Current Psychiatry Reports最新文献

{"title":"Proposition of Two Subtypes of Patients at Risk of Suicide: Pain Hypersensitive Vs. Dissociative.","authors":"Francesca Bianco, Philippe Courtet, Emilie Olié, Jorge López-Castroman, Fabio Madeddu, Raffaella Calati","doi":"10.1007/s11920-025-01600-0","DOIUrl":"https://doi.org/10.1007/s11920-025-01600-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>The pain-suicide relationship is one of the most debated in recent literature, but theories and clinical evidence have often reached contrasting conclusions. Through a critical overview of theoretical, meta-analytical and empirical contributions, we aimed at advancing the conversation on the pain-suicide relationship by integrating research on related concepts, specifically inflammation and dissociation, and their effects on interoceptive processes and pain perception.</p><p><strong>Recent findings: </strong>Ideation-to-action theories consider increased pain tolerance a key risk factor for the transition from suicidal ideation to attempt. However, several meta-analytical findings suggest that suicidal thoughts and behaviors are associated with inflammation-induced pain sensitization. On the one hand, inflammation contributes to the development and maintenance of chronic pain conditions and mood disorders, and is associated with interoceptive hypervigilance and pain hypersensitivity. Moreover, a trait of increased pain tolerance does not seem to distinguish the individuals attempting suicide among those living with suicidal thoughts. On the other, temporary hypoalgesia is often activated by dissociative experiences. Highly dissociative individuals can indeed be exposed to frequent disintegration of interoceptive processes and transitory hyposensitivity to pain. In light of this, two different patterns of responses to stress (i.e. inflammation vs. dissociation) may characterize different kinds of patients at risk of suicide, associated with specific patterns of interoceptive functioning, pain sensitivity and possibly suicidal ideation. This proposition is partially supported by neuroimaging studies on post-traumatic stress disorder and psychodynamic perspectives on neurodevelopment, as well as alternative clustering models of suicidal behavior. Theoretical, meta-analytical and neurobiological evidence highlight two opposite directions in the pain-suicide relationship: hyper- vs. hyposensitivity. Such contrasts may be explained by the existence of two tendencies in stress-response, namely inflammation and dissociation, defining two different subtypes of patients at risk of suicide. We thus propose the existence of a hypersensitive subtype, defined by underlying neuroinflammatory processes, increased vulnerability to chronic pain and mood disorders, interoceptive hypervigilance, pain hypersensitivity and potentially more persistent suicidal ideation. We further hypothesize a dissociative subtype, characterized by greater trait dissociation, vulnerability to depersonalization and derealization, frequent disintegration of interoceptive processes, transient pain hyposensitivity and abrupt peaks in suicidal ideation.</p>","PeriodicalId":11057,"journal":{"name":"Current Psychiatry Reports","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647249","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":"Towards Defining the Faculty Role in Supporting Student Mental Health.","authors":"Erica B Riba","doi":"10.1007/s11920-025-01599-4","DOIUrl":"https://doi.org/10.1007/s11920-025-01599-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review of the recent literature highlights the need to better define the role of faculty in supporting student mental health in higher education institutions in the United States.</p><p><strong>Recent findings: </strong>The last several decades, and especially since the COVID-19 pandemic, has seen an emphasis on college student mental health. While students are seeking knowledge, connectedness, and career options, faculty are focused on teaching, mentorship but also on how to best support student mental health. With this rise of concentration on mental health in higher education, a major question has arisen-what is the role of faculty in supporting student mental health? The literature is vast in terms of college student mental health and students' stressors and concerns. More and more literature is available regarding interventions used to identify, manage and treat students, and even studies on staff and faculty and their own mental health. Much of the data from faculty has recently been about burnout and their own mental health. There is, however, much less research and literature on either guidelines or guideposts regarding the specific roles that faculty have towards supporting student mental health. This brief paper highlights the potential opportunities and barriers and suggests model strategies for higher education leaders, administrators and faculty to better define the faculty role in supporting student mental health.</p>","PeriodicalId":11057,"journal":{"name":"Current Psychiatry Reports","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633710","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":"Update on Psychiatry Residency Training in Personality Disorders: Becoming a Good Psychiatrist Through Becoming \"Good Enough\" at Treating Borderline and Narcissistic Personality Disorders.","authors":"G Price Daniel, M Quayle William, T Unruh Brandon","doi":"10.1007/s11920-025-01595-8","DOIUrl":"https://doi.org/10.1007/s11920-025-01595-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>We review recent clinical developments in borderline personality disorder and personality disorders more broadly, as well as changes in national psychiatry residency training guidelines in an effort to establish a roadmap for psychiatry residency training directors to create curricula to prepare residents to manage these disorders.</p><p><strong>Recent findings: </strong>Though no randomized controlled trials exist, small studies demonstrating positive effects of teaching specialized treatment models to residents in programs with resources in these areas. The ACGME's Milestones 2.0 and their relevance for personality disorder curriculum are discussed. Narcissistic Personality Disorder (NPD), its increasing importance in public and clinical consciousness, and recent developments in diagnosis, theory, and manualized treatments are noted, including a recent model of group psychoeducation. The current state of dimensional models for personality including the DSM 5 Section III (the Alternative Model for Personality Disorders) and ICD-11's version introduced in 2022 are reviewed. Given BPD's widespread prevalence, especially in the clinical setting, and the combination of the disorder's complexity, comorbidity, and treatment challenges, we argue that devoting curricular resources to teaching about BPD makes good educational sense. We present a model curriculum based on the generalist approach of Good Psychiatric Management (GPM). This, we argue, can allow programs without specialist faculty to provide \"good enough\" preparation of residents for treating BPD, while also allowing more resource rich programs to add specialized Evidence Based Treatment (EBT) training for interested residents. We also offer GPM's adapted approach to NPD as the basis for residency curricula for this important disorder. Finally, we propose ways to teach the use of the Alternative Model for Personality Disorders in the classroom setting, and in working with NPD patients.</p>","PeriodicalId":11057,"journal":{"name":"Current Psychiatry Reports","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623872","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":"ECT and Delirium: Literature Review and a Pediatric Case Report.","authors":"Ayah Anani, Hannah Reynard, Neera Ghaziuddin","doi":"10.1007/s11920-025-01594-9","DOIUrl":"https://doi.org/10.1007/s11920-025-01594-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>There is limited information available regarding delirium that may occur during the course of electroconvulsive therapy (ECT) in pediatric patients (< 18 years). The aim of this paper is to describe ECT-associated delirium, suspected risk factors, and screening tools that may help in its identification and management. We present a case involving a 15 y.o. African American male who developed ECT-associated delirium during the treatment of catatonia.</p><p><strong>Recent findings: </strong>Three subtypes of delirium associated with ECT have been described. First, postictal delirium which occurs immediately following ECT and may last up to 1 h; second, post ECT or agitated delirium occurring upon emergence from anesthesia, and interictal delirium which is a prolonged period of disorientation following ECT or it may appear de novo separately from the postictal disorientation period. ECT-associated delirium as a side effect of ECT has been described exclusively in adults. Limited evidence in published literature suggests that predisposing factors may include catatonia, developmental disorders, cerebral vascular disease, parkinson's disease, dementia, bi-temporal electrode placement, high stimulus intensity, and/or prolonged seizures. Patients receiving ECT should be routinely screened for delirium, and if present, for worsening of catatonia with/without NMS throughout their treatment. Patients who develop delirium during ECT should be evaluated for potential underlying etiologies including contributing pharmacological strategies. Clear and consistent definitions of ECT-associated delirium are necessary to improve outcomes.</p>","PeriodicalId":11057,"journal":{"name":"Current Psychiatry Reports","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613298","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":"Exercise Interventions for Autistic People: An Integrative Review of Evidence from Clinical Trials.","authors":"Rachel A Rivera, Meredith C Robertson, Joseph P McCleery","doi":"10.1007/s11920-025-01597-6","DOIUrl":"https://doi.org/10.1007/s11920-025-01597-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review integrates recent findings from randomized controlled clinical trial (RCT) research examining the impacts of physical exercise activities on various aspects and areas of functioning for autistic individuals.</p><p><strong>Recent findings: </strong>Recent meta-analytic and clinical trials research indicates physical exercise intervention programs improve social and communication skills for autistic children and adolescents, improve executive functioning skills for autistic children, improve sleep-related behavior for autistic children and adolescents, and may be helpful for improving physical health for autistic children. There is very limited RCT research evidence on exercise intervention approaches or impacts for autistic adults, for autistic girls or women, for autistic people with co-occurring intellectual disability, and for reducing negative emotional symptoms (e.g., anxiety, depression) for any autistic population. The extant clinical trials research provides convincing, consistent evidence for positive impacts of physical exercise programs on multiple areas of functioning for autistic children and adolescents. Additional research is needed to determine and ensure potential impacts of physical exercise activity programs for important autistic sub-populations, including adults.</p>","PeriodicalId":11057,"journal":{"name":"Current Psychiatry Reports","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613302","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":"Global Aging & Geriatric Experiments in Bipolar Disorder (GAGE-BD): Building a Global Consortium Benefiting People with Bipolar Disorder in Later Life.","authors":"Melis Orhan, Laura Montejo, Martha Sajatovic, Lisa Eyler, Annemiek Dols","doi":"10.1007/s11920-025-01593-w","DOIUrl":"https://doi.org/10.1007/s11920-025-01593-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Findings from the Global Aging & Geriatric Experiments in Bipolar Disorder (GAGE-BD) project, including sociodemographic and clinical information from older age bipolar disorder (OABD) and healthy participants around the globe (approximately N = 5000) were reviewed. Data was collected in multiple waves to create a large integrated dataset.</p><p><strong>Recent findings: </strong>BD does not seem to fade with age. BD subtype and early/late onset did not show significant differences in daily functioning. Physical comorbidities were more frequent in OABD compared with controls. Women with OABD had an earlier age at onset and more psychiatric hospitalizations. GAGE-BD is the largest OABD cohort. Dataset results offer a unique and comprehensive resource for understanding the long-term trajectory of BD and the specific needs of this population. Findings are vital for guiding future research and improving care strategies for aging individuals with BD.</p>","PeriodicalId":11057,"journal":{"name":"Current Psychiatry Reports","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604289","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":"Dialectical Behavior Therapy in Autism.","authors":"Luisa Weiner, Doha Bemmouna, Madalina Elena Costache, Emilie Martz","doi":"10.1007/s11920-025-01596-7","DOIUrl":"https://doi.org/10.1007/s11920-025-01596-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Recent research indicates that Dialectical Behavior Therapy (DBT) is feasible, acceptable, and effective for autistic adults. This review aims to provide conceptual arguments and empirical evidence to support DBT as a relevant therapeutic alternative for autistic individuals experiencing emotion dysregulation (ED).</p><p><strong>Recent findings: </strong>ED is frequent in autism whereby it is associated with severe mental health challenges. However, appropriate therapeutic options are limited. Currently, DBT has amassed the most evidence for treatment of ED across a range of clinical conditions, although it was originally developed for borderline personality disorder (BPD). In the context of autism, there is evidence supporting the efficacy of DBT for ED, life-threatening behaviors and depression, but adaptations are likely to improve its dissemination and acceptability. While similar biosocial factors seem to be involved in ED in BPD and autism, alexithymia is prominent in autism and autistic features such as sensory sensitivity and social overload also contribute to ED in autistic adults.</p><p><strong>Conclusion: </strong>Given the significant impact of ED on the well-being of autistic adults, there is an urgent need to enhance our understanding of the mechanisms involved in ED in autism and the adaptations likely to improve the acceptability and dissemination of DBT for autistic people.</p>","PeriodicalId":11057,"journal":{"name":"Current Psychiatry Reports","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566246","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":"Predominant Polarity for Enhanced Phenotyping and Personalized Treatment of Bipolar Disorder: A Narrative Review on Recent Findings.","authors":"Giovanna Fico, Marta Bort, Meritxell Gonzalez-Campos, Giulia D'Alessandro, Michele De Prisco, Vincenzo Oliva, Gerard Anmella, Constanza Sommerhoff, Eduard Vieta, Andrea Murru","doi":"10.1007/s11920-025-01592-x","DOIUrl":"https://doi.org/10.1007/s11920-025-01592-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>This paper explores Predominant Polarity (PP) in Bipolar Disorder (BD), defined as the predominance of either manic or depressive episodes over a patient's course of illness. We examine its clinical relevance, neurobiological foundations, and potential for guiding personalized treatment strategies. The review seeks to determine whether PP is a reliable course specifier and how it can be utilized to improve clinical outcomes.</p><p><strong>Recent findings: </strong>PP has a significant impact on prognosis and treatment planning in BD. Manic and depressive PP are associated with distinct clinical and neurobiological profiles of BD, while individuals without a clear predominance of either episode type represent a more severe to-treat subgroup of patients. The development of the Polarity Index (PI) facilitates treatment decisions based on PP. PP offers a valuable framework for refining BD treatment and understanding its complexity. Future research should focus on refining PP definitions, validating neurobiological markers, and integrating these insights into comprehensive treatment models to improve patient outcomes.</p>","PeriodicalId":11057,"journal":{"name":"Current Psychiatry Reports","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540510","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":"Understanding Sexual Burglary.","authors":"Hana Georgoulis, Eric Beauregard, Julien Chopin","doi":"10.1007/s11920-025-01585-w","DOIUrl":"10.1007/s11920-025-01585-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review includes research on sexual burglary to highlight the distinct behaviours of such offenders. Only recently has there been a thorough examination of the decision-making that goes into this hybrid crime, and the potential for these individuals to progress to more serious and violent criminal acts.</p><p><strong>Recent findings: </strong>Work on sexual burglary has found that decisions made during the crime commission reflect rational decision-making and organization, despite previous research suggesting that sexual crimes are mostly impulsive. Furthermore, these rational choices may lead to the development of expertise in sexual burglary, with offenders learning how to avoid detection and engage in forensic awareness strategies. The knowledge that sexual burglars are expert decision-makers has important implications, as these behaviours may lead to more violent and lethal sexual crimes. Identifying these offenders through their decisions and crime characteristics is key to potentially deterring or preventing future offending.</p>","PeriodicalId":11057,"journal":{"name":"Current Psychiatry Reports","volume":" ","pages":"147-153"},"PeriodicalIF":5.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122373","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":"Therapeutic Potential of MDMA- and Psychedelic-Assisted Psychotherapy for Adolescent Depression and Trauma.","authors":"Jamarie Geller, Eric Whitney","doi":"10.1007/s11920-024-01577-2","DOIUrl":"10.1007/s11920-024-01577-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>There is a mental health crisis affecting youth, and the utility of existing treatments is often limited by lack of effectiveness and tolerability. The aim of this review is to report on outcomes of clinical trials for psilocybin-assisted psychotherapy for adults with depression and MDMA-assisted psychotherapy for adults with post-traumatic stress disorder (PTSD) and discuss recommendations for exploring these treatments in adolescent populations.</p><p><strong>Recent findings: </strong>There have been encouraging data supporting the use of psilocybin-assisted psychotherapy for depression, including previously treatment-resistant symptoms. MDMA-assisted psychotherapy is showing similar promise in treating PTSD, with excellent response and remission rates that appear durable. However, no studies have looked at the use of these treatments in younger patients. The safety and efficacy of psychedelic- and MDMA-assisted psychotherapies should be investigated in adolescents, especially considering the burden of untreated and undertreated psychiatric illness in youth, and the benefits of a potentially earlier, more effective, and more tolerable recovery process. Research and implementation should be tailored to the needs of this population, and equity and access should be considered at every stage. In this novel and rapidly evolving landscape, the psychiatric community is encouraged to advocate for safe, appropriate, and inclusive inquiry into, and application and scaling of these treatment models in adolescent patients.</p>","PeriodicalId":11057,"journal":{"name":"Current Psychiatry Reports","volume":" ","pages":"88-97"},"PeriodicalIF":5.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852953","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}