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Anxiety and older age were associated with slower updating of models used in perceptual processing, but not those used in decision-making. LIMITATIONS This was a cross-sectional study and lacked neural data to examine the role of specific brain circuits in updating of perceptual predictions. CONCLUSIONS Anxious individuals display slower updating of internal models used in perceptual processing, but not those used in decision-making. This deficit could contribute to exaggerated salience of harmless stimuli in anxiety. The results have implications for the assessment and treatment of basic processing dysfunctions in anxiety. V.BACKGROUND We examined the fast food consumption-suicide attempt relationship among 105,061 adolescents aged 12-15 years from 32 countries. METHODS This study was based on cross-sectional data from the Global School-based Student Health Survey (GSHS), and included 4 low-income, 13 lower middle-income, 9 upper middle-income, and 6 high-income countries. Data on past 7-day fast food consumption and 12-month suicide attempts were collected. The association between fast food consumption and suicide attempts was investigated with multivariable logistic regression and meta-analysis while adjusting for sex, age, food insecurity (proxy of socioeconomic status), alcohol consumption, smoking, physical activity, obesity, carbonated soft drink consumption, and fruit and vegetable consumption. RESULTS Overall, the prevalence of fast food consumption was high (53.5%) and the proportion of suicide attempts was higher among consumers of fast food compared to non-consumers (11.8% vs. 8.3%). Of the 32 countries included in the study, a positive association between fast food consumption and suicide attempts was found in 26 countries although this was not statistically significant in all countries. The pooled OR (95% CI) based on a meta-analysis was 1.31 (1.17-1.46). LIMITATIONS Since this was a cross-sectional study, it is not possible to draw any conclusions about causality or temporality in the associations assessed. CONCLUSIONS Fast food consumption is positively associated with suicide attempts in adolescents. Further research of longitudinal design is needed to confirm/refute our findings and explore the potential underlying mechanisms. BACKGROUND Clinically relevant issues in the real-world treatment of depression have not always been captured by conventional treatment guidelines. METHODS Certified psychiatrists of the Japanese Society of Clinical Neuropsychopharmacology were asked to evaluate treatment options regarding 23 clinical situations in the treatment of depression using a 9-point Likert scale (1="disagree" and 9="agree"). According to the responses of 114 experts, the options were categorized into first-, second-, and third-line treatments. RESULTS First-line antidepressants varied depending on predominant symptoms escitalopram (mean ± standard deviation score, 7.8 ± 1.7) and sertraline (7.3 ± 1.7) were likely selected for anxiety; duloxetine (7.6 ± 1.9) and venlafaxine (7.2 ± 2.1) for loss of interest; mirtazapine for insomnia (8.2 ± 1.6), loss of appetite (7.9 ± 1.9), agitation and severe irritation (7.4 ± 2.0), and suicidal ideation (7.5 ± 1.9). While first-line treatment was switched to either an SNRI (7.7 ± 1.9) or mirtazapine (7.4 ± 2.0) in the case of non-response to an SSRI, switching to mirtazapine (7.1 ± 2.2) was recommended in the case of non-response to an SNRI, and vice versa (switching to an SNRI (7.0 ± 2.0) in the case of non-response to mirtazapine). Augmentation with aripiprazole was considered the first-line treatment for partial response to an SSRI (7.1 ± 2.3) or SNRI (7.0 ± 2.5). LIMITATIONS The evidence level of expert consensus is considered low. All included experts were Japanese. CONCLUSIONS Recommendations made by experts in the field are useful and can supplement guidelines and informed decision making in real-world clinical practice. We suggest that pharmacological strategies for depression be flexible and that each patient's situational needs as well as the pharmacotherapeutic profile of medications be considered. V.BACKGROUND Overgeneral autobiographical memory (OGM), the tendency to recall fewer specific memories and recall more repeated or extended events, is associated with subsequent adult depression. However, prospective associations are only found in adolescents with additional risk factors for depression (e.g. OGM for negative material is associated with subsequent depression in females and those at familial risk of depression) and not in community samples. Navitoclax Bcl-2 inhibitor It remains unclear whether OGM is associated with subsequent depression in population-based adolescent samples or just in high-risk adolescents. METHODS We examined the relationship between OGM for negative cues (age 13) and adolescent depressive symptoms in a population-based cohort - the Avon Longitudinal Study of Parents and Children. Regression models investigated the association of OGM for negative cues with depressive symptoms at age 12.5 years (n = 3,145) and age 16.5 years (n = 2,345). Associations with alternative measures of OGM were also explored. Gender and maternal depression were examined as potential moderators of these relationships. RESULTS OGM for negative cues was associated with both contemporaneous and prospective depressive symptoms. Only OGM for negative cues and total OGM were prospectively associated with depressive symptoms. There was no evidence of moderation by gender or maternal depression. LIMITATIONS Depression was reported 6 months earlier than OGM. CONCLUSIONS To our knowledge, this is the first study to find a prospective link between OGM for negative material and depression in a population-based cohort. Results highlight memory biases can precede subsequent adolescent depression in the general population, not just high-risk samples. V.BACKGROUND Currently, no specific, systematic assessment tool for the monitoring and reporting of ketamine-related side effects exists. Our aim was to develop a comprehensive Ketamine Side Effect Tool (KSET) to capture acute and longer-term side effects associated with repeated ketamine treatments. METHODS Informed by systematic review data and clinical research, we drafted a list of the most commonly reported side effects. Face and content validation were obtained via feedback from collaborators with expertise in psychiatry and anaesthetics, clinical trial piloting and a modified Delphi Technique involving ten international experts. RESULTS The final version consisted of four forms that collect information at time points screening, baseline, immediately after a single treatment, and longer-term follow-up. Instructions were developed to guide users and promote consistent utilisation. LIMITATIONS Further evaluation of feasibility, construct validity and reliability is required, and is planned across multiple international sites.
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