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Hippocampal volume increase in response to aerobic exercise has been consistently observed in animal models. However, the evidence from human studies is equivocal. We undertook a systematic review to identify all controlled trials examining the effect of aerobic exercise on the hippocampal volumes in humans, and applied meta-analytic techniques to determine if aerobic exercise resulted in volumetric increases. We also sought to establish how volume changes differed in relation to unilateral measures of left/right hippocampal volume, and across the lifespan. A systematic search identified 4398 articles, of which 14 were eligible for inclusion in the primary analysis. A random-effects meta-analysis showed no significant effect of aerobic exercise on total hippocampal volume across the 737 participants. However, aerobic exercise had significant positive effects on left hippocampal volume in comparison to control conditions. Post-hoc analyses indicated effects were driven through exercise preventing the volumetric decreases which occur over time. These results provide meta-analytic evidence for exercise-induced volumetric retention in the left hippocampus. Aerobic exercise interventions may be useful for preventing age-related hippocampal deterioration and maintaining neuronal health.

Nutrition interventions would appear fundamental for weight management and cardiometabolic risk reduction in people experiencing severe mental illness (SMI). Comprehensive evaluation of nutrition interventions is lacking. To subject randomised controlled trials of nutrition interventions in people with SMI to systematic review and meta-analysis, and to measure anthropometric and biochemical parameters and nutritional intake. An electronic database search identified trials with nutrition intervention components. Trials were pooled for meta-analysis. Meta-regression analyses were performed on anthropometric moderators. Interventions led to significant weight loss (19 studies), reduced body mass index (17 studies), decreased waist circumference (10 studies) and lower blood glucose levels (5 studies). Dietitian-led interventions (6 studies) and studies delivered at antipsychotic initiation (4 studies) had larger effect sizes. Evidence supports nutrition interventions as standard care in preventing and treating weight gain among people experiencing SMI.

Background The novel coronavirus pandemic calls for a rapid adaptation of conventional medical practices to meet the evolving needs of such vulnerable patients. People with coronavirus disease (COVID-19) may frequently require treatment with psychotropic medications, but are at the same time at higher risk for safety issues because of the complex underlying medical condition and the potential interaction with medical treatments. Methods In order to produce evidence-based practical recommendations on the optimal management of psychotropic medications in people with COVID-19, an international, multi-disciplinary working group was established. The methodology of the WHO Rapid Advice Guidelines in the context of a public health emergency and the principles of the AGREE statement were followed. Available evidence informing on the risk of respiratory, cardiovascular, infective, hemostatic, and consciousness alterations related to the use of psychotropic medications, and drug–drug interactions between psychotropic and medical treatments used in people with COVID-19, was reviewed and discussed by the working group. Results All classes of psychotropic medications showed potentially relevant safety risks for people with COVID-19. A set of practical recommendations was drawn in order to inform frontline clinicians on the assessment of the anticipated risk of psychotropic-related unfavorable events, and the possible actions to take in order to effectively manage this risk, such as when it is appropriate to avoid, withdraw, switch, or adjust the dose of the medication. Conclusions The present evidence-based recommendations will improve the quality of psychiatric care in people with COVID-19, allowing an appropriate management of the medical condition without worsening the psychiatric condition and vice versa.

The American Medical Society for Sports Medicine (AMSSM) Position Statement on sexual violence (SV) in sports has identified SV as a serious public health and societal issue that has long-standing negative impacts on athletes' physical and mental wellbeing. The position statement highlighted the important role healthcare providers can play in identifying and responding to the health impacts of sexual violence. A 2021 'patient voices article' challenges clinicians in the sports and exercise medicine (SEM) community to do better when asking about and responding to athlete disclosures of SV. This is significant for SEM professionals working with athletes of all levels, as well as treating the general population engaging in exercise for health and rehabilitation. SV often co-occurs with violence perpetrated by an intimate partner. Gender-based violence (GBV) is a broad term that includes sexual and intimate partner violence.

The onset of schizophrenia is typically preceded by a prodromal period lasting several years during which sub-threshold symptoms may be identified retrospectively. Clinical interviews are currently used to identify individuals who have an ultra-high risk (UHR) of developing a psychotic illness with a view to provision of interventions that prevent, delay or reduce severity of future mental health issues. The utility of bio-markers as an adjunct in the identification of UHR individuals is not yet established. Several event-related potential measures, especially mismatch-negativity (MMN), have been identified as potential biomarkers for schizophrenia. In this 12-month longitudinal study, demographic, clinical and neuropsychological data were acquired from 102 anti-psychotic naive UHR and 61 healthy controls, of whom 80 UHR and 58 controls provided valid EEG data during a passive auditory task at baseline. Despite widespread differences between UHR and controls on demographic, clinical and neuropsychological measures, MMN and P3a did not differ between these groups. Of 67 UHR at the 12-month follow-up, 7 (10%) had transitioned to a psychotic illness. The statistical power to detect differences between those who did or did not transition was limited by the lower than expected transition rate. ERPs did not predict transition, with trends in the opposite direction to that predicted. In exploratory analysis, the strongest predictors of transition were measures of verbal memory and subjective emotional disturbance.

[This corrects the article DOI: 10.1371/journal.pone.0301583.].

Accurate assessment of physical activity is essential to determine the magnitude of the health-related benefits of regular physical activity. While physical activity questionnaires are easy to use, their accuracy in comparison to objective measures has been questioned. The purpose of the present study was to examine the utility of two interview-based questionnaires; a recently-developed instrument, the Simple Physical Activity Questionnaire (SIMPAQ), and the Seven Day-Physical Activity Recall (7DPAR). Accelerometer data was collected in 72 university students (50% females). Telephone interviews were conducted to complete the SIMPAQ and the 7DPAR. Significant correlations (p < .001) were found between accelerometer-based moderate-to-vigorous physical activity (MVPA), the amount of self-reported moderate-to-vigorous exercise assessed via the SIMPAQ (rho = .49), and vigorous physical activity assessed via the 7DPAR (rho = .50). Exercise assessed via the SIMPAQ was significantly correlated with the vigorous physical activity score of the 7DPAR (rho = .56, p < .001). While participants needed three minutes less to complete the SIMPAQ (p < .001), participants tended to be more confident about the accuracy of the answers they provided on the 7DPAR (p < .01). These two questionnaire measures of physical activity performed similarly in a healthy young adult sample. The SIMPAQ can be completed in 15 minutes, which could be an advantage in settings where time for physical activity assessment is limited.

Freezing of gait is a devastating symptom of Parkinson's disease (PD) that is exacerbated by the processing of cognitive information whilst walking. To date, no studies have explored the neural correlates associated with increases in cognitive load whilst performing a motor task in patients with freezing. In this experiment, 14 PD patients with and 15 PD patients without freezing of gait underwent 3T fMRI while performing a virtual reality gait task. Directions to walk and stop were presented on the viewing screen as either direct cues or as more cognitively indirect pre-learned cues. Both groups showed a consistent pattern of BOLD response within the Cognitive Control Network during performance of the paradigm. However, a between group comparison revealed that those PD patients with freezing of gait were less able to recruit the bilateral anterior insula, ventral striatum and the pre-supplementary motor area, as well as the left subthalamic nucleus when responding to indirect cognitive cues whilst maintaining a motor output. These results suggest that PD patients with freezing of gait are unable to properly recruit specific cortical and subcortical regions within the Cognitive Control Network during the performance of simultaneous motor and cognitive functions.

Background Schools could play a vital role in mental health care, particularly in low-income countries such as Uganda. An understanding of the prevalence and associated factors of mental health symptoms among school-going adolescents is essential for designing effective school-based interventions in Uganda This is important given Uganda’s regional disparities, where adolescents in post-conflict areas may face higher exposure to trauma and limited access to mental health care compared to those in non-conflict regions. This study aimed to investigate the prevalence rates of depressive and anxiety symptoms among school-going adolescents aged 14 to 17 years in both post-conflict and non-conflict settings. It also examines factors associated with moderate depressive and anxiety symptoms in both settings. Methods In total, 2845 school-going adolescents (1,273 boys; 16.3 ± 1.0 years) were screened using the Patient Health Questionnaire-9 – adolescent version, Generalized Anxiety Disorder-7, and self-report items on food insecurity, health and wealth status, history of childhood abuse and neglect and level of physical activity. Logistic regression models were applied to examine predictors of moderate to severe levels of depression and anxiety symptoms. Results Findings indicate that 67.5% ( n  = 1905) reported at least mild, 34.1% ( n  = 962) at least moderate, 12.7% ( n  = 359) at least moderate-severe and 4.9% ( n  = 138) severe symptoms of depression, while 65.6% ( n  = 1860) at least mild, 27.5% ( n  = 777) at least moderate and 7.8% ( n  = 219) severe symptoms of anxiety. In the multivariable analyses, female sex, food insecurity, poor self-reported health, co-morbid anxiety symptoms, and a history of abuse and neglect were all significantly associated with a higher odds of moderate symptoms of depression, while female sex, living in a post-conflict setting, food insecurity, poor self-reported health, co-morbid depressive symptoms, and a history of abuse were all significantly associated with a higher odds of moderate anxiety symptoms. Conclusions A substantial proportion of school-going adolescents in Uganda report at least moderate symptoms of depression and anxiety. Government and public sector agencies should re-evaluate their strategies at both family and school levels, particularly in underserved settings. Schools can serve as platforms for screening-and-referral pathways and group-based psychosocial programs, while the health system should strengthen capacity for co-occurring conditions.

People with mental illness tend to present low levels of physical activity and high levels of sedentary behavior. The study aims to compare these levels in mental illness patients, exploring the role of socioeconomic development and treatment setting. This cross-sectional study used accelerometers and the Simple Physical Activity Questionnaire (SIMPAQ) to assess physical activity and sedentary behavior in mental illness individuals living in 23 countries. Two-way ANOVAs were used to evaluate the interaction between socioeconomic development and the treatment settings on physical activity and sedentary behavior. A total of 884 (men = 55.3%) participants, mean age of 39.3 (SD = 12.8), were evaluated. A significant interaction between socioeconomic development and treatment settings was found in sedentary behavior (F = 5.525; p = 0.019; η2p = 0.009; small effect size). Main effects were observed on socioeconomic development (F = 43.004; p < 0.001; η2p = 0.066; medium effect size) and treatment setting (F = 23.001; p < 0.001; η2p = 0.036; small effect size) for sedentary behavior and physical activity: socioeconomic development (F = 20.888; p < 0.001; η2p = 0.033; small effect size) and treatment setting (F = 30.358; p < 0.001; η2p = 0.047; small effect size), showing that HIC patients were more active, while MIC patients were more sedentary. Moreover, despite of inpatients had presented higher levels of physical activity than outpatients, they also spent more time sitting. Socioeconomic development plays an important role in sedentary behavior in patients with mental disorders, warning the need to develop new strategies to reduce these levels in this population.