Psychological Medicine最新文献

{"title":"Letter to the editor regarding 'Is combined antidepressant medication (ADM) and psychotherapy better than either monotherapy at preventing suicide attempts and other psychiatric serious adverse events for depressed patients? A rare events meta-analysis'.","authors":"Alexander Lisinski, Fredrik Hieronymus","doi":"10.1017/S0033291724002071","DOIUrl":"10.1017/S0033291724002071","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-2"},"PeriodicalIF":5.9,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive behavioral interventions for depression and anxiety in adults with neurological disorders: a systematic review and meta-analysis.","authors":"Milena Gandy, Thomas Woldhuis, Wendy Wu, Marette Youssef, Madelyne A Bisby, Blake F Dear, Andreea I Heriseanu, Amelia J Scott","doi":"10.1017/S0033291724001995","DOIUrl":"10.1017/S0033291724001995","url":null,"abstract":"<p><p>We examined the efficacy of cognitive and behavioral interventions for improving symptoms of depression and anxiety in adults with neurological disorders. A pre-registered systematic search of Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, Embase, and Neurobite was performed from inception to May 2024. Randomized controlled trials (RCTs) which examined the efficacy of cognitive and behavioral interventions in treating depression and/or anxiety among adults with neurological disorders were included. Estimates were pooled using a random-effects meta-analysis. Subgroup analyses and meta-regression were performed on categorical and continuous moderators, respectively. Main outcomes were pre- and post-intervention depression and anxiety symptom scores, as reported using standardized measures. Fifty-four RCTs involving 5372 participants with 11 neurological disorders (including multiple sclerosis, epilepsy, stroke) were included. The overall effect of interventions yielded significant improvements in both depression (57 arms, Hedges' <i>g</i> = 0.45, 95% confidence interval [CI] 0.35-0.54) and anxiety symptoms (29 arms, <i>g</i> = 0.38, 95% CI 0.29-0.48), compared to controls. Efficacy was greater in studies which employed a minimum baseline symptom severity inclusion criterion for both outcomes, and greater in trials using inactive controls for depression only. There was also evidence of differential efficacy of interventions across the neurological disorder types and the outcome measure used. Risk of bias, intervention delivery mode, intervention tailoring for neurological disorders, sample size, and study year did not moderate effects. Cognitive and behavioral interventions yield small-to-moderate improvements in symptoms of both depression and anxiety in adults with a range of neurological disorders.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-14"},"PeriodicalIF":5.9,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic architecture and socio-environmental risk factors for major depressive disorder in Nepal","authors":"Karmel W. Choi, Justin D. Tubbs, Younga H. Lee, Yixuan He, Kristin Tsuo, Mary T. Yohannes, Lethukuthula L. Nkambule, Emily Madsen, Dirgha J. Ghimire, Sabrina Hermosilla, Tian Ge, Alicia R. Martin, William G. Axinn, Jordan W. Smoller","doi":"10.1017/s0033291724001284","DOIUrl":"https://doi.org/10.1017/s0033291724001284","url":null,"abstract":"<span>Background</span><p>Major depressive disorder (MDD) is the leading cause of disability globally, with moderate heritability and well-established socio-environmental risk factors. Genetic studies have been mostly restricted to European settings, with polygenic scores (PGS) demonstrating low portability across diverse global populations.</p><span>Methods</span><p>This study examines genetic architecture, polygenic prediction, and socio-environmental correlates of MDD in a family-based sample of 10 032 individuals from Nepal with array genotyping data. We used genome-based restricted maximum likelihood to estimate heritability, applied S-LDXR to estimate the cross-ancestry genetic correlation between Nepalese and European samples, and modeled PGS trained on a GWAS meta-analysis of European and East Asian ancestry samples.</p><span>Results</span><p>We estimated the narrow-sense heritability of lifetime MDD in Nepal to be 0.26 (95% CI 0.18–0.34, <span>p</span> = 8.5 × 10<span>−6</span>). Our analysis was underpowered to estimate the cross-ancestry genetic correlation (rg = 0.26, 95% CI −0.29 to 0.81). MDD risk was associated with higher age (beta = 0.071, 95% CI 0.06–0.08), female sex (beta = 0.160, 95% CI 0.15–0.17), and childhood exposure to potentially traumatic events (beta = 0.050, 95% CI 0.03–0.07), while neither the depression PGS (beta = 0.004, 95% CI −0.004 to 0.01) or its interaction with childhood trauma (beta = 0.007, 95% CI −0.01 to 0.03) were strongly associated with MDD.</p><span>Conclusions</span><p>Estimates of lifetime MDD heritability in this Nepalese sample were similar to previous European ancestry samples, but PGS trained on European data did not predict MDD in this sample. This may be due to differences in ancestry-linked causal variants, differences in depression phenotyping between the training and target data, or setting-specific environmental factors that modulate genetic effects. Additional research among under-represented global populations will ensure equitable translation of genomic findings.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"6 1","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Veteran suicide decedents that were not classified as high-suicide-risk","authors":"Maxwell Levis, Monica Dimambro, Joshua Levy, Vincent Dufort, Abby Fraade, Max Winer, Brian Shiner","doi":"10.1017/s0033291724001296","DOIUrl":"https://doi.org/10.1017/s0033291724001296","url":null,"abstract":"<span>Background</span><p>Although the Department of Veterans Affairs (VA) has made important suicide prevention advances, efforts primarily target high-risk patients with documented suicide risk, such as suicidal ideation, prior suicide attempts, and recent psychiatric hospitalization. Approximately 90% of VA patients that go on to die by suicide do not meet these high-risk criteria and therefore do not receive targeted suicide prevention services. In this study, we used national VA data to focus on patients that were not classified as high-risk, but died by suicide.</p><span>Methods</span><p>Our sample included all VA patients who died by suicide in 2017 or 2018. We determined whether patients were classified as high-risk using the VA's machine learning risk prediction algorithm. After excluding these patients, we used principal component analysis to identify moderate-risk and low-risk patients and investigated demographics, service-usage, diagnoses, and social determinants of health differences across high-, moderate-, and low-risk subgroups.</p><span>Results</span><p>High-risk (<span>n</span> = 452) patients tended to be younger, White, unmarried, homeless, and have more mental health diagnoses compared to moderate- (<span>n</span> = 2149) and low-risk (<span>n</span> = 2209) patients. Moderate- and low-risk patients tended to be older, married, Black, and Native American or Pacific Islander, and have more physical health diagnoses compared to high-risk patients. Low-risk patients had more missing data than higher-risk patients.</p><span>Conclusions</span><p>Study expands epidemiological understanding about non-high-risk suicide decedents, historically understudied and underserved populations. Findings raise concerns about reliance on machine learning risk prediction models that may be biased by relative underrepresentation of racial/ethnic minorities within health system.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"93 1","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do people recover from the impact of COVID-19 social isolation? Social connectivity and negative affective bias.","authors":"A R Bland,J P Roiser,M A Mehta,T W Robbins,R Elliott,B J Sahakian","doi":"10.1017/s0033291724001351","DOIUrl":"https://doi.org/10.1017/s0033291724001351","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"10 1","pages":"1-3"},"PeriodicalIF":6.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142195072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lisdexamfetamine maintenance treatment for binge-eating disorder following successful treatments: randomized double-blind placebo-controlled trial","authors":"Carlos M. Grilo, Valentina Ivezaj, Sydney Yurkow, Cenk Tek, Ashley A. Wiedemann, Ralitza Gueorguieva","doi":"10.1017/s003329172400148x","DOIUrl":"https://doi.org/10.1017/s003329172400148x","url":null,"abstract":"Background Controlled research examining maintenance treatments for responders to acute interventions for binge-eating disorder (BED) is limited. This study tested efficacy of lisdexamfetamine (LDX) maintenance treatment amongst acute responders. Methods This prospective randomized double-blind placebo-controlled single-site trial, conducted March 2019 to September 2023, tested LDX as maintenance treatment for responders to acute treatments with LDX-alone or with cognitive-behavioral therapy (CBT + LDX) for BED with obesity. Sixty-one (83.6% women, mean age 44.3, mean BMI 36.1 kg/m<jats:sup>2</jats:sup>) acute responders were randomized to LDX (<jats:italic>N</jats:italic> = 32) or placebo (<jats:italic>N</jats:italic> = 29) for 12 weeks; 95.1% completed posttreatment assessments. Mixed-models and generalized-estimating equations comparing maintenance LDX <jats:italic>v.</jats:italic> placebo included main/interactive effects of acute (LDX or CBT + LDX) treatments to examine their predictive/moderating effects. Results Relapse rates (to diagnosis-level binge-eating frequency) following maintenance treatments were 10.0% (<jats:italic>N</jats:italic> = 3/30) for LDX and 17.9% (<jats:italic>N</jats:italic> = 5/28) for placebo; intention-to-treat binge-eating remission rates were 59.4% (<jats:italic>N</jats:italic> = 19/32) and 65.5% (<jats:italic>N</jats:italic> = 19/29), respectively. Maintenance LDX and placebo did not differ significantly in binge-eating but differed in weight-loss and eating-disorder psychopathology. Maintenance LDX was associated with significant weight-loss (−2.3%) whereas placebo had significant weight-gain (+2.2%); LDX and placebo differed significantly in weight-change throughout treatment and at posttreatment. Eating-disorder psychopathology remained unchanged with LDX but increased significantly with placebo. Acute treatments did not significantly predict/moderate maintenance-treatment outcomes. Conclusions Adults with BED/obesity who respond to acute lisdexamfetamine treatment (regardless of additionally receiving CBT) had good maintenance during subsequent 12-weeks. Maintenance lisdexamfetamine, relative to placebo, did not provide further benefit for binge-eating but was associated with significantly better eating-disorder psychopathology outcomes and greater weight-loss.","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"15 1","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142195073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public mental health – a challenge for local communities and research","authors":"Stefan Priebe, Ulrich Reininghaus","doi":"10.1017/s0033291724001478","DOIUrl":"https://doi.org/10.1017/s0033291724001478","url":null,"abstract":"Common approaches for improving the mental health of the population in general and of vulnerable groups in particular include policies to address social determinants and the expansion of professional health services. Both approaches have substantial limitations in practice. A more promising option is actions that utilize resources that either already exist or can easily be generated in local communities. Examples are provided for various local initiatives with the potential to facilitate helpful interactions and relationships that are likely to benefit the mental health of significant parts of the population. Developing and implementing such initiatives is a challenge to communities, while their evaluation may require innovative methods in research.","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"108 1","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142195077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discussing the concept of substance-induced psychosis (SIP)","authors":"Jørgen G. Bramness, Carsten Hjorthøj, Solja Niemelä, Heidi Taipale, Eline Borger Rognli","doi":"10.1017/s0033291724001442","DOIUrl":"https://doi.org/10.1017/s0033291724001442","url":null,"abstract":"Substance-induced psychosis (SIP) is characterized by both substance use and a psychotic state, and it is assumed that the first causes the latter. In ICD-10 the diagnosis is categorized as and grouped together with substance use disorders, and to a large extent also treated as such in the health care system. Though criticism of the diagnostic construct of SIP dates back several decades, numerous large and high-quality studies have been published during the past 5–10 years that substantiate and amplify this critique. The way we understand SIP and even how we name it is of major importance for treatment and it has judicial consequences. It has been demonstrated that substance use alone is not sufficient to cause psychosis, and that other risk factors besides substance use are at play. These are risk factors that are also known to be associated with schizophrenia spectrum disorders. Furthermore, register-based studies from several different countries find that a large proportion, around one in four, of those who are initially diagnosed with an SIP over time are subsequently diagnosed with a schizophrenia spectrum disorder. This scoping review discusses the construct validity of SIP considering recent evidence. We challenge the immanent causal assumption in SIP, and advocate that the condition shares many features with the schizophrenia spectrum disorders. In conclusion, we argue that SIP just as well could be considered a first-episode psychotic disorder in patients with substance use.","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"10 1","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142195074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of depression treatment on health behaviors and cardiovascular risk factors in primary care patients with depression and elevated cardiovascular risk: data from the eIMPACT trial","authors":"Matthew D. Schuiling, Aubrey L. Shell, Christopher M. Callahan, John I. Nurnberger, Krysha L. MacDonald, Robert V. Considine, Wei Wu, Adam T. Hirsh, Christopher A. Crawford, Michelle K. Williams, Timothy C. Lipuma, Samir K. Gupta, Richard J. Kovacs, Bruce L. Rollman, Jesse C. Stewart","doi":"10.1017/s0033291724001429","DOIUrl":"https://doi.org/10.1017/s0033291724001429","url":null,"abstract":"Background Depression is an independent risk factor for cardiovascular disease (CVD), but it is unknown if successful depression treatment reduces CVD risk. Methods Using eIMPACT trial data, we examined the effect of modernized collaborative care for depression on indicators of CVD risk. A total of 216 primary care patients with depression and elevated CVD risk were randomized to 12 months of the eIMPACT intervention (internet cognitive-behavioral therapy [CBT], telephonic CBT, and select antidepressant medications) or usual primary care. CVD-relevant health behaviors (self-reported CVD prevention medication adherence, sedentary behavior, and sleep quality) and traditional CVD risk factors (blood pressure and lipid fractions) were assessed over 12 months. Incident CVD events were tracked over four years using a statewide health information exchange. Results The intervention group exhibited greater improvement in depressive symptoms (<jats:italic>p</jats:italic> &lt; 0.01) and sleep quality (<jats:italic>p &lt;</jats:italic> 0.01) than the usual care group, but there was no intervention effect on systolic blood pressure (<jats:italic>p</jats:italic> = 0.36), low-density lipoprotein cholesterol (<jats:italic>p</jats:italic> = 0.38), high-density lipoprotein cholesterol (<jats:italic>p</jats:italic> = 0.79), triglycerides (<jats:italic>p</jats:italic> = 0.76), CVD prevention medication adherence (<jats:italic>p</jats:italic> = 0.64), or sedentary behavior (<jats:italic>p</jats:italic> = 0.57). There was an intervention effect on diastolic blood pressure that favored the usual care group (<jats:italic>p</jats:italic> = 0.02). The likelihood of an incident CVD event did not differ between the intervention (13/107, 12.1%) and usual care (9/109, 8.3%) groups (<jats:italic>p</jats:italic> = 0.39). Conclusions Successful depression treatment alone is not sufficient to lower the heightened CVD risk of people with depression. Alternative approaches are needed. Trial Registration: ClinicalTrials.gov Identifier: NCT02458690","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"77 1","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142195075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural activation changes following attention bias modification treatment or a selective serotonin reuptake inhibitor for social anxiety disorder","authors":"Omer Azriel, Gal Arad, Niv Tik, Mark Weiser, Miki Bloch, Eddie Garber, Amit Lazarov, Daniel S. Pine, Ido Tavor, Yair Bar-Haim","doi":"10.1017/s0033291724001521","DOIUrl":"https://doi.org/10.1017/s0033291724001521","url":null,"abstract":"Background Delineation of changes in neural function associated with novel and established treatments for social anxiety disorder (SAD) can advance treatment development. We examined such changes following selective serotonin reuptake inhibitor (SSRI) and attention bias modification (ABM) variant – gaze-contingent music reward therapy (GC-MRT), a first-line and an emerging treatments for SAD. Methods Eighty-one patients with SAD were allocated to 12-week treatments of either SSRI or GC-MRT, or waitlist (<jats:italic>n</jats:italic>s = 22, 29, and 30, respectively). Baseline and post-treatment functional magnetic resonance imaging (fMRI) data were collected during a social-threat processing task, in which attention was directed toward and away from threat/neutral faces. Results Patients who received GC-MRT or SSRI showed greater clinical improvement relative to patients in waitlist. Compared to waitlist patients, treated patients showed greater activation increase in the right inferior frontal gyrus and anterior cingulate cortex when instructed to attend toward social threats and away from neutral stimuli. An additional anterior cingulate cortex cluster differentiated between the two active groups. Activation in this region increased in ABM and decreased in SSRI. In the ABM group, symptom change was positively correlated with neural activation change in the dorsolateral prefrontal cortex. Conclusions Brain function measures show both shared and treatment-specific changes following ABM and SSRI treatments for SAD, highlighting the multiple pathways through which the two treatments might work. Treatment-specific neural responses suggest that patients with SAD who do not fully benefit from SSRI or ABM may potentially benefit from the alternative treatment, or from a combination of the two. Trial Registration: ClinicalTrials.gov, Identifier: NCT03346239. <jats:uri xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"https://clinicaltrials.gov/ct2/show/NCT03346239\">https://clinicaltrials.gov/ct2/show/NCT03346239</jats:uri>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"65 1","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142195076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}