Bo Cao

University of Alberta | UAlberta · Department of Psychiatry

Aberrant resting-state functional connectivity (FC) of anterior cingulate cortex (ACC) has been implicated in the pathophysiology of schizophrenia and bipolar disorder (BP). This study investigated the subregional FC of ACC across schizophrenia and psychotic (PBP) and nonpsychotic BP (NPBP) and the relationship between brain functional alterations...

Background: Our previous study has shown the cingulate cortex abnormalities in first-episode drug naïve (FEDN) schizophrenia patients with comorbid depressive symptoms. However, it remains largely unknown whether antipsychotics may induce morphometric change in cingulate cortex and its relationship with depressive symptoms. The purpose of this stu...

Background Digital cognitive behavior therapy for insomnia (dCBT-I) is an effective treatment in alleviating insomnia. This study examined the effect of dCBT-I for improving sleep quality in patients with insomnia complaints from a clinical population in a real-world setting. Methods The study included 6,002 patients aged 18 years and above with p...

Self- and value-based reward processing were investigated from an individual difference perspective. Participants learnt to associate geometric shapes with three identities (self, friend, stranger) on one occasion and three values (e.g., high, medium, low monetary value) on another occasion. Participants then carried out a perceptual matching task...

Screening for adult Attention-Deficit/Hyperactivity Disorder (ADHD) and differentiating ADHD from comorbid mental health disorders remains to be clinically challenging. A screening tool for ADHD and comorbid mental health disorders is essential, as most adult ADHD is comorbid with several mental health disorders. The current pilot study enrolled 95...

Objective There is growing evidence that reduced cortical thickness has been considered to be a central abnormality in schizophrenia. Brain imaging studies have demonstrated that the cerebral cortex becomes thinner in patients with first-episode schizophrenia. This study aimed to examine whether cortical thickness is altered in drug-naïve schizophr...

Background During the ongoing COVID-19 pandemic, we are being exposed to large amounts of information each day. This “infodemic” is defined by the World Health Organization as the mass spread of misleading or false information during a pandemic. This spread of misinformation during the infodemic ultimately leads to misunderstandings of public healt...

Objective To perform a systematic review on the psychiatric adverse effects of chloroquine (CQ) and hydroxychloroquine (HCQ); to summarize what is known about psychiatric adverse effects of these drugs; to compare clinical trials, populational studies, and case report studies; and to increase awareness of the potential psychiatric adverse effects o...

Objective Opioid use disorder (OUD) is a chronic relapsing disorder with a problematic pattern of opioid use, affecting nearly 27 million people worldwide. Machine learning (ML)-based prediction of OUD may lead to early detection and intervention. However, most ML prediction studies were not based on representative data sources and prospective vali...

Background In recent years, the delivery of evidence-based therapies targeting posttraumatic stress disorder (PTSD) has been the focus of the Departments of Defense in countries such as Canada, the Netherlands, and the United States. More than 66% of military members continue to experience symptoms of PTSD that significantly impact their daily func...

Sexual dysfunction (SD) is prevalent in patients with mental health disorders and can significantly impair their quality of life. Early recognition of SD in a clinical setting may help patients and clinicians to optimize treatment options of SD and/or other primary diagnoses taking SD risk into account and may facilitate treatment compliance. SD id...

Background : Depressive symptoms, postpartum and peripartum, can affect mothers' ability to nurture their children, and may have adverse impacts on social, cognitive, language, and self-concept development. Currently, postpartum and peripartum depression are treated through psychotherapy, electroconvulsive therapy (ECT), and pharmacotherapy. These...

Background: First responders are confronted with traumatic events in their work that has a substantial toll on their psychological health and may contribute to or result in posttraumatic stress injuries (PTSIs) for many responders. Persons with a PTSI usually seek management therapies. Evidence indicates that digital delivery of these therapies is...

Neuroimaging techniques have advanced our knowledge about neurobiological mechanisms of reward and emotion processing. It remains unclear whether reward and emotion-related processing share the same neural connection topology and how intrinsic brain functional connectivity organization changes to support emotion- and reward-related prioritized effe...

Background Effective screening is important to combat the raising burden of depression and opens a critical time window for early intervention. Clinical use of non-verbal depression screening is nascent, yet a promising and viable candidate to supplement verbal screening. Differential self- and emotion-processing in depression patients were previou...

Background Individuals discharged from inpatient psychiatry units have the highest readmission rates of all hospitalized patients. These readmissions are often due to unmet need for mental health care compounded by limited human resources. Reducing the need for hospital admissions by providing alternative effective care will mitigate the strain on...

Small hippocampal size may be implicated in the pathogenesis and psychopathology of schizophrenia (SCZ). However, does the volume of hippocampal subfields in SCZ patients affect response to antipsychotic treatment? In this study, we used risperidone to treat first-episode drug naïve (FEDN) SCZ patients for 12 weeks, and then explored the relationsh...

The placebo effect across psychiatric disorders is still not well understood. In the present study, we conducted meta-analyses including meta-regression, and machine learning analyses to investigate whether the power of placebo effect depends on the types of psychiatric disorders. We included 108 clinical trials (32,035 participants) investigating...

Background Identifying the risk factors of suicide attempts(SA) in adolescents with mood disorders(MD) who engage in non-suicidal self-injury(NSSI) is of great significance for suicide prevention. The aim of the present study was to explore the psychological characteristics and risk factors of SA among MD adolescents engaged in NSSI. Methods We re...

BACKGROUND In recent years, the delivery of evidence-based therapies targeting posttraumatic stress disorder (PTSD) has been the focus of the Departments of Defense in countries such as Canada, the Netherlands, and the United States. More than 66% of military members continue to experience symptoms of PTSD that significantly impact their daily func...

Background: Although common variants in a large collection of patients are associated with increased risk for bipolar disorder (BD), studies have only been able to predict 25%-45% of risks, suggesting that lots of variants that contribute to the risk for BD haven't been identified. Our study aims to identify novel BD risk genes. Methods: We perf...

Background : Bipolar disorder (BD) is a prevalent mental health illness with a direct impact on patient's well-being. Self-report-based BD screening questionnaires such as the Mood Disorder Questionnaire (MDQ) is economical and clinically validated. We use a machine-learning approach to test whether utilizing our composite screening application - E...

A prominent cognitive aspect of anxiety is dysregulation of emotional interpretation of facial expressions, associated with neural activity from the amygdala and prefrontal cortex. We report machine learning analysis of fMRI results supporting a key role for a third area, the temporal pole (TP) for childhood anxiety in this context. This finding is...

Background Major depressive disorder (MDD) is a common and burdensome condition that has low rates of treatment success for each individual treatment. This means that many patients require several medication switches to achieve remission; selecting an effective antidepressant is typically a sequential trial-and-error process. Machine learning techn...

Small hippocampal size, especially in CA1 may be implicated in the pathogenesis and psychopathology of schizophrenia (SCZ). However, does the volume of hippocampal subfields like CA1 in SCZ patients affect response to antipsychotic treatment? In this study, we used risperidone to treat first-episode and drug naïve (FEDN) SCZ patients for 12 weeks,...

Abnormalities within frontal lobe gray and white matter of bipolar disorder (BD) patients have been consistently reported in adult and pediatric studies, yet little is known about the neurochemistry of the anterior white matter (AWM) in pediatric BD and how medication status may affect it. The present cross-sectional 3T ¹H MRS study is the first to...

Converging evidence increasingly implicates shared etiologic and pathophysiological characteristics among major psychiatric disorders (MPDs), such as schizophrenia (SZ), bipolar disorder (BD), and major depressive disorder (MDD). Examining the neurobiology of the psychotic-affective spectrum may greatly advance biological determination of psychiatr...

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Background Although social distancing is necessary to decrease COVID-19 dissemination, it might also be associated with suicidal ideation. Therefore, we analyzed the impact of social distancing and loneliness in suicidal ideation. Methods We performed two waves of a snowball sample, web-based survey in Brazil (W1: from May 6th to June 6th, 2020; W...

Altered brain gyrification in diverse cortical regions has been reported in patients with schizophrenia, which possibly reflects deviations in early neurodevelopment. The main purpose of this study was to examine the relationship between clinical symptoms and abnormal cortical gyrification in drug-naïve patients with schizophrenia in a Chinese Han...

Objectives Antidepressants are first-line treatments for major depressive disorder (MDD), but 40–60% of patients will not respond, hence, predicting response would be a major clinical advance. Machine learning algorithms hold promise to predict treatment outcomes based on clinical symptoms and episode features. We sought to independently replicate...

The interaction between psychological stress and immune system may be associated with the cognitive impairment of schizophrenia. To employ machine learning algorithms to examine patterns of stress-immune networks with cognitive impairment in chronic schizophrenia, we selected cortisol, tumor necrosis factor (TNF) - α, interleukin (IL) - 2, IL-6 and...

Background Bipolar disorder (BD) is a severe psychiatric disorder associated with structural and functional brain abnormalities, some of which have been found in unaffected relatives as well. In this study, we examined the potential role of decreased fractional anisotropy (FA) as a BD endophenotype, in adolescents at high risk for BD. Methods We i...

BACKGROUND First responders are confronted with the traumatic event(s) in their work that has a significant toll on their psychological health and that may contribute to or result in post-traumatic stress injuries (PTSI) for many responders. Persons with a PTSI usually seek management therapies, which they hope will be effective. Evidence indicates...

In proton magnetic resonance spectroscopy (¹H MRS) studies, aberrant levels of choline-containing compounds that includes glycerophosphocholine plus phosphocholine (GPC+PC), can signify alterations in the metabolism of cellular membrane phospholipids (MPLs) from a healthy baseline. In a recent ¹H MRS study, we reported increased GPC+PC in cortical...

In March 2020, Alberta Health Services launched Text4Hope, a free mental health text-message service. The service aimed to alleviate pandemic-associated stress, generalized anxiety disorder (GAD), major depressive disorder (MDD), and suicidal propensity. The effectiveness of Text4Hope was evaluated by comparing psychiatric parameters between two su...

Background This study reports on the changes in stress, anxiety, and depressive symptoms of subscribers after 3 months using Text4Hope, a supportive text messaging program designed to provide support during the pandemic. Methods Standardized self-report measures were used to evaluate perceived stress (measured with the Perceived Stress Scale-10 (P...

Background: Suicidal behavior is a major concern for patients who suffer from major depressive disorder (MDD), especially among adolescents and young adults. Machine learning models with the capability of suicide risk identification at an individual level could improve suicide prevention among high-risk patient population. Methods: A cross-sectiona...

Introduction: With the sudden onset and global dispersal of the SARS-CoV-2 virus, many nations including Canada attempted to reduce spread of the resultant COVID-19 syndrome with self-isolation and quarantine, while seeking a cure or vaccine for this disease. Understanding impacts of self-isolation and self-quarantine on stress, anxiety, and depres...

Background There is still little knowledge of objective suicide risk stratification. Methods This study aims to develop models using machine-learning approaches to predict suicide attempt (1) among survey participants in a nationally representative sample and (2) among participants with lifetime major depressive episodes. We used a cohort called t...

Structural hippocampal abnormalities are common in many neurological and psychiatric disorders, and variation in hippocampal measures is related to cognitive performance and other complex phenotypes such as stress sensitivity. Hippocampal subregions are increasingly studied, as automated algorithms have become available for mapping and volume quant...

Identifying cognitive dysfunction in early stages of Bipolar Disorder (BD) can allow for early intervention. Previous studies have shown a strong correlation between cognitive dysfunction and number of manic episodes. The objective of this study was to apply machine learning (ML) techniques on a battery of cognitive tests to identify first episode...

Background In addition to the obvious physical medical impact of COVID-19, the disease poses evident threats to people’s mental health, psychological safety, and well-being. Provision of support for these challenges is complicated by the high number of people requiring support and the need to maintain physical distancing. Text4Hope, a daily support...

Depressive symptoms are common in patients with first‐episode psychosis. However, the neural mechanisms underlying the comorbid depression in schizophrenia are still unknown. The main purpose of this study was to characterize the structural abnormalities of first‐episodes drug‐naïve (FEDN) schizophrenia comorbid with depression by utilizing both vo...

A prominent cognitive aspect of anxiety is dysregulation of emotional interpretation of facial expressions, associated with neural activity from the amygdala and prefrontal cortex. We report machine learning analysis of fMRI results supporting a key role for a third area, the temporal pole (TP) for childhood anxiety in this context. This finding is...

Disturbance of glucose metabolism may be implicated in cognitive deficits of schizophrenia in its early phases. Many studies have reported the important role of widespread disruption of white matter (WM) connectivity in pathogenesis, cognitive deficit and psychopathology of schizophrenia. However, no study has investigated their inter-relationships...

A correction to this paper has been published and can be accessed via a link at the top of the paper.

Variability in fMRI data analysis from different research teams on the same data set makes the scientific findings of similar studies using fMRI less persuasive. We want to comment that this reproductivity issue is associated with the hypothesis testing paradigm, which can be potentially mitigated by a machine learning based predictive modeling app...

Background : Screening for major depressive disorder (MDD) in tertiary care settings can be challenging, as patients often present with complex symptom profiles and false positives are common. We used machine learning (ML) to test our composite screening application—EarlyDetect (ED), which includes extant validated scales as well as a selection of...

UNSTRUCTURED As many as 80% of internet users seek health information online. The social determinants of health (SDoH) are intimately related to who has access to the internet and healthcare as a whole. Those who face more barriers to care are more likely to benefit from accessing health information online, granted the information they are retrievi...

As many as 80% of internet users seek health information online. The social determinants of health (SDoH) are intimately related to who has access to the internet and health care as a whole. Those who face more barriers to care are more likely to benefit from accessing health information online, assuming the information they are retrieving is accur...

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Chloroquine and hydroxychloroquine are commonly used drugs in the treatment of malaria as well as chronic diseases, such as rheumatoid arthritis, and systemic lupus erythematosus. Although various reports on possible psychiatric side effects of these drugs exist, the nature and extent of these effects remain poorly understood. Moreover, the relevan...

Background: A necessary shift from in-person to remote delivery of psychotherapy (eg, teletherapy, eHealth, videoconferencing) has occurred because of the COVID-19 pandemic. A corollary benefit is a potential fit in terms of the need for equitable and timely access to mental health services in remote and rural locations. Owing to COVID-19, there m...

Memory dysfunction and associated hippocampal disturbances play crucial roles in cognitive impairment of schizophrenia. To examine the relationships between cognitive function and the hippocampal subfields (HSs) in first-episode never-treated (FENT) schizophrenia patients, the HSs were segmented in 39 FENT patients and 30 healthy controls using a s...

BACKGROUND During the unprecedented time of the COVID-19 pandemic, the need to support mental wellbeing is urgent. In March 2020, Text4Hope was provided as a community health service to Alberta residents. This free service aims to promote psychological resilience and alleviate pandemic-associated stress, anxiety, and depression symptoms. OBJECTIVE...

Background In March 2020, Text4Hope—a community health service—was provided to Alberta residents. This free service aims to promote psychological resilience and alleviate pandemic-associated stress, anxiety, and depression symptoms during the COVID-19 pandemic. Objective This study aimed to evaluate the feedback, satisfaction, experience, and perce...

Structural hippocampal abnormalities are common in many neurological and psychiatric disorders, and even variation within the normal range is related to cognitive performance and other complex phenotypes such as stress sensitivity. Hippocampal subregions are increasingly studied, as automated algorithms have become available for mapping and volume...

BACKGROUND Background: In addition to the obvious medical (physical) impact of COVID-19, threats to mental health, psychological safety, and well-being are evident. Provision of support for these challenges is complicated by the high number of people requiring support and the need to maintain physical distancing. Text4Hope, a daily supportive texti...

BACKGROUND A necessary shift from in-person to remote delivery of psychotherapy (e.g., teletherapy, eHealth, videoconferencing) has occurred due to the COVID-19 pandemic. A corollary benefit is potential fit in terms of the need for equitable and timely access to mental health (MH) services in remote and rural locations. COVID-19 may increase the n...

BACKGROUND Coronavirus disease 2019 (COVID-19) has spread globally with far-reaching, significant and unprecedented impacts on health and way of life. Threats to mental health, psychological safety and well being are now emerging, increasing the impact of this virus on world health. Providing support for these challenges is difficult because of ver...

Background: Coronavirus disease 2019 (COVID-19) has spread globally with far-reaching, significant and unprecedented impacts on health and way of life. Threats to mental health, psychological safety and well being are now emerging, increasing the impact of this virus on world health. Providing support for these challenges is difficult because of v...

Identifying biomarkers in schizophrenia during the first episode without the confounding effects of treatment has been challenging. Leveraging these biomarkers to establish diagnosis and make individualized predictions of future treatment responses to antipsychotics would be of great value, but there has been limited progress. In this study, by usi...

Background: The β2 subunit of the voltage-gated l-type calcium channel gene(CACNB2) rs11013860 polymorphism is a putative genetic susceptibility marker for bipolar disorder (BD). However, the neural effects of CACNB2 rs11013860 in BD are largely unknown. Methods: Forty-six bipolar patients with first-episode mania and eighty-three healthy contro...

Functional alterations in the subregions of the anterior cingulate cortex (ACC) have been observed in patients with major depressive disorder (MDD). Studies have shown that higher depressive symptoms are associated with altered functional connectivity (FC) in different ACC sub-regions. Suicide is highly prevalent in patients with MDD; however, it i...

Background: Basal ganglia are particularly important for understanding the pathobiology of psychosis given their key roles in dopaminergic neurotransmission which are associated with psychotic symptoms and one of the target sites of antipsychotic drugs. Psychotic symptoms are prevalent in both schizophrenia (SZ) and bipolar disorder (BD). Although...

The big data analytics open a promising path to personalized psychiatry. Along with the opportunities are some unprecedented challenges. In this chapter, we will discuss some of these challenges that we are facing in the field of big data analytics in psychiatry. For example, we are still lacking data standardization in diagnoses, variables and pro...

Accumulating evidence shows that disruption of white matter (WM) may be involved in the pathophysiology of schizophrenia, even at the onset of psychosis. However, very few studies have explored sex difference in its association with psychopathology in schizophrenia. This study aims to compare sex differences in clinical features and WM abnormalitie...