The usual demographic patterns of adolescent suicide apply in Chile. An emerging variable of interest is single-parent family. No cross-sectional association between social inequality and ASR was found based on conflicting evidence. These results should be explored in future prospective population studies to further understand associated social factors.

Emil Kraepelin believed that dementia praecox, the disorder we now call schizophrenia, was caused by the brain being poisoned with toxins generated in other parts of the body, especially the mouth, intestine or genitals. In this regard, Kraepelin hinted at the microbiome and conceptualized microbial molecules as drivers of severe psychiatric illness. However, it was not until the coronavirus disease (COVID-19) pandemic that Kraepelin's paradigm gained traction, particularly because this virus was associated with both gut barrier disruption and new-onset psychosis. Likewise, despite numerous studies linking severe psychiatric illness to genomic damage and dysfunctional DNA repair, this pathogenetic mechanism was underappreciated before the COVID-19 pandemic. The use of the psychotomimetic anesthetic, ketamine, for treatment-resistant depression has reawakened the interest in endogenous serotonergic hallucinogens, especially tryptamine and N,N-dimethyltryptamine (DMT), which are beneficial for depression but associated with psychosis. In this editorial, we take a closer look at the role of the microbiome in psychopathology, attempting to answer 2 questions: 1. Why may psychosis-predisposing serotonergic hallucinogens alleviate depression? 2. Are microbiota-derived psychedelics part of an inbuilt antidepressant system similar to endogenous opioids?

A paradigm shift is currently taking place in the etiopathogenesis of neuropsychiatric disorders as immunometabolism is replacing the earlier neurotransmitter model. According to the new concept, cellular bioenergetics drives information processing in the central nervous system; therefore, neuropathology is conceptualized as a direct consequence of impaired metabolism. Along the same lines, endoplasmic reticulum stress and gut barrier dysfunction are emerging as novel targets in schizophrenia and affective disorders, linking immune responses to cellular distress. Furthermore, microglia, the brain’s innate immune cells, acquire energy through oxidative phosphorylation, while in the resting state, and glycolysis upon activation, contributing to lactate accumulation and reduced brain pH. The same metabolic signature characterizes neuropsychiatric disorders as the central nervous system derives adenosine triphosphate from aerobic glycolysis, upregulating lactate and generating an acidic environment. Although known for over three decades, the link between dysmetabolism and neuropathology was poorly defined until the discovery of brain-resident innate lymphoid cells, including natural killer cells, and lactylation of histone and nonhistone proteins. In this perspective article, we examine three anti-inflammatory microglial systems relevant for neuropsychiatry: lactate, oxytocin, and the aryl hydrocarbon receptor. We also discuss potential interventions for restoring microglial homeostasis.

Gut microbes are immunologically tolerated in the gastrointestinal tract but trigger aggressive immune responses upon translocation across the gut barrier. Although oral tolerance, a physiological process that dampens immune responses to food proteins and commensal microbiota, remains poorly defined, significant progress was made during and after the Human Immunodeficiency Virus epidemic in the 1980s and the discovery of regulatory T cells in 1995. Additional insight was gained after the discoveries of innate lymphoid cells in 2008 and the functional elucidation of mucosal mast cells. Prior to the historical discovery of human pathogens, the etiologies of most human diseases were considered unknown. The same was true about many genetic disorders prior to the Human Genome Project. Here, we hypothesize that many of the remaining idiopathic conditions, including autoimmune, fibroproliferative, and neuropsychiatric diseases as well as some cancers, can be considered microbial translocation disorders triggered by the host immune responses to extraintestinal gut microbes and/or their constituent parts. In addition to microbial translocation, we also discuss potential interventions for intestinal barrier rehabilitation, including antibodies against tumor necrosis factor-like ligand 1A and membrane lipid replacement supplements.

Ice hockey differs in dynamic, allowed body contact and equipment from other team sports, probably leading to a higher injury risk. Thus, ice hockey captures the first place of the injury statistics in German professional team sports. Therefore, the aim of this study was to analyse the epidemiology in German professional ice hockey and to elaborate appropriate prevention measures.The underlying database considers DEL players and describes injuries, resulting disabilities and costs. Additional information concerning injury situations and mechanisms was collected by means of a questionnaire-based survey. Between July 2007 and June 2008 professionals, who registered injuries received a questionnaire for detailed description of the accident. 914 injuries causing costs were registered. Response rate reached 12.4%.Thus, each DEL player sustains an average of 2.6 injuries per season. Half of those injuries lead to temporary incapacity for work. The other half merely causes treatment costs. Nine of 10 players sustain at least one injury per season. The injury list permanently contains 25% of all DEL players. Injury costs including treatment costs and lost staff costs amount to 8 million per year. 54% of all costs are allotted to knee (24%), head (16%) and shoulder injuries (14%). Remarkably, 67.2% of irregular actions leading to injuries had not been judged as a foul by the referee.Elaborated preventive measures focus on protective equipment, training measures concurrently reducing injuries and enhancing performance – in particular checking performance, revised education of referees, consistent penalisation and fair play.