JAMA Psychiatry最新文献

Childhood Maternal Warmth, Social Safety Schemas, and Adolescent Mental and Physical Health. 儿童母亲温暖、社会安全图式与青少年身心健康。

IF 22.5 1区医学

JAMA Psychiatry Pub Date : 2025-05-28 DOI: 10.1001/jamapsychiatry.2025.0815

Jenna Alley, Dimitris I Tsomokos, Summer Mengelkoch, George M Slavich

{"title":"Childhood Maternal Warmth, Social Safety Schemas, and Adolescent Mental and Physical Health.","authors":"Jenna Alley, Dimitris I Tsomokos, Summer Mengelkoch, George M Slavich","doi":"10.1001/jamapsychiatry.2025.0815","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.0815","url":null,"abstract":"Importance: Although early maternal warmth strongly predicts adolescent health, questions remain about the biopsychosocial mechanisms underlying this association.Objective: To understand how maternal warmth at 3 years of age shapes adolescent social safety schemas at 14 years of age and physical and mental health at 17 years of age.Design, setting, and participants: The Millennium Cohort Study tracks approximately 19 200 children born from late 2000 to early 2002 in the UK. Participants were assessed from ages 3 to 17 years.Exposure: Low maternal warmth (eg, lack of praise, negative tone of voice when speaking to the child) and maternal harshness (eg, using physical restraint, grabbing the child) were independently coded during a home visit (age 3 years).Main outcomes and measures: Social safety (age 14 years) was measured by children's responses to 3 items (eg, \"I have family and friends who help me feel safe, secure and happy\"). Physical health was self-reported on a scale ranging from 1 (excellent) to 5 (poor) (age 17 years). Psychological distress (age 17 years) was assessed using the 6-item Kessler Psychological Distress Scale. Psychiatric problems (age 17 years) was a latent variable composed of self-disclosed clinical diagnosis of depression/anxiety, self-harm, and suicidal behaviors.Results: The present sample included 8540 youths (52% female; 3.0% Black or Black British, 2.8% Indian, 6.7% Pakistani and Bangladeshi, 2.8% Mixed, 83% White, and 1.6% other). Data were analyzed from March 2024 to September 2024 using structural equation modeling. In models controlling for sex, ethnicity, income, neighborhood disadvantage, maternal mental health, and early cognitive ability, the paths from childhood maternal warmth (but not harshness) to social safety schemas at 14 years of age (b = 0.03; P < .001) and physical health at 17 years of age (b = 0.05; P = .02) were significant, suggesting that early maternal warmth enhances subsequent perceived social safety and physical health. Additionally, the paths from negative social safety schemas at 14 years of age to poorer physical health (b = 0.50; P < .001), psychological distress (b = 5.37; P < .001), and psychiatric problems (b = 0.21; P < .001) at 17 years of age were significant, suggesting that greater perceived social safety prospectively predicts better health. Social safety at 14 years of age mediated 20% to 100% of the effect of early maternal warmth on physical health, psychological distress, and psychiatric problems at 17 years of age (b = 0.01-0.15; P < .001 for all).Conclusions and relevance: These results show that early-life maternal warmth affected adolescent health by influencing perceptions of social safety. Improving parent-child relationships and enhancing youths' perceptions of social safety may thus improve adolescent h","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Physician Suicide and Associated Features-What Defines a Physician?-Reply. 医生自杀及其相关特征-如何定义医生？

IF 22.5 1区医学

JAMA Psychiatry Pub Date : 2025-05-28 DOI: 10.1001/jamapsychiatry.2025.1113

Hirsh Makhija, Judy E Davidson, Sidney Zisook

引用次数: 0

Dry EEG-From Laboratory to Living Room. 干脑电图-从实验室到客厅。

IF 22.5 1区医学

JAMA Psychiatry Pub Date : 2025-05-28 DOI: 10.1001/jamapsychiatry.2025.1073

Mohammad S E Sendi

引用次数: 0

Physician Suicide and Associated Features-What Defines a Physician? 医生自杀及其相关特征-如何定义医生？

IF 22.5 1区医学

JAMA Psychiatry Pub Date : 2025-05-28 DOI: 10.1001/jamapsychiatry.2025.1110

Flora Lum

引用次数: 0

Local Anesthetics Adulterating the Illicit Fentanyl Supply. 局部麻醉剂掺入非法芬太尼供应。

IF 25.8 1区医学

JAMA Psychiatry Pub Date : 2025-05-21 DOI: 10.1001/jamapsychiatry.2025.0952

Joseph J Palamar,Joshua S DeBord,Alex J Krotulski,Bruce A Goldberger

引用次数: 0

Private Equity Among US Psychiatric Hospitals. 美国精神病院的私募股权。

IF 25.8 1区医学

JAMA Psychiatry Pub Date : 2025-05-21 DOI: 10.1001/jamapsychiatry.2025.0689

Morgan C Shields,Yuanyuan Yang,Susan H Busch

{"title":"Private Equity Among US Psychiatric Hospitals.","authors":"Morgan C Shields,Yuanyuan Yang,Susan H Busch","doi":"10.1001/jamapsychiatry.2025.0689","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.0689","url":null,"abstract":"ImportancePrivate equity (PE) ownership in health care has increased, but evidence for its association with health care quality is mixed. Moreover, there is no evidence regarding inpatient psychiatric hospitals, despite considerable patient vulnerabilities.ObjectiveTo describe trends in PE ownership of psychiatric hospitals from 2013 through 2021 and the cross-sectional association between PE ownership and hospital staffing and quality.Design, Setting, and ParticipantsIn this cross-sectional study, a novel dataset of PE ownership of psychiatric hospitals in the US was constructed using industry sources and web searches. Characteristics of 87 PE-owned psychiatric hospitals in 2021 were compared with 530 non-PE-owned psychiatric hospitals. Regression models were used to estimate adjusted differences in hospital staffing and quality. Participants included all Medicare-participating freestanding psychiatric hospitals in the US (N = 617). These data were analyzed from September 2023 to October 2024.ExposurePE ownership.Main Outcomes and MeasuresMain outcomes were staffing ratios, national quality measures (restraint and seclusion rates, 7- and 30-day follow-up rates, postdischarge medication continuation, and 30-day all-cause readmission rates). Other studied characteristics included institutional characteristics (region, number of beds), services provided, measures of case mix (populations served, hospital average Diagnosis Related Group score among Medicare beneficiaries), occupancy rates, and average length of stay.ResultsBy 2021, of the 617 freestanding psychiatric hospitals in the US, 87 (14.10%), representing 4660 beds (6.30%), were PE owned, with two-thirds of PE-owned facilities in the southern US (63.22%). In adjusted models, PE ownership was associated with significantly lower staff per patient day among registered nurses (0.12 vs 0.15; P = .048 and medical social workers (0.02 vs 0.04; P = .005). Yet, PE-owned facilities performed better on quality measures, including lower reported hours of restraint use (0.03 vs 0.24 hours per 1000 patient hours; P < .001), 30-day readmissions (19.40% vs 20.16%; P = .047), and higher 7-day (29.34% vs 26.28%; P = .03) and 30-day (52.92% vs 49.08%; P = .01) follow-up visits.Conclusions and RelevancePE ownership of psychiatric hospitals is growing rapidly. In 2021, these facilities had significantly lower staffing ratios, even after controlling for observable case-mix factors. No evidence of lower quality among PE-owned facilities was found, although existing measures are limited. Expansions of US Centers for Medicare & Medicaid Services quality measures to include patient experiences will provide information on new dimensions of quality in these facilities.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"97 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Loss of PTSD Diagnosis in Response to Evidence-Based Treatments: A Systematic Review and Meta-Analysis. 创伤后应激障碍诊断丧失对循证治疗的反应：一项系统回顾和荟萃分析。

IF 25.8 1区医学

JAMA Psychiatry Pub Date : 2025-05-21 DOI: 10.1001/jamapsychiatry.2025.0695

Tiffany Milligan,Derek Smolenski,Jose Lara-Ruiz,Marija S Kelber

{"title":"Loss of PTSD Diagnosis in Response to Evidence-Based Treatments: A Systematic Review and Meta-Analysis.","authors":"Tiffany Milligan,Derek Smolenski,Jose Lara-Ruiz,Marija S Kelber","doi":"10.1001/jamapsychiatry.2025.0695","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.0695","url":null,"abstract":"ImportanceIn recent decades, evidence-based psychotherapies to treat posttraumatic stress disorder (PTSD) have been developed with robust evidence bases. However, efficacy observed in clinical trials is not always directly applicable to clinical practice.ObjectiveTo estimate the percentage of patients in both military and veteran (hereafter milvet) and nonmilvet populations that lose their PTSD diagnosis after treatment.Data SourcesWe used the PTSD Repository to identify studies with adults with a DSM-IV/DSM-5 PTSD diagnosis based on a validated assessment. The repository, maintained by the US National Center for PTSD, is continually updated with randomized clinical trials and includes studies published from January 1988 on.Study SelectionFor eligibility, PTSD had to be the primary treatment target, with psychotherapy applied as monotreatment. Eligible studies reported the number of participants who did not meet diagnostic criteria for PTSD posttreatment. When this review was initiated (October 2023), the repository contained 496 unique studies. Data analysis was completed from October 2023 to June 2024.Data Extraction and SynthesisThe repository follows Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines and uses Cochrane Risk of Bias 2.0. We used mixed-effects logistic regression models to estimate diagnosis loss and incorporated milvet status and sex as covariates.Main Outcomes and MeasuresThe primary outcome was the proportion of participants who no longer met criteria for a diagnosis of PTSD posttreatment as assessed by a validated instrument.ResultsWe included 34 randomized clinical trials (N = 3208 participants). Point estimates of diagnosis loss across trauma-focused treatments for nonmilvet samples ranged from 65% to 86%. Milvet samples had lower proportions of diagnosis loss in studies of cognitive processing therapy and prolonged exposure compared to nonmilvet samples, ranging from 44% to 50%. There was substantial overlap between the covariates of milvet status and sex. An exploratory analysis identified eye movement desensitization and reprocessing as having the highest proportion of diagnosis loss, but there was substantial heterogeneity, and none of the studies were milvet-focused or conducted in the US. Also, 95% confidence intervals partially overlapped for all trauma-focused treatment estimates.Conclusions and RelevanceThis systematic review and meta-analysis contributes to the substantial literature on psychotherapeutic treatments for PTSD by meta-analyzing the probabilities of diagnosis loss for each psychotherapy. Diagnosis loss data are a relatively straightforward way to discuss potential benefits when initiating a therapy or when discussing potential barriers to progress in treatment.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"14 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Depression and Amyloid Pathology-Methodological Aspects. 抑郁症和淀粉样蛋白病理-方法学方面。

IF 22.5 1区医学

JAMA Psychiatry Pub Date : 2025-05-21 DOI: 10.1001/jamapsychiatry.2025.0956

Nunzio Pomara, Chelsea Reichert Plaska, Bruno Pietro Imbimbo

引用次数: 0

Depression and Amyloid Pathology-Methodological Aspects-Reply. 抑郁症和淀粉样蛋白病理-方法学方面-回复。

IF 22.5 1区医学

JAMA Psychiatry Pub Date : 2025-05-21 DOI: 10.1001/jamapsychiatry.2025.0959

Wietse A Wiels, Julie E Oomens, Willemijn J Jansen

引用次数: 0

Purposeful Drug Repurposing. 有目的的药物再利用。