JAMA Psychiatry最新文献

{"title":"Traumatic and Adverse Childhood Experiences and Developmental Differences in Psychiatric Risk.","authors":"Justin D Russell,Sara A Heyn,Matthew Peverill,Samantha DiMaio,Ryan J Herringa","doi":"10.1001/jamapsychiatry.2024.3231","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2024.3231","url":null,"abstract":"ImportanceWhile adverse childhood experiences (ACEs) are known to impart significant risk for negative mental health and cognitive outcomes in youth, translation of ACE scores into clinical intervention is limited by poor specificity in predicting negative outcomes. This work expands on the ACE framework using a data-driven approach to identify 8 different forms of traumatic and adverse childhood experiences (TRACEs) and reveal their differential associations with psychiatric risk and cognition across development.ObjectiveBuilding upon the traditional ACEs model, this study aimed to characterize unique components of commonly co-occurring TRACEs and to examine moderation of longitudinal change in mental health and cognitive development during adolescence.Design, Setting, and ParticipantsThis work draws from youth and their caregivers who completed up to 4 annual behavioral assessments from 2016 to 2021 as part of the ongoing Adolescent Brain Cognitive Development (ABCD) study. Data collection was performed at 21 regionally-distributed sites across the United States. Analyses for this work were conducted January 2023 through November 2023.ExposuresYouth participants in the ABCD study's exposure to 268 different TRACEs, which were distilled into adversity components using nonlinear principal components analysis.Main Outcomes and MeasuresMixed-effects and latent change score models considered TRACEs components as moderators of longitudinal change in internalizing and externalizing mental health problems, as well as longitudinal change in cognitive ability.ResultsData were distilled from 11 876 youth participants, who were grouped into dyads with a caregiver. ABCD study youth participants were 9 to 10 years old at baseline assessment (year 0) and 12 to 13 years old at ABCD year 3. A total of 5679 participants (47.8%) were female. Analyses revealed that TRACEs organized into 8 thematic adversity components (e.g., family conflict, interpersonal violence). At baseline assessment (year 0), exposure to nearly every adversity component was associated with poorer mental health and diminished cognitive ability. Yet across time, it was observed that different forms of adversity were variably linked to both increases and decreases in internalizing and externalizing problems. For example, while peer aggression (t = 5.31) and family conflict (t = 5.67) were associated with increases in both internalizing and externalizing problems over early adolescence, community threat (t = 2.82) and poverty (t = 2.07) were linked to decreased problems, potentially representing adaptive suppression of symptoms. Finally, adversity types related to resource deprivation (eg, poverty, caregiver maladjustment) were associated with declines in cognitive ability over early adolescence.Conclusions and RelevanceIn this cohort study, distinct forms of TRACEs differentially moderated developmental changes in psychiatric risk and cognitive ability in different ways, offering the possibilit","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"34 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488195","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}

{"title":"Antipsychotic Monotherapy vs Polytherapy for Pneumonia Risk.","authors":"Yuki Kikuchi,Hiroshi Komatsu,Hiroaki Tomita","doi":"10.1001/jamapsychiatry.2024.3330","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2024.3330","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"13 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488197","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}

{"title":"Diagnosing and Treating ADHD in Adults: Balancing Individual Benefits and Population Risks.","authors":"Carlos Blanco,Craig B H Surman","doi":"10.1001/jamapsychiatry.2024.3228","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2024.3228","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"125 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488196","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}

{"title":"Addressing the Escalating Problems That Patients Encounter When Filling Buprenorphine Prescriptions.","authors":"Erin L Winstanley,Angela Gray,Douglas Thornton","doi":"10.1001/jamapsychiatry.2024.3076","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2024.3076","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"74 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443748","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}

{"title":"Patterns of Brain Maturation in Autism and Their Molecular Associations.","authors":"Charlotte M Pretzsch,Martina Arenella,Jason P Lerch,Michael V Lombardo,Christian Beckmann,Tim Schaefer,Johanna Leyhausen,Caroline Gurr,Anke Bletsch,Lisa M Berg,Hanna Seelemeyer,Dorothea L Floris,Bethany Oakley,Eva Loth,Thomas Bourgeron,Tony Charman,Jan Buitelaar,Grainne McAlonan,Declan Murphy,Christine Ecker,","doi":"10.1001/jamapsychiatry.2024.3194","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2024.3194","url":null,"abstract":"ImportanceIn the neurotypical brain, regions develop in coordinated patterns, providing a fundamental scaffold for brain function and behavior. Whether altered patterns contribute to clinical profiles in neurodevelopmental conditions, including autism, remains unclear.ObjectivesTo examine if, in autism, brain regions develop differently in relation to each other and how these differences are associated with molecular/genomic mechanisms and symptomatology.Design, Setting, and ParticipantsThis study was an analysis of one the largest deep-phenotyped, case-control, longitudinal (2 assessments separated by approximately 12-24 months) structural magnetic resonance imaging and cognitive-behavioral autism datasets (EU-AIMS Longitudinal European Autism Project [LEAP]; study dates, February 2014-November 2017) and an out-of-sample validation in the Brain Development Imaging Study (BrainMapASD) independent cohort. Analyses were performed during the 2022 to 2023 period. This multicenter study included autistic and neurotypical children, adolescents, and adults. Autistic participants were included if they had an existing autism diagnosis (DSM-IV/International Statistical Classification of Diseases and Related Health Problems, Tenth Revision or DSM-5 criteria). Autistic participants with co-occurring psychiatric conditions (except psychosis/bipolar disorder) and those taking regular medications were included.ExposuresNeuroanatomy of neurotypical and autistic participants.Main Outcomes and MeasuresIntraindividual changes in surface area and cortical thickness over time, analyzed via surface-based morphometrics.ResultsA total of 386 individuals in the LEAP cohort (6-31 years at first visit; 214 autistic individuals, mean [SD] age, 17.3 [5.4] years; 154 male [72.0%] and 172 neurotypical individuals, mean [SD] age, 16.35 [5.7] years; 108 male [62.8%]) and 146 individuals in the BrainMapASD cohort (11-18 years at first visit; 49 autistic individuals, mean [SD] age, 14.31 [2.4] years; 42 male [85.7%] and 97 neurotypical individuals, mean [SD] age, 14.10 [2.5] years; 58 male [59.8%]). Maturational between-group differences in cortical thickness and surface area were established that were mostly driven by sensorimotor regions (eg, across features, absolute loadings for early visual cortex ranged from 0.07 to 0.11, whereas absolute loadings for dorsolateral prefrontal cortex ranged from 0.005 to 0.06). Neurodevelopmental differences were transcriptomically enriched for genes expressed in several cell types and during various neurodevelopmental stages, and autism candidate genes (eg, downregulated genes in autism, including those regulating synaptic transmission; enrichment odds ratio =3.7; P =2.6 × -10). A more neurotypical, less autismlike maturational profile was associated with fewer social difficulties and more typical sensory processing (false discovery rate P <.05; Pearson r ≥0.17). Results were replicated in the independently collected BrainMapASD cohort.Conclu","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"68 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443794","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}

{"title":"Development of Sensory Regions vs the Rest of the Cortex in Autism.","authors":"Jessica Girault","doi":"10.1001/jamapsychiatry.2024.3049","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2024.3049","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"1 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443791","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}

{"title":"Antipsychotic Drugs and Cognitive Function: A Systematic Review and Pairwise Network Meta-Analysis.","authors":"Lena Feber,Natalie L Peter,Virginia Chiocchia,Johannes Schneider-Thoma,Spyridon Siafis,Irene Bighelli,Wulf-Peter Hansen,Xiao Lin,Daniel Prates-Baldez,Georgia Salanti,Richard S E Keefe,Rolf R Engel,Stefan Leucht","doi":"10.1001/jamapsychiatry.2024.2890","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2024.2890","url":null,"abstract":"ImportanceCognitive deficits are a substantial part of the symptoms of schizophrenia spectrum disorders (SSDs) and contribute heavily to the burden of disease. Antipsychotic drugs are not cognitive enhancers, but due to their different receptor-binding profiles, they could differ in their effects on cognition. No previous network meta-analysis compared antipsychotics to placebo, which is important to determine whether use of these drugs is associated with cognitive performance in SSDs at all.ObjectiveTo determine the association of treatment with various antipsychotics and cognition in patients with SSDs.Data SourcesCochrane Schizophrenia Trials Register through June 25, 2023.Study SelectionRandomized clinical trials examining the effects on cognition of antipsychotic drugs or placebo in participants with SSD.Data Extraction and SynthesisA systematic review and random-effects frequentist network meta-analysis was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses-Network Meta-analysis reporting guideline.Main Outcomes and MeasuresThe primary outcome was change in overall cognition score calculated for each study. Secondary outcomes included cognitive domains, quality of life, and functioning.ResultsThis study included 68 studies involving 9525 participants (mean [SD] age, 35.1 [8.9] years; 5878 male [70%] and 2890 [30%] female; some studies did not provide this information). There were few clear differences between antipsychotics, but first-generation dopamine antagonists haloperidol (standardized mean difference [SMD], 0.04; 95% CI, -0.25 to 0.33) and fluphenazine (SMD, 0.15; 95% CI, -0.39 to 0.69) as well as clozapine (SMD, 0.12; 95% CI, -0.23 to 0.48) ranked low. No individual antipsychotic was associated with a clearly better outcome than placebo, but antipsychotics as a group were, with small effect sizes (mean SMDs: adrenergic/low dopamine, 0.21; serotonergic/dopaminergic, 0.26; muscarinic, 0.28; dopaminergic, 0.40).Conclusion and RelevanceAlthough data are relatively sparse, those reviewed in this study suggest that first-generation dopamine antagonists and clozapine should be avoided when cognitive deficits are a concern. Antipsychotics are not procognitive drugs. The overall small superior outcomes compared to placebo may be explained by less disordered thought patterns associated with fewer positive symptoms rather than cognitive deficits in the proper sense. The findings also suggest that harmonizing measurement of cognitive function in randomized clinical trials would be beneficial.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"109 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443793","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}

{"title":"Toward Equitable Interventions in Public Mental Health: A Review.","authors":"Ulrich Reininghaus,Annika S Reinhold,Stefan Priebe,Christian Rauschenberg,Leonie Fleck,Anita Schick,Frederike Schirmbeck,Inez Myin-Germeys,Craig Morgan,Jessica A Hartmann","doi":"10.1001/jamapsychiatry.2024.3206","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2024.3206","url":null,"abstract":"ImportanceThe field of public mental health is evolving to tackle the profound impact of global challenges such as climate change, migration, and health crises. These issues accentuate health and social inequities, necessitating a focus on how to achieve interventions that are equitable and enhance mental health across all societal strata.ObservationsPopulation-based interventions can inadvertently exacerbate mental health inequities if they are primarily assessed by, and beneficial to, the most advantaged. Dimensional approaches such as the Hierarchical Taxonomy of Psychopathology offer a more nuanced understanding of mental health, capturing the whole spectrum of symptom severity in a culturally sensitive and less stigmatizing way. In addition, adopting intersectional, participatory, and settings-based approaches can help tailor interventions to the unique needs of marginalized groups.Conclusions and RelevanceIn moving toward more equitable interventions in public mental health, it is imperative to adopt an approach that integrates multiple frameworks to address the complexity of mental health inequities. At the core of this integrated approach is the recognition that mental health exists on a continuum. Intersectionality theory can help to identify the root (fundamental) causes of mental health while participatory and settings-based approaches ensure that interventions are relevant, culturally sensitive, and accessible to all. By adopting these approaches, interventions that are not only effective in \"shifting the curve\" toward better mental health, but are also equitable in their reach and impact, can be developed.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"68 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443792","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}

{"title":"Mental Health Diagnoses in People Experiencing Homelessness.","authors":"Kevin Y Xu, Sonya E Gabrielian, Tashalee R Brown","doi":"10.1001/jamapsychiatry.2024.2315","DOIUrl":"10.1001/jamapsychiatry.2024.2315","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"1047"},"PeriodicalIF":22.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking Cessation as a Priority for Psychiatrists.","authors":"Robert A Kleinman, Brian S Barnett","doi":"10.1001/jamapsychiatry.2024.2162","DOIUrl":"10.1001/jamapsychiatry.2024.2162","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"951-952"},"PeriodicalIF":22.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855613","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}