Journal of Neuropsychiatry and Clinical Neurosciences最新文献

{"title":"Deep Brain Stimulation for Methamphetamine Use Disorder: Perioperative Neuropsychiatric and Other Medical Considerations.","authors":"Luke J Weisbrod, Andrew J Schmidt, Jody Tanabe, Joseph Sakai, Steven Ojemann, Joseph R Pawlowski, Jason F Shiffermiller, Aviva Abosch","doi":"10.1176/appi.neuropsych.20240142","DOIUrl":"10.1176/appi.neuropsych.20240142","url":null,"abstract":"<p><p>Substance use disorders, including methamphetamine use disorder, are prevalent, causing extensive morbidity and death. Despite advances in evidence-based treatments for methamphetamine use disorder, many patients do not respond to these interventions, and new approaches are needed. Deep brain stimulation (DBS) involves the surgical implantation of a device to modulate nervous system function and has proven efficacy in the management of movement disorders. Recent studies of DBS for the management of substance use disorders have shown promise, and the authors of this review are currently investigating DBS for the treatment of patients with methamphetamine use disorder. However, acute and chronic intoxication with methamphetamine can result in various systemic abnormalities and medical comorbid conditions, presenting challenges for the neurosurgeon, the anesthesiologist, and other medical providers. This narrative review aims to provide a comprehensive overview of methamphetamine's systemic effects and associated medical comorbid conditions for clinicians engaged in the perioperative care of this patient population. The systemic effects and related medical comorbid conditions that may complicate the perioperative course of patients with methamphetamine use disorder are presented by organ system. With diligent preoperative planning and perioperative management, patients with methamphetamine use disorder can be successfully treated with DBS surgery. A thorough understanding of these effects and comorbid conditions is crucial for both the prevention and the rapid recognition of perioperative complications, resulting in improved outcomes in this patient population.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"209-221"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441113","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":"Refining Research Diagnostic Criteria for Catatonia Among Delirium, Medical, Affective, and Psychosis Patient Groups.","authors":"Paula T Trzepacz, José G Franco, Subho Chakrabarti, Abhishek Ghosh, Swapnajeet Sahoo, Rahul Chakravarty, Sandeep Grover","doi":"10.1176/appi.neuropsych.20230100","DOIUrl":"10.1176/appi.neuropsych.20230100","url":null,"abstract":"<p><strong>Objective: </strong>The authors proposed catatonia diagnostic criteria that require the presence of three neuropsychiatric symptom clusters, rated over 24 hours; this system differs from other symptom clustering proposals and is intended to increase diagnostic rigor over Bush-Francis Catatonia Rating Scale (BFCRS) or DSM-5 criteria.</p><p><strong>Methods: </strong>By applying new BFCRS item score thresholds, symptoms were clustered into three categories to comprise the Research Diagnostic Criteria for Catatonia (RDCC): akinesia (criterion A), unusual motor signs (criterion B), and behavioral signs (criterion C). RDCC symptom clusters were analyzed in four prospectively evaluated patient groups (delirium, medical, affective, and psychosis) (N=341).</p><p><strong>Results: </strong>Use of the RDCC, compared with the DSM-5-TR and BFCRS, resulted in far fewer diagnoses of catatonia in the four patient groups: medical, N=1 out of 42 (2%); affective, N=1 out of 45 (2%); psychosis, N=3 out of 53 (6%); and delirium, N=0 out of 201. Permutations of the RDCC with more relaxed criteria were assessed, requiring either symptom thresholds or numbers of symptoms to meet criteria, resulting in catatonia rate gradations between those obtained with the RDCC and those obtained with current systems. The Cochrane Q test found that the DSM-5-TR was not dissimilar to the RDCC, if fulfilling numerical thresholds for criteria A-C, although any level of symptom severity was allowed. Confirmatory factor analysis with three goodness-of-fit indexes validated the RDCC.</p><p><strong>Conclusions: </strong>The RDCC requires akinetic symptoms on the basis of literature demonstrating their high BFCRS prevalence and exploratory factor analysis co-loadings, plus symptoms from unusual motor and behavioral signs. Compared with current lenient diagnostic approaches, having the symptoms required by the RDCC produced lower catatonia rates in the psychosis, affective, and medical groups and revealed no patients with catatonia in the delirium group. Subdividing DSM-5-TR symptoms into several different criteria may improve diagnosis. RDCC symptom clusters are both research data-based and amenable to further research for validation.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"67-78"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391161","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":"Primary Polydipsia in a Case of Genetic Behavioral Variant Frontotemporal Dementia.","authors":"Yesenia Cantu, Taryn White, Gabriela Austgen, Christine Rizk, Olaoluwa O Okusaga, Melissa B Jones","doi":"10.1176/appi.neuropsych.20230227","DOIUrl":"10.1176/appi.neuropsych.20230227","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"179-182"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668308","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":"Altered Neural Processing of Interoception in Patients With Functional Neurological Disorder: A Task-Based fMRI Study.","authors":"Petr Sojka, Tereza Serranová, Sahib S Khalsa, David L Perez, Ibai Diez","doi":"10.1176/appi.neuropsych.20240070","DOIUrl":"10.1176/appi.neuropsych.20240070","url":null,"abstract":"<p><strong>Objective: </strong>Research suggests that disrupted interoception contributes to the development and maintenance of functional neurological disorder (FND); however, no functional neuroimaging studies have examined the processing of interoceptive signals in patients with FND.</p><p><strong>Methods: </strong>The authors examined univariate and multivariate functional MRI neural responses of 38 patients with mixed FND and 38 healthy control individuals (HCs) during a task exploring goal-directed attention to cardiac interoception-versus-control (exteroception or rest) conditions. The relationships between interoception-related neural responses, heartbeat-counting accuracy, and interoceptive trait prediction error (ITPE) were also investigated for FND patients.</p><p><strong>Results: </strong>When attention was directed to heartbeat signals versus exteroception or rest tasks, FND patients showed decreased neural activations (and reduced coactivations) in the right anterior insula and bilateral dorsal anterior cingulate cortices (among other areas), compared with HCs. For FND patients, heartbeat-counting accuracy was positively correlated with right anterior insula and ventromedial prefrontal activations during interoception versus rest. Cardiac interoceptive accuracy was also correlated with bilateral dorsal anterior cingulate activations in the interoception-versus-exteroception contrast, and neural activations were correlated with ITPE scores, showing inverse relationships to those observed for heartbeat-counting accuracy.</p><p><strong>Conclusions: </strong>This study identified state and trait interoceptive disruptions in FND patients. Convergent between- and within-group findings contextualize the pathophysiological role of cingulo-insular (salience network) areas across the spectrum of functional seizures and functional movement disorder. These findings provide a starting point for the future development of comprehensive neurophysiological assessments of interoception for FND patients, features that also warrant research as potential prognostic and monitoring biomarkers.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"149-159"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668305","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":"Race-Ethnicity, Rurality, and Age in Prospective Preferences and Concerns Regarding Closed-Loop Implanted Neural Devices.","authors":"Bryan B Chen, Tobias Haeusermann, Abraham Dada, Roy H Hamilton, Jennifer E James, Kristina Celeste Fong, Daniel Dohan, Winston Chiong","doi":"10.1176/appi.neuropsych.20230190","DOIUrl":"10.1176/appi.neuropsych.20230190","url":null,"abstract":"<p><strong>Objective: </strong>Responsive and human-centered neurotechnology development requires attention to public perceptions, particularly among groups underserved by existing treatments.</p><p><strong>Methods: </strong>The authors conducted a preregistered nationally representative survey (https://osf.io/ej9h2) using the NORC at the University of Chicago AmeriSpeak panel. One vignette compared an implanted neural device with surgical resection in a scenario involving epilepsy, and another compared an implanted neural device with medications in a scenario involving mood disorders. The survey also contained questions about respondents' confidence that a device would be available if needed and confidence that enough research has been conducted among people like themselves. Responses were entered into nested survey-weighted logistic regression models, including a base demographic model (to test the overall effect of demographic factors) and an adjusted model that also included socioeconomic, religious and political, and health care access predictors.</p><p><strong>Results: </strong>A total of 1,047 adults responded to the survey, which oversampled Black non-Hispanic (N=214), Hispanic (N=210), and rural (N=219) Americans. In the base demographic model, older Americans were more likely to prefer an implanted device in the two scenarios, and non-Hispanic Black Americans were less likely than non-Hispanic White Americans to prefer a device; rural Americans were less confident than urban or suburban Americans in having access, and non-Hispanic Black and rural Americans were less confident that enough research has been conducted among people like themselves. In adjusted models, income was a key mediator, partially explaining the effect of age and the contrast between Black and White non-Hispanic respondents on preferences for a device in the epilepsy scenario and fully explaining the effect of rurality on confidence in access.</p><p><strong>Conclusions: </strong>Demographic differences in prospective preferences and concerns highlight the importance of including members of underserved communities in neurotechnology development.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"79-87"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017720","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":"An 11-Fold Higher Risk of Incident Mild Cognitive Impairment With Hispanic Ethnicity and Baseline Neuropsychiatric Symptoms.","authors":"Ricardo Salazar, Alok K Dwivedi, Luis A Alvarado, Michael Escamilla","doi":"10.1176/appi.neuropsych.20230180","DOIUrl":"10.1176/appi.neuropsych.20230180","url":null,"abstract":"<p><strong>Objective: </strong>Neuropsychiatric symptoms (NPSs) have been linked to cognitive decline. This study explored ethnic differences and the effects of baseline NPSs on incident mild cognitive impairment (MCI) among 386 Hispanic and non-Hispanic participants from the Texas Harris Alzheimer's Research Study.</p><p><strong>Methods: </strong>Data on NPSs from the Neuropsychiatric Inventory Questionnaire were available for all participants. Cox proportional hazards regression models were used to estimate the effect of ≥1 NPS at baseline and Hispanic ethnicity on incident MCI over a 7-year follow-up period.</p><p><strong>Results: </strong>NPSs at baseline were associated with incident MCI for Hispanic participants but not non-Hispanic participants. Being Hispanic with at least one NPS at baseline had an 11-times higher risk of incident MCI.</p><p><strong>Conclusions: </strong>The Hispanic participants converted to MCI to a greater extent than the non-Hispanic participants. Only depressive symptoms increased the risk of MCI among non-Hispanics. Being of Hispanic ethnicity and having NPSs appeared to jointly increase the risk of progressing to MCI. To better understand the Alzheimer's disease continuum, further studies should explore other cultural, genetic, and medical risk factors influencing disease progression. Our findings strongly suggest the need to incorporate NPSs as outcomes of disease progression in future clinical trials involving Hispanic participants.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"29-37"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017719","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":"Characterizing Neurobehavioral Dysregulation Among Former American Football Players: Findings From the DIAGNOSE CTE Research Project.","authors":"Surya V Pulukuri, Tessa R Fagle, Diana Trujillo-Rodriguez, Suzan van Amerongen, Charles Bernick, Yonas E Geda, Jennifer V Wethe, Elaine R Peskind, Douglas I Katz, Michael L Alosco, Joseph N Palmisano, Yorghos Tripodis, Charles H Adler, Laura J Balcer, Eric M Reiman, Martha E Shenton, Jeffrey L Cummings, Robert A Stern","doi":"10.1176/appi.neuropsych.20230133","DOIUrl":"10.1176/appi.neuropsych.20230133","url":null,"abstract":"<p><strong>Objective: </strong>Neurobehavioral dysregulation (NBD), a core clinical feature of traumatic encephalopathy syndrome, encompasses neuropsychiatric symptoms reported among individuals with a history of repetitive head impact exposure, including contact sport athletes. The objective of this study was to examine the construct and subconstructs of NBD through a series of factor and cluster analyses.</p><p><strong>Methods: </strong>Six clinician-scientists selected self-report questionnaire items relevant to NBD from seven available neuropsychiatric scales through a blinded voting process. These items were subjected to confirmatory factor analyses in a sample of 178 former college and professional American football players and 60 asymptomatic individuals without a history of repetitive head impact exposure. All participants were enrolled in the Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy Research Project. Factor scores were generated on the basis of the optimal expert-informed model for NBD. Construct validity was assessed with neuropsychiatric scales not included in generation of the factor scores. Cluster analyses with NBD factor scores were used to examine symptom profiles.</p><p><strong>Results: </strong>Factor analyses confirmed that NBD was composed of four subconstructs: explosivity, emotional dyscontrol, impulsivity, and affective lability. Cluster analyses indicated four distinct symptom profiles of NBD in this group of former football players: asymptomatic (N=80, 45%), short fuse (N=33, 19%), high affective lability (N=34, 19%), and high NBD (N=31, 17%).</p><p><strong>Conclusions: </strong>These findings characterize NBD as a multifaceted clinical construct with a heterogeneous presentation, providing a foundation for empirical work on the diagnostic criteria for traumatic encephalopathy syndrome and research on the neurobiological underpinnings of NBD.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"38-46"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734402","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":"Multicenter Evaluation of Memory Remediation in Traumatic Brain Injury With Donepezil: A Randomized Controlled Trial.","authors":"David B Arciniegas, Emily J Almeida, Angelle M Sander, Jay A Bogaards, Joseph T Giacino, Flora M Hammond, Cynthia L Harrison-Felix, Tessa Hart, Jessica M Ketchum, David C Mellick, Mark Sherer, John Whyte, Ross D Zafonte","doi":"10.1176/appi.neuropsych.20230055","DOIUrl":"10.1176/appi.neuropsych.20230055","url":null,"abstract":"<p><p>Memory impairments are common chronic and functionally important consequences of traumatic brain injury (TBI). Among patients with persistent verbal memory impairments due to TBI-related cholinergic deficits, donepezil (an acetylcholinesterase inhibitor) may improve these and related problems. The Multicenter Evaluation of Memory Remediation in TBI with Donepezil (MEMRI-TBI-D) study, a four-site, randomized, parallel-group, double-blind, placebo-controlled, 10-week clinical trial, evaluated the efficacy of donepezil on verbal memory impairments, co-occurring cognitive and noncognitive neuropsychiatric problems, and functional status among persons with severe, persistent, and functionally limiting verbal memory problems at least 6 months after mild, moderate, or severe TBI. Efficacy, safety, and tolerability measures were assessed. Seventy-five participants were randomly assigned to donepezil (N=37) and placebo (N=38) groups. In both modified intent-to-treat and per-protocol analyses, donepezil significantly improved memory (i.e., verbal learning, as measured by the Hopkins Verbal Learning Test-Revised Total Trials 1-3, the primary outcome measure) when compared with placebo. Treatment-responder rates in the donepezil and placebo groups were 42% and 18%, respectively, yielding a number needed to treat of 3.5. Among donepezil responders, delayed recall and processing speed also improved significantly. Treatment-emergent adverse event rates for donepezil and placebo were 46% and 8%, respectively, and mild or moderate (85%); diarrhea and nausea were significantly more common in the donepezil group, yielding a number needed to harm of 6.25 and a likelihood to be helped or harmed ratio of 1.79. These results suggest that donepezil is an efficacious treatment for severe, persistent memory impairments after predominantly severe TBI, with a relatively favorable safety and tolerability profile.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"102-114"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769804","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":"Functional Neurological Disorders Among Patients With Tremor.","authors":"José Fidel Baizabal-Carvallo, Marlene Alonso-Juarez, Joseph Jankovic","doi":"10.1176/appi.neuropsych.20230126","DOIUrl":"10.1176/appi.neuropsych.20230126","url":null,"abstract":"<p><strong>Objective: </strong>Functional neurological disorders (FNDs) are increasingly recognized in the general population and neurology clinics, and there is evidence that patients with neurological disorders are more likely to have a FND. This study was designed to identify the clinical features of FNDs among patients with movement disorders when the two disorders coexist.</p><p><strong>Methods: </strong>The clinical histories and video recordings of 150 consecutive patients with tremors were examined: the types of tremor included essential tremor; essential tremor plus; dystonic tremor; tremor associated with dystonia; and drug-induced, myoclonic, orthostatic, task-specific, parkinsonian, Holmes, and unclassified tremor. Using criteria for \"possible\" and \"probable\" coexistent FND, clinical features that helped differentiate between functional and other neurological tremors were identified.</p><p><strong>Results: </strong>There were 27 (18%) patients with functional manifestations, and 17 (11% of full sample) of these patients had signs suggestive of comorbid functional tremor. Patients with comorbid functional manifestations were younger at presentation, and these patients had greater severity of tremor, particularly upper limb postural tremor. Functional manifestations were not more commonly observed among patients with any particular type of tremor, except for patients with Holmes tremor, who were more likely to have comorbid functional neurological manifestations.</p><p><strong>Conclusions: </strong>About 18% of patients with diverse types of tremors also had comorbid functional neurological manifestations. Of the coexistent FNDs, functional tremor was the most common. Patients with co-occurring functional and other neurological tremors presented for evaluation at a younger age and had greater severity of arm tremor than those without comorbid functional neurological manifestations.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"61-66"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734403","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":"Poststroke Impulsivity: A Narrative Review.","authors":"Melissa B Jones, Dakota E Broadway, Malena Gimenez-Zapiola, Ricardo E Jorge","doi":"10.1176/appi.neuropsych.20240080","DOIUrl":"10.1176/appi.neuropsych.20240080","url":null,"abstract":"<p><p>In this narrative review, the authors examine the multidimensional nature and presentations of impulsivity after stroke. Impulsivity manifests as immediate or premature responses, impaired delayed gratification, perseverance despite punishment, and other displays of impaired emotional and behavioral regulation. The literature on the assessments, outcomes, and treatment of patients with these various manifestations after a cerebrovascular injury is reviewed. Findings from case reports indicate that poststroke impulsivity may manifest across neurobehavioral syndromes that are not well defined in the psychiatric nomenclature, such as alien hand syndrome and atypical impulse control disorders. Overall, impulse control disorders appear to be rare poststroke. Therapeutic approaches for poststroke impulsivity require further evidence. The field would benefit from refinement of impulsivity definitions and integration with psychiatric nomenclature.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"201-208"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441118","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}