CNS Spectrums最新文献

{"title":"Skin picking disorder and hazardous alcohol use.","authors":"Jon E Grant, Sophie Boutouis","doi":"10.1017/S1092852925100813","DOIUrl":"10.1017/S1092852925100813","url":null,"abstract":"<p><strong>Background: </strong>Skin picking disorder is characterized by repetitive excoriation of one's skin. Although skin picking disorder is associated with substance use problems, no previous research has examined the associations of alcohol use on skin picking symptomatology.</p><p><strong>Methods: </strong>Adults with skin picking disorder (<i>n</i> = 182) were recruited from the general community via an online survey. Participants completed the Alcohol Use Disorders Identification Test (AUDIT) to measure alcohol use and various self-report measures to assess clinical profiles and associated characteristics. We compared variables of interest between those with hazardous alcohol use in the past year (AUDIT ≥8) compared to those with low-risk or no alcohol use in the past year. We also examined the extent to which skin picking disorder symptoms were dimensionally related to AUDIT scores while controlling for confounders.</p><p><strong>Results: </strong>Of the 182 adults with skin picking disorder, 62 (34.1%) met criteria for hazardous alcohol use. Hazardous drinking was associated with less frequent skin picking but higher overall picking-related severity and impairment, aggression, and rates of comorbid borderline personality disorder, gambling disorder, and compulsive sexual behavior disorder. Skin picking-related impairment predicted the degree of hazardous drinking while controlling for sex.</p><p><strong>Conclusions: </strong>This study highlights the importance of screening for hazardous alcohol use in people with skin picking disorder. More research is needed to explore the relationship between aggression, hazardous alcohol use, and skin picking, as well as how treatments might best be adapted to treat individuals with this cluster of symptoms.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e99"},"PeriodicalIF":4.6,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ritual to relief: ethical frontiers in repurposing psychoactive substances.","authors":"Emma O'Leary, Seetal Dodd, Stephen Stahl","doi":"10.1017/S1092852924002232","DOIUrl":"10.1017/S1092852924002232","url":null,"abstract":"<p><p>Psychoactive substances, known for their acute impact on perception and cognition, are gaining attention for their potential therapeutic applications. Many of these substances are plant-derived with deep-rooted histories of use in non-medical contexts, where they have been viewed as either tools for social cohesion or sources of discord, depending on cultural and societal contexts. This review explores psychoactive substances; psychedelics, cannabis, and stimulants, in a legitimized medical context, focusing on the ethical considerations shaping research and the regulatory and prescribing challenges involved in translating these compounds into viable clinical treatments. It highlights the diverse voices; Indigenous, philosophical, psychiatric, and using communities advocating for careful consideration of their broader implications. Key issues include navigating the blurred boundaries between therapeutic benefit and potential misuse, ensuring rigorous scientific methodologies, and addressing the sociopolitical factors shaping public perception and policy. The article emphasizes the need for evidence-based frameworks that balance innovation with patient safety and calls for approaches that recognize the social and commercial determinants of health, extending ethical considerations beyond merely prescribing. By critically assessing the promise and limitations of repurposing these substances, the article contributes to the ongoing discourse on their role in contemporary psychiatric practice.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":"30 1","pages":"e93"},"PeriodicalIF":4.6,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mediating effect of trauma and loss spectrum on the relationship between autistic traits and eating disorder symptoms among patients with borderline personality disorder.","authors":"Barbara Carpita, Chiara Bonelli, Stefano Pini, Carla Cappiello, Benedetta Nardi, Margarita Pustynnikova, Filippo Del Grande, Matteo Pioltino, Gabriele Massimetti, Ivan Mirko Cremone, Mario Luciano, Andrea Fiorillo, Lilliana Dell'Osso","doi":"10.1017/S1092852925100783","DOIUrl":"10.1017/S1092852925100783","url":null,"abstract":"<p><strong>Background: </strong>While increasing research is reporting a higher presence of autistic traits (AT) in patients with borderline personality disorder (BPD), both autism spectrum disorder (ASD) and BPD have been associated in literature with a vulnerability to trauma and eating disorders.</p><p><strong>Aim: </strong>The present study aimed at evaluating trauma-related symptoms and eating disorder symptoms in BPD patients with or without significant AT.</p><p><strong>Methods: </strong>A sample of 73 BPD patients was assessed with the adult autism subthreshold (AdAS) Spectrum, trauma and loss spectrum-self report (TALS-SR), and EDI-2 questionnaires.</p><p><strong>Results: </strong>The findings revealed that BPD patients with autistic traits (BPD-AT) scored significantly higher on the eating disorder inventory (EDI-2) and trauma and loss scale (TALS-SR) compared to those without AT. Moreover, while both AdAS Spectrum and TALS-SR scores predicted higher EDI-2 scores, a significant mediating effect of TALS-SR on the relationship between AdAS Spectrum and EDI-2 scores was reported.</p><p><strong>Conclusion: </strong>These results suggest that AT may imply more severe clinical correlates in the BPD population, including an enhanced vulnerability toward psychopathological traits frequently reported in BPD patients such as eating disorders and trauma-related symptoms, stressing the need to clarify the complex interactions among these disorders and the factors that may shape specific illness trajectories.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e97"},"PeriodicalIF":4.6,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are orexin antagonists capable of improving both insomnia and vasomotor symptoms in menopausal women?","authors":"Christine E Dri, Yang Jing Zheng, Roger S McIntyre","doi":"10.1017/S109285292510076X","DOIUrl":"10.1017/S109285292510076X","url":null,"abstract":"<p><p>The menopausal period in women is characterized by neuroendocrine alterations, which is in part mediated by the reduction in circulating estrogen. During this transition, many perimenopausal and menopausal women experience sleep disturbances and increased susceptibility to sleep-related disorders. Sleep disruptions are partially attributed to nighttime vasomotor symptoms (VMS), which exacerbates the insomnia risk in the menopausal woman. Converging data implicate the orexin system in the pathophysiology of insomnia and VMS, particularly through regulation of arousal, thermoregulation, and sympathetic outputs. Estrogen decline due to menopause is postulated to modulate orexin signaling, thereby heightening sympathetic drive and thermoregulatory instability. Given this potential mechanistic framework, orexin receptor antagonists, notably dual orexin receptor antagonists (DORAs), have been proposed as alternative menopausal therapeutics. Herein, we aim to examine preclinical, translation, and clinical literature assessing the therapeutic potentials of DORAs as a nonhormonal intervention for the mitigation of insomnia and VMS in midlife women.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e95"},"PeriodicalIF":4.6,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender differences in outpatients affected by Borderline Personality Disorder.","authors":"Anna Pan, Cecilia Maria Esposito, Luigi Piccirilli, Alessandro Ceresa, Francesco Giuseppe Zanvit, Francesco Zanelli Quarantini, Enrico Capuzzi, Massimo Clerici, Massimiliano Buoli","doi":"10.1017/S1092852925100746","DOIUrl":"https://doi.org/10.1017/S1092852925100746","url":null,"abstract":"","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"1-22"},"PeriodicalIF":4.1,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630833","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":"Early career psychiatrists in Europe during the COVID-19 pandemic: a cross-sectional study.","authors":"Mariana Pinto da Costa, Ozge Kilic, Egor Chumakov, Asilay Seker, Gaia Sampogna, Olga Kazakova, Jamila Ismayilova, Tove Mogren, Federico Mucci, Matilda Naesström, Franziska Baessler, Thomas Gargot, Victor Pereira-Sanchez, Diego Quattrone, Georgios Schoretsanitis, Ewelina Cichoń, Tomasz M Gondek","doi":"10.1017/S1092852925100734","DOIUrl":"10.1017/S1092852925100734","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the effects of the COVID-19 pandemic on the education and professional development, working conditions, and wellbeing of early career psychiatrists (ECPs) in Europe, as well as their attitudes to telepsychiatry.</p><p><strong>Methods: </strong>A questionnaire comprising 24 items was designed by the Early Career Psychiatrists Committee of the European Psychiatric Association. Data were collected online from June 2020 to September 2021. A series of multiple regression analyses were conducted to determine variables that could predict the dependent variables.</p><p><strong>Results: </strong>Data were obtained from 517 early career psychiatrists from 39 different countries. Men were more confident than women in their knowledge of COVID-19 symptoms and management, including in managing patients with a comorbidity of COVID-19 and a mental disorder. Providing specific recommendations during the COVID-19 pandemic, access to additional educational activities for ECPs, following COVID-19-related recommendations and access to protective equipment were the significant predictors of a higher confidence in managing patients with comorbidity of COVID-19 and mental disorders. The obligation to change the place of work predicted a decreased satisfaction with telepsychiatry as well as a decreased willingness to use telepsychiatry after the COVID-19 pandemic, while a diagnosis of COVID-19, having recommendations for telepsychiatry and access to dedicated platform for telemedicine were predictors of an increased satisfaction with telepsychiatry.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic has affected ECPs in Europe to varying degrees. The results point to areas where decision-makers can improve the working conditions for ECPs.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e98"},"PeriodicalIF":4.6,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive behavioral treatment for Sexsomnia (CBT-S). Case report and literature review.","authors":"Ulises Jiménez Correa, Horacio B Alvarez García, Leon Rosenthal","doi":"10.1017/S1092852925100710","DOIUrl":"10.1017/S1092852925100710","url":null,"abstract":"<p><p>Sexsomnia is an arousal disorder in which abnormal sexual behaviors and experiences (such as masturbation, sexual intercourse, loud sexual vocalizations) are manifested during NREM sleep and are followed by amnesia upon awakening from these episodes. Both behavioral and pharmacological interventions are available for management of these manifestations, but no clinical trials have been performed to determine their effectiveness or guide clinical management. The aim of this review and case report is to describe the effectiveness of Cognitive Behavioral Therapy for sexsomnia (CBT-S) in a 27-year-old male whose chief complaint was sexual behavior 2 to 3 nights per week. The initial clinical assessment yielded diagnoses of sexsomnia, insufficient sleep syndrome, and snoring. The components of CBT-S used in this case included sleep extension, sleep hygiene, and relaxation therapy (diaphragmatic breathing with autogenic training) employing client-centered Motivational Interviewing. The patient reported no recurrence of sexsomnia events during the first month of therapy, but experienced 1 recurrence between the third and sixth months of follow-up, which was likely triggered by sleep deprivation and following alcohol consumption. No further recurrence of sexsomnia events was reported while maintaining adequate adherence to therapy. As is the case for insomnia, CBT represents a viable therapeutic option for the management of sexsomnia.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e92"},"PeriodicalIF":4.6,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential protective role of GLP-1 receptor agonists for lithium-induced nephrotoxicity: a population-based observational study.","authors":"Roger S McIntyre, Angela T H Kwan","doi":"10.1017/S1092852925100709","DOIUrl":"10.1017/S1092852925100709","url":null,"abstract":"<p><strong>Objectives: </strong>We hypothesized that semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA) and treatment currently U.S. Food and Drug Administration (FDA) approved to reduce worsening of kidney disease and kidney failure may protect against lithium-induced nephrotoxicity.</p><p><strong>Methods: </strong>Renal adverse events (AEs) reported to the FDA Adverse Event Reporting System (FAERS) between December 2003 and December 2024 were analyzed using the validated OpenVigil 2.1 platform. Reporting odds ratios (RORs) were computed for the MedDRA terms renal impairment, renal failure, chronic kidney disease (CKD), end-stage renal disease (ESRD), and acute kidney injury (AKI) in association with lithium, semaglutide, and their co-reporting. A disproportionality signal was considered statistically significant when <i>p</i> < 0.05, and the lower bound of the information component (IC₀₂₅) was greater than 0.</p><p><strong>Results: </strong>Lithium was associated with significantly elevated reporting odds across all renal AEs, with each outcome exceeding statistical signal thresholds (<i>p</i> < 0.0001, IC₀₂₅ > 0). In contrast, semaglutide demonstrated inverse associations for renal impairment, renal failure, CKD, and ESRD (RORs = 0.25-0.54), and a neutral association for AKI (ROR = 0.96); however, none met the criteria for a disproportionality signal (IC₀₂₅ < 0). Co-reported use of lithium and semaglutide did not yield a significant signal for any renal outcome, including AKI (ROR = 5.81, <i>p</i> = 0.015, IC₀₂₅ < 0).</p><p><strong>Conclusions: </strong>This observation, provides impetus to conduct adequate, thorough, mechanistic, clinical, and observational studies to determine whether semaglutide (and/or other incretin receptor agonists) could possibly mitigate the risk for, and/or modify the trajectory of, lithium-induced nephrotoxicity.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e5"},"PeriodicalIF":4.6,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focused and automatic subtypes of skin picking disorder.","authors":"Austin Huang, Madison Collins, Jon E Grant","doi":"10.1017/S1092852925100667","DOIUrl":"10.1017/S1092852925100667","url":null,"abstract":"<p><strong>Objective: </strong>While prior studies have analyzed Skin Picking Disorder as a unitary condition, little research has been done examining clinical and neurocognitive characteristics of specific subtypes. The objective of this study is to analyze differences in impulsivity, emotional regulation, symptom severity, cognitive performance, and the presence of comorbid psychiatric conditions between focused and automatic subtypes of Skin Picking Disorder.</p><p><strong>Methods: </strong>83 adults aged 18-65 with skin picking disorder were enrolled at the University of Chicago and separated into 4 skin picking subtype groups based on high or low levels of focused and automatic picking scores on the Milwaukee Inventory for the Dimension of Adult Skin Picking. The 4 subtype groups were separated using K-means clustering. Each group completed the same clinical and neurocognitive assessments. ANOVA or Chi-Squared tests were used to analyze differences in assessment outcomes.</p><p><strong>Results: </strong>Higher focused picking scores were significantly associated with greater symptom severity and impairment. Differences in levels of automatic/focused picking were not associated with impulsivity, emotional/behavior regulations, or neurocognitive outcomes.</p><p><strong>Conclusions: </strong>The findings suggest that focused skin pickers are likely to have more impairment due to their behavior compared to automatic or mixed pickers; however, overall, the groups did not differ in clinical or neurocognitive measures. Thus, it is unclear whether focused and automatic picking are particularly useful clinically in subtyping skin picking disorder.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e91"},"PeriodicalIF":4.6,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-acting injectable antipsychotics for patients with first-episode and early-phase schizophrenia: still not considered often enough - ERRATUM.","authors":"Christoph U Correll","doi":"10.1017/S1092852925100655","DOIUrl":"10.1017/S1092852925100655","url":null,"abstract":"","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":"30 1","pages":"e85"},"PeriodicalIF":4.6,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}