Current Opinion in Psychiatry最新文献

{"title":"Recent advances in HIV-associated neurocognitive disorders: a focus on older adults and sub-Saharan Africa.","authors":"Stella-Maria Paddick, Elizabeta B Mukaetova-Ladinska","doi":"10.1097/YCO.0000000000000919","DOIUrl":"10.1097/YCO.0000000000000919","url":null,"abstract":"<p><strong>Purpose of review: </strong>We reviewed recent literature on prevalence and interventional approaches for cognitive impairment in the context of HIV infection alongside current controversies and challenges around its nomenclature, screening, and diagnosis.</p><p><strong>Recent findings: </strong>Prevalence estimates for HIV-associated neurocognitive disorder (HAND) indicate that HAND remains highly prevalent despite combination antiretroviral treatment (cART) widely used. The available data are heterogeneous, particularly in sub-Saharan Africa (SSA) where recent reviews indicate substantial heterogeneity, wide prevalence estimates and lack of data from the majority SSA countries, despite them currently experiencing the greatest burden worldwide of both HIV and HAND.Several alternative approaches to diagnosis and classification of cognitive impairment in HIV have been published, taking into account changing clinical phenotypes.</p><p><strong>Summary: </strong>Cognitive impairment remains a significant challenge in the care of people living with HIV despite advances in treatment. Ongoing controversies exist around nomenclature and classification, screening measures, and the phenotype and aetiology of observed impairments. Two current areas of research priority and focus include understanding current phenotypes of individuals living and ageing with treated HIV and differing levels of risk for HAND in these phenotypes, alongside the effects of commonly occurring comorbidities.The current evidence base for interventional approaches is limited, but growing. The most promising avenues appear to be multidisciplinary. These are currently focussed on high income settings rather than SSA where the majority of people living with HIV, and affected by cognitive impairment in the context of HIV, currently reside.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472291","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 advances in understanding of sleep disorders and disturbances for dementia risk and prevention.","authors":"Aaron Lam, Shawn Kong, Sharon L Naismith","doi":"10.1097/YCO.0000000000000921","DOIUrl":"10.1097/YCO.0000000000000921","url":null,"abstract":"<p><strong>Purpose of review: </strong>To synthesise the recent work examining the relationship between sleep disturbances and dementia, emphasising studies involving individuals with mild cognitive impairment (MCI) or Alzheimer's disease (AD) and/or those investigating AD biomarkers. Additionally, we provide an update on recent interventions targeting sleep-related issues in older adults with MCI or AD.</p><p><strong>Recent findings: </strong>Various studies have examined obstructive sleep apnoea, sleep duration, and circadian alterations in relation to Alzheimer's pathology and dementia risk, with an emerging body of evidence suggesting that cardiovascular disease, hypertension, glymphatic function, and inflammation might serve as plausible pathophysiological mechanisms contributing to dementia during critical brain periods. Conversely, recent studies investigating insomnia have produced disparate results. Regarding intervention studies, the scarcity of prospective randomised control trials poses a challenge in establishing the benefits of addressing sleep disorders and disturbances.</p><p><strong>Summary: </strong>Recent work examining the pathophysiological links between sleep and dementia is strongest for obstructive sleep apnoea and sleep duration, while findings in insomnia studies exhibit inconsistency, possibly due to varied associations with dementia among different insomnia subtypes. It is apparent that more longitudinal studies examining the underlying pathophysiological mechanisms are necessary, alongside more rigorous clinical trials. Although some trials are underway in this field, there is still scarcity in trials examining interventions for circadian disturbances.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472297","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":"Safety of noninvasive brain stimulation in children.","authors":"Mohammad Ali Salehinejad, Michael Siniatchkin","doi":"10.1097/YCO.0000000000000923","DOIUrl":"10.1097/YCO.0000000000000923","url":null,"abstract":"<p><strong>Purpose of review: </strong>Noninvasive brain stimulation (NIBS) is a promising method for altering cortical excitability with clinical implications. It has been increasingly used in children, especially in neurodevelopmental disorders. Yet, its safety and applications in the developing brain require further investigation. This review aims to provide an overview of the safety of commonly used NIBS techniques in children, including transcranial electrical stimulation (tES) and transcranial magnetic stimulation (TMS). Safety data for other NIBS methods is not reported in this review.</p><p><strong>Recent findings: </strong>In line with studies from the last decade, findings in the last 2 years (2022-2023) support the safety of NIBS in children and adolescents within the currently applied protocols. Both tES and TMS are well tolerated, if safety rules, including exclusion criteria, are applied.</p><p><strong>Summary: </strong>We briefly discussed developmental aspects of stimulation parameters that need to be considered in the developing brain and provided an up-to-date overview of tES/TMS applications in children and adolescents. Overall, the safety profile of tES/TMS in children is good. For both the tES and TMS applications, epilepsy and active seizure disorder should be exclusion criteria to prevent potential seizures. Using child-sized earplugs is required for TMS applications. We lack large randomized double-blind trialsand longitudinal studies to establish the safety of NIBS in children.</p><p><strong>Video abstract: </strong>http://links.lww.com/YCO/A78 .</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139471359","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":"Deep learning applications in vascular dementia using neuroimaging.","authors":"Chao Dong, Shizuka Hayashi","doi":"10.1097/YCO.0000000000000920","DOIUrl":"10.1097/YCO.0000000000000920","url":null,"abstract":"<p><strong>Purpose of review: </strong>Vascular dementia (VaD) is the second common cause of dementia after Alzheimer's disease, and deep learning has emerged as a critical tool in dementia research. The aim of this article is to highlight the current deep learning applications in VaD-related imaging biomarkers and diagnosis.</p><p><strong>Recent findings: </strong>The main deep learning technology applied in VaD using neuroimaging data is convolutional neural networks (CNN). CNN models have been widely used for lesion detection and segmentation, such as white matter hyperintensities (WMH), cerebral microbleeds (CMBs), perivascular spaces (PVS), lacunes, cortical superficial siderosis, and brain atrophy. Applications in VaD subtypes classification also showed excellent results. CNN-based deep learning models have potential for further diagnosis and prognosis of VaD.</p><p><strong>Summary: </strong>Deep learning neural networks with neuroimaging data in VaD research represent significant promise for advancing early diagnosis and treatment strategies. Ongoing research and collaboration between clinicians, data scientists, and neuroimaging experts are essential to address challenges and unlock the full potential of deep learning in VaD diagnosis and management.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472284","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":"Advancements in the phenomenology, assessment, and treatment of Tourette syndrome.","authors":"Kesley A Ramsey, Joseph F McGuire","doi":"10.1097/YCO.0000000000000922","DOIUrl":"10.1097/YCO.0000000000000922","url":null,"abstract":"<p><strong>Purpose of review: </strong>Tourette syndrome (TS) and chronic tic disorders, collectively referred to as TS, are relatively common childhood onset neuropsychiatric conditions associated with functional impairment and distress. Over the past several years, clinical research has contributed to the advancement of the field's understanding of mechanisms and clinical correlates of TS. This progress has led to the development of key assessment tools and the implementation of novel interventions for individuals with TS.</p><p><strong>Recent findings: </strong>This article provides a review of innovative TS research focusing on four key themes: investigation of clinical phenomenology of TS; validation of assessment tools for TS; dissemination of current evidence-based treatments for TS; and exploration of new intervention programs.</p><p><strong>Summary: </strong>Cumulatively, this growing body of work presents considerable progress and provides a path forward to improve the assessment and treatment of TS.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10922452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472283","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":"Longitudinal trajectories of cognitive aging.","authors":"Elena Lobo, Patricia Gracia-García, Antonio Lobo","doi":"10.1097/YCO.0000000000000918","DOIUrl":"10.1097/YCO.0000000000000918","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes recent evidence related to the cognitive trajectories of aging, the factors associated with the different trajectories, and the effect of sex on cognitive decline.</p><p><strong>Recent findings: </strong>Trajectories of cognitive aging identified in different studies vary in number, in the proportion of individuals falling into each of the classes and in the predictors of class membership. Trajectories observed include types with 'rapid decline', those with 'gradual decline' and those with 'maintenance of high level' of cognitive performance. Predictors of decline and predictors of maintenance of cognitive performance may be different. While factors such as education were in general associated with high performance, and reversely with low performance, other factors, such as depression were predictors only for some groups, particularly the declining ones. Sex differences in cognitive trajectories and the associated predictive factors have also been identified.</p><p><strong>Summary: </strong>The findings on education may be particularly important in populations with low educational level, especially among women and the findings on depression have special interest in preventing cognitive decline in women. Further work is required to explain intriguing inconsistencies observed in the literature.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472288","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":"Adverse childhood experiences predict internet gaming disorder in university students: the mediating role of resilience.","authors":"Jinghao Ma, Bo Yang, Shizhen Wang, Yujie Yao, Chencheng Wu, Mei Li, Guang-Heng Dong","doi":"10.1097/YCO.0000000000000910","DOIUrl":"10.1097/YCO.0000000000000910","url":null,"abstract":"<p><strong>Background: </strong>To investigate the relationship between adverse childhood experiences and internet gaming disorder (IGD) and the mediating role of resilience in the relationship between these two factors.</p><p><strong>Methods: </strong>The adverse childhood experience scale, resilience scale and IGD Scale were administered to 9349 university students. Correlations and mediating effects were calculated among these scores.</p><p><strong>Results: </strong>After controlling for sex and age, significant correlations among adverse childhood experiences, resilience and IGD were observed; resilience was a partial mediator variable in the relationship between adverse childhood experiences and IGD.</p><p><strong>Conclusions: </strong>The more adverse childhood experiences an individual has, the less their mental toughness and the greater their tendency to become addicted to internet games. Adverse childhood experiences can effectively predict IGD, and the risk of becoming addicted to the internet can be decreased by increasing one's mental toughness.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136396777","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":"Consolidating evidence on the role of insulin resistance in major depressive disorder.","authors":"Anna Julia Krupa, Dominika Dudek, Marcin Siwek","doi":"10.1097/YCO.0000000000000905","DOIUrl":"10.1097/YCO.0000000000000905","url":null,"abstract":"<p><strong>Purpose of review: </strong>The circular interactions between type 2 diabetes (TMD2) and major depressive disorder (MDD) are well documented but the understanding of their mechanisms has only recently gained more clarity. Latest research indicates, that the association between TMD2 and MDD is largely mediated by insulin resistance (IR).</p><p><strong>Recent findings: </strong>A metabolic subtype of MDD can be distinguished from other MDD subpopulations, that is characterized by predominantly atypical clinical presentation, IR and different responsiveness to antidepressant interventions. IR is a predictor of nonresponse to some antidepressants. The IR seems to be a state-marker of clinical or subclinical depression and the relationship between IR and MDD varies between sexes and ethnicities. Insulin has a direct impact on the monoaminergic systems known to underlie MDD symptoms: serotoninergic and dopaminergic, which are dysregulated in IR subjects. Several trials assessed the efficacy of insulin-sensitizing drugs in MDD with mixed results for metformin and more consistent evidence for pioglitazone and lifestyle intervention/physical activity.</p><p><strong>Summary: </strong>Recently published data suggest a significant role of IR in the clinical presentation, pathophysiology and treatment response in MDD. Further research of IR in MDD and integration of existing data into clinical practice are needed.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136396779","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":"New trends in personalized treatment of depression.","authors":"Gaia Sampogna, Claudia Toni, Pierluigi Catapano, Bianca Della Rocca, Matteo Di Vincenzo, Mario Luciano, Andrea Fiorillo","doi":"10.1097/YCO.0000000000000903","DOIUrl":"10.1097/YCO.0000000000000903","url":null,"abstract":"<p><strong>Purpose of review: </strong>Major depressive disorder (MDD) is a common and burdensome severe mental disorder, which is expected to become the leading cause of disease burden worldwide. Most patients with MDD remain untreated/undertreated. For many decades \"a trial and error\" approach has been adopted for selecting the best treatment plan for each individual patient, but more recently a personalized treatment approach has been proposed, by taking into account several individual and clinical factors (e.g., clinical stage, comorbidity, duration of illness). Therefore, the aim of this study is to address the most relevant innovations in the personalized treatment plan for patients with MDD.</p><p><strong>Recent findings: </strong>In recent years, several pharmacological and nonpharmacological innovations have been introduced in the treatment of patients with MDD. As regards pharmacological treatments, the newly developed drugs have an innovative mechanism of action, targeting the glutamatergic systems. These drugs are highly effective in improving depressive symptoms, with a good level of safety and tolerability. As regards nonpharmacological interventions, innovations include both new strategies targeting different domains (e.g., lifestyle interventions aiming to improve the physical symptoms of depression or virtual reality) and classical interventions provided through innovative mechanisms (e.g., web-based psychotherapies and use of digital approaches). Patients globally report a good level of acceptability of these interventions.</p><p><strong>Summary: </strong>Depression is a heterogeneous, complex and multidimensional disorder, representing one of the leading causes of disability worldwide. The final aim of the management of patients is functional recovery, which can be achieved by using personalized, integrated and recovery-oriented interventions. Several innovative pharmacological and nonpharmacological treatments are now available; interventions should be selected on the basis of the patient's needs and preferences in order to tailor the treatment, according to a shared decision-making approach.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49675428","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":"Predictors of suicidality among Polish university students during COVID-19 pandemic.","authors":"Ewelina Cichoń, Magdalena Gawrych, Andrzej Kiejna, Tomasz M Gondek, Beata Andrzejewska, Tomasz Adamowski, Karol Kozak, Philippe Mortier, Jordi Alonso","doi":"10.1097/YCO.0000000000000911","DOIUrl":"10.1097/YCO.0000000000000911","url":null,"abstract":"<p><strong>Purpose of review: </strong>The main purpose of the study was to assess university students' mental health and identify factors associated with the risk of suicidal thoughts, plans, and attempts during coronavirus disease 2019 (COVID-19) pandemic and distance learning.</p><p><strong>Recent findings: </strong>The study was conducted in spring 2021 and comprised 10 760 Polish students. The survey employed modified versions of the C-SSRS, CIDI, WHO-5, GAD-7, the PTSD checklist for DSM-5 and CAGE-AID Questionnaire and included questions about panic attacks, COVID-19-related information and sociodemographic characteristics. The correlates of suicidality were examined using a series of logistic regression analyses. Almost 40% students experienced any suicidal thoughts and/or behaviours in the previous month: passive ideations only (15.8%), active ideations only (7.1%), plans without attempts (15%), and attempts (1.4%). Following variables were related to the increased risk for suicide attempts: severe anxiety [odds ratio (OR) = 11.39; 95% confidence interval (CI): 1.44-90.26], panic attacks (OR = 3.21; 95% CI: 1.75-5.91), and COVID-19 hospitalisation (OR = 11.04; 95% CI: 1.17-104.59). Major depression was associated with passive and active ideations, suicide plans, but not with attempts (OR = 1.37; 95% CI: 0.45-4.13).</p><p><strong>Summary: </strong>University students present a high level of adverse mental health and increased risk of STBs during COVID-19 pandemic. A suicide prevention program tailored to this population is needed during and after the pandemic.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136396781","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}