General hospital psychiatry最新文献

{"title":"Opioid-related emergency admissions in people with opioid dependence/use disorder with and without sickle cell disease: An analysis of multi-state insurance claims","authors":"Shiyuan A. Liu ,&nbsp;Tashalee R. Brown ,&nbsp;Allison A. King ,&nbsp;Lewei Allison Lin ,&nbsp;Sana S. Rehman ,&nbsp;Richard A. Grucza ,&nbsp;Kevin Y. Xu","doi":"10.1016/j.genhosppsych.2024.09.013","DOIUrl":"10.1016/j.genhosppsych.2024.09.013","url":null,"abstract":"<div><h3>Objective</h3><div>We estimated rates of opioid-related admissions in people with sickle cell disease (SCD) diagnosed with opioid-related disorders.</div></div><div><h3>Method</h3><div>We analyzed ten years (1/2006–12/2016) of multi-state claims data from 191,638 people receiving treatment for opioid-related disorders in the U.S. We used multivariable cox regression to estimate the association between admissions for opioid-related adverse events after initiating treatment and SCD status (SCD[<em>n</em> = 320] vs no SCD[<em>n</em> = 191,318]) among people with opioid-related disorders, controlling for sociodemographic variables and comorbidities. In secondary analyses, we excluded events occurring simultaneously as vaso-occlusive crises (VOCs) and computed rates of admissions for non-opioid substance-related events (i.e., alcohol, cannabis).</div></div><div><h3>Results</h3><div>Whereas 287(90 %) of the SCD cohort had &gt;1 all-cause admission, of which 199 were for VOCs, only 78(20 %) experienced an opioid-related adverse event. The SCD cohort experienced higher rates of opioid-related admissions than the non-SCD cohort (aHR = 1.82[95 % CI = 1.51–2.19), a finding that remained robust even after excluding events that occurred at the same time as a VOC. SCD diagnoses were not associated with admissions for non-opioid substance-related events.</div></div><div><h3>Conclusions</h3><div>Even though clinicians may perceive people with SCD as being at elevated risk for substance use disorders, opioid-related admissions made up only a small fraction of all-cause admissions among people with SCD diagnosed with opioid-related disorders, in contrast to VOCs that comprised the majority of admissions. Opioid-related admissions, while modestly higher among those with SCD than among peers without SCD, were relatively uncommon.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"91 ","pages":"Pages 83-88"},"PeriodicalIF":4.1,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389550","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":"Insomnia moderates the association between positive symptoms and suicidal ideation: A large-scale cross-sectional study in Chinese patients with chronic schizophrenia","authors":"Pu Peng ,&nbsp;Zejun Li ,&nbsp;Qianjin Wang ,&nbsp;Yanan Zhou ,&nbsp;Qiuxia Wu ,&nbsp;Jinsong Tang ,&nbsp;Yanhui Liao ,&nbsp;Xiangyang Zhang","doi":"10.1016/j.genhosppsych.2024.09.012","DOIUrl":"10.1016/j.genhosppsych.2024.09.012","url":null,"abstract":"<div><h3>Objective</h3><div>Both insomnia and positive symptoms are linked to suicidal ideation (SI) in schizophrenia, yet their interaction remains unexplored. This study aims to investigate whether insomnia moderates the relationship between positive symptoms and SI in a large sample of Chinese patients with chronic schizophrenia.</div></div><div><h3>Method</h3><div>We recruited 1407 patients and assessed them using the Positive and Negative Syndrome Scale (PANSS), Insomnia Severity Index (ISI), and Beck Scale for Suicide Ideation (BSSI). We also collected demographic information and lifetime history of suicide attempts (SA). Positive symptoms were evaluated using the PANSS positive factor. Multivariate logistic regression and moderation analysis were performed.</div></div><div><h3>Results</h3><div>The prevalence of insomnia and SI was 13.5 % and 9.7 %, respectively. ISI scores (adjusted odds ratio [AOR]: 1.06; 95 % confidence interval [CI]: 1.01–1.10, <em>p</em> = 0.011), PANSS positive factor (AOR: 1.05; 95 % CI: 1.01–1.09, <em>p</em> = 0.008), PANSS mood factor (AOR: 1.16; 95 % CI: 1.10–1.22, <em>p</em> &lt; 0.001), and lifetime SA (AOR: 4.35; 95 % CI: 2.86–6.61, p &lt; 0.001) were independently associated with SI. Moderation analysis revealed that insomnia amplified the association between positive symptoms and SI. Specifically, higher levels of insomnia significantly strengthened this relationship (b = 0.086, 95 % CI = 0.048–0.124, <em>p</em> &lt; 0.001), while the association was negligible in patients with low levels of insomnia (b = −0.003, 95 % CI = -0.042–0.036, <em>p</em> = 0.870).</div></div><div><h3>Conclusion</h3><div>Both insomnia and positive symptoms were independently related to SI in schizophrenia, with insomnia moderating the relationship between positive symptoms and SI. Further studies are needed to test whether interventions against insomnia and positive symptoms would be effective at reducing SI in this population.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"91 ","pages":"Pages 66-71"},"PeriodicalIF":4.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323314","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":"Corrigendum to \"Prevalence of mental health conditions and brain fog in people with long COVID: A systematic review and meta-analysis\" [General Hospital Psychiatry volume 88 (2024)10-22 10.1016/j.genhosppsych.2024.02.009].","authors":"Christina M van der Feltz-Cornelis, Fidan Turk, Jennifer Sweetman, Kamlesh Khunti, Mark Gabbay, Jessie Shepherd, Hugh Montgomery, W David Strain, Gregory Y H Lip, Dan Wootton, Caroline Leigh Watkins, Daniel J Cuthbertson, Nefyn Williams, Amitava Banerjee","doi":"10.1016/j.genhosppsych.2024.09.006","DOIUrl":"https://doi.org/10.1016/j.genhosppsych.2024.09.006","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142283604","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":"N-methyl-d-aspartate (NMDA) receptor antagonists for treatment of catatonia in adults: Narrative review","authors":"Jeong Hoo Lee ,&nbsp;Joji Suzuki","doi":"10.1016/j.genhosppsych.2024.09.005","DOIUrl":"10.1016/j.genhosppsych.2024.09.005","url":null,"abstract":"<div><h3>Objective</h3><p>While the majority of patients with catatonia fully respond to benzodiazepines or ECT, some have a partial or no response. Benzodiazepines may be contraindicated such as when delirium co-exists. This review discusses the utility of NMDA receptor antagonists as alternatives to benzodiazepines in the treatment of catatonia in adults.</p></div><div><h3>Methods</h3><p>A PubMed search adhering to PRISMA guidelines was conducted for articles on NMDA receptor antagonists in catatonia treatment.</p></div><div><h3>Results</h3><p>Thirty-seven articles, including case reports and case series were identified. Amantadine (27 cases in 13 articles) and memantine (20 cases in 14 articles) were the most commonly reported agents. Amantadine, typically used as monotherapy or adjunctive therapy with benzodiazepines, showed quick responses. Memantine, used alone or with lorazepam, demonstrated rapid responses. A small number of cases (5 cases in 4 articles) reported successful use of ketamine and esketamine, highlighting their potential role in catatonia treatment.</p></div><div><h3>Conclusion</h3><p>Despite limitations, NMDA receptor antagonists may be viable options when the patient is partially or not responsive to benzodiazepine, ECT is not available or may not be well tolerated, there is a concern for co-morbid delirium where benzodiazepines may be contraindicated. Further research is needed.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"91 ","pages":"Pages 60-65"},"PeriodicalIF":4.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230322","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":"Independent and joint role of inflammatory diet and physical activity with cognitive function in aging: Evidence from a population-based survey","authors":"Litao Du ,&nbsp;Ting Li ,&nbsp;Xiangli Xue ,&nbsp;Qiang He ,&nbsp;Yang Pan ,&nbsp;Si Chen ,&nbsp;Xianliang Zhang","doi":"10.1016/j.genhosppsych.2024.09.003","DOIUrl":"10.1016/j.genhosppsych.2024.09.003","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to explore the independent and joint association of physical activity (PA) and inflammatory diet with cognitive function in aging.</p></div><div><h3>Method</h3><p>Data from the 2011–2014 National Health and Nutrition Examination Survey (NHANES) was used. 2249 NHANES participants with valid data represented a weighted population of 50.5 million American residents aged 60 and older. This study separately analyzed the independent associations of PA (measured by global physical activity questionnaire) and inflammatory diet (measured by energy-adjusted dietary inflammatory index from 24-h dietary recall), and their joints (inactive &amp; pro-inflammatory as reference) with cognitive function (assessed by three cognitive tests), and considered an individual of different status and non-linear effect by sub-group and restricted cubic splines (RCS) analysis, respectively. All analysis was multivariable-adjusted and sample-weighted.</p></div><div><h3>Results</h3><p>The results showed that inflammatory diet was independently associated with lower cognitive function, with a 1.08, 1.29, 2.67, 0.56 lower score in the Registry for Alzheimer's Disease word list learning test (CERAD), the Animal Fluency Test (AFT), the Digit Symbol Substitution test (DSST), <em>Z</em>-scores, and 51 %, 62 %, 63 %, 93 % higher odds ratio (OR) of lower performance in CERAD, AFT, DSST, and p-MCI, respectively. PA was independently associated with higher cognitive function, with a 1.41, 3.37, and 0.52 higher score in AFT, DSST, <em>Z</em>-scores, and 28 %, 51 %, 41 % lower ORs of lower performance in CERAD and DSST and p-MCI, respectively. Active &amp; Anti-inflammatory was always positively associated with cognitive function, with a 1.42, 2.69, 5.47, and 1.04 higher score for CERAD, AFT, DSST, and <em>Z</em>-score, a 58 %, 56 %, 74 %, 76 % lower ORs of lower performance in CERAT, AFT, DSST, and p-MCI, respectively, which elicited the maximum compared to other joints.</p></div><div><h3>Conclusion</h3><p>Adhering to both active PA and anti-inflammatory diet is recommended for cognitive management in older adults. Sticking to either active PA or anti-inflammatory diet also shows potential cognitive benefits, with the diet possibly playing more vital role.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"91 ","pages":"Pages 52-59"},"PeriodicalIF":4.1,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163817","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":"Addressing the surge in suicide attempts among Iranian physicians: A call for systemic and cultural reforms","authors":"Mohsen Khosravi","doi":"10.1016/j.genhosppsych.2024.09.002","DOIUrl":"https://doi.org/10.1016/j.genhosppsych.2024.09.002","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"10 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190414","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":"Assessing the efficacy and safety of combined buspirone and venlafaxine treatment in late-life depression accompanied by cognitive impairment: A randomized controlled trial","authors":"ShuJia Hu,&nbsp;Ke Chen,&nbsp;QiuXia Xu,&nbsp;Fei Wang,&nbsp;WanQiu Na","doi":"10.1016/j.genhosppsych.2024.09.001","DOIUrl":"10.1016/j.genhosppsych.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><p>Late-life depression, often accompanied by cognitive impairment, poses significant clinical challenges owing to its complex etiology and diverse manifestations. While antidepressants like venlafaxine and anxiolytics such as buspirone are effective for treating depression, their effects on cognitive function remain less well-understood. With the aging population increasingly experiencing geriatric depression, there is an urgent need for innovative treatment approaches that address both depressive symptoms and cognitive impairments.</p></div><div><h3>Objective</h3><p>This study aimed to evaluate the clinical efficacy and safety of combined buspirone and venlafaxine therapy in elderly patients diagnosed with geriatric depression accompanied by cognitive impairment.</p></div><div><h3>Methods</h3><p>A 12-week, randomized controlled trial was conducted involving 170 elderly patients. Participants were randomized into two groups: one receiving venlafaxine alone (control group) and the other receiving a combination of venlafaxine and buspirone (experimental group). The primary analysis was performed using an Intent-to-Treat (ITT) approach with mixed-effects linear models to assess changes in depressive symptoms, cognitive function, and anxiety levels. A supplementary Per-Protocol (PP) analysis, utilizing repeated measures ANOVA, was also conducted.</p></div><div><h3>Results</h3><p>The ITT analysis showed that the combination therapy significantly reduced depressive symptoms, as indicated by the HAMD-17 scores (<em>p</em> = 0.033 at week 12). Cognitive function, as measured by MoCA scores, also improved significantly in the experimental group by week 12 (<em>p</em> = 0.025). However, no statistically significant differences were observed in anxiety reduction between the groups (<em>p</em> = 0.127). The PP analysis confirmed these findings, demonstrating consistent improvements in depressive symptoms and cognitive function, particularly in those who completed the full course of treatment. The incidence of adverse events was comparable between groups, primarily mild and manageable symptoms like dry mouth, dizziness, and fatigue.</p></div><div><h3>Conclusion</h3><p>The combination of buspirone and venlafaxine was found to be effective in reducing depressive symptoms and enhancing cognitive function in elderly patients with geriatric depression. However, the long-term benefits, especially regarding anxiety reduction, require further investigation. Future studies should consider larger sample sizes, longer follow-up periods, and the inclusion of placebo controls to fully assess the efficacy and safety of this treatment approach.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"91 ","pages":"Pages 1-10"},"PeriodicalIF":4.1,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145518","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":"Diagnosis and treatment of Wernicke's encephalopathy: A systematic literature review","authors":"","doi":"10.1016/j.genhosppsych.2024.04.012","DOIUrl":"10.1016/j.genhosppsych.2024.04.012","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"90 ","pages":"Pages 176-177"},"PeriodicalIF":4.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859117","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":"Retrospective descriptive analysis of an urban pediatric collaborative care program","authors":"","doi":"10.1016/j.genhosppsych.2024.05.005","DOIUrl":"10.1016/j.genhosppsych.2024.05.005","url":null,"abstract":"<div><h3>Objective</h3><p>The prevalence of mental health conditions in pediatric patients in the United States is approximately 15%. Concerningly, nearly half go untreated, with lower treatment rates among children of color. Collaborative care can increase access to care and has an emerging evidence base for pediatrics. We present retrospective results from a collaborative care program that accepted referrals for a variety of conditions.</p></div><div><h3>Methods</h3><p>Pediatric patients seen in an academic, urban collaborative care program from July 2019 to December 2021 were tracked in a registry. Demographics, presenting problem(s), symptoms, treatment, and discharge dispositions were examined. Descriptive data were analyzed, including changes in reported symptoms via paired <em>t</em>-tests.</p></div><div><h3>Results</h3><p>Three hundred nineteen patients were seen. Racial and ethnic diversity in our clinic's population was similar to that of the surrounding community, with half belonging to a minoritized racial or ethnic group. Symptom comparisons demonstrated clinically and statistically significant improvements from intake to discharge.</p></div><div><h3>Conclusion</h3><p>Collaborative care can improve access to care and outcomes for a diverse pediatric population. Our clinic served racial and ethnic patient populations that were representative of the demographics of the metropolitan area. Further study is necessary to determine if collaborative care increases access for these underserved groups.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"90 ","pages":"Pages 181-182"},"PeriodicalIF":4.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904449","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":"Elevated rates of GI-focused inflammatory illnesses in trichotillomania and skin picking disorder: A survey study","authors":"","doi":"10.1016/j.genhosppsych.2024.06.002","DOIUrl":"10.1016/j.genhosppsych.2024.06.002","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"90 ","pages":"Pages 194-195"},"PeriodicalIF":4.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305756","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}