CNS Spectrums最新文献

{"title":"Attenuated mental symptoms in the general population: first data from the observational cross-sectional ATTENTION study in Greece.","authors":"Michaela Koummati, Jelena Vrublevska, Marc De Hert, Allan H Young, Paolo Fusar-Poli, Rajiv Tandon, Afzal Javed, Konstantinos N Fountoulakis","doi":"10.1017/S1092852925000112","DOIUrl":"10.1017/S1092852925000112","url":null,"abstract":"<p><strong>Background: </strong>It has been reported that abnormal experiences could be common in the general \"healthy\" population, with the vast majority of individuals never proceeding to manifest a frank mental disorder.</p><p><strong>Aims: </strong>This study aimed to quantify subthreshold psychiatric symptoms in the general population.</p><p><strong>Methods: </strong>The protocol included clinicodemographic data and a mental symptoms questionnaire, and additionally, the CES-D, STAI-S, RASS, and the GloDiS to assess depression, anxiety, suicidality, and functional impairment, respectively. The data were collected online and anonymously from 1504 persons (75.66% females; 23.73% males). Descriptive statistics, risk ratios, and factor analysis were utilized.</p><p><strong>Results: </strong>Clinical depression was present in approximately 10%, any somatic disorder in 20.21% (9.90% both), and a history of any mental disorder was present in 42.75%. The healthy individuals (46.94% of the study sample) were experiencing distress (8.6%) and subthreshold mental symptoms (attenuated psychotic, schizotypal distrust, emotional lability, conformity, and interpersonal and social functioning). Attenuated psychotic symptoms are present in almost 10%, and the conversion rate to any kind of psychosis was probably 0.5% per year until the age of 40, with one-third of these persons eventually converting. Beyond the age of 40, no conversion to psychosis seems to occur. All aspects of symptoms correlated weakly but significantly with aspects of functional impairment.</p><p><strong>Conclusions: </strong>The results of the current study are in accord with the literature and suggest that a significant number of persons in the general population experience attenuated psychiatric symptoms and mild functional impairment without ever manifesting an overt mental disorder. There is a need for further research on this matter to confirm these findings and to explore their implications both for mental and somatic health and the provision of health care.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e27"},"PeriodicalIF":3.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of glucagon-like peptide-1 and glucose dependent insulinotropic polypeptide receptor agonists on neurogenesis, differentiation, and plasticity (Neuro-GDP): potential mechanistically informed therapeutics in the treatment and prevention of mental disorders.","authors":"Roger S McIntyre, Natalie Rasgon, Joseph Goldberg, Sabrina Wong, Gia Han Le, Rodrigo B Mansur, Joshua D Rosenblat, Kayla M Teopiz, Stephen M Stahl","doi":"10.1017/S1092852925000124","DOIUrl":"10.1017/S1092852925000124","url":null,"abstract":"<p><p>Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists (RAs) mimic naturally occurring GLP-1 and GIP and are highly effective anti-diabetic and anti-obesity agents. In addition to their robust acute and long-term effects on weight, metabolism, and blood pressure, these agents also reduce cardiovascular mortality as well as stroke risk and associated consequences. A replicated and convergent body of preclinical evidence also indicates that incretin receptor agonists activate molecular effectors critical to neuroplasticity, neuroprotection, and anti-apoptosis. Herein, we propose that GLP-1 RAs and GIP RAs are promising transdiagnostic mechanistically informed therapeutics in the treatment and prevention of multiple domains of psychopathology, including general cognitive, reward, and motivation systems and mental disorders. Major neurocognitive disorders (eg, Alzheimer's Disease, Parkinson's Disease), alcohol and substance use disorders, traumatic brain injury, and depressive disorders are near-term therapeutic targets. In addition, GLP-1 RAs and GIP RAs have robust effects on comorbidities that differentially affect persons with mental disorders (eg, cardiovascular, cerebrovascular, and metabolic disorders) and psychotropic drug-related weight gain.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e23"},"PeriodicalIF":3.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the delivery technology used in ADHD stimulant medications can help to individualize treatment.","authors":"Andrew J Cutler, Jacob Hanaie","doi":"10.1017/S1092852925000070","DOIUrl":"10.1017/S1092852925000070","url":null,"abstract":"<p><p>Attention-deficit/hyperactivity disorder (ADHD) is a highly heterogeneous disorder for which treatment personalization is essential. Stimulant medications are the first-line option for ADHD management due to their high efficacy. While the choice of stimulant is limited to methylphenidate or amphetamine, there are numerous formulation options each associated with different potential benefits and restrictions. The goal is to deliver a stimulant medication that provides an even, continuous control of symptoms tailored to the patient's symptoms and lifestyle. This article reviews the technologies used to deliver stimulants and the impact their characteristics have on the pharmacokinetic profiles, dosing regimens, and flexibility of the medication. The aim was to help clinicians in their treatment decision-making process and provide patients with effective and individualized management of their ADHD symptoms.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e30"},"PeriodicalIF":3.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From assessment to intervention: evidence-based approaches in tardive dyskinesia.","authors":"Desiree Matthews","doi":"10.1017/S1092852925000082","DOIUrl":"10.1017/S1092852925000082","url":null,"abstract":"<p><p>Tardive dyskinesia (TD) is a potentially irreversible movement disorder induced by dopamine receptor-blocking agents, including antipsychotics. Despite progress in antipsychotic medications, TD remains widely prevalent even in the era of second-generation antipsychotics. Early detection is critical for preventing irreversible damage and minimizing the disorder's impact on patients' daily lives. Risk factors for TD include advanced age, female sex, medical comorbidities, and prolonged use of dopamine receptor-blocking agents (DRBAs). Effective screening for TD should incorporate evidence-based screening techniques such as the Abnormal Involuntary Movement Scale (AIMS) and informal methods to capture a comprehensive view of TD's severity and impact. Combining these approaches allows for a thorough assessment of both healthcare practitioner-perceived severity and patient-reported effects on daily life. Modern treatment options, including vesicular monoamine transporter 2 (VMAT2) inhibitors like valbenazine and deutetrabenazine, have demonstrated significant efficacy and safety in clinical trials. Approved by the FDA in 2017, these medications enable continued psychiatric care while managing TD symptoms. Long-term studies support their sustained efficacy and safety, underscoring the importance of individualized, evidence-based treatment plans to improve patient outcomes.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e25"},"PeriodicalIF":3.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dispositional mindfulness, interoceptive awareness, and panic-agoraphobic spectrum, in a general population sample.","authors":"Mario Miniati, Alessandra Battani, Laura Palagini, Rebecca Ciacchini, Ciro Conversano, Graziella Orrù, Giulio Perugi, Donatella Marazziti, Angelo Gemignani","doi":"10.1017/S1092852925000100","DOIUrl":"https://doi.org/10.1017/S1092852925000100","url":null,"abstract":"","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"1-27"},"PeriodicalIF":3.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current progress in targeted pharmacotherapy to treat symptoms of major depressive disorder: moving from broad-spectrum treatments to precision psychiatry.","authors":"Manpreet K Singh, Michael E Thase","doi":"10.1017/S1092852925000094","DOIUrl":"10.1017/S1092852925000094","url":null,"abstract":"<p><p>Major depressive disorder (MDD) is a disabling condition affecting children, adolescents, and adults worldwide. A high proportion of patients do not respond to one or more pharmacological treatments and are said to have treatment-resistant or difficult-to-treat depression. Inadequate response to current treatments could be due to medication nonadherence, inter-individual variability in treatment response, misdiagnosis, diminished confidence in treatment after many trials, or lack of selectivity. Demonstrating an adequate response in the clinical trial setting is also challenging. Patients with depression may experience non-specific treatment effects when receiving placebo in clinical trials, which may contribute to inadequate response. Studies have attempted to reduce the placebo response rates using adaptive designs such as sequential parallel comparison design. Despite some of these innovations in study design, there remains an unmet need to develop more targeted therapeutics, possibly through precision psychiatry-based approaches to reduce the number of treatment failures and improve remission rates. Examples of precision psychiatry approaches include pharmacogenetic testing, neuroimaging, and machine learning. These approaches have identified neural circuit biotypes of MDD that may improve precision if they can be feasibly bridged to real-world clinical practice. Clinical biomarkers that can effectively predict response to treatment based on individual phenotypes are needed. This review examines why current treatment approaches for MDD often fail and discusses potential benefits and challenges of a more targeted approach, and suggested approaches for clinical studies, which may improve remission rates and reduce the risk of relapse, leading to better functioning in patients with depression.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e16"},"PeriodicalIF":3.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Love is expensive: the impact of initiating versus terminating romantic relationships on the onset of obsessive-compulsive disorder.","authors":"Donatella Marazziti, Leonardo F Fontenelle, Gustavo A de-Medeiros, Maria Eduarda Moreira-de-Oliveira, Gabriela B de Menezes, Manuel Glauco Carbone, Stefania Palermo, Lara Foresi Crowther, Francesco Weiss, Riccardo Gurrieri, Alessandro Arone","doi":"10.1017/S1092852925000033","DOIUrl":"10.1017/S1092852925000033","url":null,"abstract":"<p><strong>Introduction: </strong>Recently, some observational studies suggested that romantic love (RL) might influence the phenotypic expression of obsessive-compulsive disorder (OCD). The aim of the present study was to investigate the impact of different stages of RL on the clinical expression of OCD.</p><p><strong>Materials and methods: </strong>Two hundred and twelve patients with OCD onset related to the development or the termination of a romantic relationship (RR) and who were attending outpatient units at the University Psychiatric Clinic of Pisa, Italy, and seven specialized OCD clinics in Brazil were recruited. The assessment instruments were: the Structured Clinical Interview for DSM-5 Disorders (SCID-5), the Yale OCD Natural History Questionnaire, and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Participants were divided into two groups (love-precipitated [LP-OCD] and break-up OCD [BU-OCD]).</p><p><strong>Results: </strong>The total Y-BOCS and obsessions and compulsions subscales scores were similar and indicative of severe OCD in the two groups. The average age of onset was significantly lower in the BU-OCD group, perhaps reflecting a vulnerability of the brain's maturational stages to \"undesirable\" events in young individuals at risk for OCD. A trend towards aggression and symmetry, and ordering and rearrangement dimensions in BU-OCD patients emerged, possibly reflecting an amplification of some normal features of a RR.</p><p><strong>Conclusions: </strong>Our findings suggest that different stages of RL may influence some features of OCD, namely the age of onset and specific dimensions. Again, RL poses the risk of developing this pathological condition in vulnerable individuals. Further research on the topic should be encouraged.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e21"},"PeriodicalIF":3.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MDMA-assisted therapy: challenges, clinical trials, and the future of MDMA in treating behavioral disorders.","authors":"Steve O'Brien, David Nutt","doi":"10.1017/S1092852925000057","DOIUrl":"10.1017/S1092852925000057","url":null,"abstract":"<p><p>This chapter explores the complex and controversial path of MDMA-assisted therapy (MDMA-AT) for treating post-traumatic stress disorder (PTSD) and other behavioral disorders. It covers MDMA's history from research to recreation to medicine, the pivotal trials, and the challenges faced by researchers. Despite recent setbacks for the clinical application of MDMA, the chapter argues that it holds potential for transforming psychiatry and discusses the uncertain future amidst ongoing debates over ethics, methodology, and political influence.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e15"},"PeriodicalIF":3.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assisted outpatient treatment: are court-ordered antipsychotic medications effective?","authors":"Sophia Kocher, Marvin Swartz","doi":"10.1017/S1092852925000045","DOIUrl":"10.1017/S1092852925000045","url":null,"abstract":"<p><p>Assisted Outpatient Treatment (AOT) is a controversial civil court program wherein a judge orders a person with severe mental illness to adhere to an outpatient treatment plan designed to improve treatment adherence, prevent relapse and dangerous deterioration. Several states, including California and New York, have recently promoted use of AOT to try to address high rates of homelessness among person with severe mental illness. Under AOT, clinicians treating these patients must balance the ethical principles of patient autonomy and beneficence, and employ AOT only when previous treatment failed as a result of treatment non-adherence. However, some critics of AOT argue that not only is it coercive and ineffective but that the court mandate to adhere to prescribed medications, usually antipsychotic medications, compels AOT recipients to take ineffective and even harmful medications. This article examines the assertion of these critics and reviews the evidence of antipsychotic effectiveness and potential harms in treating psychotic disorders under a civil court order.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e17"},"PeriodicalIF":3.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Italian general psychiatry and forensic psychiatry treatment model: a unique story.","authors":"Felice F Carabellese, Lia Parente","doi":"10.1017/S1092852924000646","DOIUrl":"10.1017/S1092852924000646","url":null,"abstract":"<p><p>The history of Italian general psychiatry and forensic psychiatry over the last 50 years has been unique in the European and Western healthcare landscape. Western politicians often visit Italy to observe the successful community-based systems that have developed in that country.This article represents a first step toward a necessary attempt, to explore how specific political decisions, such as the Italian one, have produced positive outcomes for patients with psychotic disorders, outcomes not observed in many Western countries, which are instead grappling with negative outcomes such as the complicated management of homelessness and the incarceration of people who would instead require psychiatric care.In its historical context, the 1978 decision to abandon the asylum tradition in favor of socialization for patients living with severe mental disorders represented a difficult choice. This choice led to inevitable critical issues, which today are still not completely dormant.This choice has also, undoubtedly, restored dignity to people living with serious mental illness, even when that person commits a crime.To understand these changes, it is appropriate to mention the regulations that finally led to Law number 180 of 1978, which decreed the closure of psychiatric hospitals (Ospedale Psichiatrico) throughout Italy and continued after 2015 with the closure of high-security psychiatric hospitals (Ospedale Psichiatrico Giudiziario) as well.Culturally, much has changed throughout this time in assistance to the mentally ill in Europe.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e1"},"PeriodicalIF":3.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}