General hospital psychiatry最新文献

{"title":"Large decrease in posttraumatic stress disorder severity and cardiovascular disease outcomes","authors":"Joanne Salas ,&nbsp;Poorva Sheth ,&nbsp;Beth E. Cohen ,&nbsp;Kenneth E. Freedland ,&nbsp;Allan S. Jaffe ,&nbsp;Paula P. Schnurr ,&nbsp;Matthew Friedman ,&nbsp;Patrick J. Lustman ,&nbsp;Jeffrey F. Scherrer","doi":"10.1016/j.genhosppsych.2025.04.011","DOIUrl":"10.1016/j.genhosppsych.2025.04.011","url":null,"abstract":"<div><h3>Background</h3><div>Posttraumatic stress disorder (PTSD) is associated with risk for cardiovascular disease (CVD). Improved physical health often follows large decreases in PTSD severity, but it is not known if better CVD outcomes follow PTSD improvement in patients with comorbid PTSD and CVD.</div></div><div><h3>Methods</h3><div>De-identified medical record data between 2011 and 2022 was used to create a cohort of 7120 Veterans Health Administration patients with PTSD and comorbid CVD. The exposure was clinically meaningful PTSD improvement defined as ≥20-point PTSD Checklist (PCL) decrease. Entropy balance controlled for confounding. Cox proportional hazard models estimated the association between clinically meaningful PCL decrease and CVD outcomes: myocardial infarction or revascularization procedure, all-cause mortality, and stroke.</div></div><div><h3>Results</h3><div>About half (52.2 %) of the sample was 65–80 years of age, 95.5 % were male, 17.3 % identified as Black and 79.2 % as White race. Clinically meaningful PTSD improvement occurred for 20.4 % of patients. After controlling for confounding, those with vs. without clinically meaningful PTSD improvement did not significantly differ on risk for myocardial infarction or revascularization procedure (HR = 1.07; 95 %CI:0.94–1.20), all-cause mortality (HR = 1.02; 95 %CI:0.89–1.17), and stroke (HR = 1.10; 95 %CI:0.96–1.26). Neither race, age nor depression significantly modified the association of PTSD improvement and risk for adverse CVD outcomes.</div></div><div><h3>Conclusions</h3><div>In this sample of veterans, large reductions in PTSD severity were not associated with better or worse CVD outcomes. Research is needed to determine if clinically meaningful PTSD improvement and the lack of association with CVD outcomes is seen in other populations of patients with comorbid PTSD and CVD.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"95 ","pages":"Pages 102-108"},"PeriodicalIF":4.1,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903596","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":"Ethnic disparities in rapid tranquillisation use and explanations in adult mental health emergency settings?","authors":"Martin Locht Pedersen ,&nbsp;Alessio Bricca ,&nbsp;John Baker ,&nbsp;Ole Schjerning ,&nbsp;Trine Munk-Olsen ,&nbsp;Frederik Alkier Gildberg","doi":"10.1016/j.genhosppsych.2025.04.014","DOIUrl":"10.1016/j.genhosppsych.2025.04.014","url":null,"abstract":"<div><h3>Objective</h3><div>Ethnicity is a frequently reported risk factor for rapid tranquillisation (RT) use in mental health. We aimed to investigate the association between ethnicity and RT use in adult mental health emergency settings and explore potential explanations for the relationship between ethnicity and RT use in these settings.</div></div><div><h3>Methods</h3><div>Studies were included if they reported the association between ethnicity and RT use in adult mental health emergency settings. Searches were conducted across six databases and in grey sources and references until 15 April 2024. A narrative synthesis was performed and, in addition, a random-effects model was used for meta-analysis, with odds ratio as the measure. GRADE was applied to evaluate the overall certainty of evidence. Potential explanations for RT use in relation to ethnicity were also synthesised narratively.</div></div><div><h3>Results</h3><div>Five studies from Norway (<em>n</em> = 1), Spain (n = 1) and the United States (<em>n</em> = 3) were included (14,777 individuals). Multiple classifications of ethnicity were used, with White, non-Hispanic and native-born serving as the ethnic majority group compared to ethnic minority counterparts. Overall, ethnic minorities in adult mental health emergency settings were non-statistically more likely to receive RT than ethnic majority populations. The overall certainty of evidence was deemed as low according to GRADE.</div></div><div><h3>Conclusion</h3><div>While RT use was not statistically significantly higher among ethnic minorities overall, Black individuals, as a specific ethnic group, had significantly increased odds of experiencing RT compared to ethnic majority populations. Additional research is necessary to confirm these findings and better understand the reasons behind these disparities through valid explanations.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"95 ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903595","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":"The impact of multimorbidity on suicidal behaviour: A systematic review and meta-analysis","authors":"Richmond Opoku ,&nbsp;Adwoa Konadu Mensah ,&nbsp;Mintu Nath","doi":"10.1016/j.genhosppsych.2025.04.008","DOIUrl":"10.1016/j.genhosppsych.2025.04.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Multimorbidity, the co-occurrence of multiple health conditions, is increasingly recognised as a significant public health concern. While the association between multimorbidity and suicidal thoughts is well-documented, its relationship with suicidal behaviour remains underexplored. This study aims to quantify the association between multimorbidity and both suicide attempts and suicide mortality.</div></div><div><h3>Methods</h3><div>We searched Medline, PsycINFO, and Scopus databases for studies published from January 1990 up to July 2024. We applied prespecified eligibility criteria to select studies for inclusion. To assess the risk of bias, we used the Mixed Methods Appraisal Tool. We conducted meta-analyses using random-effects models and assessed heterogeneity with Cochran's <em>Q</em> and <em>I</em>^<em>2</em> statistics. We evaluated publication bias using funnel plots and Egger's test. Sub-group analysis was conducted incorporating potential moderator variables.</div></div><div><h3>Results</h3><div>Out of 2202 identified records, 38 studies were included in the analysis. Participants with multimorbidity were over five times more likely to attempt suicide compared to those without multimorbidity (pooled odds ratio [OR] = 5.31; 95 % confidence interval [CI] = 3.98, 7.09; <em>I</em>^<em>2</em> = 94.9 %). Multimorbidity was associated with an 83 % increased likelihood of suicide mortality (pooled OR = 1.83; 95 % CI = 1.21, 2.77; <em>I</em>^<em>2</em> = 99.9 %). Mental multimorbidity was associated with the highest odds of suicide attempts (OR = 6.96; 95 % CI = 4.94, 9.81; <em>I</em>^<em>2</em> = 81.8 %), with higher odds also observed in studies with single disease comparator (OR = 6.16; 95 % CI = 3.68, 10.31; <em>I</em>^<em>2</em> = 95.5 %), and across both high income and low-middle income regions. For suicide mortality, significant associations were found in studies assessing physical-mental multimorbidity (OR = 2.32; 95 % CI = 1.14, 4.71; <em>I</em>^<em>2</em> = 99.8 %), studies from Europe/USA and Asia, and those using a mixed comparator group, with additional significant effects noted by study design, publication year, covariate adjustment, and risk of bias.</div></div><div><h3>Conclusions</h3><div>Multimorbidity significantly increases the risk of both suicide attempts and suicide mortality. We recommend enhanced suicide risk assessment among patients with multiple chronic conditions, especially when mental health diagnoses are present.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"95 ","pages":"Pages 80-92"},"PeriodicalIF":4.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902226","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":"Evidence of physical deconditioning during psychiatric hospitalization in a Veteran sample","authors":"Laura E. Ong ,&nbsp;Gilbert Ramirez ,&nbsp;Steven H. Woodward","doi":"10.1016/j.genhosppsych.2025.04.009","DOIUrl":"10.1016/j.genhosppsych.2025.04.009","url":null,"abstract":"<div><div>Prior observations of low physical activity in psychiatric inpatient care suggest a risk of physical deconditioning, but to date no studies have explicitly investigated this possibility by measuring change in cardiovascular fitness over the course of hospitalization. The present study used mattress actigraphy to obtain a passive measure of sleep heart rate (sHR) among a sample of 111 male Veterans receiving treatment for PTSD at the VA Palo Alto Health Care System Trauma Recovery Program (TRP). A linear mixed-effect regression model indicated that sHR significantly increased over nights hospitalized, though this effect was attenuated among those who participated at least once in a voluntary cycling program. Conversely, higher BMI at intake was associated with greater increases in sHR over nights. These findings provide evidence of physical deconditioning in the context of residential psychiatric treatment, while suggesting that at least some patients are protected from its impacts. Whole health interventions that promote exercise in tandem with mental health treatment may help to counteract physical deconditioning in psychiatric inpatient settings and should be designed to support patients of diverse fitness levels.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"95 ","pages":"Pages 109-113"},"PeriodicalIF":4.1,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911694","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":"Trauma and PTSD symptoms in a drug abuse service center in Hong Kong","authors":"Hong Wang Fung","doi":"10.1016/j.genhosppsych.2025.04.012","DOIUrl":"10.1016/j.genhosppsych.2025.04.012","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"95 ","pages":"Pages 65-66"},"PeriodicalIF":4.1,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882954","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":"Acupuncture for alcohol use disorder: Research status and potential strategies to improve therapeutic efficacy","authors":"Han Gao ,&nbsp;Yixuan Jin ,&nbsp;Guan-Hua Lv ,&nbsp;Rongwei Huang","doi":"10.1016/j.genhosppsych.2025.04.010","DOIUrl":"10.1016/j.genhosppsych.2025.04.010","url":null,"abstract":"<div><div>Alcohol use disorder (AUD) is a prevalent, chronic relapsing substance use disorder, with its prevalence increasing worldwide, along with socioeconomic development. Given the limitations of conventional AUD treatments, including the variable efficacy of pharmacotherapy and implementation challenges of some psychotherapy methods, researchers have increasingly investigated acupuncture as a potential adjunctive therapy. Acupuncture is a traditional complementary therapy that has shown potential in managing mental and behavioral disorders. While its cost-effectiveness and accessibility vary across healthcare systems, preliminary evidence suggests adjunctive benefits for AUD. Through modulation of the dopaminergic and opioid systems and the hypothalamic–pituitary–adrenal axis, acupuncture may reduce alcohol consumption and cravings, thereby facilitating AUD management and alleviating associated mental health issues such as anxiety, depression, and insomnia. This review investigated and stratified commonly used acupoints in preclinical and clinical studies, offering recommendations for enhanced application and investigation of acupuncture treatment for AUD. The paucity of research in this domain warrants further exploration through well-structured research initiatives.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"95 ","pages":"Pages 67-77"},"PeriodicalIF":4.1,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898769","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":"Diagnostic yield of laboratory testing in hospitalized older adults with altered mental status","authors":"Izumi Sato ,&nbsp;Hideki Onishi ,&nbsp;Yoshitaka Ooya ,&nbsp;Nozomu Uchida ,&nbsp;Akira Yoshioka ,&nbsp;Mayumi Ishida","doi":"10.1016/j.genhosppsych.2025.04.007","DOIUrl":"10.1016/j.genhosppsych.2025.04.007","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"95 ","pages":"Page 62"},"PeriodicalIF":4.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870264","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":"The prevalence of suicide ideation, suicide attempt and suicide in borderline personality disorder patients: A systematic review and meta-analysis","authors":"Mohammadmahdi Lak ,&nbsp;Shima Shakiba ,&nbsp;Behrooz Dolatshahi ,&nbsp;Mohammad Saatchi ,&nbsp;Mohammadamin Shahrbaf ,&nbsp;Atefeh Jafarpour","doi":"10.1016/j.genhosppsych.2025.04.005","DOIUrl":"10.1016/j.genhosppsych.2025.04.005","url":null,"abstract":"<div><h3>Background</h3><div>Borderline personality disorder (BPD) is associated with a high risk of suicidality, including suicide ideation, suicide attempts, and suicide. This meta-analysis aims to determine the lifetime prevalence of these dimensions in patients with BPD and to identify associated factors to inform clinical practice and intervention strategies.</div></div><div><h3>Methods</h3><div>We searched PubMed, Scopus, Web of Science, and Embase for observational articles (cross-sectional, cohort, longitudinal and case-control) reporting suicide ideation, suicide attempts, and suicide in patients with BPD. Data including age, sex, diagnostic criteria, inpatient/outpatient care, comorbidity, and rates of suicide ideation, suicide attempts, and suicide were extracted. A pooled analysis with a random effects model was performed using STATA.</div></div><div><h3>Results</h3><div>35 studies including 34,832 patients with BPD were included in the final analysis. The pooled rate of suicidal ideation, suicide attempts, and suicides in patients with BPD was 80 % (95 % CI: 61 %–94 %), 52 % (95 % CI: 47 %–58 %), and 6 % (95 % CI: 4 %–8 %), respectively. The younger age group of BPD patients had a significantly higher lifetime prevalence of suicide ideation, and suicide attempt (<em>p</em> &lt; 0.001). The inpatient group of BPD patients had a significantly higher lifetime prevalence of suicidal attempt (<em>p</em> &lt; 0.001), while the outpatient group had a significantly higher lifetime prevalence of suicide (<em>p</em> = 0.003).</div></div><div><h3>Conclusion</h3><div>BPD carries a high suicide risk, influenced by factors like age and clinical setting, while the impact of comorbid depression remains unclear. Future research should standardize diagnostics and use longitudinal studies to better understand and mitigate suicide risk in BPD.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"95 ","pages":"Pages 52-61"},"PeriodicalIF":4.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870263","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":"Red flag: A notable proportion of anti-NMDAR encephalitis cases may be admitted to psychiatric units in general hospitals","authors":"Michitaka Funayama ,&nbsp;Hisashi Wada ,&nbsp;Risa Hirata ,&nbsp;Takaki Akahane ,&nbsp;Yusuke Hasegawa ,&nbsp;Naoko Satake ,&nbsp;Shigeki Sato ,&nbsp;Hiraki Koishikawa ,&nbsp;Shigeru Nohara ,&nbsp;Naohisa Tsujino ,&nbsp;Ken Wada ,&nbsp;On Kato ,&nbsp;Shin Yokoyama ,&nbsp;Hirokazu Kumazaki ,&nbsp;Katsuji Nishimura","doi":"10.1016/j.genhosppsych.2025.04.006","DOIUrl":"10.1016/j.genhosppsych.2025.04.006","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"95 ","pages":"Pages 41-43"},"PeriodicalIF":4.1,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855772","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":"Five-year survival following a non-small-cell lung cancer diagnosis among Veterans Health Administration patients with schizophrenia and bipolar disorder","authors":"Anna L. Philibert ,&nbsp;Benjamin R. Szymanski ,&nbsp;Phoebe A. Tsao ,&nbsp;Daniel W. Bradford ,&nbsp;Nicholas W. Bowersox","doi":"10.1016/j.genhosppsych.2025.04.004","DOIUrl":"10.1016/j.genhosppsych.2025.04.004","url":null,"abstract":"<div><h3>Objective</h3><div>Veterans with schizophrenia or bipolar disorder (SZ/BP) experience excess mortality due to several reasons, including cancer. We evaluated whether disparities exist in stage of non-small-cell lung cancer (NSCLC) diagnosis and survival between Veterans Health Administration (VHA) patients with and without SZ/BP.</div></div><div><h3>Method</h3><div>This retrospective evaluation used VHA data to identify patients newly diagnosed with NSCLC from 2005 to 2014. Bivariate analyses compared NSCLC stage at diagnosis by SZ/BP status. Kaplan-Meier and adjusted Cox proportional hazards regression analyses examined differences in survival by SZ/BP status. Meaningful differences were assessed using statistical significance, <em>p</em> &lt; .01, and effect sizes of least 0.2 less/greater than 1.</div></div><div><h3>Results</h3><div>The cohort included 64,269 VHA patients with newly diagnosed NSCLC. These included 1605 (2.5 %) patients with schizophrenia and 1099 (1.7 %) with bipolar disorder. Stage at diagnosis did not meaningfully differ between patients with and without SZ/BP. After adjusting for stage of diagnosis and other factors, schizophrenia, but not bipolar disorder, was associated with an increased risk of five-year all-cause mortality compared to no SZ/BP (schizophrenia: HR 1.22, 95 % CI 1.14–1.30; bipolar: HR 1.01, 95 % CI 0.94–1.10).</div></div><div><h3>Conclusions</h3><div>VHA patients diagnosed with NSCLC who had schizophrenia experienced greater mortality compared to those without SZ/BP, despite no meaningful differences between the two groups in stage of NSCLC at diagnosis. Further work to understand drivers of this difference (e.g., access to NSCLC treatment) and subsequent interventions are needed.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"95 ","pages":"Pages 44-51"},"PeriodicalIF":4.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859259","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}