Scientific interest in the therapeutic effects of classical psychedelics has increased in the past two decades. The psychological effects of these substances outside the period of acute intoxication have not been fully characterized. This study aimed to: (1) quantify the effects of psilocybin, ayahuasca, and lysergic acid diethylamide (LSD) on psychological outcomes in the post-acute period; (2) test moderators of these effects; and (3) evaluate adverse effects and risk of bias.

We conducted a systematic review and meta-analysis of experimental studies (single-group pre-post or randomized controlled trials) that involved administration of psilocybin, ayahuasca, or LSD to clinical or non-clinical samples and assessed psychological outcomes ⩾24 h post-administration. Effects were summarized by study design, timepoint, and outcome domain.

A total of 34 studies (24 unique samples, n = 549, mean longest follow-up = 55.34 weeks) were included. Classical psychedelics showed significant within-group pre-post and between-group placebo-controlled effects on a range of outcomes including targeted symptoms within psychiatric samples, negative and positive affect-related measures, social outcomes, and existential/spiritual outcomes, with large between-group effect in these domains (Hedges' gs = 0.84 to 1.08). Moderator tests suggest some effects may be larger in clinical samples. Evidence of effects on big five personality traits and mindfulness was weak. There was no evidence of post-acute adverse effects.

High risk of bias in several domains, heterogeneity across studies, and indications of publication bias for some models highlight the need for careful, large-scale, placebo-controlled randomized trials.

Investigation of treatments that effectively treat adults with post-traumatic stress disorder from childhood experiences (Ch-PTSD) and are well tolerated by patients is needed to improve outcomes for this population.

The purpose of this study was to compare the effectiveness of two trauma-focused treatments, imagery rescripting (ImRs) and eye movement desensitisation and reprocessing (EMDR), for treating Ch-PTSD.

We conducted an international, multicentre, randomised clinical trial, recruiting adults with Ch-PTSD from childhood trauma before 16 years of age. Participants were randomised to treatment condition and assessed by blind raters at multiple time points. Participants received up to 12 90-min sessions of either ImRs or EMDR, biweekly.

A total of 155 participants were included in the final intent-to-treat analysis. Drop-out rates were low, at 7.7%. A generalised linear mixed model of repeated measures showed that observer-rated post-traumatic stress disorder (PTSD) symptoms significantly decreased for both ImRs (d = 1.72) and EMDR (d = 1.73) at the 8-week post-treatment assessment. Similar results were seen with secondary outcome measures and self-reported PTSD symptoms. There were no significant differences between the two treatments on any standardised measure at post-treatment and follow-up.

ImRs and EMDR treatments were found to be effective in treating PTSD symptoms arising from childhood trauma, and in reducing other symptoms such as depression, dissociation and trauma-related cognitions. The low drop-out rates suggest that the treatments were well tolerated by participants. The results from this study provide evidence for the use of trauma-focused treatments for Ch-PTSD.

Research in schizophrenia and pregnancy has traditionally been conducted in small samples. More recently, secondary analysis of routine healthcare data has facilitated access to data on large numbers of women with schizophrenia.

To discuss four scientific advances using data from Canada, Denmark and the UK from population-level health registers and clinical data sources.

Narrative review of research from these three countries to illustrate key advances in the area of schizophrenia and pregnancy.

Health administrative and clinical data from electronic medical records have been used to identify population-level and clinical cohorts of women with schizophrenia, and follow them longitudinally along with their children. These data have demonstrated that fertility rates in women with schizophrenia have increased over time and have enabled documentation of the course of illness in relation with pregnancy, showing the early postpartum as the time of highest risk. As a result of large sample sizes, we have been able to understand the prevalence of and risk factors for rare outcomes that would be difficult to study in clinical research. Advanced pharmaco-epidemiological methods have been used to address confounding in studies of antipsychotic medications in pregnancy, to provide data about the benefits and risks of treatment for women and their care providers.

Use of these data has advanced the field of research in schizophrenia and pregnancy. Future developments in use of electronic health records include access to richer data sources and use of modern technical advances such as machine learning and supporting team science.

While taxonomy segregates anxiety symptoms into diagnoses, patients typically present with multiple diagnoses; this poses major challenges, particularly for youth, where mixed presentation is particularly common. Anxiety comorbidity could reflect multivariate, cross-domain interactions insufficiently emphasized in current taxonomy. We utilize network analytic approaches that model these interactions by characterizing pediatric anxiety as involving distinct, inter-connected, symptom domains. Quantifying this network structure could inform views of pediatric anxiety that shape clinical practice and research.

Participants were 4964 youths (ages 5–17 years) from seven international sites. Participants completed standard symptom inventory assessing severity along distinct domains that follow pediatric anxiety diagnostic categories. We first applied network analytic tools to quantify the anxiety domain network structure. We then examined whether variation in the network structure related to age (3-year longitudinal assessments) and sex, key moderators of pediatric anxiety expression.

The anxiety network featured a highly inter-connected structure; all domains correlated positively but to varying degrees. Anxiety patients and healthy youth differed in severity but demonstrated a comparable network structure. We noted specific sex differences in the network structure; longitudinal data indicated additional structural changes during childhood. Generalized-anxiety and panic symptoms consistently emerged as central domains.

Pediatric anxiety manifests along multiple, inter-connected symptom domains. By quantifying cross-domain associations and related moderation effects, the current study might shape views on the diagnosis, treatment, and study of pediatric anxiety.

Implementation of genome-scale sequencing in clinical care has significant challenges: the technology is highly dimensional with many kinds of potential results, results interpretation and delivery require expertise and coordination across multiple medical specialties, clinical utility may be uncertain, and there may be broader familial or societal implications beyond the individual participant. Transdisciplinary consortia and collaborative team science are well poised to address these challenges. However, understanding the complex web of organizational, institutional, physical, environmental, technologic, and other political and societal factors that influence the effectiveness of consortia is understudied. We describe our experience working in the Clinical Sequencing Evidence-Generating Research (CSER) consortium, a multi-institutional translational genomics consortium.

A key aspect of the CSER consortium was the juxtaposition of site-specific measures with the need to identify consensus measures related to clinical utility and to create a core set of harmonized measures. During this harmonization process, we sought to minimize participant burden, accommodate project-specific choices, and use validated measures that allow data sharing.

Identifying platforms to ensure swift communication between teams and management of materials and data were essential to our harmonization efforts. Funding agencies can help consortia by clarifying key study design elements across projects during the proposal preparation phase and by providing a framework for data sharing data across participating projects.

In summary, time and resources must be devoted to developing and implementing collaborative practices as preparatory work at the beginning of project timelines to improve the effectiveness of research consortia.

The present study addresses the empirical basis for alerting health professionals to potential risk factors for excessive gambling. On the basis of international and Swiss literature on gambling, an explanatory model for the development of gambling problems is developed.

This work is based on the hypothesis that the prediction rule for excessive gambling, based on a sample of the general population and for different types of frequent gambling preferences, differs from the prediction rule for disordered gambling in patients, seeking psychiatric treatment. The goal of this study is, therefore, to contribute to an early identification of disordered gambling behaviour in the general population, as well as in the target group of patients seeking psychiatric treatment.

Various sources of information were analysed separately, in order to develop and test a prediction rule for excessive gambling, namely the 2002 Swiss Health Survey, which is a survey of the general population, involving 19'706 participants, as well as the data of psychiatric patients of Lausanne/Geneva, recruited consecutively from 1996 to 2004 at the Psychiatric Hospital of the University of Lausanne. This patient population comprised a total of 886 patients. Further data from the Centre for Excessive Gambling are presented, covering 105 patients.

Results show that indicators of depressive behaviour as well as smoking are good candidates for the early identification of gambling problems. On the basis of these data it is safe to assume that signs of depressive behaviour should encourage health professionals to enquire about gambling problems.

Excessive gambling touch between 1 and 3% of the adult population (Shaffer et al. 1999).

Studies of treatment-seeking gamblers establish a relationship between gambling and suicide. We investigated clinical characteristics in excessive gamblers of a Swiss University Hospital(CHUV).

The aim of this study is to compare gamblers with prior suicide attempts (GPSA) with gamblers without prior suicide attempts (Non-GPSA) and with the international literature.

Hypothesis:

1. - GPSA are confronted with a higher problem load than Non-GPSA.

2. - GPSA lack social networks and family support as compared to Non-GPSA.

Patients treated for gambling disorders typically show a high level of co-morbidity. Bourget, Data are based on medical files of our treatment center. Among our consecutively admitted patients (2002-2006), we identified pathological gamblers who reported prior suicide attempts directly or not directly linked with gambling.

1. – GPSA were more likely to be women, separated or divorced, referred by the forensic network.

2. – GPSA were more likely to be disabled and had a history of alcohol abuse. GPSA showed no difference with respect to age at intake or employment status as compared to NON-GPSA.

Further research is needed to find out whether the higher proportion of women with prior suicide attempts is due to the fact that men are more likely to complete suicide.

Actually, the suicidal risk in people with gambling problems is insufficiently evaluated; this risk is all the more hard to specify within a population which underreports gambling behaviour and associated co-morbidities. Estimations of suicidal behaviour vary between studies, suicide attempts were observed in 4% to 40% of gamblers studied. Suicidal thoughts were reported for 25% to 92% of people with gambling problems. 64% of gamblers that committed suicide did neither inform family or friends nor health professionals about their suicidal intents. In the context of a pilot study, we wish to study suicidal behaviour in people with gambling problems.

The goal of the study consists in the early identification of gambling problems associated with suicidal behaviour. A short intervention, specifically targeted towards the prevention of suicide will be compared with the current treatment for gambling problems. Gambling and suicidal behaviour will be monitored over 6 meetings during 12 months.

On the basis of this study, we wish to develop a blended E-Learning tool for professionals in psychiatry and primary health care that help to detect and treat people with gambling and suicidal behaviour.

Les effets cliniques de l’intoxication alcoolique aiguë seraient liés à une modulation des systèmes de neurotransmission du GABA et du glutamate. Les caractéristiques longitudinales de cette modulation et l’impact de la dose d’éthanol absorbée restent mal connus. Nous avons voulu étudier in vivo les effets aigus de l’éthanol sur les niveaux de GABA et de glutamate du cortex préfrontal en spectroscopie par résonance magnétique (SRM).

Après une première acquisition de SRM (zone préfrontale), trois groupes de rats Wistar mâles (363 ± 27 g) ont reçu par voie intrapéritonéale (IP) :

– éthanol 1 g/kg (n = 6) ;

– éthanol 2 g/kg (n = 8) ;

– sérum physiologique (n = 5).

Des acquisitions répétées de SRM ont été réalisées jusque 300 minutes post-injection. Une cinétique de l’éthanolémie a également été réalisée dans des groupes similaires de rats Wistar. Après alcoolisation par voie IP, des prélèvements sanguins successifs ont été réalisés jusque 180 minutes pour le groupe 1 g/kg (n = 6) et 300 minutes pour le groupe 2 g/kg (n = 14). Pour la SRM, des analyses statistiques inter- et intragroupes ont été effectuées à l’aide d’un modèle linéaire mixte visant à étudier la variation des taux de GABA et glutamate.

La cinétique de l’éthanolémie était superposable à celle de la cinétique cérébrale. En SRM, une diminution significative du GABA, de 11,4 % ± 3,8 % (p < 0,0059) dans le groupe 1 g/kg et du glutamate de 13,8 % ± 2,6 % dans le groupe 2 g/kg (p < 0,0001) ont été observées, sans modification significative dans les autres groupes. La variation du ratio GABA/glutamate s’est montrée différente entre les deux groupes éthanol avec une augmentation dans le groupe 2 g/kg et une diminution dans le groupe 1 g/kg (p < 0,01).

La dose d’éthanol détermine les variations des niveaux de GABA et de glutamate du cortex préfrontal, pouvant expliquer les différents effets cliniques induits par l’alcool selon la dose.