Angelika Rauchlatner, Eva Fleischmann, Frederike T Fellendorf, Eva Z Reininghaus, Nina Dalkner
{"title":"Resilience in borderline personality disorder: a scoping review.","authors":"Angelika Rauchlatner, Eva Fleischmann, Frederike T Fellendorf, Eva Z Reininghaus, Nina Dalkner","doi":"10.1097/YCO.0000000000001028","DOIUrl":"10.1097/YCO.0000000000001028","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes current research on resilience in individuals with borderline personality disorder (BPD), its role in the development of BPD, and its impact on symptoms and recovery. Low resilience is considered a key factor contributing to emotional dysregulation and difficulty coping with adversity in BPD.</p><p><strong>Recent findings: </strong>A scoping literature search identified 177 records, of which 12 studies met the inclusion criteria. Patients with BPD consistently exhibit lower resilience scores compared to mentally healthy control groups, with higher BPD features linked to reduced resilience. When compared to other mental disorders, such as major depressive disorder, persistent depressive disorder, and posttraumatic stress disorder, individuals with BPD tend to show the lowest resilience levels. Additionally, resilience has been identified as a mediator between childhood maltreatment and BPD features. Treatment interventions like dialectical behavior therapy have been found to significantly improve resilience in patients with BPD.</p><p><strong>Summary: </strong>The findings underline the importance of resilience regarding the development, symptoms, and treatment of BPD, with lower resilience linked to higher BPD features and a history of childhood adversity. Results also suggest that enhancing resilience, particularly through interventions such as dialectical behavior therapy, could be a valuable therapeutic target.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"317-326"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689462","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":"Prevention of eating disorders: recent advances.","authors":"Eric Stice, Carlie Malott, Sareena Shah","doi":"10.1097/YCO.0000000000001034","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001034","url":null,"abstract":"<p><strong>Purpose of review: </strong>Only one in five people with eating disorders ever receive care, making effective prevention critical. This review synthesizes prevention trials from the past 2 years - highlighting new interventions and implementation strategies.</p><p><strong>Recent findings: </strong>A dissonance-based program for Brazilian men reduced muscle dysmorphia and body dissatisfaction, but not eating-disorder symptoms. The Body Advocacy Movement, designed to lessen fatphobia, produced medium declines in weight bias but only small symptom reductions, performing no better than the Body Project. Eat Breathe Thrive, a yoga-based program for female athletes, improved anxiety and interoceptive body trusting but did not reduce eating pathology. Two studies testing the Diabetes Body Project for young women with type 1 diabetes - an open pilot and a multinational randomized trial - produced large, durable reductions in general and diabetes specific symptoms but did not improve glycemic control. An implementation experiment across 63 colleges showed that pairing train-the-trainer workshops with technical assistance and ongoing quality assurance supervision maximized clinical benefit per dollar.</p><p><strong>Summary: </strong>Recent work demonstrates promising population-specific adaptations of dissonance-based programs and underscores that comprehensive implementation support enhances effectiveness. Future work should optimize high-school delivery, boost effect sizes, and verify long-term reductions in future eating disorder onset.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706675","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":"Mentalization-based therapy for personality disorder in adolescents.","authors":"Sebastian Simonsen, Sune Bo, Carla Sharp","doi":"10.1097/YCO.0000000000001033","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001033","url":null,"abstract":"<p><strong>Purpose of review: </strong>Mentalization-based therapy for adolescents (MBT-A) is a treatment approach that aligns well with dimensional models of personality disorders. This article reviews recent literature on mentalizing and MBT, proposing ways in which findings may inform future research and clinical innovations.</p><p><strong>Recent findings: </strong>There have been few new treatment studies and meta-analyses, and the evidence generally does not support the superiority of MBT-A over other well structured treatments for personality disorder in adolescents. Long-term follow-up studies suggest heterotypic continuity of personality disorder (PD) and indicate that discrepancies between adolescent and parent reporting may point to important mentalizing problems. A pilot study of MBT-A for conduct disorder has been published and shows promising results, despite a high dropout rate.</p><p><strong>Summary: </strong>MBT was originally developed for BPD in adults, but it is increasingly being recognized as a transdiagnostic common-factor model relevant to many conditions, such as those affecting adolescents who have experienced childhood adversity and juveniles with persistent aggressive behavior. For the field to progress further, there is a strong need for more research and clinical innovation, which should continue to move beyond categorical classification and approach disorder and alleviation of suffering from a developmental and social-ecological starting point.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706674","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":"Scaling up a success story: how do we achieve universal access to transcranial magnetic stimulation?","authors":"Jonathan Downar","doi":"10.1097/YCO.0000000000001029","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001029","url":null,"abstract":"<p><strong>Purpose of review: </strong>Over one billion people suffer from psychiatric and/or neurological disorders for which transcranial magnetic stimulation (TMS) has shown efficacy. Achieving widespread TMS access will require major improvements to cost and convenience. A key figure of merit for a given TMS protocol concerns not its remission rate or tolerability, but simply its treatment time per remission (TTPR).</p><p><strong>Recent findings: </strong>Outcomes for conventional bilateral TMS protocols imply a TTPR of more than 100 h - incompatible with widespread access. However, briefer accelerated and/or theta-burst protocols may improve TTPR to less than 20 h. Personalization strategies that improve remission rates sometime improve TTPR, depending on associated cost-penalties of time or complexity. A potentially groundbreaking new strategy to improve TTPR involves pharmacological augmentation of neuroplasticity, using agents such as D-cycloserine. Plasticity-augmentation may improve TTPR by improving remission rates, and by reducing the number of required sessions. Recent literature suggests that TTPR values of under 5 h per remission may be achievable via neuroplasticity augmentation.</p><p><strong>Summary: </strong>The most recent plasticity-augmented TMS protocols may approach or exceed cost-parity with pharmacotherapy, in terms of reducing the prevalence of depression. With the health economics of TMS improving steadily, a pathway to universal access may be within reach.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697764","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}
Milan Latas, Nevena Baščarević, Dušanka Vučinić Latas
{"title":"Co-occurrence of personality disorders and anxiety disorders.","authors":"Milan Latas, Nevena Baščarević, Dušanka Vučinić Latas","doi":"10.1097/YCO.0000000000001031","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001031","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review explores the high co-occurrence between personality disorders (PDs) and anxiety disorders (ADs), focusing on clinical implications, the frequency of their association, and the challenges these comorbidities pose for diagnosis and treatment. In addition, this review highlights recent research findings and the need for better therapeutic strategies.</p><p><strong>Recent findings: </strong>Contemporary studies have confirmed a strong association between PDs and ADs, particularly borderline personality disorder (BPD), which shows an 85% comorbidity with anxiety disorders. Gender differences are also observed, with women generally exhibiting higher rates of co-occurring psychiatric conditions. These comorbidities contribute to increased symptom severity, a higher suicide risk, and worse long-term outcomes. Recent clinical trials have shown positive results in managing these disorders. However, treatment approaches remain inconsistent, and further research is needed to refine these strategies.</p><p><strong>Summary: </strong>The co-occurrence of PDs and ADs complicates diagnosis and treatment, leading to worse outcomes. Although promising therapies exist, the current lack of a standardized treatment approach for this comorbid population highlights the need for further research. Future studies should explore more targeted treatment options, causal mechanisms linking PDs and ADs, and potential benefits of personalized interventions to improve clinical outcomes.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706672","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":"Gondal hormones and binge eating in females: developmental and etiologic insights from puberty to adulthood.","authors":"Kristen M Culbert, Cheryl L Sisk, Kelly L Klump","doi":"10.1097/YCO.0000000000001030","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001030","url":null,"abstract":"<p><strong>Purpose of review: </strong>Binge eating (BE) is a core symptom of multiple eating disorders and disproportionately affects females during/after puberty. Gonadal hormones (estrogen, progesterone, testosterone) are sex-differentiated and have been posited as key biological contributors to BE risk. This review synthesizes recent findings from animal and human studies regarding gonadal hormone influences on the etiology BE in females during puberty and adulthood.</p><p><strong>Recent findings: </strong>Estrogen may exert organizational effects (i.e., long-lasting) during puberty that shape responsivity to activational effects (i.e., transient) of gonadal hormones on BE in late adolescence/adulthood. In adulthood, estradiol appears to be protective against BE, while progesterone antagonizes this effect. Emerging data also implicate testosterone as an additional hormonal risk factor for BE in women, particularly under conditions of lower estradiol. However, not all females exposed to these high-risk gonadal hormone milieus develop BE; behavior genetic studies provide empirical support for gene-by-hormone interactions in individual susceptibility.</p><p><strong>Summary: </strong>Methodologically rigorous approaches (e.g., daily assessments, behavior genetics, hormone manipulation) have been critical in uncovering the complex etiologic influences of gonadal hormones on BE in females. Future research is needed to identify the specific neural circuits, genetic variants, and transcriptional pathways involved in these processes.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706673","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":"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}
Joe Schofield, Susanna Galea-Singer, Alexander Mario Baldacchino
{"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":"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}
Joseph Tay Wee Teck, Hui Shan Tan, Alexander Baldacchino
{"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}