Psychological interventions for interoception in mental health disorders: A systematic review of randomized-controlled trials

Disturbed interoception (i.e., the sensing, awareness, and regulation of internal body signals) has been found across several mental disorders, leading to the development of interoception-based interventions (IBIs). Searching PubMed and PsycINFO, we conducted the first systematic review of randomised-controlled trials (RCTs) investigating the efficacy of behavioural IBIs at improving interoception and target symptoms of mental disorders in comparison to a non-interoception-based control condition [CRD42021297993]. Thirty-one RCTs fulfilled inclusion criteria. Across all studies, a pattern emerged with 20 (64.5%) RCTs demonstrating IBIs to be more efficacious at improving interoception compared to control conditions. The most promising results were found for post-traumatic stress disorder, irritable bowel syndrome, fibromyalgia and substance use disorders. Regarding symptom improvement, the evidence was inconclusive. The IBIs were heterogenous in their approach to improving interoception. The quality of RCTs was moderate to good. In conclusion, IBIs are potentially efficacious at improving interoception for some mental disorders. In terms of symptom reduction, the evidence is less promising. Future research on the efficacy of IBIs is needed. This article is protected by copyright. All rights reserved

Machine learning models for diagnosis and risk prediction in eating disorders, depression, and alcohol use disorder

This study uses machine learning models to uncover diagnostic and risk prediction markers for eating disorders (EDs), major depressive disorder (MDD), and alcohol use disorder (AUD). Utilizing case-control samples (ages 18-25 years) and a longitudinal population-based sample (n=1,851), the models, incorporating diverse data domains, achieved high accuracy in classifying EDs, MDD, and AUD from healthy controls. The area under the receiver operating characteristic curves (AUC-ROC [95% CI]) reached 0.92 [0.86-0.97] for AN and 0.91 [0.85-0.96] for BN, without relying on body mass index as a predictor. The classification accuracies for MDD (0.91 [0.88-0.94]) and AUD (0.80 [0.74-0.85]) were also high. Each data domain emerged as accurate classifiers individually, with personality distinguishing AN, BN, and their controls with AUC-ROCs ranging from 0.77 to 0.89. The models demonstrated high transdiagnostic potential, as those trained for EDs were also accurate in classifying AUD and MDD from healthy controls, and vice versa (AUC-ROCs, 0.75-0.93). Shared predictors, such as neuroticism, hopelessness, and symptoms of attention-deficit/hyperactivity disorder, were identified as reliable classifiers. For risk prediction in the longitudinal population sample, the models exhibited moderate performance (AUC-ROCs, 0.64-0.71), highlighting the potential of combining multi-domain data for precise diagnostic and risk prediction applications in psychiatry.</p

Psychological interventions for interoception in mental health disorders: A systematic review of randomised-controlled trials

Disturbed interoception (i.e., the sensing, awareness, and regulation of internal body signals) has been found across several mental disorders, leading to the development of interoception-based interventions (IBIs). Searching PubMed and PsycINFO, we conducted the first systematic review of randomised-controlled trials (RCTs) investigating the efficacy of behavioural IBIs at improving interoception and target symptoms of mental disorders in comparison to a non-interoception-based control condition [CRD42021297993]. Thirty-one RCTs fulfilled inclusion criteria. Across all studies, a pattern emerged with 20 (64.5%) RCTs demonstrating IBIs to be more efficacious at improving interoception compared to control conditions. The most promising results were found for post-traumatic stress disorder, irritable bowel syndrome, fibromyalgia and substance use disorders. Regarding symptom improvement, the evidence was inconclusive. The IBIs were heterogenous in their approach to improving interoception. The quality of RCTs was moderate to good. In conclusion, IBIs are potentially efficacious at improving interoception for some mental disorders. In terms of symptom reduction, the evidence is less promising. Future research on the efficacy of IBIs is needed

Differing impact of the COVID-19 pandemic on youth’s mental health:: combined population and clinical study

Background: Identifying youths most at risk to COVID19-related mental illness will be essential to develop effective targeted interventions.Aims: To compare trajectories of mental health throughout the pandemic, in youths with and without prior mental illness, and identify youths most at risk to COVID-19-related mental illness.Methods: Data was collected from youths aged 18-26 years (N=669) from two existing cohorts: IMAGEN, a population-based cohort, and ESTRA/STRATIFY, clinical cohorts with pre-existing diagnoses of mental disorders. Repeated COVID-19 surveys and standardized mental health assessments were used to compare trajectories of mental health symptoms from prior to the pandemic through to the second lockdown.Results: Mental health trajectories differed significantly between cohorts. In the population cohort, depression and ED symptoms increased by 33.9% [95% CI, 31.78-36.57] and 15.6%, [95% CI, 15.39-15.68] during the pandemic, respectively. In contrast, these remained high over time in the clinical cohort. Conversely, trajectories of alcohol abuse were similar in both cohorts, decreasing continuously (15.2% decrease) during the pandemic. Pre-pandemic symptoms severity predicted the observed mental health trajectories in the population cohort. Surprisingly, being relatively healthy predicted the increases in depression and ED symptoms, and BMI. In contrast, youths initially at higher risks for depression or ED reported a lasting decrease.Conclusions: Healthier youths may be at greater risk of developing depressive or ED symptoms during the COVID-19 pandemic. Targeted mental health interventions considering prior diagnostic risk may be warranted to help youths cope with the challenges of psychosocial stress and reduce the associated health care burden.<br/

Association of Genetic and Phenotypic Assessments With Onset of Disordered Eating Behaviors and Comorbid Mental Health Problems Among Adolescents

International audienceImportance Eating disorders are serious mental disorders with increasing prevalence. Without early identification and treatment, eating disorders may run a long-term course.Objective To characterize any associations among disordered eating behaviors (DEBs) and other mental health disorders and to identify early associations with the development of symptoms over time.Design, Setting, and Participants This multicenter, population-based, longitudinal cohort study used data from baseline (collected in 2010), follow-up 1 (collected in 2012), and follow-up 2 (collected in 2015) of the IMAGEN Study, which included adolescents recruited from 8 European sites. The present study assessed data from 1623 healthy adolescents, aged 14 years at baseline, recruited from high schools. Data analyses were performed from January 2018 to September 2019.Main Outcomes and Measures Body mass index (BMI), mental health symptoms, substance use behaviors, and personality variables were investigated as time-varying associations of DEBs (dieting, binge eating, and purging) or change in BMI over time. Polygenic risk scores were calculated to investigate genetic contributions associated with BMI, attention-deficit/hyperactivity disorder (ADHD) and neuroticism to DEBs.Results In this cohort study of 1623 adolescents (829 girls [51.1%]) recruited at a mean (SD) age of 14.5 (0.4) years and followed up at ages 16 and 19 years, 278 adolescents (17.1%) reported binge eating, 334 adolescents (20.6%) reported purging, and 356 adolescents (21.9%) reported dieting at 14, 16, or 19 years. Among the precursors of DEBs, high BMI was associated with future dieting (OR, 3.44; 95% CI, 2.09-5.65). High levels of neuroticism (OR, 1.04; 95% CI, 1.01-1.06), conduct problems (OR, 1.41; 95% CI, 1.17-1.69), and deliberate self-harm (OR, 2.18; 95% CI, 1.37-3.45) were associated with future binge eating. Low agreeableness (OR, 0.95; 95% CI, 0.92-0.97), deliberate self-harm (OR, 2.59; 95% CI, 1.69-3.95), conduct problems (OR, 1.42; 95% CI, 1.20-1.68), alcohol misuse (OR, 1.31; 95% CI, 1.10-1.54), and drug abuse (OR, 2.91; 95% CI, 1.78-4.74) were associated with future purging. Polygenetic risk scores for BMI were associated with dieting (at 14 years: OR, 1.27; lower bound 95% CI, 1.08; at 16 years: OR, 1.38; lower bound 95% CI, 1.17); ADHD, with purging (at 16 years: OR, 1.25; lower bound 95% CI, 1.08; at 19 years, OR, 1.23; lower bound 95% CI, 1.06); and neuroticism, with binge eating (at 14 years: OR, 1.32; lower bound 95% CI, 1.11; at 16 years: OR, 1.24; lower bound 95% CI, 1.06), highlighting distinct etiologic overlaps between these traits. The DEBs predated other mental health problems, with dieting at 14 years associated with future symptoms of depression (OR, 2.53; 95% CI, 1.56-4.10), generalized anxiety (OR, 2.27; 95% CI, 1.14-4.51), deliberate self-harm (OR, 2.10; 95% CI, 1.51-4.24), emotional problems (OR, 1.24; 95% CI, 1.08-1.43), and smoking (OR, 2.16; 95% CI, 1.36-3.48). Purging at 14 years was also associated with future depression (OR, 2.87; 95% CI, 1.69-5.01) and anxiety (OR, 2.48; 95% CI, 1.49-4.12) symptoms.Conclusions and Relevance The findings of this study delineate temporal associations and shared etiologies among DEBs and other mental health disorders and emphasize the potential of genetic and phenotypical assessments of obesity, behavioral disorders, and neuroticism to improve early and differential diagnosis of eating disorders

Differing impact of the COVID-19 pandemic on youth mental health:combined population and clinical study

International audienceBackground Identifying youths most at risk to COVID-19-related mental illness is essential for the development of effective targeted interventions. Aims To compare trajectories of mental health throughout the pandemic in youth with and without prior mental illness and identify those most at risk of COVID-19-related mental illness. Method Data were collected from individuals aged 18–26 years ( N = 669) from two existing cohorts: IMAGEN, a population-based cohort; and ESTRA/STRATIFY, clinical cohorts of individuals with pre-existing diagnoses of mental disorders. Repeated COVID-19 surveys and standardised mental health assessments were used to compare trajectories of mental health symptoms from before the pandemic through to the second lockdown. Results Mental health trajectories differed significantly between cohorts. In the population cohort, depression and eating disorder symptoms increased by 33.9% (95% CI 31.78–36.57) and 15.6% (95% CI 15.39–15.68) during the pandemic, respectively. By contrast, these remained high over time in the clinical cohort. Conversely, trajectories of alcohol misuse were similar in both cohorts, decreasing continuously (a 15.2% decrease) during the pandemic. Pre-pandemic symptom severity predicted the observed mental health trajectories in the population cohort. Surprisingly, being relatively healthy predicted increases in depression and eating disorder symptoms and in body mass index. By contrast, those initially at higher risk for depression or eating disorders reported a lasting decrease. Conclusions Healthier young people may be at greater risk of developing depressive or eating disorder symptoms during the COVID-19 pandemic. Targeted mental health interventions considering prior diagnostic risk may be warranted to help young people cope with the challenges of psychosocial stress and reduce the associated healthcare burden

A shared neural basis underlying psychiatric comorbidity

Funder: National Key R and D Program of China(2019YFA0709501,2018YFC1312900) The Shanghai Pujiang Project(18PJ1400900)Funder: Medical Research Foundation and Medical Research Council (grants MR/R00465X/1 and MR/S020306/1); NIH Consortium grant U54 EB020403; the cross-NIH alliance that funds Big Data to Knowledge Centres of Excellence (ENIGMA, Grant Nos. 5U54EB020403-05 and 1R56AG058854-01Funder: the Eranet Neuron (AF12-NEUR0008-01 – WM2NA; and ANR-18-NEUR00002-01 – ADORe);Paris Sud University IDEX 2012;Fédération pour la Recherche sur le Cerveau;Funder: Assistance Publique - Hôpitaux de Paris (Assistance Publique Hôpitaux de Paris); doi: https://doi.org/10.13039/501100002738Funder: Fondation de l'Avenir pour la Recherche Médicale Appliquée (Fondation de l'Avenir); doi: https://doi.org/10.13039/100007380Funder: the ANR (ANR-12-SAMA-0004); INSERM (interface grant)Funder: DH | National Institute for Health Research (NIHR); doi: https://doi.org/10.13039/501100000272Funder: South London and Maudsley NHS Foundation Trust; doi: https://doi.org/10.13039/100009362Funder: the European Union-funded FP6 Integrated Project IMAGEN (Reinforcement-related behavior in normal brain function and psychopathology) (LSHM-CT- 2007-037286);the Horizon 2020-funded ERC Advanced Grant' STRATIFY' (Brain network based stratification of reinforcement-related disorders) (695313);ERANID (Understanding the Interplay between Cultural, Biological and Subjective Factors in Drug Use Pathways) (PR-ST-0416-10004);Human Brain Project (HBP SGA 2, 785907, and HBP SGA 3, 945539);the Medical Research Council Grant' c-VEDA' (Consortium on Vulnerability to Externalising Disorders and Addictions) (MR/N000390/1) ;Forschungsnetz AERIAL 01EE1406A, 01EE1406B)Funder: Guangdong Key Research and Development Project(No. 2018B030335001);the 111 Project (B18015);the key project of Shanghai Science and Technology (16JC1420402);Recent studies proposed a general psychopathology factor underlying common comorbidities among psychiatric disorders. However, its neurobiological mechanisms and generalizability remain elusive. In this study, we used a large longitudinal neuroimaging cohort from adolescence to young adulthood (IMAGEN) to define a neuropsychopathological (NP) factor across externalizing and internalizing symptoms using multitask connectomes. We demonstrate that this NP factor might represent a unified, genetically determined, delayed development of the prefrontal cortex that further leads to poor executive function. We also show this NP factor to be reproducible in multiple developmental periods, from preadolescence to early adulthood, and generalizable to the resting-state connectome and clinical samples (the ADHD-200 Sample and the STRATIFY & ESTRA Project). In conclusion, we identify a reproducible and general neural basis underlying symptoms of multiple mental health disorders, bridging multidimensional evidence from behavioral, neuroimaging and genetic substrates. These findings may help to develop new therapeutic interventions for psychiatric comorbidities

Author Correction: A shared neural basis underlying psychiatric comorbidity.

Funder: National Key R and D Program of China(2019YFA0709501,2018YFC1312900) The Shanghai Pujiang Project(18PJ1400900)Funder: Medical Research Foundation and Medical Research Council (grants MR/R00465X/1 and MR/S020306/1); NIH Consortium grant U54 EB020403; the cross-NIH alliance thatfunds Big Data to Knowledge Centres of Excellence (ENIGMA, GrantNos. 5U54EB020403-05 and 1R56AG058854-01Funder: the Eranet Neuron (AF12-NEUR0008-01 – WM2NA ; and ANR-18-NEUR00002-01 – ADORe);Paris Sud University IDEX 2012;Fédération pour la Recherche sur le Cerveau;Funder: Assistance Publique - Hôpitaux de Paris (Assistance Publique Hôpitaux de Paris); doi: https://doi.org/10.13039/501100002738Funder: Fondation de l&apos;Avenir pour la Recherche Médicale Appliquée (Fondation de l&apos;Avenir); doi: https://doi.org/10.13039/100007380Funder: the ANR (ANR-12-SAMA-0004）；INSERM (interface grant)Funder: DH | National Institute for Health Research (NIHR); doi: https://doi.org/10.13039/501100000272Funder: South London and Maudsley NHS Foundation Trust; doi: https://doi.org/10.13039/100009362Funder: the European Union-funded FP6 Integrated Project IMAGEN (Reinforcement-related behavior in normal brain function and psychopathology) (LSHM-CT- 2007-037286);the Horizon 2020-funded ERC Advanced Grant&apos; STRATIFY&apos; (Brain network based stratification of reinforcement-related disorders) (695313);ERANID (Understanding the Interplay between Cultural, Biological and Subjective Factors in Drug Use Pathways) (PR-ST-0416-10004);Human Brain Project (HBP SGA 2, 785907, and HBP SGA 3, 945539);the Medical Research Council Grant&apos; c-VEDA&apos; (Consortium on Vulnerability to Externalising Disorders and Addictions) (MR/N000390/1) ;Forschungsnetz AERIAL 01EE1406A, 01EE1406B)Funder: Guangdong Key Research and Development Project(No. 2018B030335001);the 111 Project (B18015);the key project of Shanghai Science and Technology (16JC1420402)

Author Correction: A shared neural basis underlying psychiatric comorbidity

Correction to: Nature Medicine. Published online 24 April 2023. In the version of this article initially published, the STRATIFY data also included cohort data from the ESTRA consortium, though this was not acknowledged in the author list and the section in Methods on the Stratify dataset. The Methods are now updated, and the author list is amended to combine the STRATIFY and ESTRA consortium names and to include the following authors: Marina Bobou, M. John Broulidakis, Betteke Maria van Noort, Zuo Zhang, Lauren Robinson, Nilakshi Vaidya, Jeanne Winterer, Yuning Zhang, Sinead King, Hervé Lemaître, Ulrike Schmidt, Julia Sinclair, Argyris Stringaris and Sylvane Desrivières. The STRATIFY and ESTRA consortia are now combined to list Marina Bobou, M. John Broulidakis, Betteke Maria van Noort, Zuo Zhang, Lauren Robinson, Nilakshi Vaidya, Jeanne Winterer, Yuning Zhang, Sinead King, Gareth J. Barker, Arun L. W. Bokde, Hervé Lemaître, Frauke Nees, Dimitri Papadopoulos Orfanos, Ulrike Schmidt, Julia Sinclair, Argyris Stringaris, Henrik Walter, Robert Whelan, Sylvane Desrivières and Gunter Schumann as members, and the IMAGEN consortium is updated to also include Sylvane Desrivières. Affiliations, author contributions and acknowledgements have been updated to reflect the new authorship, and all changes have been made in the HTML and PDF versions of the article