The University of Minnesota's Clinical Research Support Center Feasibility Review: An objective protocol assessment carving a pathway to study success.

To successfully and efficiently initiate clinical research studies, it is critical to develop a strong, feasible, and well-written study protocol early in the start-up phase. The University of Minnesota's Clinical Research Support Center designed and implemented a structured Feasibility Review process in 2018 that addresses common start-up challenges such as poor study design, inappropriate outcomes, and limited resources. This process has been shown to turn an unfeasible study into a well-designed protocol that is IRB-approved with few protocol-related stipulations and well prepared for execution.

The relative efficiency of schizophrenia health care systems: an international comparison using data envelopment analysis.

Aim: To compare the health economic efficiency of health care systems across nations, within the area of schizophrenia, using a data envelopment analysis (DEA) approach.

Methods: The DEA was performed using countries as decision-making units, schizophrenia disease investment (cost of disease as a percentage of total health care expenditure) as the input, and disability-adjusted life years (DALYs) per patient due to schizophrenia as the output. Data were obtained from the Global Burden of Disease 2017 study, the World Bank Group, and a literature search of the PubMed database.

A transdiagnostic dimensional approach towards a neuropsychological assessment for addiction: an international Delphi consensus study.

Background: The US National Institutes of Mental Health Research Domain Criteria (RDoC) seek to stimulate research into biologically validated neuropsychological dimensions across mental illness symptoms and diagnoses. The RDoC framework comprises 39 functional constructs designed to be revised and refined, with the overall goal of improving diagnostic validity and treatments. This study aimed to reach a consensus among experts in the addiction field on the 'primary' RDoC constructs most relevant to substance and behavioural addictions.

Neuroanatomical Correlates of Impulsive Action in Excoriation (Skin-Picking) Disorder.

Excoriation (skin-picking) disorder (SPD) has similarities to obsessive-compulsive disorder (OCD) and is included within the obsessive-compulsive and related disorders (OCRD) diagnostic class in DSM-5. Separate neuroimaging and neurocognitive studies suggest that people affected by SPD find it difficult to inhibit dominant motor responses due to a failure of "top-down" control mechanisms. No study has examined the neural correlates of SPD in participants with varying degrees of impulsive motor behavior.

Cognitive inflexibility in a young woman with pyromania.

Background Pyromania is a rare disorder that is characterized by multiple episodes of deliberate and purposeful fire-setting. It is typically associated with significant psychosocial dysfunction and legal problems. Even so, little research has examined cognitive aspects of the disorder.

Stealing behavior and impulsivity in individuals with kleptomania who have been arrested for shoplifting.

Objectives: Kleptomania is characterized by strong urges to steal and is one of only a few psychiatric disorders defined by illegal behaviors, but the clinical characteristics of individuals with kleptomania who have faced legal consequences due to their behavior are poorly understood.

Method: From 2001 to 2012, we recruited 107 adult participants with DSM-IV kleptomania. Participants with a history of shoplifting-related arrest (N=82) were compared with those who had no such history (N=25) on demographics, clinical features, and a self-report measure of impulsivity.

A structural MRI study of excoriation (skin-picking) disorder and its relationship to clinical severity.

Excoriation (skin-picking) disorder (SPD) shares symptomology with other obsessive-compulsive and related disorders. Few studies, however, have examined the neurological profile of patients with SPD. This study examined differences in cortical thickness and basal ganglia structural volumes between 20 individuals with SPD and 16 healthy controls using magnetic resonance imaging (MRI).

Placebo response in trichotillomania.

Trichotillomania is a functionally impairing, often overlooked disorder with no Food and Drug Administration-approved medications indicated for its treatment. The ability of clinical trials to detect the beneficial effects of pharmacologic treatment in trichotillomania has been hampered by the high placebo response rate. Very little is known about baseline demographic and clinical characteristics that may be predictive of placebo response in such patients.

Trichotillomania and its clinical relationship to depression and anxiety.

Objective: Trichotillomania (TTM) is associated with high rates of co-occurring depression and anxiety disorders. What the co-occurrence of TTM, depression or anxiety disorders means clinically and cognitively, however, has garnered little research attention.

Methods: About 530 adults with TTM were examined on a variety of clinical measures including symptom severity, psychosocial measures of functioning, psychiatric comorbidity and neurocognitive testing assessing motor inhibition and cognitive flexibility.

Latent class analysis of gambling subtypes and impulsive/compulsive associations: Time to rethink diagnostic boundaries for gambling disorder?

Background: Gambling disorder has been associated with cognitive dysfunction and impaired quality of life. The current definition of non-pathological, problem, and pathological types of gambling is based on total symptom scores, which may overlook nuanced underlying presentations of gambling symptoms. The aims of the current study were (i) to identify subtypes of gambling in young adults, using latent class analysis, based on individual responses from the Structured Clinical Interview for Gambling Disorder (SCI-GD); and (ii) to explore relationships between these gambling subtypes, and clinical/cognitive measures.

Gambling disorder, DSM-5 criteria and symptom severity.

Introduction: Gambling disorder (GD) is a prevalent psychiatric condition whose severity is typically defined by the number of DSM-5 criteria met out of a maximum of nine. The relationships between the levels of gambling severity, thus defined, and other measures of psychopathology and everyday functioning are clinically important.

Methods: Baseline data were collected in patients with GD, conducted from 2001 to 2016.

The Young and the Stressed: Stress, Impulse Control, and Health in College Students.

High levels of stress are common among young adults, particularly those enrolled in college. These degrees of stress have shown numerous deleterious effects across both academic and health variables. Findings regarding the role of stress in the presentation of impulse control disorders, particular among college students, are limited.

Does comorbidity matter in body-focused repetitive behavior disorders?

Background: Trichotillomania (TTM) and skin-picking disorder (SPD) have been characterized as body-focused repetitive behavior disorders (BFRBs). Because BFRBs frequently co-occur, we sought to discover the similarities and differences for individuals having both TTM and SPD as opposed to 1 of these disorders.

Methods: Participants with primary TTM (N = 421) were evaluated regarding the comorbidity of SPD, and participants with primary SPD (N = 124) were evaluated regarding the comorbidity of TTM.

A comparison of clinical vs subclinical skin pickers in Israel.

Background: Skin-picking disorder (SPD) was recognized as its own entity for the first time in DSM-5. The existing SPD literature is limited and, to date, no study has examined the differences between clinical and sub- clinical SPD. Identifying differences between these 2 groups may improve diagnostic accuracy, treatment, and prevention efforts.

Racial-ethnic related clinical and neurocognitive differences in adults with gambling disorder.

Recent epidemiological data suggest that the lifetime prevalence of gambling problems differs depending on race-ethnicity. Understanding variations in disease presentation in blacks and whites, and relationships with biological and sociocultural factors, may have implications for selecting appropriate prevention strategies. 62 non-treatment seeking volunteers (18-29 years, n=18 [29.

Psychosocial dysfunction associated with skin picking disorder and trichotillomania.

Skin picking disorder (SPD) and trichotillomania (TTM) are common and oftentimes disabling disorders. 125 Participants with SPD and 152 with TTM undertook clinical and neurocognitive evaluation, and were grouped according to mild, moderate, or severe levels of psychosocial dysfunction. Relationships between functional impairment and other variables were explored using linear regression and categorical analyses.

N-Acetylcysteine in the Treatment of Excoriation Disorder: A Randomized Clinical Trial.

Importance: Excoriation (skin-picking) disorder (SPD) is a disabling, underrecognized condition in which individuals repeatedly pick at their skin, leading to noticeable tissue damage. To date, there has been no clearly effective pharmacologic or psychological treatment for SPD.

Objective: To determine whether N-acetylcysteine, an amino acid that appears to restore extracellular glutamate concentration in the nucleus accumbens, will be more effective than placebo in reducing compulsive picking behavior.

White matter tract integrity in treatment-resistant gambling disorder.

Background: Gambling disorder is a relatively common psychiatric disorder recently re-classified within the DSM-5 under the category of 'substance-related and addictive disorders'.

Aims: To compare white matter integrity in patients with gambling disorder with healthy controls; to explore relationships between white matter integrity and disease severity in gambling disorder.

Method: In total, 16 participants with treatment-resistant gambling disorder and 15 healthy controls underwent magnetic resonance imaging (MRI).

Characteristics and correlates of stealing in college students.

Background: Stealing is a fairly common behaviour among young adults. Understanding the potential associations and characteristics of individuals who steal may help educational institutions, health services and young people themselves resolve difficulties before the behaviour impacts on their academic performance and health.

Aims: We aim to test the hypothesis that desires to steal among students would be associated with worse academic achievements and higher rates of mood and impulse control disorders.

Neural and psychological underpinnings of gambling disorder: A review.

Gambling disorder affects 0.4 to 1.6% of adults worldwide, and is highly comorbid with other mental health disorders.

Abnormal brain activation in excoriation (skin-picking) disorder: evidence from an executive planning fMRI study.

Background: Excoriation (skin-picking) disorder (SPD) is a relatively common psychiatric condition whose neurobiological basis is unknown.

Aims: To probe the function of fronto-striatal circuitry in SPD.

Method: Eighteen participants with SPD and 15 matched healthy controls undertook an executive planning task (Tower of London) during functional magnetic resonance imaging (fMRI).

Skin picking disorder with co-occurring body dysmorphic disorder.

There is clinical overlap between skin picking disorder (SPD) and body dysmorphic disorder (BDD), but little research has examined clinical and cognitive correlates of the two disorders when they co-occur. Of 55 participants with SPD recruited for a neurocognitive study and two pharmacological studies, 16 (29.1%) had co-occurring BDD.

COMT genotype, gambling activity, and cognition.

Neuropsychological studies of adults with problem gambling indicate impairments across multiple cognitive domains. Catechol-O-methyltransferase (COMT) plays a unique role in the regulation of dopamine in the prefrontal cortex, and has been implicated in the cognitive dysfunction evident in problem gambling. This study examined adults with varying levels of gambling behavior to determine whether COMT genotype was associated with differences in gambling symptoms and cognitive functioning.