Harvard Review of Psychiatry最新文献_第10页

Does Hippocampal Volume in Patients with Posttraumatic Stress Disorder Vary by Trauma Type? 创伤后应激障碍患者的海马体积是否因创伤类型而异?

IF 3.8 4区医学

Harvard Review of Psychiatry Pub Date : 2022-02-16 DOI: 10.1097/HRP.0000000000000328

Cecilia A. Hinojosa

{"title":"Does Hippocampal Volume in Patients with Posttraumatic Stress Disorder Vary by Trauma Type?","authors":"Cecilia A. Hinojosa","doi":"10.1097/HRP.0000000000000328","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000328","url":null,"abstract":"Abstract Posttraumatic stress disorder (PTSD) is a debilitating disorder that can develop after experiencing a traumatic event and is, in part, characterized by memory disturbances. Given its important role in learning and memory, the hippocampus has been studied extensively in PTSD using volumetric neuroimaging techniques. However, the results of these studies are mixed. The variability in findings across studies could arise from differences in samples with regard to trauma type, but this connection has not yet been formally assessed. To assess this question, we conducted (1) mixed-effects meta-analyses to replicate previous meta-analytic findings of significant differences in hippocampal volumes in PTSD groups versus two different types of control groups (trauma-exposed and -unexposed groups), and (2) mixed-effects subgroup and meta-regression analyses to determine whether trauma type moderated these hippocampal volume differences. Overall, the PTSD groups showed significantly smaller right hippocampal volumes than both control groups and significantly smaller left hippocampal volumes than trauma-unexposed control groups. Subgroup and meta-regression analyses revealed that trauma type did not moderate the effect seen between PTSD and trauma-exposed non-PTSD groups but did moderate the effect between the PTSD and trauma-unexposed control groups: studies that contained participants with PTSD related to combat trauma exhibited significantly smaller effect sizes for right hippocampal volumes compared to the interpersonal violence and “other” trauma-type groups with PTSD. These findings suggest that trauma type may moderate hippocampal volume in trauma-exposed individuals but not in those with PTSD.","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 1","pages":"118 - 134"},"PeriodicalIF":3.8,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45882683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Brick by Brick: Building a Transdiagnostic Understanding of Inflammation in Psychiatry. 一砖一瓦:在精神病学中建立对炎症的跨诊断理解。

IF 3.8 4区医学

Harvard Review of Psychiatry Pub Date : 2022-01-01 DOI: 10.1097/HRP.0000000000000326

David S Thylur, David R Goldsmith

{"title":"Brick by Brick: Building a Transdiagnostic Understanding of Inflammation in Psychiatry.","authors":"David S Thylur, David R Goldsmith","doi":"10.1097/HRP.0000000000000326","DOIUrl":"10.1097/HRP.0000000000000326","url":null,"abstract":"Abstract: Inflammatory phenomena are found in many psychiatric disorders-notably, depression, schizophrenia, and posttraumatic stress disorder. Inflammation has been linked to severity and treatment resistance, and may both contribute to, and result from, the pathophysiology of some psychiatric illnesses. Emerging research suggests that inflammation may contribute to symptom domains of reward, motor processing, and threat reactivity across different psychiatric diagnoses. Reward-processing deficits contribute to motivational impairments in depression and schizophrenia, and motor-processing deficits contribute to psychomotor slowing in both depression and schizophrenia. A number of experimental models and clinical trials suggest that inflammation produces deficits in reward and motor processing through common pathways connecting the cortex and the striatum, which includes the nucleus accumbens, caudate nucleus, and putamen.The observed effects of inflammation on psychiatric disorders may cut across traditional conceptualizations of psychiatric diagnoses. Further study may lead to targeted immunomodulating treatments that address difficult-to-treat symptoms in a number of psychiatric disorders. In this review, we use a Research Domain Criteria framework to discuss proposed mechanisms for inflammation and its effects on the domains of reward processing, psychomotor slowing, and threat reactivity. We also discuss data that support contributing roles of metabolic dysregulation and sex differences on the behavioral outcomes of inflammation. Finally, we discuss ways that future studies can help disentangle this complex topic to yield fruitful results that will help advance the field of psychoneuroimmunology.","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 1","pages":"40-53"},"PeriodicalIF":3.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8849593/pdf/nihms-1759932.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10806618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Introduction. 介绍。

IF 3.8 4区医学

Harvard Review of Psychiatry Pub Date : 2022-01-01 DOI: 10.1097/HRP.0000000000000324

Paulo Lizano

引用次数: 0

The Effects of Peripheral Inflammation on the Brain-A Neuroimaging Perspective. 外周炎症对大脑的影响——神经影像学的视角。

IF 3.8 4区医学

Harvard Review of Psychiatry Pub Date : 2022-01-01 DOI: 10.1097/HRP.0000000000000323

Caitlin E Millett, Katherine E Burdick, Marek R Kubicki

{"title":"The Effects of Peripheral Inflammation on the Brain-A Neuroimaging Perspective.","authors":"Caitlin E Millett, Katherine E Burdick, Marek R Kubicki","doi":"10.1097/HRP.0000000000000323","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000323","url":null,"abstract":"Abstract: In the field of neuropsychiatry, neuroinflammation is one of the prevailing hypotheses to explain the pathophysiology of mood and psychotic disorders. Neuroinflammation encompasses an ill-defined set of pathophysiological processes in the central nervous system that cause neuronal or glial atrophy or death and disruptions in neurotransmitter signaling, resulting in cognitive and behavioral changes. Positron emission tomography for the brain-based translocator protein has been shown to be a useful tool to measure glial activation in neuropsychiatric disorders. Recent neuroimaging studies also indicate a potential disruption in the choroid plexus and blood-brain barrier, which modulate the transfer of ions, molecules, toxins, and cells from the periphery into the brain. Simultaneously, peripheral inflammatory markers have consistently been shown to be altered in mood and psychotic disorders. The crosstalk (i.e., the communication between peripheral and central inflammatory pathways) is not well understood in these disorders, however, and neuroimaging studies hold promise to shed light on this complex process. In the current Perspectives article, we discuss the neuroimaging insights into neuroimmune crosstalk offered in selected works. Overall, evidence exists for peripheral immune cell infiltration into the central nervous system in some patients, but the reason for this is unknown. Future neuroimaging studies should aim to extend our knowledge of this system and the role it likely plays in symptom onset and recurrence.","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 1","pages":"54-58"},"PeriodicalIF":3.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8979074/pdf/nihms-1753372.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10806613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Neuroinflammation, Early-Life Adversity, and Brain Development. 神经炎症、早期生活逆境和大脑发育。

IF 3.8 4区医学

Harvard Review of Psychiatry Pub Date : 2022-01-01 DOI: 10.1097/HRP.0000000000000325

Susan L Andersen

{"title":"Neuroinflammation, Early-Life Adversity, and Brain Development.","authors":"Susan L Andersen","doi":"10.1097/HRP.0000000000000325","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000325","url":null,"abstract":"Abstract: The overarching objective is to review how early exposure to adversity interacts with inflammation to alter brain maturation. Both adversity and inflammation are significant risk factors for psychopathology. Literature relevant to the effects of adversity in children and adolescents on brain development is reviewed. These studies are supported by research in animals exposed to species-relevant stressors during development. While it is known that exposure to adversity at any age increases inflammation, the effects of inflammation are exacerbated at developmental stages when the immature brain is uniquely sensitive to experiences. Microglia play a vital role in this process, as they scavenge cellular debris and prune synapses to optimize performance. In essence, microglia modify the synapse to match environmental demands, which is necessary for someone with a history of adversity. Overall, by piecing together clinical and preclinical research areas, what emerges is a picture of how adversity uniquely sculpts the brain. Microglia interactions with the inhibitory neurotransmitter GABA (specifically, the subtype expressing parvalbumin) are discussed within contexts of development and adversity. A review of inflammation markers in individuals with a history of abuse is combined with preclinical studies to describe their effects on maturation. Inconsistencies within the literature are discussed, with a call for standardizing methodologies relating to the age of assessing adversity effects, measures to quantify stress and inflammation, and more brain-based measures of biochemistry. Preclinical studies pave the way for interventions using anti-inflammation-based agents (COX-2 inhibitors, CB2 agonists, meditation/yoga) by identifying where, when, and how the developmental trajectory goes awry.","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 1","pages":"24-39"},"PeriodicalIF":3.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8820591/pdf/nihms-1758542.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10806614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

Altered Mental Status in Patients Hospitalized with COVID-19: Perspectives from Neurologic and Psychiatric Consultants. COVID-19住院患者的精神状态改变:来自神经病学和精神病学顾问的观点

IF 3.8 4区医学

Harvard Review of Psychiatry Pub Date : 2021-11-01 DOI: 10.1097/HRP.0000000000000298

Daniel Talmasov, Sean M Kelly, Ariane Lewis, Adrienne D Taylor, Lindsey Gurin

{"title":"Altered Mental Status in Patients Hospitalized with COVID-19: Perspectives from Neurologic and Psychiatric Consultants.","authors":"Daniel Talmasov, Sean M Kelly, Ariane Lewis, Adrienne D Taylor, Lindsey Gurin","doi":"10.1097/HRP.0000000000000298","DOIUrl":"10.1097/HRP.0000000000000298","url":null,"abstract":"History of Present Illness A 62-year-old man with a past medical history of asthma and opioid use disorder on methadone developed respiratory symptoms in mid-March, which progressed to subacute respiratory failure by early April. He was diagnosed with COVID-19 by nasopharyngeal RT-PCR and admitted to an academic New York City hospital. The patient was intubated for hypoxemia, sedated with propofol and fentanyl, and admitted to themedical intensive care unit (MICU). Laboratory testing revealed elevated serum levels of D-dimer at 1143 ng/mL (reference level <500 ng/mL), C-reactive protein at 73.70 mg/L (reference level <8 mg/L), and ferritin at 554 ng/mL, together reflecting a pattern of elevated inflammatory markers associated with severe COVID-19 infection. The patient’s prolonged hospital course was complicated by numerous infections, including methicillin-resistant Staphylococcus aureus bacteremia (hospital day 8), vancomycinresistant Enterococus bacteremia (hospital day 13), multidrugresistant Enterobacter pneumonia (hospital day 14), and a Pseudomonas-positive urinary tract infection (hospital day 17), all of which were treated with multiple courses of antibiotics. Attempts to wean sedation and ventilatory support were complicated by the above infections and,when sedationwasweaned, by ventilator dyssynchrony and agitation, resulting in the uptitration of propofol and maintenance on mechanical ventilation. Because of a need for prolonged respiratory support, the patient required tracheostomy on hospital day 10. By hospital day 14, the patient had developed acute kidney injury with creatinine elevated to 2.1 mg/dL, from a baseline 0.8 mg/dL at time of admission.","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"29 6","pages":"422-430"},"PeriodicalIF":3.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575114/pdf/hrp-29-422.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38962192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acting Out or Acting In: A Case of Dangerous, Sexual, Self-Injurious Behavior. 表演或表演:一个危险的，性的，自残行为的案例。

IF 3.8 4区医学

Harvard Review of Psychiatry Pub Date : 2021-11-01 DOI: 10.1097/HRP.0000000000000307

Varsha Radhakrishnan, Matthew C Johnson, Marta D Herschkopf, Marshall Forstein, Fabien M Saleh, Elizabeth R Dunn

引用次数: 0

Digital Phenotyping in Child and Adolescent Psychiatry: A Perspective. 数字表现型在儿童和青少年精神病学:一个视角。

IF 3.8 4区医学

Harvard Review of Psychiatry Pub Date : 2021-11-01 DOI: 10.1097/HRP.0000000000000310

Melanie Nisenson, Vanessa Lin, Meredith Gansner

{"title":"Digital Phenotyping in Child and Adolescent Psychiatry: A Perspective.","authors":"Melanie Nisenson, Vanessa Lin, Meredith Gansner","doi":"10.1097/HRP.0000000000000310","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000310","url":null,"abstract":"Abstract: Digital phenotyping (DP) provides opportunities to study child and adolescent psychiatry from a novel perspective. DP combines objective data obtained from digital sensors with participant-generated \"active data,\" in order to understand better an individual's behavior and environmental interactions. Although this new method has led to advances in adult psychiatry, its use in child psychiatry has been more limited. This review aims to demonstrate potential benefits of DP methodology and passive data collection by reviewing studies specifically in child and adolescent psychiatry. Twenty-six studies were identified that collected passive data from four different categories: accelerometer/actigraph data, physiological data, GPS data, and step count. Study topics ranged from the associations between manic symptomology and cardiac parameters to the role of daily emotions, sleep, and social interactions in treatment for pediatric anxiety. Reviewed studies highlighted the diverse ways in which objective data can augment naturalistic self-report methods in child and adolescent psychiatry to allow for more objective, ecologically valid, and temporally resolved conclusions. Though limitations exist-including a lack of participant adherence and device failure and misuse-DP technology may represent a new and effective method for understanding pediatric cognition, behavior, disease etiology, and treatment efficacy.","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"29 6","pages":"401-408"},"PeriodicalIF":3.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39225570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Challenges and Strategies to Mitigate Problematic Social Media Use in Psychiatric Disorders. 缓解精神疾病中社交媒体使用问题的挑战和策略。

IF 3.8 4区医学

Harvard Review of Psychiatry Pub Date : 2021-11-01 DOI: 10.1097/HRP.0000000000000308

Christina L Macenski, Matthew P Hamel, Christopher J McDougle, Robyn P Thom

{"title":"Challenges and Strategies to Mitigate Problematic Social Media Use in Psychiatric Disorders.","authors":"Christina L Macenski, Matthew P Hamel, Christopher J McDougle, Robyn P Thom","doi":"10.1097/HRP.0000000000000308","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000308","url":null,"abstract":"Learning objectives: After participating in this activity, learners should be better able to:• Outline and discuss strategies to mitigate problematic social media use in psychiatric disorders• Identify solutions to encourage healthy use.Abstract: Social media has been found to contribute to a variety of different psychiatric disorders, with recent research showing a complex relationship between social media use and mental health outcomes. This article outlines how the strategies that social media sites utilize to increase user engagement can differentially affect individuals with psychiatric disorders, and proposes solutions that may promote more healthy use. With these aims in view, the article (1) delineates the strategies, often unrecognized, that social media sites use to increase user engagement, (2) highlights how these strategies can affect individuals with psychiatric disorders, and (3) proposes novel solutions to encourage healthy use. The first step to creating innovative and universal interventions is to understand the challenges faced by individuals with psychiatric disorders when using social media.","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"29 6","pages":"409-415"},"PeriodicalIF":3.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39290246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Enhancing Quality Supervision for the Delivery of Mental Health Care Through Nonspecialist Clinicians in Resource-Limited Settings. 在资源有限的环境下，通过非专业临床医生加强精神卫生保健服务的质量监督。

IF 3.8 4区医学

Harvard Review of Psychiatry Pub Date : 2021-11-01 DOI: 10.1097/HRP.0000000000000313

Stephanie Collier, Rachel Meyen, Stephanie L Smith, Cidna Valentin, Fr Eddy Eustache

{"title":"Enhancing Quality Supervision for the Delivery of Mental Health Care Through Nonspecialist Clinicians in Resource-Limited Settings.","authors":"Stephanie Collier, Rachel Meyen, Stephanie L Smith, Cidna Valentin, Fr Eddy Eustache","doi":"10.1097/HRP.0000000000000313","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000313","url":null,"abstract":"Abstract: Supervision of nonspecialist clinicians by trained mental health professionals is integral to developing capacity for providing mental health care in low-resource settings. Current supervision efforts in low-resource settings, however, are often variable in quality. Scant published literature addresses how supervision practices affect treatment outcomes; only a few studies have been published on evidence-based supervision methods. Additionally, in low-resource settings many systems-level obstacles exist in providing adequate mental health supervision to nonspecialist clinicians. This article seeks to address psychiatrists' role in providing supervision and promoting quality of care in low-resource settings. We review the literature on evidence-based supervision practices, address obstacles and current practices of providing high-quality mental health supervision in low-resource settings, and weave this knowledge with our experiences learning from the clinicians at Partners in Health in Haiti. We also discuss feasible strategies and provide recommendations for strengthening the supervision process in resource-limited settings.","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"29 6","pages":"390-400"},"PeriodicalIF":3.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39342288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0