Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Child and Adolescent Psychiatry
Total Results:
11429
An Assessment of Surgical Outcomes in Malignant Peripheral Nerve Sheath Tumors: A Systematic Review and Meta-Analysis of Surgical Interventions
BACKGROUND/OBJECTIVES/OBJECTIVE:Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive malignancies with a challenging prognosis, especially for patients with Neurofibromatosis type 1 (NF1). Their low incidence necessitates comprehensive studies to investigate the survival outcome. METHODS:We conducted a systematic review and meta-analysis, including data from 16 studies and 4265 patients, to explore surgical outcomes and survival rates, focusing on time-related outcomes, including overall survival (OS), progression-free survival (PFS), and recurrence rate. RESULTS:The analysis revealed that the OS rate was 86% [95% CI: 75-97%] at 1 year, decreasing to 60% [95% CI: 45-75%] at 3 years, and further declining to 47% [95% CI: 35-58%] by 5 years. For PFS, the 1-year rate was 61% [95% CI: 25-98%], which remained similar at 62% [95% CI: 35-89%] for 3 and 5 years. In NF1-associated MPNSTs, the 1-year OS was relatively high at 93% [95% CI: 83-100%], but it dropped to 68% [95% CI: 53-84%] at 3 years and further to 50% [95% CI: 31-68%] at 5 years. Additionally, the hazard ratio indicated a 38% lower survival rate in NF1 patients than those with sporadic MPNSTs when data were presented in the same study. Recurrence rates were high, with 56% of patients experiencing a relapse, primarily as local recurrences (70.6%). Mortality was significant, with over 50% of patients dying within an average follow-up period of 33.45 months. CONCLUSIONS:MPNSTs, particularly in NF1 patients, are associated with poor prognosis and high recurrence rates. These results underline the necessity of targeted therapeutic strategies and improved programs for screening, mainly through a multidisciplinary approach to optimize management.
PMCID:12190973
PMID: 40563647
ISSN: 2072-6694
CID: 5892302
Leveraging clinical sleep data across multiple pediatric cohorts for insights into neurodevelopment: the retrospective analysis of sleep in Pediatric (RASP) cohorts study
Sleep disturbances are prominent across neurodevelopmental disorders (NDDs) and may reflect specific abnormalities in brain development and function. Overnight polysomnography (PSG) allows for detailed investigation of sleep architecture, offering a unique window into neurocircuit function. Analysis of existing pediatric PSGs from clinical studies could enhance the availability of sleep studies in pediatric patients with NDDs towards a better understanding of mechanisms underlying abnormal development in NDDs. Here, we introduce and characterize a retrospective collection of 1527 clinical pediatric overnight PSGs across five different sites. We first developed an automated stager trained on independent pediatric sleep data, which yielded better performance compared to a generic stager trained primarily on adults. Using consistent staging across cohorts, we derived a panel of EEG micro-architectural features. This unbiased approach replicated broad trajectories previously described in typically developing sleep architecture. Further, we found sleep architecture disruptions in children with Down's Syndrome (DS) that were consistent across independent cohorts. Finally, we built and evaluated a model to predict age from sleep EEG metrics, which recapitulated our previous findings of younger predicted brain age in children with DS. Altogether, by creating a resource pooled from existing clinical data we expanded the available datasets and computational resources to study sleep in pediatric populations, specifically towards a better understanding of sleep in NDDs. This Retrospective Analysis of Sleep in Pediatric (RASP) cohorts dataset, including staging annotation derived from our automated stager, is deposited at https://sleepdata.org/datasets/rasp.
PMID: 40488421
ISSN: 1550-9109
CID: 5868972
The value of mental science: we publish what matters
Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.
PMID: 40485480
ISSN: 1472-1465
CID: 5868892
Prevalence of mental disorder symptoms among university students: An umbrella review
This umbrella review synthesizes data on the prevalence of mental disorder symptoms among university students worldwide. A systematic search of seven databases (inception-July 23, 2023) followed PRISMA guidelines. We included meta-analyses assessing the prevalence of mental disorder symptoms, evaluating methodological quality with AMSTAR-2. A random-effects meta-analysis was conducted, along with meta-regression and subgroup analyses for moderators (percentage of females, publication date, healthcare-related degrees, COVID-19 pandemic). We included 1,655 primary studies from 62 meta-analyses, encompassing 8,706,185 participants. AMSTAR-2 ratings classified 35 % of meta-analyses as low quality and 65 % as critically low. Pooled prevalence estimates were: depression-mild (35.41 %, CI=33.9-36.93) and severe (13.42 %, CI=8.03-19.92; k=952; n=2,108,813); anxiety-mild (40.21 %, CI=37.39-43.07) and severe (16.79 %, CI=7.21-29.29; k=433; n=1,579,780); sleep disorders (41.09 %, CI=35.7-46.58); eating disorders (17.94 %, CI=15.79-20.20); gambling disorder (6.59 %, CI=5.52-7.75); post-traumatic stress disorder (25.13 %, CI=20.55-30.02); stress (36.34 %, CI=29.36-43.62); and suicide-related outcomes (ideation past 12 months: 10.76 %, CI=9.53-12.06; lifetime ideation: 20.33 %, CI=16.15-24.86; suicide attempt past 12 months: 1.37 %, CI=0.67-2.29; lifetime attempt: 3.44 %, CI=2.48-4.54). Meta-regression analyses identified statistically significant moderators of prevalence such as healthcare academic degrees and the pandemic in the case of depression and studies with more females in the case of sleep disorders. This is the most comprehensive synthesis on the prevalence of mental disorder symptoms in university students, providing crucial insights for clinicians, policymakers, and stakeholders.
PMID: 40480638
ISSN: 1873-7528
CID: 5862912
General disease factor: evidence of a unifying dimension across mental and physical illness in children and adolescents
BACKGROUND:) that underlies the vulnerability to both physical and mental conditions could have important implications for our approach to health assessment and treatment. OBJECTIVE:in children and adolescents. METHODS:This Swedish registry-based cross-sectional study included children and adolescents born between 1996 and 2003 with follow-up until 2013. We extracted data on 25 mental and physical health conditions according to the ICD-10 system. To determine the optimal dimensional structure of these conditions, several competing measurement models were tested, including correlated factors, one factor, various bifactor specifications and bifactor exploratory structural equation modelling (ESEM). FINDINGS/RESULTS:=0.423; ECV=0.130) factors also indicated additional significant unique contributions. CONCLUSIONS:underlying both mental and physical conditions, alongside distinct domain-specific factors. These findings have important implications for clinical practice, providing evidence that suggests the need for more integrated approaches to health assessment and treatment that consider the interconnectedness of mental and physical health.
PMCID:12142111
PMID: 40461262
ISSN: 2755-9734
CID: 5862302
Building Community Through Data: The value of a Researcher Driven Open Science Ecosystem
PMID: 39836639
ISSN: 1526-4637
CID: 5802192
Understanding Placebo Mechanisms to Reduce Attrition in Psychiatric Trials
PMID: 40238132
ISSN: 2168-6238
CID: 5828202
High-resolution volumetric dynamic magnetic resonance imaging of the wrist using an 8-channel flexible receive coil
OBJECTIVE:Real-time imaging is useful for the evaluation of wrist instability. However, currently available real-time magnetic resonance imaging (MRI) methods are limited due to their 2D nature or provide insufficient temporal resolution and image quality for quantitative kinematic analysis. This work introduces a novel approach for volumetric dynamic MRI of the wrist joint during active motion and demonstrates the feasibility of tracking carpal bone motion. MATERIALS AND METHODS/METHODS:A flexible 8-element 3 T wrist receive coil and 3D-printed support platform for guiding motion were designed for dynamic wrist imaging. 2D real-time images were acquired using a fat-saturated FLASH sequence with radial sampling and reconstructed with the GRASP algorithm. Corresponding volumetric dynamic wrist images were obtained by assembling 2D real-time images into 3D snapshots using autodetected MRI-visible markers for slice alignment. The proposed method was demonstrated for radial-ulnar deviation on five healthy volunteers. RESULTS:The flexible wrist coil provided high SNR while allowing a wide range of wrist movements. 2D real-time wrist images were acquired with a temporal resolution of 48 ms/frame with negligible streaking artifacts. Carpal bones and metacarpal bones were properly aligned in the assembled dynamic volumes for all five subjects. The excellent bone-to-tissue contrast enabled accurate segmentation of the individual carpal bones on the assembled dynamic volumes. CONCLUSION/CONCLUSIONS:This work introduces a novel wrist coil and demonstrates that real-time volumetric dynamic examination of the moving wrist is feasible. The achieved image quality and high temporal resolution could enable automatic segmentation of carpal bones and quantitative kinematic assessment for evaluating wrist instability.
PMID: 39560769
ISSN: 1432-2161
CID: 5758362
Genome-wide analyses identify 30 loci associated with obsessive-compulsive disorder
Obsessive-compulsive disorder (OCD) affects ~1% of children and adults and is partly caused by genetic factors. We conducted a genome-wide association study (GWAS) meta-analysis combining 53,660 OCD cases and 2,044,417 controls and identified 30 independent genome-wide significant loci. Gene-based approaches identified 249 potential effector genes for OCD, with 25 of these classified as the most likely causal candidates, including WDR6, DALRD3 and CTNND1 and multiple genes in the major histocompatibility complex (MHC) region. We estimated that ~11,500 genetic variants explained 90% of OCD genetic heritability. OCD genetic risk was associated with excitatory neurons in the hippocampus and the cortex, along with D1 and D2 type dopamine receptor-containing medium spiny neurons. OCD genetic risk was shared with 65 of 112 additional phenotypes, including all the psychiatric disorders we examined. In particular, OCD shared genetic risk with anxiety, depression, anorexia nervosa and Tourette syndrome and was negatively associated with inflammatory bowel diseases, educational attainment and body mass index.
PMID: 40360802
ISSN: 1546-1718
CID: 5844232
Efficacy of cognitive behavioral therapies with a trauma focus for posttraumatic stress disorder: An individual participant data meta-analysis
OBJECTIVE:This individual participant data meta-analysis aimed to investigate the effectiveness of cognitive behavioral therapy with a trauma focus (CBT-TF) for posttraumatic stress disorder (PTSD). Furthermore, we examined the effect of moderators on PTSD symptom severity. METHOD/METHODS:This study included randomized controlled trials comparing CBT-TF to an inactive or active comparison group for adults with PTSD. The primary and secondary outcomes were PTSD symptom severity and remission, respectively. Moderators included sociodemographic and clinical variables. RESULTS:Twelve studies compared CBT-TF with inactive (n = 625) and 11 with active comparison conditions (n = 706). The one-stage individual participant data meta-analysis found that CBT-TF was more effective than inactive comparison conditions (β = -0.78; OR = 2.34) and not significantly different from active comparison conditions (β = 0.02; OR = 0.53) in reducing PTSD symptom severity and achieving PTSD remission, respectively. When comparing CBT-TF with inactive treatments, moderator analysis found that divorced participants had greater PTSD symptoms postintervention following CBT-TF than participants who were single, cohabitating, or married receiving CBT-TF, both in the completer (β = 0.93) and full-sample (β = 0.59) analyses. For the active treatment comparison, moderator analysis found that participants taking psychotropic medication had lower PTSD symptoms following CBT-TF than those not taking psychotropic medication in the completer analysis (β = -0.39). CONCLUSION/CONCLUSIONS:Based on our moderator analyses, further research is needed to understand the effect of psychotropic medication on the CBT-TF intervention process. Moreover, divorced participants with PTSD receiving CBT-TF might benefit from enhanced support. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
PMID: 40388148
ISSN: 1939-2117
CID: 5852862
