Current Opinion in Psychiatry最新文献_第5页

Challenging behaviors in adolescents with intellectual and developmental disabilities: current pharmacological perspectives. 智力和发育障碍青少年的挑战性行为：当前的药理学观点。

IF 5.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-03-01 Epub Date: 2026-01-05 DOI: 10.1097/YCO.0000000000001074

Donald E Greydanus, Muhammad Waqar Azeem, Maha AlMuraikhi, Ahsan Nazeer

{"title":"Challenging behaviors in adolescents with intellectual and developmental disabilities: current pharmacological perspectives.","authors":"Donald E Greydanus, Muhammad Waqar Azeem, Maha AlMuraikhi, Ahsan Nazeer","doi":"10.1097/YCO.0000000000001074","DOIUrl":"10.1097/YCO.0000000000001074","url":null,"abstract":"Purpose of review: Adolescents with neurodevelopmental disorders (NDDs) often display challenging behaviors such as hypersexuality, severe irritability, and aggression. This review emphasizes current management strategies, focusing on the evaluation of problematic behaviors and considering both pharmacological and nonpharmacological options, as well as their level of evidence in the current literature.Recent findings: Hypersexuality in adolescents with NDDs may result from conditions such as precocious puberty, polycystic ovary syndrome, neurologic disorders, trauma, or medication effects. Management should be etiology-based; limited evidence suggests selective serotonin reuptake inhibitors (SSRIs) and opioid antagonists may help in compulsive sexual behavior, though data in youth remain scarce. Irritability is most consistently improved with atypical antipsychotics, particularly risperidone and aripiprazole. Adjunctive options include NMDA modulators, stimulants, alpha-2 agonists, and anti-inflammatory or nutraceutical agents. Aggression management relies on antipsychotics, with clozapine considered for refractory cases; benzodiazepines, guanfacine, sertraline, and investigational agents such as vafidemstat show early promise. Psychotherapeutic and family-based interventions remain essential.Summary: Effective care requires holistic evaluation, elimination of iatrogenic contributors, and individualized treatment. Combining behavioral therapies with judicious medication use can improve functioning and safety. Emerging pharmacologic and biologic strategies warrant further investigation in this vulnerable population.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"109-117"},"PeriodicalIF":5.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mouse models of vascular cognitive impairment and dementia induced by carotid artery manipulations: current status. 颈动脉手法诱导的血管性认知障碍和痴呆小鼠模型：现状。

IF 5.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-03-01 Epub Date: 2026-01-08 DOI: 10.1097/YCO.0000000000001061

Juyeon Mun, Yorito Hattori, Masafumi Ihara

{"title":"Mouse models of vascular cognitive impairment and dementia induced by carotid artery manipulations: current status.","authors":"Juyeon Mun, Yorito Hattori, Masafumi Ihara","doi":"10.1097/YCO.0000000000001061","DOIUrl":"10.1097/YCO.0000000000001061","url":null,"abstract":"Purpose of review: This review highlights three of the most promising mouse models of vascular cognitive impairment and dementia (VCID) that recapitulate chronic cerebral hypoperfusion. It also discusses therapeutic candidates evaluated using these models.Recent findings: The three mouse models of chronic cerebral hypoperfusion induced by carotid artery manipulations are bilateral common carotid artery stenosis (BCAS), asymmetric common carotid artery surgery (ACAS), and gradual common carotid artery stenosis (GCAS). Altogether, these models reproduce white matter lesions and executive dysfunction. Notably, ACAS and GCAS exhibit gradual cerebral blood flow (CBF) reduction and motor impairments, addressing key limitations of BCAS, which induces abrupt CBF decrease and no motor deficits. Furthermore, ACAS uniquely demonstrates subcortical small infarcts, a hallmark feature of clinical VCID. These models have greatly contributed to elucidating VCID pathophysiology, including abnormal oligodendrocyte maturation, astrocytic dysfunction, and neuroinflammation. Several therapeutic strategies developed using these models - such as adrenomedullin and SIRT1 activator - are currently under investigation in clinical trials.Summary: The three models are robust and complementary tools for exploring the VCID mechanisms. They have been instrumental in advancing our understanding of VCID pathogenesis and in facilitating the development of novel therapeutic approaches.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"182-188"},"PeriodicalIF":5.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Instrumental assessment of psychotic disorders in intellectual developmental disorders and autism with cognitive or major communication issues. 智力发育障碍和自闭症伴认知或主要沟通问题的精神障碍的工具评估。

IF 5.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-03-01 Epub Date: 2026-01-05 DOI: 10.1097/YCO.0000000000001075

Luciana Forte, Annamaria Bianco, Marco O Bertelli

{"title":"Instrumental assessment of psychotic disorders in intellectual developmental disorders and autism with cognitive or major communication issues.","authors":"Luciana Forte, Annamaria Bianco, Marco O Bertelli","doi":"10.1097/YCO.0000000000001075","DOIUrl":"10.1097/YCO.0000000000001075","url":null,"abstract":"Purpose of review: The high comorbidity and complex clinical presentation of psychotic disorders in adults with intellectual developmental disorders (IDDs) and autism spectrum disorder with cognitive or major communication issues (ASD-CMCI) requires highly accurate assessment approaches. This targeted review examines the availability, validity, and clinical utility of existing instruments for this high-risk population, in whom diagnostic procedures are often hindered by communication deficits and diagnostic overshadowing.Recent findings: There is a substantial lack of PD-specific assessment tools for this population. Adapted neurotypical scales, including the PANSS and PSYRATS, demonstrate limited validity because they rely heavily on introspective self-report. The primary methodological challenge is distinguishing chronic neurodevelopmental features from acute psychotic change, a process that requires careful observation of objective deviations from the individual's baseline functioning and behaviour.Summary: This targeted review underscores the need for dedicated, informant-based instruments for PD in IDD/ASD-CMCI. Approaches grounded in behavioural equivalents and systematic evaluation of change from baseline appear essential for reducing diagnostic overshadowing and improving diagnostic accuracy, although further validation of these methods remains necessary.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"83-90"},"PeriodicalIF":5.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The spectrum of neurodevelopmental disorders: comorbidities as clues to pathogenesis. 神经发育障碍谱系：共病作为发病机制的线索。

IF 5.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-03-01 Epub Date: 2026-01-22 DOI: 10.1097/YCO.0000000000001068

Catherine M McHugh, James R John, Weng Tong Wu, Valsamma Eapen

{"title":"The spectrum of neurodevelopmental disorders: comorbidities as clues to pathogenesis.","authors":"Catherine M McHugh, James R John, Weng Tong Wu, Valsamma Eapen","doi":"10.1097/YCO.0000000000001068","DOIUrl":"10.1097/YCO.0000000000001068","url":null,"abstract":"Purpose of review: High comorbidity rates across neurodevelopmental disorders (NDDs) may suggest shared pathogenic mechanisms rather than independent disease processes. This review synthesizes recent neuroimaging evidence (2024-2025) examining how comorbidity patterns reveal circuit-level convergence across traditional diagnostic boundaries.Recent findings: Studies of brain connectivity demonstrate that four core transdiagnostic dimensions of cognitive rigidity, sensory processing, repetitive behaviours, and social-emotional regulation show both circuit convergence and disorder-specific patterns across autism spectrum disorder, attention deficit hyperactivity disorder, obsessive compulsive disorder, Tourette syndrome and anxiety disorders. Analyses of how brain networks change over time clarify inconsistencies in earlier static studies, revealing that temporal network inflexibility predicts symptom severity better than anatomical connectivity alone. Developmental studies suggest circuit dysfunction emerges early (as early as 18 months for sensory processing) and creates cascade effects throughout maturation. Interventions targeting specific brain circuits produce transdiagnostic improvements, validating circuit-based approaches over disorder-specific supports.Summary: Comorbidity patterns provide critical clues to shared pathogenesis, with circuit-level evidence supporting dimensional models over categorical diagnoses. The timing and of circuit dysfunction inform whether patterns reflect shared vulnerabilities, developmental cascades, or independent processes converging on similar phenotypes. These findings suggest that assessments and interventions targeting underlying brain mechanisms may be more effective than traditional categorical diagnosis-based interventions.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"91-102"},"PeriodicalIF":5.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neurodevelopmental disorders. 神经发育障碍。

IF 4.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1097/YCO.0000000000001073

Muhammad Waqar Azeem, Ahsan Nazeer

引用次数: 0

Age-only versus multivariable models for dementia prediction: a comparative analysis. 仅年龄与多变量痴呆预测模型：比较分析。

IF 5.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-03-01 Epub Date: 2025-11-27 DOI: 10.1097/YCO.0000000000001056

Jennifer Dunne, Zhongyang Guan, Eduwin Pakpahan, Blossom C M Stephan

{"title":"Age-only versus multivariable models for dementia prediction: a comparative analysis.","authors":"Jennifer Dunne, Zhongyang Guan, Eduwin Pakpahan, Blossom C M Stephan","doi":"10.1097/YCO.0000000000001056","DOIUrl":"10.1097/YCO.0000000000001056","url":null,"abstract":"Purpose of review: Accurate dementia risk prediction is critical for prevention, yet it remains unclear which predictors add meaningful value beyond chronological age. This review evaluates the extent to which multivariable dementia risk models identify modifiable risk factors that enhance prediction value.Recent findings: We systematically reviewed cohort studies reporting both age-only and multivariable dementia prediction models in the same population. Six age-only models across five cohorts were included. Age-only models achieved poor to good discrimination (C-statistics 0.66-0.84). Adding modifiable cardiovascular and lifestyle factors provided consistent, modest improvements of 0.02-0.05 in the UK Biobank, Atherosclerosis Risk in Communities (ARIC), and Rotterdam cohorts. Larger improvements of 0.07-0.12 were observed in models including cognitive testing or genetic factors [e.g., UK Biobank Dementia Risk Score (UKBDRS-APOE)] with the Hanley-McNeil z-test confirming the improvements were significant, indicating genuine improvement rather than random variation.Summary: While age is a significant risk factor for dementia, modifiable cardiovascular and lifestyle factors provide incremental predictive value beyond age and represent actionable targets for prevention. Despite modest statistical improvements, these factors offer the most clinically relevant targets for prevention strategies. Future efforts should prioritise interventions addressing these modifiable determinants to reduce dementia risk across populations.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"151-159"},"PeriodicalIF":5.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145629455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Climate change and dementia: the impacts of social inequalities. 气候变化与痴呆症：社会不平等的影响。

IF 5.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-03-01 Epub Date: 2025-11-21 DOI: 10.1097/YCO.0000000000001055

Xiaowen Zhou, Ding Ding

{"title":"Climate change and dementia: the impacts of social inequalities.","authors":"Xiaowen Zhou, Ding Ding","doi":"10.1097/YCO.0000000000001055","DOIUrl":"10.1097/YCO.0000000000001055","url":null,"abstract":"Purpose of review: Climate change has emerged as a critical global health challenge, which poses significant risks to brain health and well being among older adults. This review summarized the evidence from the past 2 years on how climate change shapes cognitive health and further explored how social inequities amplify the climate-related exposures and the burden of dementia and its consequence.Recent findings: Emerging evidence have linked climate-related exposures to the dementia continuum, from accelerating cognitive decline to increase acute hospitalization and mortality, through direct biological processes and indirect behavioral or social influences. These impacts were unequally distributed, with the greatest in low-income and middle-income countries and other socially disadvantaged groups. The socio-ecological framework provided a structured lens for understanding these dynamics, emphasizing public policy as a key lever for equitable adaptation and mitigation, such as climate-resilient infrastructure and specialized disaster protocols.Summary: This review underscored the need to integrate climate considerations across the spectrum of cognitive health and to recognize the amplifying role of social inequities. Further research is required to close evidence gaps in resource-poor settings, implement advanced exposure measurements, and integrate social determinants and biomarkers for mechanisms exploration. Public policy should mitigate these inequities through targeted, equity-focused interventions and intersectoral collaboration.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"39 2","pages":"129-135"},"PeriodicalIF":5.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Etiology of autism spectrum disorders: recent advances and emerging directions. 自闭症谱系障碍的病因学：最新进展和新兴方向。

IF 5.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-03-01 Epub Date: 2026-01-16 DOI: 10.1097/YCO.0000000000001063

Kerim M Munir

{"title":"Etiology of autism spectrum disorders: recent advances and emerging directions.","authors":"Kerim M Munir","doi":"10.1097/YCO.0000000000001063","DOIUrl":"10.1097/YCO.0000000000001063","url":null,"abstract":"Purpose of review: This narrative review synthesizes advances from the past 18 months on the etiology of autism spectrum disorder (ASD), integrating findings from genetics, neurobiology, environmental epidemiology, and developmental psychiatry. Given the profound clinical heterogeneity of ASD, improved etiologic clarity is essential for risk stratification, early identification, and targeted intervention.Recent findings: Extensive genomic and multiancestry studies are now further clarifying how both common polygenic and rare high-impact variants contribute to ASD. These studies reveal different patterns of genetic liability that underlie distinct ASD subgroups. In parallel, functional and multiomic research is highlighting shared pathways involving synaptic signaling, gene regulation, immune processes, and the balance between excitatory and inhibitory signals. Environmental research, especially on maternal immune activation and maternal metabolic factors, uses causal inference methods to clarify modest but plausible causal effects, tempering earlier claims. Longitudinal imaging and infant cohort studies continue to show that atypical connectivity and social-brain differences occur before behavioral diagnosis. Sex differences and global diversity underscore the need for etiology models to incorporate sex-specific genetic architecture and address significant gaps in ancestral representation.Summary: ASD arises from a dynamic interplay of genetic liability, early neurodevelopmental processes, and environmental exposures. Etiologic progress now depends on integrating multilevel and multiomic data - including genomic, transcriptomic, epigenetic, imaging, and epidemiologic information - toward stratified developmental models and better-tailored interventions.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"75-82"},"PeriodicalIF":5.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Conceptual frameworks and future directions for functional cognitive disorders in adults: a narrative review and integrative perspective. 成人功能性认知障碍的概念框架和未来方向：叙述回顾和综合观点。

IF 5.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-03-01 Epub Date: 2026-01-08 DOI: 10.1097/YCO.0000000000001062

Adith Mohan, Catherine J Hayes, Arun V Krishnan

{"title":"Conceptual frameworks and future directions for functional cognitive disorders in adults: a narrative review and integrative perspective.","authors":"Adith Mohan, Catherine J Hayes, Arun V Krishnan","doi":"10.1097/YCO.0000000000001062","DOIUrl":"10.1097/YCO.0000000000001062","url":null,"abstract":"Purpose of this review: This narrative review provides an overview of functional cognitive disorder (FCD) as a cognitive subtype within the functional neurological disorder (FND) spectrum. It addresses the conceptual challenges, diagnostic criteria, and epidemiology of FCD, emphasizing the need for standardization of internal inconsistency and clearer diagnostic boundaries to improve clinical assessment and research.Recent findings: FCD is characterized by persistent cognitive complaints disproportionate to objective performance, underpinned by metacognitive, attentional, and cognitive-behavioural dysfunction. Emerging evidence supports a predictive processing framework in which maladaptive top-down priors and attentional dysregulation perpetuate subjective cognitive deficits despite preserved or inconsistent objective cognitive performance. Diagnostic criteria and FCD checklists show promise, although challenges remain in standardizing neuropsychological assessments and integrating patient-reported experiences. Epidemiological data highlight the stability of FCD and its distinctiveness from neurodegenerative conditions, with a nonprogressive trajectory in most cases.Summary statement: Defining and refining FCD through standardized criteria and mechanistic models is crucial for enhancing diagnostic accuracy, patient care, and research validity. Advancing our understanding of the pathophysiology of FCD within the FND framework will facilitate targeted interventions and improve trial cohort purity in neurodegenerative disease research. Future studies should focus on objective biomarkers and therapeutic strategies that address attentional and metacognitive dysfunction in FCD.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"175-181"},"PeriodicalIF":5.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

133 Real-time cognitive load assessment and adaptive optimization of human-machine interface in electric vehicle cockpit based on psychological health and physiological feedback: Erratum. 133基于心理健康和生理反馈的电动汽车驾驶舱实时认知负荷评估与人机界面自适应优化：校误。

IF 4.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1097/YCO.0000000000001077

引用次数: 0