Current Opinion in Psychiatry最新文献

{"title":"What is needed for the roll-out of psychedelic treatments?","authors":"Stephen N Xenakis, Scott M Shannon","doi":"10.1097/YCO.0000000000000946","DOIUrl":"10.1097/YCO.0000000000000946","url":null,"abstract":"<p><strong>Purpose of review: </strong>The pace of psychedelic treatments continues to increase. Regulation and coherent clinical guidance have not been established. A philosophical divide limits effective resolution of a practice delivery quandary: is this primarily a pharmacological or psychotherapeutic intervention?</p><p><strong>Recent findings: </strong>Lykos (formerly MAPS) has submitted its new drug application (NDA) request to the FDA for 3-4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for PTSD and is expecting a response by the summer of 2024. Australia endorsed psilocybin and MDMA for regulated use in 2023. Multiple phase II and III clinical trials are also being conducted in the United States and Europe to study the use of psilocybin. Currently, Colorado and Oregon have legalized psilocybin in different manners. In Colorado, plants containing psilocybin, ibogaine, dimethyltryptamine (DMT) and mescaline (other than peyote) are now legal to possess, share and cultivate. Guidelines for regulated treatment with psilocybin containing mushrooms are in process with service delivery to begin early in 2025. In Oregon, clients must complete a preparation session with a licensed facilitator before consuming psilocybin products at a licensed service center. A prescription is not required. It is expected that other states will follow suit with a ballot measure likely in Massachusetts this year. Additionally, in the United States, the DEA, state boards, pharmaceutical distributors, and professional liability carriers all share mounting concerns about the in-home use of compounded ketamine used as a psychedelic therapeutic via remote prescribing.</p><p><strong>Summary: </strong>Psychedelic treatments are rapidly entering the mainstream of medical care delivery in the United States. Clinical guidelines are urgently needed to ensure well tolerated practice and coherent regulation. The delivery of this guidance is limited by a core philosophical disagreement. Resolution of this conflict will be needed to deliver coherent clinical guidelines. Current research and clinical experience provide a solid foundation for practical clinical guidance and the introduction of psychedelics into healthcare.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"277-281"},"PeriodicalIF":6.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897609","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":"Evidence-based psychosocial interventions in schizophrenia: a critical review.","authors":"Stefano Barlati, Gabriele Nibbio, Antonio Vita","doi":"10.1097/YCO.0000000000000925","DOIUrl":"10.1097/YCO.0000000000000925","url":null,"abstract":"<p><strong>Purpose of review: </strong>Schizophrenia Spectrum Disorders (SSD) are severe conditions that frequently produce significant impairment in cognitive performance, social skills and psychosocial functioning. As pharmacological treatment alone often provides only limited improvements on these outcomes, several psychosocial interventions are employed in psychiatric rehabilitation practice to improve of real-world outcomes of people living with SSD: the present review aims to provide a critical overview of these treatments, focusing on those that show consistent evidence of effectiveness.</p><p><strong>Recent findings: </strong>Several recent systematic reviews and meta-analyses have investigated in detail the acceptability, the effectiveness on several specific outcomes and moderators of response of different psychosocial interventions, and several individual studies have provided novel insight on their implementation and combination in rehabilitation practice.</p><p><strong>Summary: </strong>Cognitive remediation, metacognitive training, social skills training, psychoeducation, family interventions, cognitive behavioral therapy, physical exercise and lifestyle interventions, supported employment and some other interventions can be fully considered as evidence-based treatments in SSD. Psychosocial interventions could be of particular usefulness in the context of early intervention services. Future research should focus on developing newer interventions, on better understanding the barriers and the facilitators of their implementation in clinical practice, and exploring the opportunities provided by novel technologies.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"131-139"},"PeriodicalIF":6.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971332","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":"Bane or boon regarding urbanicity and psychotic spectrum disorders: a scoping review of current evidence.","authors":"Qian Hui Chew, Kang Sim","doi":"10.1097/YCO.0000000000000928","DOIUrl":"10.1097/YCO.0000000000000928","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to provide an update on the association between urbanization and psychotic spectrum disorders, focusing on specific aspects of the urban environment that could be a bane or boon for the risk of psychosis.</p><p><strong>Recent findings: </strong>Majority of the included studies support previous evidence suggesting that urbanization is linked to a higher risk of psychotic experiences and psychotic spectrum disorders. A small minority, however, have also found specific factors in the urban environment that could give rise to positive outcomes, such as better social functioning and lower mortality rates in psychotic spectrum disorders, or mitigate the risks associated with urbanization. The perception of the urban environment was also an important factor that increased or mitigated stress levels in patients with psychosis, which in turn affected their susceptibility to psychotic symptoms.</p><p><strong>Summary: </strong>Specific aspects of the urban environment such as the availability and density of greenspaces are crucial for mitigating the effect of urbanization on risk of psychotic spectrum disorders, and should be incorporated into urban planning. At the same time, there is a need to further explore how modifiable risk factors of the urban environment such as air and noise pollution can be minimized to allow for more liveable cities in the context of psychotic spectrum conditions.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"212-224"},"PeriodicalIF":6.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982618","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":"Current perspectives on perinatal mental health and neurobehavioral development: focus on regulation, coregulation and self-regulation.","authors":"Bea R H Van den Bergh, Marta C Antonelli, Dan J Stein","doi":"10.1097/YCO.0000000000000932","DOIUrl":"10.1097/YCO.0000000000000932","url":null,"abstract":"<p><strong>Purpose of review: </strong>Perinatal mental health research provides an important perspective on neurobehavioral development. Here, we aim to review the association of maternal perinatal health with offspring neurodevelopment, providing an update on (self-)regulation problems, hypothesized mechanistic pathways, progress and challenges, and implications for mental health.</p><p><strong>Recent findings: </strong>(1) Meta-analyses confirm that maternal perinatal mental distress is associated with (self-)regulation problems which constitute cognitive, behavioral, and affective social-emotional problems, while exposure to positive parental mental health has a positive impact. However, effect sizes are small. (2) Hypothesized mechanistic pathways underlying this association are complex. Interactive and compensatory mechanisms across developmental time are neglected topics. (3) Progress has been made in multiexposure studies. However, challenges remain and these are shared by clinical, translational and public health sciences. (4) From a mental healthcare perspective, a multidisciplinary and system level approach employing developmentally-sensitive measures and timely treatment of (self-)regulation and coregulation problems in a dyadic caregiver-child and family level approach seems needed. The existing evidence-base is sparse.</p><p><strong>Summary: </strong>During the perinatal period, addressing vulnerable contexts and building resilient systems may promote neurobehavioral development. A pluralistic approach to research, taking a multidisciplinary approach to theoretical models and empirical investigation needs to be fostered.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"237-250"},"PeriodicalIF":6.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A lifetime of mental health treatments for people with schizophrenia: update and narrative review.","authors":"Lynn E DeLisi","doi":"10.1097/YCO.0000000000000926","DOIUrl":"10.1097/YCO.0000000000000926","url":null,"abstract":"<p><strong>Purpose of review: </strong>To provide a summary of the most up-to-date thoughts about treatment for schizophrenia at different stages of illness.</p><p><strong>Recent findings: </strong>The use of Coordinated Specialty Care clinics has arisen as the standard for early on in the treatment of psychosis, providing the notion that recovery is possible. New medications that do not depend on postsynaptic dopamine receptor blockade are soon becoming available.</p><p><strong>Summary: </strong>A focus should be made by clinicians to personalize treatment plans for each patient who has the possibility of being diagnosed with a primary psychosis and the plan should be to predict outcomes based on biological markers that include genetic vulnerability, early psychosocial combined with pharmacological treatments as needed and then a plan to determine or maintain treatments going forward into the future. It is important to individualize treatment by stage of illness, as well as characteristics of the individual patient. Research is ongoing to advance knowledge for interventions at each stage from the premorbid period through to chronicity.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"37 3","pages":"140-146"},"PeriodicalIF":6.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183990","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":"Access to mental health services in urban areas: examine the availability, affordability, and accessibility of mental health services in urban settings, particularly for individuals with intersecting marginalized identities.","authors":"Xiangfei Meng","doi":"10.1097/YCO.0000000000000924","DOIUrl":"10.1097/YCO.0000000000000924","url":null,"abstract":"<p><strong>Purpose of review: </strong>To offer an integrative overview of mental health services in urban areas across different social groups and underscore the challenges and potential solutions to improve access to mental health services in urban areas.</p><p><strong>Recent findings: </strong>The process of urbanization places a lot of toll on the current mental health services system. Challenges to both mental health and mental health services include the elevated risk of some mental and behavioral health issues, the increased demand for mental health services, and the intensification of mental health inequalities. The phenomenon of mental health inequalities is exacerbated in urban areas, with certain disadvantaged population groups more likely to report higher mental health issues and difficulties in accessing mental health services. Targeted and dedicated strategies are warranted to develop and allocate resources to address the mental health services needs among those simultaneously with multiple disadvantaged social and economic characteristics.</p><p><strong>Summary: </strong>Urbanization places a substantive burden on both mental health and mental health services and creates challenges to mental health services access. Integrative and multisectoral initiatives could shed light on effectively addressing the issues of access to mental health services in urban cities.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"185-190"},"PeriodicalIF":6.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982617","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":"Urbanization and psychosis: an update of recent evidence.","authors":"Sandeep Grover, Natarajan Varadharajan, Sandesh Venu","doi":"10.1097/YCO.0000000000000931","DOIUrl":"10.1097/YCO.0000000000000931","url":null,"abstract":"<p><strong>Purpose of review: </strong>Urbanization, a complex global phenomenon, has a significant bearing on schizophrenia/psychosis burden through various socioeconomic and environmental factors. This review focuses on recent evidence (2019-2023) linking urbanization, schizophrenia, and the role of green space.</p><p><strong>Recent findings: </strong>This review analyzed 43 articles that examined the correlation between urban birth or upbringing, urban living (urbanicity), and various schizophrenia/psychosis-related outcomes such as incidence, psychotic experiences, etc. The studies showed differing results across geographical locations. Socioeconomic factors like area deprivation, migrant status (ethnic density) and social fragmentation were independently associated with the risk of schizophrenia/psychosis irrespective of urbanicity. More recently, environmental factors such as green space reduction and air pollution have been explored in urban living conditions and were positively associated with an increased risk of schizophrenia/psychosis.</p><p><strong>Summary: </strong>There is a need for further investigation in low and middle-income countries. The impact of urbanization-related factors and green space on the risk of schizophrenia/psychosis calls for appropriate governmental commitments toward structured and healthy urban planning.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"191-201"},"PeriodicalIF":6.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140027581","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":"Benefits of nature-based intervention in combating the impact of urbanization on psychopathology in industrialized societies.","authors":"Yuanyuan Wang, Franklin Timms, Jiaqi Li, Hui Yu","doi":"10.1097/YCO.0000000000000937","DOIUrl":"10.1097/YCO.0000000000000937","url":null,"abstract":"<p><strong>Purpose of review: </strong>The assumption has been made that urbanization adversely affects mental health, primarily attributed to the lack of access to nature. Our objective is to examine whether nature-based interventions can reduce psychopathology within an urban setting.</p><p><strong>Recent findings: </strong>Nature-based interventions are generally categorized as either physical or virtual. Physical interventions engage participants in various activities like passive exposure, outdoor swimming, or physical activities in natural environments. On the other hand, virtual interventions expose participants to visual, auditory, or even olfactory stimuli to simulate natural environments. While most interventions achieved some degree of success in enhancing overall well being, not all demonstrated a significant reduction in depression and anxiety.</p><p><strong>Summary: </strong>The review identified a shortage of well designed and well implemented outdoor or virtual nature-based interventions. Longitudinal designs in physical nature-based interventions provided the strongest evidence for reducing anxiety and depression. Multisensory virtual nature-based interventions also show significant potential for alleviating anxiety and depression in urban dwellers. Conversely, brief nature-based interventions yielded inconsistent results in improving mental health. Urgent investment in high-quality interventions and research in this domain is imperative to inform policy and enhance overall mental health in urban settings.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"202-211"},"PeriodicalIF":6.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982619","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 impact of urbanization on youth mental health in Hong Kong.","authors":"Teris Cheung, Kwan Hin Fong, Yu-Tao Xiang","doi":"10.1097/YCO.0000000000000930","DOIUrl":"10.1097/YCO.0000000000000930","url":null,"abstract":"<p><strong>Purpose of review: </strong>Urbanization is a multifaceted process that can have both positive and negative effects on mental health, especially in adolescents. This paper attempts to summarize the impact of urbanization on youth mental health in Hong Kong.</p><p><strong>Recent findings: </strong>Several studies have shown that urbanization is associated with an increased risk of youth mental health problems in Hong Kong. Psychosocial factors like perceived stress, social isolation, and exposure to environmental pollutants may contribute to a negative association between urbanization and mental health issues. Academic pressure, poor transparency and accessibility to mental health services in Hong Kong further exacerbate youth's mental health wellbeing. Environmental factors like housing conditions, green spaces, and visible urban greenery have been found to influence mental health outcomes. Existing empirical studies have found a positive association between urbanization and mental health problems, while others have found no association or even a negative association.</p><p><strong>Summary: </strong>Further research is warranted to investigate the complex relationship between urbanization and youth mental health in Hong Kong. Exploration of effective interventions is necessary to mitigate the negative impacts of urbanization on youth mental health. Understanding this relationship can inform health policy-making and formulate interventions to promote youth's mental health well being in the short-and long run.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"37 3","pages":"172-176"},"PeriodicalIF":6.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183991","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":"Shifting the paradigm of social withdrawal: a new era of coexisting pathological and non-pathological hikikomori.","authors":"Takahiro A Kato, Norman Sartorius, Naotaka Shinfuku","doi":"10.1097/YCO.0000000000000929","DOIUrl":"10.1097/YCO.0000000000000929","url":null,"abstract":"<p><strong>Purpose of review: </strong>Social withdrawal syndrome, known as \"hikikomori,\" has been highlighted since the late 1990 s in Japan. Hikikomori is more common in urban areas, and often comorbid with mental disorders, and now spreading throughout the world. In the post-COVID-19 era, not outing is no longer considered pathological in itself as the \"new normal,\" and a novel concept of hikikomori is needed. This review summarizes the concept of hikikomori, and presents the latest methods for identification of hikikomori.</p><p><strong>Recent findings: </strong>The novel definition can distinguish between pathological and non-pathological hikikomori using the scale of \"Hikikomori Diagnostic Evaluation (HiDE),\" which has been developed in the hikikomori research lab at Kyushu University. An online survey among non-working adults has revealed that persons who have become pathological hikikomori for less than three months showed a particularly strong tendency toward gaming disorder and depression.</p><p><strong>Summary: </strong>Now, physical isolation itself is not pathological, but when dysfunction and distress are present, rapid mental health support should be provided. In the novel urban society, the establishment of a checkup system to assess whether persons who stay home are happy or suffering is important for prevention against mental disorders triggered by social isolation.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"177-184"},"PeriodicalIF":6.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982623","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}