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Journal: Psychiatry research


Hair-pulling disorder (trichotillomania, HPD) is a disabling condition that is characterized by repetitive hair-pulling resulting in hair loss. Although there is evidence of structural grey matter abnormalities in HPD, there is a paucity of data on white matter integrity. The aim of this study was to explore white matter integrity using diffusion tensor imaging (DTI) in subjects with HPD and healthy controls. Sixteen adult female subjects with HPD and 13 healthy female controls underwent DTI. Hair-pulling symptom severity, anxiety and depressive symptoms were also assessed. Tract-based spatial statistics were used to analyze data on fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD). There were no differences in DTI measures between HPD subjects and healthy controls. However, there were significant associations of increased MD in white matter tracts of the fronto-striatal-thalamic pathway with longer HPD duration and increased HPD severity. Our findings suggest that white matter integrity in fronto-striatal-thalamic pathways in HPD is related to symptom duration and severity. The molecular basis of measures of white matter integrity in HPD deserves further exploration.

Concepts: Anxiety, Statistics, Symptoms, Symptom, White matter, Diffusion MRI, Imaging, Tensors


Insomnia is common in people experiencing psychosis. It has been identified as a contributory cause of paranoia, but any causal relationship with hallucinations has yet to be established. We tested the hypotheses that insomnia i) has a cross-sectional association with hallucinations ii) predicts new inceptions of hallucinations and iii) that these associations remain after controlling for depression, anxiety, and paranoia. Data from the second (2000, N=8580) and third (2007, N=7403) British Psychiatric Morbidity Surveys were used to assess cross-sectional associations between insomnia and hallucinations. The 2000 dataset included an 18 month follow up of a subsample (N=2406) used to test whether insomnia predicted new inceptions of hallucinations. Insomnia was associated with hallucinations in both cross-sectional datasets. Mild sleep problems were associated with 2-3 times greater odds of reporting hallucinations, whilst chronic insomnia was associated with four times greater odds. Insomnia was also associated with increased odds of hallucinations occurring de novo over the next 18 months. These associations remained significant, although with smaller odds ratios, after controlling for depression, anxiety and paranoia. This is the first longitudinal evidence that insomnia is associated with the development of hallucinatory experiences. Effective treatment of insomnia may lessen the occurrence of hallucinations.

Concepts: Causality, Sleep deprivation, Schizophrenia, Hallucination, Psychosis, Bipolar disorder, Insomnia, Hallucinations in the sane


The role that cognitive processing of a recent trauma has in the occurrence of hallucinations has not been examined longitudinally. This study investigated trauma-related cognitive predictors of hallucinations in the months following an interpersonal assault. Four weeks after treatment at an emergency department for interpersonal assault injuries, 106 participants were assessed for peri-traumatic cognitive processing, cognitive responses to trauma memories, negative beliefs about the self, Posttraumatic-stress disorder (PTSD), and hallucinatory experiences. Hallucinatory experiences were reassessed six months later. Cognitive processing during trauma (lack of self-referential processing, and dissociation), beliefs about permanent negative change, self-vulnerability, and self-blame and cognitive response styles (thought suppression, rumination, and numbing) were significant predictors of later hallucinations. The way in which trauma is processed may partly determine the occurrence of hallucinations.

Concepts: Psychology, Cognition, Mind, Thought, Hallucination, Psychosis, Rape, Hallucinations in the sane


Mistrust of others may build upon perceptions of the self as vulnerable, consistent with an association of paranoia with perceived lower social rank. Height is a marker of social status and authority. Therefore we tested the effect of manipulating height, as a proxy for social rank, on paranoia. Height was manipulated within an immersive virtual reality simulation. Sixty females who reported paranoia experienced a virtual reality train ride twice: at their normal and reduced height. Paranoia and social comparison were assessed. Reducing a person’s height resulted in more negative views of the self in comparison with other people and increased levels of paranoia. The increase in paranoia was fully mediated by changes in social comparison. The study provides the first demonstration that reducing height in a social situation increases the occurrence of paranoia. The findings indicate that negative social comparison is a cause of mistrust.

Concepts: Sociology, Human height, Mind, Concepts in metaphysics, Simulated reality, Reality, Virtual reality, Social status


Although some studies have reported potential associations of dietary patterns with depression risk, a consistent perspective hasn’t been estimated to date. Therefore, we conducted this meta-analysis to evaluate the relation between dietary patterns and the risk of depression. A literature research was conducted searching MEDLINE and EMBASE databases up to September 2016. In total, 21 studies from ten countries met the inclusion criteria and were included in the present meta-analysis. A dietary pattern characterized by a high intakes of fruit, vegetables, whole grain, fish, olive oil, low-fat dairy and antioxidants and low intakes of animal foods was apparently associated with a decreased risk of depression. A dietary pattern characterized by a high consumption of red and/or processed meat, refined grains, sweets, high-fat dairy products, butter, potatoes and high-fat gravy, and low intakes of fruits and vegetables is associated with an increased risk of depression. The results of this meta-analysis suggest that healthy pattern may decrease the risk of depression, whereas western-style may increase the risk of depression. However, more randomized controlled trails and cohort studies are urgently required to confirm this findings.

Concepts: Nutrition, Mathematics, Milk, Cereal, Fruit, Tomato, Olive, Whole grain


This study examined the psychometric properties of the Danish WEMWBS and its short version (SWEMWBS) in a Danish population sample, and compared scores in Denmark with scores representative of three other European settings. A total of 3,508 Danish men and women aged 16-95 filled out an electronic survey. Face validity was examined by cognitive interviews. Content validity was assessed by examining response distributions and construct validity by confirmatory factor analysis, measurement invariance, and relations to other or similar measures. Overall mental well-being scores were calculated, as well as stratified by sex and age. Support was found for the single-factor hypothesis, yielding good model fits for both versions of the scale. Both scales have high internal consistency. Correlations with mental health measures were largely in line with expectations. The highest mental well-being scores were reported for Catalonia, followed by Denmark, Iceland, and England. The (S)WEMWBS appear to be appropriate instruments to measure mental well-being in the Danish population. The present findings encourage the use of the scales, particularly SWEMWBS, in epidemiological, intervention and evaluation studies in research and practice. Cross-cultural comparisons like the one reported here may be essential to inform international mental health policy.


Text messaging may be excessive and young people may be dependent on it. We distributed the Self-perception of Text-message Dependency Scale (STDS), Hospital Anxiety and Depression Scale (HADS), Temperament and Character Inventory (TCI), and Relationship Questionnaire (RQ) to 223 Japanese university students in a two-wave study, separated by a 5-month interval. The STDS yielded a three-factor structure. The STDS scores across the two measurement occasions were stable across time (except for the Relationship Maintenance subscale). A hierarchical cluster analysis suggested a three-class structure interpreted as Normal Users, Excessive Users, and Dependent Users. Excessive Users and Dependent Users were characterized by a young age at initial mobile phone use, more frequent use of text messaging, higher Novelty Seeking, and better Other-Model patterns of adult attachment. Unlike Excessive Users, Dependent Users were characterized by lower Self-directedness, poorer Self-Model of adult attachment, and higher anxiety and depression. The Excessive Users, but not the Dependent Users, were characterized by high Reward Dependence and Co-operativeness. The present study demonstrated that the STDS has a robust factor structure, good construct validity, and temporal stability (except for Relationship Maintenance subscale); students could be classified into normal, excessive, and Dependent Users of the text messaging; and Dependent Users were characterized by Excessive Use and personality immaturity.

Concepts: Cluster analysis, Psychometrics, Mobile phone, Dependency, Text messaging, SMS, Instant messaging, Tridimensional Personality Questionnaire


Physical activity has been proposed to be beneficial for prevention of depression, although the importance of exercise intensity, sex-specific mechanisms, and duration of the effects need to be clarified. Using an observational study design, following 395,369 individuals up to 21 years we studied whether participation in an ultralong-distance cross-country ski race was associated with lower risk of developing depression. Skiers (participants in the race) and matched non-skiers from the general population (non-participants in the race) were studied after participation (same year for non-participation) in the race using the Swedish population and patient registries. The risk of depression in skiers (n = 197,685, median age 36 years, 38% women) was significantly lower, to nearly half of that in non-skiers (adjusted hazard ratio, HR 0.53) over the follow-up period. Further, a higher fitness level (measured as the finishing time to complete the race, a proxy for higher exercise dose) was associated with lower incidence of depression in men (adjusted HR 0.65), but not in women. Our results support the recommendations of engaging in physical activity as a preventive strategy decreasing the risk for depression in both men and women. Furthermore, the exercise could reduce risk for depression in a dose-dependent matter, in particular in males.


Self-mutilation (SM) not only occurs among patients with schizophrenia, personality disorders or transsexuality but also as a phenomenon induced by psychotropic substances (PS). We intended to find characteristics of patients at risk to perform SM induced by PS (SMIPS), frequent PS within this phenomenon and typical presentations of SMIPS. A systematic review of the literature (including Medline, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials and Scopus) was conducted. On October 2011 we identified 26 cases (23 publications) of SM related to PS. Majority of patients (85%) was male, mean age was 30 years (median 41 years). Seventy-three percent of patients developed SM subsequent to the use of one PS, 27% presented SM after the use of more than one PS. Alcohol (25%), hallucinogens (25%) and amphetamines (22%) were found most frequently among the reported substances. Major impairment was present in 80%. Our findings suggest male sex, young age, a previous history of abuse of PS and the current use of alcohol, hallucinogens or amphetamines to favour SMIPS.

Concepts: Evidence-based medicine, Systematic review, Randomized controlled trial, Ketamine, Convention on Psychotropic Substances


Previous research has shown that in response to a monotonous, boring lab situation, non-clinical participants voluntarily self-administer electric shocks. The shocks probably served to disrupt the tedious monotony: they were the only available external source of stimulation. Alternatively, the shocks might have functioned to regulate the negative emotional experience caused by the induction of boredom, consistent with theories on the function of non-suicidal self-injury (NSSI). According to this latter explanation, induction of other negative emotions would also increase the administration of shocks. To test this explanation, 69 participants watched a monotonous, sad or neutral film fragment, during which they could self-administer electric shocks. Participants in the boredom condition self-administered more shocks and with higher intensity, compared to both the neutral and sadness condition. Sadness had no effect on the self-administration of shocks. The effect of boredom was more pronounced in participants with a history of NSSI: they administered more shocks in the first 15min. The results indicate that the shocks function to disrupt monotony and not to regulate negative emotional experience in general. Moreover, boredom appears an important impetus for NSSI.

Concepts: Explanation, Emotion, Suffering, Self-harm, Boredom, Emotions, Sadness, Mortification of the flesh