Current Opinion in Psychiatry最新文献

{"title":"Transactive response DNA-binding protein 43 (TDP-43) proteinopathy: the complex biological and clinical findings in limbic-predominant age-related TDP-43 encephalopathy (LATE) neuropathological changes, limbic-predominant amnestic neurodegenerative syndrome, and other mixed age-related major neurocognitive disorders.","authors":"Marcia Radanovic, Carlos Eduardo Borges Passos Neto, Luiz Henrique Monteiro, Orestes Vicente Forlenza","doi":"10.1097/YCO.0000000000001025","DOIUrl":"10.1097/YCO.0000000000001025","url":null,"abstract":"<p><strong>Purpose of review: </strong>As the term limbic-predominant age-related transactive response DNA-binding protein 43 (TDP-43) encephalopathy (LATE) was coined in 2019, more than 200 articles addressing the subject were published. This review aims to provide an updated synthesis of knowledge regarding LATE-NC as a cause of age-related neurodegeneration and cognitive decline while addressing the challenges posed by overlapping neuropathologies in aging populations.</p><p><strong>Recent findings: </strong>LATE-NC is marked by TDP-43 deposition in limbic structures, such as the amygdala and hippocampus, and is often associated with cognitive decline resembling Alzheimer's disease, though with a slower progression in isolated cases. The frequent coexistence of LATE-NC with other neuropathologies, particularly Alzheimer's disease neuropathologic changes (ADNC) and Lewy body dementia (LBD), exacerbates dementia severity and complicates diagnosis and treatment. Recent efforts have established clinical criteria for in-vivo diagnosis, including neuroimaging markers like hippocampal atrophy and limbic hypometabolism. Genetic studies have identified key risk genes, including GRN, TMEM106B, SORL1, and APOE, while biomarker development in cerebrospinal fluid (CSF) and blood remains in its early stages.</p><p><strong>Summary: </strong>The review highlights the importance of multidisciplinary research and clinical approaches in addressing the complexities of neurodegenerative diseases involving TDP-43 proteinopathy, enhancing diagnostic accuracy, and developing effective treatments tailored to individual patient profiles.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"341-347"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706678","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":"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":"Antiamyloid treatment for dementia: concerns outweigh hopes.","authors":"Leon Flicker","doi":"10.1097/YCO.0000000000001021","DOIUrl":"10.1097/YCO.0000000000001021","url":null,"abstract":"<p><strong>Purpose of review: </strong>To review the association between Alzheimer pathology and dementia and the role of mAbs targeting amyloid in the treatment of people with dementia and mild cognitive impairment.</p><p><strong>Recent findings: </strong>There is an association, but Alzheimer pathology explains less than 40% of the attributable risk of dementia when other pathologies such as vascular, Lewy Body and TDP-43 are accounted. Recent trials of passive immunization with MABs, including Aducanumab Lecanemab and Donanemab, have demonstrated some benefits but the effects are small in size and may be due to bias. The side effect of amyloid-related imaging abnormalities (ARIA) is common and potentially serious. The costs of assessments for treatment and actual treatment costs are large compared with potentially modest benefits.</p><p><strong>Summary: </strong>It is still uncertain about the place of MABs in the treatment of Alzheimer's dementia. Further research is required regarding the long-term benefits and risks.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"355-360"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282763","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":"The role of gut microbiota in psychiatric disorders: current findings.","authors":"Ivona Šimunović Filipčić, Ivana Kolčić, Vladimir Grošić, Igor Filipčić","doi":"10.1097/YCO.0000000000001019","DOIUrl":"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":"327-333"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","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}

{"title":"Neurodiversity-affirming eating disorder care: insights into addressing co-occurring autism and eating disorders.","authors":"Emma Saure, Anna Keski-Rahkonen","doi":"10.1097/YCO.0000000000001042","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001042","url":null,"abstract":"<p><strong>Purpose of review: </strong>Eating disorders, particularly anorexia nervosa and avoidant-restrictive food intake disorder, commonly co-occur with autism. Many autistic people with eating disorders face delays and challenges in assessment and treatment because their particular needs are not understood. The aim of this narrative review is to introduce the concept of neurodivergence-affirming eating disorder care and to review recent scientific research on this topic.</p><p><strong>Recent findings: </strong>Some of the unique challenges that autistic individuals with eating disorders face include sensory processing differences, communication barriers, and unmet support needs. Neurodiversity-affirming care challenges structural ableism by emphasizing co-designing care with autistic experts by experience. Neurodiversity-affirming practitioners presume that their clients are autonomous and competent. When providing care, they respect different communication styles, tailor support to their client's individual needs and strengths, and seek to foster a positive autistic identity. This involves respecting autistic eating behaviours, providing timely assessment and support, individualized treatment goals, and carefully considering communication and sensory needs.</p><p><strong>Summary: </strong>Eating disorder service providers often have a hard time understanding their autistic clients. This can contribute to poor eating disorder treatment outcomes. Neurodiversity-affirming practitioners seek insight from the autistic community and participatory research to improve eating disorder services for their clients.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130172","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":"Emotion regulation and eating disorders - the current status of research and future directions.","authors":"Tânia F Rodrigues, Paulo P P Machado","doi":"10.1097/YCO.0000000000001043","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001043","url":null,"abstract":"<p><strong>Purpose of review: </strong>Difficulties in emotion regulation are increasingly recognized as a transdiagnostic mechanism across the spectrum of feeding and eating disorders. In this article, we aim to provide an update on the latest contributions and research trends in the field of emotion regulation and eating psychopathology, in order to reflect on future research directions and implications for treatment.</p><p><strong>Recent findings: </strong>Emerging research highlights the relevance of considering process-based and context-sensitive models of emotion regulation in the field of eating disorders. While neuroimaging, neurochemical, genetics, and gut-brain axis research shows promise for refining precision treatment, ecological momentary assessment and network analysis studies may be instrumental in the integration of interdisciplinary correlates of emotion regulation and eating psychopathology. Technologically-enhanced interventions including immersive virtual reality, mobile health, artificial intelligence, and serious games, hold potential for targeting difficulties in emotion regulation in individuals diagnosed with an eating disorder.</p><p><strong>Conclusions: </strong>Interdisciplinary research that integrates genetic, biological, psychological, and environmental correlates is crucial to enhance precision medicine targeting emotion regulation-focused prevention and treatment of disordered eating symptomatology. Sustainable funding and prospective research are required to attain the full potential of evidence-based and data-driven care for those in need.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069294","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":"From categories to traits: assessing personality dysfunction in ICD-11 and the DSM-5 alternative model for personality disorders.","authors":"Robert F Bornstein","doi":"10.1097/YCO.0000000000001040","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001040","url":null,"abstract":"<p><strong>Purpose of review: </strong>A paradigm shift in the assessment of personality pathology is underway, as diagnosticians move beyond traditional personality disorder categories and assess personality dysfunction using contemporary dimensional frameworks. This article describes the assessment of personality pathology in ICD-11 and the DSM-5 Alternative Model for Personality Disorders (AMPD).</p><p><strong>Recent findings: </strong>Recent findings in this area can be grouped into three domains: reliability, factor structure, and temporal stability of ICD-11 and AMPD constructs, convergence of personality pathology ratings with external indices of psychopathology and adjustment, and clinical utility (e.g., usefulness in rendering clinical decisions, prediction of treatment outcome).</p><p><strong>Summary: </strong>Research in this area confirms that level of personality functioning and the presence of one or more pathological personality traits predict an array of clinical outcomes, including symptom disorders (e.g., anxiety, depression), suicide risk, and psychotherapy effectiveness. Findings support the cross-cultural generalizability of these patterns, and the clinical utility of assessing personality functioning and traits in adolescents and adults.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069323","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":"Recent insights into the epidemiology of avoidant/restrictive food intake disorder (ARFID).","authors":"Liv Hog, Lisa Dinkler","doi":"10.1097/YCO.0000000000001041","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001041","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes recent research on the epidemiology of avoidant/restrictive food intake disorder (ARFID), including prevalence, diagnostic criteria, drivers of food avoidance, comorbidities, and illness course. It focuses on studies published in 2024 and the first half of 2025, with selected key studies from 2021 to 2023.</p><p><strong>Recent findings: </strong>ARFID is as prevalent as other eating disorders, with estimates of 11.41% in clinical and 2.84% in nonclinical populations. It affects individuals across all age groups, confirming it as an age-independent condition. Most individuals with ARFID present with sensory sensitivity and/or low appetite, and restricted intake often results in weight loss and psychosocial impairment. Comorbidities are common and span medical, psychiatric and neurodevelopmental conditions. Several studies highlight issues with the current diagnostic criteria - particularly the exclusion of ARFID alongside other eating disorders - prompting discussions about potential revisions. Research on illness course is scarce and robust longitudinal (cohort) studies are lacking.</p><p><strong>Summary: </strong>ARFID is marked by considerable heterogeneity affecting prevalence estimates and distribution of clinical presentation characteristics. To ensure accurate diagnosis and optimal outcomes, further research is needed - particularly to clarify diagnostic boundaries, overlap with other eating disorders, and long-term course and its predictors.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069352","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":"Conspiracy theories, personality dimensions and personality disorders.","authors":"Vladan Starcevic, Aleksandar Janca","doi":"10.1097/YCO.0000000000001037","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001037","url":null,"abstract":"<p><strong>Purpose of review: </strong>Conspiracy theories are not a recent phenomenon, but their dissemination has been facilitated by the internet and modern means of communication such as social media. This article reviews personality-based factors that increase the likelihood of endorsing conspiracy theories.</p><p><strong>Recent findings: </strong>Most studies used a correlational approach and examined personality traits and dimensions rather than personality disorders. The strongest and most consistent relationships were found between endorsement of conspiracy theories and suspiciousness and paranoid ideation, pseudoscientific tendencies and beliefs, schizotypal personality traits and narcissism. Similar personality characteristics were identified as correlates of the endorsement of the specific COVID-19 conspiracy theories, but antisocial personality traits have also been reported in this context. Epistemic mistrust has emerged as arguably the key factor that facilitates endorsement of conspiracy theories. Schizotypal, paranoid, antisocial, borderline, and narcissistic personality disorders were more likely to accompany endorsement of conspiracy theories than other types of personality disorders.</p><p><strong>Summary: </strong>Although correlation does not imply causation, recent work has identified personality-related characteristics that confer an increased risk of espousing conspiracy theories. Further research is necessary to ascertain how this vulnerability could be decreased, thus minimizing the harms of conspiracy theories that are inflicted on their adherents and broader society.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069347","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":"Dissociative and traumatic experiences in people with eating disorders.","authors":"Anna Keski-Rahkonen","doi":"10.1097/YCO.0000000000001032","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001032","url":null,"abstract":"<p><strong>Purpose of review: </strong>The review synthesizes existing literature on the prevalence, assessment, and treatment of dissociation, focusing on its manifestation in eating disorders. The review explores various conceptualizations of dissociation, its relationship with trauma, and its role in emotion regulation.</p><p><strong>Recent findings: </strong>Dissociation is a complex psychological process ranging from mild detachment to severe identity fragmentation. Everyday experiences like daydreaming or losing track of time are common examples of dissociation. More severe dissociative experiences are present in dissociative disorders, trauma-related stress disorders, and borderline personality disorder. In eating disorders, dissociation serves as a coping mechanism for managing intense emotions that can originate from traumatic and nontraumatic events. Recent studies highlight the role of dissociative experiences in emotion regulation, its association with functional seizures, and its link to night eating. Psychoeducation offers a promising way to address trauma-related dissociation and challenges with emotion regulation. Incorporating eye movement desensitization and reprocessing (EMDR) and other trauma-focused therapies into eating disorder treatment can also help reduce trauma-related dissociative symptoms in individuals with eating disorders.</p><p><strong>Summary: </strong>This review underscores the multifaceted nature of dissociation and its role in eating disorders. It highlights the need for further research into effective treatments for people with eating disorders.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798471","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}