The primary care companion for CNS disorders最新文献

{"title":"Health Care Providers and Internet Gaming Disorder: Attitudes, Knowledge, and Clinical Readiness.","authors":"Sahil Anand, Nicholas Romano, Evguenia Makovkina, Yuqing Qiu, Jonathan Avery","doi":"10.4088/PCC.26m04192","DOIUrl":"https://doi.org/10.4088/PCC.26m04192","url":null,"abstract":"<p><p><b>Objective:</b> Internet gaming disorder (IGD) has gained increasing global recognition, yet little is known about how health care providers perceive and manage this condition in clinical practice. The objective of this study was to assess health care providers' IGD-related beliefs, familiarity with diagnostic criteria, confidence in diagnosis and management, and perceived training needs.</p><p><p><b>Methods:</b>A cross-sectional online survey of internal medicine and psychiatry health care providers was conducted between September and October 2025 at a large academic medical center, assessing IGD-related beliefs, familiarity with diagnostic criteria, confidence in diagnosis and management, and perceived training needs.</p><p><p><b>Results:</b> Among 67 respondents, most participants endorsed IGD as a clinically significant condition (84%) that contributes to psychiatric comorbidities (87%). However, fewer than half of providers reported confidence diagnosing (44%) or managing IGD (29%), and only 37% were familiar with currently proposed <i>Diagnostic and Statistical Manual of Mental Disorders</i> criteria. Psychiatric health care providers reported greater confidence and familiarity with IGD than their internal medicine counterparts, particularly in diagnosis, management, and identification of diagnostic criteria during clinical encounters. Overall, 81% of participants indicated that they would benefit from additional IGD-related education.</p><p><p><b>Conclusion:</b> Despite broad recognition of IGD's clinical significance, substantial gaps remain in provider confidence and familiarity with diagnostic and management approaches, particularly outside of psychiatry. These findings identify actionable gaps in provider preparedness and highlight the need for targeted educational efforts to support effective clinical management of IGD across medical specialties.</p><p><p><i>Prim Care Companion CNS Disord</i> <i>2026;28(4):26m04192</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":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621426","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":"Modafinil Use for Hypoactive Delirium in the Intensive Care Unit.","authors":"Austin J Eason, Noelle Dorvault, Hope Bentley, Matthew Gunther, Shixie Jiang","doi":"10.4088/PCC.26cr04193","DOIUrl":"https://doi.org/10.4088/PCC.26cr04193","url":null,"abstract":"","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621462","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":"Psychometric Properties of the Borderline Symptom List 23 for Brazilian Portuguese in a Nonclinical Sample.","authors":"Ramiro Figueiredo Catelan, Verena Barroso Bastos, Vinicius Guimarães Dornelles, Nikolaus Kleindienst, Maria Mocarz-Kleindienst, Antonio Egidio Nardi, Pedro Paulo Pires","doi":"10.4088/PCC.26m04184","DOIUrl":"https://doi.org/10.4088/PCC.26m04184","url":null,"abstract":"<p><p><b>Objective:</b> To adapt the Borderline Symptom List 23 (BSL-23) to Brazilian Portuguese and evaluate its psychometric properties in a large nonclinical sample.</p><p><p><b>Methods:</b> A total of 2,682 participants completed an online questionnaire between December 2021 and January 2022. Participants had a mean age of 26.64 years; most were female (78.2%) and had completed higher education. The adaptation process followed established guidelines, including translation, back-translation, expert evaluation, and target-population review. In addition to the BSL-23, participants completed the Depression, Anxiety and Stress Scale-21 Items (DASS-21), Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsiveness Scale, and Childhood Trauma Questionnaire. Statistical analyses included exploratory and confirmatory factor analyses, internal consistency assessment, and tests of concurrent validity and measurement invariance.</p><p><p><b>Results:</b> The BSL-23 maintained a unidimensional structure and demonstrated excellent internal consistency (Cronbach α=0.95). Exploratory factor analysis indicated high factor loadings for most items, while confirmatory factor analysis required minor adjustments due to collinearity between certain item pairs. Measurement invariance analyses showed small but statistically significant gender differences with minimal practical impact. Concurrent validity was supported by strong correlations with DASS-21 stress and depression subscales and moderate correlations with DERS dimensions.</p><p><p><b>Conclusion:</b> The Brazilian Portuguese version of the BSL-23 demonstrated robust psychometric properties, confirming its validity for use in Brazilian samples. Future studies should include clinical populations and assess test-retest reliability to strengthen evidence of temporal stability.</p><p><p><i>Prim Care Companion CNS Disord</i> <i>2026;28(4):26m04184</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":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621394","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":"Recurrent Rectal Foreign Body Insertion Associated With Cocaine-Induced Compulsive Sexual Behavior Resulting in Permanent Colostomy.","authors":"Ann C Schwartz, Ashley Smith, Caroline Stiles, Gregg A Robbins-Welty","doi":"10.4088/PCC.26cr04212","DOIUrl":"https://doi.org/10.4088/PCC.26cr04212","url":null,"abstract":"","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537201","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":"Mirtazapine-Induced Severe Hyponatremia in a Young Man Taking Oxcarbazepine.","authors":"Nathan R Luzum, Sahil Munjal","doi":"10.4088/PCC.26cr04199","DOIUrl":"https://doi.org/10.4088/PCC.26cr04199","url":null,"abstract":"","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537088","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":"Agoraphobia Secondary to Stiff Person Spectrum Disorder Freeze Attacks.","authors":"Drew Cumming, Gabriel Hastreiter, Justin Abbatemarco","doi":"10.4088/PCC.26cr04185","DOIUrl":"https://doi.org/10.4088/PCC.26cr04185","url":null,"abstract":"","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537035","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":"Comorbid Cardiovascular Disease and Posttraumatic Stress Disorder in Older US Veterans: Prevalence, Health Burden, and Functional Impairment.","authors":"Alina Yang, Atreya Manaswi, Melanie W Fischer, Ian C Fischer, Peter J Na, Robert H Pietrzak","doi":"10.4088/PCC.26m04187","DOIUrl":"https://doi.org/10.4088/PCC.26m04187","url":null,"abstract":"<p><p><b>Objective:</b> Cardiovascular disease (CVD) and posttraumatic stress disorder (PTSD) are prevalent and disabling conditions among older US veterans. Both are independently associated with poor physical, mental, and functional outcomes, but little is known about the combined burden. This study aims to examine the prevalence, risk correlates, health comorbidities, and functional outcomes of comorbid CVD+PTSD in older US veterans.</p><p><p><b>Methods:</b> Data were analyzed from 3,001 US veterans aged 60 years and older who participated in the 2019-2020 National Health and Resilience in Veterans Study. Self-reported CVD, PTSD, health comorbidities, and functional outcomes were examined using weighted bivariate and multivariable analyses.</p><p><p><b>Results:</b> A total of 23.1% of veterans had CVD only, 5.5% PTSD only, and 2.2% comorbid CVD+PTSD. Veterans with CVD+PTSD were more likely to report combat exposure, childhood adversity, and greater lifetime trauma compared to other groups. Relative to controls, they had particularly elevated odds of major depressive disorder (MDD), generalized anxiety disorder (GAD), cognitive disorder (ie, mild cognitive impairment, dementia, or Alzheimer disease), sleep disorder, and concussion/traumatic brain injury (TBI; odds ratios [ORs] = 4.78-13.27). Compared to CVD-only veterans, those with CVD+PTSD had higher odds of GAD, MDD, cognitive disorder, sleep disorder, suicidal ideation, and chronic pain (ORs = 1.89-9.64). Relative to PTSD-only veterans, they had greater odds of kidney disease, concussion/TBI, MDD, and sleep disorder (ORs = 2.67-4.85). Veterans with CVD+PTSD also showed moderately greater impairments in psychosocial and cognitive functioning compared to single-diagnosis groups (<i>d</i>'s = 0.50-0.66).</p><p><p><b>Conclusions:</b> Older veterans with comorbid CVD+PTSD have a markedly elevated burden of health and functional difficulties, underscoring the importance of integrated, trauma-informed care to improve outcomes in this high-risk population.</p><p><p><i>Prim Care Companion CNS Disord</i> <i>2026;28(4):26m04187</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":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537070","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":"NMDA Receptor Antagonists in Pediatric Autism Spectrum Disorder: A Systematic Review.","authors":"Nihit Gupta, Noah Parker, Azl Saeed, Priyal Khurana, Fahad Qureshi, Kelechie Emeronye, Raghu Gandhi, Srinija Srinivasan, Mayank Gupta","doi":"10.4088/PCC.25r04152","DOIUrl":"10.4088/PCC.25r04152","url":null,"abstract":"<p><p><b>Objective:</b> To review conclusive evidence concerning the usage, efficacy, and side effects of 2 <i>N</i>-methyl-D-aspartate (NMDA) receptor antagonists, memantine and amantadine, in children with autism spectrum disorder (ASD) to determine their effectiveness in treating associated core and comorbid conditions.</p><p><p><b>Data Sources:</b> A comprehensive literature search was conducted across multiple electronic databases, utilizing a combination of controlled vocabulary and keywords: <i>autism spectrum disorder</i>, <i>autistic disorder</i>, <i>Asperger's</i>, <i>PDD-NOS</i>, <i>neurodevelopmental disorders</i>, <i>memantine</i>, <i>amantadine</i>, and <i>NMDA receptor antagonist</i>.</p><p><p><b>Study Selection:</b> The initial screening identified 87 studies, and 11 were selected for full review. A total of 8 studies met the inclusion criteria of the qualitative synthesis and were included in the systematic review. The inclusion criteria were children aged <18 years with an ASD diagnosis, studies assessing amantadine or memantine with a comparison of placebo or treatment as usual, studies reporting clinical improvement in common ASD symptoms, and clinical trials or retrospective chart reviews. Exclusion criteria included unpublished data and multiple reports from the same dataset.</p><p><p><b>Data Extraction:</b> Data were extracted using a standardized form focused on study design and validity domains. Multiple reviewers independently abstracted data, with discrepancies resolved by consensus.</p><p><p><b>Data Synthesis:</b> Memantine and amantadine demonstrated favorable safety profiles. However, the evidence regarding their efficacy in addressing core ASD symptoms was inconclusive. Memantine was associated with potential improvements in cognitive and behavioral outcomes, though the evidence was confounded by methodological limitations. Amantadine showed potential in adjunctive treatment with risperidone, particularly in mitigating disruptive behaviors, but variability in outcomes between parent-reported and clinician-assessed measures raised concerns about the reliability and robustness of the findings.</p><p><p><b>Conclusions:</b> This systematic review highlights the need for large-scale, multicenter, double-blind, randomized controlled trials with rigorously standardized assessment tools and diverse clinical populations to better define the therapeutic potential and establish guidelines for the use of memantine and amantadine in ASD.</p><p><p><i>Prim Care Companion CNS Disord</i> <i>2026;28(4):25r04152</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":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438054","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":"Alcohol Use Disorder and Pharmacotherapy: What's Shame Got to Do With It?","authors":"Vania Modesto-Lowe, Gabrielle Rodrigues, Margaret Chaplin","doi":"10.4088/PCC.26lr04197","DOIUrl":"10.4088/PCC.26lr04197","url":null,"abstract":"","PeriodicalId":22814,"journal":{"name":"The primary care companion for CNS disorders","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438073","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":"The Meaning of Monitoring Among Patients and Their Families in Critical Care Units.","authors":"Joseph D Dragonetti, Katerina V Mastronardi, Samah Ibrahim, Rachel R Hammer, Ewa D Bieber, Michalla Braford, Dona A Kiriella, Maya Ganeshan, Hannah Browne, Shannon Weatherly, Prisha Thapar, Theodore A Stern","doi":"10.4088/PCC.25f04175","DOIUrl":"10.4088/PCC.25f04175","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):25f04175</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":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438081","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}