Objectives: To determine the prevalence and correlates of treatment-resistant schizophrenia (TRS) through a systematic review and meta-analysis. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, an electronic search was performed in PubMed and Embase through May 17, 2022. All study designs that assessed a minimum of 20 schizophrenia-spectrum patients and provided data on TRS prevalence or allowed its calculation were included. Estimates were produced using a random-effects model meta-analysis. Results: The TRS prevalence across 50 studies (n = 29,390) was 36.7% (95%CI 33.1-40.5, p < 0.0001). The prevalence ranged from 22% (95%CI 18.4-25.8) in first-episode to 39.5% (95%CI 32.2-47.0) in multiple-episode samples (Q = 18.27, p < 0.0001). Primary treatment resistance, defined as no response from the first episode, was 23.6% (95%CI 20.5-26.8) vs. 9.3% (95%CI 6.8-12.2) for later-onset/secondary (≥ 6 months after initial treatment response). Longer illness duration and recruitment from long-term hospitals or clozapine clinics were associated with higher prevalence estimates. In meta-regression analyses, older age and poor functioning predicted greater TRS. When including only studies with lower bias risk, the TRS prevalence was 28.4%. Conclusion: Different study designs and recruitment strategies accounted for most of the observed heterogeneity in TRS prevalence rates. The results point to early-onset and later-onset TRS as two separate disease pathways requiring clinical attention. Registration number: PROSPERO CRD42018092033. Objectives treatmentresistant resistant (TRS metaanalysis. metaanalysis meta analysis. analysis meta-analysis Methods MetaAnalyses Meta Analyses PRISMA (PRISMA criteria 17 2022 2 schizophreniaspectrum spectrum included randomeffects random effects Results 5 n 29,390 29390 29 390 367 36 7 36.7 95%CI 95CI CI 95 33.140.5, 331405 33.1 40.5, 33 1 40 33.1-40.5 0.0001. 00001 0.0001 . 0 0001 0.0001) 22 18.425.8 184258 18.4 25.8 18 4 25 8 18.4-25.8 firstepisode episode 395 39 39.5 32.247.0 322470 32.2 47.0 32 47 32.2-47.0 multipleepisode multiple Q 1827 27 18.27 resistance 236 23 23.6 20.526.8 205268 20.5 26.8 26 20.5-26.8 vs 93 9 3 9.3 6.812.2 68122 6.8 12.2 12 6.8-12.2 lateronset/secondary lateronsetsecondary later onset/secondary onset secondary ≥ ( response. response) longterm long term estimates metaregression regression analyses risk 284 28 28.4% Conclusion rates earlyonset early lateronset attention number CRD42018092033 CRD 202 29,39 2939 36. 140 33.140.5 33140 331 33. 405 40.5 33.1-40. 0000 0.000 000 425 18.425. 18425 184 18. 258 25. 18.4-25. 39. 247 32.247. 32247 322 32. 470 47. 32.2-47. 182 18.2 23. 526 20.526. 20526 205 20. 268 26. 20.5-26. 9. 812 6.812. 6812 68 6. 122 12. 6.8-12. onsetsecondary 28.4 CRD4201809203 29,3 293 14 33.140. 3314 40. 33.1-40 0.00 00 42 18.425 1842 18.4-25 24 32.247 3224 32.2-47 52 20.526 2052 20.5-26 81 6.812 681 6.8-12 28. CRD420180920 29, 33.140 33.1-4 0.0 18.42 18.4-2 32.24 32.2-4 20.52 20.5-2 6.81 6.8-1 CRD42018092 33.14 33.1- 0. 18.4- 32.2- 20.5- 6.8- CRD4201809 CRD420180 CRD42018 CRD4201 CRD420 CRD42 CRD4

Lack of diversity regarding genetic and environmental backgrounds weakens the generalization and clinical applicability of research findings on psychotic disorders. Notably, Latin Americans have been generally neglected in genetic studies, comprising less than 2% of genome-wide association study samples. But Latin American populations represent a unique opportunity for research, given the exceptionally high ethnic admixture of this group. Increasing genetic diversity is essential to improve the fine mapping of known regions associated with psychotic disorders, discover novel genetic associations, and replicate studies. Additionally, Latin America is characterized by massive social, political, and economic inequalities, all known risk factors for mental health issues, including psychotic disorders. This article aims to 1) discuss the challenges and advantages of studying Latin America’s particular genetic makeup and environmental context; 2) review previous studies conducted in the region; and 3) describe three Latin American research initiatives in progress: the Neuropsychiatric Genetics of Psychosis in Mexican Populations (NeuroMEX), the Paisa, and the Latin American Network for the Study of Early Psychosis (ANDES) studies.

Objective: To determine whether psychiatric and gaming pattern variables are associated with gaming disorder in a school-based sample. Methods: We analyzed data from the Brazilian High-Risk Cohort for Psychiatric Disorders, a community sample aged 10 to 18, using questionnaires on gaming use patterns. We applied the Gaming Addiction Scale to diagnose gaming disorder and the Development and Well-Being Behavior Assessment for other diagnoses. Results: Out of 407 subjects, 83 (20.4%) fulfilled the criteria for gaming disorder. More role-playing game players were diagnosed with gaming disorder that any other genre. Gaming disorder rates increased proportionally to the number of genres played. Playing online, being diagnosed with a mental disorder, and more hours of non-stop gaming were associated with higher rates of gaming disorder. When all variables (including age and gender) were considered in a logistic regression model, the number of genres played, the number of non-stop hours, the proportion of online games, and having a diagnosed mental disorder emerged as significant predictors of gaming disorder. Conclusion: Each variable seems to add further risk of gaming disorder among children and adolescents. Monitoring the length of gaming sessions, the number and type of genres played, time spent gaming online, and behavior changes may help parents or guardians identify unhealthy patterns of gaming behavior.