Harvard Review of Psychiatry最新文献

{"title":"Religiosity, Spirituality, Meaning-Making, and Suicidality in Psychiatric Patients and Suicide Attempters: A Systematic Review and Meta-Analysis.","authors":"Bart van den Brink, Rianne Roodnat, Ralph C A Rippe, Aaron D Cherniak, Kenny van Lieshout, Sanne G Helder, Arjan W Braam, Hanneke Schaap-Jonker","doi":"10.1097/HRP.0000000000000409","DOIUrl":"10.1097/HRP.0000000000000409","url":null,"abstract":"<p><strong>Learning objective: </strong>After participating in this CME activity, the psychiatrist should be better able to:• Explain current understanding of how religiosity, spirituality, and meaning-making (R/S/M) affect patients with psychiatric diagnoses.</p><p><strong>Introduction: </strong>R/S/M generally protect against suicidality and suicide. Thus far, reviews on the topic have largely been descriptive, and there are no meta-analyses focused on psychiatric patients. This study systematically evaluates all empirical evidence on R/S/M's potential influences on suicidality for psychiatric patients and recent suicide attempters.</p><p><strong>Methods: </strong>A systematic PROSPERO preregistered search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was performed in MEDLINE and PsycInfo. Quantitative studies until 31 December 2022 on R/S/M and suicidality in psychiatric populations and recent suicide attempters were selected; psychological autopsy studies were excluded.</p><p><strong>Results: </strong>The search identified 4,374 studies for screening. This resulted in 108 eligible studies for the systematic review and 75 studies for the meta-analysis, including 231 effect sizes (ES) and 17,561 subjects. Research focused mainly on the emotional, moral, and ritual aspects of R/S/M. Most research was cross-sectional; repeated R/S/M assessments were rarely reported. A combined significant and negative ES (Fisher Z = -0.13, p = .006, equivalent to Cohen's d = -0.26) was found for all good- and fair-quality studies.</p><p><strong>Conclusion: </strong>Overall, R/S/M was associated with lowering suicidality. Maladaptive-distressing dimensions of R/S/M correlated with higher rates of suicidality (e.g., religious struggles). The explanatory value was limited by the predominantly cross-sectional nature of ESs.</p><p><strong>Registration and funding: </strong>PROSPERO registration 2023 CRD42023398692; there was no funding involved.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"32 6","pages":"195-206"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604358","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}

{"title":"Therapeutic Discharge: Thoughtful Approaches to a Complex Practice.","authors":"Jeong Hoo Lee, Jhilam Biswas, Thomas G Gutheil, John R Peteet, Sejal B Shah","doi":"10.1097/HRP.0000000000000410","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000410","url":null,"abstract":"","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"32 6","pages":"228-232"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604361","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}

{"title":"Cariprazine and Cognition in Patients with Schizophrenia and Bipolar Disorder: A Systematic Review.","authors":"Lorena García-Fernández, Verónica Romero-Ferreiro, Inmaculada Peñuelas-Calvo, Miguel A Álvarez-Mon, Mauro Scala, Carmen Romero-Ferreiro, Estela Jiménez López, José Luis Santos, Roberto Rodriguez-Jimenez","doi":"10.1097/HRP.0000000000000411","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000411","url":null,"abstract":"<p><strong>Background: </strong>Cariprazine (CAR), an antipsychotic with partial agonism at the D3 receptor and higher affinity than dopamine, has shown significant procognitive effects in preclinical animal studies. This study systematically reviews CAR's effects on cognitive measures in patients with schizophrenia and bipolar disorder.</p><p><strong>Methods: </strong>Two independent reviewers systematically searched PubMed, Web of Science, Scopus, and the Cochrane Library up to May 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Additional studies were found by hand searching the references of included studies. Eligible studies were randomized controlled trials (RCTs) in English that assessed CAR's effects on cognition in patients with schizophrenia or bipolar disorder. Quality was assessed using the Jadad scale.</p><p><strong>Results: </strong>Out of 139 reports, 5 studies (involving 6,104 patients with schizophrenia or bipolar disorder) were included. In schizophrenia, CAR showed better cognitive outcomes (mainly indirect measures) than placebo (PBO) in both early and late stages. It also outperformed risperidone and aripiprazole in attention-related cognitive tests. In bipolar disorder, CAR improved cognition compared to PBO (also using indirect measures). Most studies found the greatest cognitive benefits with low doses of CAR (1.5-3 mg/d).</p><p><strong>Conclusions: </strong>CAR improved cognitive measures compared to PBO and other D2 antagonists or partial agonists in RCTs, especially in patients with greater baseline impairment. Thus, CAR may be a promising option for enhancing cognition in schizophrenic and bipolar patients; though, more trials using specific cognitive assessment tools are needed.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023485028.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"32 6","pages":"207-217"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604352","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}

{"title":"Psychological Assessment for Gender-Affirming Care in Transgender and Nonbinary Youth: The Companionship Model.","authors":"Joonwoo Lee,Hyun-Hee Kim,Stephanie L Budge","doi":"10.1097/hrp.0000000000000404","DOIUrl":"https://doi.org/10.1097/hrp.0000000000000404","url":null,"abstract":"This article introduces The Companionship Model as a template for conducting ethical and affirming assessment sessions for transgender and nonbinary youths (TNBY) and their guardians. The Companionship Model emphasizes proactive clinical companionship as TNBY and their guardians navigate access to gender-affirming care. The model offers specific action steps for establishing a therapeutic alliance and centers TNBY and their guardians' access to resources based on the informed consent/assent process. In this article, we provide sample session questions and illustrative clinical examples.","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"7 Suppl 1 1","pages":"183-192"},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247745","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}

{"title":"Ketamine in the Treatment of Obsessive-Compulsive Disorder: A Systematic Review: Erratum.","authors":"","doi":"10.1097/HRP.0000000000000408","DOIUrl":"10.1097/HRP.0000000000000408","url":null,"abstract":"","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"32 5","pages":"193"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285867","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}

{"title":"Emotional Eating in Primary Care: Considerations for Assessment and Management.","authors":"Jana DeSimone Wozniak, Hsiang Huang","doi":"10.1097/HRP.0000000000000405","DOIUrl":"10.1097/HRP.0000000000000405","url":null,"abstract":"<p><strong>Learning objectives: </strong>After participating in this CME activity, the psychiatrist should be better able to:• Describe how to identify and address emotional eating in the primary care setting.</p><p><strong>Abstract: </strong>Emotional eating (i.e., eating in response to negative emotional states and stress) is a highly prevalent concern within primary care settings. It is associated with myriad health issues such as the experience of overweight or obesity, increased difficulty losing weight and sustaining weight loss, various eating disorders, diabetes, and heart disease. Given the effects of emotional eating on patient health goals regarding weight loss or management, it is imperative to incorporate interventions that address emotional underpinnings alongside traditional, behaviorally based weight-loss treatment. Ensuring that primary care providers, who represent pivotal frontline touch points for patients interested in weight-related treatment, can identify emotional eating is an important first step in supporting these patients' goals. The primary purpose of this paper is to provide background information and practical guidance for addressing emotional eating in the primary care setting. We summarize theorized biological and psychological mechanisms that underlie emotional eating, and review traditional (i.e., psychological) interventions, with special consideration for adapting available treatments for use in primary care contexts.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":" ","pages":"166-172"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080126","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}

{"title":"Lupus on the Mind: A Case of Psychosis in Uncontrolled Systemic Lupus Erythematosus.","authors":"Harish S Pudukodu,Lauren Goldschen,Shamik Bhattacharyya,Ana Valle,Senada Arabelovic,Sejal Shah,Karli Retzel,Candace H Feldman,Hermioni L Amonoo","doi":"10.1097/hrp.0000000000000403","DOIUrl":"https://doi.org/10.1097/hrp.0000000000000403","url":null,"abstract":"","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"13 1","pages":"173-182"},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247744","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}

{"title":"Announcing the Shelly F. Greenfield MD, MPH Award for Best Manuscript by an Early Career Author.","authors":"Joshua L Roffman","doi":"10.1097/hrp.0000000000000406","DOIUrl":"https://doi.org/10.1097/hrp.0000000000000406","url":null,"abstract":"","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"36 1","pages":"165"},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268283","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}

{"title":"Dysphoric Milk Ejection Reflex (D-MER): A Novel Neuroendocrine Condition with Psychiatric Manifestations.","authors":"Barbara Schildkrout, Lindsey MacGillivray, Shreya Raj, Margo Lauterbach","doi":"10.1097/HRP.0000000000000402","DOIUrl":"10.1097/HRP.0000000000000402","url":null,"abstract":"<p><strong>Learning objectives after participating in this cme activity, readers should be better able to: </strong>• Describe how the symptoms of dysphoric milk ejection reflex (D-MER) affect nursing patients.• Discuss how physicians, psychologists, and clinicians can support their patients experiencing D-MER.</p><p><strong>Abstract: </strong>Dysphoric milk ejection reflex (D-MER) is characterized by a sudden onset of profoundly negative emotions that are temporally linked to milk letdown when breastfeeding or pumping breast milk. These affective experiences have no psychological precipitants and only last for minutes. D-MER is relatively underappreciated in the physician-oriented medical literature, although there are important clinical and public health consequences when a nursing parent experiences unwanted, negative emotions paired with breastfeeding. D-MER can undermine the parent's confidence and may affect bonding with their infant; it may also contribute to weaning earlier than planned. It is especially important for psychiatrists and other health care professionals who may be called upon to evaluate postpartum patients or nursing parents to be knowledgeable about D-MER. This perspective article aims to provide information about D-MER to the psychiatric and broader medical communities, and to underscore the need for additional research on this topic. Drawing on a literature search, the article first traces historical recognition of D-MER as a clinical entity, then summarizes the clinical characteristics of D-MER and recommends an assessment and management approach that emphasizes psychoeducation. The article also discusses factors that have contributed to the underappreciation of this condition, outlines gaps in our understanding, and suggests next steps for epidemiological and clinical research. D-MER is likely a neuroendocrine condition with psychiatric manifestations. Given that it is episodic but with predictable timing, this condition presents a unique opportunity for scientific investigation.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"32 4","pages":"133-139"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590186","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}

{"title":"Psychiatric Hospitals and the Ethics of Salutogenic Design: The Return of Moral Architecture?","authors":"Meghan Crnic, Stephanie Bi, Philip J Candilis, Dominic Sisti","doi":"10.1097/HRP.0000000000000398","DOIUrl":"10.1097/HRP.0000000000000398","url":null,"abstract":"<p><strong>Abstract: </strong>Bioethicists have long been concerned with the mistreatment of institutionalized patients, including those suffering from mental illness. Despite this attention, the built environments of health care settings have largely escaped bioethical analysis. This is a striking oversight given that architects and social scientists agree that buildings reflect and reinforce prevailing social, cultural, and medical attitudes. Architectural choices are therefore ethical choices. We argue that mental health institutions are fertile sites for ethical analysis. Examining the ethics of architecture calls attention to the potential for hospitals to hinder autonomy. Additionally, such examination highlights the salutogenic possibilities of institutional design, that is to care, nurture, and enhance patient and provider well-being.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"32 4","pages":"127-132"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590189","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}