Review
Biochemistry & Molecular Biology
Morteza Abyadeh, Vivek Gupta, Joao A. Paulo, Veer Gupta, Nitin Chitranshi, Angela Godinez, Danit Saks, Mafruha Hasan, Ardeshir Amirkhani, Matthew McKay, Ghasem H. Salekdeh, Paul A. Haynes, Stuart L. Graham, Mehdi Mirzaei
Summary: This review discusses the therapeutic properties of cannabinoids found in cannabis for various diseases and the need for more research to understand the molecular and biochemical effects of cannabis at a cellular level. Proteomics technology is highlighted as an efficient tool to study the mechanistic effects of cannabis on the human body, drawing conclusions about its toxicity, therapeutic benefits, safety, and efficacy profiles.
Article
Multidisciplinary Sciences
Jonathan D. Schaefer, Nayla R. Hamdi, Stephen M. Malone, Scott Vrieze, Sylia Wilson, Matt McGue, William G. Iacono
Summary: Observational studies have found associations between adolescent cannabis use and negative outcomes in young adulthood, particularly in terms of mental health and socioeconomic status.
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
(2021)
Article
Plant Sciences
Daniela Vergara, Ezra L. Huscher, Kyle G. Keepers, Rahul Pisupati, Anna L. Schwabe, Mitchell E. McGlaughlin, Nolan C. Kane
Summary: The Cannabis varieties produced by the National Institute on Drug Abuse (NIDA) lack diversity and potency compared to commercially produced Cannabis, and are genetically divergent from those in the private legal market. Research results based on NIDA's varieties are not generalizable due to their lack of diversity in various aspects of the genome, hindering scientific investigation into the effects of Cannabis after consumption.
FRONTIERS IN PLANT SCIENCE
(2021)
Article
Psychiatry
Lauren Moran, Erica S. Tsang, Dost Ongur, John Hsu, May Y. Choi
Summary: This study used the 2017 National Inpatient Sample database to investigate the association between cannabis legalization in the United States and hospitalizations for cannabis-associated psychosis. The findings showed a higher proportion of hospital discharges for psychosis associated with cannabis use in areas with more liberal cannabis legalization laws.
PSYCHIATRY RESEARCH
(2022)
Article
Emergency Medicine
George Sam Wang, Christine Buttorff, Asa Wilks, Daniel Schwam, Gregory J. Tung, Shireen Banerji, Richard C. Dart, Rosalie Liccardo Pacula
Summary: This study compares the trends of healthcare encounters and poison center cases related to opioids, cannabis, and synthetic cannabinoids in Colorado. The results show an increase in cannabis-related encounters and exposures after cannabis legalization, while opioid-related exposures have decreased.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Article
Plant Sciences
Sebastian Pino, Luis Espinoza, Carlos Jara-Gutierrez, Joan Villena, Andres F. Olea, Katy Diaz
Summary: Currently, efforts are being made to obtain extracts or essential oils from Cannabis sativa L. for specific therapeutic purposes or pharmacological compositions. The composition of these oils depends on the type of C. sativa and the extraction method used. This study evaluated the content of secondary metabolites, THC, CBD, as well as the total phenolic, flavonoids, and anthraquinone content in oils extracted using SLE and SCF, and assessed their antioxidant, antifungal, and anticancer activities. The results suggest that oils extracted by SLE with high CBD, flavonoids, and phenolic compounds have strong antioxidant capacity and exhibit a significant reduction in viability of breast cancer cell lines, potentially making them natural anticancer agents.
Review
Clinical Neurology
Babasola O. Okusanya, Breanne E. Lott, John Ehiri, Jean McClelland, Cecilia Rosales
Summary: This review assessed the effectiveness and safety of medical cannabis (MC) for treating migraines in adults. The results showed that MC significantly reduced nausea and vomiting associated with migraine attacks, as well as the number of migraine days and frequency. Compared to non-cannabis products, MC was more effective in reducing migraines. However, its use was associated with medication overuse headaches and mild adverse events. More well-designed experimental studies are needed to further support this hypothesis.
FRONTIERS IN NEUROLOGY
(2022)
Review
Plant Sciences
Tristan K. Adams, Nqobile A. Masondo, Pholoso Malatsi, Nokwanda P. Makunga
Summary: The development of protocols for large-scale production of Cannabis and its variants, particularly focusing on tissue culture and micropropagation, is an emerging area of research. Challenges remain in obtaining industrially acceptable micropropagation regimes due to difficulties in regenerating in vitro cultured plants. Future advancements may rely on reliable plant tissue culture techniques and genetic engineering systems for large-scale production of Cannabis.
Article
Psychology, Clinical
Jonathan D. Schaefer, Seon-Kyeong Jang, Scott Vrieze, William G. Iacono, Matt McGue, Sylia Wilson
Summary: While adolescent cannabis use and cannabis use disorder are consistently associated with increased risk of psychosis, the correlation is more likely due to familial confounding factors rather than a causal effect of cannabis exposure. This suggests that efforts to reduce psychotic illnesses may benefit from focusing on other therapeutic targets.
JOURNAL OF ABNORMAL PSYCHOLOGY
(2021)
Review
Biochemistry & Molecular Biology
Andrew J. Kesner, David M. Lovinger
Summary: Cannabis sativa is the most widely used illicit drug in the world, with its main psychoactive component being THC. Despite its medical therapeutic qualities, frequent cannabis or THC users may develop cannabis use disorder, exhibiting classical addiction symptoms. Effective treatments for cannabis use disorder and withdrawal symptoms are currently lacking, highlighting the importance of research on the neurobiological mechanisms underlying these syndromes.
JOURNAL OF NEUROCHEMISTRY
(2021)
Article
Psychiatry
Tabea Schoeler, Jason Ferris, Adam R. Winstock
Summary: Cannabis use can lead to acute psychotic symptoms, known as cannabis-associated psychotic symptoms (CAPS), that may require emergency medical treatment. In a global sample of cannabis users, approximately 0.47% reported lifetime occurrence of CAPS, characterized by hallucinations and/or paranoia. Several factors, including age, country of residence, type of cannabis used, and mental health diagnosis, were associated with increased risk of CAPS. More research is needed to understand the potential harms of cannabis use and educate users and the public about associated risks.
TRANSLATIONAL PSYCHIATRY
(2022)
Article
Critical Care Medicine
Danielle C. Hergert, Cidney Robertson-Benta, Veronik Sicard, Daniela Schwotzer, Kent Hutchison, Dan P. Covey, Davin K. Quinn, Joseph R. Sadek, Jacob McDonald, Andrew R. Mayer
Summary: For traumatic brain injury (TBI), medical cannabis may have neuroprotective and psychotherapeutic properties, but there is currently a lack of high-quality research. Patients are using medical and recreational cannabis to treat symptoms, highlighting inconsistencies with public policy and empirical evidence.
JOURNAL OF NEUROTRAUMA
(2021)
Article
Plant Sciences
Christopher J. Grassa, George D. Weiblen, Jonathan P. Wenger, Clemon Dabney, Shane G. Poplawski, S. Timothy Motley, Todd P. Michael, C. J. Schwartz
Summary: The study found that CBD-type cannabis primarily expresses cannabidiolic acid synthase (CBDAS), while cannabis strains with a balanced THC:CBD ratio express both CBDAS and THCAS. Cannabinoid synthase genes are arranged in tandem structure and embedded within long terminal repeat retrotransposons on chromosome 7.
Article
Neurosciences
Sarah D. Lichenstein, Daniel S. Shaw, Erika E. Forbes
Summary: Cannabis use is common among adolescents and emerging adults, and this study found that moderate cannabis use during adolescence is associated with the development of certain white matter pathways, while long-term use may delay maturation of these pathways.
FRONTIERS IN HUMAN NEUROSCIENCE
(2022)
Review
Chemistry, Medicinal
Rachel Riera, Rafael Leite Pacheco, Angela Maria Bagattini, Ana Luiza Cabrera Martimbianco
Summary: The debate surrounding the therapeutic use of cannabinoids is growing, with evidence suggesting potential benefits for certain health conditions such as ulcerative colitis and chemotherapy-related nausea and vomiting. However, the certainty of evidence is generally low for other outcomes, indicating a lack of support for or against routine use.
PHYTOTHERAPY RESEARCH
(2022)
Article
Psychology, Clinical
Olesya Ajnakina, Robin Murray, Andrew Steptoe, Dorina Cadar
Summary: This study examines the relationship between polygenic predisposition to general cognition and the rate of cognitive decline during a 10-year follow-up period. The results show that an increase in polygenic scores for general cognition is associated with higher baseline verbal memory and semantic fluency scores. However, there is no association between polygenic predisposition and age-related cognitive decline.
PSYCHOLOGICAL MEDICINE
(2023)
Review
Behavioral Sciences
Uzma Zahid, Ellis C. Onwordi, Emily P. Hedges, Matthew B. Wall, Gemma Modinos, Robin M. Murray, Alice Egerton
Summary: Glutamatergic and GABAergic dysfunction play a role in the pathophysiology of schizophrenia. Previous research has shown associations between glutamate, GABA, and brain activity in healthy volunteers. This systematic review found disrupted relationships between neurometabolites and brain activity in psychosis, with reduced positive associations between glutamate levels and brain activity during resting state and increased associations during cognitive control tasks, as well as reduced negative relationships between GABA and local activation in the ACC. There is potential for using these findings as biomarkers and for developing novel therapeutic approaches.
NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS
(2023)
Article
Psychology, Clinical
Tessa Roberts, Ezra Susser, Joni Lee Pow, Casswina Donald, Sujit John, Vijaya Raghavan, Olatunde Ayinde, Bola Olley, Georgina Miguel Esponda, Joseph Lam, Robin M. M. Murray, Alex Cohen, Helen A. A. Weiss, Gerard Hutchinson, Rangaswamy Thara, Oye Gureje, Jonathan Burns, Adejoke Agboola, Craig Morgan
Summary: Extensive evidence suggests that rates of psychotic disorder are higher in urban areas compared to less urban areas, but this evidence is mainly based on Northern Europe. This study examined the association between urban residence and rates of psychotic disorder in India, Nigeria, and Northern Trinidad. The results showed that there is a higher rate of psychosis in urban areas of Trinidad, a negative association in Nigeria, and no association in India. However, a modest positive association was found in recent onset cases in India.
PSYCHOLOGICAL MEDICINE
(2023)
Letter
Psychiatry
Marco Colizzi, Alexis E. E. Cullen, Natasha Martland, Marta Di Forti, Robin Murray, Tabea Schoeler, Sagnik Bhattacharyya
Article
Genetics & Heredity
Jessica Mundy, Christopher Hubel, Brett N. N. Adey, Helena L. L. Davies, Molly R. R. Davies, Jonathan R. I. Coleman, Matthew Hotopf, Gursharan Kalsi, Sang Hyuck Lee, Andrew M. M. McIntosh, Henry C. C. Rogers, Thalia C. C. Eley, Robin M. M. Murray, Evangelos Vassos, Gerome Breen
Summary: The Mood Disorder Questionnaire (MDQ) is commonly used for screening bipolar disorder but its validity for genetic studies has not been fully examined. A study compared the MDQ to self-reported bipolar disorder and conducted genome-wide association studies to investigate genetic correlations with bipolar disorder and other traits. The MDQ showed low positive predictive value for self-reported bipolar disorder and no genetic correlations with bipolar disorder were found. The study also suggested that the MDQ may capture symptoms of general distress or psychopathology instead of specifically targeting hypomania/mania in at-risk populations.
AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS
(2023)
Article
Biochemistry & Molecular Biology
Dominic B. Dwyer, Ganesh B. Chand, Alessandro Pigoni, Adyasha Khuntia, Junhao Wen, Mathilde Antoniades, Gyujoon Hwang, Guray Erus, Jimit Doshi, Dhivya Srinivasan, Erdem Varol, Rene S. Kahn, Hugo G. Schnack, Eva Meisenzahl, Stephen J. Wood, Chuanjun Zhuo, Aristeidis Sotiras, Russell T. Shinohara, Haochang Shou, Yong Fan, Maristela Schaulfelberger, Pedro Rosa, Paris A. Lalousis, Rachel Upthegrove, Antonia N. Kaczkurkin, Tyler M. Moore, Barnaby Nelson, Raquel E. Gur, Ruben C. Gur, Marylyn D. Ritchie, Theodore D. Satterthwaite, Robin M. Murray, Marta Di Forti, Simone Ciufolini, Marcus V. Zanetti, Daniel H. Wolf, Christos Pantelis, Benedicto Crespo-Facorro, Geraldo F. Busatto, Christos Davatzikos, Nikolaos Koutsouleris, Paola Dazzan
Summary: Using machine learning, researchers found that schizophrenia can be decomposed into two volumetric subgroups with distinct neuroanatomical characteristics: a 'lower brain volume' subgroup and a 'higher striatal volume' subgroup. These subgroups were already present at the first episode of psychosis and were associated with different clinical presentations and remission outcomes. The findings suggest that these subgroups may be important in understanding the underlying mechanisms of schizophrenia and could be targeted in future treatment trials.
MOLECULAR PSYCHIATRY
(2023)
Article
Biochemistry & Molecular Biology
Luis Alameda, Zhonghua Liu, Pak C. Sham, Monica Aas, Giulia Trotta, Victoria Rodriguez, Marta Di Forti, Simona A. Stilo, Radhika Kandaswamy, Celso Arango, Manuel Arrojo, Miguel Bernardo, Julio Bobes, Lieuwe de Haan, Cristina Marta Del-Ben, Charlotte Gayer-Anderson, Lucia Sideli, Peter B. Jones, Hannah E. Jongsma, James B. Kirkbride, Caterina La Cascia, Antonio Lasalvia, Sarah Tosato, Pierre-Michel Llorca, Paulo Rossi Menezes, Jim van Os, Diego Quattrone, Bart P. Rutten, Jose Luis Santos, Julio Sanjuan, Jean-Paul Selten, Andrei Szoke, Ilaria Tarricone, Andrea Tortelli, Eva Velthorst, Craig Morgan, Emma Dempster, Eilis Hannon, Joe Burrage, Daniella Dwir, Atheeshaan Arumuham, Jonathan Mill, Robin M. Murray, Chloe C. Y. Wong
Summary: Studies have found that DNA methylation is sensitive to childhood adversity in psychotic disorders, but it is unclear whether it mediates the association between childhood adversity and psychosis. This study found that childhood adversity was associated with psychosis, but no specific CpG sites were found to mediate the association. However, there were differentially methylated probes associated with genes previously linked to psychosis.
MOLECULAR PSYCHIATRY
(2023)
Article
Multidisciplinary Sciences
Andre Zugman, Luz Maria Alliende, Vicente Medel, Richard A. I. Bethlehem, Jakob Seidlitz, Grace Ringlein, Celso Arango, Aurina Arnatkeviciute, Laila Asmal, Mark Bellgrove, Vivek Benegal, Miquel Bernardo, Pablo Billeke, Jorge Bosch-Bayard, Rodrigo Bressan, Geraldo F. Busatto, Mariana N. Castro, Tiffany Chaim-Avancini, Albert Compte, Monise Costanzi, Leticia Czepielewski, Paola Dazzan, Camilo de la Fuente-Sandoval, Marta Di Forti, Covadonga M. Diaz-Caneja, Ana Maria Diaz-Zuluaga, Stefan Du Plessis, Fabio L. S. Duran, Sol Fittipaldi, Alex Fornito, Nelson B. Freimer, Ary Gadelha, Clarissa S. Gama, Ranjini Garani, Clemente Garcia-Rizo, Cecilia Gonzalez Campo, Alfonso Gonzalez-Valderrama, Salvador Guinjoan, Bharath Holla, Agustin Ibanez, Daniza Ivanovic, Andrea Jackowski, Pablo Leon-Ortiz, Christine Lochner, Carlos Lopez-Jaramillo, Hilmar Luckhoff, Raffael Massuda, Philip McGuire, Jun Miyataaaa, Romina Mizrahi, Robin Murray, Aysegul Ozerdem, Pedro M. Pan, Mara Parellada, Lebogan Phahladira, Juan P. Ramirez-Mahalu, Ramiro Reckziegel, Tiago Reis Marques, Francisco Reyes-Madrigal, Annerine Roos, Pedro Rosa, Giovanni Salum, Freda Scheffler, Gunter Schumann, Mauricio Serpa, Dan J. Stein, Angeles Tepper, Jeggan Tiego, Tsukasa Ueno, Juan Undurraga, Eduardo A. Undurrag, Pedro Valdes-Sosaooo, Isabel Valliy, Mirta Villarrealu, Toby T. Winton-Brownrrr, Nefize Yalin, Francisco Zamorano, Marcus V. Zanetti, Anderson M. Winkler, Daniel S. Pine, Sara Evans-Lacko, Nicolas A. Crossley
Summary: Gender inequality has been linked to higher mental health risks and lower academic achievement for women globally. Differences in brain structure between men and women may be partially explained by unequal exposure to harsher conditions in gender-unequal countries, leading to worse outcomes for women. A meta-analysis of MRI scans from 139 samples across 29 countries revealed that women in gender-equal countries had no differences or even thicker cortical regions, while those in countries with greater gender inequality had thinner cortices. These findings highlight the potential negative impact of gender inequality on women's brains and the need for policies based on neuroscience for gender equality.
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
(2023)
Article
Psychology, Clinical
Edoardo Spinazzola, Diego Quattrone, Victoria Rodriguez, Giulia Trotta, Luis Alameda, Giada Tripoli, Charlotte Gayer-Anderson, Tom P. Freeman, Emma C. Johnson, Hannah E. Jongsma, Simona Stilo, Caterina La Cascia, Laura Ferraro, Daniele La Barbera, Antonio Lasalvia, Sarah Tosato, Ilaria Tarricone, Giuseppe D'Andrea, Michela Galatolo, Andrea Tortelli, Ilaria Tagliabue, Marco Turco, Maurizio Pompili, Jean-Paul Selten, Lieuwe de Haan, Paulo Rossi Menezes, Cristina M. Del Ben, Jose Luis Santos, Manuel Arrojo, Julio Bobes, Julio Sanjuan, Miguel Bernardo, Celso Arango, James B. Kirkbride, Peter B. Jones, Michael O'Donovan, Bart P. Rutten, Jim Van Os, Craig Morgan, Pak C. Sham, Isabelle Austin-Zimmerman, Zhikun Li, Evangelos Vassos, Robin M. Murray, Marta Di Forti
Summary: This study found an association between reasons for first using cannabis and patterns of use and risk of psychosis. Most patients started using cannabis because of friends, but a higher proportion of patients compared to controls reported using cannabis to feel better.
PSYCHOLOGICAL MEDICINE
(2023)
Article
Psychology, Clinical
Giulia Trotta, Victoria Rodriguez, Diego Quattrone, Edoardo Spinazzola, Giada Tripoli, Charlotte Gayer-Anderson, Tom P. Freeman, Hannah E. Jongsma, Lucia Sideli, Monica Aas, Simona A. Stilo, Caterina La Cascia, Laura Ferraro, Daniele La Barbera, Antonio Lasalvia, Sarah Tosato, Ilaria Tarricone, Giuseppe D'Andrea, Andrea Tortelli, Franck Schuerhoff, Andrei Szoeke, Baptiste Pignon, Jean-Paul Selten, Eva Velthorst, Lieuwe de Haan, Pierre-Michel Llorca, Paulo Rossi Menezes, Cristina M. Del Ben, Jose Luis Santos, Manuel Arrojo, Julio Bobes, Julio Sanjuan, Miquel Bernardo, Celso Arango, James B. Kirkbride, Peter B. Jones, Alexander Richards, Bart P. Rutten, Jim Van Os, Isabelle Austin-Zimmerman, Zhikun Li, Craig Morgan, Pak C. Sham, Evangelos Vassos, Chloe Wong, Richard Bentall, Helen L. Fisher, Robin M. Murray, Luis Alameda, Marta Di Forti
Summary: This study aims to explore the relationship between childhood adversity and psychosis, and whether cannabis use acts as a mediator between adversity and psychotic disorders. Data from 881 first-episode psychosis patients and 1231 controls were analyzed, and it was found that the association between household discord and psychosis was partially mediated by the use of cannabis. Children exposed to challenging environments could benefit from psychosocial interventions aimed at preventing cannabis misuse.
PSYCHOLOGICAL MEDICINE
(2023)
Article
Psychiatry
Edward Millgate, Sophie E. Smart, Antonio F. Pardinas, Eugenia Kravariti, Olesya Ajnakina, Adrianna P. Kapinska, Ole A. Andreassen, Thomas R. E. Barnes, Domenico Berardi, Benedicto Crespo-Facorro, Giuseppe D'Andre, Arsime Demjaha, Marta Di Forti, Gillian A. Doody, Laura Kassoumeri, Aziz Ferchiou, Lorenzo Guidi, Eileen M. Joyce, Ornella Lastrina, Ingrid Melle, Baptiste Pignon, Jean-Romain Richard, Carmen Simonsen, Andrei Szoke, Ilaria Tarricone, Andrea Tortelli, Javier Vazquez-Bourgon, Robin M. Murray, James T. R. Walters, James H. MacCabe
Summary: This study aimed to determine whether cognitive impairment at first episode significantly differs between future antipsychotic responders and resistant cases. The findings showed that patients who were future classified as treatment resistant reported poorer performance across most cognitive domains at baseline. These results indicate that deficits in IQ/general cognitive functioning at first episode are associated with future treatment resistance.
SCHIZOPHRENIA RESEARCH
(2023)
Article
Psychiatry
Lucia Sideli, Monica Aas, Diego Quattrone, Daniele La Barbera, Caterina La Cascia, Laura Ferraro, Luis Alameda, Eva Velthorst, Giulia Trotta, Giada Tripoli, Adriano Schimmenti, Andrea Fontana, Charlotte Gayer-Anderson, Simona Stilo, Fabio Seminerio, Crocettarachele Sartorio, Giovanna Marrazzo, Antonio Lasalvia, Sarah Tosato, Ilaria Tarricone, Domenico Berardi, Giuseppe D'Andrea, Celso Arango, Manuel Arrojo, Miguel Bernardo, Julio Bobes, Julio Sanjuan, Jose Luis Santos, Paulo Rossi Menezes, Cristina Marta Del-Ben, Hannah E. Jongsma, Peter B. Jones, James B. Kirkbride, Pierre-Michel Llorca, Andrea Tortell, Baptiste Pignon, Lieuwe de Haan, Jean-Paul Selten, Jim Van Os, Bart P. Rutten, Richard Bentall, Marta Di Fort, Robin M. Murray, Craig Morgan, Helen L. Fisher
Summary: This study aimed to investigate whether the relationship between childhood maltreatment and cognition in patients with psychosis and community controls was influenced by genetic factors related to psychosis. The study included first-episode psychosis patients (N=755) and unaffected controls (N=1219) from the EU-GEI study, who were assessed for childhood maltreatment, intelligence quotient (IQ), family history of psychosis (FH), and polygenic risk score for schizophrenia (SZ-PRS). The results showed that controlling for FH and SZ-PRS did not weaken the association between childhood maltreatment and IQ in either cases or controls, suggesting that genetic liability factors do not explain the lower levels of cognition in adults who experienced childhood maltreatment.
SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY
(2023)
Article
Substance Abuse
Dominic Oliver, Amir Englund, Edward Chesney, Lucy Chester, Jack Wilson, Simina Sovi, Stina Wigroth, John Hodsoll, John Strang, Robin M. Murray, Tom P. Freeman, Paolo Fusar-Poli, Philip McGuire
Summary: This study aimed to investigate the effects of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) on attentional bias and explicit liking. The results showed that inhaled THC increased attentional bias towards cannabis, while CBD had no influence on this effect.
Article
Psychiatry
Rebecca Pollard, Helen L. Fisher, Paul Fearon, Kevin Morgan, Julia Lappin, Gerard Hutchinson, Gillian A. Doody, Peter B. Jones, Robin M. Murray, Craig Morgan, Paola Dazzan
Summary: A study found that parenting styles with high control and low caring were associated with mental disorders including schizophrenia. However, the study also showed that a more caring and less controlling parenting style from fathers was associated with better functioning at follow-up in individuals with schizophrenia. Surprisingly, uncaring and controlling parenting styles were not associated with a notably worse course of illness or symptom severity over the follow-up period.
ARCHIVES OF WOMENS MENTAL HEALTH
(2023)