Journal of Psychiatric Practice最新文献

{"title":"Commentary on Nitrous Oxide: Weighing the Toxic Neuropsychiatric Effects of Abuse Against Potential Therapeutic Benefits for Psychiatric Disorders.","authors":"Amir Garakani","doi":"10.1097/PRA.0000000000000854","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000854","url":null,"abstract":"<p><p>Nitrous oxide (N2O), an anesthetic gas used for dental procedures, has recently become increasingly recognized as a potential drug of misuse and abuse, with an increasing number of case studies reporting serious adverse effects, including megaloblastic anemia, myelopathy, neuropathy, subacute combined degeneration, psychosis, and even death. There is also growing research support for the use of N2O in the treatment of several psychiatric disorders, including major depressive disorder. In this issue, we present the case of a 37-year-old man with no significant psychiatric history who presented with agitation, self-inflicted arm lacerations, paranoia, and hallucinations. The patient admitted to about 6 months of increasing recreational nitrous oxide use. He was found to have a low vitamin B12 level and anemia with results of other laboratory tests and head imaging within normal limits. His presentation suggested psychosis and delirium with withdrawal-like symptoms due to nitrous oxide abuse. He responded to treatment with olanzapine, a diazepam taper, and the addition of sertraline. The case highlights challenges with identifying and treating patients who misuse N2O, given the absence of a drug test for it and a lack of a consensus on how to classify and manage patients who abuse this drug. Further clinical research should be done, in parallel, on the risks of misuse and abuse of nitrous oxide, along with larger scale, yet measured, investigations of N2O as a treatment option in psychiatry.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 3","pages":"178-179"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180028","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":"Pharmacotherapy for Complex Substance Use Disorders: A Practical Guide.","authors":"Smita Das","doi":"10.1097/PRA.0000000000000857","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000857","url":null,"abstract":"","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 3","pages":"180-181"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180877","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":"Clinical Insights Concerning Rickets in Association With Neurodevelopmental Disorders: A Systematic Review Focused on Autism.","authors":"Sunny Cui, Leon Wickramage, Leah Snodgrass, Asima A Zehgeer","doi":"10.1097/PRA.0000000000000855","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000855","url":null,"abstract":"<p><p>This systematic review examines the intersection of rickets and autism spectrum disorder (ASD), highlighting clinical insights from 10 studies involving 13 patients. Rickets, a pediatric bone disorder resulting from vitamin D, calcium, and/or phosphate deficiencies, often manifests through skeletal deformities, muscle weakness, and bone pain. ASD is a neurodevelopmental condition characterized by deficits in social communication and repetitive behaviors. The coexistence of these conditions, although uncommon, is notable due to overlapping factors such as selective eating habits and sensory sensitivities in children with ASD, which may exacerbate nutritional deficiencies. A comprehensive search across PubMed, Google Scholar, and Web of Science identified 65 relevant articles meeting the initial inclusion criteria, 10 of which (reporting on 13 patients) met the final review criteria for inclusion. All patients exhibited food selectivity, with most excluding dairy products and favoring potato-based foods. Musculoskeletal symptoms were predominant, with genu valgum, wrist widening, and metaphysis fraying being common findings. Seizures were the second most frequent reason for hospital admission, emphasizing the importance of monitoring neurological health in these patients. Calcium supplementation, primarily with calcium carbonate or calcium gluconate, was used in all cases, and the majority of patients experienced normalization of biochemical markers, including serum calcium levels. This review underscores the need for interdisciplinary care, focusing on nutritional and behavioral interventions to manage both rickets and ASD effectively. Future research should aim to explore larger and more diverse populations to better understand the clinical interplay between these conditions and inform more comprehensive treatment strategies.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 3","pages":"145-155"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181589","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":"How the Use of Generic Names for Drugs Can Help Patients Avoid Untoward Adverse Effects.","authors":"Sheldon H Preskorn","doi":"10.1097/PRA.0000000000000852","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000852","url":null,"abstract":"<p><p>This column presents the case example of a patient who was prescribed 3 different brand name drugs, all of which contain bupropion, which has a dose-dependent seizure risk. This case illustrates how such prescribing can result in a patient exceeding the recommended maximum daily dose of bupropion and having a seizure. This column also explains why prescribers should advise their patients to get their prescriptions filled by the same pharmacy or pharmacy chain.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 3","pages":"156-157"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182104","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":"Baseline Data From the Anti-Human Trafficking Program in Texas: A Focus on Substance Use as a Critical Concern.","authors":"Temilola Salami, Charlotte Hillegass, Cayla Hari, Katie Robichaux, Giacomo Tiznado, Anka A Vujanovic, Mollie Gordon, Nguyen Phuong, Kimberly Williams, John Coverdale","doi":"10.1097/PRA.0000000000000859","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000859","url":null,"abstract":"<p><strong>Objective: </strong>The goal of this study was to describe the demographic characteristics of sex-trafficked patients encountered through one of the few hospital-based anti-human trafficking specialty programs available nationally and assess how these characteristics relate to substance use.</p><p><strong>Method: </strong>The sample involved 336 survivors of sex trafficking (mean age=32.39 y). Structured interviews and human trafficking screening tools were used to assess the history of sex trafficking. Demographic and substance use information was collected from patient records.</p><p><strong>Results: </strong>A significant proportion of patients were female (91.7%), homeless (53.3%), and Black/African American (48.5%), and 72.9% reported using substances at the time of intake. When age, sex, race/ethnicity, and housing status were included in the same model, our logistic regressions did not show a significant effect on substance use.</p><p><strong>Conclusions: </strong>Although our logistic regressions did not find differences between demographic characteristics and substance use, the high level of substance use in this population underscores the importance of this issue across demographic categories. Given the high prevalence of substance use and the role of substance use in both the coercion and continued exploitation of trafficking victims, it is important to assess and treat substance use as a central and universal concern among trafficked individuals.​​.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 3","pages":"139-144"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183172","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":"Psychosis and Delirium as Manifesting Symptoms of Chronic and Heavy Nitrous Oxide Use in a 37-Year-Old Samoan Male Patient: A Case Report.","authors":"Xiaowen Sylvia Wang, Gregory Rose, Rick Peter Fritz Wolthusen","doi":"10.1097/PRA.0000000000000856","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000856","url":null,"abstract":"<p><p>Nitrous oxide (N2O) is a clear gas used in the food industry as well as in clinical settings as an analgesic and anesthetic agent. It is also a commonly used recreational drug due to its anxiolytic and euphoric effects. We discuss the case of a 37-year-old Samoan male with a long-standing history of N2O use who was brought to the emergency department for psychotic symptoms, which expanded to symptoms of delirium soon after his presentation. This case report adds to the literature about N2O-induced psychiatric presentations, particularly by focusing on a patient from an underrepresented population. We outline his clinical presentation, describe the presenting physical and psychiatric symptoms, and discuss management options based on existing literature and knowledge. The patient's information is adequately de-identified in this case report.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 3","pages":"173-177"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180161","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":"A Cross-sectional Analysis of Immunological and Hematological Parameters in Patients With Chronic Opioid Use.","authors":"Mine Ergelen, Nazife Gamze Usta Sağlam, Mahmut Selim Arpacioğlu, Murat Yalçin, Filiz İzci","doi":"10.1097/PRA.0000000000000861","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000861","url":null,"abstract":"<p><strong>Background and aim: </strong>Previous research has recognized the dual role of opioids [agonists at μ-opioid receptors (MOP-r agonists)] in modulating immunity and neuroinflammation in individuals with opioid use disorder (OUD). This cross-sectional study investigates the interplay between chronic use of MOP-r agonists and inflammatory parameters in individuals with OUD, with the goal of providing insights into the relationship between immunological responses and OUD.</p><p><strong>Materials and methods: </strong>A cohort of 129 patients with OUD seeking treatment at an addiction detoxification center underwent detailed clinical assessments. Blood samples were collected for analyses of serum alanine aminotransferase, aspartate aminotransferase, and C-reactive protein levels, and a complete blood count. Participants were categorized into inflammation and noninflammation groups based on C-reactive protein levels. Hematological and inflammation indices, along with pain severity, were compared between these groups.</p><p><strong>Results: </strong>Significant differences were observed between the inflammation and noninflammation groups on variables such as duration of MOP-r agonist intake, daily buprenorphine/naloxone dose, consumption route, severity of withdrawal symptoms, and level of self-reported pain. The inflammation group exhibited higher neutrophil counts and an increased neutrophil-to-lymphocyte ratio. The binary logistic regression models revealed that self-reported pain level, daily buprenorphine/naloxone dosage, Beck Depression Inventory scores, and age were significant predictors of inflammation.</p><p><strong>Conclusions: </strong>This study contributes to our understanding of OUD as a chronic inflammatory condition, shedding light on the intricate relationships between MOP-r agonist addiction, inflammatory responses, and withdrawal-related parameters. The findings offer valuable perspectives on effective management, emphasizing the need for further research in diverse populations to enhance understanding of this complex condition.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 3","pages":"116-124"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181943","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":"Screening and Clinical Risk Assessment for Suicide and Self-directed Violence.","authors":"Daniel J Reis, Bridget B Matarazzo, Hal S Wortzel","doi":"10.1097/PRA.0000000000000850","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000850","url":null,"abstract":"<p><p>Most patients who die by suicide receive care outside mental or behavioral health settings in the year before their deaths. As such, effective suicide prevention efforts require screening and assessment of suicide risk broadly across treatment settings, not just within mental health services. Clinical suicide risk assessment (CSRA) is also a fundamental component of therapeutic risk management. This column provides an approach for suicide risk screening and assessment that is consistent with current best practices and applicable guidelines. Theoretical, empirical, and practical considerations for suicide risk screening and CSRA processes are reviewed. Specific topic areas include therapeutic alliance and goal setting, suicidal ideation and behaviors, risk and protective factors, warning signs, and providing assessment feedback. CSRA is framed as a method for gathering information, as well as a form of brief therapeutic intervention. In doing so, the CSRA can inform future treatment decisions, as well as directly mitigate risk, by helping the patient and provider better understand the patient's suicidal ideation and behaviors.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 3","pages":"161-168"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182152","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":"Recognition of Suicide Risk.","authors":"John M Oldham","doi":"10.1097/PRA.0000000000000858","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000858","url":null,"abstract":"","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 3","pages":"115"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182376","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":"Divergent Effects of Psilocybin for 2 Patients Participating in a Psilocybin-assisted Cognitive Behavioral Therapy Trial for Major Depressive Disorder.","authors":"Marc J Weintraub, David J Miklowitz, Jessica K Jeffrey","doi":"10.1097/PRA.0000000000000853","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000853","url":null,"abstract":"<p><p>We present divergent experiences of 2 patients who participated in a clinical trial of psilocybin-assisted cognitive behavioral therapy for major depressive disorder. Both patients participated in an open trial involving 2 drug administration sessions separated by one month (10 and 25 mg, respectively) along with 12 sessions of cognitive behavioral therapy. The first of the 2 patients had powerful and beneficial experiences on psilocybin that led to immediate and sustained antidepressant effects over the 7-month study. The second participant reported significant challenges with psilocybin and minimal to no antidepressant effects following the drug administration. We present the clinicians' experiences who treated both patients. Finally, we theorize and discuss areas of future research to elucidate how psilocybin can yield the greatest psychiatric benefit, the conditions within the patient that can lead to (or inhibit) psychiatric benefit, and the psychosocial environment that can best facilitate psilocybin therapy.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 3","pages":"169-172"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182375","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}