Inclusion Scenarios and Conformational Flexibility of the SSRI Paroxetine as Perceived from Polymorphism of β-Cyclodextrin–Paroxetine Complex

Depression, a global mental health problem, is prevalent during the coronavirus disease 2019 (COVID-19) pandemic and can be efficiently treated by selective serotonin reuptake inhibitors (SSRIs). Our study series aims at forwarding insights on the β-cyclodextrin (β-CD)–SSRI inclusion complexes by X-ray crystallography combined with density functional theory (DFT) calculation. Here, we report a new crystal form (II) of the 1:1 β-CD–paroxetine (PXT) complex, which is inspired by the reported 2:1 β-CD–PXT complex (crystal form I), reflecting an elusive phenomenon of the polymorphism in CD inclusion complexes. The β-CD–PXT polymorphism stems from the PXT conformational flexibility, which is defined by torsion angles κ, ε around the -CH2–O- group bridging the A- and C–D-rings, of which those of PXT in I and II are totally different. While PXT (II) in an open V-shaped conformation that has the B-ring shallowly inserted in the β-CD cavity, PXT (I) in a closed U-shaped structure is mostly entirely embedded in the β-CD dimeric cavity, of which the A-ring is deeply inserted in the main β-CD cavity. However, PXT molecules in both crystal forms are similarly maintained in the CD cavity via host–guest N–H···O5/O6 H-bonds and C/O–H···π(B/C) interactions and β-CDs have similar 3D arrangements, channel (II) vs. screw-channel (I). Further theoretical explorations on the β-CD–PXT thermodynamic stabilities and the PXT conformational stabilities based on their potential energy surfaces (PESs) have been completed by DFT calculations. The 2:1 β-CD–PXT complex with the greater presence of dispersion interactions is more energetically favorable than the unimolar complex. Conversely, whereas free PXT, PXT (II) and PXT in complex with serotonin transporter are more energetically stable, PXT (I) is least stable and stabilized in the β-CD cavity. As SSRIs could lessen the COVID-19 severity, the CD inclusion complexation not only helps to improve the drug bioavailability, but also promotes the use of antidepressants and COVID-19 medicines concurrently.

Uncertainty and Perceived Control as Predictors of Communicative Participation and Mental Health in Adults Who Stutter

Purpose: This study examined the role of uncertainty and perceived control in predicting the communicative participation and mental health of adults who stutter. Method: Two hundred sixty-nine adults who stutter completed measures of uncertainty about stuttering, perceived control of stuttering, communicative participation, and global mental health. In addition, participants self-reported on a variety of demographic and speech-related measures. Correlational analyses and hierarchical regression were performed to determine associations between variables of interest. Results: Uncertainty accounted for significant variance in communicative participation and global mental health after statistically controlling for the effects of demographic and speech-related variables. Perceived control accounted for significant variance in communicative participation over and above what was accounted for by demographic variables, speech-related variables, and uncertainty. Conclusions: The findings suggest that uncertainty about stuttering and perceived control of stuttering should be accounted for during assessment and intervention with adults who stutter. Interventions that specifically target uncertainty and perceived control may be useful in improving therapeutic outcomes for individuals who stutter.

AI-Based Prediction and Prevention of Psychological and Behavioral Changes in Ex-COVID-19 Patients

The COVID-19 pandemic has adverse consequences on human psychology and behavior long after initial recovery from the virus. These COVID-19 health sequelae, if undetected and left untreated, may lead to more enduring mental health problems, and put vulnerable individuals at risk of developing more serious psychopathologies. Therefore, an early distinction of such vulnerable individuals from those who are more resilient is important to undertake timely preventive interventions. The main aim of this article is to present a comprehensive multimodal conceptual approach for addressing these potential psychological and behavioral mental health changes using state-of-the-art tools and means of artificial intelligence (AI). Mental health COVID-19 recovery programs at post-COVID clinics based on AI prediction and prevention strategies may significantly improve the global mental health of ex-COVID-19 patients. Most COVID-19 recovery programs currently involve specialists such as pulmonologists, cardiologists, and neurologists, but there is a lack of psychiatrist care. The focus of this article is on new tools which can enhance the current limited psychiatrist resources and capabilities in coping with the upcoming challenges related to widespread mental health disorders. Patients affected by COVID-19 are more vulnerable to psychological and behavioral changes than non-COVID populations and therefore they deserve careful clinical psychological screening in post-COVID clinics. However, despite significant advances in research, the pace of progress in prevention of psychiatric disorders in these patients is still insufficient. Current approaches for the diagnosis of psychiatric disorders largely rely on clinical rating scales, as well as self-rating questionnaires that are inadequate for comprehensive assessment of ex-COVID-19 patients’ susceptibility to mental health deterioration. These limitations can presumably be overcome by applying state-of-the-art AI-based tools in diagnosis, prevention, and treatment of psychiatric disorders in acute phase of disease to prevent more chronic psychiatric consequences.

Changes in College Student Anxiety and Depression From Pre- to During-COVID-19: Perceived Stress, Academic Challenges, Loneliness, and Positive Perceptions

The COVID-19 pandemic is a major stressor that has negatively impacted global mental health. Many U.S. college students faced an abrupt transition to remote learning in March 2020 that significantly disrupted their routines, likely causing changes in mental health. The current study examined changes in anxiety and depressive symptoms among 990 college students, from before COVID-19 had reached U.S. community spread to 5 months into the pandemic. Results indicate overall increases in anxiety and depressive symptoms; this effect was amplified as more COVID-related challenges with academic impact and loneliness were reported. Increases in anxiety and depression were buffered as a function of greater perceived positive changes attributed to COVID-19; the differences in anxiety and depressive symptoms over time were also lessened when greater perceived stress prior to COVID-19 was reported. Findings reveal an unexpected effect involving pre-pandemic stress, and highlight potential targets to promote resilience, which should be examined long-term.

Cold War Psychiatry, Extremism, and Expertise: The “Special Committee on the Political Abuse of Psychiatry”

Throughout the history of psychiatric ethical professionalization, the question of the “extremist” contextualizes and frames the limits of medical practice. Using archival research at the Royal College of Psychiatrists, the article explores how professional committees debated medical ethics after evidence of psychiatric participation in national security measures against dissidents. British, American, and global professional associations organized a prominent struggle against Soviet membership of the World Psychiatric Association in the 1970s and 1980s—reconstituting the field of professional expertise through Cold War geopolitics. The Special Committee on the Political Abuse of Psychiatry was formed in 1978 at the British Royal College of Psychiatry to publicize the medical detention of dissidents in the USSR and to pursue the expulsion of the USSR delegation from global professional fora. In doing so, it constituted an identity for Global Mental Health (vis-à-vis Soviet abusive practice) as impartial, objective, and uncompromised. However, this article explores the many ambiguities that complicate the performative constitution of Western psychiatry as good, and Soviet psychiatry as bad—reflecting on the political dynamics, and philosophy of science, which underwrote the struggle for global expertise.