The primary care companion for CNS disorders最新文献

{"title":"Vision Care Pathway Measures and Vision Outcomes in US Children With Mental, Emotional, Developmental, or Behavioral Problems: National Survey of Children's Health 2019-2023.","authors":"Juan M Riestra, Sedra T Alabed, Diana B Riestra, Mustafa Jaffry, Suqin Guo, Prashanth Iyer, Bernard C Szirth, Albert S Khouri, Najeeb U Hussain","doi":"10.4088/PCC.26m04278","DOIUrl":"https://doi.org/10.4088/PCC.26m04278","url":null,"abstract":"<p><p><b>Objective:</b> Children with mental, emotional, developmental, or behavioral (MEDB) problems may face higher risk of vision concerns and more complicated care pathways. The objective of this study was to evaluate whether vision care utilization, screening/referral steps, and vision-related outcomes differ by MEDB status in US children.</p><p><p><b>Methods:</b> A cross-sectional analysis was conducted using National Survey of Children's Health (NSCH) Interactive Data Query outputs for children aged 3-17 years from 2019-2023. MEDB status was defined by the NSCH composite indicator (≥1 qualifying condition and/or meeting emotional/behavioral/developmental criteria). We extracted survey-weighted prevalence estimates (95% CIs) for eye doctor exam/visit, non-eye-doctor screening, postscreening recommendations, diagnosis of a nonrefractive vision disorder, unmet vision care need, and functional vision limitation despite correction. Between-group differences were tested using 2-sided comparisons of weighted proportions.</p><p><p><b>Results:</b> In 2023, children with MEDB issues had higher rates of having seen an eye doctor, non-eye doctor vision screening, and recommendations for eye exams (<i>P</i><.001). Diagnosis of a nonrefractive vision disorder was also higher in the MEDB group (<i>P</i>=.005). Unmet vision care need did not differ by MEDB status (<i>P</i>=.599). Functional vision limitation despite correction was numerically higher among children with MEDB in most years but not significant in 2023 (<i>P</i>=.274).</p><p><p><b>Conclusion:</b> US children with MEDB problems report more screening, referrals, and eye doctor contact and higher rates of nonrefractive vision disorder diagnosis compared with peers without MEDB. Differences in unmet need were minimal, suggesting that follow-up and care coordination after screening/referral may be targets for improving vision-related outcomes.</p><p><p><i>Prim Care Companion CNS Disord</i> <i>2026;28(5):26m04278</i>.</p><p><p>\u0000 <i>Author affiliations are listed at the end of this article.</i>\u0000 </p>","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945656","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":"Resurrecting Voice: Role of Lorazepam in Chronic Catatonia Reversal.","authors":"G Shreya Eashwar, Lokesh Kumar Singh, Namish Kumar","doi":"10.4088/PCC.26cr04217","DOIUrl":"https://doi.org/10.4088/PCC.26cr04217","url":null,"abstract":"","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945691","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":"When Obsession and Psychosis Become Indistinguishable: A Clinical Case Report.","authors":"Marta Rebelo, Patrícia Baronet, José Abrantes, Marta Croca","doi":"10.4088/PCC.26cr04228","DOIUrl":"https://doi.org/10.4088/PCC.26cr04228","url":null,"abstract":"","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945717","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":"Reactions to, and Coping With, the Sequelae of Medical Errors That Lead to Disfigurement and Loss of Function.","authors":"Daniel Powell, David Wilkerson, Gregg Robbins-Welty, James K Rustad, Theodore A Stern","doi":"10.4088/PCC.26f04216","DOIUrl":"https://doi.org/10.4088/PCC.26f04216","url":null,"abstract":"<p><p>The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.</p><p><p><i>Prim Care Companion CNS Disord 2026;28(5):26f04216</i>.</p><p><p><i>Author affiliations are listed at the end of this article</i>.</p>","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945666","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":"Clinical Recognition and Management of Catatonia: A Practical Guideline and Treatment Algorithm.","authors":"Namratha Mohan, Ashish Sarangi","doi":"10.4088/PCC.26nr04231","DOIUrl":"https://doi.org/10.4088/PCC.26nr04231","url":null,"abstract":"<p><p><b>Importance:</b> Catatonia is a neuropsychiatric syndrome characterized by abnormalities in motor behavior, speech, volition, and affect. Although historically associated with schizophrenia, contemporary diagnostic frameworks recognize catatonia as a transdiagnostic condition occurring across psychiatric, medical, and neurological disorders. Despite its potential for serious complications (including dehydration, autonomic instability, and malignant catatonia), the syndrome remains underrecognized in many clinical settings.</p><p><p><b>Observations:</b> A focused PubMed/MEDLINE search was conducted using combinations of keywords related to catatonia, diagnosis, and treatment. Publications from the past decade were prioritized, with foundational studies included when necessary for diagnostic instruments. Thirty PubMed-indexed studies were selected as the core evidence set and synthesized narratively due to heterogeneity in study design and outcome reporting. Across the literature, diagnosis consistently requires the presence of 3 or more characteristic psychomotor signs, with the Bush-Francis Catatonia Rating Scale representing the most widely used structured assessment tool. Epidemiologic studies estimate an annual incidence of approximately 5.15 cases per 100,000 persons, while prevalence may exceed 10% in psychiatric inpatient populations. Benzodiazepines, particularly lorazepam, remain first-line therapy with response rates ranging from 66 to 100%. Electroconvulsive therapy demonstrates response rates approaching 80-100% in severe or refractory cases.</p><p><p><b>Conclusions:</b> Catatonia is a highly treatable yet frequently missed syndrome. Improved recognition, systematic screening, and timely treatment remain essential to reducing morbidity and improving patient outcomes.</p><p><p><i>Prim Care Companion CNS Disord</i> <i>2026;28(5):26nr04231</i>.</p><p><p>\u0000 <i>Author affiliations are listed at the end of this article.</i>\u0000 </p>","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892316","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":"Relaxation, Guided Imagery, Willful Dissociation, and Hypnosis: Practical Strategies for Primary Care Providers.","authors":"Philip R Muskin, Jose R Maldonado, Joseph D Dragonetti, Theodore A Stern","doi":"10.4088/PCC.26f04222","DOIUrl":"https://doi.org/10.4088/PCC.26f04222","url":null,"abstract":"<p><p>The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.</p><p><p><i>Prim Care Companion CNS Disord</i> <i>2026;28(5):26f04222</i>.</p><p><p>\u0000 <i>Author affiliations are listed at the end of this article.</i>\u0000 </p>","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892301","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":"Association of Intrusive Posttraumatic Stress Symptoms With Elevated C-Reactive Protein Levels in World Trade Center Responders.","authors":"Sarah B Rutter, Abigail B Collins, Marin Kautz, Leo M Cancelmo, Olivia Diab, Leah Cahn, Cindy Aaronson, Jamie Schaffer, Nicoló Cipriani, Clyde Schechter, Linda M Bierer, Michael Crane, Jacqueline M Moline, Iris G Udasin, Denise J Harrison, Rachel Yehuda, Sarah R Horn, Robert H Pietrzak, Adriana Feder","doi":"10.4088/PCC.25m04177","DOIUrl":"https://doi.org/10.4088/PCC.25m04177","url":null,"abstract":"<p><p><b>Objective:</b> Greater severity of posttraumatic stress disorder (PTSD) symptoms has been linked to elevated C-reactive protein (CRP), a marker of systemic inflammation. The association between PTSD symptoms and CRP levels has been difficult to interpret due to confounding associations between CRP levels and medical comorbidities associated with PTSD and heterogeneity of trauma exposures and PTSD symptoms. The objective of this study was to characterize the relation between clinician-rated PTSD symptom dimensions, medical conditions, and CRP levels among individuals exposed to the World Trade Center (WTC) attacks. WTC rescue, recovery, and clean-up workers were recruited from the WTC Health Program General Responder Cohort.</p><p><p><b>Methods:</b> Participants were assessed using the Clinician-Administered PTSD Scale, completed a questionnaire about medical conditions, and underwent a morning fasting blood draw. Two multivariable binary logistic regression analyses were conducted to identify correlates of elevated CRP levels (>3 mg/dL) and associations between specific PTSD symptom dimensions and elevated CRP levels.</p><p><p><b>Results:</b> After adjusting for demographics, trauma exposure, and medical comorbidities, obesity (<i>odds ratio [OR]</i>=2.96; <i>95% CI</i> [1.68, 5.21]), lower high-density lipoprotein cholesterol (<i>OR</i>=0.97; <i>95% CI</i> [0.95, 0.99]), and greater severity of intrusive PTSD symptoms (<i>OR</i>=1.38; <i>95% CI</i> [1.08, 1.75]) were associated with elevated CRP levels. Post hoc analyses revealed that, among intrusive symptoms, emotional reactivity to trauma cues was independently associated with elevated CRP levels (<i>OR</i>=1.50; <i>95% CI</i> [1.15, 1.96]).</p><p><p><b>Conclusions:</b> The results suggest that intrusive PTSD symptoms may contribute to systemic inflammation in WTC responders. This finding suggests that targeting both PTSD symptoms and obesity/dyslipidemia may help mitigate risk for elevated systemic inflammation.</p><p><p><i>Prim Care Companion CNS Disord</i> <i>2026;28(5):25m04177</i>.</p><p><p>\u0000 <i>Author affiliations are listed at the end of this article.</i>\u0000 </p>","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892296","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":"7-Hydroxymitragynine Withdrawal Treated With Buprenorphine-Naloxone.","authors":"Jacob T Held, Francisco P Varicat","doi":"10.4088/PCC.26cr04232","DOIUrl":"https://doi.org/10.4088/PCC.26cr04232","url":null,"abstract":"","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851485","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":"Aripiprazole-Induced Persistent Hiccups in an Adult With Drug-Induced Psychosis.","authors":"Tingting Ge, Suresh Yadav, Chelsea Chen, Sandeep Grover","doi":"10.4088/PCC.26cr04224","DOIUrl":"https://doi.org/10.4088/PCC.26cr04224","url":null,"abstract":"","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851524","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":"Generative Artificial Intelligence in Mental Health: A Guide for Primary Care Providers.","authors":"Ashwini Nadkarni, Kyle Faust, Sofia E Matta, Jacob R Weiss, Naomi A Schmelzer, Theodore A Stern","doi":"10.4088/PCC.26f04201","DOIUrl":"https://doi.org/10.4088/PCC.26f04201","url":null,"abstract":"<p><p>The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.</p><p><p><i>Prim Care Companion CNS Disord</i> <i>2026;28(4):26f04201</i>.</p><p><p>\u0000 <i>Author affiliations are listed at the end of this article.</i>\u0000 </p>","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851508","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}