Current Opinion in Psychiatry最新文献

Treatment escalation for people with anorexia nervosa: setting, therapies and nutritional interventions. 神经性厌食症患者的治疗升级：环境、疗法和营养干预。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2024-09-05 DOI: 10.1097/YCO.0000000000000964

Hubertus Himmerich, Johanna Louise Keeler, Kate Tchanturia, Janet Treasure

{"title":"Treatment escalation for people with anorexia nervosa: setting, therapies and nutritional interventions.","authors":"Hubertus Himmerich, Johanna Louise Keeler, Kate Tchanturia, Janet Treasure","doi":"10.1097/YCO.0000000000000964","DOIUrl":"https://doi.org/10.1097/YCO.0000000000000964","url":null,"abstract":"Purpose of review: Adult patients with severe anorexia nervosa often receive the same unsuccessful treatment without changes regarding the setting, the therapies, or nutritional interventions.Recent findings: Settings where people with anorexia nervosa are treated include their general practitioner, an independent psychiatric practice, a community mental health team (CMHT), a specialized eating disorder outpatient service, eating disorder early intervention services, a highly intensive eating disorder outpatient or home treatment programme, eating disorder daycare, an inpatient eating disorder service, a general hospital or a general psychiatric hospital, or residential treatment. At a specialized eating disorder service, patients should be offered evidence-based psychotherapy for anorexia nervosa, dietary advice and physical health monitoring as a first step. Additionally, they may be allocated to a specific treatment pathway, family interventions and creative therapies. As a second step, clinicians may consider integrating interventions targeting psychiatric or physical comorbidities, medication for anorexia nervosa or noninvasive neurostimulation. After several years of futile treatment, deep brain stimulation (DBS) should be considered to prevent a chronic course of anorexia nervosa. Nutritional interventions can be escalated from nutritional counselling to nasogastric tube feeding. Patients who rely on nasogastric tube feeding might benefit from percutaneous endoscopic gastrostomy (PEG). Patients with an who vomit despite a nasogastric tube, might need nasojejunal tube feeding.Summary: Treatment for people with anorexia nervosa should be regularly reviewed and, if necessary, escalated to avoid a chronic and longstanding disease course.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 narrative review of community-based dementia care in India: experiences, challenges, and policy initiatives. 印度社区痴呆症护理回顾：经验、挑战和政策倡议。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2024-09-01 Epub Date: 2024-05-07 DOI: 10.1097/YCO.0000000000000944

Trisha Thomas, Jayashree Dasgupta

{"title":"A narrative review of community-based dementia care in India: experiences, challenges, and policy initiatives.","authors":"Trisha Thomas, Jayashree Dasgupta","doi":"10.1097/YCO.0000000000000944","DOIUrl":"10.1097/YCO.0000000000000944","url":null,"abstract":"Purpose of review: India is facing a significant increase in the aging population who are at risk for dementia. This review evaluates recent literature on community-based care, focusing on caregiver experiences, challenges and policy initiatives.Recent findings: Dementia care in India is traditionally provided by family members who take on the role of caregivers. Studies on caregiver experiences have reflected high caregiving burden and related impact on their mental health. During the pandemic, caregivers experienced several unprecedented challenges in providing care, emphasizing the need for more research on community-based dementia care across the country. Telehealth and online caregiver training were identified as viable alternatives to support community dementia care. However, it may not be a feasible mode of delivery suitable across the Indian context, underscoring the need for culturally relevant and acceptable interventions. India is currently undertaking concerted policy efforts for dementia care through multiple initiatives like the National Program for Healthcare of the Elderly, the Mental Healthcare Act, and initiatives like the Atal Vayo Abhyuday Yojna. These initiatives aim to address the healthcare requirements of the elderly; nevertheless, a comprehensive evaluation of their impact is yet to be discerned.Summary: There is a need for comprehensive research, to inform evidence-based policy and improve dementia care systems in India. Addressing gaps in existing dementia care capacities and healthcare initiatives, along with tailoring interventions to India's diverse contexts are critical for effective community care for dementia.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

The role of human involvement and support in digital mental health interventions for people with schizophrenia spectrum disorders: a critical review. 人类参与和支持在针对精神分裂症谱系障碍患者的数字心理健康干预中的作用：评论性综述。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2024-09-01 Epub Date: 2024-06-24 DOI: 10.1097/YCO.0000000000000957

Urska Arnautovska, Alyssa Milton, Mike Trott, Rebecca Soole, Dan Siskind

{"title":"The role of human involvement and support in digital mental health interventions for people with schizophrenia spectrum disorders: a critical review.","authors":"Urska Arnautovska, Alyssa Milton, Mike Trott, Rebecca Soole, Dan Siskind","doi":"10.1097/YCO.0000000000000957","DOIUrl":"10.1097/YCO.0000000000000957","url":null,"abstract":"Purpose of review: Schizophrenia spectrum disorders (SDD) are characterized by a complex array of psychosis symptoms, and typically require ongoing and long-term support, including pharmacological and nonpharmacological management. Digital mental health interventions (DMHIs) have been suggested as a novel therapeutic approach to enable low-cost, scalable improvements in quality of care for adults living with SSD. However, the types and role of human involvement and support within DMHIs is currently unknown.Recent findings: Several recent systematic reviews and meta-analyses have investigated the potential efficacy of DMHIs for people with SSD, with scant yet emerging systematic evidence on the effects of human support within DMHIs on mental health outcomes. Further, several recent individual studies examined the efficacy of DMHIs with human support among people with SSD and provided valuable insights into the potential key elements of such support on outcomes relevant to this population.Summary: The current critical review provides the first narrative synthesis of available evidence to guide clinicians and intervention develops in designing DMHIs with adequate human support that may enhance long-term outcomes of people living with SSD.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141589893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Psychotropic drugs, eating behaviour and weight gain. 精神药物、饮食行为和体重增加。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2024-09-01 Epub Date: 2024-06-10 DOI: 10.1097/YCO.0000000000000953

Shalika Arniotis-Streat, Anthony Fonte, Hisham Ziauddeen

引用次数: 0

Transcranial magnetic stimulation and transcranial direct current stimulation in reducing depressive symptoms during the peripartum period. 经颅磁刺激和经颅直流电刺激在减少围产期抑郁症状方面的作用。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2024-09-01 Epub Date: 2024-06-13 DOI: 10.1097/YCO.0000000000000954

Ana Ganho-Ávila, Mónica Sobral, Mijke Lambregtse-van den Berg

{"title":"Transcranial magnetic stimulation and transcranial direct current stimulation in reducing depressive symptoms during the peripartum period.","authors":"Ana Ganho-Ávila, Mónica Sobral, Mijke Lambregtse-van den Berg","doi":"10.1097/YCO.0000000000000954","DOIUrl":"10.1097/YCO.0000000000000954","url":null,"abstract":"Purpose of review: To present the latest data on the efficacy, safety, and acceptability of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in peripartum depression (PPD), complemented by notes emerging from our clinical and research experience.Recent findings: TMS and tDCS show promising results to manage mild to moderate depressive symptoms in the peripartum period. Evidence of TMS efficacy during pregnancy and the postpartum comes from two small randomized controlled trials (RCTs) with encouraging but still inconsistent results. Evidence of tDCS efficacy during pregnancy comes from one small RCT and in the postpartum the first RCT is just now being conducted and results are highly expected. The safety profile (with transient mild adverse effect to women and no known risk to the foetus/newborn) and acceptability by women seems overall good. However, the perspectives from health professionals and managers are unclear.Summary: Whereas TMS accelerated protocols (e.g., more than one session/day) and shorter sessions (e.g., theta burst stimulation) could address the need for fast results in PPD, home-based tDCS systems could address accessibility issues. Currently, the evidence on the efficacy of TMS and tDCS in PPD is limited warranting further research to support stronger evidence-based clinical guidelines.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141589894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Sex and gender differences in cancer in individuals with severe mental disorders. 严重精神障碍患者罹患癌症的性别差异。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2024-09-01 Epub Date: 2024-07-15 DOI: 10.1097/YCO.0000000000000958

Žarko Bajić, Sandra Vuk-Pisk, Igor Filipčić, Ivona Šimunović Filipčić

{"title":"Sex and gender differences in cancer in individuals with severe mental disorders.","authors":"Žarko Bajić, Sandra Vuk-Pisk, Igor Filipčić, Ivona Šimunović Filipčić","doi":"10.1097/YCO.0000000000000958","DOIUrl":"10.1097/YCO.0000000000000958","url":null,"abstract":"Purpose of review: Although cancer incidence is similar between individuals with severe mental disorders (SMD) and the general population (GP), survival rates are lower, particularly in those with schizophrenia. While the scientific and medical communities acknowledge sex differences in cancer mechanisms, including risk factors and cancer types, less is known about sex and gender disparities in incidence, mortality, and care pathways among those with SMD. This review aims to explore these differences in cancer among individuals with SMD.Recent findings: Current evidence on sex and gender differences in cancer care for SMD is limited. It is unclear how these factors affect cancer incidence and mortality in the SMD population, and if they correspond to those in the GP. The literature frequently omits detailed information on sex-based differences in SMD-related cancer rates, complicating conclusive analysis. Moreover, people with SMD experience significant challenges in accessing cancer screenings compared to the GP, and findings on sex and gender disparities in this context remain inconclusive.Summary: This review emphasizes that while significant sex and gender-based differences in cancer mechanisms, incidence, and survival exist within the GP, they have not been fully integrated into clinical practice. It underscores the need of addressing these differences in cancer incidence, outcomes, mortality, and care pathways to enhance treatment for individuals with SMD.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

End of life care for people with dementia and comorbid cancer: recent studies and research gaps. 痴呆症患者和合并癌症患者的临终关怀：最新研究和研究空白。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2024-09-01 Epub Date: 2024-05-21 DOI: 10.1097/YCO.0000000000000951

Claire Surr, Laura Ashley

{"title":"End of life care for people with dementia and comorbid cancer: recent studies and research gaps.","authors":"Claire Surr, Laura Ashley","doi":"10.1097/YCO.0000000000000951","DOIUrl":"10.1097/YCO.0000000000000951","url":null,"abstract":"Purpose of review: This narrative review examines recent research on end of life (EOL) care for people with dementia and comorbid cancer, highlighting the complexity and challenge of providing effective EOL care for this group and areas of interest for future research.Recent findings: People with cancer and dementia and their family/supporters have more complex care and support needs at EOL that are less well met than those of older adults with cancer alone, including questionable use of aggressive EOL care interventions, poorer access to specialist palliative care teams and poor pain management. Those diagnosed with dementia at the same time as, or after their cancer diagnosis, are at greater risk of aggressive EOL care and EOL cancer treatment and care plans that are not able to meet their care needs as dementia progresses.Summary: There is a lack of research on EOL care for people with cancer and dementia. There is little understanding of what good care for this population looks like and if and how EOL care can best meet the needs of people with cancer and dementia or their carers/supporters. More research is needed to inform improved care for this population.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

GLP-1 receptor agonists and weight loss in schizophrenia - past, present, and future. GLP-1 受体激动剂与精神分裂症患者的体重减轻--过去、现在和未来。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2024-09-01 Epub Date: 2024-06-07 DOI: 10.1097/YCO.0000000000000952

Mike Trott, Urska Arnautovska, Dan Siskind

{"title":"GLP-1 receptor agonists and weight loss in schizophrenia - past, present, and future.","authors":"Mike Trott, Urska Arnautovska, Dan Siskind","doi":"10.1097/YCO.0000000000000952","DOIUrl":"10.1097/YCO.0000000000000952","url":null,"abstract":"Purpose of review: People with schizophrenia experience three to five times higher prevalence of diabetes and obesity than the general population, contributing to a 20-year reduced lifespan. The impacts of weight gain extend beyond physical health, affecting people's self-esteem, quality of life, and triggering treatment nonadherence, leading to relapse and deteriorations in health. Clinical guidelines recommend patients with antipsychotic-induced weight gain are treated with cognitive behaviour therapy and lifestyle changes; however, effective treatments for obesity in schizophrenia are critically lacking. Glucagon-like peptide-1 receptor agonists (GLP-RAs) have shown large effects in weight loss in the general population; however, effects are less clear in people with schizophrenia. This review aims to assess the clinical trials that have been completed, are in progress, and directions for future trials.Recent findings: To date, six clinical trials have been completed, four of which have published their findings. Three further trials are currently in progress.Summary: Results from completed trials suggest that GLP-1RAs decrease weight in people with schizophrenia, however effect sizes are mostly smaller than studies based on the general population. Future trials could focus on dual or triple agonist agents, and/or explore the effects of GLP-1 s at antipsychotic medication commencement, to potentially prevent antipsychotic weight gain.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Psychotherapies for the treatment of personality disorders: the state of the art. 治疗人格障碍的心理疗法：最新进展。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2024-08-27 DOI: 10.1097/YCO.0000000000000968

Paul M G Emmelkamp, Katharina Meyerbröker

{"title":"Psychotherapies for the treatment of personality disorders: the state of the art.","authors":"Paul M G Emmelkamp, Katharina Meyerbröker","doi":"10.1097/YCO.0000000000000968","DOIUrl":"https://doi.org/10.1097/YCO.0000000000000968","url":null,"abstract":"Purpose of review: To provide an update of systematic reviews, meta-analyses and recent clinical outcome studies for personality disorder (PD) in order to investigate the state of the art of the evidence of psychotherapy for personality disorders.Recent findings: Few outcome studies in patients with Cluster A and Cluster C PD have been conducted, which limits the conclusions which can be drawn. Most recently published research has been conducted with borderline PD. There is limited evidence that dialectical behavior therapy (DBT), mentalization based therapy and schema therapy are more effective than treatment as usual. There is no convincing evidence that long and intensive therapy is more effective than short and less intensive therapy. Drop-out is rather high for patients with borderline PD. Group therapy results in more drop-outs than individual therapy.Summary: There is a clear need of studies evaluating whether psychotherapies developed for PDs are more effective than CBT for patients with Cluster C PD. Given that studies with patients with Cluster B PD suggest that longer treatment of DBT and mentalization-based treatment is not more effective than shorter treatment this needs to be studied with other evidence-based therapies as well. Serious efforts are needed to evaluate therapies for patients with Cluster A PDs.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Eating disorders: etiology, risk factors, and suggestions for prevention. 饮食失调症：病因、风险因素和预防建议。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2024-08-23 DOI: 10.1097/YCO.0000000000000965

Anna Keski-Rahkonen

{"title":"Eating disorders: etiology, risk factors, and suggestions for prevention.","authors":"Anna Keski-Rahkonen","doi":"10.1097/YCO.0000000000000965","DOIUrl":"https://doi.org/10.1097/YCO.0000000000000965","url":null,"abstract":"Purpose of review: The incidence of eating disorders has increased worldwide. This narrative review gives an overview of research on etiology and risk factors of eating disorders published in 2022-2024.Recent findings: Eating disorders arise from a complex set of risk factors. The recent increase in incidence of eating disorders can be linked to root causes that include sociocultural pressure to conform to unrealistic and gendered body ideals, rise in obesogenic environments, and the global COVID-19 pandemic. Recent studies have shown that screen time and social media intensify sociocultural pressure to look a certain way. Individual-specific risk factors also increase the likelihood of onset of eating disorders. These include sports, stressful and traumatic life events, family factors, and psychological factors, including disgust sensitivity, aversive experiences, low self-esteem, perfectionism, neuroticism, obsessive-compulsive and impulsive features, and emotional dysregulation. Preexisting mental health conditions, particularly anxiety, depression, and posttraumatic stress disorder, and neurodevelopmental conditions, such as autism and attention-deficit hyperactive disorder, are also associated with increased eating disorder risk. Genetic and biological factors contribute both to risk and resiliency.Summary: The risk factors of eating disorders are well established. Future studies should focus on increasing resilience and preventive interventions.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":7.5,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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