CNS Spectrums最新文献

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Visual release hallucinations presenting as psychosis - a scoping review. 表现为精神病的视觉释放幻觉--范围综述。
IF 3.4 3区 医学
CNS Spectrums Pub Date : 2024-11-21 DOI: 10.1017/S1092852924002281
Nicholas Bonomo, Ben Schoenbachler, Steven Lippmann
{"title":"Visual release hallucinations presenting as psychosis - a scoping review.","authors":"Nicholas Bonomo, Ben Schoenbachler, Steven Lippmann","doi":"10.1017/S1092852924002281","DOIUrl":"https://doi.org/10.1017/S1092852924002281","url":null,"abstract":"<p><strong>Objective: </strong>Visual release hallucinations are perceptual disturbances that occur in individuals who have experienced vision loss. Almost 50 million people worldwide are believed to experience visual release hallucinations, yet they are profoundly underdiagnosed. Although first described within the Charles Bonnet syndrome, the paradigm underlying this syndrome precludes their consideration in many populations, such as those with underlying psychiatric illness or dementia. Consequently, visual release hallucinations have rarely been studied in patients presenting with psychosis. We conducted a scoping review to determine whether visual-release hallucinations occur in psychotic patients.</p><p><strong>Methods: </strong>The PubMed research database was searched from inception through April 2023. Cases were collected reporting on psychotic patients experiencing suspected visual release hallucinations. Individual treatment courses and responses were extracted.</p><p><strong>Results: </strong>Thirteen cases compiled from 11 different studies were summarized to provide baseline characteristics and overall trends in treatment response. Most patients did not remit from pharmacological management alone. All patients who received reafferentation therapy remitted, though many were not candidates. Almost half of the patients did not achieve remission.</p><p><strong>Conclusions: </strong>Visual release hallucinations can manifest in psychosis and may contribute to treatment-resistant psychosis among psychiatric populations. A shift in our understanding of visual release hallucinations may aid their recognition in psychotic patients by shifting the focus toward visual release features. Recognizing release features among patients with hallucinatory conditions may open new treatment avenues for managing patients with psychosis. A preliminary screening index for visual release features is provided to support this shift.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"1-7"},"PeriodicalIF":3.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681088","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
Ayahuasca: pharmacology, safety, and therapeutic effects. 死藤水:药理学、安全性和治疗效果。
IF 3.4 3区 医学
CNS Spectrums Pub Date : 2024-11-20 DOI: 10.1017/S109285292400213X
Rafael Guimarães Dos Santos, Jaime Eduardo Cecilio Hallak
{"title":"Ayahuasca: pharmacology, safety, and therapeutic effects.","authors":"Rafael Guimarães Dos Santos, Jaime Eduardo Cecilio Hallak","doi":"10.1017/S109285292400213X","DOIUrl":"10.1017/S109285292400213X","url":null,"abstract":"<p><p>Ayahuasca is a botanical hallucinogen traditionally used for therapeutic and ritual purposes by indigenous groups from Northwestern Amazonian countries such as Brazil, Peru, Colombia, and Ecuador. Ayahuasca is made by the decoction of two plants, which are rich in the 5-HT1A/2A partial agonist dimethyltryptamine or DMT (from the leaves of the <i>Psychotria viridis</i> bush) and β-carbolines such as harmine, from the stalks of the <i>Banisteriopsis caapi</i> vine. There is an increasing interest in the possible therapeutic effects of ayahuasca, especially for psychiatric disorders (major depression, posttraumatic stress disorder, and substance use disorder). This review summarizes information on the pharmacology, safety, and therapeutic potentials of ayahuasca. Although human experimental and naturalist studies published until now suggest a good safety and tolerability profile, often associated with improvements in depressive and anxious symptoms, there are few controlled studies, with small sample sizes, using only single doses, and with short follow-ups. Potential benefits of ayahuasca should be evaluated in larger samples in both experimental and observational studies and using different doses in controlled trials.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e2"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675344","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
Ketamine for the Treatment of Psychiatric Disorders: A Systematic Review and Meta-Analysis. 氯胺酮治疗精神障碍:系统回顾与元分析》。
IF 3.4 3区 医学
CNS Spectrums Pub Date : 2024-11-20 DOI: 10.1017/S1092852924000580
Angela T H Kwan, Moiz Lakhani, Gurkaran Singh, Gia Han Le, Sabrina Wong, Kayla M Teopiz, Donovan A Dev, Arshpreet Singh Manku, Gurnoor Sidhu, Roger S McIntyre
{"title":"Ketamine for the Treatment of Psychiatric Disorders: A Systematic Review and Meta-Analysis.","authors":"Angela T H Kwan, Moiz Lakhani, Gurkaran Singh, Gia Han Le, Sabrina Wong, Kayla M Teopiz, Donovan A Dev, Arshpreet Singh Manku, Gurnoor Sidhu, Roger S McIntyre","doi":"10.1017/S1092852924000580","DOIUrl":"https://doi.org/10.1017/S1092852924000580","url":null,"abstract":"<p><strong>Background: </strong>Inadequate response to first- and second-line pharmacological treatments for psychiatric disorders is commonly observed. Ketamine has demonstrated efficacy in treating adults with treatment-resistant depression (TRD), with additional off-label benefits reported for various psychiatric disorders. Herein, we performed a systematic review and meta-analysis to examine the therapeutic applications of ketamine across multiple mental disorders, excluding mood disorders.</p><p><strong>Methods: </strong>We conducted a multidatabase literature search of randomized controlled trials and open-label trials investigating the therapeutic use of ketamine in treating mental disorders. Studies utilizing the same psychological assessments for a given disorder were pooled using the generic inverse variance method to generate a pooled estimated mean difference.</p><p><strong>Results: </strong>The search in OVID (MedLine, Embase, AMED, PsychINFO, JBI EBP Database), EBSCO CINAHL Plus, Scopus, and Web of Science yielded 44 studies. Ketamine had a statistically significant effect on PTSD Checklist for DSM-5 (PCL-5) scores (pooled estimate = ‒28.07, 95% CI = [‒40.05, ‒16.11], p < 0.001), Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) scores (pooled estimate = ‒14.07, 95% CI = [‒26.24, ‒1.90], p = 0.023), and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores (pooled estimate = ‒8.08, 95% CI = [‒13.64, ‒2.52], p = 0.004) in individuals with PTSD, treatment-resistant PTSD (TR-PTSD), and obsessive compulsive disorder (OCD), respectively. For alcohol use disorders and at-risk drinking, there was disproportionate reporting of decreased urge to drink, increased rate of abstinence, and longer time to relapse following ketamine treatment.</p><p><strong>Conclusions: </strong>Extant literature supports the potential use of ketamine for the treatment of PTSD, OCD, and alcohol use disorders with significant improvement of patient symptoms. However, the limited number of randomized controlled trials underscores the need to further investigate the short- and long-term benefits and risks of ketamine for the treatment of psychiatric disorders.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"1-8"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675300","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
Effects of esketamine combined with dexmedetomidine on postoperative delirium and quality of recovery in elderly patients undergoing thoracoscopic radical lung cancer surgery: a randomized controlled trial. 艾司卡胺联合右美托咪定对接受胸腔镜肺癌根治术的老年患者术后谵妄和恢复质量的影响:随机对照试验。
IF 3.4 3区 医学
CNS Spectrums Pub Date : 2024-11-20 DOI: 10.1017/S1092852924002177
Cong-Li Zhang, Yan Yan, Yang Zhang, Han-Lin Bai, Qin Zhuang, Nan-Nan Song, Chuan-Jiang Feng, Li-Juan Xie, Si-Yi Wang, Xiao-Hong Li, Di Liu, Li Ren
{"title":"Effects of esketamine combined with dexmedetomidine on postoperative delirium and quality of recovery in elderly patients undergoing thoracoscopic radical lung cancer surgery: a randomized controlled trial.","authors":"Cong-Li Zhang, Yan Yan, Yang Zhang, Han-Lin Bai, Qin Zhuang, Nan-Nan Song, Chuan-Jiang Feng, Li-Juan Xie, Si-Yi Wang, Xiao-Hong Li, Di Liu, Li Ren","doi":"10.1017/S1092852924002177","DOIUrl":"https://doi.org/10.1017/S1092852924002177","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the effects of esketamine (Esk) combined with dexmedetomidine (Dex) on postoperative delirium (POD) and quality of recovery (QoR) in elderly patients undergoing thoracoscopic radical lung cancer surgery.</p><p><strong>Methods: </strong>In this prospective, randomized, and controlled study, 172 elderly patients undergoing thoracoscopic radical lung cancer surgery were divided into two groups: the Esk + Dex group (n = 86) and the Dex group a (n = 86). The primary outcome was the incidence of POD within 7 days after surgery and the overall Quality of Recovery-15 (QoR - 15) scores within 3 days after surgery. Secondary outcomes included postoperative adverse reactions, extubation time, PACU stay, and hospitalization time. Serum levels of IL-6, IL-10, S100β protein, NSE, CD3<sup>+</sup>, CD4<sup>+</sup>, and CD8<sup>+</sup> were detected from T0 to T5.</p><p><strong>Results: </strong>Compared with the Dex group, the incidence of POD in the Esk + Dex group was significantly lower at 7 days after surgery (14.6% vs 30.9%; P = 0.013). The QoR - 15 score was significantly increased 3 days after surgery (P < 0.01). Levels of IL-6 and CD8<sup>+</sup> were significantly decreased, and IL - 10 levels were significantly increased at T1-T2 (P < 0.05). At T1-T4, NSE levels were significantly decreased, while CD3<sup>+</sup> and CD4<sup>+</sup>/CD8<sup>+</sup> values were significantly increased (P < 0.01). At T1-T5, serum S100β protein concentration decreased significantly, and CD4<sup>+</sup> value increased significantly (P < 0.01). The incidence of nausea/vomiting and hyperalgesia decreased significantly 48 hours after surgery (P < 0.01). The duration of extubation, PACU stay, and postoperative hospitalization were significantly shortened.</p><p><strong>Conclusions: </strong>Esketamine combined with dexmedetomidine can significantly reduce the POD incidence and improve the QoR in patients undergoing thoracoscopic radical lung cancer surgery, which may be related to the improvement of cellular immune function.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"1-10"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675350","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
Characterizing the relationship between psychosis and violence in the forensic psychiatric population: a systematic review. 描述法医精神病人群中精神病与暴力之间的关系:系统性综述。
IF 3.4 3区 医学
CNS Spectrums Pub Date : 2024-11-19 DOI: 10.1017/S1092852924000488
Angad Singh, William Pereira, Sapriya Birk, Mark Mohan Kaggwa, John M W Bradford, Gary Chaimowitz, Andrew Toyin Olagunju
{"title":"Characterizing the relationship between psychosis and violence in the forensic psychiatric population: a systematic review.","authors":"Angad Singh, William Pereira, Sapriya Birk, Mark Mohan Kaggwa, John M W Bradford, Gary Chaimowitz, Andrew Toyin Olagunju","doi":"10.1017/S1092852924000488","DOIUrl":"10.1017/S1092852924000488","url":null,"abstract":"<p><strong>Objective: </strong>The relationship between psychosis and violence is often construed focusing on a narrow panel of factors; however, recent evidence suggests violence might be linked to a complex interplay of biopsychosocial factors among forensic psychiatric patients with psychosis (FPPP). This review describes violence incidents in FPPP, the factors associated with violence, and relevant implications.</p><p><strong>Methods: </strong>This review was conducted following the preferred reporting items for systematic reviews and meta-analyses guideline. Databases, including CINAHL, EMBASE, Medline/PubMed, PsycINFO, and Web of Science, were searched for eligible studies that examined violence among adult FPPP. Screening of reports and data extraction were completed by at least two independent reviewers.</p><p><strong>Results: </strong>Across the 29 included studies, violence was consistently related to prior contact with psychiatric services, active psychotic symptoms, impulsivity, adverse experiences, and low social support. However, FPPP who reported violence varied in most other biopsychosocial domains, suggesting the underlying combinatorial effects of multiple risk factors for violence rather than individual factors. Variability in violence was addressed by stratifying FPPP into subgroups using composite/aggregate of identifiable factors (including gender, onset/course of illness, system-related, and other biopsychosocial factors) to identify FPPP with similar risk profiles.</p><p><strong>Conclusions: </strong>There are multiple explanatory pathways to violence in FPPP. Recent studies identify subgroups with underlying similarities or risk profiles for violence. There is a need for future prospective studies to replicate the clinical utility of stratifying FPPP into subgroups and integrate emerging evidence using recent advancements in technology and data mining to improve risk assessment, prediction, and management.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"1-12"},"PeriodicalIF":3.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667058","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
Post-COVID condition: a focus on psychiatric symptoms and diagnoses in patients with cognitive complaints. 后 COVID 状态:关注认知症状患者的精神症状和诊断。
IF 3.4 3区 医学
CNS Spectrums Pub Date : 2024-11-11 DOI: 10.1017/S1092852924000464
Matteo Cerioli, Luca Giacovelli, Chiara Nostro, Luca Larini, Michele Castiglioni, Carolina Scarpa, Niccolò Cassina, Alessia Nicotra, Giorgia Maestri, Valentina Cucumo, Federico Masserini, Simone Pomati, Giovanna Cirnigliaro, Leonardo Pantoni, Bernardo Dell'Osso
{"title":"Post-COVID condition: a focus on psychiatric symptoms and diagnoses in patients with cognitive complaints.","authors":"Matteo Cerioli, Luca Giacovelli, Chiara Nostro, Luca Larini, Michele Castiglioni, Carolina Scarpa, Niccolò Cassina, Alessia Nicotra, Giorgia Maestri, Valentina Cucumo, Federico Masserini, Simone Pomati, Giovanna Cirnigliaro, Leonardo Pantoni, Bernardo Dell'Osso","doi":"10.1017/S1092852924000464","DOIUrl":"https://doi.org/10.1017/S1092852924000464","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive and psychiatric symptoms are frequently reported after SARS-CoV-2 infection, but their interplay has been only partially explored. We investigated frequency and severity of psychiatric symptoms in patients with persistent cognitive complaints after COVID-19.</p><p><strong>Methods: </strong>We conducted a cross-sectional study. Neurologists assessed 101 patients reporting cognitive symptoms after COVID-19. Patients were invited to fill a screening battery with self-reported psychometric scales (Depression Anxiety Stress Scales-21, Impact of Event Scale-Revised, Insomnia Severity Index). Patients scoring above validated cut-offs in ≥1 scale were referred to psychiatrists who administered the Mini-International Neuropsychiatric Interview (M.I.N.I.), Hamilton Anxiety (HAM-A), and Hamilton Depression (HAM-D) rating scales and asked to complete the Personality Inventory for DSM-5-Brief Form (PID-5-BF).</p><p><strong>Results: </strong>Out of the 57 referred patients, 38 (64.4%) accepted to undergo the psychiatric examination. Among these, 18 (47.4%) were diagnosed with adjustment disorder (23.7%), anxiety disorder (10.5%), major depressive disorder (7.9%), and post-traumatic stress disorder (2.6%). Pharmacologic treatment before post-COVID condition (present in 12 patients, 31.6%) was associated with a score above cut-off on the HAM-A and HAM-D scales. A longer duration of untreated psychiatric illness after COVID-19 was associated with worse scores on the same scales. Patients with a higher PID-5-BF total score had a higher probability of receiving a psychiatric diagnosis.</p><p><strong>Conclusion: </strong>Almost half of patients with post-COVID-19 conditions reporting cognitive symptoms were found to suffer from a psychiatric condition after psychiatric evaluation. The application of a psychiatric screening in a population suffering from long-term effects of COVID-19 can lead to early diagnosis and timely treatment.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"1-7"},"PeriodicalIF":3.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615539","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
Criteria and diagnostic scale of the post-combat delayed response (tension) syndrome. 战后延迟反应(紧张)综合征的标准和诊断量表。
IF 3.4 3区 医学
CNS Spectrums Pub Date : 2024-11-04 DOI: 10.1017/S1092852924000397
Natalia Danilevska
{"title":"Criteria and diagnostic scale of the post-combat delayed response (tension) syndrome.","authors":"Natalia Danilevska","doi":"10.1017/S1092852924000397","DOIUrl":"https://doi.org/10.1017/S1092852924000397","url":null,"abstract":"<p><strong>Objective: </strong>War participation risks mental disorders. Ukrainian combatants in Anti-Terrorist Operation/Joint Forces Operation since 2014 receive psychiatric care. Some show unique symptoms, not fitting recognized disorders, termed post-combat delayed response (tension) syndrome. The aim of this study was to establish diagnostic criteria and develop a scale of differential diagnosis of post-combat delayed response (tension) syndrome.</p><p><strong>Methods: </strong>This was a clinical retrospective study conducted on the basis of Zaporizhzhia Military Hospital and Zaporizhzhia and State Medical University, Ukraine, in the period from 2015 to 2021. Combatants of Ukraine-members of Anti-Terrorist Operation/Joint Forces Operation were involved in the study. In total, 426 male combatants were surveyed from whom those suffering from post-traumatic stress disorder (<i>n</i> = 24), neurasthenia (<i>n</i> = 35), and post-combat delayed response (tension) syndrome (<i>n</i> = 46) were selected.</p><p><strong>Results: </strong>The key symptoms of post-combat delayed response (tension) syndrome were selected and ranked in order of their differential diagnostic value. The diagnostic scale for post-combat delayed response (tension) syndrome was developed, which consists of 12 points.</p><p><strong>Conclusions: </strong>The received anamnestic information is important for classifying patients at risk of post-combat delayed response (tension) syndrome.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"1-9"},"PeriodicalIF":3.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567749","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
Efficacy of esketamine for perinatal depression: a systematic review and meta-analysis. 艾司氯胺酮治疗围产期抑郁症的疗效:系统回顾和荟萃分析。
IF 3.4 3区 医学
CNS Spectrums Pub Date : 2024-10-31 DOI: 10.1017/S1092852924000452
Sabrina Wong, Gia Han Le, Angela T H Kwan, Kayla M Teopiz, Taeho Greg Rhee, Roger Ho, Joshua D Rosenblat, Rodrigo Mansur, Roger S McIntyre
{"title":"Efficacy of esketamine for perinatal depression: a systematic review and meta-analysis.","authors":"Sabrina Wong, Gia Han Le, Angela T H Kwan, Kayla M Teopiz, Taeho Greg Rhee, Roger Ho, Joshua D Rosenblat, Rodrigo Mansur, Roger S McIntyre","doi":"10.1017/S1092852924000452","DOIUrl":"https://doi.org/10.1017/S1092852924000452","url":null,"abstract":"<p><strong>Objective: </strong>Postpartum depression (PPD), now referred to as perinatal depression, is a prevalent and debilitating mood disorder that reduces health-related quality of life (HRQoL) and psychosocial functioning. Esketamine, which is efficacious in adults with treatment-resistant depression and individuals with depression and suicidality, is also analgesic in pain management during childbirth labour. Herein, we investigate the efficacy of prophylactic esketamine in reducing the incidence of PPD.</p><p><strong>Methods: </strong>We performed a systematic review (i.e., PubMed, Scopus, and Ovid databases; inception to January 22, 2024) of randomized controlled trials that investigated the use of esketamine for PPD. We delimited our search to studies that prespecified the prevention of PPD with esketamine as the primary outcome. A meta-analysis was performed on PPD incidence rates using a random effects model.</p><p><strong>Results: </strong>Our analysis consisted of seven studies that met our eligibility criteria. We found that esketamine was significantly associated with a decreased incidence of PPD diagnosis within one week of childbirth (OR = 0.30, 95% CI = [0.15, 0.60], p = 0.0047). We also observed that esketamine was significantly associated with a decreased incidence of PPD diagnosis between 4 to 6 weeks post-delivery (OR = 0.33, 95% CI = [0.18, 0.59], p = 0.0034).</p><p><strong>Conclusion: </strong>Our results indicate that esketamine may have preventive antidepressant effects during the postpartum period. The aforementioned points have both mechanistic and clinically meaningful implications for the treatment of PPD.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"1-9"},"PeriodicalIF":3.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544163","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
Liberty or life: mental health care in Australia. 自由或生命:澳大利亚的精神保健。
IF 3.4 3区 医学
CNS Spectrums Pub Date : 2024-10-31 DOI: 10.1017/S1092852924000634
Kirsty MacDonald, Andrew Ellis
{"title":"Liberty or life: mental health care in Australia.","authors":"Kirsty MacDonald, Andrew Ellis","doi":"10.1017/S1092852924000634","DOIUrl":"10.1017/S1092852924000634","url":null,"abstract":"<p><p>This article reviews the development of mental health and psychiatric services in Australia for the international reader. The development of relevant legislation, health-care systems, and the effectiveness of treatment for people with schizophrenia is reviewed. Gaps in service delivery and future directions are considered.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e7"},"PeriodicalIF":3.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544164","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
A clinical algorithm for diagnosis and treatment of insomnia in adults: an updated review. 成人失眠症诊断和治疗的临床算法:最新综述。
IF 3.4 3区 医学
CNS Spectrums Pub Date : 2024-10-31 DOI: 10.1017/S1092852924000385
Habibolah Khazaie, Amir Sharafkhaneh, Ali Zakiei, Earl Charles Crew
{"title":"A clinical algorithm for diagnosis and treatment of insomnia in adults: an updated review.","authors":"Habibolah Khazaie, Amir Sharafkhaneh, Ali Zakiei, Earl Charles Crew","doi":"10.1017/S1092852924000385","DOIUrl":"https://doi.org/10.1017/S1092852924000385","url":null,"abstract":"<p><p>Difficulty falling asleep and/or maintaining sleep are common complaints in patients visiting medical clinics. Insomnia can occur alone or in combination with other medical or psychiatric disorders. Diagnosis and management of insomnia at times are perplexing. This updated study review aimed at a clinical algorithm for diagnosis and treatment of insomnia in adults. We developed an easy-to-apply algorithm to diagnose and manage insomnia that can be used by general practitioners and non-sleep specialists. To this end, our team reviewed the previous studies to determine the prevalence, evaluation, and treatment of insomnia. We used the results to develop a clinical algorithm for diagnosing and managing insomnia.Insomnia occurs in a short (less than 3 months duration) or chronic form (≥3 months duration). Insomnia management includes both pharmacological and non-pharmacological interventions. There is ample research evidence for the impact of a variety of non-pharmacological treatments, but both types of treatments can be used for each patient. If there are any contradictions in the diagnosis process, therapists should use objective instruments, such as polysomnography, but they should not be in a hurry to use these instruments.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"1-11"},"PeriodicalIF":3.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544162","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
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