CNS Spectrums最新文献_第4页

Current progress in targeted pharmacotherapy to treat symptoms of major depressive disorder: moving from broad-spectrum treatments to precision psychiatry. 靶向药物治疗重度抑郁症症状的最新进展：从广谱治疗到精确精神病学。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-02-07 DOI: 10.1017/S1092852925000094

Manpreet K Singh, Michael E Thase

{"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":"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.","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}

引用次数: 0

Love is expensive: the impact of initiating versus terminating romantic relationships on the onset of obsessive-compulsive disorder. 爱情是昂贵的：开始和结束浪漫关系对强迫症发病的影响。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-31 DOI: 10.1017/S1092852925000033

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

{"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":"Introduction: 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.Materials and methods: 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]).Results: 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.Conclusions: 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.","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}

引用次数: 0

MDMA-assisted therapy: challenges, clinical trials, and the future of MDMA in treating behavioral disorders. MDMA辅助治疗：MDMA治疗行为障碍的挑战、临床试验和未来。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-30 DOI: 10.1017/S1092852925000057

Steve O'Brien, David Nutt

引用次数: 0

Assisted outpatient treatment: are court-ordered antipsychotic medications effective? 辅助门诊治疗：法院命令的抗精神病药物有效吗？

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-28 DOI: 10.1017/S1092852925000045

Sophia Kocher, Marvin Swartz

引用次数: 0

The Italian general psychiatry and forensic psychiatry treatment model: a unique story. 意大利普通精神病学和法医精神病学治疗模式：一个独特的故事。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-17 DOI: 10.1017/S1092852924000646

Felice F Carabellese, Lia Parente

{"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":"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.","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}

引用次数: 0

Rethinking psychometric testing in autism: overcoming the challenges of comorbidity and diagnostic overshadowing. 对自闭症心理测试的反思：克服共病和诊断遮蔽的挑战。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-17 DOI: 10.1017/S1092852925000021

Nihit Gupta, Srinija Srinivasan, Mayank Gupta

{"title":"Rethinking psychometric testing in autism: overcoming the challenges of comorbidity and diagnostic overshadowing.","authors":"Nihit Gupta, Srinija Srinivasan, Mayank Gupta","doi":"10.1017/S1092852925000021","DOIUrl":"10.1017/S1092852925000021","url":null,"abstract":"Epidemiological data indicates a rising prevalence of autism spectrum disorder (ASD) among eight-year-old children, with rates increasing from 1 in 44 to 1 in 36 between 2022 and 2023. This growing prevalence poses significant challenges in achieving accurate diagnoses, particularly due to comorbid conditions and diagnostic overshadowing. Certain subgroups-such as females with ASD, individuals with high cognitive abilities, and ethnic minorities-remain at heightened risk of underdiagnosis. Diagnostic tools like the Autism Diagnostic Observation Schedule (ADOS-2) have limitations, particularly in clinical settings where gender biases and cultural differences in symptom presentation can complicate accurate assessment. Moreover, rural areas face additional burdens due to limited access to care, further exacerbating diagnostic challenges. The review underscores the necessity for improved screening and diagnostic methods tailored to diverse populations, acknowledging the current limitations of existing tools. It also highlights significant barriers such as workforce shortages and lengthy wait times for evaluations. Emphasizing the importance of clinician education and targeted diagnostic approaches, the review calls for attention to cultural and gender differences in ASD evaluation.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e19"},"PeriodicalIF":3.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001191","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}

引用次数: 0

Esketamine nasal spray versus quetiapine XR in adults with treatment-resistant depression: a secondary analysis of the ESCAPE-TRD randomized clinical trial. 艾氯胺酮鼻喷雾剂与奎硫平XR治疗成人难治性抑郁症：ESCAPE-TRD随机临床试验的二次分析

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-17 DOI: 10.1017/S1092852924002451

Roger S McIntyre, Gregory Mattingly, Yordan Godinov, Jozefine Buyze, Ibrahim Turkoz, Patricia Cabrera, Manish Patel, Larry Martinez, Mai Himedan, Oliver Lopena

{"title":"Esketamine nasal spray versus quetiapine XR in adults with treatment-resistant depression: a secondary analysis of the ESCAPE-TRD randomized clinical trial.","authors":"Roger S McIntyre, Gregory Mattingly, Yordan Godinov, Jozefine Buyze, Ibrahim Turkoz, Patricia Cabrera, Manish Patel, Larry Martinez, Mai Himedan, Oliver Lopena","doi":"10.1017/S1092852924002451","DOIUrl":"10.1017/S1092852924002451","url":null,"abstract":"Objective: Esketamine nasal spray (ESK) is approved in combination with an oral antidepressant (OAD) for the treatment of adults with treatment-resistant depression (TRD); however, direct comparisons with atypical antipsychotics for TRD are limited. This secondary analysis of the ESCAPE-TRD study compared rates of remission and response, and improvements in depressive symptoms over time, between ESK and quetiapine extended-release (XR) in patients with TRD treated in accordance with US prescribing information (USPI).Methods: ESCAPE-TRD (NCT04338321) was a randomized, open-label, rater-blinded phase 3b trial investigating ESK versus quetiapine XR for acute and maintenance treatment of patients with TRD. This secondary analysis included patients aged 18-64 years who were treated/dosed according to USPI. The primary endpoint was remission, defined as Montgomery-Åsberg Depression Rating Scale (MADRS) total score ≤ 10. Treatment-emergent adverse events (TEAEs) leading to discontinuation were summarized descriptively.Results: Among 636 patients in this secondary analysis (ESK, n = 316; quetiapine XR, n = 320), significantly more ESK-treated patients achieved remission starting at week 8 (28.3% versus 18.6%; P = 0.005) through week 32 (55.7% versus 36.3%; P < 0.001), compared with quetiapine XR-treated patients. There were clinically and statistically significant improvements in MADRS scores with ESK versus quetiapine XR at each visit from day 8 onwards. Fewer patients discontinued treatment because of TEAEs with ESK (4.5%) versus quetiapine XR (10.1%).Conclusions: Consistent with the primary analysis, this secondary analysis demonstrated that ESK improves short- and long-term outcomes compared with quetiapine XR in patients with TRD treated according to USPI.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e26"},"PeriodicalIF":3.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001164","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}

引用次数: 0

What role did serious mental illness play in Jackson Pollock's drip paintings? Abstract expressionism and possible links to serious mental illness and encrypted images (polloglyphs). 严重的精神疾病在杰克逊·波洛克的水滴画中扮演了什么角色？抽象表现主义和可能与严重精神疾病和加密图像（polloglyphs）有关。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-13 DOI: 10.1017/S1092852924002347

Stephen M Stahl, Debbi Ann Morrissette, Jahon Jabali, Jon A Gates

{"title":"What role did serious mental illness play in Jackson Pollock's drip paintings? Abstract expressionism and possible links to serious mental illness and encrypted images (polloglyphs).","authors":"Stephen M Stahl, Debbi Ann Morrissette, Jahon Jabali, Jon A Gates","doi":"10.1017/S1092852924002347","DOIUrl":"10.1017/S1092852924002347","url":null,"abstract":"The link between creativity and serious mental illness (SMI) is widely discussed. Jackson Pollock is one example of a giant in the field of art who was both highly creative and experiencing an SMI. Pollock created a new genre of art known as abstract expressionism (\"action painting\") defined as showing the frenetic actions of painting. The question arises whether his SMI played any role in the way he created his drip paintings, especially when he was overactive and manic. Furthermore, did visual hallucinations or enhanced visual perception associated with mania or psychosis facilitate Pollock in embedding and camouflaging images under layers of thrown paint? Seeing images in Pollocks drip paintings has been a controversy ever since these paintings were created. Some experts attribute this to pareidolia-perceiving specific images out of random or ambiguous visual patterns-a phenomenon known to be enhanced by fractal fuzzy edges such as seen in Rorschach ink blots as well as in Pollock drip paintings. So, are Pollock's drip paintings merely giant Rorschach images, or did Pollock insert polloglyphs-images that are encrypted that tell a story about Pollock's inner being-into his paintings and then disguise them with drippings? Here, we explore answers to these questions and discuss images that Pollock included in his earliest sketches and used repeatedly in his abstract paintings and later in his drip paintings to argue that these images are not accidental.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e9"},"PeriodicalIF":3.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969973","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}

引用次数: 0

Beyond the hot flashes: how machine learning is uncovering the complexity of menopause-related depression. 除了潮热：机器学习如何揭示更年期相关抑郁症的复杂性。

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-06 DOI: 10.1017/S1092852924002463

Graziella Orrù, Rebecca Ciacchini, Anna Conversano, Ciro Conversano, Angelo Gemignani

{"title":"Beyond the hot flashes: how machine learning is uncovering the complexity of menopause-related depression.","authors":"Graziella Orrù, Rebecca Ciacchini, Anna Conversano, Ciro Conversano, Angelo Gemignani","doi":"10.1017/S1092852924002463","DOIUrl":"10.1017/S1092852924002463","url":null,"abstract":"Background: The transition into menopause marks a significant stage in a woman's life, indicating the end of reproductive capability. This period, encompassing perimenopause and menopause, is characterized by declining levels of estrogen and progesterone, leading to various symptoms such as hot flashes, sleep disturbances, sexual dysfunction, and mood irregularities. Moreover, cognitive functions, notably memory, may decline during this phase.Objective: This exploratory study aimed to evaluate psychological factors in a sample of 98 women recruited from a diagnostic-assistance hospital pathway (AOUP).Methods: Psychological variables, including depression, anxiety, stress, sleep quality, memory, personality traits, and mindfulness, were assessed using psychometric questionnaires. Machine learning techniques were employed to identify independent variables strongly correlated with higher levels of depression measured by BDI-II.Results: The findings revealed positive associations between depression and anxiety, stress, low mood, poor sleep quality, and memory complaints, while mindfulness showed a negative correlation. Remarkably, the machine learning analysis achieved a high classification accuracy in distinguishing between individuals with different levels of depression (low vs high).Conclusions: These results underscore the importance of addressing psychological factors during menopause and offer valuable insights for future research and the development of targeted clinical interventions aimed at enhancing mental health and quality of life for women during this transitional phase.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e33"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930823","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}

引用次数: 0

Correlation analysis of the platelet-to-lymphocyte ratio with attention-deficit hyperactivity disorder in children aged 6-14: based on the National Health and Nutrition Examination Survey database. 6-14岁儿童血小板/淋巴细胞比值与注意缺陷多动障碍的相关性分析：基于全国健康与营养检查调查数据库

IF 3.4 3区医学

CNS Spectrums Pub Date : 2025-01-06 DOI: 10.1017/S1092852924002475

Xianhua Li, Yan Luo, Xiaodan Zeng, Xuewen Qiu, Yang Hua, Lingling Zhan

{"title":"Correlation analysis of the platelet-to-lymphocyte ratio with attention-deficit hyperactivity disorder in children aged 6-14: based on the National Health and Nutrition Examination Survey database.","authors":"Xianhua Li, Yan Luo, Xiaodan Zeng, Xuewen Qiu, Yang Hua, Lingling Zhan","doi":"10.1017/S1092852924002475","DOIUrl":"10.1017/S1092852924002475","url":null,"abstract":"Objective: This study aimed to elucidate the association between the platelet-to-lymphocyte ratio (PLR) and the risk of attention deficit hyperactivity disorder (ADHD) in children aged 6-14 based on National Health and Nutrition Examination Survey (NHANES) data.Method: We utilized data from NHANES 2013-2014 for analysis, with PLR as the independent variable and ADHD as the dependent variable. Weighted logistic regression was used to construct the relationship model. The subgroup analysis with stratification and adjustment for confounding factors was conducted to explore the association between PLR and ADHD risk in children aged 6-14. Finally, the restricted cubic spline (RCS) analysis was carried out to explore the non-linear relationship between PLR and ADHD.Results: The study included 1455 samples with 91 ADHD cases. A significant positive association (OR > 1, P < 0.05) was observed between PLR and ADHD risk in the multivariate weighted logistic regression model. Race and asthma status remarkably influenced the relationship between PLR and ADHD (P for interaction<0.05). The positive association between PLR and ADHD risk was particularly significant (P < 0.05) in boys, children born to mothers aged 20-29, and children with asthma. The RCS curve indicated a non-linear association between PLR and ADHD risk (P-non-linear = 0.0040), with OR > 1 when PLR ≥ 106.40.Conclusion: Increased PLR elevated the risk of ADHD, especially in males, children born to mothers aged 20-29, and children with asthma, with 106.40 possibly being an effective threshold for PLR's impact on ADHD risk.","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e20"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930824","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}

引用次数: 0