Current Issue : July-September Volume : 2026 Issue Number : 3 Articles : 5 Articles
5a-reductase (5a-R) isozymes are essential for androgen metabolism and neurosteroid biosynthesis, linking endocrinology and neuropsychiatry. This systematic review, conducted in accordance with PRISMA 2020 guidelines, aimed to synthesize current evidence on the tissue distribution of SRD5A1, SRD5A2, and SRD5A3 and their implications in mental health. A systematic search of the PubMed, Scopus, and Web of Science databases up to February 2025 identified 257 articles, of which 83 met the inclusion criteria. SRD5A1 is broadly expressed in the liver, skin, and central nervous system, contributing to allopregnanolone synthesis; SRD5A2 is mainly restricted to androgen-dependent tissues, playing a key role in prostate development and alopecia; and SRD5A3 is associated with glycosylation processes and oncogenesis. Converging evidence suggests that impaired neurosteroidogenesis due to 5α-R inhibition may underlie vulnerability to anxiety, depression, and suicidality. While earlier epidemiological findings were heterogeneous, recent pharmacovigilance data have strengthened the evidence supporting this association. Pharmacovigilance and clinical reports show that a subset of patients treated with finasteride or dutasteride may experience persistent psychiatric and sexual adverse effects, known as post-finasteride syndrome. The current findings underscore the need for careful patient counseling, systematic monitoring, and further translational studies integrating genetics, neuroendocrine markers, and standardized psychiatric outcomes to identify individuals at risk and advance personalized medicine in this field....
Background and Purpose: Functional stroke- like episodes (FSMs) are an increasingly recognised stroke mimic with demographic and clinical characteristics that differ from acute ischaemic strokes (AISs) but have unclear long- term outcomes. Materials and Methods: We report retrospective data on consecutive patients with FSM who underwent acute perfusion- CT (PCT) admitted to Lausanne University Hospital (2003–2017). We compared them to all contemporaneous AISs undergoing PCT from the Acute- STroke- Registry- and- Analysis- of- Lausanne (ASTRAL). Results: Twenty- five FSMs and 3201 control- AISs were included. FSM patients were significantly younger (median 43 vs. 73 years, adjusted odds ratio (ORadj) 0.92), had a higher incidence of psychiatric disorders (ORadj 5.33/17.07), and over half had a prior history of neurological and non- neurological functional disorders. FSM patients more often presented decreased vigilance (ORadj = 9.28) and sensory deficits (ORadj = 3.87), and less visual field defects (ORadj = 0.14) and dysarthria (ORadj = 0.20). FSM patients showed no significant changes on plain- CT and PCT. Acute revascularisation rates were similar in both groups (48% vs. 43%). Follow- up at 3- months revealed significant handicap in 41% of patients, similar to the control group in propensity- scorematched analysis, and lower mortality (0% vs. 20%, padj 0.04). After a median of 9 years follow- up, FSM patients failed to functionally improve further and 55% experienced additional functional neurological events. Conclusion: In this single- centre cohort of consecutive FSMs undergoing acute PCT, we identified distinctive demographic and clinical features, normal CT- based neuroimaging, but still a high thrombolysis rate. Long- term observation revealed a high rate of recurrent functional events and persistent disability, suggesting the need for more effective treatment and regular follow- up....
Polygenic risk scores (PRS) estimate individuals' genetic risk for developing multifactorial conditions. Recent genome- wide association studies have enabled development of psychiatric PRS, which hold potential to streamline diagnosis and treatment of psychiatric conditions. As individuals with mental illness often identify concern about passing on psychiatric conditions as a key factor in family planning, some may also seek to use psychiatric PRS in reproductive decisions like childbearing or embryo selection for in vitro fertilization. Despite calls for increased regulation, there remains no clinical consensus on the utility of psychiatric PRS in reproductive contexts. Therefore, we conducted semi- structured interviews of adults with psychiatric conditions (n = 29) to evaluate patient perspectives toward the tool's potential benefits and risks. Approximately half of participants would be interested in harnessing psychiatric PRS for reproductive purposes—including embryo screening and family planning— driven largely by desires to improve children's quality of life and seek empowerment while parenting. Others worried selecting against embryos with genetic risk for psychiatric disorders could exacerbate stigma. Regardless of personal stance, many noted using psychiatric PRS in reproductive decisions should be permissible for the general population. As psychiatric PRS continue to mature, patient views reported here can help inform their future in reproductive spaces....
The COVID-19 pandemic (2020–2023) profoundly disrupted healthcare systems and imposed sustained psychological burdens on healthcare professionals and trainees. Reliable instruments are essential for assessing these impacts. This study evaluated the construct validity and reliability of the Fear of COVID-19 Scale (FCV-19S) in a convenience sample of 1761 healthcare professionals, trainees, and academic staff at a single U.S. academic health sciences center (the University of Oklahoma Health Campus). Participants completed the FCV-19S; confirmatory factor analysis (CFA) examined its dimensional structure; and internal consistency was assessed using Cronbach’s α and McDonald’s ω. The one-factor model demonstrated good internal consistency (α = 0.89; ω = 0.89) but exhibited sub-optimal model fit (CFI = 0.89; TLI = 0.83; SRMR = 0.06; RMSEA = 0.18). The two-factor model, distinguishing emotional and somatic fear, showed substantially improved fit (CFI = 0.97; TLI = 0.96; SRMR = 0.03; RMSEA = 0.09) and acceptable internal consistency for both factors (α = 0.85 and 0.86; ω = 0.85 and 0.87), although RMSEA remained above conventional thresholds for close fit. Overall, findings support a two-factor structure as a comparatively superior and more nuanced representation of fear responses among an academic health workforce. The validated FCV-19S offers a reliable tool for assessing COVID-19-related distress in clinical and educational health settings, informing targeted interventions to strengthen workforce resilience....
Introduction: The consequences of the pandemic on the mental health of healthcare professionals in West Africa, particularly in Mali, are poorly documented. This study aimed to assess the mental health status of healthcare workers in Mali during the COVID-19 pandemic. Methods: A cross-sectional survey was conducted among 218 healthcare workers. Data were collected on socio- demographic characteristics, vaccination status against SARS-CoV-2, working hours, and mental health indicators (i .e ., stress, anxiety, depression, and post-traumatic stress) using validated scales. Measures of central tendency and dispersion were calculated for quantitative variables. Percentages were calculated for categorical variables. Results: The sample consisted of 55.0% male participants with an average age of 31.8 ± 7.9 years. The majority of respondents (28.4%) were health technicians or nurses. A total of 61.5% of the respondents indicated that they had received the vaccination against the novel coronavirus. Regarding workload, 50.9% of respondents reported working more than 72 hours per week. Mental health assessments revealed that 53.2% of the participants reported being able to manage stress, 3.7% perceived life as constantly under threat, and 31.2% reported a lack of well-being. The Generalized Anxiety Disorder (GAD-7) scale indicated that 59.2% of participants exhibited symptoms of anxiety, while the Patient Health Questionnaire (PHQ- 9) scale indicated that 58.8% experienced elevated depressive symptoms. Additionally, the Impact of Event Scale-Revised (IES-R) revealed that 98.2% of participants displayed symptoms of post-traumatic stress, with 6.4% meeting the criteria for a post-traumatic stress disorder diagnosis. Conclusion: The results demonstrate the significant mental health difficulties encountered by health professionals during the COVID-19 pandemic. They underscore the necessity for comprehensive support and targeted interventions to enhance the well-being of healthcare workers during public health emergencies....
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