Comprehensive psychiatry最新文献

{"title":"We've all been wrong about provisional tic disorder","authors":"Sarah C. Grossen ,&nbsp;Amanda L. Arbuckle ,&nbsp;Emily C. Bihun ,&nbsp;Jonathan M. Koller ,&nbsp;David Y. Song ,&nbsp;Angela M. Reiersen ,&nbsp;Bradley L. Schlaggar ,&nbsp;Deanna J. Greene ,&nbsp;Kevin J. Black","doi":"10.1016/j.comppsych.2024.152510","DOIUrl":"10.1016/j.comppsych.2024.152510","url":null,"abstract":"<div><h3>Background</h3><p>Provisional Tic Disorder (PTD) is common in childhood. The received wisdom among clinicians is that PTD is short-lived and mild, with at most a few tics, and rarely includes complex tics, premonitory phenomena or comorbid illnesses. However, such conclusions come from clinical experience, with biased ascertainment and limited follow-up.</p></div><div><h3>Methods</h3><p>Prospective study of 89 children with tics starting 0–9 months ago (median 4 months), fewer than half from clinical sources. Follow-up at 12 (± 24, 36, 48) months after the first tic.</p></div><div><h3>Results</h3><p>At study entry, many children had ADHD (39), an anxiety disorder (27), OCD (9) or enuresis (17). All had at least two current tics, with a mean total since onset of 6.9 motor and 2.0 phonic tics. Forty-one had experienced a complex tic, and 69 could suppress some tics. Tics were clinically meaningful: 64 had tics severe enough for a clinical trial, and 76 families sought medical attention for the tics.</p><p>At 12 months, 79 returned, and 78 still had tics. Of these, 29 manifested no tics during history and extended examination, but only <em>via</em> audio-visual monitoring when the child was seated alone. Only 12/70 now had plans to see a doctor for tics. Most who returned at 2–4 years still had tics known to the child and family, but medical impact was low.</p></div><div><h3>Conclusions</h3><p>Our results do not contradict previous data, but overturn clinical lore. The data strongly argue against the longstanding but arbitrary tradition of separating tic disorders into recent-onset <em>versus</em> chronic.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"134 ","pages":"Article 152510"},"PeriodicalIF":4.3,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000610/pdfft?md5=61fd9091c12047ff8f118725c0e81c02&pid=1-s2.0-S0010440X24000610-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pixels and perception: Mapping the association between digital media and psychotic-like experiences in adolescents","authors":"Kaiden Hein ,&nbsp;Daniel Zarate ,&nbsp;Tyrone Burleigh ,&nbsp;Vasileios Stavropoulos","doi":"10.1016/j.comppsych.2024.152509","DOIUrl":"10.1016/j.comppsych.2024.152509","url":null,"abstract":"<div><h3>Introduction</h3><p>Psychotic-like experiences (PLEs) during adolescence can lead to psychotic disorders. Digital media usage has been suggested to link to PLEs, but research is limited on how different types of screen exposure may differentially relate to PLEs over time. This study aimed to examine longitudinal associations between screen usage patterns and PLEs in adolescents.</p></div><div><h3>Methods</h3><p>Participants comprised 11,876 adolescents assessed annually from ages 9–12 years as part of the Adolescent Brain Cognitive Development study (ABCD). Screen usage (TV, video games, online video, social media, texting, video chat) and PLEs were assessed via self-report. Longitudinal network analysis models were estimated to examine connections between screen usage types and PLEs across three time points.</p></div><div><h3>Results</h3><p>Two clusters were formed, including <em>digital media for socializing</em> (e.g., social media/texting/video chat) and <em>digital media for entertainment</em> (e.g., online video/video games/TV). Texting and online video(s) had the highest centrality at each time point, suggesting importance in the network. PLE symptoms of hallucinations and concentration difficulties exhibited higher centrality than other symptoms. Online video and TV were influential bridges between screen usage and PLEs. Network structure significantly differed between ages 9–10 and 10–12 years, but global strength was unchanged over time.</p></div><div><h3>Discussion</h3><p>Results highlight the importance of understanding the associations between specific screen usage types and PLE symptoms. Texting and online video usage appear most influential in the development of adolescent PLEs over time. Findings can inform targeted interventions to promote healthy screen habits and reduce PLEs in at-risk youth.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"134 ","pages":"Article 152509"},"PeriodicalIF":4.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000609/pdfft?md5=6d79fbd7d90d727d10b32f9cb11c6217&pid=1-s2.0-S0010440X24000609-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141393001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Permissive beliefs in the context of gaming, online shopping and alcohol drinking – Systematic development of a self-report measure","authors":"Annika Brandtner ,&nbsp;Silke M. Müller ,&nbsp;Sofie Behrens ,&nbsp;Andreas Oelker ,&nbsp;Matthias Brand","doi":"10.1016/j.comppsych.2024.152507","DOIUrl":"10.1016/j.comppsych.2024.152507","url":null,"abstract":"<div><h3>Background</h3><p>The activation of permissive beliefs is a cognitive mechanism through which individuals permit themselves to engage in pleasurable, yet potentially unregulated activities. Existing measures are heterogenous, focusing either on specific behaviors or on particular licensing mechanisms. The new Permissive Beliefs Questionnaire (PBQ) seeks to integrate self-licensing mechanisms from various research domains and to be applicable to different behaviors.</p></div><div><h3>Methods</h3><p>Study 1 aimed at exploring the factor structure and reduce the number of items. In study 2, we used confirmatory factor analysis and tested convergent and discriminant validity in three subsamples of individuals playing videogames (<em>n</em> = 489), shopping online (<em>n</em> = 506), and drinking alcohol (<em>n</em> = 511). We tested the hypothesis whether individuals who experience a self-regulatory conflict show a greater expression of permissive beliefs.</p></div><div><h3>Results</h3><p>The final version of the PBQ consists of 12 items which represent two factors: Deserving Reward and Defensive Optimism. The PBQ exhibited robust model fit indices and internal consistencies in the three samples. Permissive beliefs were heightened among individuals intending to downregulate their gaming, shopping, or drinking behaviors as compared to individuals without this intention.</p></div><div><h3>Conclusion</h3><p>The PBQ is a valid measure of permissive beliefs for gaming, online shopping, and drinking alcohol. It serves an ecologic and psychometrically valid tool to address empirical research questions regarding the functioning of permissive beliefs. Additionally, it may be used in clinical settings to measure and raise an understanding for permissive beliefs in clients.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"134 ","pages":"Article 152507"},"PeriodicalIF":4.3,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000580/pdfft?md5=7759c6418af80f68d30f50edbde4acd7&pid=1-s2.0-S0010440X24000580-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141411877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cumulative impact of trauma, chronic illness, and COVID-19 stress on mental health in a case-control study of adults with psychotic disorders in Ethiopia","authors":"Manasi Sharma ,&nbsp;Melkam Alemayehu ,&nbsp;Engida Girma ,&nbsp;Barkot Milkias ,&nbsp;Anne Stevenson ,&nbsp;Bizu Gelaye ,&nbsp;Karestan C. Koenen ,&nbsp;Solomon Teferra","doi":"10.1016/j.comppsych.2024.152508","DOIUrl":"10.1016/j.comppsych.2024.152508","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic has profoundly impacted the economic, psychological, and social well-being of people in Ethiopia. Pandemic-related fears can exacerbate anxiety and depression symptoms among those with pre-existing physical and mental health conditions as well as those with prior exposure to traumatic events.</p></div><div><h3>Methods</h3><p>We used data from the Ethiopia NeuroGAP-Psychosis study (898 cases and 941 controls with and without a diagnosis of psychosis respectively, 66% male, mean age = 37 years). Data was collected between November 2021 and June 2022 during the COVID-19 pandemic from four hospitals in Ethiopia (three in Addis Ababa and one in Jimma city). Structural equation modeling analysis was conducted to examine the associations between trauma exposure, physical health conditions (like arthristis, neurological disorders, diabetes), COVID-19 stress, and psychological distress (depression and anxiety symptoms). We assessed direct and indirect effects for mediation, and conducted multigroup analysis to examine moderation by case control status.</p></div><div><h3>Results</h3><p>We found evidence that the impact of greater trauma exposure and physical health conditions on higher psychological distress was mediated through higher COVID-19 stress. Sociodemographic characteristics (older age and being maried) were associated with higher psychological distress, with these associations mediated through greater trauma, physical health conditions, and COVID-19 stress. Case-control status also moderated the associations between these variables, with the mediation effects being stronger in cases and weaker in controls. Further, cases reported greater trauma and psychological distress, while controls reported more physical health conditions and COVID-19 stress.</p></div><div><h3>Implications</h3><p>Our findings uniquely assess the interaction of health and emergency related factors in understudied settings like Ethiopia. They underscore the importance of including daily hardships and environmental stressors, along with prior trauma exposure, as risk factors for the assessment of mental health symptoms. This study has key implications for mental health screening and intervention research in response to complex emergency contexts like Ethiopia with a history of armed conflict in addition to the COVID-19 pandemic. Our findings can aid the development of targeted services that address the mental health of at-risk groups with pre-existing mental and physical health conditions.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"134 ","pages":"Article 152508"},"PeriodicalIF":4.3,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000592/pdfft?md5=a54ae2be4c9d9586f3ae9a272d7c104c&pid=1-s2.0-S0010440X24000592-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141391772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A national survey of pandemic fear and cyberchondria after ending zero-COVID policy: The chain mediating role of alexithymia and psychological distress","authors":"Jinbo Fang ,&nbsp;Changjian Qiu ,&nbsp;Zeyuan Sun ,&nbsp;Jing Zhou ,&nbsp;Ping He ,&nbsp;Aldo Conti ,&nbsp;Yi Lu ,&nbsp;Xia Huang ,&nbsp;Jiuping Xu ,&nbsp;Wanjie Tang","doi":"10.1016/j.comppsych.2024.152505","DOIUrl":"https://doi.org/10.1016/j.comppsych.2024.152505","url":null,"abstract":"<div><h3>Background</h3><p>More than half the domestic population in China were infected with COVID-19 in two months after ending “zero-infection policy”, which severely overwhelmed frontline healthcare providers with stress and fear. However, there is no study to date investigating the associations between nurses' fear of pandemic and cyberchondria. This study aimed to 1) investigate the correlations between fear pandemic and cyberchondria among frontline nurses, and 2) discover its potential mechanism.</p></div><div><h3>Methods</h3><p>A cross-sectional sample of frontline nurses (<em>N</em> = 8161) was recruited from 98 hospitals across China in February 2023. Participants were invited to complete an online, self-rated standardized questionnaire focused on pandemic fear, alexithymia, psychological distress, and cyberchondria. Environmental, clinical and socioeconomic information were collected for adjustment while conducting chain mediation analysis.</p></div><div><h3>Results</h3><p>When other covariates were controlled, it was found that fear of the pandemic significantly contributed to cyberchondria (<em>b</em> = 0.58, 95%CI [0.56, 0.60], <em>p</em> &lt; .001). The chain mediation model suggested that both alexithymia and psychological distress were mediating factors between pandemic fear and cyberchondria.</p></div><div><h3>Conclusions</h3><p>The higher the perceived fear, the greater the cyberchondria, which suggests that reducing fear about the pandemic and providing adequate support could reduce the incidence of cyberchondria. As alexithymia and psychological distress may be transdiagnostic mechanisms between fear and cyberchondria, targeted interventions focused on expression dysregulation and emotional identification could be useful.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"133 ","pages":"Article 152505"},"PeriodicalIF":7.3,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000567/pdfft?md5=007514b8092095047816c7bb299b2d48&pid=1-s2.0-S0010440X24000567-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141291864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships between trauma types and psychotic symptoms: A network analysis of patients with psychotic disorders in a large, multi-country study in East Africa","authors":"Anne Stevenson ,&nbsp;Supriya Misra ,&nbsp;Engida Girma ,&nbsp;Adela-Maria Isvoranu ,&nbsp;Dickens Akena ,&nbsp;Melkam Alemayehu ,&nbsp;Lukoye Atwoli ,&nbsp;Bizu Gelaye ,&nbsp;Stella Gichuru ,&nbsp;Symon M. Kariuki ,&nbsp;Edith Kamaru Kwobah ,&nbsp;Joseph Kyebuzibwa ,&nbsp;Rehema M. Mwema ,&nbsp;Carter P. Newman ,&nbsp;Charles R.J.C. Newton ,&nbsp;Linnet Ongeri ,&nbsp;Rocky E. Stroud II ,&nbsp;Solomon Teferra ,&nbsp;Karestan C. Koenen ,&nbsp;Soraya Seedat","doi":"10.1016/j.comppsych.2024.152504","DOIUrl":"10.1016/j.comppsych.2024.152504","url":null,"abstract":"<div><h3>Background</h3><p>The link between trauma exposure and psychotic disorders is well-established. Further, specific types of trauma may be associated with specific psychotic symptoms. Network analysis is an approach that can advance our understanding of the associations across trauma types and psychotic symptoms.</p></div><div><h3>Methods</h3><p>We conducted a network analysis with data from 16,628 adult participants (mean age [standard deviation] = 36.3 years [11.5]; 55.8% males) with psychotic disorders in East Africa recruited between 2018 and 2023. We used the Life Events Checklist and the Mini International Neuropsychiatric Interview to determine whether specific trauma types experienced over the life course and specific psychotic symptoms were connected. We used an Ising model to estimate the network connections and bridge centrality statistics to identify nodes that may influence trauma types and psychotic symptoms.</p></div><div><h3>Results</h3><p>The trauma type “exposure to a war zone” had the highest bridge strength, betweenness, and closeness. The psychotic symptom “odd or unusual beliefs” had the second highest bridge strength. Exposure to a war zone was directly connected to visual hallucinations, odd or unusual beliefs, passivity phenomena, and disorganized speech. Odd or unusual beliefs were directly connected to transportation accidents, physical assault, war, and witnessing sudden accidental death.</p></div><div><h3>Conclusion</h3><p>Specific trauma types and psychotic symptoms may interact bidirectionally. Screening for psychotic symptoms in patients with war-related trauma and evaluating lifetime trauma in patients with odd or unusual beliefs in clinical care may be considered points of intervention to limit stimulating additional psychotic symptoms and trauma exposure. This work reaffirms the importance of trauma-informed care for patients with psychotic disorders.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"133 ","pages":"Article 152504"},"PeriodicalIF":7.3,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000555/pdfft?md5=db4f2f5a924f512dcfb2412cfefb26d0&pid=1-s2.0-S0010440X24000555-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The genetics of trichotillomania and excoriation disorder: A systematic review","authors":"Madison Reid ,&nbsp;Ashley Lin ,&nbsp;Luis C. Farhat ,&nbsp;Thomas V. Fernandez ,&nbsp;Emily Olfson","doi":"10.1016/j.comppsych.2024.152506","DOIUrl":"https://doi.org/10.1016/j.comppsych.2024.152506","url":null,"abstract":"<div><h3>Background</h3><p>Trichotillomania (TTM) and excoriation disorder (ED) are impairing obsessive-compulsive related disorders that are common in the general population and for which there are no clear first-line medications, highlighting the need to better understand the underlying biology of these disorders to inform treatments. Given the importance of genetics in obsessive-compulsive disorder (OCD), evaluating genetic factors underlying TTM and ED may advance knowledge about the pathophysiology of these body-focused repetitive behaviors.</p></div><div><h3>Aim</h3><p>In this systematic review, we summarize the available evidence on the genetics of TTM and ED and highlight gaps in the field warranting further research.</p></div><div><h3>Method</h3><p>We systematically searched Embase, PsycInfo, PubMed, Medline, Scopus, and Web of Science for original studies in genetic epidemiology (family or twin studies) and molecular genetics (candidate gene and genome-wide) published up to June 2023.</p></div><div><h3>Results</h3><p>Of the 3536 records identified, 109 studies were included in this review. These studies indicated that genetic factors play an important role in the development of TTM and ED, some of which may be shared across the OCD spectrum, but there are no known high-confidence specific genetic risk factors for either TTM or ED.</p></div><div><h3>Conclusions</h3><p>Our review underscores the need for additional genome-wide research conducted on the genetics of TTM and ED, for instance, genome-wide association and whole-genome/whole-exome DNA sequencing studies. Recent advances in genomics have led to the discovery of risk genes in several psychiatric disorders, including related conditions such as OCD, but to date, TTM and ED have remained understudied.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"133 ","pages":"Article 152506"},"PeriodicalIF":7.3,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000579/pdfft?md5=532f2b718b9e3b92a43d24a408748944&pid=1-s2.0-S0010440X24000579-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141241726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician homicide: Reports in the National Violent Death Reporting System (2003–2018)","authors":"Brooke E. Palmer ,&nbsp;Rachel D. Barnes ,&nbsp;Rebecca L. Freese ,&nbsp;Michael H. Kim ,&nbsp;William N. Robiner","doi":"10.1016/j.comppsych.2024.152503","DOIUrl":"https://doi.org/10.1016/j.comppsych.2024.152503","url":null,"abstract":"<div><h3>Objective</h3><p>To explore the occurrence, demographics, and circumstances of homicides of physicians.</p></div><div><h3>Method</h3><p>Authors interrogated the National Violent Death Reporting System (NVDRS), the Centers for Disease Control and Prevention's surveillance system tracking violent deaths between 2003 and 2018 which integrates data from law enforcement and coroner/medical examiner reports. Authors identified cases of homicide decedents whose profession was physician, surgeon, or psychiatrist. Data collected included decedents' demographics as well as circumstances of death.</p></div><div><h3>Results</h3><p>Data were provided by 7–41 states as participating states increased over time. Fifty-six homicides were reported, most were male (73.2%) and white (76.8%). Most (67.9%) identified assailants reportedly knew decedents: 23.2% were perpetrated by partners/ex-partners; 10.7% by patients/patients' family members. Deaths were mainly due to gunshot wounds (44.6%), stabbing (16.1%), and blunt force trauma (16.1%). More (58.9%) homicides occurred at victims' homes than work (16.1%).</p></div><div><h3>Conclusions</h3><p>Physician homicides are relatively rare and occur at lower rates than in the general population. Physicians were more frequently killed by partners or ex-partners than by patients. Most homicides occurred away from the workplace. Broader efforts are needed to promote interventions throughout America's violent society to reduce domestic/partner violence and gun violence.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"133 ","pages":"Article 152503"},"PeriodicalIF":7.3,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000543/pdfft?md5=b43de0a58f674becadb737dd4a22268f&pid=1-s2.0-S0010440X24000543-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141090942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical utility and relevance in clinical practice of DSM-5 specifiers for major depressive disorder: A Delphi expert consensus study","authors":"Andrea Fiorillo ,&nbsp;Umberto Albert ,&nbsp;Bernardo Dell'Osso ,&nbsp;Maurizio Pompili ,&nbsp;Gabriele Sani ,&nbsp;Gaia Sampogna","doi":"10.1016/j.comppsych.2024.152502","DOIUrl":"10.1016/j.comppsych.2024.152502","url":null,"abstract":"<div><p>Major depressive disorder (MDD) is a heterogeneous syndrome, associated with different levels of severity and impairment on the personal functioning for each patient. Classification systems in psychiatry, including ICD-11 and DSM-5, are used by clinicians in order to simplify the complexity of clinical manifestations. In particular, the DSM-5 introduced specifiers, subtypes, severity ratings, and cross-cutting symptom assessments allowing clinicians to better describe the specific clinical features of each patient. However, the use of DSM-5 specifiers for major depressive disorder in ordinary clinical practice is quite heterogeneous.</p><p>The present study, using a Delphi method, aims to evaluate the consensus of a representative group of expert psychiatrists on a series of statements regarding the clinical utility and relevance of DSM-5 specifiers for major depressive disorder in ordinary clinical practice. Experts reached an almost perfect agreement on statements related to the use and clinical utility of DSM-5 specifiers in ordinary clinical practice. In particular, a complete consensus was found regarding the clinical utility for ordinary clinical practice of using DSM-5 specifiers. The use of specifiers is considered a first step toward a “dimensional” approach to the diagnosis of mental disorders.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"133 ","pages":"Article 152502"},"PeriodicalIF":7.3,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000531/pdfft?md5=c623e5bda2de6cdabf8a3b93004cfb25&pid=1-s2.0-S0010440X24000531-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141132639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of psychopathology on day-to-day living in patients with schizophrenia: A network analysis","authors":"Mona Redlich Bossy ,&nbsp;Daniel R. Müller ,&nbsp;Daryl W. Niedermoser ,&nbsp;Achim Burrer ,&nbsp;Tobias R. Spiller ,&nbsp;Stefan Vetter ,&nbsp;Erich Seifritz ,&nbsp;Stephan T. Egger","doi":"10.1016/j.comppsych.2024.152501","DOIUrl":"10.1016/j.comppsych.2024.152501","url":null,"abstract":"<div><p>Although the relationship between schizophrenia and disability is well established, the association between the symptoms of the disorder and functional domains remains unclear. The current study explored the nuances of the relationship between symptoms and domains of functioning in a sample of 1127 patients with schizophrenia. We assessed the symptoms of schizophrenia with the Positive and Negative Syndrome Scale (PANSS) and psychosocial functioning with the mini-ICF-APP (mini-International Classification of Functioning Rating for Limitations of Activities and Participation in Psychological Disorders). The mean PANSS score was 94.28 (27.20), and the mean mini-ICF-APP score was 25.25 (8.96), both of which are indicative of severe symptom load and impairment. We were able to show a strong relationship and overlap between symptoms and disability in patients with schizophrenia. We identified several symptoms related to functional impairment. Deficits in judgment and abstract thinking contribute to impairment through poor adherence (to routines and compliance with rules) and difficulties in planning and organizing. We believe that in schizophrenia, symptoms and their interactions constitute a disorder beyond any single manifestation. Furthermore, we suggest that cognitive testing and cognitive treatment should become part of the standard of care for patients with schizophrenia.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"133 ","pages":"Article 152501"},"PeriodicalIF":7.3,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X2400052X/pdfft?md5=fe9c94278b4a8b603977ffb185a028bc&pid=1-s2.0-S0010440X2400052X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141038620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}