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Many women diagnosed with varying psychiatric disorders take antipsychotic medications during pregnancy. The safety of antipsychotic medications in pregnancy is largely unknown. We established the National Register of Antipsychotic Medications in Pregnancy in 2005. Women who are pregnant and taking an antipsychotic medication are interviewed every 6 weeks during pregnancy and then followed until their babies are one year old. The baby's progress is closely followed for the first year of life. As of April 18 2012, 147 pregnancies had been followed through to completion. There were 142 live births and data is available for 100 one year old babies. 18% of babies were born preterm, with a higher dose of antipsychotic medication correlating to an increased likelihood of premature delivery; 43% of babies required special care nursery or intensive care after birth; 37% had any degree of respiratory distress and 15% of babies developed withdrawal symptoms. Congenital anomalies were seen in eight babies. Most pregnancies resulted in the birth of live, healthy babies. The use of mood stabilisers or higher doses of antipsychotics during pregnancy increased the likelihood of babies experiencing respiratory distress or admission to Special Care Nursery or Neonatal Intensive Care Units. There is a great need for safety and efficacy information about the use of antipsychotic medications in pregnancy. Live, healthy babies are the most common outcome following the use of antipsychotic medication in pregnancy, but clinicians should be particularly mindful of neonatal problems such as respiratory distress.

Iron has been increasingly implicated in the pathology of neurodegenerative diseases. In the past decade, development of the new magnetic resonance imaging technique, quantitative susceptibility mapping (QSM), has enabled for the more comprehensive investigation of iron distribution in the brain. The aim of this systematic review was to provide a synthesis of the findings from existing QSM studies in neurodegenerative diseases. We identified 80 records by searching MEDLINE, Embase, Scopus, and PsycInfo databases. The disorders investigated in these studies included Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, Wilson's disease, Huntington's disease, Friedreich's ataxia, spinocerebellar ataxia, Fabry disease, myotonic dystrophy, pantothenate-kinase-associated neurodegeneration, and mitochondrial membrane protein-associated neurodegeneration. As a general pattern, QSM revealed increased magnetic susceptibility (suggestive of increased iron content) in the brain regions associated with the pathology of each disorder, such as the amygdala and caudate nucleus in Alzheimer's disease, the substantia nigra in Parkinson's disease, motor cortex in amyotrophic lateral sclerosis, basal ganglia in Huntington's disease, and cerebellar dentate nucleus in Friedreich's ataxia. Furthermore, the increased magnetic susceptibility correlated with disease duration and severity of clinical features in some disorders. Although the number of studies is still limited in most of the neurodegenerative diseases, the existing evidence suggests that QSM can be a promising tool in the investigation of neurodegeneration.

Self-report surveys were conducted in Australia between May 2020 and April 2024, allowing for an analysis of perceived psychological resilience in those with and without suicidal ideation (SI) during and after the COVID-19 pandemic. Linear mixed models were used to describe the factors associated with psychological resilience in these populations and in people experiencing transitions between SI states. Of the 1145 people who responded more than once to the survey, 879 (77%) always reported “never SI”, 84 (7%) always reported SI, while 182 (16%) reported SI for only some of their surveys. People who moved between SI states reported significantly lower psychological resilience than those who reported “never SI”, but significantly higher psychological resilience than those reporting SI in all their surveys. For participants always reporting SI, greater psychological resilience was significantly associated with greater hopefulness and quality of life, and less sleep than usual. In people who moved between SI states, greater psychological resilience was significantly associated with greater hopefulness, less psychological distress and lower likelihood of mental illness. Only participants with “never SI” reported better psychological resilience alongside consistent sleep and exercise quantities. These results have important implications for suicide prevention in Australia. However, bidirectional associations require further investigation.

A recent systematic review has demonstrated objective neurocognitive difficulties in people with body dysmorphic disorder (BDD). Limited research has also shown that individuals with BDD frequently self-report cognitive difficulties, but little is known about how they understand these difficulties in relation to their disorder or daily and life functioning. This study aimed to comprehensively examine adults' perceptions of cognitive difficulties in BDD. A mixed-methods design was employed using an international online survey, which analysed quantitative and qualitative data (Interpretative Phenomenological Analysis) of lived experiences of cognitive difficulties from participants who self-reported a BDD diagnosis or severe BDD symptomatology via the Dysmorphic Concern Questionnaire (N = 433). Most participants (82%) endorsed significant cognitive difficulties they believed were linked to their disorder, with 75% reporting substantial effects on daily life and overall quality of life. Few had discussed these concerns with clinicians due to shame, misattribution, or uncertainty about their relevance. Participants expressed strong support for research into cognitive aspects of BDD. Perceived cognitive difficulties are widespread, distressing, and functionally impactful for individuals with BDD. These findings highlight the need for clinicians to actively assess cognitive difficulties, consider the possibility of co-occurring conditions such as ADHD, and incorporate this understanding into treatment planning to enhance engagement and therapeutic outcomes. Research Question(s) or Topic(s): How do adults with body dysmorphic disorder perceive their cognitive difficulties and what impacts do they report? Main Findings: Adults who reported a diagnosis of body dysmorphic disorder or severe dysmorphic concerns described frequent cognitive difficulties they believed were connected to their condition. Most reported effects on daily functioning and quality of life, yet many had not discussed these concerns with clinicians due to shame, uncertainty about their cause, or not recognising their significance. Study Contributions: This study offers the most detailed account to date of how people with body dysmorphic disorder understand and experience their cognitive difficulties. It identifies barriers to disclosure, emphasises the need for clinicians to enquire proactively about cognitive concerns, and calls for further research to clarify their role in the disorder. •Most individuals with BDD report cognitive difficulties related to their symptoms.•Self-reported cognitive difficulties impact daily tasks and life goals.•Many participants lack treatment access but want to engage in research.

Biological heterogeneity presents a formidable challenge in understanding psychiatric illness, yet it remains underexplored at scale or in a pan-disease setting. We characterized biochemical and brain heterogeneity in 445,374 individuals, considering 9 psychiatric disorders and 30 non-psychiatric medical conditions. Psychiatric and non-psychiatric illnesses were characterized by greater biological heterogeneity than predicted by healthy variation. Notably, heterogeneity in psychiatric disorders was comparable to non-psychiatric illnesses and often diverged from diagnostic classification. Circulating glucose and glycated hemoglobin levels were the most heterogeneous traits in 65% of diagnoses, suggesting that glucose dysregulation is pervasive yet variable across diseases. Diagnosis-specific patterns also surfaced—e.g., in schizophrenia, developmental brain markers ranked among the most heterogeneous traits. These characterizations of biochemical and brain heterogeneity lay the groundwork for biological focal points to aid precision psychiatry research. To support this effort, we provide an interactive online resource for exploring and downloading illness-specific heterogeneity measures. Biological heterogeneity is a challenge in understanding psychiatric disorders. Here, by studying psychiatric and other chronic illnesses in a large cohort, the authors find that blood and brain biomarkers show substantial diversity within the same diagnosis, suggesting that psychiatric disorders are not uniquely heterogeneous compared with other chronic conditions.

While previous studies have identified relationships between hippocampal volumes and memory performance in schizophrenia, these relationships are not apparent in healthy individuals. Further, few studies have examined the role of hippocampal subfields in illness-related memory deficits, and no study has examined potential differences across varying illness stages. The current study aimed to investigate whether individuals with early and established psychosis exhibited differential relationships between visuospatial associative memory and hippocampal subfield volumes. Measurements of visuospatial associative memory performance and grey matter volume were obtained from 52 individuals with a chronic schizophrenia-spectrum disorder, 28 youth with recent-onset psychosis, 52 older healthy controls, and 28 younger healthy controls. Both chronic and recent-onset patients had impaired visuospatial associative memory performance, however, only chronic patients showed hippocampal subfield volume loss. Both chronic and recent-onset patients demonstrated relationships between visuospatial associative memory performance and hippocampal subfield volumes in the CA4/dentate gyrus and the stratum that were not observed in older healthy controls. There were no group by volume interactions when chronic and recent-onset patients were compared. The current study extends the findings of previous studies by identifying particular hippocampal subfields, including the hippocampal stratum layers and the dentate gyrus, that appear to be related to visuospatial associative memory ability in individuals with both chronic and first-episode psychosis.

Background Bodily illusion research has demonstrated that altered bodily-self-perception in eating disorders (EDs) may be linked to abnormalities in the integration of sensory bodily signals. Experiencing bodily illusions can also temporarily reduce body image disturbance. Whether similar alterations in multisensory integration processes extend to self-face representation and whether face-based multisensory illusions can reduce face or body image disturbance remains unclear. This study investigated whether susceptibility to the enfacement illusion differs based on ED risk status and whether experiencing the illusion reduces face and body image disturbance. Methods The sample included 226 women classified as high ( n  = 102) or low ( n  = 124) ED risk, who underwent an enfacement illusion induction procedure involving synchronous (ilillusion-inducing) versus asynchronous (control) visuo-motor stimulation (via facial mimicry) between their own face and an unfamiliar person’s face. Illusion strength was assessed subjectively (via self-report) and objectively (via a self-face recognition task), alongside pre- and post-illusion face and body image outcomes. Results Synchronous interpersonal visuo-motor stimulation led to modest changes in self-face recognition (i.e., the other person's face came to be perceived as more similar to one's own); however, these changes were not modulated by ED risk status (high versus low). Cognitive-affective responses to the illusion diverged in unexpected ways. Low ED-risk participants reported reduced body dissatisfaction and dysmorphic concern following synchronous interpersonal visuo-motor stimulation, whilst high ED-risk participants reported increased head and body dissatisfaction following both synchronous and asynchronous stimulation. Conclusion These findings suggest that the multisensory processes underlying self-face representation, and ultimately supporting self-recognition and the integrity of self-other boundaries, may not be disrupted in individuals with elevated ED symptomatology. This observation may challenge the notion of a globally disrupted sense of bodily self in EDs, at least with respect to self-face processing. Instead, current results suggest that ED-related body image disturbance may reflect altered higher-order evaluative or affective processing of self-related social information rather than a fundamental deficit in multisensory integration. Plain English summary People with eating disorders (EDs) often experience a distorted sense of their own body. Researchers have used body illusions—like the \"rubber hand illusion\", where participants can experience a fake hand as their own—to explore how the brain combines sensory information to create a sense of \"this is my body\". Some of these illusions can even temporarily improve body image. The current study investigated how a face-based illusion—the “enfacement illusion,” which induces the feeling that another person’s facial features are blended with one’s own—affects how people at high versus low risk for EDs perceive themselves. Both groups experienced the illusion to a similar degree, suggesting that people at higher risk for EDs may not have deficits in basic brain processes that combine sensory signals to recognise their own face. However, cognitive and emotional responses to the illusion differed. After the illusion, low-ED-risk participants felt more satisfied with their physical appearance, whereas high-ED-risk participants felt more dissatisfied. These findings suggest that for people vulnerable to EDs, body image disturbances may not stem from the way that the brain perceives or integrates body-related sensory information. Instead, disturbances may arise from how these individuals interpret and evaluate such information, especially during social interactions involving another person.

Increased severity of neurological soft signs (NSS) in schizophrenia have been associated with abnormal brain morphology in cerebello-thalamo-cortical structures, but it is unclear whether similar structures underlie NSS prior to the onset of psychosis. The present study investigated the relationship between severity of NSS and grey matter volume (GMV) in individuals at ultra-high risk for psychosis (UHR) stratified for later conversion to psychosis. Structural T1-weighted MRI scans were obtained from 56 antipsychotic-naïve UHR individuals and 35 healthy controls (HC). The UHR individuals had follow-up data (mean follow-up: 5.2 years) to ascertain clinical outcome. Using whole-brain voxel-based morphometry, the relationship between NSS and GMV at baseline was assessed in UHR, HC, as well as individuals who later transitioned (UHR-P, n = 25) and did not transition (UHR-NP, n = 31) to psychosis. NSS total and subscale scores except motor coordination were significantly higher in UHR compared to HC. Higher signs were also found in UHR-P, but not UHR-NP. Total NSS was not associated with GMV in the whole sample or in each group. However, in UHR-P individuals, greater deficits in sensory integration was associated with lower GMV in the left cerebellum, right insula, and right middle frontal gyrus. In conclusion, NSS are present in UHR individuals, particularly those who later transitioned to a psychotic disorder. While these signs show little overall variation with GMV, the association of sensory integration deficits with lower GMV in UHR-P suggests that certain brain areas may be implicated in the development of specific neurological abnormalities in the psychosis prodrome.

[This corrects the article DOI: 10.1371/journal.pone.0094788.].[This corrects the article DOI: 10.1371/journal.pone.0094788.].

Considerable cognitive heterogeneity is present within the schizophrenia spectrum disorder (SSD) population. Several subgroups characterised by more homogenous cognitive profiles have been identified. It is not yet clear however, whether these subgroups represent different points along a continuum of cognitive symptom severity, or whether they reflect unique profiles of the disorder. One way to determine this is by comparing subgroups on their non-cognitive characteristics. The aim of the present review was to systematically summarise our current understanding of the non-cognitive features of the cognitive subgroups of schizophrenia spectrum disorder (SSD). Thirty-five relevant studies were identified from January 1980 to March 2020. Cognitive subgroups were consistently compared on age, sex, education, age of illness onset, illness duration, positive, negative and disorganised symptoms, depression and psychosocial functioning. It was revealed that subgroups were consistently distinguished by education, negative symptom severity and degree of functional impairment; with subgroups characterised by worse cognitive functioning performing/rated worse on these characteristics. The lack of consistent subgroup differences for the majority of the non-cognitive characteristics provides partial support for the notion that cognitive subgrouping in SSD is not simply reflecting a rehash of previously identified clinical subtypes. However, as subgroups were consistently distinguished by three characteristics known to be associated with cognition, our understanding of the extent to which the cognitive subgrouping approach is representing separate subtypes versus subdivisions along a continuum of symptom severity is still not definitive.