Association of Attention Deficit Hyperactivity Disorder with the Use of Oral Propranolol in Infantile Haemangiomas: An Ambispective Comparative Study.

Previous studies have raised concerns about the effects of oral propranolol on the central nervous system in infants, the exact measure and mechanism and the long-term follow-up of which is less well studied. This was an ambispective comparative study of children with infantile haemangioma (IH) followed by a repeat visit 4-10 years after completion of propranolol therapy. Parents were asked about psychologic functioning along with an initial screening examination. All patients were evaluated by a paediatric psychiatrist. After evaluation by the Strength and Difficulties Questionnaire, and subsequently by the paediatric psychiatrist, 2 of 12 patients (16.67%) showed features of attention deficit hyperactivity disorder in comparison to 0 of 40 subjects in the control group (0.0498; α = 0.05). These results indicate an increased risk of neuropsychiatric illnesses such as attention deficit hyperactivity disorder (ADHD) in patients given propranolol for IH, as supporting evidence to previous claims.

'Coming out'/self-disclosure in LGBTQ+ adolescents and youth: International and Indian scenario - A narrative review of published studies in the last decade (2012-2022).

Background: People who identify themselves as Lesbian, Gay, Bisexual, Transgender, Queer, and others (LGBTQ+) go through a process of self-exploration and self-identification during adolescence, and the process resolves when one decides to self-disclosure. The experience of 'Coming Out' (CO) can be positive, leading to acceptance and a feeling of liberation, or it can be harmful, leading to stigma, humiliation, and discrimination, subsequently leading to significant psychological distress. Aim: This study was to do a narrative review on the studies published in the area/topic of CO in youth in the last decade (2012-2022) and to look for factors that act as barriers and facilitators of CO. Additionally, we have tried to look for differences in CO in LGBTQ+ adolescents and youth in the Western world vis-a-vis Indian/Eastern societies. Materials and Methods: An extensive literature search in electronic databases, PUBMED, Web of Science, EMBASE, Medline, Scopus, and search engine 'Google Scholar' using specific search terms and assessment of all published articles until 20th May 2023 was done. Results: Twenty-three studies were found eligible for data extraction, which discussed the problems faced during the CO process. Most of the studies are from developed countries, and only one is from India. Eleven were qualitative studies, 11 were cross-sectional studies, and one was a case study. The qualitative studies focused on generating themes of CO along with various issues/problems faced by the participants. The cross-sectional studies mainly explored parental reactions, stigma, parental support, psychological distress, and perceived stress in the participants. Major themes emerging from the qualitative studies were the experience of prejudice from various strata of society, such as parental, societal, racial, cultural, and religious factors that lead to problems of hiding, internalized homophobia, and anticipatory rejections that put this population under extreme conditions. Limited research is available from Eastern societies. More recently, the new generation of adolescents has taken the help of social media platforms for self-disclosure. Conclusions: CO is an elaborate multi-step process that considers the presence of parental/family and societal support, cultural/traditional values, and several psychosocial factors that determine the degree of positive outcomes. Emerging data indicated an improved trend of adolescents deciding to come out to families or in online platforms, both of which are associated with challenges, more in eastern collectivistic societies and developing countries.

Response Processes to Looming Appetitive and Aversive Cues in Euthymic Bipolar Patients and Their First-Degree Relatives: An Exploratory Study.

BACKGROUND: Patients with bipolar disorder demonstrate increased sensitivity to appetitive/rewarding stimuli even during euthymia. On presentation of arousing pictures, they show a peculiar response, suggesting heightened vigilance. While responding to looming arousing cues, studies show subjects with anxiety spectrum disorders exhibit increased reaction time (RT), explained by the "looming-vulnerability model." This study aimed to investigate the responses to looming arousing cues in euthymic bipolar patients and their first-degree relatives, as compared to healthy controls. METHOD: A looming appetitive and aversive cue paradigm was designed for assessing the RT of patients to process appetitive and aversive cues. The behavioral inhibition/activation and sensitivity to reward/punishment amongst the groups were also assessed. RESULTS: The bipolar group showed significantly longer RT to process appetitive cues irrespective of the looming condition. Aversive cues elicited significantly longer RT in both the bipolar group and in first-degree relatives, but only when presented with the looming condition. Significant looming bias was elicited in the bipolar group which suggested a particular cognitive style to looming cues. A composite measure of RT along with sensitivity to reward/punishment distinguishes the bipolar group and their first-degree relatives from the healthy controls. CONCLUSION: The looming vulnerability model may provide important insights for future exploration of cognitive endophenotypes in bipolar disorder.

Postinjection Delirium/Sedation Syndrome After 31st Long-Acting Olanzapine Depot Injection.

OBJECTIVE: Long-acting depot preparations of antipsychotics are the mainstay of treatment for patients with schizophrenia who show nonadherence to their medications. Olanzapine pamoate is one of the recently approved long-acting depot psychotropic preparations that have shown its efficacy both in clinical trials and in clinical uses against the illness. However, emerging literature indicates toward a cluster of adverse effects known as postinjection delirium/sedation syndrome (PDSS). METHODS: We here present a case of PDSS in a woman with paranoid schizophrenia. After maintaining well for almost 1½ years, she developed PDSS at her 31st scheduled long-acting olanzapine injection. RESULTS: Several features of PDSS including its mechanism and course have been discussed. CONCLUSIONS: More research is necessary to understand the syndrome and the association between PDSS and long-acting olanzapine injection. Clinicians should keep in mind that PDSS may worsen compliance in an index patient and affect the course of the illness.