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Abstract Objective: The clinical overlap between autism spectrum disorder (ASD) and personality disorders (PDs) poses significant diagnostic challenges. Shared features – such as social communication difficulties, rigidity, and emotional dysregulation – often lead to misdiagnosis or delayed diagnosis, especially in adults and underrepresented populations (e.g., women). Methods: This narrative review synthesizes current evidence on the differential diagnosis and comorbidity of ASD and PDs to guide clinical practice. Results: Findings highlight substantial symptom overlap, particularly in social cognition and emotional regulation. For instance, both ASD and schizotypal PD may exhibit social withdrawal, while ASD and borderline PD share impulsivity and identity disturbances – though with distinct etiologies (neurodevelopmental vs. trauma-related). Conclusions: Clinicians must adopt a developmental perspective to disentangle ASD from PDs, integrating longitudinal history, neuropsychological testing, and multidisciplinary evaluations. Future research should prioritize biomarker-based diagnostics and tailored interventions for comorbid presentations.

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Abstract Objective: Caregivers appear to experience mental health implications related to their role in supporting patients with bipolar disorder (BD). This study aimed to review the literature assessing the presence of not only psychiatric symptoms but also mental disorders and personality disorders in caregivers of patients with BD. Methods: This is a narrative review. Articles were searched in some online databases, including PubMed, Embase, Web of Science, PsychINFO, Lilacs, and SciELO up to June 2024. Inclusion criteria comprised articles in any language, focusing on primary caregivers of patients with BD, and quantitative studies evaluating the presence of mental disorder, personality disorder, or psychiatric symptoms in this caregiver group. Results: The review encompassed 15 articles. Only two studies utilized appropriate diagnostic instruments for assessing mental disorder, and no article evaluated personality disorder. Prevalence of caregiver's psychiatric symptoms and mental disorder was found to be higher compared to the general population. Conclusion: The lack of studies employing diagnostic assessment tools for mental disorder in these individuals may impede timely access to treatment, affecting both the caregiver's health and the clinical course of patients with BD. This study provides an updated overview of research on caregivers of patients with BD, despite the limitation of not being a systematic review. Further studies employing diagnostic assessments on caregivers are essential to gain deeper insights into this critical topic.

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Abstract Objective: The offspring of parents with bipolar disorder (BD) and with attention deficit hyperactivity disorder (ADHD) have a higher risk of having the same condition. Both disorders also share psychopathological symptoms; however, little is known about their genetic overlap. To examine whether the offspring of parents with BD have a greater chance of being affected by ADHD, we conducted a systematic review. Methods: From inception to August 12, 2024, we searched the PubMed, SciELO, PsycInfo and Cochrane databases. We included studies if they investigated the association of parental bipolar disorder with offspring outcomes and made a proper investigation of disorders using validated instruments based on the Diagnostic Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD) criteria. Studies were excluded if: parents were under 18 years old or over 70; did not report original data; systematic reviews; in vitro studies; with an animal model; offspring older than 17 years of age or with any comorbid diagnosis with ADHD. To assess risk of bias, two authors independently used the Newcastle-Ottawa Scale quality assessment tool. Results: 23 articles met the inclusion criteria. The majority of the studies reported that the offspring of parents with BD were at higher risk for ADHD. Particularly, in all case-control studies, the risk of ADHD was higher in the case group than the control group. Conclusion: The current studies are yet heterogeneous and literature did not uncover the biological correlation of these disorders regarding genetic, biochemical, neuroimaging and neuropsychological aspects.

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Abstract Introduction: The nucleus accumbens (NAc) is central to the brain's reward circuitry, mediating motivation and emotional processes. Emerging evidence suggests that structural and functional changes in the NAc, including volume alterations, may contribute to the neuropathology of substance use disorder (SUD). This review evaluates current findings on the association between NAc volumetric changes depicted by magnetic resonance imaging (MRI) and SUD. Methods: A literature search was conducted in PubMed, EMBASE, BVS, Web of Science, Scopus, Cochrane Library, and PsycInfo. Terms used in searches included Nucleus Accumbens, Mental Disorder, Substance Use Disorder, Drug Addiction, and Magnetic Resonance Imaging (MRI). The main findings from the selected studies were synthesized in a table. Results: The initial database searches yielded 3686 articles. After screening, duplicate articles, non-English/Spanish/Portuguese articles, animal studies, and studies that did not address SUD were excluded. Additional exclusion criteria included studies involving only familial risk of substance use or abstinence, as well as studies without NAc analysis or structural MRI analysis. 52 cross-sectional studies regarding associations between NAc volumes and SUDs were selected. Conclusion: The reviewed studies suggest that NAc volumetric alterations may play a pivotal role as an associated factor in addiction, with strong associations mainly to cigarette smoking and alcohol use. Other substances show inconsistent findings. Discrepancies in results may reflect differences in study designs, the type of volumetric analysis employed, and control over confounding variables. Future studies that use multimodal approaches and control for confounding variables are required to strengthen these associations.

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Abstract Objective: The Personality Inventory for DSM-5 (PID-5) is a tool used to assess maladaptive personality traits according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) alternative model. The objective is to seek evidence of the validity and reliability of the PID-5 - Self Reported Form (PID-5-SRF) administered online and assess its measurement invariance compared to the paper-and-pencil administration. Method: A sample of 274 individuals from the general population (73.4% of women; 34.76 years old ± 11.6) completed the instrument online after the study was disseminated on social media and among the authors’ contacts. Results: Internal consistency (facets α ≥ 0.70; domains α ≥ 0.89) and test-retest reliability (15 to 30 days: facets intraclass correlation coefficient [ICC] ≥ 0.63; domains ICC ≥ 0.82) were satisfactory, but a floor effect was found in almost all the items. A large number of facets (n = 9) showed better fit to a bifactorial structure, and the exploratory factor analysis (EFA) suggested that a six-factor model better fits the data. Measurement invariance between the online and paper-and-pencil administrations was not attested at a configural level. Conclusion: The results revealed satisfactory psychometric indicators when the instrument was applied online, confirming its feasibility in collecting data. However, the instrument's structure is not invariant, and caution must be adopted when comparing and interpreting data collected through different formats.

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Abstract Objective: Bipolar disorder (BD) is a chronic pathology that is associated with several impairments throughout a patient's life, including decreased sexual function. Despite the importance in quality of life (QoL), functionality and medication adherence, it is still little investigated in these patients. The objective of this study was to compare the sexual function of patients with Bipolar Disorder type I (BD-I), in remission, with healthy controls (HCs) and to investigate the clinical and socio-demographic characteristics associated with sexual function in these individuals. Also, to assess the QoL in patients with and without sexual dysfunction (SD). Methods: Cross-sectional study with 132 patients with BD-I in euthymic phase and 61 HCs from an outpatient clinic. All the participants were evaluated through the Arizona Sexual Scale (ASEX) and the brief version of the World Health Organization Quality of Life Assessment (WHOQoL-BREF). The patients with BD-I were compared with the HCs. The patients were divided into two groups: the ones diagnosed with SD and the ones without it. Results: The patients with BD-I had higher rates of SD (42.4%) compared to the HCs (16.4%) (OR 3.67, 95%CI 1.55-8.67; p = 0.003). SD in patients was associated with being women (p = 0.001), older age (p = 0.003) and having a longer duration of untreated illness (p = 0.010). Patients with SD had worse QoL scores compared to those without SD. Conclusion: Patients with BD-I have a high prevalence of SD and this was associated with worse QoL scores in all domains.

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Abstract Objective: Major depressive disorder (MDD) is a leading cause of global disability, contributing to substantial individual, social, and economic burdens. While antidepressant therapy remains the cornerstone of treatment, complementary lifestyle-based interventions, such as multimodal exercise and mindfulness, have shown promise in alleviating mood symptoms. However, their specific impact on sleep quality, a critical therapeutic target in MDD, remains underexplored. Methods: In a 12-week randomized controlled trial, 88 patients with MDD were assigned to three groups: pharmacotherapy alone (control group – CG), pharmacotherapy plus home-based multimodal exercise (exercise group – EG), or pharmacotherapy plus home-based mindfulness training (mindfulness group – MF). Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) at baseline, week 5, and week 12. Results: A linear mixed-model (LMM) was performed, and significant group-by-time interactions were observed. At baseline, the EG exhibited lower PSQI scores compared to the MF (p = 0.002, d = 0.75) and CG (p = 0.001, d = 0.83). At week 5, the EG continued to show superior sleep quality relative to mindfulness (p = 0.018, d = 0.64) and CG (p = 0.001, d = 0.89). At week 12, the MF also demonstrated better sleep quality than the CG (p = 0.002, d = 0.80). All groups improved over time, with exercise yielding rapid benefits and MF showing progressive, sustained improvements. Conclusion: Lifestyle-based interventions enhance sleep quality in MDD when combined with antidepressant therapy. Multimodal exercise offers immediate improvements, while mindfulness provides gradual, long-term benefits. These findings underscore the value of adjunctive lifestyle interventions in MDD management and highlight the need for further research into their long-term efficacy and potential synergistic effects. Clinical trial registration: Brazilian Registry of Clinical Trials, RBR-4pgd3ct, date of registration: 10/19/2023.

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Abstract Objective: This study aimed to compare sociocognitive skills and emotion comprehension between children with autism spectrum disorder (ASD) and children with neurotypical development. Methods: This quantitative, cross-sectional, controlled study involved 19 children in each group, matched by age (6-12 years) and sex. The assessments examined cognitive aspects (Intelligence Quotient was assessed using the Vocabulary and Matrix Reasoning subtests; working memory using the digit span and letter-number sequencing subtests; attention using the Continuous Performance Test – Identical Pairs; and executive functions using the Trail Making Test), social functions (Children's Social Skills, Behavior Problems, and Academic Competence Inventory), and emotion comprehension (language was assessed using the Strange Stories Test; emotional facial expressions using the digital emotion comprehension test; emotional/affective prosody using the Profiling Elements of Prosody in Speech-Communication – Brazilian Portuguese adapted version). Results: The group with ASD exhibited better performance in executive functions (p = 0.02). However, they lagged the control group in social skills (p = 0.04), behavior problems (p = 0.03), and emotion comprehension (language, facial expressions, and prosody) (all p < 0.05). Conclusion: The findings indicate that children with ASD have diminished performance in social skills and emotion comprehension compared to children with neurotypical development. Therefore, the development of technologies and/or therapeutic interventions that address these deficits among children with ASD is recommended.

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Abstract Objective: This study evaluated the quality and reliability of information about autism spectrum disorder (ASD) available in Portuguese on YouTube, based on the growing demand for accessible information about ASD and the relevance of digital platforms as sources of health information. Methods: Using a cross-sectional observational study design, videos published in the last 5 years with more than 50,000 views were selected. The analysis consisted of two stages: characterization of the profile of the selected videos and assessment of information quality with the DISCERN Questionnaire. Results: A total of 48 videos, predominantly produced by healthcare providers and educators, were analyzed. The content of videos made by professionals was of higher quality and reliability compared to videos posted by laypersons and news reports. These findings highlight expertise in the field as a critical determinant of content quality, stressing the importance of relying on expert sources when disseminating information about ASD. The ICD-10 and DSM-V were rarely mentioned, especially in videos by non-professionals, which is indicative of challenges in conveying diagnostic information. Conclusion: The findings of this study demonstrate the significant potential of YouTube as an educational tool to raise ASD awareness, but also highlight the need for a collaborative approach between content creators, healthcare providers, educators, and policymakers to ensure that the information made available is reliable, accurate, and of high quality. Therefore, we recommend the development of specific guidelines for content creators and the implementation of verification mechanisms for YouTube channels run by subject matter experts.

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Abstract Objective: Life experiences that promote or attenuate depression have been studied primarily in adults. Therefore, we investigated the association between lifestyle factors and symptoms of depression in adolescents. Methods: A cross-sectional study was carried out in Brazilians. Data from 93 individuals were analyzed out of the 150 invited participants (age 14.2±1.8, 67.74% girls). Lifestyle habits (SMILE-C), physical activity and sitting time (IPAQ), as well as symptoms of depression (DASS-21) were evaluated. A network analysis was performed using the EBIC-LASSO model, with the expected influence as a centrality parameter. Results: The lifestyle domains with the highest expected influence were diet and nutrition (1.423), walking (1.126) and stress management (1.015). The variables with the highest direct partial negative correlation with depression were social support (-0.307) and moderate-vigorous physical activity (-0.244), suggesting a bidirectional relationship between these variables with lower symptoms of depression. Conclusion: Specific lifestyle areas such as social support, physical activity and nutrition appear to impact other healthy habits while reducing teen depressive symptoms.