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A computational pipeline for a neurotransmitter-centric analysis of the effects of psychiatric medication on EEG spectral power

IntroductionTraditional pharmaco-electroencephalography (EEG) studies have mainly examined the effects of psychotropic medications at the level of individual drugs or broad drug classes, limiting biological specificity and clinical translation. This study aimed to determine whether modeling EEG spectral power changes according to the engagement of distinct neurotransmitter systems provides a more mechanistic understanding of psychotropic drug effects in a real-world clinical population.MethodsWe analyzed 4,128 EEG sessions from 2,083 patients in the Temple University Hospital EEG Corpus, a large heterogeneous dataset. EEG data were preprocessed and segmented into canonical frequency bands (delta, theta, alpha, beta, and gamma). Psychotropic medication data were systematically extracted and coded at the receptor level for serotonin, dopamine, norepinephrine, histamine, and acetylcholine systems using the Neuroscience-based Nomenclature framework. Receptor profiles were summarized to represent each patient’s overall neurotransmitter engagement (agonistic, neutral, antagonistic, or mixed). Linear mixed-effects models were applied to assess relationships between neurotransmitter profiles and log-transformed spectral power while controlling for electrode location and patient-level variability.ResultsFrequency- and region-specific EEG patterns were identified across neurotransmitter systems. Dopamine antagonists were associated with higher delta and theta power at central electrode locations and lower alpha power at occipital and temporal locations, whereas dopamine agonists were associated with higher delta activity at occipital locations and increased frontal gamma power. Serotonin antagonists showed associations with elevated slow-wave and alpha power, while serotonin agonists were linked to increased frontal alpha, decreased occipital alpha, and enhanced temporal gamma power. Both norepinephrine antagonists and agonists showed positive relationships with delta power, with a broader topographical pattern for antagonists. Theta power was positively associated with norepinephrine antagonists and negatively associated with norepinephrine agonists. Norepinephrine antagonists were related to lower temporal alpha and higher frontal and parietal gamma power. Histamine antagonists and mixed histaminergic agents were associated with lower delta, theta, and alpha power. Acetylcholine antagonists were linked to higher delta, theta, and alpha power across electrode locations.DiscussionModeling psychotropic medication effects on EEG at the neurotransmitter receptor level offers a biologically grounded and clinically relevant improvement over traditional drug class-based approaches. This neurotransmitter-centric framework enhances mechanistic interpretability and may support the development of EEG biomarkers for personalized, mechanism-based psychiatric care.
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Outcomes from the ASPEN intervention program: a randomized clinical trial of a culturally adapted parent-mediated intervention program in low-resource settings

This randomized controlled study examined the efficacy of a culturally adapted parent-mediated intervention for parents and young children with autism (n = 45) from low-resource households (ClinicalTrials.gov Identifier: NCT04505488). Families from these settings are often left out of autism intervention studies and arguably have unique needs not considered in autism intervention work. Parent/child dyads were randomized to the intervention group, which received 12 weekly sessions that included psychoeducation and coaching of evidence-based (EB) strategies with their children, or the comparison group who received all materials and 4 triweekly check-in sessions. We found that parents in the intervention group showed improvement in their self-efficacy (confidence) in using EB strategies, compared to the comparison group, and both groups improved in the use of EB strategies. Parents in the comparison group also improved in feeling more empowered and their children improved in social communication skills. These findings suggest that less intense parent interventions may be just as efficacious as those that require more regular participation for families from low-resource households. More research is needed to find the right balance and active ingredients to benefit these families.Clinical Trial Registrationhttps://clinicaltrials.gov/study/NCT04505488, identifier NCT04505488.
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Burnout and perceived health in medical residents after the COVID-19 pandemic: a single-center cross-sectional study

IntroductionResidents have a high risk of burnout during the training period. The COVID-19 pandemic has had a great impact on work conditions and health of medical residents. We therefore estimated the prevalence of post-pandemic burnout and perceived health, and their relationship with psychosocial factors, stress profile, and job satisfaction, as well as the pre-post pandemic changes.MethodsWe carried out a retrospective cross-sectional, online, anonymous survey using the validated FPSICO-4.0 questionnaire in a teaching hospital after the COVID-19 pandemic (2023). We also studied the pre-post changes from an independent pre-pandemic online survey (2018) with the same tool.ResultsOne hundred ninety-seven residents, 64% females, answered the questionnaire (43.5%); 28% had post-pandemic burnout without gender differences, being higher in surgical specialties (p=0.017) and along residency years (p=0.041). Role performance, behavior stress, job satisfaction and residency years were associated with an increase in odds of burnout (p<0.05). Supervision, conflict of role/cognitive stress explained 35% of the variation in perceived general health (adjusted-R2 = 0.356); temporary autonomy, supervision, information/training/promotion, behavior/somatic stress, and job satisfaction did 68% of mental health (adjusted-R2 = 0.683); and take decisions, conflict of role, behavior/somatic/cognitive stress, and male gender did 62% of vitality (adjusted-R2 = 0.624). Pre/post pandemic mean differences, adjusted by gender and residency year, showed deterioration of variety sense of work (p<0.001), effort of attention (p=0.026), behavior stress (p=0.022), and improvement of temporary autonomy (p=0.045).ConclusionsThe identification after pandemic of high prevalence of burnout, stress levels and certain psychosocial risk factors (role performance and supervision), highlights the need of specific health promotion plan.
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Diagnosis of prolonged grief disorder among older adults: mapping physicians’ knowledge and practice, and evaluating the effectiveness of a brief targeted training program

BackgroundProlonged Grief Disorder (PGD) is a psychiatric diagnosis with significant implications for individuals and society. Familiarity with its diagnostic criteria and recommended interventions is essential for early detection and effective treatment. As aging naturally involves multiple losses, older adults are at distinct risk of developing PGD, a condition associated with psychological and physical comorbidities and increased mortality. In the Israeli context, this issue holds particular significance following the events of October 7, 2023, and the ensuing war, which have had — and continue to have — a profound impact on the population’s mental health. Given PGD’s recent inclusion in diagnostic manuals, many physicians may lack sufficient knowledge, leading to under-recognition or misdiagnosis. This gap is particularly evident among older adults, for whom the assessment and management of psychological distress are often underassessed and undertreated, highlighting the urgent need for targeted training and broader integration of existing knowledge into clinical practice. Accordingly, the present study has two main objectives: (1) to assess physicians’ knowledge and use of PGD diagnostic criteria with older patients, and (2) to evaluate the effectiveness of a brief informational intervention on their understanding and diagnostic application.MethodsUsing a mixed experimental design, the study will include senior physicians and residents specializing in geriatrics, psychiatry, and family medicine. Data will be collected via an online structured questionnaire containing professional background items and clinical vignettes designed to assess participants’ knowledge and application of PGD diagnostic criteria. Afterwards, participants will be individually randomized (1:1) via a computer-generated sequence in a partially participant-blinded, assessor-blinded controlled trial to either an experimental group viewing an informational PGD video or a control group viewing a structurally equivalent video (matched in length, graphics, and word count) addressing bereavement in older adults without directly referencing PGD. All participants will then complete the vignettes again to evaluate the effects of the intervention. A one-month follow-up assessment will evaluate the retention of intervention effects.DiscussionThis first systematic Israeli study on PGD implementation will provide an empirical basis for policy development, professional training, and prevention programs. Its findings may enhance diagnostic accuracy, improve care efficiency, reduce systemic costs, and support ongoing evaluation and refinement of clinical practices.Clinical trial registrationClinicalTrials.gov, identifier NCT07487233.