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1. Correlates of suicidal thoughts and attempts in males engaging in muscle dysmorphia or eating disorder symptoms

   https://doi.org/10.1002/jclp.23102  

   Ortiz, Shelby N. ; Forrest, Lauren N. ; Smith, April R. ( December 2020 , Journal of Clinical Psychology)

   Despite the high rates of suicidality in body dysmorphic disorder and eating disorders (EDs), research on suicidality in a related disorder, muscle dysmorphia (MD), is essentially nonexistent. Thus, this study tested relations between suicidal thoughts and behaviors and MD and ED symptoms in an online male community sample.

   A total of 464 males (M_age = 40.3; 85% Caucasian) recruited from Amazon's Mechanical Turk completed measures that evaluated ED symptoms, MD symptoms, current suicidal ideation, and past suicide attempts.

   Most MD and ED symptoms were correlated with current suicidal ideation and previous suicide attempts. In multivariate regression models, vomiting and appearance intolerance remained significantly related to suicidal ideation, while hard exercise and lower functional impairment were significantly related to prior suicide attempts.

   Results indicate that appearance dissatisfaction, a core MD criterion, and hard exercise, a common behavioral symptom of MD, are associated with suicidality.

    

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2. Restrictive eating, but not binge eating or purging, predicts suicidal ideation in adolescents and young adults with low‐weight eating disorders

   https://doi.org/10.1002/eat.23210  

   Wang, Shirley B. ; Mancuso, Christopher J. ; Jo, Jenny ; Keshishian, Ani C. ; Becker, Kendra R. ; Plessow, Franziska ; Izquierdo, Alyssa M. ; Slattery, Meghan ; Franko, Debra L. ; Misra, Madhusmita ; et al ( December 2019 , International Journal of Eating Disorders)

   This study examined the relationship between eating‐disorder behaviors—including restrictive eating, binge eating, and purging—and suicidal ideation. We hypothesized that restrictive eating would significantly predict suicidal ideation, beyond the effects of binge eating/purging.

   Participants were 82 adolescents and young adults with low‐weight eating disorders. We conducted a hierarchical logistic regression, with binge eating and purging in Step 1 and restrictive eating in Step 2, to predict suicidal ideation.

   Step 1 was significant (p= .01) and explained 20% variance in suicidal ideation; neither binge eating nor purging significantly predicted suicidal ideation. Adding restrictive eating in Step 2 significantly improved the model (ΔR²= .07,p= .009). This final model explained 27% of the variance, and restrictive eating (but not binge eating/purging) significantly predicted suicidal ideation (p= .02).

   Restrictive eating is associated with suicidal ideation in youth with low‐weight eating disorders, beyond the effects of other eating‐disorder behaviors. Although healthcare providers may be more likely to screen for suicidality in patients with binge eating and purging, our findings indicate clinicians should regularly assess suicide and self‐injury in patients with restrictive eating. Future research examining how individuals progress from suicidal ideation to suicidal attempts can further enhance our understanding of suicide in eating disorders.

    

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3. Presence and severity of suicidal thoughts and behaviors across the eating disorder diagnostic spectrum: A pilot study

   https://doi.org/10.1002/jclp.23095  

   Duffy, Mary E. ; Siegfried, Nicole ; Bass, Garrett ; Joiner, Thomas E. ( December 2020 , Journal of Clinical Psychology)

   There is a dearth of research on suicidal thoughts and behaviors among eating disorder patients diagnosed with binge eating disorder (BED) or other specified feeding or eating disorder (OSFED). This pilot study evaluated presence and severity of suicidal thoughts and behaviors by eating disorder diagnosis in a transdiagnostic clinical eating disorder sample.

   Participants were individuals (N = 257; 91.1% female; 94.6% Caucasian) currently receiving eating disorder treatment for anorexia nervosa (AN), bulimia nervosa (BN), BED, or OSFED. Participants completed online measures of variables.

   Lifetime and current presence and severity of suicidal ideation and suicide attempts were statistically similar among diagnostic groups.

   Though largely overlooked, treatment‐utilizing individuals with BED and OSFED may experience elevated rates and severity of suicidal thoughts and behaviors, like those with AN and BN. Attention to suicide‐related risk assessment and management is needed when treating individuals with eating disorders, regardless of diagnosis.

    

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4. Evidence for machine learning guided early prediction of acute outcomes in the treatment of depressed children and adolescents with antidepressants

   https://doi.org/10.1111/jcpp.13580  

   Athreya, Arjun P. ; Vande Voort, Jennifer L. ; Shekunov, Julia ; Rackley, Sandra J. ; Leffler, Jarrod M. ; McKean, Alastair J. ; Romanowicz, Magdalena ; Kennard, Betsy D. ; Emslie, Graham J. ; Mayes, Taryn ; et al ( March 2022 , Journal of Child Psychology and Psychiatry)

   The treatment of depression in children and adolescents is a substantial public health challenge. This study examined artificial intelligence tools for the prediction of early outcomes in depressed children and adolescents treated with fluoxetine, duloxetine, or placebo.

   The study samples included training datasets (N = 271) from patients with major depressive disorder (MDD) treated with fluoxetine and testing datasets from patients with MDD treated with duloxetine (N = 255) or placebo (N = 265). Treatment trajectories were generated using probabilistic graphical models (PGMs). Unsupervised machine learning identified specific depressive symptom profiles and related thresholds of improvement during acute treatment.

   Variation in six depressive symptoms (difficulty having fun, social withdrawal, excessive fatigue, irritability, low self‐esteem, and depressed feelings) assessed with the Children’s Depression Rating Scale‐Revised at 4–6 weeks predicted treatment outcomes with fluoxetine at 10–12 weeks with an average accuracy of 73% in the training dataset. The same six symptoms predicted 10–12 week outcomes at 4–6 weeks in (a) duloxetine testing datasets with an average accuracy of 76% and (b) placebo‐treated patients with accuracies of 67%. In placebo‐treated patients, the accuracies of predicting response and remission were similar to antidepressants. Accuracies for predicting nonresponse to placebo treatment were significantly lower than antidepressants.

   PGMs provided clinically meaningful predictions in samples of depressed children and adolescents treated with fluoxetine or duloxetine. Future work should augment PGMs with biological data for refined predictions to guide the selection of pharmacological and psychotherapeutic treatment in children and adolescents with depression.

    

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5. Psychotic Symptom, Mood, and Cognition-associated Multimodal MRI Reveal Shared Links to the Salience Network Within the Psychosis Spectrum Disorders

   https://doi.org/10.1093/schbul/sbac158  

   Liang, Chuang ; Pearlson, Godfrey ; Bustillo, Juan ; Kochunov, Peter ; Turner, Jessica A. ; Wen, Xuyun ; Jiang, Rongtao ; Fu, Zening ; Zhang, Xiao ; Li, Kaicheng ; et al ( October 2022 , Schizophrenia Bulletin)

   Schizophrenia (SZ), schizoaffective disorder (SAD), and psychotic bipolar disorder share substantial overlap in clinical phenotypes, associated brain abnormalities and risk genes, making reliable diagnosis among the three illness challenging, especially in the absence of distinguishing biomarkers. This investigation aims to identify multimodal brain networks related to psychotic symptom, mood, and cognition through reference-guided fusion to discriminate among SZ, SAD, and BP.

   Psychotic symptom, mood, and cognition were used as references to supervise functional and structural magnetic resonance imaging (MRI) fusion to identify multimodal brain networks for SZ, SAD, and BP individually. These features were then used to assess the ability in discriminating among SZ, SAD, and BP. We observed shared links to functional and structural covariation in prefrontal, medial temporal, anterior cingulate, and insular cortices among SZ, SAD, and BP, although they were linked with different clinical domains. The salience (SAN), default mode (DMN), and fronto-limbic (FLN) networks were the three identified multimodal MRI features within the psychosis spectrum disorders from psychotic symptom, mood, and cognition associations. In addition, using these networks, we can classify patients and controls and distinguish among SZ, SAD, and BP, including their first-degree relatives. The identified multimodal SAN may be informative regarding neural mechanisms of comorbidity for psychosis spectrum disorders, along with DMN and FLN may serve as potential biomarkers in discriminating among SZ, SAD, and BP, which may help investigators better understand the underlying mechanisms of psychotic comorbidity from three different disorders via a multimodal neuroimaging perspective.

    

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