{"title":"Health care workers' mental health in the face of COVID-19: a systematic review and meta-analysis.","authors":"Sulmaz Ghahramani, Hengameh Kasraei, Ramin Hayati, Reza Tabrizi, Milad Ahmadi Marzaleh","doi":"10.1080/13651501.2022.2101927","DOIUrl":"https://doi.org/10.1080/13651501.2022.2101927","url":null,"abstract":"<p><strong>Background: </strong>Healthcare workers are leading the way in treating patients with coronavirus disease 2019 (COVID-19). Due to the high levels of psychological stress, this group is more likely to experience psychological issues. These psychological problems in healthcare providers include depression, anxiety, insomnia, stress and post-traumatic stress disorder (PTSD). The goal of this systematic review and meta-analysis was to find out how common these problems were in the face of COVID-19.</p><p><strong>Methods: </strong>On 20 February 2022, systematic searches were conducted in the PubMed, Cochrane Library, Scopus, EMBASE, Science Direct, Web of Science and ProQuest databases. Two authors selected articles based on search keywords. As a last step, articles about the prevalence of psychological problems among healthcare workers in the face of COVID-19 were looked at and analysed for five different outcomes.</p><p><strong>Results: </strong>The initial search yielded 18,609 articles. After reviewing the titles, abstracts and full texts of the articles, 44 were chosen for the final analysis and 29 were subjected to a meta-analysis. Insomnia, anxiety, depression, PTSD and stress are among the psychological issues faced by healthcare workers. Furthermore, the highest pooled prevalence of depression, anxiety, insomnia, PTSD and stress was 36% (95% confidence interval (CI) 24-50%), 47% (95% CI 22-74%), 49% (95% CI 28-70%), 37% (95% CI 19-59%) and 27% (95% CI 6-69%).</p><p><strong>Conclusions: </strong>In this meta-analysis, insomnia was found to be the most common mental health problem, followed by anxiety, PTSD, depression and stress in healthcare workers in the face of the COVID-19 pandemic. Generally, the pooled prevalence of these mental health problems was higher among physicians, nurses and older staff in the subgroup analysis. As a result, health policymakers and managers of the health care system should think about effective interventions to promote mental health, paying particular attention to these two groups.Key pointsStudies conducted in China reported more mental problems than in other countries.Health policymakers and health system managers should hold training programs to promote healthcare workers' mental health with a particular focus on more vulnerable groups.The prevalence of PTSD, stress, anxiety, depression and insomnia were higher among physicians, nurses and older staff.Health systems at both national and local levels have to take older physicians, nurses and healthcare providers into consideration while designing interventions.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"27 2","pages":"208-217"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9600979","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}
Marcelo B Generoso, Ivan Taiar, Quirino Cordeiro, Pedro Shiozawa, Siegfried Kasper
{"title":"Cariprazine for treating psychosis: an updated meta-analysis.","authors":"Marcelo B Generoso, Ivan Taiar, Quirino Cordeiro, Pedro Shiozawa, Siegfried Kasper","doi":"10.1080/13651501.2022.2071740","DOIUrl":"https://doi.org/10.1080/13651501.2022.2071740","url":null,"abstract":"<p><strong>Purpose: </strong>Early treatment of psychotic illness improves outcomes, reduces relapse rates and should not be delayed. Cariprazine is a promising antipsychotic drug and may be a valuable resource when clinicians are in doubt if psychotic symptoms are due to schizophrenia or bipolar disorder.</p><p><strong>Materials and methods: </strong>We conducted a systematic review and meta-analysis that included seven studies (n = 2896) analyzing the effect of cariprazine in psychotic symptoms assessed by the positive and negative symptoms scale (PANSS).</p><p><strong>Results: </strong>We found cariprazine to be significantly superior to placebo (Hedges' g = 0.40; 95% CI 0.32-0.49) for acute psychosis independently of primary psychiatric diagnosis and also to be superior to placebo for both schizophrenia (Hedges' g = 0.39; 95% CI 0.29-0.50) and bipolar patients (Hedges' g = 0.43; 95% CI 0.27-0.58).</p><p><strong>Conclusions: </strong>We propose that cariprazine may be useful in treating psychosis independently of nosological differentiation at the beginning of the treatment Key pointsEarly treatment of psychotic illness with antipsychotic medications improves outcomes and reduces relapse rates.Cariprazine was found to be significantly superior to placebo for acute psychosis independently of primary psychiatric diagnosis.Cariprazine may be useful in treating psychosis independently of nosological differentiation between schizophrenia and bipolar disorder at the beginning of the treatment.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"27 1","pages":"107-109"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454050","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":"The effects of the COVID-19 pandemic on patients with obsessive-compulsive disorder.","authors":"Raşit Tükel, Oğuzhan Başaran, Simge Ergün, Mourat Giousouf Chousein, Mesut Keskin, Erhan Ertekin","doi":"10.1080/13651501.2022.2082984","DOIUrl":"https://doi.org/10.1080/13651501.2022.2082984","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about the impact of the COVID-19 pandemic on obsessive-compulsive disorder (OCD). The main aim of this study was to investigate how the pandemic has affected OCD patients and the relationship between the clinical features and the fear and obsession with COVID-19.</p><p><strong>Methods: </strong>A total of 30 consecutive patients with OCD and 30 age-and sex-matched healthy controls were included in this cross-sectional study. Based on retrospective information provided by the patients, we evaluated changes in the severity of their OCD during the pandemic compared to the pre-pandemic period. We compared patients with OCD and healthy subjects using scores obtained from various scales.</p><p><strong>Results: </strong>We found that symptom severity worsened in 60% of OCD patients during the pandemic compared to the pre-pandemic period, remained unchanged in 30%, and improved in 10%. The levels of obsession with COVID-19 were found to be higher in OCD patients than in healthy control subjects. The levels of fear of and obsession with COVID-19 both correlated with the anxiety levels of patients with OCD and healthy controls.</p><p><strong>Conclusions: </strong>Our results suggest that the levels of COVID-19 related fear and obsession are not linked to the severity of OCD, but to anxiety levels. Key pointsObsessive-compulsive symptom severity worsened in 60% of OCD patients in the pandemic.COVID-19 obsession levels were higher in OCD patients than healthy controls.COVID-19 fear levels did not differ between the OCD and healthy control groups.COVID-19 obsession levels were correlated with anxiety severity in OCD and healthy control groups.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"27 1","pages":"35-41"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454053","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}
Amal Abdel-Baki, Émile Poulin, Sofia Medrano, Paula Pires de Oliveira Padilha, Emmanuel Stip, Stéphane Potvin
{"title":"Impact of early use of long-acting injectable antipsychotics on functional outcome in first episode psychosis: a 3-year longitudinal study.","authors":"Amal Abdel-Baki, Émile Poulin, Sofia Medrano, Paula Pires de Oliveira Padilha, Emmanuel Stip, Stéphane Potvin","doi":"10.1080/13651501.2022.2079531","DOIUrl":"https://doi.org/10.1080/13651501.2022.2079531","url":null,"abstract":"<p><strong>Objectives: </strong>To describe, in a naturalistic setting, the impact of the early use of LAI-AP on functional outcomes of early psychosis patients as compared to oral antipsychotics (OAP).</p><p><strong>Methods: </strong>Longitudinal prospective 3-year naturalistic study of all consecutive admissions (<i>n</i> = 416) to two <i>Early intervention services (EIS)</i> for psychosis comparing baseline characteristics and the evolution of global functioning, occupation (work and studies), and living arrangements autonomy according to the route of administration of the antipsychotic medication. The cohort was divided into four groups: <i>LAI-AP firs</i>t (started on LAI-AP and later received OAP), <i>OAP first, LAI-AP only</i>, and <i>OAP only</i>.</p><p><strong>Results: </strong>Global assessment of functioning (GAF) improved in all groups, but our mixed-effect model did not show any significant association between the route of administration and the GAF outcome. The <i>LAI-AP</i> only group was significantly less likely to have extreme residential instability at 3 years than the other groups despite its highest proportion of homeless youth and their poor prognostic factors at baseline.</p><p><strong>Conclusions: </strong>Our naturalistic study suggests a significant protective effect of LAI-AP on extreme residential instability for the most vulnerable patients, but no impact of the first AP administration route on other functional outcomes was observed at 3 years of follow-up. Key pointsLong-acting injectable antipsychotics seem promising to avoid extreme residential instability in early psychosis.Global assessment of functioning (GAF) improved in all groups.There was no significant association between the first route of administration and global functionning.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"27 1","pages":"25-34"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454057","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}
Huixia Zhou, Dongmei Wang, Bo Cao, Xiangyang Zhang
{"title":"Association of reduced cortical thickness and psychopathological symptoms in patients with first-episode drug-naïve schizophrenia.","authors":"Huixia Zhou, Dongmei Wang, Bo Cao, Xiangyang Zhang","doi":"10.1080/13651501.2022.2129067","DOIUrl":"https://doi.org/10.1080/13651501.2022.2129067","url":null,"abstract":"<p><strong>Objective: </strong>There is growing evidence that reduced cortical thickness has been considered to be a central abnormality in schizophrenia. Brain imaging studies have demonstrated that the cerebral cortex becomes thinner in patients with first-episode schizophrenia. This study aimed to examine whether cortical thickness is altered in drug-naïve schizophrenia in a Chinese Han population and the relationship between cortical thickness and clinical symptoms.</p><p><strong>Methods: </strong>We compared cortical thickness in 41 schizophrenia patients and 30 healthy controls. Psychopathology of patients with schizophrenia was assessed using the Positive and Negative Syndrome Scale (PANSS).</p><p><strong>Results: </strong>The cortical thickness of left banks of superior temporal sulcus, left lateral occipital gyrus, left rostral middle frontal gyrus, right inferior parietal lobule and right lateral occipital gyrus in schizophrenia patients was generally thinner compared with healthy controls. Correlation analysis revealed a negative correlation between cortical thickness of the left banks of superior temporal sulcus and general psychopathology of PANSS.</p><p><strong>Conclusions: </strong>Our results suggest that cortical thickness abnormalities are already present early in the onset of schizophrenia and are associated with psychopathological symptoms, suggesting that it plays an important role in the pathogenesis and symptomatology of schizophrenia.Key points(1) The first-episode drug-naïve schizophrenia had reduced cortical thickness than the controls.(2) Cortical thickness was associated with psychopathological symptoms in patients with schizophrenia.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"27 1","pages":"42-50"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9456250","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":"The impact of obsessive-compulsive personality disorder in perfectionism.","authors":"Sarah A Redden, Nora E Mueller, Jesse R Cougle","doi":"10.1080/13651501.2022.2069581","DOIUrl":"https://doi.org/10.1080/13651501.2022.2069581","url":null,"abstract":"<p><strong>Objective: </strong>The construct of perfectionism has long been related to Obsessive-Compulsive Personality Disorder (OCPD), though research has not considered how OCPD could distinguish individuals with elevated perfectionism. The aim of this study was to evaluate clinical differences between those with and without OCPD in a sample of individuals with elevated perfectionism.</p><p><strong>Methods: </strong>Seventy-four university students with elevated perfectionism completed a diagnostic assessment and several self-report measures of clinical characteristics and were randomly assigned to complete an exposure-based treatment for perfectionism or waitlist. Thirty-four (45.95%) participants met DSM-IV diagnostic criteria for OCPD.</p><p><strong>Results: </strong>Compared to those without OCPD, individuals with OCPD had higher levels of general and specific domains of perfectionism and higher levels of social anxiety. OCPD diagnosis was also associated with higher rates of current anxiety disorder. Importantly, those with and without OCPD showed comparable benefits from treatment.</p><p><strong>Conclusions: </strong>This study provides novel evidence of the role of OCPD in perfectionism and demonstrates the efficacy of a perfectionism-oriented treatment in individuals with OCPD.Key pointsWe examined the role of obsessive-compulsive personality disorder (OCPD) in a high perfectionism sample.OCPD was associated with higher perfectionism and personal standards.OCPD was also associated with higher social anxiety and higher rates of current anxiety disorder.Those with and without OCPD had comparable responses to an exposure-based treatment for perfectionism.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"27 1","pages":"18-24"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9471171","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}
Hans-Peter Volz, Johanna Stirnweiß, Siegfried Kasper, Hans-Jürgen Möller, Erich Seifritz
{"title":"Subthreshold depression - concept, operationalisation and epidemiological data. A scoping review.","authors":"Hans-Peter Volz, Johanna Stirnweiß, Siegfried Kasper, Hans-Jürgen Möller, Erich Seifritz","doi":"10.1080/13651501.2022.2087530","DOIUrl":"10.1080/13651501.2022.2087530","url":null,"abstract":"<p><strong>Purpose: </strong>In diagnostic systems (e.g., DSM-5, ICD-10), depression is defined categorically. However, the concept of subthreshold depression (SD) has gained increasing interest in recent years. The purpose of the present paper was to review, based on a scoping review, the relevant papers in this field published between October 2011 and September 2020.</p><p><strong>Materials and methods: </strong>Of the 1,160 papers identified, 64 records could be included in further analysis. The scoping review was conducted using both electronic and manual methods.</p><p><strong>Results: </strong>The main result of the analysis is that the operationalisation criteria used are highly heterogeneous, which also leads to very heterogenous epidemiological data.</p><p><strong>Conclusions: </strong>Clear conclusions are not possible scrutinising the reported results. Most definitions seem to be arbitrary, with considerable overlap (e.g., between SD and minor depression). The review also revealed that the impact of SD on quality of life and related parameters appear to be in the range of the respective impact of major depression (MD) and therapeutic approaches might be helpful for SD and also for the prevention of conversion from SD to MD. Keeping the presented difficulties in mind, a proposal for the definition of SD is made in the present paper in order to facilitate the discussion leading to more homogeneous criteria.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"27 1","pages":"92-106"},"PeriodicalIF":2.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825038","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}
Estefanía Mónaco, Mar Zaragozá, Inmaculada Montoya-Castilla
{"title":"'Sleep and emotions: How much are they affected by confinement due to COVID-19? A longitudinal study'.","authors":"Estefanía Mónaco, Mar Zaragozá, Inmaculada Montoya-Castilla","doi":"10.1080/13651501.2022.2060838","DOIUrl":"https://doi.org/10.1080/13651501.2022.2060838","url":null,"abstract":"<p><strong>Objective: </strong>Our aim is to study changes in sleep and emotions in Spanish population during the confinement period due to first wave of COVID-19.</p><p><strong>Methods: </strong>A total of 363 adults (69.4% women) aged between 18 and 65 (M<sub>age </sub>= 32.59; SD = 12.57) participated in the study. Socio-demographics, sleep quality and emotional experience were evaluated. The study was longitudinal: a first data collection was developed after 15 d of confinement (asking for a subjective comparison with the pre-confined period), and a second collection after 30 d.</p><p><strong>Results: </strong>Results suggest differences in sleep quality depending on the time confined. Difficulty falling asleep increases and daytime activity decreases with longer confined periods. Morning fatigue, sleepiness and nightmares are reduced significantly after 15 d of confinement when compared with the subjective data from pre-confinement. After 15 d of confinement participants felt higher levels of apathy, sadness, irritability and lower levels of euphoria and joy than they remember feeling before confinement. Anxiety, concern and fear seem to increase at 15 d of confinement and decrease at 30 d. Sleep quality and emotional experiences in confinement are closely correlated.</p><p><strong>Conclusions: </strong>The confinement in Spain worsened the emotional state and changed sleep habits, although it did not necessarily worsen the quality of sleep. Key pointsThere are differences in sleep quality depending on the time spent in confinement.Confinement situation is related with higher levels of apathy, sadness, and irritability and lower levels of euphoria and joy.Anxiety, concern and fear seem to increase at 15 d of confinement and then decrease at 30 d.Sleep quality and emotional experiences in confinement are closely correlated.After COVID-19, there is a remarkable need of attend the disturbances emerged in sleep habits and daily moods of general popunlation.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"27 1","pages":"8-17"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9456205","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}
David Fraguas, David Almenta Gallego, Sergio Arques-Egea, Marcos Gómez-Revuelta, Carlos Gómez Sánchez-Lafuente, Daniel Hernández Huerta, Daniel Núñez Arias, Beatriz Oda Plasencia-García, Carlos Parro Torres, Samuel Leopoldo Romero-Guillena, Elena Ros Cucurul, Cecilio Alamo
{"title":"Aripiprazole for the treatment of schizophrenia: Recommendations of a panel of Spanish experts on its use in clinical practice.","authors":"David Fraguas, David Almenta Gallego, Sergio Arques-Egea, Marcos Gómez-Revuelta, Carlos Gómez Sánchez-Lafuente, Daniel Hernández Huerta, Daniel Núñez Arias, Beatriz Oda Plasencia-García, Carlos Parro Torres, Samuel Leopoldo Romero-Guillena, Elena Ros Cucurul, Cecilio Alamo","doi":"10.1080/13651501.2022.2064308","DOIUrl":"https://doi.org/10.1080/13651501.2022.2064308","url":null,"abstract":"<p><strong>Objectives: </strong>Aripiprazole is an antipsychotic with a partial agonism of dopamine D<sub>2</sub> and D<sub>3</sub> receptors. This differential mechanism implies a rigorous appraisal of the appropriate therapeutic strategies in certain situations. To answer currently unsolved clinical questions about the use of oral and long-acting injectable (LAI) aripiprazole, we present here an expert consensus from 12 Spanish psychiatrists and a pharmacologist with extensive experience in the use of this antipsychotic.</p><p><strong>Methods: </strong>Through one face-to-face session and online collaboration, we reached consensus and established practical recommendations based on scientific evidence and clinical experience. We classified the available scientific literature according to SIGN system and attributed a level of evidence to each reviewed article.</p><p><strong>Results: </strong>The recommendations were divided according to (i) chronological dimension (based on previous treatments, including patients naïve or not to antipsychotic treatment and maintenance regimen), and (ii) dimension related to therapeutic options, comprising switches to aripiprazole and the most used combinations with this antipsychotic.</p><p><strong>Conclusions: </strong>We recommend considering aripiprazole as first treatment option in the early stages of schizophrenia and in patients with affective symptoms and contemplating a switch to aripiprazole LAI in all candidate patients. Importantly, switches from other antipsychotics should consider previous antipsychotic history and exposure to aripiprazole. KEYPOINTSAripiprazole can be considered as first treatment option in early stages of schizophrenia and in patients with significant affective symptoms.Aripiprazole LAI shows better adherence than oral aripiprazole and could be considered in all candidate patients.Before switching to aripiprazole, detailed information about previous antipsychotic history should be gathered.Switch to aripiprazole should be managed differently for aripiprazole naïve and non-naïve patients.Rigorous and controlled studies on antipsychotics in real clinical practice should be carried out.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"27 1","pages":"82-91"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9509249","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}
Marwan Sabbagh, Gary W Small, Stuart H Isaacson, Yasar Torres-Yaghi, Fernando Pagan, Rajesh Pahwa
{"title":"Unmet needs in the diagnosis and treatment of Parkinson's disease psychosis and dementia-related psychosis.","authors":"Marwan Sabbagh, Gary W Small, Stuart H Isaacson, Yasar Torres-Yaghi, Fernando Pagan, Rajesh Pahwa","doi":"10.1080/13651501.2022.2058406","DOIUrl":"https://doi.org/10.1080/13651501.2022.2058406","url":null,"abstract":"<p><p>Dementia due to Parkinson's disease and Alzheimer's disease are associated with behavioural and psychological symptoms, including psychosis. Long-term management presents a challenge for health care providers and caregivers. Symptoms of psychosis include hallucinations and delusions; if untreated, these can lead to institutionalisation, decreased quality of life, and significant patient and caregiver distress. A critical step in the effective management of dementia-related psychosis (DRP) is the identification and diagnosis of affected patients. The lack of a standardised diagnostic approach presents a barrier to treatment and there are no consensus guidelines for DRP. Furthermore, there are no approved therapies for the treatment of DRP. Antipsychotic medications are often prescribed off-label, even though some are associated with an increased risk of adverse events or mortality. We present currently available screening tools and guidelines for the diagnosis and treatment of Parkinson's disease psychosis and DRP in the context of what is needed for effective management of psychosis.KEY POINTSWe present currently available screening tools and guidelines for Parkinson's disease psychosis and dementia-related psychosis, and discuss the unmet need for simple clinical diagnostic tools and treatment guidelines.The identification of psychosis is variable across different settings and specialties, without a unified approach to screening, definition, or diagnosis.Currently used tools for defining and assessing psychosis in a research setting are usually too cumbersome for everyday clinical practice.The development of a standardised set of diagnostic criteria would provide clinicians the opportunity to improve the detection, treatment, and quality of life of patients and their caregivers.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"27 1","pages":"69-81"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825034","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}