, MDD showed increased LPFC RSFC with the posterior middle temporal gyrus (pMTG) and superior frontal cortex (SFG) involved in attentional networks. Responders showed greater changes in LPFC RSFC with the MTG and SFG after AD treatment compared to non-responders and HC (Figure 1).

Our finding suggests that reduced LPFC RSFC with the pMTG and SFG reflecting decreased attentional network connectivity may serve as a biomarker to predict AD treatment outcome in adolescents with MDD.

No significant relationships.

Schizophrenia is highly familial neuropsychiatric disorder with heritability estimated at 60-90%. Even unaffected first-degree relatives of schizophrenia manifested some neuropsychological abnormalities as well as neurologic soft sign and morphologic anomalies. the aim of this study was to evaluate personality profile in first-degree relatives of schizophrenia compared to their schizophrenia probands and healthy controls and whether personality profile might be endophenotype of schizophrenia.

The subjects were 97 first-degree relatives of schizophrenia, 48 their schizophrenia probands, and 106 healthy controls, who completed Temperament and Character Inventory (TCI) scale. Relatives were further divided into presumed carriers and pesumed non-carriers by schizophrenia genetic loading. Group difference in TCI scores were compared by general linear model using age and gender as covariates.

1. 1. There were significant group differences in HA scores between healthy controls, relatives, and probands after controlling age and gender, in that HA scores were increased by healthy controls, relatives, and probands in order.

2. 2. Presumed carriers have higher HA scores than presumed non-carriers and healthy controls.

3. 3. Proband group showed significantly lower RD and lower P in temperament dimension and lower SD, lower C, and higher ST in character dimension compared to other groups.

We found that HA scores of first-degree relatives of schizophrenia is intermediate level between schizophrenia probands and healthy controls. Considering increase of HA with schizophrenia genetic loading, HA may be potential endophenotype of schizophrenia. Further research with longitudinal follow up is needed to elucidate the clinical implication of high HA observed in schizophrenia family.

The purposes of this study were to estimate the prevalence rates of subtypes of late life depression (LLD) including (vascular depression and non-vascular depression) in the baseline study, to examine the natural course of LLD and to investigate influence of white matter hyperintensities (WMH) volume on depression and neurocognitive function in the 3-year follow-up study.

WMH was rated by the modified Fazekas scale and the volume of WMH was also calculated by an automated quantification method. Patients were classified as having vascular depression if they suffered from any type of depressive disorders and had a score of 2 or more on either deep white matter hyperintensity or subcortical gray matter ratings. in the 3- year follow-up study, the participants of the in the baseline were follow-uped with the same methodology of the baseline study.

The prevalence rates of vascular major depressive disorder (MDD) and vascular non-major depressive disorder (nMDD) were 2.39% (53.6% of MDD) and 4.24% (34.0% of nMDD), respectively, in the baseline study. Among non-depressive group in the baseline study, subjects with WMH(+) had 13.5 times (OR=13.5, 95% CI=1.10-165.97) risk of developing depressive disorder in the 3-year follow-up study, as compared to those without WMH(+). Log WMH volume (OR=5.78, 95 CI=1.04-31.72) in the baseline study was an independent predictor for depressive disorder in the 3-year follow-up study

WMH is a crucial predictor for future depressive disorder, which supports the previous vascular depression hypothesis. Vascular depression is a useful construct accounting for clinical characteristics of LLD.

Although prenatal maternal smoking is an established risk factor for offspring's attention deficit hyperactivity disorder (ADHD), the studies of association between paternal smoking and childhood ADHD have produced inconsistent results.

The objective of the present study was to determine whether paternal smoking during early developmental period is associated with an increased risk of offspring's ADHD.

We conducted hospital-based case-control study with 107 medically diagnosed ADHD cases and 205 controls (aged 6–12 years). The diagnoses of ADHD were assessed with DSM-IV based semi-structured diagnostic interviews. Paternal smoking behavior was assessed with spouse-report questionnaire. The association between exposure to paternal smoking and ADHD were analyzed using multivariate logistic regression analysis. The primary outcome of interest was an odds ratio (ORs) reflecting the risk of offspring's ADHD incidence associated with father's smoking during the index pregnancy, up to one year after birth, and current smoking status. Control variables in our regression model were age, sex, financial status, parents’ education levels, low birth weight, and premature birth.

Our final regression model revealed that paternal smoking during pregnancy (OR = 1.68, 95% CI = 1.03–2.76) and up to one year after birth (OR = 1.69, 95% CI = 1.04–2.77) were significantly related to their offspring's ADHD.

The current results suggest that exposure to paternal smoking during the fetal and newborn period is associated with increased risk of ADHD. This study warrants public health policies to reduce children's exposure to secondhand smoke and their risk of ADHD.

The authors have not supplied their declaration of competing interest.

This study was conducted to examine sexual dimorphic effects of highly palatable food access during adolescence and youth on psychoemotional behaviors of rats and its underlying neural mechanism.

Male and female Sprague Dawley pups had free access to chocolate cookie rich in fat (highly palatable food) from postnatal day 28 in addition to ad libitum chow, and the control groups received chow only. The food conditions were continued though out the entire experimental period, and the neurochemical and behavioral measurements were performed during young adulthood. Corticosterone levels during 2 h of restraint stress were analyzed with radioimmunoassay, and ΔFosB and brain-derived neurotrophic factor (BDNF) expression in the nucleus accumbens (NAc) with western blot analysis.

Cookie access did not affect body weight gain and total caloric intake in both sexes; however, it increased retroperitoneal fat depot only in males. The time spent in open arms during elevated plus maze test was decreased and immobility during forced swim test was increased in cookie-fed males, but not in cookie-fed females. Main effect of food condition on the stress-induced corticosterone increase was observed in males, but not in females, and cookie access increased BDNF expression in the NAc only in males.

Increased BDNF expression in the NAc and fat depot, in addition to the HPA axis dysfunction, may play roles in the pathophysiology of depression- and/or anxiety-like behaviors induced by cookie access.

The authors have not supplied their declaration of competing interest.

The international guideline for treating depression has been widely used.

The current study focused on the maintenance treatment section of the third revision of Korean Medication Algorithm for Depressive Disorder (KMAP-DD)

A 44-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for depressive disorder. Of the 144 committee members, 79 psychiatrists responded to the survey. Each treatment strategy or treatment option was evaluated with the nine-point scale.

Most clinicians answered to maintain both antidepressants (AD) and atypical antipsychotics (AAP) for psychotic depression in remission state. The duration of AD maintenance: from 19.8 weeks to 46.8 weeks for patients in remission of the first episode, from 34.8 weeks to 78.4 weeks for the second depressive episode, and long-term continuation for three or more depressive episodes. Aripiprazole was the most preferred AAP. The preferred doses of AD and AAP in maintenance treatment were about 75% and 50% of those in acute treatment The maintenance of AAP in the psychotic depression in remission was similar to the AD, although shorter and less.

The maintenance strategies of KMAP-DD 2017 were similar to those of KMAP-DD 2012. Most clinicians preferred to maintain AD for substantial duration after achieving remission. The maintenance of AAP was also preferred, but the duration was shorter than AD.

The authors have not supplied their declaration of competing interest.

The primary aim of this non-inferiority study was to investigate the clinical effectiveness and safety of generic escitalopram (Lexacure) versus branded escitalopram (Lexapro) for patients with major depressive disorder (MDD).

The present study included 158 patients who were randomized (1:1) to receive a flexible dose of generic escitalopram (n = 78) or branded escitalopram (n = 80) over a 6-week single-blind treatment period. The clinical benefits in the two groups were evaluated using the Montgomery–Åsberg Depression Rating Scale (MADRS), the 17-item Hamilton Depression Rating Scale (HDRS), the Clinical Global Impressions-Severity Scale (CGI-S), and the Clinical Global Impressions-Improvement Scale (CGI-I) at baseline, week 1, week 2, week 4, and week 6. The frequency of adverse events (AEs) was also assessed to determine safety at each follow-up visit.

At week 6, 28 patients (57.1%) in the generic escitalopram group and 35 patients (67.3%) in the branded escitalopram group had responded to treatment (P = 0.126), and the remission rates (MADRS score: ≤ 10) were 42.9% (n = 21) in generic escitalopram group and 53.8% (n = 28) in the branded escitalopram group (P = 0.135). The most frequently reported AEs were nausea (17.9%) in the generic escitalopram group and nausea (20.0%) in the branded escitalopram group.

The present non-inferiority study demonstrated that generic escitalopram is a safe and effective initial treatment for patients with MDD and may also be considered as an additional therapeutic option for this population.

The authors have not supplied their declaration of competing interest.

Evidences for antipsychotics augmentation for schizophrenic patients with suboptimal efficacy have been lacking although it has been widespread therapeutic strategy in clinical practice.

The purpose of this study was to investigate the efficacy and tolerability of blonanserin augmentation with an atypical antipsychotics (AAPs) in schizophrenic patients.

A total of 100 patients with schizophrenia partially or completely unresponsive to treatment with an AAP recruited in this 12-week, open-label, non-comparative, multicenter study. Blonanserin was added to existing AAPs which were maintained during the study period. Efficacy was primarily evaluated using Positive and Negative Syndrome Scale (PANSS) at baseline, week 2, 4, 8, and 12. Predictors for PANSS response (≥ 20% reduction) was investigated.

The PANSS total score was significantly decreased at 12 weeks after blonanserin augmentation (–21.0 ± 18.1, F = 105.849, P < 0.001). Response rate on PANSS at week 12 was 51.0%. Premature discontinuation was occurred in 17 patients (17.0%) and 4 patients among them discontinued the study due to adverse events. Nine patients experienced significant weight gain during the study. Response to blonanserin augmentation was associated with severe (PANSS > 85) baseline symptom (OR = 10.298, P = 0.007) and higher dose (> 600 mg/day of chlorpromazine equivalent dose) of existing AAPs (OR = 4.594, P = 0.014).

Blonanserin augmentation improved psychiatric symptoms of schizophrenic patients in cases of partial or non-responsive to an AAP treatment with favorable tolerability. Patients with severe symptom despite treatment with higher dose of AAP were benefited from this augmentation. These results suggested that blonanserin augmentation could be an effective strategy for specific patients with schizophrenia.

The authors have not supplied their declaration of competing interest.

Rat gambling task (rGT) is a recently developed animal model making translational research possible in psychiatric disorders related to decision-making deficits. Methiopropamine (MPA) is a structural analog to methamphetamine and a temporary controlled substance. Although increasing concerns have been raised regarding MPA's abuse, few sources of information exist regarding its psychopharmacology. Thus, we investigated whether MPA produces any changes in the choice of preference in rGT.

Rats were trained in a touch screen chamber to learn the relationships between 4 different light signals on the screen and accompanied reward outcomes and punishments set up with different schedules, for one session of 30 min each day. Once animals showed a stabilized pattern of preference, they were given a total of 5 IP injections (a single injection per day, every other day) with saline or MPA followed by 2 weeks of withdrawal. Upon MPA challenge injection, their preference of choice was re-tested in rGT chambers.

Depending upon their preference of choice, rats were separated as risk-averse or risk-seeking groups. When they were pre-exposed to and challenged with MPA, rats in the risk-averse group significantly changed their preference toward more disadvantageous choices. These effects were not shown when they were pre-exposed to saline and challenged with MPA.

These results indicate that MPA badly influences decision-making behavior as in gambling task, implying that it may aggravate pathological symptoms of bad choices, resulting in negative consequences, observed in the patients with behavioral addictions.

The authors have not supplied their declaration of competing interest.

Limited research has been conducted to understand the relationship between heat wave warnings with public awareness and behavioral changes in the Asian population. The Hong Kong Observatory introduced the “very hot weather warning” in 2000 to alert the public of heatstroke and sunburn in Hong Kong. However, the population's behavioral responses to these weather alerts is unclear. Moreover, the relationship between perceived health risks and behavioral changes has not been examined. The goal of this study is to examine the health risk perceptions and behavioral changes following public heat wave warnings in Hong Kong.

A cross-sectional, population-based, telephone survey, using the last-birthday method was conducted within two weeks following a heat wave warning in 2009. A heat warning and a health study instrument, based on Intergovernmental Panel on Climate Change (IPCC) guidelines and related literature was developed and validated. Descriptive and multivariate logistic regression analyses were conducted.

The questionnaire was completed by 1,123 individuals whose socio-demographic characteristics were comparable to 2009 Hong Kong population census data. Of respondents, 83.6% were aware of the heat wave weather warning. Multivariate logistic regression of socio-demographic factors indicated that being female, those in middle age groups, and those with higher educational attainment was significantly associated with heat wave warning awareness. Among those aware of the public warning, the majority were unconcerned about potential adverse health effects, < 40% were aware of the community heat-related preparedness plans, and < 50% changed their behavior to mitigate the potential adverse health impacts of hot weather.

This is the first study to examine climate change and health behavioral responses in an urban Chinese population. Future research direction should further investigate correlations between awareness and health protective actions, as well as the drivers for health behavioral changes that mitigate the impact of climate change.