{"title":"Monogenic causes of cerebral small vessel disease- models for vascular cognitive impairment and dementia?","authors":"Danit G Saks, Perminder S Sachdev","doi":"10.1097/YCO.0000000000000978","DOIUrl":"10.1097/YCO.0000000000000978","url":null,"abstract":"<p><strong>Purpose of review: </strong>Recent advancements in molecular biomarkers and therapeutic options for Alzheimer's disease have brought into focus the need for greater progress in the second most common cause of dementia, vascular cognitive impairment and dementia (VCID). We examine how the study of monogenic causes of VCID has contributed to the understanding of its pathophysiology and potential biomarker and treatment research.</p><p><strong>Recent findings: </strong>It is widely accepted that conditions which disrupt the cerebral small vessels contribute to vascular pathologies including stroke and cerebral microbleeds, ultimately leading to vascular cognitive impairment and dementia. Among these conditions are a range of monogenic small vessel diseases (SVDs) such as CADASIL, CARASIL, Fabry disease and COL4A-related disorders.</p><p><strong>Summary: </strong>This review indicates the importance of furthering research into monogenic SVDs in order to gain insight into the pathomechanisms of VCID more broadly. Monogenic conditions are easier to model than sporadic VCID and can serve as a guide for identifying biomarkers for diagnosis, monitoring and intervention outcomes.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"112-118"},"PeriodicalIF":7.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001706","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":"Urban air pollution and child neurodevelopmental conditions: a systematic bibliometric review.","authors":"Rosalyn Kefas, Raymond Roy, Amedeo D'Angiulli","doi":"10.1097/YCO.0000000000000984","DOIUrl":"10.1097/YCO.0000000000000984","url":null,"abstract":"<p><strong>Purpose of review: </strong>Using advanced bibliometric analysis, we systematically mapped the most current literature on urban air pollution and neurodevelopmental conditions to identify key patterns and associations. Here, we review the findings from the broader literature by discussing a distilled, validated subset of 44 representative studies.</p><p><strong>Recent findings: </strong>Literature highlights a complex relationship between environmental toxins, neurodevelopmental disorders in children, and neurobehavioral pathways involving oxidative stress, neuroinflammation, and protein aggregation. Chronic prenatal and postnatal exposure to airborne pollutants - such as particulate matter and heavy metals - may contribute to early formation of amyloid plaques through preadolescence. These processes may compromise synaptic plasticity and neural integrity, which can progressively induce cognitive, emotional, and behavioral dysregulation, sharing some pathological features traditionally associated with adult neurodegenerative diseases.</p><p><strong>Summary: </strong>The interactions between air pollution exposure levels, developmental timing, and factors such as genetic vulnerability associated with neurodevelopmental disorders are still undetermined. However, accelerated neurodegenerative processes leading to cognitive decline and suboptimal mental health in children and adolescents seem most likely linked with pollutants penetrating the blood-brain barrier, and inducing oxidative stress and neuroinflammation. Urgent precautionary action might reduce environmental exposures during critical early developmental periods, thereby safeguarding children's cognitive function and mental health.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"87-94"},"PeriodicalIF":7.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969993","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":"Autoimmune dementia.","authors":"Alessandro Dinoto, Eoin P Flanagan","doi":"10.1097/YCO.0000000000000980","DOIUrl":"https://doi.org/10.1097/YCO.0000000000000980","url":null,"abstract":"<p><strong>Purpose of review: </strong>The aim of this review is to summarize clinical, radiological and laboratory findings in autoimmune dementia, to help clinicians in promptly identify this elusive condition.</p><p><strong>Recent findings: </strong>The rapid advances in the field of autoimmune neurology have led to the discovery of novel antibodies and associated disorders, which are more frequent than previously hypothesized. The correct and prompt identification of cognitive decline of autoimmune origin is vital to ensure early treatment and better outcomes. The diagnosis of autoimmune dementia relies on specific clinical and radiological features and on the detection of specific autoantibodies. Autoantibody specificities predict response to treatment and the occurrence of cancer. In recent years, the differential diagnosis of autoimmune dementia has become more relevant, as the overinterpretation of antibody results, clinical and radiological findings may lead to an erroneous diagnosis of autoimmune dementia, with potential harm to patients due to inappropriate exposure to immunosuppressants.</p><p><strong>Summary: </strong>Autoimmune dementia is a potentially treatable condition and should not be missed in clinical practice given the potential for reversibility with immunotherapy. The diagnosis of autoimmune dementia relies on a comprehensive review of clinical, radiological and laboratory data, and exclusion of other causes of dementia.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"38 2","pages":"101-111"},"PeriodicalIF":7.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064395","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}
Lee Wachtel, James Luccarelli, John Michael Falligant, Joshua Ryan Smith
{"title":"Electroconvulsive therapy in autism spectrum disorders: an update to the literature.","authors":"Lee Wachtel, James Luccarelli, John Michael Falligant, Joshua Ryan Smith","doi":"10.1097/YCO.0000000000000985","DOIUrl":"10.1097/YCO.0000000000000985","url":null,"abstract":"<p><strong>Purpose of review: </strong>Over the last quarter century, the clinical evidence surrounding the use of electroconvulsive therapy (ECT) in individuals with autism spectrum disorder (ASD) has expanded. This review provides the most up-to-date findings on the usage of ECT in ASD and discusses these results within the historical context and direct patient care experience.</p><p><strong>Recent findings: </strong>ECT is typically implemented for psychotropic-refractory catatonic, affective, psychotic, and combined pathology for individuals across the lifespan. Although highly stigmatized, ECT is well tolerated, efficacious, and potentially lifesaving for select individuals. A case presentation of an individual with autism as well as a summary of legal restrictions hampering his ECT access is presented.</p><p><strong>Summary: </strong>ECT is increasingly used in individuals with ASD who present with a wide range of ECT-responsive psychopathology, as well as repetitive self-injury and late, autistic-like regression for which no cause is found. ECT is well tolerated and offers real hope for many ASD individuals with devastating, treatment-refractory conditions.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"79-86"},"PeriodicalIF":7.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969810","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}
Joyla A Furlano, Maira Okada de Oliveira, Maritza Pintado-Caipa, Susanne Röhr
{"title":"Dementia prevalence and dementia risk in Indigenous Peoples: recent findings, current developments, and future directions.","authors":"Joyla A Furlano, Maira Okada de Oliveira, Maritza Pintado-Caipa, Susanne Röhr","doi":"10.1097/YCO.0000000000000987","DOIUrl":"10.1097/YCO.0000000000000987","url":null,"abstract":"<p><strong>Purpose of review: </strong>To highlight recent findings on the prevalence and risk and protective factors for dementia in Indigenous Peoples, who are disproportionately affected by health inequities driven by social determinants of health and historical injustices. With increasing numbers of Indigenous individuals entering older age, there is a growing need for research to better understand dementia and opportunities for prevention in Indigenous Peoples.</p><p><strong>Recent findings: </strong>Recent studies highlight a wide range of dementia prevalence across Indigenous Peoples, with estimates varying significantly by methodology, socio-cultural context, and region with stark gaps in regional representation. Studies suggested that Indigenous Peoples show distinct profiles of dementia risk factors, including higher rates of cardiovascular disease, lower educational attainment, and socioeconomic disadvantage. However, traditional lifestyles, strong social ties, and culturally grounded practices are suggested to offer protective effects against cognitive decline.</p><p><strong>Summary: </strong>Despite growing research attention, significant limitations remain in understanding dementia in Indigenous Peoples. The available evidence points to the need for culturally sensitive approaches in research and dementia prevention, as well as greater consideration of the social and environmental factors shaping brain health. Future research should aim to incorporate Indigenous knowledge systems and address the social determinants of dementia risk in Indigenous Peoples.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"119-125"},"PeriodicalIF":7.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969840","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":"Risk of depression and dementia among individuals treated with sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists.","authors":"Osvaldo P Almeida","doi":"10.1097/YCO.0000000000001001","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001001","url":null,"abstract":"<p><strong>Purpose of the review: </strong>To review whether sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists decrease the risk of depression, suicidal ideation and cognitive impairment in later life.</p><p><strong>Recent findings: </strong>The results of studies using information derived from large registries and administrative health datasets suggest that GLP-1 receptor agonists (RAs) increase the risk of suicidality, although findings have been inconsistent. One nested-case control study reported that SGLT2i decreases the risk of depression among adults with diabetes, and findings from a small trial of the SGLT2i empagliflozin provided supportive evidence. Several observational studies reported that SGLT2i and GLP-1 RAs decrease dementia risk, with a target trial finding greater cognitive benefit associated with the use of GLP-1 RAs compared with other medicines commonly used to manage diabetes.</p><p><strong>Summary: </strong>Recent results from large observational studies suggest that SGLT2i and GLP-1 RA may decrease the risk of cognitive impairment in later life. The effects of these medicines on mood have not been as well explored, but there are concerns about the potential increased risk of suicidality among GLP-1 RA users. Prescription bias could explain some of these associations, so that robust trial evidence is now needed to confirm or dismiss the reported findings.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515009","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":"https://doi.org/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":""},"PeriodicalIF":7.5,"publicationDate":"2025-01-31","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}
Tomasz M Gondek, Tomasz Adamowski, Jolanta Janus, Ewelina Cichoń, Sylwia Paciorek, Mariusz Zięba, Alicja Bukowska, Agata Todzia-Kornaś, Andrzej Kiejna
{"title":"Mortality in people with mental disorders in Poland during the COVID-19 pandemic: a nationwide, register-based cohort study.","authors":"Tomasz M Gondek, Tomasz Adamowski, Jolanta Janus, Ewelina Cichoń, Sylwia Paciorek, Mariusz Zięba, Alicja Bukowska, Agata Todzia-Kornaś, Andrzej Kiejna","doi":"10.1097/YCO.0000000000000975","DOIUrl":"10.1097/YCO.0000000000000975","url":null,"abstract":"<p><strong>Purpose of review: </strong>People with mental disorders in Poland have increased standardized mortality ratios (SMRs). This is the first study to assess all-cause mortality in people with mental disorders in Poland during the COVID-19 pandemic.</p><p><strong>Recent findings: </strong>A nationwide, register-based cohort study utilizing data from the registry of healthcare services (2011-2020) and the all-cause death registry (2021) in Poland was conducted. Individuals who were consulted or hospitalized in public mental healthcare facilities and received at least one diagnosis of mental disorders (ICD-10) from 2011 to 2020 were identified. SMRs were compared between people with a history of mental disorder and the general population. SMRs for the pandemic period were also compared with prepandemic SMRs calculated for 2019.No significant differences in SMRs were observed overall between 2021 and 2019. A minor increase in SMR was observed in 2021 for people treated only in outpatient mental health clinics. In 2021, a significant decrease in SMRs was shown for individuals with diagnoses from groups F10-F19 and F20-F29, and a significant increase in SMRs was observed for those with diagnoses from group F40-F48.</p><p><strong>Summary: </strong>SMRs for people with any mental disorder in Poland in 2021 remained at comparable levels to those in 2019.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"3-34"},"PeriodicalIF":7.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616347","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":"Psychotherapies for the treatment of personality disorders: the state of the art.","authors":"Paul M G Emmelkamp, Katharina Meyerbröker","doi":"10.1097/YCO.0000000000000968","DOIUrl":"10.1097/YCO.0000000000000968","url":null,"abstract":"<p><strong>Purpose of review: </strong>To provide an update of systematic reviews, meta-analyses and recent clinical outcome studies for personality disorder (PD) in order to investigate the state of the art of the evidence of psychotherapy for personality disorders.</p><p><strong>Recent findings: </strong>Few outcome studies in patients with Cluster A and Cluster C PD have been conducted, which limits the conclusions which can be drawn. Most recently published research has been conducted with borderline PD. There is limited evidence that dialectical behavior therapy (DBT), mentalization based therapy and schema therapy are more effective than treatment as usual. There is no convincing evidence that long and intensive therapy is more effective than short and less intensive therapy. Drop-out is rather high for patients with borderline PD. Group therapy results in more drop-outs than individual therapy.</p><p><strong>Summary: </strong>There is a clear need of studies evaluating whether psychotherapies developed for PDs are more effective than CBT for patients with Cluster C PD. Given that studies with patients with Cluster B PD suggest that longer treatment of DBT and mentalization-based treatment is not more effective than shorter treatment this needs to be studied with other evidence-based therapies as well. Serious efforts are needed to evaluate therapies for patients with Cluster A PDs.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"66-71"},"PeriodicalIF":7.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}