Current Opinion in Psychiatry最新文献_第10页

Predictors and motives of polydrug use in opioid users. A narrative review. 阿片类药物使用者多种药物使用的预测因素和动机。叙述性评论

IF 6.9 2区医学

Current Opinion in Psychiatry Pub Date : 2023-07-01 DOI: 10.1097/YCO.0000000000000875

Jan van Amsterdam, Mimi Pierce, Wim van den Brink

{"title":"Predictors and motives of polydrug use in opioid users. A narrative review.","authors":"Jan van Amsterdam, Mimi Pierce, Wim van den Brink","doi":"10.1097/YCO.0000000000000875","DOIUrl":"https://doi.org/10.1097/YCO.0000000000000875","url":null,"abstract":"Purpose of review: To review the recent literature on predictors and personal motives of polydrug use in opioid users with a focus on combined use of opioids with stimulants, benzodiazepines and gabapentinoids.Recent findings: In North America, methamphetamine is now the most prevalent co-drug in opioid users and is responsible for high mortality rates. In Europe, opioids are rather combined with either cocaine, benzodiazepines or gabapentionoids, but recent data are lacking.Main personal motives of opioid users to combine opioids with methamphetamine or cocaine is to boost the opioid high, inhibit the withdrawal effects of heroin and have a cheaper alternative to maintain the opioid high. Risk factors of polydrug use by opioid users included being male, younger age, homelessness, high-risk sexual behavior, needle sharing, incarceration, poor mental health and recent use of cocaine or prescription opioids. The motives for co-use of opioids and gabapentinoids also include seeking a better high, lower price and to self-medicate pain/physical symptoms, including those resulting from withdrawal.Summary: When treating opioid users with polydrug drug use, special attention should be paid to dosing when in opioid agonist methadone/buprenorphine treatment and to the presence of physical pain. The validity of part of the personal motives seems questionable which deserves attention when counselling opioid users with polydrug use.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"36 4","pages":"301-307"},"PeriodicalIF":6.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10040114","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: 4

The ever-growing case for clozapine in the treatment of schizophrenia: an obligation for psychiatrists and psychiatry. 氯氮平治疗精神分裂症的案例越来越多:精神科医生和精神病学的义务。

IF 6.9 2区医学

Current Opinion in Psychiatry Pub Date : 2023-07-01 DOI: 10.1097/YCO.0000000000000871

Robert A Bittner, Andreas Reif, Mishal Qubad

{"title":"The ever-growing case for clozapine in the treatment of schizophrenia: an obligation for psychiatrists and psychiatry.","authors":"Robert A Bittner, Andreas Reif, Mishal Qubad","doi":"10.1097/YCO.0000000000000871","DOIUrl":"https://doi.org/10.1097/YCO.0000000000000871","url":null,"abstract":"Purpose of review: Clozapine remains the gold standard for treatment-resistant schizophrenia (TRS). Although the evidence base for its wide-ranging, unique efficacy continues to expand, clozapine remains alarmingly underutilized in industrialized countries. Analyzing the causes and consequences of this problem is crucial for substantially improving the quality of care for TRS patients.Recent findings: Clozapine is the most effective antipsychotic for reducing all-cause mortality in TRS. In most cases, treatment resistance emerges during the first psychotic episode. Delaying clozapine treatment has a negative impact on long-term outcome. Patients' experience with clozapine treatment is largely positive despite a comparatively high rate of side effects. Patients prefer clozapine, while psychiatrists regard it as a burden due to concerns regarding safety and side effect management. Shared decision-making (SDM), which increases the likelihood of a clozapine recommendation, is not routinely used, possibly due to stigmatization of TRS patients.Summary: The mortality-reducing effects of clozapine alone warrant its regular use. Therefore, psychiatrists must not exclude patients from the decision regarding a clozapine trial by not even offering it. Rather, they have a clear obligation to align their actions more closely with the existing evidence and patients' needs and to facilitate the timely initiation of clozapine.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"36 4","pages":"327-336"},"PeriodicalIF":6.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9681895","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: 1

Rapid opioid overdose response system technologies. 阿片类药物过量快速反应系统技术。

IF 6.9 2区医学

Current Opinion in Psychiatry Pub Date : 2023-07-01 DOI: 10.1097/YCO.0000000000000870

Joseph Tay Wee Teck, Alberto Oteo, Alexander Baldacchino

{"title":"Rapid opioid overdose response system technologies.","authors":"Joseph Tay Wee Teck, Alberto Oteo, Alexander Baldacchino","doi":"10.1097/YCO.0000000000000870","DOIUrl":"https://doi.org/10.1097/YCO.0000000000000870","url":null,"abstract":"Purpose of review: Opioid overdose events are a time sensitive medical emergency, which is often reversible with naloxone administration if detected in time. Many countries are facing rising opioid overdose deaths and have been implementing rapid opioid overdose response Systems (ROORS). We describe how technology is increasingly being used in ROORS design, implementation and delivery.Recent findings: Technology can contribute in significant ways to ROORS design, implementation, and delivery. Artificial intelligence-based modelling and simulations alongside wastewater-based epidemiology can be used to inform policy decisions around naloxone access laws and effective naloxone distribution strategies. Data linkage and machine learning projects can support service delivery organizations to mobilize and distribute community resources in support of ROORS. Digital phenotyping is an advancement in data linkage and machine learning projects, potentially leading to precision overdose responses. At the coalface, opioid overdose detection devices through fixed location or wearable sensors, improved connectivity, smartphone applications and drone-based emergency naloxone delivery all have a role in improving outcomes from opioid overdose. Data driven technologies also have an important role in empowering community responses to opioid overdose.Summary: This review highlights the importance of technology applied to every aspect of ROORS. Key areas of development include the need to protect marginalized groups from algorithmic bias, a better understanding of individual overdose trajectories and new reversal agents and improved drug delivery methods.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"36 4","pages":"308-315"},"PeriodicalIF":6.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9687183","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: 3

Polysubstance use in South Asia. 南亚的多物质使用。

IF 6.9 2区医学

Current Opinion in Psychiatry Pub Date : 2023-07-01 DOI: 10.1097/YCO.0000000000000869

Piyali Mandal, Sumegha Mittal, Rakesh Kumar Chadda

{"title":"Polysubstance use in South Asia.","authors":"Piyali Mandal, Sumegha Mittal, Rakesh Kumar Chadda","doi":"10.1097/YCO.0000000000000869","DOIUrl":"https://doi.org/10.1097/YCO.0000000000000869","url":null,"abstract":"Purpose of review: Polysubstance use is very common in the world, but there has been limited research in this area. South Asia is sandwiched between two of the world's largest heroin producing areas: the Golden Crescent and the Golden Triangle. The burden and prevalence of polysubstance use have not been estimated in this region of the world. We review the research findings on polysubstance use in different South Asian countries. The review also comments on the gaps in knowledge regarding polysubstance use in this region of the world.Recent findings: The available literature on polysubstance use from South Asia suggests its widespread presence in the region, ranging from 20 to 90%, more commonly among illicit opioid drug users and injection drug users. Most of the available data is from epidemiological studies. There are few studies on the adverse effects of polysubstance use, but the limited data clearly suggests an elevated risk of comorbid psychopathology and health problems.Summary: Polysubstance use still lacks a consensus definition. There is a need of more research on its prevalence, effects on health, and prevention and treatment.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"36 4","pages":"269-276"},"PeriodicalIF":6.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9687184","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

Traditional and faith-based healthcare in the management of psychotic disorders in Africa: in search for synergy. 非洲精神疾病管理中的传统和基于信仰的保健:寻求协同作用。

IF 6.9 2区医学

Current Opinion in Psychiatry Pub Date : 2023-07-01 DOI: 10.1097/YCO.0000000000000872

Martine C E van der Zeijst, Wim Veling, Bonginkosi Chiliza, Hans W Hoek

{"title":"Traditional and faith-based healthcare in the management of psychotic disorders in Africa: in search for synergy.","authors":"Martine C E van der Zeijst, Wim Veling, Bonginkosi Chiliza, Hans W Hoek","doi":"10.1097/YCO.0000000000000872","DOIUrl":"https://doi.org/10.1097/YCO.0000000000000872","url":null,"abstract":"Purpose of review: This review summarizes the current literature on the role of traditional and faith-based healthcare in the management of psychotic disorders in Africa.Recent findings: In contemporary Africa, individuals with psychosis and traditional and faith healers (TFH) are pluralistic towards their understanding of psychosis and their help-seeking behaviour. Traditional healing is perceived to be helpful to patients with psychotic disorders and their family members and may have a positive influence on the course of psychosis in some selected individuals. Studies show that potentially harmful practices are commonly used by African TFH, but that these are associated with a lack of resources and are susceptible to training. Although various TFH and biomedical practitioners are open to collaboration, the many identified obstacles hinder actual partnerships. However, the few studies that have been conducted on collaborative care for patients with psychotic disorders on the continent, show positive outcomes.Summary: Rather than harmonizing the two healing paradigms, synergistic collaboration between traditional/faith-based and biomedical mental healthcare in the management of individuals with psychosis seems to be possible within certain limits. Synergistic collaboration is more culturally syntonic and may actually contribute to bridging the treatment gap for mental disorders in present-day Africa.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"36 4","pages":"337-344"},"PeriodicalIF":6.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9682751","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}

引用次数: 1

Middle-income country perspectives on global mental health. 中等收入国家对全球精神卫生的看法。

IF 6.9 2区医学

Current Opinion in Psychiatry Pub Date : 2023-07-01 DOI: 10.1097/YCO.0000000000000877

Amy S Adams, Goodman Sibeko, Dan J Stein

{"title":"Middle-income country perspectives on global mental health.","authors":"Amy S Adams, Goodman Sibeko, Dan J Stein","doi":"10.1097/YCO.0000000000000877","DOIUrl":"https://doi.org/10.1097/YCO.0000000000000877","url":null,"abstract":"Purpose of review: Despite being a relatively new discipline, global mental health (GMH) has made substantial advances, paying particular attention to optimising the provision of mental health services in low- and middle-income countries (LMICs). Much of the work done in GMH has focused on low-income countries (LIC), but middle-income countries (MIC) such as Brazil, China, India, and South Africa, have particular characteristics that may impact the nature of this work. Here we examine key GMH issues, including mental health legislation, burden of disease, task-sharing, and mental health clinical and research capacity-building, in the MIC context.Recent findings: In MICs there is particular concern about an increase in non-communicable diseases, including mental disorders. MICs have more resources than LICs, but the treatment gap in these settings remains significant. MICs are better equipped than LICs to mobilize task-sharing programs, and these can potentially include more highly educated community health workers. In MICs there have been important advances in mental health legislation, but more is needed regarding implementation and the promotion of human rights. Clinical and research capacity-building initiatives in MIC contexts are easier to establish and have potential to be more ambitious in scope.Summary: GMH has developed important universal principles that apply across low-, middle-, and high-income countries. Nevertheless, particular issues in MICs may require moulding of more general GMH frameworks.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"36 4","pages":"321-326"},"PeriodicalIF":6.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9737323","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 polysubstance use on criminal justice involvement in the United States. 在美国，多种物质的使用对参与刑事司法所起的作用。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2023-07-01 Epub Date: 2023-05-03 DOI: 10.1097/YCO.0000000000000873

Abenaa A Jones, Sienna Strong-Jones, Hannah B Apsley

{"title":"The role of polysubstance use on criminal justice involvement in the United States.","authors":"Abenaa A Jones, Sienna Strong-Jones, Hannah B Apsley","doi":"10.1097/YCO.0000000000000873","DOIUrl":"10.1097/YCO.0000000000000873","url":null,"abstract":"Purpose of review: Polysubstance use, broadly defined as using more than one type of substance, disproportionately impacts those involved in the criminal justice system (CJS). This review synthesizes recent findings on polysubstance use among those involved in the CJS and highlights areas of particular concern and interventions.Recent findings: We use 18 recent articles to identify the prevalence and types of criminal justice involvement and correlates of polysubstance use and criminal justice involvement. We highlight latent patterns of polysubstance use among various criminal justice populations (adults, pregnant women, and youth) and differential associations with adverse substance use and criminal justice outcomes. Lastly, we discuss substance use treatment in the justice system, the role of polysubstance use in treatment access and outcomes, and substance use-related services for previously incarcerated individuals reentering society.Summary: Current research provides further evidence of the syndemic nature of polysubstance use, criminal justice involvement, and adverse outcomes, which are complicated by significant barriers to accessing evidence-based treatment in justice settings. Yet, current research is limited due to methodological inconsistency and limited focus on the social determinants of health, racial/ethnic disparities, and interventions to increase treatment and reentry services.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"36 4","pages":"290-300"},"PeriodicalIF":7.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10280570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10299680","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}

引用次数: 0

Emerging patterns of substance abuse and related treatment in China. 中国药物滥用的新模式及相关治疗。

IF 6.9 2区医学

Current Opinion in Psychiatry Pub Date : 2023-07-01 DOI: 10.1097/YCO.0000000000000878

Xuyi Wang, Yuanrong Li, Jin Li, Wei Hao

{"title":"Emerging patterns of substance abuse and related treatment in China.","authors":"Xuyi Wang, Yuanrong Li, Jin Li, Wei Hao","doi":"10.1097/YCO.0000000000000878","DOIUrl":"https://doi.org/10.1097/YCO.0000000000000878","url":null,"abstract":"Purpose of review: The situation of China drug use has seen dramatic changes in recent years. The aim of this review is to give a perspective of the current situation of drug abuse, the problems associated with it, and the strategy to control it in China.Recent findings: The number of registered drug users and newly discovered drug users had declined for 5 consecutive years, Moreover, the scaling down of drug trafficking and drug-related crimes had been seen for recent years. There are four main drug treatment modalities in China. The drug abuse and its related problems in China face new challenges, including the impact of the coronavirus disease 2019 pandemic, the role of compulsory treatment is overemphasized, the voluntary treatment facilities and community treatment cannot meet the requirements of Chinese society, and the coordination among government departments in drug control and treatment in China need to improved.Summary: With years of the joint efforts, the overall drug situation kept improving. The drug abuse and its related problems in China still is a problem, and require effective and immediate interventions.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"36 4","pages":"277-282"},"PeriodicalIF":6.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9737321","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: 1

Effects of cannabis legalization on the use of cannabis and other substances. 大麻合法化对使用大麻和其他物质的影响。

IF 6.9 2区医学

Current Opinion in Psychiatry Pub Date : 2023-07-01 DOI: 10.1097/YCO.0000000000000868

Sawitri Assanangkornchai, Rasmon Kalayasiri, Woraphat Ratta-Apha, Athip Tanaree

{"title":"Effects of cannabis legalization on the use of cannabis and other substances.","authors":"Sawitri Assanangkornchai, Rasmon Kalayasiri, Woraphat Ratta-Apha, Athip Tanaree","doi":"10.1097/YCO.0000000000000868","DOIUrl":"https://doi.org/10.1097/YCO.0000000000000868","url":null,"abstract":"Purpose of review: As more jurisdictions legalize cannabis for non-medical use, the evidence on how legalization policies affect cannabis use and the use of other substances remains inconclusive and contradictory. This review aims to summarize recent research findings on the impact of recreational cannabis legalization (RCL) on cannabis and other substance use among different population groups, such as youth and adults.Recent findings: Recent literature reports mixed findings regarding changes in the prevalence of cannabis use after the adoption of RCL. Most studies found no significant association between RCL and changes in cannabis use among youth in European countries, Uruguay, the US, and Canada. However, some studies have reported increases in cannabis use among youth and adults in the US and Canada, although these increases seem to predate RCL. Additionally, there has been a marked increase in unintentional pediatric ingestion of cannabis edibles postlegalization, and an association between RCL and increased alcohol, vaping, and e-cigarette use among adolescents and young adults.Summary: Overall, the effects of cannabis legalization on cannabis use appear to be mixed. Further monitoring and evaluation research is needed to provide longer-term evidence and a more comprehensive understanding of the effects of RCL.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"36 4","pages":"283-289"},"PeriodicalIF":6.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9687180","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: 4

Polysubstance use and lived experience: new insights into what is needed. 多物质使用和生活经验:对需要什么的新见解。

IF 6.9 2区医学

Current Opinion in Psychiatry Pub Date : 2023-07-01 DOI: 10.1097/YCO.0000000000000876

Chelsea L Shover, Jordan G Spoliansky, Morgan Godvin

{"title":"Polysubstance use and lived experience: new insights into what is needed.","authors":"Chelsea L Shover, Jordan G Spoliansky, Morgan Godvin","doi":"10.1097/YCO.0000000000000876","DOIUrl":"https://doi.org/10.1097/YCO.0000000000000876","url":null,"abstract":"Purpose of review: During the current overdose crisis in the United States and Canada, both polysubstance use and interventions involving people with lived experience of substance use disorder have grown. This review investigates the intersection of these topics to recommend best practices.Recent findings: We identified four themes from the recent literature. These are ambivalence about the term lived experience and the practice of using private disclosure to gain rapport or credibility; efficacy of peer participation; promoting equitable participation by fairly compensating staff hired for their lived experience; challenges unique to the current polysubstance-dominated era of the overdose crisis. People with lived experience make important contributions to research and treatment, especially given the additional challenges that polysubstance use creates above and beyond single substance use disorder. The same lived experience that can make someone an excellent peer support worker also often comes with both trauma related to working with people struggling with substance use and lack of opportunities for career advancement.Summary: Policy priorities for clinicians, researchers and organizations should include steps to foster equitable participation, such as recognizing expertise by experience with fair compensation; offering career advancement opportunities; and promoting self-determination in how people describe themselves.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"36 4","pages":"316-320"},"PeriodicalIF":6.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10040115","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