Current Opinion in Psychiatry最新文献

{"title":"Integrating community perspectives to enhance the utility of wastewater-based epidemiology for addressing substance use in the United States.","authors":"Tara Sabo-Attwood, Devin A Bowes, Joseph H Bisesi","doi":"10.1097/YCO.0000000000001016","DOIUrl":"10.1097/YCO.0000000000001016","url":null,"abstract":"<p><strong>Purpose of review: </strong>Wastewater-based epidemiology (WBE) of substances can serve as a valuable tool to supplement traditional surveillance techniques, providing information rapidly on community use. Despite ongoing WBE-opioid programs occurring throughout the world, few have integrated such data into public health decision-making to drive meaningful interventions. This gap could be due to several factors and concerns that vary across diverse communities. This perspective examines multiple levels of stakeholders involved in the implementation of WBE for substance use, their roles, and the challenges facing each.</p><p><strong>Recent findings: </strong>Challenges have been identified by our team while conducting a multiyear project focused on integrating WBE in several communities across the United States. We also highlight communities that have successfully implemented such programs and the benefits they have seen from this approach. Based on our experience and the current state of the literature, we identify current priority needs to increase the utility and impact of using WBE for monitoring substance use across communities.</p><p><strong>Summary: </strong>There is great promise for the utility of WBE as a tool for strengthening public health systems to address substance use. Understanding the roles and perspectives of stakeholders broadly will help to move this concept into an effective and trusted approach.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"302-308"},"PeriodicalIF":7.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110032","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":"Interventions to improve medication adherence in persons with mental disorders.","authors":"Jahnavi Kedare, Abhijeet Faye","doi":"10.1097/YCO.0000000000000993","DOIUrl":"10.1097/YCO.0000000000000993","url":null,"abstract":"<p><strong>Purpose of review: </strong>Nonadherence to medication is prevalent in patients with mental illness. Various factors responsible for it. As a result, there are more hospitalizations, increased risk of suicide and increased cost of care. Thus, there is a need for effective interventions to improve adherence in mentally ill patients.</p><p><strong>Recent findings: </strong>Adherence to medication includes participation of patient in decision making. Interventions in the recent years help patients through techniques like psychoeducation, motivational interviewing and cognitive behaviour therapy. Interventions involve both patients and caregivers. There is a growing body of research about use of technology -based interventions using smart phones, various applications, digital platforms and artificial intelligence. Recent findings of research indicate that a combination of methods of intervention may be more useful in improving adherence. Some conventional interventions yield good results. Robust research is needed in the field of technology- based interventions.</p><p><strong>Summary: </strong>Non adherence to medication leads to poorer health outcomes and hampers integration of the patient in the society. A collaborative effort of the team of healthcare providers, the patient and caregivers is the way ahead for better adherence and good quality of life.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"309-315"},"PeriodicalIF":7.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515007","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}

{"title":"Co-production in community-based substance use disorder treatment services: a scoping review.","authors":"Joe Schofield, Susanna Galea-Singer, Alexander Mario Baldacchino","doi":"10.1097/YCO.0000000000001011","DOIUrl":"10.1097/YCO.0000000000001011","url":null,"abstract":"<p><strong>Purpose of review: </strong>The personal and social harms from unmanaged substance use disorders (SUD) are substantial. Too few people with SUD are engaged in treatment, partly due to the acceptability and accessibility of services. Co-production - sharing power and decision-making between professionals and people with lived experience (PWLE) - could address barriers to improve uptake and outcomes of SUD treatment. This scoping review examined recent (01/09/2023-08/03/2025) literature on co-production in community SUD treatment services.</p><p><strong>Recent findings: </strong>Co-production has been used to address barriers to care and co-design new interventions and services, especially for marginalised populations and groups with complex needs. Methods, processes, and the degree of meaningful involvement of PWLE varied across projects. Most work occurred in higher income countries and the impacts on PWLE were rarely explored.</p><p><strong>Summary: </strong>Co-production is feasible and can inform the development of more patient-centred SUD treatment services. Projects should be grounded in theory and power differentials in decision-making addressed to ensure equitable and meaningful participation throughout the process. There is a need to explore co-production in the design and evaluation of general SUD treatment, sustainability, impacts on participants, and evaluation of long-term outcomes.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"265-273"},"PeriodicalIF":7.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110044","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}

{"title":"Digital exclusion and people experiencing homelessness: implications for opioid use disorder care.","authors":"Joseph Tay Wee Teck, Hui Shan Tan, Alexander Baldacchino","doi":"10.1097/YCO.0000000000001012","DOIUrl":"10.1097/YCO.0000000000001012","url":null,"abstract":"<p><strong>Purpose of review: </strong>People experiencing homelessness (PEH) are at increased risk of adverse consequences from opioid use disorder and other health conditions yet face multiple structural and personal barriers to accessing care. The expansion of digitized health and social care services may have improved access and efficiency of services to many in the general population but at the cost of further marginalizing PEH. Current digital exclusion mitigation strategies may not be sufficiently nuanced to address the deeply complex and challenging circumstances of PEH lives.</p><p><strong>Recent findings: </strong>Providing devices, data and skills to PEH is no guarantee of increased use and benefit from digitally enabled services. Precarious and constantly mobile lives mean that maintaining sustained digital access is problematic and not always desirable. Even where digital access is secured, PEH are constrained in the range of activities they can engage with online due to privacy and other structural constraints. Justifiable distrust of institutions including healthcare colors the acceptability of digitized services for PEH. This distrust is magnified due to new inequities and vulnerabilities introduced by digitized services including the need for a digital persona, adverse outcomes from adverse digital inclusion and a widening of power imbalances. These more nuanced understandings of digital exclusion are increasingly incorporated into mitigation strategies, premised on co-production and engagement with PEH.</p><p><strong>Summary: </strong>Improved engagement with digitally enabled OUD care for PEH must be prefaced by improved access to technology, optimized physical environments to maintain and use technology, and collaborative cross-sectoral efforts to build trust and engage this group through co-production and rebalanced power dynamics.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"274-281"},"PeriodicalIF":7.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110030","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}

{"title":"Lived experience of gaming disorder among people with psychotic disorders: implications for tailored interventions and clinical management.","authors":"Maxime Huot-Lavoie, Laurent Béchard, Olivier Corbeil, Olivier Roy, Sophie L'Heureux, Ingrid Salvini, Catherine Lehoux, Anne-Marie Essiambre, Chantale Thériault, Sébastien Brodeur, Marie-France Demers, Yasser Khazaal, Marc-André Roy","doi":"10.1097/YCO.0000000000001013","DOIUrl":"10.1097/YCO.0000000000001013","url":null,"abstract":"<p><strong>Purpose of review: </strong>Despite growing recognition of the impact of Gaming Disorder in individuals with psychotic disorders, little is known about the clinical and personal implications of this dual diagnosis. Preliminary data suggest that Gaming Disorder may be associated with increased psychotic symptoms and reduced occupational and social functioning. However, insight from lived experience remain largely absent, despite their importance.</p><p><strong>Recent findings: </strong>This review synthesizes recent literature on the comorbidity between Gaming Disorder and psychotic disorders, highlighting the scarcity of research in this emerging field. It also presents preliminary findings from an ongoing qualitative study focussing on the lived experiences of individuals receiving early psychosis intervention. These data focus on participants' motivations for gaming and their perceptions of both positive and negative effects gaming has on their life.</p><p><strong>Summary: </strong>This review underscores the significant lack of data on the dual diagnosis of Gaming Disorder and psychosis. Early qualitative insights reveal diverse gaming motivations, including symptom regulation, anxiety management, cognitive stimulation, and social connection. These first-person accounts emphasize the functional role of gaming and the need for recovery-oriented care. Integrating lived experience into research and clinical practice can improve relevance, support nuanced interventions, and advance our understanding of behavioral addictions in early psychosis.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"295-301"},"PeriodicalIF":7.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126951","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":"Developing a sentinel network for illicit substance use monitoring in Spain: a qualitative approach to key determinants.","authors":"Leonor Varela-Lema, Sara Esteves Araujo Correia, Carla Guerra-Tort, Ana Teijeiro, Linda B Cottler, Jasjit S Ahluwalia, Mónica Perez-Rios","doi":"10.1097/YCO.0000000000001017","DOIUrl":"10.1097/YCO.0000000000001017","url":null,"abstract":"<p><strong>Purpose of review: </strong>Sentinel surveillance networks have been developed in different countries to monitor changes in patterns of addiction. The aim of this study was to ascertain fundamental aspects required for the design and implementation of a sentinel network for the surveillance of illicit drugs use in Spain.</p><p><strong>Recent findings: </strong>Internationally, sentinel networks vary in organization, collaboration, and informants. Some rely on hospital emergency departments, such as Euro-DEN Plus and SISVEA; others include community pharmacists (Addictovigilance, Catalan Sentinel Pharmacies) or drug users themselves (IDRS, EDRS). Networks like N-DEWS and CCENDU combine real-time community data with epidemiological analysis. The challenges identified in the literature include the inclusion of drug users as informants due to reliability concerns, inconsistencies in data collection across health services, and professional fatigue. While focused on Spain, these findings may also be relevant for other countries with comparable public health challenges.</p><p><strong>Summary: </strong>This qualitative study, based on focus groups with key informants, offers recommendations for the creation of a multidisciplinary, flexible sentinel network adapted to the Spanish context. Integration of professionals from diverse sectors, training in toxicology and digital tools, and mechanisms for feedback and motivation are critical. These insights can support clinical early detection, improve alert dissemination, and serve as a foundation for future research on surveillance systems for substance use.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"287-294"},"PeriodicalIF":7.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110027","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}

{"title":"A case against purity: prioritizing translational polysubstance use research.","authors":"Cassandra D Gipson, Amanda Fallin-Bennett, Jibran Y Khokhar, Lori Knackstedt, William W Stoops, Rachel Vickers-Smith, Linda Cottler","doi":"10.1097/YCO.0000000000001010","DOIUrl":"10.1097/YCO.0000000000001010","url":null,"abstract":"<p><strong>Purpose of review: </strong>Preclinical (nonhuman) research on neurobehavioral underpinnings of addiction often focuses on one addictive drug studied in isolation, however, this does not reflect real-world substance use patterns of polysubstance use (PSU). Here we make a case against purity, incorporating patterns of clinically relevant PSU into preclinical models. We argue that the meaningful inclusion of people with living experience as integral collaborators in translational addiction models is critical to advance the identification of novel efficacious therapeutics to reduce the harms associated with PSU.</p><p><strong>Recent findings: </strong>Substance use disorders are complex as clinically defined and diagnosed. Further, PSU is highly prevalent and individuals may use multiple substances within the illicit drug supply which continually evolves and is tracked via surveillance efforts (e.g., the National Drug Early Warning System). Preclinical models often model monosubstance use patterns which do not reflect real world drug use and omits expertise from people who use drugs in driving preclinical addiction science.</p><p><strong>Summary: </strong>Here, we argue a case against purity in the development, design, and implementation of preclinical translational studies of addictive drugs, a need for inclusion of individuals with living experience, and highlight the need for additional research on PSU across the translational spectrum.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"282-286"},"PeriodicalIF":7.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110042","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":"Editorial introductions.","authors":"","doi":"10.1097/YCO.0000000000001014","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001014","url":null,"abstract":"","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"38 4","pages":"v"},"PeriodicalIF":7.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172976","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}

{"title":"Substantiating policy recommendations for reducing gambling-related harms with perspectives from individuals with lived experience.","authors":"Li Yan McCurdy, Jennifer J Park, Marc N Potenza","doi":"10.1097/YCO.0000000000001008","DOIUrl":"10.1097/YCO.0000000000001008","url":null,"abstract":"<p><strong>Purpose of review: </strong>Changes in gambling regulation have been linked to public health concerns, with system- and population-level approaches suggested to prevent and reduce gambling-related harms in societies. This review utilizes recent qualitative studies on individuals with lived experience of gambling-related harms to substantiate and inform refinement of current policy-level recommendations.</p><p><strong>Recent findings: </strong>Recent policy recommendations are well poised to address issues faced by individuals with lived experience of gambling-related harms, as reflected in several recent qualitative studies. Pertinent topics include increased accessibility to gambling via digitization, limitations of self-exclusion, and difficulty adhering to self-imposed financial limits. A range of barriers, including stigma, aggressive advertising by gambling operators, and gambling opportunities in video games, may undermine the effectiveness of some policies (e.g., self-exclusion, deposit limits, and age restrictions, respectively).</p><p><strong>Summary: </strong>The perspectives of individuals with lived experience of gambling-related harms can be invaluable in complementing, strengthening, and contextualizing quantitative results to substantiate policy recommendations and provide insight into potential limitations of the recommendations to refine population-level strategies. Individuals with lived experience should be involved in future research involving monitoring of the gambling industry and assessing the impact of regulatory measures to strengthen the process of evaluating and adapting policies.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"259-264"},"PeriodicalIF":7.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751575","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 role of gut microbiota in psychiatric disorders: current findings.","authors":"Ivona Šimunović Filipčić, Ivana Kolčić, Vlado Grošić, Igor Filipčić","doi":"10.1097/YCO.0000000000001019","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001019","url":null,"abstract":"<p><strong>Purpose of review: </strong>Gut microbiota and its alterations have been increasingly implicated in the pathophysiology of major psychiatric disorders via the microbiota-gut-brain axis. This narrative review aims to highlight current findings from recent systematic reviews and meta-analyses (published between September 2023 and March 2025), addressing the role of gut microbiota in major depressive disorder (MDD) and schizophrenia, with particular attention to the effects of psychotropic medications and microbiota-targeted interventions.</p><p><strong>Recent findings: </strong>In MDD, consistent changes in gut microbiota composition, such as depletion of Faecalibacterium and enrichment of Bifidobacterium, have been reported, although alpha diversity findings remain inconsistent. Antidepressants may modulate microbiota in both humans and animal models, while probiotic and synbiotic interventions yield modest reductions in depressive symptoms and inflammatory markers. In schizophrenia, observational studies showed stable alpha diversity, but altered beta diversity, with taxa like Bifidobacterium, Lactobacillus, and Roseburia linked to symptom severity, cognition, and antipsychotic exposure. Interventional studies, though limited, suggest small-to-moderate clinical improvements with probiotic supplementation, and emerging evidence supports potential benefits for both cognition and reducing metabolic side effects of psychotropic medications.</p><p><strong>Summary: </strong>Across depressive and psychotic disorders, growing evidence supports a multifaceted and indispensable role of gut microbiota in clinical symptomatology, treatment response, and cognition of patients. However, substantial variability of methodological frame, limited sample sizes, lack of mechanistic precision, and heterogeneity between published studies result in unequivocal conclusions on the exact effect of microbiota on mental health in general, and on major psychiatric disorders. While microbiota-targeted therapies remain adjunctive and exploratory, recent findings reinforce them as a promising target for more successful treatment of mental health disorders in the near future. In order to reach that goal, we need more rigorous, longitudinal, and integrative studies to guide the clinical implementation.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282764","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}