Personalized Medicine in Psychiatry最新文献

{"title":"Currently available means to achieve personalized psychiatry","authors":"Bruce M. Cohen ,&nbsp;Peter Q. Harris","doi":"10.1016/j.pmip.2023.100105","DOIUrl":"https://doi.org/10.1016/j.pmip.2023.100105","url":null,"abstract":"<div><p>Psychiatry awaits new biomarkers to guide diagnosis and treatment, but identifying, testing, and applying valid technologies will be an extended process, likely requiring years of development. Meanwhile, numerous features of illness and proven techniques for gathering key information on individual patients are underutilized. Such information includes: Details of current presentation and history, including treatments and outcomes; other medical history, including treatments and outcomes; general health and habits; family history of relevant illnesses; and the personal and social context of each patient’s life and illness. Rarely is enough time allotted or resources made available to obtain all this information. However, these data can be obtained by system modifications including: Offloading some work from the treating psychiatrist to allow more time for discussion, data gathering, and relationship building with the patient; using standardized tools and procedures, such as electronic assessment and tracking tools, to gather and share information; improving means to obtain information from other sources, such as other informants, colleagues treating the patient, and the medical record; and providing easily accessible assessment and treatment guidelines containing evidence-based expert-consensus techniques for matching treatment to individual presentation and circumstances. These approaches can be implemented, by means detailed in the text. Briefly, providing more personalized care requires some shifts in funding, some changes in staffing and communication, and some improvements in electronic data gathering, sharing, and searching. In the service of care, it is incumbent on all involved agencies, institutions, and practices to make these changes in the immediate future.</p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"39 ","pages":"Article 100105"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50180194","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":"Can probiotics reduce bipolar symptoms?: A systematic review","authors":"Nida Ahmed,&nbsp;Mustafa M. Husain","doi":"10.1016/j.pmip.2022.100098","DOIUrl":"https://doi.org/10.1016/j.pmip.2022.100098","url":null,"abstract":"<div><h3>Background</h3><p>There is growing evidence suggesting a connection between gut dysbiosis and the development of psychiatric disorders. A number of studies have shown that probiotics <strong>contribute</strong> to symptom reduction in major depressive disorder, but very few such studies have been conducted on bipolar disorder. The present study is a systematic review of such studies.</p></div><div><h3>Methods</h3><p>Systematic review following PRISMA guidelines of studies published in the past ten years which involve the use of probiotics in patients with bipolar disorder.</p></div><div><h3>Results</h3><p>Of 4717 articles screened, 5 were included in this review [n = 193]. Collectively, the studies measured the effects of probiotics on the symptoms of bipolar disorder as well as rehospitalization rates.</p></div><div><h3>Conclusion</h3><p>Despite the limited number of studies done on this topic, there is evidence that probiotics improve symptoms of bipolar disorder, particularly manic symptoms, with no significant negative effects.</p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"39 ","pages":"Article 100098"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50180195","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":"Using empathy to prevent burnout treating patients with cluster B personality disorders in psychiatry residency: A case study in context","authors":"LT Derrick Knox,&nbsp;CDR. David Nissan","doi":"10.1016/j.pmip.2023.100102","DOIUrl":"https://doi.org/10.1016/j.pmip.2023.100102","url":null,"abstract":"","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"37 ","pages":"Article 100102"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50185599","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":"Personalized definition of surgical targets in major depression and obsessive-compulsive disorder: A potential role for low-intensity focused ultrasound?","authors":"Salvador M. Guinjoan","doi":"10.1016/j.pmip.2023.100100","DOIUrl":"10.1016/j.pmip.2023.100100","url":null,"abstract":"<div><p><span><span><span>Major Depressive Disorder (MDD) and Obsessive-Compulsive Disorder (OCD) are common and potentially incapacitating conditions. Even when recognized and adequately treated, in over a third of patients with these conditions the response to first-line pharmacological and psychotherapeutic measures is not satisfactory. After more assertive measures including pharmacological augmentation (and in the case of depression, </span>transcranial magnetic stimulation, electroconvulsive therapy, or treatment with </span>ketamine<span><span> or esketamine), a significant number of individuals remain severely symptomatic. In these persons, different ablation and deep-brain stimulation (DBS) psychosurgical techniques have been employed. However, apart from the cost and potential morbidity associated with surgery, on average only about half of patients show adequate response, which limits the widespread application of these potentially life-saving interventions. Possible reasons are considered for the wide variation in outcomes across different series of patients with MDD or OCD exposed to ablative or DBS psychosurgery, including interindividual anatomical and etiological variability. Low-intensity focused ultrasound (LIFU) is an emerging technique that holds promise in its ability to achieve anatomically circumscribed, noninvasive, and reversible </span>neuromodulation of deep brain structures. A possible role for LIFU in the personalized presurgical definition of neuromodulation targets in the individual patient is discussed, including a proposed roadmap for </span></span>clinical trials addressed at testing whether this technique can help to improve psychosurgical outcomes.</p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"37 ","pages":"Article 100100"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10034711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9552134","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":"Baseline monitoring of atypical antipsychotics at a Family Medicine Teaching Unit (FMTU) in Ontario, Canada","authors":"Manish Ranpara,&nbsp;Matthew Orava","doi":"10.1016/j.pmip.2022.100099","DOIUrl":"https://doi.org/10.1016/j.pmip.2022.100099","url":null,"abstract":"","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"37 ","pages":"Article 100099"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50185597","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":"Health disparities in the treatment of bipolar disorder","authors":"Vladimir Tchikrizov ,&nbsp;Mark E. Ladner ,&nbsp;Felicia V. Caples ,&nbsp;Mitzi Morris ,&nbsp;Hailey Spillers ,&nbsp;Christina D. Jordan ,&nbsp;Joyce E. Balls-Berry ,&nbsp;Monica J. Taylor-Desir ,&nbsp;Mark A. Frye ,&nbsp;Eric J. Vallender","doi":"10.1016/j.pmip.2023.100101","DOIUrl":"https://doi.org/10.1016/j.pmip.2023.100101","url":null,"abstract":"<div><h3>Background</h3><p>Therapeutic options for bipolar disorder vary based on individual presentation and phase of illness. In addition to well documented disparities in diagnosis, racial and gender differences in treatment complicate efforts to provide effective individualized treatment to patients with bipolar disorder. The present work was undertaken to identify the persistence of racial and gender disparities across diverse community and national populations and to compare treatment disparities in bipolar disorder with those observed for schizophrenia.</p></div><div><h3>Methods</h3><p>Commonly prescribed treatments for bipolar disorder and schizophrenia were quantified using information gathered from the All of Us Research Program and de-identified electronic health records at the University of Mississippi Medical Center.</p></div><div><h3>Results</h3><p>Black patients with bipolar disorder, in comparison to white patients, had significantly less utilization of lithium, lamotrigine, and antidepressants, but greater utilization of haloperidol and other first-generation antipsychotics. Disparities in antipsychotic use were reduced in patients with schizophrenia compared to those with a bipolar diagnosis.</p></div><div><h3>Conclusions</h3><p>The disparities enumerated here have real world clinical implications. Black patients with bipolar disorder have less utilization of lithium, the gold standard mood stabilization treatment. Further community-guided research to better understand the origins of these disparities and clinical trials to evaluate non-antipsychotic mood stabilization treatment for bipolar disorder across populations is warranted.</p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"37 ","pages":"Article 100101"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50185598","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":"Cranial electrotherapy stimulation in the treatment of posttraumatic stress disorder: A feasibility, safety, and preliminary efficacy study","authors":"James K. Rustad ,&nbsp;Ryan P. Waaland ,&nbsp;Lauren M. Sippel ,&nbsp;Pablo Martinez-Camblor ,&nbsp;Samuel I. Kohrman ,&nbsp;H. Samuel Landsman ,&nbsp;Krista Buckley ,&nbsp;Paul E. Holtzheimer","doi":"10.1016/j.pmip.2022.100096","DOIUrl":"10.1016/j.pmip.2022.100096","url":null,"abstract":"<div><h3>Background</h3><p><span>Neuromodulation of brain circuits important for affect, </span>behavior<span><span><span>, and cognition may decrease the symptomatology and functional impairment of military veterans suffering from </span>posttraumatic stress disorder (PTSD). Cranial </span>electrotherapy<span> stimulation (CES) techniques, such as Alpha-Stim®, have demonstrated preliminary benefit for symptoms that commonly co-occur with PTSD, such as pain, anxiety, depression, and insomnia. However, CES has not yet been specifically tested as a treatment for PTSD. The objective of this open-label pilot study was to examine feasibility, safety, and preliminary efficacy of Alpha-Stim® for treatment of PTSD.</span></span></p></div><div><h3>Methods</h3><p>Open-label Alpha-Stim® was administered to nine veterans who were diagnosed with PTSD via structured interview (Clinician-Administered PTSD Scale for DSM-5 [CAPS-5]) and were taking at least one psychotropic medication. Treatment consisted of 20 CES sessions administered at home over 40 days. Effects on PTSD symptoms, functioning, depression symptoms, pain, anxiety symptoms, and insomnia were assessed at baseline and every week of treatment for four weeks. Effects on PTSD symptoms, depression symptoms, and pain were assessed one month and three months post-treatment.</p></div><div><h3>Results</h3><p>Seven patients (78%) successfully completed treatment. There were no adverse events. Following four weeks of Alpha-Stim® treatment, PTSD symptoms decreased by 38%, depression symptoms decreased by 52%, insomnia decreased by 34%, and pain decreased by 11%. Significant improvements in PTSD and depression, but not pain, persisted at one-month and three-months posttreatment. Presumptive loss of diagnosis rates (i.e., PTSD Checklist for <em>DSM-5</em> total score below 33) immediately following treatment and one and three months later were 43%, 33%, and 29%, respectively.</p></div><div><h3>Conclusions</h3><p><span>Alpha-Stim® showed an excellent safety profile with no adverse effects. The results suggest preliminary efficacy for improving PTSD symptoms as well as concomitant depression symptoms, insomnia, and pain. Limitations of this pilot study include the open-label, uncontrolled design and small sample size. These results support additional larger, </span>randomized controlled trials of Alpha-Stim® for veterans with PTSD.</p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"35 ","pages":"Article 100096"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122644372","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":"Characterizing chronic non-suicidal self-injury and other forms of repetitive and escalating suicide behaviour as endocannabinoid-mediated pain and reward disorders","authors":"Hye Ji J. Kim ,&nbsp;David A. Petrishen ,&nbsp;Robert B. Laprairie ,&nbsp;Evyn M. Peters","doi":"10.1016/j.pmip.2022.100095","DOIUrl":"https://doi.org/10.1016/j.pmip.2022.100095","url":null,"abstract":"<div><p><span><span>Suicide is a devastating complication of psychiatric disorders characterized by despair<span>, hopelessness, and overwhelming mental distress or pain. Non-suicidal self-injury (NSSI), suicide ideation (SI) and suicide attempts (SA) all fall under the umbrella of suicide behaviour (SB). Several biopsychological theories describe SB as an attempt to relieve mental pain. They comment on the role of tolerance-habituation to the rewarding effects of SB-induced emotional regulation, as well as increasing physical or somatic pain tolerance, both of which contribute to the escalating patterns of repetitive SB. The </span></span>endocannabinoid system<span> (ECS) is involved in a wide range of homeostatic and neuromodulatory functions including appetite/feeding, sleep, motor control, pain perception<span>, cognition, mood/affect, and reward processing. The downregulation of endocannabinoid signalling has major implications for affective disorders, </span></span></span>pain disorders, and substance use disorders. SB can be seen as a manifestation of these disorders and has also been linked to ECS dysfunction. Drawing from both animal and human studies, we aim to understand repetitive SB as an endocannabinoid-mediated pain and reward disorder. We hypothesize that mental distress triggers the first incidence of NSSI or SB, from which patients derive stress-induced endocannabinoid-mediated analgesia. As patients become increasingly tolerant to this mechanism of analgesia, SB escalates to override increasing mental distress. This hypothesis calls for more research on endocannabinoid-based therapies to prevent the progression from NSSI or SI to fatal SA.</p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"33 ","pages":"Article 100095"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91746010","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":"Multimodal phenotyping of psychiatric disorders from social interaction: Protocol of a clinical multicenter prospective study","authors":"Alexandra König ,&nbsp;Philipp Müller ,&nbsp;Johannes Tröger ,&nbsp;Hali Lindsay ,&nbsp;Jan Alexandersson ,&nbsp;Jonas Hinze ,&nbsp;Matthias Riemenschneider ,&nbsp;Danilo Postin ,&nbsp;Eric Ettore ,&nbsp;Amandine Lecomte ,&nbsp;Michel Musiol ,&nbsp;Maxime Amblard ,&nbsp;François Bremond ,&nbsp;Michal Balazia ,&nbsp;Rene Hurlemann","doi":"10.1016/j.pmip.2022.100094","DOIUrl":"https://doi.org/10.1016/j.pmip.2022.100094","url":null,"abstract":"<div><p><span><span>Identifying objective and reliable markers to tailor diagnosis and treatment of psychiatric patients remains a challenge, as conditions like </span>major depression, </span>bipolar disorder<span><span>, or schizophrenia<span><span> are qualified by complex behavior observations or subjective self-reports instead of easily measurable somatic features. Recent progress in computer vision, speech processing and machine learning has enabled detailed and objective characterization of </span>human behavior<span><span> in social interactions. However, the application of these technologies to personalized </span>psychiatry is limited due to the lack of sufficiently large corpora that combine multi-modal measurements with longitudinal assessments of patients covering more than a single disorder. To close this gap, we introduce Mephesto, a multi-centre, multi-disorder longitudinal corpus creation effort designed to develop and validate novel multi-modal markers for </span></span></span>psychiatric conditions. Mephesto will consist of multi-modal audio-, video-, and physiological recordings as well as clinical assessments of psychiatric patients covering a six-week main study period as well as several follow-up recordings spread across twelve months. We outline the rationale and study protocol and introduce four cardinal use cases that will build the foundation of a new state of the art in personalized treatment strategies for psychiatric disorders.</span></p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"33 ","pages":"Article 100094"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91664358","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":"Differences in perceived life stress in bipolar I and II disorder: Implications for future epigenetic quantification","authors":"Adrienne Grzenda ,&nbsp;Marin Veldic ,&nbsp;Yun-Fang Jia ,&nbsp;Susan L. McElroy ,&nbsp;David J. Bond ,&nbsp;Jennifer R. Geske ,&nbsp;Aysegul Ozerdem ,&nbsp;Balwinder Singh ,&nbsp;Joanna M. Biernacka ,&nbsp;Doo-Sup Choi ,&nbsp;Mark A. Frye","doi":"10.1016/j.pmip.2022.100093","DOIUrl":"https://doi.org/10.1016/j.pmip.2022.100093","url":null,"abstract":"<div><h3>Objective</h3><p>Few instruments measuring life events over the course of bipolar disorder distinguish the valence of events or consider cumulative stress burden. In the current study, we used a valence-focused life event questionnaire to assess stress in the last 12 months in patients with bipolar I (n = 863) and bipolar II (n = 362) disorder.</p></div><div><h3>Methods</h3><p>Associations between recent stress and lifetime illness severity features were evaluated via linear and logistic regression, adjusting for age and gender. We additionally investigated the feasibility of quantifying recent stress burden by measuring methylation at a known bipolar susceptibility locus, <em>SLC1A2</em> in a subset of bipolar I patients (n = 150) with or without comorbid substance use.</p></div><div><h3>Results</h3><p>Bipolar II patients endorsed higher total, negative, and positive stress burden than their bipolar I counterparts, but the latter displayed more significant stress-illness severity associations, notably to all forms of substance abuse (e.g., alcohol, nicotine, food, other drugs). Irrespective of bipolar subtype, negative stress burden was significantly associated with illness severity features. High versus low total stress predicted hypomethylation of the <em>SLC1A2</em> promoter (p &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>Together, these findings reveal substantial differences in how bipolar subtypes experience and perceive stress. The observed degree of association between recent stress and substance abuse in bipolar I lend further support to the multidirectional effects of stress, affective episodes, and substance abuse on illness severity. Quantification of recent total stress using the methylation status of the <em>SLC1A2</em> promoter is feasible, although a whole-methylome approach will likely prove more effective in disaggregating other environmental influences.</p></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"33 ","pages":"Article 100093"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468171722000035/pdfft?md5=a0876a56d8d1a5478d019ec307625f94&pid=1-s2.0-S2468171722000035-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91664357","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}