Explore the vast range of titles available.

Hoarding disorder (HD) has been recently added as a separate diagnostic category in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. HD is a common and disabling disorder, with an estimated prevalence in the general population of 2–6%. Although evidence suggests that the onset of hoarding symptoms is usually during childhood and adolescence (youth), relatively little is known about HD in this population. The present article is a selective review of emerging literature on the clinical features of hoarding in youth.

Individuals with substance use disorders exhibit risk-taking behaviors, potentially leading to negative consequences and difficulty maintaining recovery. Non-invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) have yielded mixed effects on risk-taking among healthy controls. Given the importance of risk-taking behaviors among substance-using samples, this study aimed to examine the effects of tDCS on risk-taking among a sample of adults using cannabis. Using a double-blind design, 27 cannabis users [M(SD) age = 32.48 (1.99), 41% female] were randomized, receiving one session of active or sham tDCS over the bilateral dorsolateral prefrontal cortex (dlPFC). Stimulation parameters closely followed prior studies with anodal right dlPFC and cathodal left dlPFC stimulation. Risk-taking—assessed via a modified Cambridge Gambling Task—was measured before and during tDCS. Delay and probability discounting tasks were assessed before and after stimulation. No significant effects of stimulation on risk-taking behavior were found. However, participants chose the less risky option ~86% of the trials before stimulation which potentially contributed to ceiling effects. These results contradict one prior study showing increased risk-taking among cannabis users following tDCS. There was a significant increase in delay discounting of a $1000 delayed reward during stimulation for the sham group only, but no significant effects for probability discounting. The current study adds to conflicting and inconclusive literature on tDCS and cognition among substance-using samples. In conclusion, results suggest the ineffectiveness of single session dlPFC tDCS using an established stimulation protocol on risk-taking, although ceiling effects at baseline may have also prevented behavior change following tDCS.

The study of seasonal patterns of public interest in psychiatric disorders has important theoretical and practical implications for service planning and delivery. The recent explosion of internet searches suggests that mining search databases yields unique information on public interest in mental health disorders, which is a significantly more affordable approach than population health studies. This study aimed to investigate seasonal patterns of internet mental health queries in Ontario, Canada. Weekly data on health queries in Ontario from Google Trends were downloaded for a 5-year period (2012-2017) for the terms \"schizophrenia,\" \"autism,\" \"bipolar,\" \"depression,\" \"anxiety,\" \"OCD\" (obsessive-compulsive disorder), and \"suicide.\" Control terms were overall search results for the terms \"health\" and \"how.\" Time-series analyses using a continuous wavelet transform were performed to isolate seasonal components in the search volume for each term. All mental health queries showed significant seasonal patterns with peak periodicity occurring over the winter months and troughs occurring during summer, except for \"suicide.\" The comparison term \"health\" also exhibited seasonal periodicity, while the term \"how\" did not, indicating that general information seeking may not follow a seasonal trend in the way that mental health information seeking does. Seasonal patterns of internet search volume in a wide range of mental health terms were observed, with the exception of \"suicide.\" Our study demonstrates that monitoring internet search trends is an affordable, instantaneous, and naturalistic method to sample public interest in large populations and inform health policy planners.

Background Anxiety disorders are the most common psychiatric problems among Canadian youth and typically have an onset in childhood or adolescence. They are characterized by high rates of relapse and chronicity, often resulting in substantial impairment across the lifespan. Genetic factors play an important role in the vulnerability toward anxiety disorders. However, genetic contribution to anxiety in youth is not well understood and can change across developmental stages. Large-scale genetic studies of youth are needed with detailed assessments of symptoms of anxiety disorders and their major comorbidities to inform early intervention or preventative strategies and suggest novel targets for therapeutics and personalization of care. Methods The Genetic Architecture of Youth Anxiety (GAYA) study is a Pan-Canadian effort of clinical and genetic experts with specific recruitment sites in Calgary, Halifax, Hamilton, Toronto, and Vancouver. Youth aged 10–19 ( n  = 13,000) will be recruited from both clinical and community settings and will provide saliva samples, complete online questionnaires on demographics, symptoms of mental health concerns, and behavioural inhibition, and complete neurocognitive tasks. A subset of youth will be offered access to a self-managed Internet-based cognitive behavioral therapy resource. Analyses will focus on the identification of novel genetic risk loci for anxiety disorders in youth and assess how much of the genetic risk for anxiety disorders is unique or shared across the life span. Discussion Results will substantially inform early intervention or preventative strategies and suggest novel targets for therapeutics and personalization of care. Given that the GAYA study will be the biggest genomic study of anxiety disorders in youth in Canada, this project will further foster collaborations nationally and across the world.

Background A growing body of research has demonstrated associations between specific neurodevelopmental disorders and variation in DNA methylation (DNAm), implicating this molecular mark as a possible contributor to the molecular etiology of these disorders and/or as a novel disease biomarker. Furthermore, genetic risk variants of neurodevelopmental disorders have been found to be enriched at loci associated with DNAm patterns, referred to as methylation quantitative trait loci (mQTLs). Methods We conducted two epigenome-wide association studies in individuals with attention-deficit/hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD) (aged 4–18 years) using DNA extracted from saliva. DNAm data generated on the Illumina Human Methylation 450 K array were used to examine the interaction between genetic variation and DNAm patterns associated with these disorders. Results Using linear regression followed by principal component analysis, individuals with the most endorsed symptoms of ADHD or OCD were found to have significantly more distinct DNAm patterns from controls, as compared to all cases. This suggested that the phenotypic heterogeneity of these disorders is reflected in altered DNAm at specific sites. Further investigations of the DNAm sites associated with each disorder revealed that despite little overlap of these DNAm sites across the two disorders, both disorders were significantly enriched for mQTLs within our sample. Conclusions Our DNAm data provide insights into the regulatory changes associated with genetic variation, highlighting their potential utility both in directing GWAS and in elucidating the pathophysiology of neurodevelopmental disorders.

IntroductionBest practice approaches for addressing COVID-19-related psychological distress among young people (<25 years) and their families remain unclear. Psychological first aid (PFA) is promoted by public health authorities to provide psychological support in the context of extreme events; however, there is limited evidence for its effectiveness. As a prerequisite to conducting a randomised controlled trial to examine programme effectiveness, this project is evaluating the acceptability and feasibility of implementing and evaluating a PFA training programme (‘LIVES for Families’) for mental health (MH) practitioners to improve their ability to recognise and respond to COVID-19-related psychological distress among their clients.Methods and analysisWe are using a triangulation mixed methods research design; complementary strands of quantitative and qualitative data are being collected in parallel and will be merged at the interpretation phase of the project. The quantitative strand uses a repeated measures design; a consecutive sample of MH practitioners (n=80) providing MH support to young people or their families are being recruited to participate in the LIVES for Families PFA training programme and complete quantitative measures at baseline (pretraining), 2-week and 6-month follow-up time points. The qualitative strand uses fundamental description and semistructured interviews with a subset of practitioners (n=30), as well as managers of MH agencies (n=20). A mixed methods joint display and associated narrative will generate a comprehensive understanding regarding acceptability and feasibility.Ethics and disseminationThe Hamilton Integrated Research Ethics Board approved the study (project number: 11295). Results will be shared broadly with the policy and practice community through publications, presentations and public webinars. As a brief, evidence-informed intervention, the LIVES for Families PFA training programme is suitable in its mode of delivery across care settings. The outcomes of this study could have international implications for mitigating the MH impacts of viral pandemics.

Background There is a need to develop a multipurpose obsessive–compulsive disorder (OCD) measure that is useful for cross disorder research and as a reliable clinical rating scale. The current study examined the psychometric properties and established clinical cutoffs for the parent‐report version of the Toronto Obsessive–Compulsive Scale (TOCS), a 21‐item rating scale of obsessive–compulsive traits. Method Participants ranged in age from 6 to 21 years old and had a primary diagnosis of OCD (n = 350, 50% female), attention‐deficit/hyperactivity disorder (ADHD) (n = 820, 25% female), autism spectrum disorder (ASD) (n = 794, 22% female), or were typically developing controls (n = 391, 51% female). Confirmatory factor analyses, internal consistency reliability, and convergent and divergent validity of the TOCS were examined in the OCD group. Using various scoring approaches, receiver operating characteristic (ROC) analyses were used to establish a clinical cut‐off by splitting the OCD group into a discovery sample (166 OCD cases, 164 controls) and a validation sample (184 OCD cases, 227 controls). Classification accuracy and TOCS scores were compared across OCD, ADHD, and ASD groups. Results The psychometric properties of the TOCS were confirmed. ROC analyses across TOCS scoring approaches in the discovery sample indicated excellent diagnostic discrimination (AUC ≥0.95, sensitivity 77%–92%, specificity 92%–98%). Established cutoffs, when applied in the independent validation sample of OCD cases and controls, showed an overall classification accuracy of 85%–90%. The TOCS total score and symptom count showed good discrimination of OCD from ADHD (AUC ≥0.86) and ASD (AUC ≥0.81). The OCD group scored significantly higher on all TOCS dimensions (except Hoarding) than the ADHD and ASD groups. Conclusion The TOCS is a reliable and valid rating scale with strong sensitivity and specificity in discriminating OCD cases from controls, as well as from ASD and ADHD. It is a quantitative OCD measure with important clinical and research applications, with particular relevance for cross disorder phenotyping and population‐based studies.

Neuroimaging has played an important part in advancing our understanding of the neurobiology of obsessive–compulsive disorder (OCD). At the same time, neuroimaging studies of OCD have had notable limitations, including reliance on relatively small samples. International collaborative efforts to increase statistical power by combining samples from across sites have been bolstered by the ENIGMA consortium; this provides specific technical expertise for conducting multi‐site analyses, as well as access to a collaborative community of neuroimaging scientists. In this article, we outline the background to, development of, and initial findings from ENIGMA's OCD working group, which currently consists of 47 samples from 34 institutes in 15 countries on 5 continents, with a total sample of 2,323 OCD patients and 2,325 healthy controls. Initial work has focused on studies of cortical thickness and subcortical volumes, structural connectivity, and brain lateralization in children, adolescents and adults with OCD, also including the study on the commonalities and distinctions across different neurodevelopment disorders. Additional work is ongoing, employing machine learning techniques. Findings to date have contributed to the development of neurobiological models of OCD, have provided an important model of global scientific collaboration, and have had a number of clinical implications. Importantly, our work has shed new light on questions about whether structural and functional alterations found in OCD reflect neurodevelopmental changes, effects of the disease process, or medication impacts. We conclude with a summary of ongoing work by ENIGMA‐OCD, and a consideration of future directions for neuroimaging research on OCD within and beyond ENIGMA.

Delay discounting (DD), a behavioural economic index estimating one's preference for immediate over delayed gratification, has emerged as a potential transdiagnostic process. Steeper DD (i.e., greater preference for immediate reward) is seen among substance-based and behavioural addictions and multiple psychiatric disorders relative to controls. Limited research has investigated DD among anxiety and related disorders. Adults with primary diagnoses of generalized anxiety disorder (GAD; n = 166), obsessive-compulsive disorder (OCD; n = 62), panic disorder (PD; n = 46), posttraumatic stress disorder (PTSD; n = 68), or social anxiety disorder (SAD; n = 100) were recruited in order to compare DD rates relative to healthy controls (n = 77). Measures included the Monetary Choice Questionnaire (measure of DD) and the Depression, Anxiety, Stress Scale-21 item version. Univariate analyses of variance (ANOVAs) with planned pairwise comparisons examining group differences in DD revealed steeper discounting among GAD (d = .32), SAD (d = .32), and PTSD (d = .53) groups relative to controls. No significant differences were found between OCD and PD relative to controls. These results suggest steeper DD rates are not universally found among anxiety and related disorders, limiting the use of DD as a transdiagnostic construct. La dévalorisation des gains futurs (Delay discounting, ou DD), un indice comportemental économique estimant les préférences d'une personne pour la satisfaction (ou gratification) immédiate par rapport à la satisfaction différée, apparaît aujourd'hui comme un processus transdiagnostique potentiel. On constate également une dévalorisation des gains futurs plus prononcée (c.-à-d., une préférence plus marquée pour la récompense immédiate) chez les personnes aux prises avec des toxicomanies et des dépendances comportementales ainsi qu'avec des troubles psychiatriques multiples par rapport aux groupes témoins. Peu d'études ont été réalisées sur la dévalorisation des gains futurs chez les personnes atteintes d'anxiété et de troubles connexes. Des adultes dont le diagnostic primaire concerne un trouble anxieux généralisé (TAG; n = 166), un trouble obsessionnel-compulsif (TOC; n = 62), un trouble panique (TP; n = 46), un trouble de stress post-traumatique (TSPT; n = 68) ou un trouble d'anxiété sociale (TAS; n = 100) ont été recrutés en vue de comparer les taux de dévalorisation des gains futurs par rapport à des sujets témoins en bonne santé (n = 77). Le « Questionnaire sur les choix monétaires » (Monetary Choice Questionnaire) et l'échelle de mesure de la dépression, du stress et de l'anxiété (Depression, Anxiety, Stress Scale) en 21 points comptaient parmi les outils de mesure utilisés. Des analyses de variance unidimensionnelles assorties de comparaisons par paires planifiées visant à examiner les différences au niveau de la dévalorisation des gains futurs entre les groupes ont mis en lumière une dévalorisation plus prononcée chez les groupes TAG (d = 32), TAS (d = 32) et TSPT (d = 53) relativement aux témoins en bonne santé. Aucune différence significative n'a été observée entre les groupes TOC et TP par rapport aux témoins en bonne santé. Ces résultats semblent indiquer que des taux plus élevés de dévalorisation des gains futurs ne sont pas universels parmi les personnes souffrant d'anxiété et d'autres troubles connexes, ce qui vient restreindre le recours à la mesure de la dévalorisation des gains futurs en tant que concept transdiagnostique. Public Significance Statement Delay discounting (DD) is considered an indicator of preference for immediate over delayed rewards and has been found to be elevated among a range of psychiatric disorders, suggesting that it may be a useful tool across many disorders. This study found that some (but not all) anxiety and related disorder presentations (e.g., generalized anxiety disorder, social anxiety disorder, and posttraumatic stress disorder) exhibited higher rates of discounting (suggesting increased preference for immediate rewards) compared with healthy control subjects; however, these findings did not remain after accounting for symptoms of depression. These findings suggest that DD may not be elevated in all psychiatric conditions, and as such, this measure may not be as useful in understanding the full range of psychiatric conditions as was previously thought.

The Children’s Saving Inventory (CSI) was introduced in 2011 and is the first parent-rated questionnaire specifically designed to measure the severity of hoarding symptoms in youth. To date, however, no replication studies of the CSI have been published. Additionally, the total CSI score includes several items measuring acquisition, a behavioural dimension that has since been excluded from DSM-5’s hoarding disorder criteria. Given these limitations, the primary goal of the present study was to test a modified, DSM-5-consistent, total score of the CSI. Because a confirmatory factor analysis did not support the 2011 four-factor model of the CSI, we reviewed the original CSI and excluded all acquisition items. An exploratory factor analysis yielded a strong three-factor solution (difficulty discarding, Clutter, and distress/impairment) with good reliability and validity for a 15-item version of the CSI. Overall, our results support the use of the 15-item CSI in youth with OCD.