Harvard Review of Psychiatry最新文献

{"title":"Unremitting Suicidality in Borderline Personality Disorder: A Single Case Study and Discussion of Technology in Clinical Care.","authors":"Lois W Choi-Kain, Grace E Murray, Mark J Goldblatt, Chelsey R Wilks, Ipsit V Vahia, Daniel D L Coppersmith, Gabrielle S Ilagan, Boyu Ren","doi":"10.1097/HRP.0000000000000351","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000351","url":null,"abstract":"CASE HISTORYAND TREATMENT This report presents the case of a young woman, “Jane.” The case is followed by commentary from three experts in suicidal or self-destructive behavior and the use of technology in clinical care. Jane is a college-aged female with a diagnosis of borderline personality disorder (BPD) and a history of repetitive self-harm, including head banging and cutting, as well as chronic, unremitting suicidal ideation. Jane had been in an intensive residential program for many months, and during this time she was stepped up to inpatient psychiatric hospitalization multiple times due to concerns about safety. Jane had a history of multiple suicide attempts while in outpatient, residential, and inpatient settings.Most of these attempts occurred on hospital units using methods like self-strangulation with available objects, self-suffocation, and self-starvation. Upon discharge from her last inpatient psychiatric admission, Jane was admitted to an intensive specialized residential program for adult women with borderline and other severe personality disorders. This unit integrates evidence-based treatments includingdialectical behavior therapy (DBT),mentalization based treatment (MBT), and good psychiatric management (GPM). The standard treatment protocol includes daily DBT diary cards, check-ins with the program’s 24-hour counselors,","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 6","pages":"350-360"},"PeriodicalIF":3.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/b0/hrp-30-350.PMC9770128.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10846269","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}

{"title":"Structural and Functional Brain Alterations in Populations with Familial Risk for Depression: A Narrative Review.","authors":"Birce Begum Burhanoglu,&nbsp;Ali Saffet Gonul","doi":"10.1097/HRP.0000000000000350","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000350","url":null,"abstract":"<p><strong>Learning objectives: </strong>After completing this activity, practitioners will be better able to:• Discuss the association between brain alterations and vulnerability or resilience to MDD in people with familial risk• Define how structural and functional brain alterations associated with vulnerability or resilience could lead to a better understanding of the pathophysiology of MDD.</p><p><strong>Aim: </strong>Familial history is associated with an increased risk for major depressive disorder (MDD). Despite the increased risk, some members of the familial high-risk population remain healthy, that is, resilient. Defining the structural and functional brain alterations associated with vulnerability or resilience could lead to a better understanding of the pathophysiology of MDD. This study aimed to review the current literature and discuss the association between brain alterations and vulnerability or resilience to MDD in people with familial risk.</p><p><strong>Methods: </strong>A literature search on MRI studies investigating structural and functional alterations in populations at familial risk for MDD was performed using the PubMed and SCOPUS databases. The search was conducted through June 13, 2022.</p><p><strong>Results: </strong>We reviewed and summarized the data of 72 articles (25 structural MRI, 35 functional MRI, 10 resting-state fMRI, one structural/functional MRI combined, and one structural/functional/resting-state fMRI combined). These findings suggested that resilience in high-risk individuals is related to the amygdala structure, frontal lobe activity, and functional connectivity between the amygdala and multiple frontal regions.</p><p><strong>Conclusion: </strong>Resilient and vulnerable individuals exhibit structural and functional differences in multiple frontal and limbic regions. However, further systematic longitudinal research incorporating environmental factors is required to validate the current findings.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 6","pages":"327-349"},"PeriodicalIF":3.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10553183","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":"(In)Equality and Beyond: Achieving Justice in Gender-Affirming Hormone Initiation.","authors":"Christina L Macenski, Alex S Keuroghlian, Christopher G AhnAllen, Genny Beemyn, Eli Erlick, Jules Gill-Peterson, Joanna Marie Harper, Rebeca Ramos, Daphna Stroumsa, Fernando J Benetti, John A Fromson","doi":"10.1097/HRP.0000000000000349","DOIUrl":"10.1097/HRP.0000000000000349","url":null,"abstract":"<p><strong>Abstract: </strong>The World Professional Association for Transgender Health (WPATH) is an international organization that aims to advocate for transgender and gender-diverse (TGD) people by promoting safe and effective ways to access and deliver healthcare to maximize psychological health and well-being. One way this is achieved is through the WPATH's published Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, a set of guidelines for gender-affirming care that is based on the available science and expert consensus. In anticipation of the release of updated guidelines (Standards of Care Version 8) in 2022 the Radcliffe Institute for Advanced Study at Harvard University hosted an Exploratory Seminar in December 2021 that brought together experts from the United States, Mexico, and the United Kingdom to share knowledge across disciplines in order to propose revisions to the WPATH's updated guidelines. This article shares the workgroup's high-level consensus and recommendations.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 6","pages":"369-372"},"PeriodicalIF":2.5,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10553181","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":"From Alchemy to Psychiatry: A Glimpse into the Ethics and Mental Health Practices of Tenth-Century Muslim Physician Abū Bakr al-Rāzī.","authors":"Rania Awaad,&nbsp;Yusif Salaam Conn,&nbsp;Nahlah Kolkailah,&nbsp;Heba El-Haddad,&nbsp;Sara Ali,&nbsp;Soraya Fereydooni","doi":"10.1097/HRP.0000000000000347","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000347","url":null,"abstract":"TheIslamic Renaissance saw a flourishing and advancement in philosophy, the natural sciences, the humanities, and many other academic disciplines. Though this era is often confined in the historical literature as ranging from the eighth through thirteenth centuries CE, recent research has considered expanding its timeline to the nineteenth century. The early stages of this period were known for the synthesis of previous traditions that later led to the creation of a new canon of knowledge; this new canon heavily influenced those living within the Islamic empire and also those in Europe. In the early years of the Islamic Renaissance, the physician and philosopher Abū Bakr Muhammad ibn Zakarīyā al-Rāzī was a major figure whose works influenced the course of medicine. While he remains well-known to this day for his writings that later influenced the likes of Ibn Sīnā, many of his contributions to the world of psychiatry remain underappreciated. In revisiting the texts and life of al-Rāzī, what emerges is a portrait of a psychiatrist well ahead of his time and whose methodology brought tradition and innovation together as a means of providing the best care to his patients.","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 5","pages":"323-326"},"PeriodicalIF":3.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10861633","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":"Neuromodulation Using Computer-Altered Music to Treat a Ten-Year-Old Child Unresponsive to Standard Interventions for Functional Neurological Disorder.","authors":"Nadia Rajabalee, Kasia Kozlowska, Seung Yeon Lee, Blanche Savage, Clare Hawkes, Daniella Siciliano, Stephen W Porges, Susannah Pick, Souraya Torbey","doi":"10.1097/HRP.0000000000000341","DOIUrl":"10.1097/HRP.0000000000000341","url":null,"abstract":"","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 5","pages":"303-316"},"PeriodicalIF":2.5,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fa/fe/hrp-30-303.PMC9470039.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10861610","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}

{"title":"Prevalence of Posttraumatic Stress Disorder Symptoms Following Traumatic Spinal Cord Injury: A Systematic Review and Meta-analysis.","authors":"Mahmoud Yousefifard,&nbsp;Fatemeh Ramezani,&nbsp;Gholamreza Faridaalaee,&nbsp;Masoud Baikpour,&nbsp;Arian Madani Neishaboori,&nbsp;Alexander R Vaccaro,&nbsp;Mostafa Hosseini,&nbsp;Vafa Rahimi-Movaghar","doi":"10.1097/HRP.0000000000000340","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000340","url":null,"abstract":"<p><strong>Background: </strong>Limited evidence is currently available on the prevalence of posttraumatic stress disorder (PTSD) following traumatic spinal cord injury (SCI). This systematic review and meta-analysis aims to assess the prevalence and geographic distribution of PTSD symptoms after SCI.</p><p><strong>Methods: </strong>After a search in the MEDLINE, Embase, Scopus, and Web of Science databases, two reviewers independently summarized relevant studies published through 20 October 2021. Observational studies were included. The studies were eligible if they assessed PTSD symptoms using standard self-report or clinician-based instruments. Data and results were reported using the overall prevalence and the odds ratio (OR), with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>24 articles (5646 patients) met the inclusion criteria. The prevalence of PTSD symptoms ranged from 6.33% (95% CI, 2.73-13.97) to 61.76% (95% CI, 52.07-70.61). Pooled analysis demonstrated that the overall prevalence of PTSD symptoms in SCI patients was significantly higher in developing countries (41.64%; 95% CI, 31.11-52.55) than in developed countries (19.35%; 95% CI, 14.66-24.51) (OR = 1.24; 95% CI, 1.08-1.42; p = .003). The highest prevalence of PTSD symptoms was reported in South Africa (56.25%; 95% CI, 47.01-65.08), followed by Sri Lanka (45.71%; 95% CI, 30.47-61.81), and Greece (43.55%; 95% CI, 31.94-55.91). By contrast, Norway (6.33%; 95% CI, 2.73-13.97), Switzerland/Germany (8.65%; 95% CI, 4.8-13.42), and Denmark (10.71%; 95% CI, 6.89-16.30) were found to have the lowest prevalence of PTSD symptoms after SCI.</p><p><strong>Conclusion: </strong>Many traumatic SCI patients suffer from PTSD symptoms, and their prevalence seems to be higher in developing countries than in developed countries. These findings underscore the need to consider the psychological aspects of traumatic SCI.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 5","pages":"271-282"},"PeriodicalIF":3.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10861632","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":"Men's Depression, Externalizing, and DSM-5-TR: Primary Signs and Symptoms or Co-occurring Symptoms?","authors":"Simon Rice,&nbsp;Zac Seidler,&nbsp;David Kealy,&nbsp;John Ogrodniczuk,&nbsp;Ian Zajac,&nbsp;John Oliffe","doi":"10.1097/HRP.0000000000000346","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000346","url":null,"abstract":"Major depressive disorder (MDD) is a highly heterogeneous diagnosis wherein the nine MDD criterion signs and symptoms reflect 256 unique symptom combinations. Accordingly, MDD comprises a broad set of phenotypes observed across clinical practice, including primary care. With intensifying global efforts to prevent male suicide, attention has rapidly focused on better understanding men’s experiences of MDD. Pertinent to these efforts is the operationalization of MDD, which is characterized by the two cardinal symptoms of depressed mood and anhedonia (the loss of interest or pleasure in all, or nearly all, activities for most of the day nearly every day). However, debate remains regarding the adequacy of this conceptualization of depression as applied to men socialized within dominant discourses of masculinity that prohibit men acknowledging or seeking help for depression.","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 5","pages":"317-322"},"PeriodicalIF":3.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10861631","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":"Back to Basics: Lifestyle Interventions for Adolescent Depression.","authors":"Talia S Benheim,&nbsp;Michelle Dalal,&nbsp;Juliana M Holcomb,&nbsp;Anamika Dutta,&nbsp;Daniel Hosker,&nbsp;Michael S Jellinek,&nbsp;J Michael Murphy","doi":"10.1097/HRP.0000000000000343","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000343","url":null,"abstract":"<p><strong>Learning objectives: </strong>After completing this activity, practitioners will be better able to:• Discuss and better understand the recently adopted screening standards for adolescents with depression and the potential advantages of using \"lifestyle medicine\"• Set up a process for providing effective interventions for the increased number of patients with adolescent depression• Design or update their toolbox of treatment options for adolescents with depression based on the new literature and increased demand.</p><p><strong>Abstract: </strong>Recently adopted quality standards recommend that pediatricians screen adolescents for depression and that they document follow-up plans for those who screen positive. As a result of these new recommendations, pediatricians and other pediatric providers, as well as psychiatrists and other mental health professionals, may face an increasing number of referrals and a growing need for effective interventions for adolescent depression. Given the widely acknowledged scarcity of traditional mental health resources, the current study reviewed the rapidly expanding array of evidence-based, but nontraditional, interventions applicable to outpatient pediatric and mental health care settings. Many of these interventions come from a lifestyle medicine framework. Lifestyle medicine interventions are congruent with the cultures of pediatrics and outpatient psychiatry, and offer additional evidence-based tools for providers managing adolescent depression. These interventions can be implemented individually or within group or community settings, and may be used in conjunction with more common interventions such as psychotherapy or psychotropic medications.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 5","pages":"283-302"},"PeriodicalIF":3.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10861636","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":"Malignant Self-Regard: Overview and Future Directions.","authors":"Steven K Huprich,&nbsp;Brady C Malone","doi":"10.1097/HRP.0000000000000342","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000342","url":null,"abstract":"<p><strong>Abstract: </strong>Malignant self-regard (MSR) is a self-representation that encompasses the shared features of depressive personality disorder, masochistic/self-defeating personality disorder, depressive-masochistic personality, and vulnerable narcissism. In this review we begin by describing the construct's historical precursors, which begin in early psychoanalytic/dynamic theory, and then trace its development across iterations of the Diagnostic and Statistical Manual of Mental Disorders. Special attention is paid to differentiating MSR from vulnerable narcissism. We then consider MSR's place within transdiagnostic, transtheoretical, and dimensional models of personality pathology. We focus heavily on MSR's impact on various personality systems (e.g., thought and affect systems) and also on overall personality functioning. The empirical research on MSR in relation to these systems is thoroughly reviewed and largely supports its psychometric properties and clinical significance. We suggest that MSR may map onto the distress subfactor in the hierarchical taxonomy of psychopathology (HiTOP) and that MSR seems to occupy the shared internalizing space across the neurotic and borderline level of personality organization in Kernberg's model of personality disorders. We also identify four major directions for future research: the possible benefits of self-defeating tendencies that involve pathological narcissism and self-esteem; MSR's relationship to overall health and well-being; depressive states and MSR severity; and how MSR fits within the Alternative Model for Personality Disorders and the personality disorder framework of the International Classification of Diseases.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 4","pages":"226-237"},"PeriodicalIF":3.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10865917","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":"Medical Mistrust in Perinatal Mental Health.","authors":"Nkechi Conteh,&nbsp;Jane Gagliardi,&nbsp;Shunda McGahee,&nbsp;Rose Molina,&nbsp;Crystal T Clark,&nbsp;Camille A Clare","doi":"10.1097/HRP.0000000000000345","DOIUrl":"https://doi.org/10.1097/HRP.0000000000000345","url":null,"abstract":"<p><strong>Abstract: </strong>Despite the advancement of telemedicine and recent innovations in treatment, minoritized women continue to bear a disproportionate burden of pregnancy-related psychiatric conditions and complications, which the pandemic has further exacerbated. Research demonstrates that medical mistrust and systemic racism play central roles in the underutilization of services by racially and ethnically diverse women during pregnancy and postpartum. To effectively address these disparities, it is imperative to understand the drivers of medical mistrust in perinatal health care systems. This Perspectives article describes the historical context of medical mistrust in psychiatric and obstetric health systems and offers solutions to mitigate mistrust and the impact of systemic racism on perinatal care.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"30 4","pages":"238-247"},"PeriodicalIF":3.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10848324","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}