Research shows that adolescents with mental illnesses have a bias for processing negative facial emotions, and this may play a role in impaired social functioning that often co-exists with a mental health diagnosis. This study examined associations between psychological and somatic problems and facial emotion recognition in early adolescence; as any processing biases in this age-group may be an early indicator of later mental illnesses. A community sample of 40 12-year-olds self-rated their symptoms of anxiety, depression, and somatization via two mental health screeners. They also completed a computerized emotion recognition task in which they identified photographs of 40 faces showing expressions of anger, fear, sadness, happiness, or neutral expression. Results showed that increased symptoms of anxiety, depression, and somatization were significantly associated with fewer correct responses to angry expressions. These symptoms were also associated with faster and more accurate recognition of fearful expressions. However, there was no association between mental health and recognition of sad affect. Finally, increased psychological and/or somatic symptomology was also associated with better identification of neutral expressions. In conclusion, youth with increased psychological and/or somatic problems exhibited a processing bias for negative anger and fear expressions, but not sadness. They showed better processing of neutral faces than youth with fewer psychological and/or somatic problems. Findings are discussed in relation to indicators of mental illnesses in early adolescence and the potential underpinning neural mechanisms associated with mental health and emotional facial recognition.
Recently, low-dose ketamine has been proposed as a rapid-acting treatment option for suicidality. The majority of studies to date have utilised intravenous (IV) ketamine, however, this route of administration has limitations. On the other hand, oral ketamine can be administered in a range of settings, which is important in treating suicidality, although studies as to safety and feasibility are lacking. n = 32 adults (aged 22–72 years; 53% female) with chronic suicidal thoughts participated in the Oral Ketamine Trial on Suicidality (OKTOS), an open-label trial of sub-anaesthetic doses of oral ketamine over 6 weeks. Participants commenced with 0.5 mg/kg of ketamine, which was titrated to a maximum 3.0 mg/kg. Follow-up assessments occurred at 4 weeks after the final dose. The primary outcome measure was the Beck Scale for Suicide Ideation (BSS) and secondary measures included scales for suicidality and depressive symptoms, and measures of functioning and well-being. Mean BSS scores significantly reduced from a high level of suicidal ideation at the pre-ketamine (week 0) timepoint to below the clinical threshold at the post-ketamine (week 6) timepoint. The proportion of participants that achieved clinical improvement within the first 6 weeks was 69%, whereas 50% achieved a significant improvement by the follow-up (week 10) timepoint. Six weeks of oral ketamine treatment in participants with chronic suicidality led to significant reduction in suicidal ideation. The response observed in this study is consistent with IV ketamine trials, suggesting that oral administration is a feasible and tolerable alternative treatment for chronic suicidality.
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