Personalized Medicine in Psychiatry最新文献

{"title":"Expert opinion in mental disorder: Why is acceptance of the COVID-19 vaccines so problematic?","authors":"Jack M. Gorman,&nbsp;David A. Scales,&nbsp;Sara E. Gorman","doi":"10.1016/j.pmip.2021.100072","DOIUrl":"10.1016/j.pmip.2021.100072","url":null,"abstract":"<div><p>A substantial number of people say they will probably or definitely not have a vaccine for COVID-19. We place the reasons for vaccine hesitancy<span> and refusal into three categories: fears that the vaccines are not safe, misinformed ideas, and agreement with conspiracy theories. Evidence-based approaches are available that account for the psychological factors underlying vaccine hesitancy and refusal that should form the basis for counteracting facts and persuasion.</span></p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"25 ","pages":"Article 100072"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.pmip.2021.100072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130243007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left versus right subcallosal cingulate deep brain stimulation for treatment-resistant depression","authors":"Susan K. Conroy ,&nbsp;Shannon Malloy ,&nbsp;Mary E. Kelley ,&nbsp;Megan M. Filkowski ,&nbsp;Ryan M. Trimble ,&nbsp;Megan E. Pirtle ,&nbsp;Ashley Maher ,&nbsp;Sarah Dreyer-Oren ,&nbsp;Wilder Doucette ,&nbsp;Robert M. Roth ,&nbsp;Joshua P. Aronson ,&nbsp;David W. Roberts ,&nbsp;Ki Sueng Choi ,&nbsp;Helen S. Mayberg ,&nbsp;Paul E. Holtzheimer","doi":"10.1016/j.pmip.2021.100069","DOIUrl":"https://doi.org/10.1016/j.pmip.2021.100069","url":null,"abstract":"<div><p><span>Deep brain stimulation<span> (DBS) of the subcallosal cingulate has emerged as a promising therapy for treatment-resistant depression (TRD). To date, all studies have employed bilateral stimulation; however, the physiology of affect and pathophysiology of depression are known to be asymmetric across hemispheres. Unilateral stimulation may provide efficacy while decreasing risk. Five patients were exposed to unilateral open-label DBS to the subcallosal cingulate for 12 weeks each to the left and then </span></span>right hemispheres<span><span> in a double-blind, crossover fashion. After 12 weeks of stimulation to each hemisphere, bilateral stimulation was initiated, and patients were followed for 12 additional weeks. Additionally, nine months of long-term follow up data were collected. Left, but not right, unilateral stimulation was associated with significant decrease in depression scores; with bilateral stimulation, all patients improved and one patient remitted. No serious adverse events were associated with surgery or acute or chronic stimulation. This small study suggests that unilateral DBS to the subcallosal cingulate may be an effective treatment for TRD. All patients improved with bilateral stimulation, though </span>antidepressant effects following 12 weeks were modest. These findings contrast somewhat with prior open-label trials, though duration of bilateral stimulation was shorter in this trial. The current study continues to confirm safety of implantation and use of DBS to the subcallosal cingulate for patients with TRD and highlights the importance of personalization of therapy, for example by hemisphere, in future trials.</span></p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"25 ","pages":"Article 100069"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.pmip.2021.100069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92000719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"T3 augmentation in major depressive disorder: Sex and age differences","authors":"Natalia Hajnas ,&nbsp;Kathryn Cushing ,&nbsp;Olusola Ajilore","doi":"10.1016/j.pmip.2020.100068","DOIUrl":"https://doi.org/10.1016/j.pmip.2020.100068","url":null,"abstract":"<div><h3>Objective</h3><p>T3 use with antidepressants has long been studied. Studies have shown that T3 augmentation is particularly beneficial in various subsets of the population, including individuals with treatment-resistant depression, atypical depression, and particular genetic polymorphisms. This study aims to identify specific populations that may benefit most from T3 augmentation using sex and age to create a targeted treatment plan for patients with depression.</p></div><div><h3>Methods</h3><p>Data was obtained from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study. Data were extracted for the 73 patients who received T3 in addition to their antidepressant therapy. Patients were given the Quick Inventory of Depressive Symptomatology-Clinician depression assessment before and after treatment with T3. Improvement with T3 was calculated as percent improvement based on the difference in scores from these assessments. Statistical analysis was conducted using exploratory correlational analysis and independent samples t-tests.</p></div><div><h3>Results</h3><p>In men, there was a significant negative correlation between the age and percent improvement in depressive symptoms, while in women, there was no correlation. An age median split of the data revealed differences in younger versus older patients. In the younger group, there was no significant difference in percent improvement in men versus women. However, there was a significant difference in percent improvement in men versus women in the older group.</p></div><div><h3>Conclusion</h3><p>This study suggests that age and sex affect gain with T3 augmentation. Our results indicate that T3 augmentation is a beneficial treatment overall and is the least helpful in older men.</p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"25 ","pages":"Article 100068"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.pmip.2020.100068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92000720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert opinion in Alzheimer disease: The silent scream of patients and their family during coronavirus disease 2019 (COVID-19) pandemic","authors":"Salvador M. Guinjoan","doi":"10.1016/j.pmip.2021.100071","DOIUrl":"10.1016/j.pmip.2021.100071","url":null,"abstract":"<div><p>COVID-19 pandemic is expected to be the greatest challenge for mental health since World War II in general, but the toll exacted on patients with Alzheimer’s disease (AD) and their family is the greatest in several respects. AD patients are at the highest risk for contagion and death from the disease, but also at the very bottom in the list of priorities to access critical care services at times of medical resource scarcity. In this communication we examine the impact of the pandemic on AD patients and their family from the general medical, neurological, and mental health perspectives. We propose that instances of undue restriction of access to care based upon age and diagnosis show that society, governments, and health professionals need to exert maximum care, human compassion, and adherence to original Hippocratic values when addressing the needs of persons with AD and other major neurocognitive disorders during the COVID-19 pandemic, and that psychiatry is called to contribute to societal measures oriented to diminish human burden in this population.</p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"25 ","pages":"Article 100071"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.pmip.2021.100071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124517467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycogen synthase kinase3β: A key player of cognitive dysfunction in chronic kidney disease patients and a possible link between abnormal pTau and platelet APP processing and therapeutic role of erythropoietin","authors":"G. Vinothkumar ,&nbsp;R. Lavanya ,&nbsp;N. Mohanraj ,&nbsp;P. Venkataraman","doi":"10.1016/j.pmip.2021.100073","DOIUrl":"https://doi.org/10.1016/j.pmip.2021.100073","url":null,"abstract":"<div><p><span><span><span>Glycogen synthase<span> kinase3β (GSK3β) is connected to several important organic processes like glycogen metabolism, </span></span>apoptosis<span><span><span>, protein synthesis<span>, cell signaling, cell transport, </span></span>gene transcription, proliferation, and intracellular communication. Accordingly, GSK3β has been implicated in a wide variety of diseases, and various pharmaceutical organizations depend on GSK3β as a therapeutic target for disease remedy. </span>Erythropoietin (EPO) is used routinely to treat anemia in </span></span>chronic kidney disease<span> (CKD). However, increasing evidence from human and animal studies has shown that treatment<span> with EPO can improve hemoglobin and cognitive function. The aims of the review paper clarify the potential significance of GSK3β in anemic CKD patients with cognitive dysfunction as a multipotent molecular mechanism of change of platelets induced by EPO. Previously, we investigated the therapeutic effect of EPO on abnormal platelet amyloid precursor </span></span></span>protein processing<span><span><span> and expression, and also analyzed the relationship between abnormal platelet GSK3β expressions, plasma β amyloid (Aβ), total Tau, phosphorylated tau 181 (ptau-181) levels </span>in patients<span> with cognitive dysfunction with complete neuropsychological test scores (Mini Mental scale examination (MMSE), Wechsler memory scale (WMS I) and Tower of London (TOL)). We then highlight evidence indicating that GSK3β influences platelet expression in patients with cognitive impairment with anemic CKD, and how this may support targeting more effective therapies particularly for cognitive dysfunction in patients with CKD. We conclude by suggesting how to further advance this clinical development field, such as the use of EPO treatment </span></span>pharmacogenomics studies in patients with anemic CKD with cognitive dysfunction.</span></p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"25 ","pages":"Article 100073"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.pmip.2021.100073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92000717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired meaning-based cognitive skills are specifically associated with poorer subjective quality of life in schizophrenia","authors":"Eric J. Tan ,&nbsp;Susan L. Rossell ,&nbsp;Stuart J. Lee","doi":"10.1016/j.pmip.2020.100062","DOIUrl":"https://doi.org/10.1016/j.pmip.2020.100062","url":null,"abstract":"<div><p><span><span>Cognitive impairment is characteristic of </span>schizophrenia but the nature and severity often differ between patients and the relationship with subjective </span>quality of life<span><span> (sQOL) is inconsistent. This study sought to better characterise the cognition-sQOL relationship in schizophrenia by 1) examining associations between factor analysis-derived cognitive domains and sQOL, 2) investigating if these domains independently predicted sQOL, and 3) exploring if clinical, demographic and functional variables moderated any significant relationships. 47 schizophrenia/schizoaffective disorder patients and 48 healthy controls were assessed. QOL was measured using the Lehman’s QOL Interview. Composite scores were created to represent objective QOL and sQOL, and factor analysis was used to determine cognitive domains from 14 cognitive tasks. Three cognitive domains were derived: visuospatial planning, verbal linguistic and inhibition switching. Tasks comprising the verbal linguistic cognitive domain were significantly associated with and predicted sQOL. Moderation analyses revealed that the direction of this relationship differed between patients and healthy controls, and may be moderated by positive symptom severity </span>in patients<span>. In conclusion, meaning-based (e.g. verbal-linguistic) cognitive abilities may be most closely related to sQOL in schizophrenia. Symptomatology may also impact this relationship, with worsening sQOL among those with more intact verbal-linguistic processing and persistent positive symptoms. These patients may therefore be at greater risk for poor sQOL, but may be more motivated and capable of engaging in and benefiting from offered psychosocial interventions.</span></span></p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"23 ","pages":"Article 100062"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92066291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individualized theta-burst stimulation modulates hippocampal activity and connectivity in patients with major depressive disorder","authors":"Clemens Mielacher ,&nbsp;Johannes Schultz ,&nbsp;Maximilian Kiebs ,&nbsp;Torge Dellert ,&nbsp;Anna Metzner ,&nbsp;Larissa Graute ,&nbsp;Hanna Högenauer ,&nbsp;Wolfgang Maier ,&nbsp;Claus Lamm ,&nbsp;René Hurlemann","doi":"10.1016/j.pmip.2020.100066","DOIUrl":"https://doi.org/10.1016/j.pmip.2020.100066","url":null,"abstract":"<div><h3>Background</h3><p>While intermittent theta-burst stimulation (iTBS) has been shown to improve symptoms of major depressive disorder (MDD), research has been largely limited to targeting the dorsolateral prefrontal cortex (DLPFC). New approaches utilize patients’ individual resting state fMRI data in order to identify superficial cortical stimulation targets functionally connected to deeper brain regions, thus enabling the modulation of previously inaccessible targets for antidepressant therapy.</p></div><div><h3>Objective</h3><p>To improve iTBS treatment of MDD by inducing plasticity in the hippocampus through stimulation of an individually mapped, functionally interconnected site in the parietal cortex.</p></div><div><h3>Methods</h3><p>Fifty-three MDD patients were randomized to three treatment groups and underwent 15 sessions of iTBS to the left DLPFC. This was augmented by adding a second daily session of (i) stimulation over individualized parietal targets functionally connected to the hippocampus, (ii) left DLPFC stimulation, or (iii) sham stimulation. To evaluate the improvement of treatment, we assessed depression severity, neuropsychological performance, functional connectivity and neural activation during an associative memory paradigm pre- vs. post-treatment.</p></div><div><h3>Results</h3><p>Augmentation of left DLPFC stimulation by parieto-hippocampal stimulation increased functional connectivity between hippocampus and DLPFC as well as encoding-related hippocampal activation; the latter was associated with better performance during a spatial planning task dependent on prefrontal and hippocampal contributions. Depressive symptoms improved in all groups after treatment, with best clinical outcomes following twice-daily left DLPFC stimulation.</p></div><div><h3>Conclusion</h3><p>Functional connectivity-guided stimulation of the hippocampus may serve as an adjunct to iTBS in order to target the cognitive symptoms of MDD.</p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"23 ","pages":"Article 100066"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468171720300120/pdfft?md5=c41c2cf7104566ededf937abde5c43b9&pid=1-s2.0-S2468171720300120-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91989355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diurnal variation of heart rate variability as a physiological index of mood and emotion regulation processes in Major Depression and Borderline Personality Disorder","authors":"Agustina E. Wainsztein ,&nbsp;Carolina Abulafia ,&nbsp;Ximena Goldberg ,&nbsp;Vicente Camacho-Téllez ,&nbsp;Mercedes Vulcano ,&nbsp;Daniel E. Vigo ,&nbsp;Menchón José M. ,&nbsp;Carles Soriano-Mas ,&nbsp;Charles B. Nemeroff ,&nbsp;Guinjoan Salvador M. ,&nbsp;Mariana N. Castro","doi":"10.1016/j.pmip.2020.100065","DOIUrl":"https://doi.org/10.1016/j.pmip.2020.100065","url":null,"abstract":"<div><h3>Background</h3><p>Heart rate variability (HRV), a measure of autonomic nervous system activity, has been studied in a number of psychiatric disorders during the resting state but evidence on its circadian patterns in Major Depressive Disorder (MDD) and Borderline Personality Disorder (BPD) is scarce. We sought to identify and differentiate HRV circadian patterns in MDD, BPD and healthy controls (HC) while exploring potential physiological mechanisms associated with mood and emotion dysregulation.</p></div><div><h3>Methods</h3><p>24-Hour electrocardiographic recordings were obtained from fifty subjects (16 HC, 18 BPD, 16 MDD). HRV was calculated during sleep and wake periods. Associations with mood and affect measures, and with cognitive emotion regulation strategies and self-reported difficulties in emotion regulation (DERS) were examined. Participant’s resilience traits were explored in relation to mood and emotion regulation variables.</p></div><div><h3>Results</h3><p>Lower diurnal measures of HRV (i.e, RMSSD and HF) were observed in MDD subjects compared to HCs. Decreased HF was observed during wake vs. sleep in MDD patients. HAM-D and negative affect scores negatively correlated with HRV in MDD and BPD respectively. MDD and BPD exhibited a positive relationship between the implementation of emotion regulation strategies and HRV compared to HC. Increased resilience was associated with lower HAM-D and DERS scores in BPD and HC.</p></div><div><h3>Conclusion</h3><p>HRV alterations characterized by low diurnal cardiac parasympathetic control constitute a potential trait biomarker of major depression and psychiatric vulnerability to depressive episodes in BPD. HRV anomalies in MDD may persist during clinical remission. Diurnal HRV may represent a psychophysiological index of mood and emotion regulation.</p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"23 ","pages":"Article 100065"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.pmip.2020.100065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92066290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A challenging case of catatonia during pregnancy","authors":"Natalie Martinez-Sosa,&nbsp;Joshua Delaney,&nbsp;Stephen McLeod-Bryant","doi":"10.1016/j.pmip.2020.100064","DOIUrl":"https://doi.org/10.1016/j.pmip.2020.100064","url":null,"abstract":"<div><p><span>Co-occurring pregnancy and catatonia<span> is a challenging combination to treat as the first line treatment for catatonia, </span></span>benzodiazepines<span><span><span>, have been shown to have negative effects on a fetus. ECT is another recommended treatment in this patient population but was not available on admission. The patient was treated with </span>risperidone and </span>lorazepam<span>, which was deemed ineffective, and memantine was started. Shortly after, ECT became available and in combination with memantine, catatonia was treated effectively.</span></span></p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"23 ","pages":"Article 100064"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.pmip.2020.100064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91989357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining irritability as a diagnostic marker and a target for responsiveness","authors":"Erica Bell ,&nbsp;Gin S. Malhi","doi":"10.1016/j.pmip.2020.100067","DOIUrl":"10.1016/j.pmip.2020.100067","url":null,"abstract":"","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"23 ","pages":"Article 100067"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.pmip.2020.100067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121785635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}