Swiss Archives of Neurology, Psychiatry and Psychotherapy

Alzheimer’s disease has recently been redefined as a complex clinical–biological entity by the International Working Group (IWG), and while the cognitive symptoms associated with the disease progression have been thoroughly investigated, subtle behavioral changes that precede functional decline have been less systematically explored. Mild Behavioral Impairment has recently emerged and been operationalized with a dedicated checklist (MBI-C) to identify individuals presenting later-life persistent behavioral changes that might represent the first clinical signs related to an underlying neurodegenerative process. Here, we review current evidence supporting MBI as a promising clinical marker along the Alzheimer’s disease (AD) continuum since its preclinical stages, and we call for further research to investigate the potential added clinical value of a more structured, systematic assessment of behavioral changes in individuals at risk of progression. We outline that a structured MBI assessment could therefore be integrated first into future research diagnostic frameworks and, once validated in real-world settings, into routine clinical workups. Assessing MBI could then become a cost-effective, non-invasive tool aiding in distinguishing early neurodegenerative from primarily psychiatric disorders.

Background: The COVID-19 pandemic disrupted employment, but whether distinct types of employment change are differentially associated with suicidal behavior remains unclear. This study examined the association between pandemic-related employment changes and past-year suicide attempts. Methods: We conducted a cross-sectional analysis of 172,970 adults aged ≥19 years who were economically active before January 2020, using data from the 2021 Korea Community Health Survey (KCHS). Employment change was classified as no change, job loss, deteriorated employment conditions or improved employment conditions. Survey-weighted multivariable logistic regression was used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Results: Overall, 520 participants reported a suicide attempt in the past year. Compared with no change, job loss (AOR, 2.548; 95% CI, 1.777–3.654) and deteriorated employment conditions (AOR, 1.435; 95% CI, 1.116–1.845) were associated with higher odds of suicide attempts, whereas improved employment conditions were not (AOR, 0.678; 95% CI, 0.302–1.521). Job loss was associated with higher odds than deteriorated employment conditions (AOR, 1.776; 95% CI, 1.230–2.564). The interaction was significant for age (p = 0.0130) and income (p = 0.0035), but not for sex (p = 0.1008). Conclusions: Job loss and deteriorated employment conditions were differentially associated with past-year suicide attempts. Because of the cross-sectional design, temporal order and causality cannot be established.

Nightmares are distressing sleep experiences associated with emotional difficulties, impaired daytime functioning, and reduced sleep quality. Although imagery rescripting (IR) has demonstrated effectiveness in reducing nightmare-related distress among adults, evidence regarding its applicability in children remains limited, particularly in Japan. IR is thought to operate, at least in part, by enabling individuals to actively modify threatening imagery and thereby enhance a sense of mastery or perceived control over distressing dream experiences. Although developmental factors may influence how children engage with this process, current evidence does not establish that the fundamental mechanism of IR differs substantially between children and adults. This pilot study examined immediate changes in self-reported fear associated with recalled bad dreams following a brief web-based imagery-rescripting procedure in non-clinical Japanese elementary school children and explored children’s rescripting strategies. Participants were thirty-five fourth- and sixth-grade students (aged 9–12 years) recruited from public elementary schools in Japan. Using a web-based procedure, participants recalled a safe image, described a memorable bad dream, rated its fear intensity, rescripted the dream, and then re-rated fear intensity. Among the 23 participants with complete pre- and post-task ratings, self-reported fear was significantly lower after the procedure than before it. Subgroup patterns according to rescripting status and rescripting strategy were examined descriptively. These findings indicate that self-reported fear associated with recalled bad dreams decreased immediately following the procedure. Further research using larger samples and controlled designs is needed to determine the specific contribution of imagery rescripting and the durability and clinical relevance of these changes.