Background: Cognitive behavioral therapy (CBT) is a goal-oriented intervention that aims to improve detrimental emotional or behavioral distress by modifying individuals’ thought processes. This review evaluates the efficacy and specific adaptations of CBT in persons with mild cognitive impairment and dementia. Methods: A literature search of PubMed, Embase, and PsycINFO was conducted up to March 2020. Study quality was assessed using the Cochrane risk of bias criteria. Results: Twelve publications were identified. Seven of the studies demonstrated CBT efficacy to improve depression, anxiety, and/or quality of life. One study’s positive postintervention outcome became insignificant with longer term follow up. Two of the studies improved sleep outcomes. Four studies integrated caregivers into intervention delivery. Three studies utilized content, memory, and adherence adaptations aimed to improve intervention efficacy. Two studies included adaptations to address caregiver burden and depression. Conclusion: There is strong evidence to suggest that CBT is associated with improvements in anxiety, depression, and quality of life in persons with mild cognitive impairment and dementia. CBT showed a reduction in insomnia and improvements in sleep quality. However, there is insufficient evidence to draw conclusions on the effects of CBT on insomnia. These results suggest that further investigation into insomnia outcomes is needed.

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Background Interleukin-18 (IL-18) may participate in the development of major depressive disorder, but the specific mechanism remains unclear. This study aimed to explore whether IL-18 correlates with areas of the brain associated with depression. Methods Using a case–control design, 68 subjects (34 patients and 34 healthy controls) underwent clinical assessment, blood sampling, and resting-state functional Magnetic Resonance Imaging (fMRI). The total Hamilton depression-17 (HAMD-17) score was used to assess depression severity. Enzyme-linked immunosorbent assay (ELISA) was used to detect IL-18 levels. Rest-state fMRI was conducted to explore spontaneous brain activity. Results The level of IL-18 was higher in patients with depression in comparison with healthy controls. IL-18 was negatively correlated with degree centrality of the left posterior cingulate gyrus in the depression patient group, but no correlation was found in the healthy control group. Conclusion This study suggests the involvement of IL-18 in the pathophysiological mechanism for depression and interference with brain activity.

A 28-year-old woman presenting with agitation and mania with psychotic features developed symptoms of isolated lingual dystonia shortly after the initiation of a haloperidol concentrate regimen.

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Background: Interleukin-18 (IL-18) may participate in the development of major depressive disorder, but the specific mechanism remains unclear. This study aimed to explore whether IL-18 correlates with areas of the brain associated with depression.Methods: Using a case-control design, 68 subjects (34 patients and 34 healthy controls) underwent clinical assessment, blood sampling, and resting-state functional Magnetic Resonance Imaging (fMRI). The total Hamilton depression-17 (HAMD-17) score was used to assess depression severity. Enzyme-linked immunosorbent assay (ELISA) was used to detect IL-18 levels. Rest-state fMRI was conducted to explore the spontaneous brain activity. Results: The level of IL-18 was higher in patients with depression in comparison with health controls. IL-18 and degree centrality (DC) were negatively correlated with the left posterior cingulate gyrus in the depression patient group, but no correlation was found in the healthy control group. Conclusion: This study suggests the involvement of IL-18 in the pathophysiological mechanism for depression and interference with brain activity.

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Introduction: COVID-19 pandemic has been associated with increased rates of depression, anxiety, and suicidal ideation. Individuals with mental illnesses are disproportionately affected by additional complex health issues. This study aims to examine the knowledge and impact of COVID-19 among patients with mental disorders at the Harris County Psychiatric Center (HCPC). Methods: A retrospective review of surveys conducted for patients with mental illness at HCPC. Participants were surveyed on demographics, COVID-19 knowledge, and COVID-19 healthcare impact. The data was analyzed with SPSS 20 for Windows at a 0.05 significance level. Results: A total of 46 patients were included in the study. We found that the patient population with mental disorders has different methods of obtaining information regarding COVID-19 and practices varying safety measures. To be precise, more women (52.2%) than men (21.7%) learned about COVID-19 through family and friends [p=0.032]. More Hispanic (21.4%) compared to non-Hispanic (0%) patients learned about COVID-19 through resources from the World Health Organization (WHO) [p=0.032]. Fewer African American (AA) patients avoided contact with people who were sick (39% vs. 81% Caucasian [p=0.01] and 100% Asian/Native American/Pacific Islander [ANAPI] patients [p=0.04]). We found more non-Hispanic (50.0%) vs. Hispanic (7.1%) patients reported that their personal time (time outside of work) was unchanged by COVID-19 [p=0.007]. More Hispanic (57.1%) vs. non-Hispanic (17.9%) patients reported increased time with family members [p=0.009]. Compared to Hispanic patients, more non-Hispanic patients reported unchanged difficulty scheduling appointments (46.4% vs. 7.1%) [p=0.015], obtaining prescription (71.4% vs. 35.7%) [p=0.045], and finding housing placement (53.6% vs. 21.4%) [p=0.047]. Furthermore, more Caucasian compared to AA patients reported more changes in how they feel (35.7% vs. 76.2%) [p=0.033], anxiety (52.6% vs. 0%) [p=0.002], stress (47.4% vs. 7.7%) [p=0.024], and sadness (30% vs. 0%) [p=0.031]. Finally, more ANAPI (67%) compared to AA patients (0%) reported increased anxiety [p=0.025]. Conclusion: Our findings suggest that African American patients report less knowledge of COVID-19 prevention and less impact on their mental health by the pandemic compared to other racial groups. Our findings suggest that African American patients may have limited knowledge of COVID-19 prevention compared to other races, Caucasian and Asian/Native American/Pacific Islander patients may have increased mood changes, and Hispanic patients may be experiencing more healthcare inequality amidst the pandemic. However, further investigation of the impending ramifications of the pandemic is warranted.