Journal of Psychiatric Practice最新文献

{"title":"Modeling the Structural Relationships of Irritable Bowel Syndrome Symptom Severity Based on Hostile Attribution, Perceived Stress, and Cognitive Bias With the Mediating Role of Negative Meta-emotion.","authors":"Abdulaziz A Qrmli","doi":"10.1097/PRA.0000000000000877","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000877","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder that significantly impairs quality of life and is commonly associated with psychological factors. This study explores the mediating role of negative meta-emotions, defined as emotional responses to one's own emotions (eg, shame about anxiety), in the relationship between IBS symptom severity, perceived stress, cognitive bias, and hostile attribution.</p><p><strong>Participants and procedure: </strong>This descriptive-correlational and cross-sectional study was conducted in 2024 and involved 300 patients with IBS, 18 to 60 years of age, who were attending gastroenterology clinics in Tabuk, Saudi Arabia. Participants completed a set of validated questionnaires, including the Hostile Attribution Scale, Perceived Stress Scale, Negative Meta-Emotions Scale, Cognitive Bias Questionnaire, and the IBS Symptom Severity Scale (IBS-SSS). Data were analyzed using SPSS and AMOS. Structural equation modeling was used to examine both direct and indirect effects.</p><p><strong>Results: </strong>Perceived stress (β=0.42), hostile attribution (β=0.30), and cognitive bias (β=0.35) had significant direct effects on IBS symptom severity. Negative meta-emotions significantly mediated the effects of all 3 variables, with perceived stress showing the strongest total effect (β=0.56). Model fit indices confirmed a good fit (root mean square error of approximation=0.047, comparative fit index=0.94).</p><p><strong>Conclusions: </strong>The findings highlight the critical role of negative meta-emotions in intensifying IBS symptoms and support the integration of psychological interventions, especially those targeting stress reduction, emotion regulation, and cognitive restructuring, into standard IBS care. Further longitudinal studies are recommended to clarify the temporal order and causality of these psychological influences.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 5","pages":"245-250"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069796","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":"Intravenous Ketamine Followed by Intranasal Esketamine in 2 Subsequent Treatment-resistant Depressive Episodes: Insights From a Case Series.","authors":"Matteo Carminati, Mattia Tondello, Barbara Barbini, Raffaella Zanardi","doi":"10.1097/PRA.0000000000000879","DOIUrl":"10.1097/PRA.0000000000000879","url":null,"abstract":"<p><p>Treatment-resistant depression (TRD) remains a relevant issue in psychiatric practice, driving the exploration of innovative therapeutic alternatives. Ketamine and its enantiomer, esketamine, are emerging as treatments known for their effectiveness as rapid-acting antidepressants. Although previous comparative studies have highlighted some differences in their effects, they did not concurrently evaluate these 2 therapies in the same patient. The goal of this case series is to extend this investigation by comparing the efficacy of ketamine and esketamine in the same patient. This study included 5 patients diagnosed with TRD who had previously received treatment with intravenous ketamine as inpatients on the Mood Disorder Unit at San Raffaele Hospital in Milan. The patients subsequently underwent intranasal esketamine treatment as outpatients due to relapse. All patients received routine oral antidepressant therapy during both episodes, including selective serotonin reuptake inhibitors or serotonin norepinephrine reuptake inhibitors. The depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) before the first administration of each treatment (T0) and after 6 infusions of ketamine (3 wk) or after 8 administrations of esketamine (4 wk), respectively (T1). Four of the 5 patients showed a clinical response to intravenous ketamine, but only 1 patient showed a clinical response to intranasal esketamine (with clinical response defined as a 50% reduction in MADRS score). In particular, a better response to ketamine did not predict a good response to esketamine. Conversely, the only patient who did not respond to ketamine showed a good response to esketamine. All of the patients showed a significant and rapid reduction in MADRS scores after both treatments, but none of the patients achieved remission with either treatment (defined as a MADRS score<10). Findings from this case series suggest that both ketamine and esketamine are associated with significant reductions in depressive symptoms in TRD. We observed a generally better response to ketamine than to esketamine. This difference may be due both to the pharmacological effects of the R-ketamine (arketamine) component of intravenous ketamine and to the different settings in which the 2 treatments were administered (inpatient vs. outpatient). A better response to ketamine was not predictive of a better response to esketamine in our case series. A deeper insight into the side effects of the treatments (eg, dissociation) and into the clinical history of the patients would be helpful in better understanding the relationship between the 2 treatments.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 5","pages":"278-281"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069842","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":"Coping on Campus: Mental Health and the University Student.","authors":"Meera Menon","doi":"10.1097/PRA.0000000000000876","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000876","url":null,"abstract":"","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 5","pages":"290"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069853","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 Pilot Clinical Trial Examining Exposure and Stress Management Therapy for Adults With Misophonia.","authors":"Samuel D Spencer, Dean McKay, Katie H Mangen, Ana Rabasco","doi":"10.1097/PRA.0000000000000874","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000874","url":null,"abstract":"<p><p>Misophonia is a recently recognized condition characterized by extreme intolerance of idiosyncratic and repetitive sounds (often human-generated gustatory or breathing-based noises), coupled with intense affective-based reactions, that results in significant impairment and distress. Cognitive-behavioral therapy approaches, including exposure principles and stress management/distress tolerance skills, have demonstrated promise for the treatment of misophonia. However, efforts to develop interventions remain ongoing and further empirical examination of candidate treatment models is needed. In the pilot study described in this article, we preliminarily examined the efficacy of exposure and stress management therapy (ESMT) individually delivered via synchronous telehealth modality for adults with misophonia. Data from 26 participants (mean age=34.4 y) enrolled between April 2016 and September 2020 provided initial support for ESMT on the basis of pretreatment to post-treatment reductions in misophonia symptomology and increases in distress tolerance. Gains were generally maintained at 3- and 6-month follow-ups. The results did not appear to differ based on the order in which the exposure and stress management modules were delivered, which was randomized across participants. Participant perceptions of ESMT homework regarding adherence, comprehension, and usefulness were generally acceptable. This study provides preliminary support for ESMT as a potentially viable psychosocial intervention for misophonia and highlights the promising roles of exposure (with appropriate adaptations) and stress management for alleviating misophonia-related distress and impairment. Findings are discussed in the context of continuing to develop, refine, and test ESMT using more rigorous methodologies and diverse samples.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 5","pages":"251-259"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069828","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":"Treatment-refractory Psychosis With Catatonia and Persistent Generalized Retrograde Amnesia: A Case Report of a 41-year-old, Mandarin-speaking Male.","authors":"Jinjie Ling, Angelica P Kurtz, Patrick J Hurley","doi":"10.1097/PRA.0000000000000883","DOIUrl":"10.1097/PRA.0000000000000883","url":null,"abstract":"<p><p>In this report, we describe an unknown patient who presented to the emergency department with severe catatonia and a constellation of symptoms indicative of a primary psychotic disorder. Simultaneously, the patient exhibited severe autobiographical memory impairment suggestive of a comorbid dissociative disorder. Our report offers insight into a rare instance in which catatonia, a primary psychotic disorder, and dissociative disorder may have intersected in a clinical case. While the patient was successfully treated with lorazepam for his catatonia, his psychotic symptoms responded only minimally to several antipsychotic trials. Ultimately, his psychotic symptoms, disorganized speech and behavior, and autobiographical memory impairment were refractory to treatment, including dual clozapine-risperidone therapy. Remarkably, the patient scored an 8/30 on the Montreal Cognitive Assessment with multidomain deficits in executive function, naming, delayed recall, language, and abstraction. Finally, the patient demonstrated limited vocabulary in his native language, consistent with low educational attainment. Based on his presentation and hospital course, a differential diagnosis, which included unspecified primary psychotic disorder with catatonia, dissociative amnesia, neurodevelopmental disorder, and cognitive malingering, was proposed. The findings from this case highlight the occurrence of co-existing psychotic and dissociative disorders with multidomain neurocognitive deficits and clinical challenges in treating these cases.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 5","pages":"285-289"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069858","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":"Applying Motivational Interviewing Strategies to Facilitate Secure Firearm Storage During Clinical Encounters-Part 1: Relational Foundation.","authors":"Frances M Aunon, Steve Martino, Gabriela Khazanov, Suzanne E Decker, Steven Dobscha, Joseph A Simonetti","doi":"10.1097/PRA.0000000000000875","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000875","url":null,"abstract":"<p><p>Encouraging changes in firearm-related storage practices through lethal means safety (LMS) counseling can be challenging. Motivational interviewing (MI) may be a useful clinical approach for clinicians who deliver LMS counseling. The aim of this 2-part series is to provide clinicians with guidance on applying MI strategies to evoke motivation for changing firearm storage practices. In part 1 of this series, we provide a rationale for considering an MI-based approach to facilitate secure firearm storage practices and briefly review the relational foundations of MI that are critical to successful MI-based interventions (ie, how we approach our patients). In part 2 of this work, we will discuss how MI technical strategies may be applied to LMS counseling to facilitate secure firearm storage practices.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 5","pages":"275-277"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069839","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":"Devices.","authors":"John M Oldham","doi":"10.1097/PRA.0000000000000880","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000880","url":null,"abstract":"","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 5","pages":"237"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069844","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":"Use of Point-of-care Testing Devices for Patients on Clozapine: A Literature Review.","authors":"Peyton Whiston, Ana Tucker, Oliver Glass","doi":"10.1097/PRA.0000000000000878","DOIUrl":"10.1097/PRA.0000000000000878","url":null,"abstract":"<p><p>Clozapine, an antipsychotic medication for treatment-resistant schizophrenia, remains underutilized due to its serious side effects and need for extensive hematologic monitoring. Recently, discussions have focused on the use of point-of-care testing (POCT) devices to monitor laboratory values, including the absolute neutrophil count (ANC) and clozapine concentration, in patients being treated with clozapine. This review assesses whether these devices could ease the monitoring burden on patients and providers without compromising the accuracy of results and subsequent patient safety. We found several devices that are reported to have acceptable accuracy for the initial screening of ANC and clozapine concentration. Although confirmatory standard venous testing is sometimes required based on point-of-care results, these devices offer results more quickly than traditional methods, increasing utility for clinicians. Further research is needed to evaluate the performance of these devices in diverse patient populations, including individuals with benign ethnic neutropenia and those susceptible to diurnal variation of ANC.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 5","pages":"260-266"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069851","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 FDA-approved and Manufacturer-approved Prescribing Information: Why the Expectation That the Prescriber Has Read It and Suggestions About How to Do So Efficiently.","authors":"Sheldon H Preskorn","doi":"10.1097/PRA.0000000000000885","DOIUrl":"10.1097/PRA.0000000000000885","url":null,"abstract":"<p><p>Based on survey feedback, ~5% of prescribers do not understand the importance of the prescribing information (PI) provided by the U.S. Food and Drug Administration (FDA) and the specific manufacturer of the drug, even though it is provided every time the drug is dispensed. This column addresses 3 representative comments from this subset of prescribers about whether it is an appropriate expectation that the prescriber be familiar with the PI, whether by reading it in its entirety or the first page summary and any additional sections that they wish to know. It also discusses that many, if not all, prescribing \"guides\" are in fact the PI reformatted for the guide. This column refers the reader back to earlier columns that discuss some of these matters in more detail. This column also addresses comments by 8% of surveyed prescribers about the need for training programs to cover this information for the benefit of prescribers in training and their eventual patients.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 5","pages":"267-269"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069866","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 16-Minute Hour: Combining Abbreviated Psychotherapy With Medication Visits. Part 3: Psychodynamic Therapy.","authors":"David Mintz, Samuel Dotson, John C Markowitz, Michael E Thase","doi":"10.1097/PRA.0000000000000862","DOIUrl":"10.1097/PRA.0000000000000862","url":null,"abstract":"<p><p>Psychiatrists increasingly practice psychotherapy by integrating their therapeutic training into brief medication visits. Insurance companies reimburse this approach using the 90833 Current Procedural Terminology (CPT) code, which corresponds to 16 to 37 minutes of add-on psychotherapy combined with pharmacotherapy. As scholarship focused on such short-form combined therapy is scarce, this 4-part series addresses the practice gap, providing guidance to practicing professionals. This installment addresses psychodynamic psychotherapy, a deeply personalized intervention that is increasingly recognized as a modality well suited to integration with psychopharmacology.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 4","pages":"217-221"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659433","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}