General hospital psychiatry最新文献

{"title":"A guideline-based perspective on neurostimulation in treatment-resistant obsessive-compulsive disorder: An international overview","authors":"Nadine D. Wolf ,&nbsp;Martin Jakobs ,&nbsp;R. Christian Wolf","doi":"10.1016/j.genhosppsych.2025.10.014","DOIUrl":"10.1016/j.genhosppsych.2025.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Obsessive-compulsive disorder (OCD) is a severe psychiatric illness associated with substantial psychosocial burden. Although evidence-based first- and second-line treatments are often effective, a significant proportion of patients continue to experience treatment-resistant symptoms. In such cases, brain neurostimulation is gaining increasing attention. This study aims to provide a structured overview of national and international clinical guidelines for the management of treatment-resistant OCD, with a particular focus on neurostimulation techniques.</div></div><div><h3>Materials and methods</h3><div>Relevant clinical guidelines were identified and compared with respect to their recommendations on various neurostimulatory procedures. Among the approaches examined were transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), Deep Brain Stimulation (DBS), ablative neurosurgical procedures, and further techniques such as transcranial direct current stimulation (tDCS).</div></div><div><h3>Results</h3><div>Across guidelines, DBS is regarded as a potentially effective treatment option for carefully selected, severely affected patients. Its use is restricted to specialized centers and requires an interdisciplinary treatment approach. Ablative procedures are endorsed by certain guidelines solely in exceptionally severe cases. The evidence basis for TMS remains inconsistent, though certain stimulation protocols have shown short-term efficacy. For ECT and tDCS, current evidence is insufficient to support their use in targeting core OCD symptoms.</div></div><div><h3>Conclusions</h3><div>Overall, the reviewed guidelines emphasize the need for clearly defined indications, standardized treatment protocols, and continuous scientific evaluation. Invasive procedures are not considered standard treatment but represent highly specialized therapeutic options within interdisciplinary care frameworks.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 196-202"},"PeriodicalIF":3.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358707","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":"Efficacy and safety of quetiapine prophylaxis for delirium in hospitalized adult patients: A systematic review and meta-analysis of randomized controlled trials","authors":"Raj Kiran Donthu ,&nbsp;Sneha Mary Minz ,&nbsp;Mamidipalli Sai Spoorthy ,&nbsp;R. Dyuthy ,&nbsp;A. Balaji ,&nbsp;P.S. Sethu ,&nbsp;Libnus B. Varghese ,&nbsp;Shahul Ameen ,&nbsp;Brijesh Sathian ,&nbsp;Vikas Menon","doi":"10.1016/j.genhosppsych.2025.10.011","DOIUrl":"10.1016/j.genhosppsych.2025.10.011","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to compare summary estimates of efficacy and safety of quetiapine versus comparator treatments in preventing delirium among hospitalized adult patients by pooling evidence from parallel-group randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>We searched MEDLINE, Embase, Scopus, and clinical trial registers from inception till January 31st, 2025. Our primary outcome was between-group incidence of delirium. Secondary outcomes included 10-day mortality, duration of hospital stay, duration of delirium, severity of delirium, readmission rates (efficacy outcomes), and reported adverse effects (safety outcomes).</div></div><div><h3>Results</h3><div>Six eligible RCTs (pooled <em>N</em> = 491) were identified; of these, five were included in the meta-analysis. The pooled RR for preventing the incidence of delirium was 0.61 (95 % CI, 0.45–0.83;5 RCTs; I² = 0;<em>p</em> = .001), favoring quetiapine (dose range 12.5-75 mg/day). The SMD for duration of delirium was −1.21 (95 % CI, −2.08 to −0.35; 3 RCTs; I² = 86 %; <em>p</em> = .006), again favoring quetiapine. No significant between-group differences were noted on other outcomes. Adverse effects with quetiapine were absent in four studies and minimal in the other two. The findings were robust to sensitivity analyses.</div></div><div><h3>Conclusion</h3><div>Low-dose quetiapine prophylaxis may be a safe and effective treatment option for preventing delirium. These conclusions are tempered by the small number and size of existing trials.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 192-195"},"PeriodicalIF":3.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354394","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":"Treatment of cannabinoid hyperemesis syndrome: A systematic review and treatment algorithm for consultation-liaison psychiatrists","authors":"Jennifer Hsu ,&nbsp;Saurabh Kashyap ,&nbsp;Cheryl Hurd ,&nbsp;Lauren McCormack ,&nbsp;Zachary Herrmann ,&nbsp;Ann C. Schwartz ,&nbsp;Joshua Jackson ,&nbsp;Dustin DeMoss","doi":"10.1016/j.genhosppsych.2025.10.012","DOIUrl":"10.1016/j.genhosppsych.2025.10.012","url":null,"abstract":"<div><h3>Background</h3><div>Cannabinoid Hyperemesis Syndrome (CHS) is a cyclical vomiting syndrome associated with chronic cannabis use and is often resistant to anti-emetics. Despite increasing incidence of suspected CHS, literature regarding its treatment is limited, and there are no established treatment guidelines.</div></div><div><h3>Objectives</h3><div>With the goal of establishing treatment guidelines for consultation-liaison (C-L) psychiatrists managing CHS, the authors systematically reviewed existing literature for pharmacologic treatment strategies using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. With the results of the review, the authors propose a treatment algorithm for CHS.</div></div><div><h3>Methods</h3><div>We searched PubMed, PyschINFO &amp; PsychARTICLES, Embase, and Web of Science from inception to July 2021 to identify literature describing treatment of CHS. We included cases of CHS where patient-level data describing the treatment of CHS was available. Pharmacologic treatments were considered beneficial if the patient's nausea, hyperemesis, and urge to take hot showers resolved. Non-independent review of exclusion criteria assisted in reducing individual bias of the literature.</div></div><div><h3>Results</h3><div>The authors identified 34 eligible articles, consisting of 63 individual cases. Among these articles and cases, capsaicin cream, antipsychotics, and benzodiazepines were reported to improve CHS more effectively than other, more frequently used anti-emetics, such as promethazine, ondansetron, and metoclopramide.</div></div><div><h3>Conclusion</h3><div>An examination of treatment strategies for CHS can allow for more effective care while providing a foundation for further research in treatment. This proposed algorithm is designed to aid in establishing treatment strategies for C-L psychiatrists who assist with managing CHS for patients in general medical settings. The goal of this research is to establish evidence-based treatment guidelines for C-L psychiatrists who are managing patients with CHS in general medical settings. Recognizing the limitations of this algorithm being based on case reports adds to the necessity of further research in this area.</div></div><div><h3>Registration</h3><div>PROSPERO (<span><span>https://www.crd.york.ac.uk/PROSPERO/view/CRD42021254888</span><svg><path></path></svg></span>) registration number CRD42021254888.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 185-191"},"PeriodicalIF":3.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354358","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":"Reliability and validation of the Japanese version of the somatic symptom disorder-B criteria scale (J-SSD-12)","authors":"Toshiyuki Tominaga ,&nbsp;Yasuhide Nagoshi ,&nbsp;Akihiko Iwahara ,&nbsp;Daisuke Ueno ,&nbsp;Mayu Ogawa ,&nbsp;Jin Narumoto","doi":"10.1016/j.genhosppsych.2025.10.009","DOIUrl":"10.1016/j.genhosppsych.2025.10.009","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluated the reliability and validity of the Japanese version of the Somatic Symptom Disorder–B Criteria Scale (J-SSD-12), which assesses psychological features of somatic symptom disorder (SSD) as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Criterion B.</div></div><div><h3>Methods</h3><div>A total of 1148 Japanese internet panel participants completed the J-SSD-12, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 scale (GAD-7), Patient Health Questionnaire-15 (PHQ-15), and Short Health Anxiety Inventory (SHAI). Confirmatory factor analysis (CFA) examined factorial validity, with a correlated error specified between Items 7 and 10 for their shared negative wording and emphasis on others' evaluations. Reliability was assessed using test–retest correlations, intraclass correlation coefficients (ICCs), and Cronbach's alpha (α). Convergent validity was primarily evaluated through correlations with four additional scales.</div></div><div><h3>Results</h3><div>The mean participant age was 48.8 years (SD = 17.3), and 54.6 % were female. The scree plot and high inter-factor correlations suggested a possible unidimensional structure; however, the one-factor model did not achieve satisfactory fit (Comparative Fit Index [CFI] = 0.94, Root Mean Square Error of Approximation [RMSEA] = 0.107). In contrast, the three-factor structure showed acceptable fit on CFI (0.96) and Tucker–Lewis Index (TLI; 0.95), while RMSEA (0.091) indicated only marginal fit. The J-SSD-12 demonstrated good test–retest reliability (correlation coefficient [r] = 0.72; ICCs = 0.72–0.84) and excellent internal consistency (α = 0.95). Moderate correlations with the PHQ-9, GAD-7, PHQ-15, and SHAI (<em>r</em> = 0.60–0.66) supported convergent validity.</div></div><div><h3>Conclusion</h3><div>The J-SSD-12 provides evidence supporting the reliability and validity of assessing SSD-related psychological features in a Japanese sample. Despite certain limitations, this measure appears useful for both research and potential clinical applications.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 161-169"},"PeriodicalIF":3.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307545","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":"Set and setting in psilocybin-assisted therapy: A qualitative study of patients with cancer and depression","authors":"Yvan Beaussant ,&nbsp;Elise Tarbi ,&nbsp;Kabir Nigam ,&nbsp;Skye Miner ,&nbsp;Zachary Sager ,&nbsp;Justin Sanders ,&nbsp;Michael Ljuslin ,&nbsp;Benjamin Guérin ,&nbsp;Roxanne Sholevar ,&nbsp;Kimberly Roddy ,&nbsp;James A. Tulsky ,&nbsp;Manish Agrawal","doi":"10.1016/j.genhosppsych.2025.10.010","DOIUrl":"10.1016/j.genhosppsych.2025.10.010","url":null,"abstract":"<div><h3>Background</h3><div>Psilocybin-assisted therapy (PAT) shows promise for cancer-related depression, yet little research has examined how therapeutic context shapes patient experiences. While set (mindset) and setting (environment) are considered central to psychedelic treatment, empirical evidence on their role in PAT acceptability remains limited. This study explores factors influencing the acceptability of PAT from the perspective of patients with cancer and depression.</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews with participants in a clinical trial of psilocybin-assisted therapy. Using template analysis, we examined themes related to the acceptability of the experience and the surrounding therapeutic environment.</div></div><div><h3>Results</h3><div>Participants (<em>n</em> = 28) described the psilocybin experience as intense and demanding, with therapeutic benefits closely tied to their ability to “surrender”—a term used to describe accepting and remaining open to the experience's intensity and unpredictability. A safe, supportive, and ethical environment was critical in fostering trust and engagement. Preparation and integration were key to maximizing benefit. Music played a significant but variable role, sometimes enhancing and other times distracting. While the clinical setting provided safety, ceremonial elements added meaning for many.</div></div><div><h3>Conclusions</h3><div>Findings highlight how therapeutic structure, preparation, and setting shape PAT acceptability, supporting the need for patient-centered approaches to optimize care and outcomes.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 175-184"},"PeriodicalIF":3.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318058","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 preliminary evaluation of the effectiveness of massed delivery of PTSD psychotherapy in VA residential treatment","authors":"Ryan Holliday ,&nbsp;Nicholas Holder ,&nbsp;Cynthia Yamokoski ,&nbsp;Jennifer Burden ,&nbsp;Lauren M. Sippel ,&nbsp;Ilan Harpaz-Rotem ,&nbsp;Noelle B. Smith","doi":"10.1016/j.genhosppsych.2025.10.004","DOIUrl":"10.1016/j.genhosppsych.2025.10.004","url":null,"abstract":"<div><h3>Objective</h3><div>“Massed” (≥ 3 times a week) delivery of psychotherapy for posttraumatic stress disorder (PTSD) has emerged as an alternative to traditional “spaced” (weekly/bi-weekly) delivery. Massed delivery has been shown to be non-inferior to spaced delivery, with higher rates of treatment completion. This pilot project evaluated the effectiveness of massed delivery in Department of Veterans Affairs (VA) PTSD Residential Rehabilitation Treatment Programs (RRTPs).</div></div><div><h3>Method</h3><div>A massed treatment program called Models of Accelerated Service Delivery (MASD) was piloted in six RRTPs. Data from Veterans who received either MASD or non-MASD delivery at a pilot site between 10/2022–09/2023 were included in this evaluation (<em>n</em> = 466). Veterans received PTSD symptom assessment at admission, discharge, and 1-year post-discharge. A hierarchical linear modeling (HLM) approach was used to evaluate trajectories of PTSD symptom change between delivery approaches.</div></div><div><h3>Results</h3><div>Veterans who received MASD delivery of PTSD psychotherapy had significantly shorter lengths of stay as well as higher rates of treatment completion. Veterans participating in RRTP treatment experienced symptom attenuation, with no observed differences in the trajectory of symptom change between delivery approaches.</div></div><div><h3>Conclusions</h3><div>This pilot project provides preliminary support for the MASD program in residential treatment. Further research is needed to understand how treatment decisions are made by clinicians and Veterans.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 126-129"},"PeriodicalIF":3.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291829","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":"Psychiatric morbidity among youth diagnosed with gender dysphoria: An analysis of National Administrative Data in the U.S.","authors":"Yifan Li ,&nbsp;Jessica Khaw ,&nbsp;Mengyao Li ,&nbsp;Binx Yezhe Lin ,&nbsp;Hui Xie ,&nbsp;Alexander In ,&nbsp;Anita S. Kablinger ,&nbsp;Kevin Y. Xu ,&nbsp;Jack L. Turban","doi":"10.1016/j.genhosppsych.2025.10.007","DOIUrl":"10.1016/j.genhosppsych.2025.10.007","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 172-174"},"PeriodicalIF":3.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312718","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":"Childbirth-related post-traumatic stress disorder (CB-PTSD): Quantifying missed opportunities for intervention","authors":"Amanda M. Koire ,&nbsp;Natalie S. Feldman ,&nbsp;Hung-Chu Lin ,&nbsp;Leena P. Mittal ,&nbsp;Carmina Erdei ,&nbsp;Nancy Byatt ,&nbsp;Cindy H. Liu","doi":"10.1016/j.genhosppsych.2025.10.006","DOIUrl":"10.1016/j.genhosppsych.2025.10.006","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 144-145"},"PeriodicalIF":3.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307575","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":"Association between COVID-19 infection and risk of mental disorders: a systematic review and meta-analysis","authors":"Jiayi Liu ,&nbsp;Honghao Lai ,&nbsp;Weilong Zhao ,&nbsp;Jiajie Huang ,&nbsp;Bei Pan ,&nbsp;Janne Estill ,&nbsp;Long Ge","doi":"10.1016/j.genhosppsych.2025.10.008","DOIUrl":"10.1016/j.genhosppsych.2025.10.008","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically review and meta-analyse the association between COVID-19 and the risk of mental disorders.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, CINAHL, PsycINFO, and the reference lists of systematic reviews and included cohort studies assessing the association between COVID-19 and mental disorders. Two reviewers independently performed literature screening, data extraction, and the risk of bias assessment. We conducted a random-effect meta-analysis to assess the association and calculated the pooled risk ratio with 95 % confidence interval.</div></div><div><h3>Results</h3><div>Twenty-eight cohorts with a total of 977,434,207 participants proved eligible. We revealed a 40 % increased risk (RR = 1.40, 95 %CI: 1.23 to 1.59; absolute risk difference = 31 more per 1000 persons, 18 more to 45 more) of mental disorders in patients with COVID-19 compared with non-exposed individuals. Moreover, COVID-19 may be related to the risks of anxiety or fear-related disorders, mood disorders, bipolar or related disorders, depressive disorders, unspecified mood disorders, neurocognitive disorders, dementia, mild cognitive disorders, unspecified neurocognitive disorders, psychotic disorders, stress and adjustment disorders, post-traumatic stress disorder, unspecified stress and adjustment disorders, and prescriptions for psychotropic medications.</div></div><div><h3>Conclusions</h3><div>Our findings suggest an association between COVID-19 and risk of mental disorders, as well as the prescriptions for psychotropic medications. It is imperative for individuals to become vigilant of mental health problems that may arise following COVID-19.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 130-143"},"PeriodicalIF":3.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291890","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":"Is intranasal esketamine versus intravenous ketamine a therapeutic innovation or a divide in access to care?","authors":"Yassine Benhaddouch,&nbsp;Adil El Ammouri","doi":"10.1016/j.genhosppsych.2025.10.005","DOIUrl":"10.1016/j.genhosppsych.2025.10.005","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 170-171"},"PeriodicalIF":3.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307621","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}