World Psychiatry最新文献

The contribution of the WPA to the development of the ICD-11 CDDR.

IF 73.3 1区医学

World Psychiatry Pub Date : 2024-10-01 DOI: 10.1002/wps.21259

Bianca Della Rocca

引用次数: 0

Treatment-resistant depression: definition, prevalence, detection, management, and investigational interventions. 难治性抑郁症：定义、患病率、检测、管理和研究干预。

IF 73.3 1区医学

World Psychiatry Pub Date : 2023-10-01 DOI: 10.1002/wps.21120

Roger S McIntyre, Mohammad Alsuwaidan, Bernhard T Baune, Michael Berk, Koen Demyttenaere, Joseph F Goldberg, Philip Gorwood, Roger Ho, Siegfried Kasper, Sidney H Kennedy, Josefina Ly-Uson, Rodrigo B Mansur, R Hamish McAllister-Williams, James W Murrough, Charles B Nemeroff, Andrew A Nierenberg, Joshua D Rosenblat, Gerard Sanacora, Alan F Schatzberg, Richard Shelton, Stephen M Stahl, Madhukar H Trivedi, Eduard Vieta, Maj Vinberg, Nolan Williams, Allan H Young, Mario Maj

{"title":"Treatment-resistant depression: definition, prevalence, detection, management, and investigational interventions.","authors":"Roger S McIntyre, Mohammad Alsuwaidan, Bernhard T Baune, Michael Berk, Koen Demyttenaere, Joseph F Goldberg, Philip Gorwood, Roger Ho, Siegfried Kasper, Sidney H Kennedy, Josefina Ly-Uson, Rodrigo B Mansur, R Hamish McAllister-Williams, James W Murrough, Charles B Nemeroff, Andrew A Nierenberg, Joshua D Rosenblat, Gerard Sanacora, Alan F Schatzberg, Richard Shelton, Stephen M Stahl, Madhukar H Trivedi, Eduard Vieta, Maj Vinberg, Nolan Williams, Allan H Young, Mario Maj","doi":"10.1002/wps.21120","DOIUrl":"10.1002/wps.21120","url":null,"abstract":"Treatment-resistant depression (TRD) is common and associated with multiple serious public health implications. A consensus definition of TRD with demonstrated predictive utility in terms of clinical decision-making and health outcomes does not currently exist. Instead, a plethora of definitions have been proposed, which vary significantly in their conceptual framework. The absence of a consensus definition hampers precise estimates of the prevalence of TRD, and also belies efforts to identify risk factors, prevention opportunities, and effective interventions. In addition, it results in heterogeneity in clinical practice decision-making, adversely affecting quality of care. The US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have adopted the most used definition of TRD (i.e., inadequate response to a minimum of two antidepressants despite adequacy of the treatment trial and adherence to treatment). It is currently estimated that at least 30% of persons with depression meet this definition. A significant percentage of persons with TRD are actually pseudo-resistant (e.g., due to inadequacy of treatment trials or non-adherence to treatment). Although multiple sociodemographic, clinical, treatment and contextual factors are known to negatively moderate response in persons with depression, very few factors are regarded as predictive of non-response across multiple modalities of treatment. Intravenous ketamine and intranasal esketamine (co-administered with an antidepressant) are established as efficacious in the management of TRD. Some second-generation antipsychotics (e.g., aripiprazole, brexpiprazole, cariprazine, quetiapine XR) are proven effective as adjunctive treatments to antidepressants in partial responders, but only the olanzapine-fluoxetine combination has been studied in FDA-defined TRD. Repetitive transcranial magnetic stimulation (TMS) is established as effective and FDA-approved for individuals with TRD, with accelerated theta-burst TMS also recently showing efficacy. Electroconvulsive therapy is regarded as an effective acute and maintenance intervention in TRD, with preliminary evidence suggesting non-inferiority to acute intravenous ketamine. Evidence for extending antidepressant trial, medication switching and combining antidepressants is mixed. Manual-based psychotherapies are not established as efficacious on their own in TRD, but offer significant symptomatic relief when added to conventional antidepressants. Digital therapeutics are under study and represent a potential future clinical vista in this population.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":null,"pages":null},"PeriodicalIF":73.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503923/pdf/WPS-22-394.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10359288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management. 重性抑郁障碍与身体疾病的共病：流行病学、机制和管理的综合综述。

IF 73.3 1区医学

World Psychiatry Pub Date : 2023-10-01 DOI: 10.1002/wps.21110

Michael Berk, Ole Köhler-Forsberg, Megan Turner, Brenda W J H Penninx, Anna Wrobel, Joseph Firth, Amy Loughman, Nicola J Reavley, John J McGrath, Natalie C Momen, Oleguer Plana-Ripoll, Adrienne O'Neil, Dan Siskind, Lana J Williams, Andre F Carvalho, Lianne Schmaal, Adam J Walker, Olivia Dean, Ken Walder, Lesley Berk, Seetal Dodd, Alison R Yung, Wolfgang Marx

{"title":"Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management.","authors":"Michael Berk, Ole Köhler-Forsberg, Megan Turner, Brenda W J H Penninx, Anna Wrobel, Joseph Firth, Amy Loughman, Nicola J Reavley, John J McGrath, Natalie C Momen, Oleguer Plana-Ripoll, Adrienne O'Neil, Dan Siskind, Lana J Williams, Andre F Carvalho, Lianne Schmaal, Adam J Walker, Olivia Dean, Ken Walder, Lesley Berk, Seetal Dodd, Alison R Yung, Wolfgang Marx","doi":"10.1002/wps.21110","DOIUrl":"10.1002/wps.21110","url":null,"abstract":"Populations with common physical diseases - such as cardiovascular diseases, cancer and neurodegenerative disorders - experience substantially higher rates of major depressive disorder (MDD) than the general population. On the other hand, people living with MDD have a greater risk for many physical diseases. This high level of comorbidity is associated with worse outcomes, reduced adherence to treatment, increased mortality, and greater health care utilization and costs. Comorbidity can also result in a range of clinical challenges, such as a more complicated therapeutic alliance, issues pertaining to adaptive health behaviors, drug-drug interactions and adverse events induced by medications used for physical and mental disorders. Potential explanations for the high prevalence of the above comorbidity involve shared genetic and biological pathways. These latter include inflammation, the gut microbiome, mitochondrial function and energy metabolism, hypothalamic-pituitary-adrenal axis dysregulation, and brain structure and function. Furthermore, MDD and physical diseases have in common several antecedents related to social factors (e.g., socioeconomic status), lifestyle variables (e.g., physical activity, diet, sleep), and stressful live events (e.g., childhood trauma). Pharmacotherapies and psychotherapies are effective treatments for comorbid MDD, and the introduction of lifestyle interventions as well as collaborative care models and digital technologies provide promising strategies for improving management. This paper aims to provide a detailed overview of the epidemiology of the comorbidity of MDD and specific physical diseases, including prevalence and bidirectional risk; of shared biological pathways potentially implicated in the pathogenesis of MDD and common physical diseases; of socio-environmental factors that serve as both shared risk and protective factors; and of management of MDD and physical diseases, including prevention and treatment. We conclude with future directions and emerging research related to optimal care of people with comorbid MDD and physical diseases.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":null,"pages":null},"PeriodicalIF":73.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503929/pdf/WPS-22-366.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10305833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Labour market marginalization in children of persons with major psychiatric disorders: a Swedish national cohort study. 严重精神疾病患者子女劳动力市场边缘化：瑞典国家队列研究。

IF 73.3 1区医学

World Psychiatry Pub Date : 2023-10-01 DOI: 10.1002/wps.21127

Ashley E Nordsletten, Kayoko Isomura, James J Crowley, Matti Cervin, Henrik Larsson, Paul Lichtenstein, David Mataix-Cols, Anna Sidorchuk

引用次数: 0

Putting psychological interventions first in primary health care. 把心理干预放在初级保健的首位。

IF 73.3 1区医学

World Psychiatry Pub Date : 2023-10-01 DOI: 10.1002/wps.21114

Mark van Ommeren, Sian Lewis, Edith Van't Hof, Kenneth Carswell

引用次数: 0

Nurturing the next generation of clinician-scientists in child and adolescent psychiatry: recommendations from a WPA Presidential Task Force. 培养儿童和青少年精神病学的下一代临床医生科学家：WPA总统特别工作组的建议。

IF 73.3 1区医学

World Psychiatry Pub Date : 2023-10-01 DOI: 10.1002/wps.21133

Peter Szatmari, Christian Kieling, Andrea Raballo, Norbert Skokauskas, Bennett Leventhal

引用次数: 0

Thoughts of self-harm in late adolescence as a risk indicator for mental disorders in early adulthood. 将青春期晚期的自残视为成年早期精神障碍的风险指标。

IF 73.3 1区医学

World Psychiatry Pub Date : 2023-10-01 DOI: 10.1002/wps.21125

David Mongan, Colm Healy, Emmet Power, Jonah F Byrne, Stan Zammit, Ian Kelleher, Mary Cannon, David R Cotter

引用次数: 0

The curse and opportunity of heterogeneity in the pursuit of psychiatric biomarkers. 精神病学生物标志物研究中异质性的诅咒与机遇。

IF 73.3 1区医学

World Psychiatry Pub Date : 2023-06-01 DOI: 10.1002/wps.21085

Lianne Schmaal

{"title":"The curse and opportunity of heterogeneity in the pursuit of psychiatric biomarkers.","authors":"Lianne Schmaal","doi":"10.1002/wps.21085","DOIUrl":"https://doi.org/10.1002/wps.21085","url":null,"abstract":"271 other and which cluster with a target outcome, using replication to build confidence in an interpretation. Indeed, in the Bipolar and Schizophrenia Network for Intermediate Phenotypes (BSNIP) study, it was the entire biomarker battery which went into defining the final characteristics of the experimental biomarkerdefined entities, which were called “psychosis biotypes”. These biotype constructs have provided research with an alternative to phenomenologically defined entities, as a stage in developing final disease cate gories. Moreover, it is the full biomarker battery which can be ap plied to distinguishing and understanding defined features of the illness, such as negative symptoms. BSNIP researchers have developed several individual studies, now ongoing, to test the clinical applicability of the above biotype constructs. One such study tests the hypothesis that biotype 1, with its low intrinsic EEG activity, is a biomarker which indicates responsiveness to clozapine; specifically, we test the hypothesis that increasing intrinsic EEG activity with clozapine in biotype 1 will correlate with symptomatological improvement, using the attractor network model. A second study, designed to predict treatment response in early psychosis, hypothesizes that the biotypes will define good (biotype 3), moderate (biotype 2) or poor (biotype 1) response to standard coordinated specialty care (CSC). In each of these examples, a doubleblind trial of the biomarker observation (now ongoing) is necessary, and its application can only be supported if this is done with rigorous design. There is no doubt that considerable hard work will have to go into the study of biomarkers in psychiatry before we are able to bring them to a clinically useful place. Yet, the validation of biomarkers, as reviewed in AbiDargham et al’s paper, can be so decisive for the future of our field that these stud ies need to be conducted. Costs have to be born. Yes, wisely; but urgently.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":null,"pages":null},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168170/pdf/WPS-22-271.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Antidepressants in primary care: limited value at the first visit. 抗抑郁药在初级保健中的应用:首次就诊时价值有限。

IF 73.3 1区医学

World Psychiatry Pub Date : 2023-06-01 DOI: 10.1002/wps.21057

Bruce Arroll, Rachel Roskvist, Fiona Moir, Matire Harwood, Kyle Eggleton, Christopher Dowrick, Pim Cuijpers

{"title":"Antidepressants in primary care: limited value at the first visit.","authors":"Bruce Arroll, Rachel Roskvist, Fiona Moir, Matire Harwood, Kyle Eggleton, Christopher Dowrick, Pim Cuijpers","doi":"10.1002/wps.21057","DOIUrl":"https://doi.org/10.1002/wps.21057","url":null,"abstract":"When patients with a depressive condition first visit a general practitioner, they often get the prescription of an antidepressant. We think that it is better to prescribe medication at a later stage, if at all. Here we explain why. It is well known that most patients in primary care have mild to moderate depression, while severe depression is an excep tion. For example, we found that, among primary care patients in waiting rooms, 13% had a score on the Patient Health Question naire9 (PHQ9) between 9 and 11, which is above the thresh old for major depression, but only 5% had a severe depression (PHQ9 score higher than 14). There is also considerable evidence that the effects of anti depressants in mild and moderate depression are small, and may not be clinically relevant. In one individual patient data metaanalysis, the risk difference (percent response to medica tion minus percent response to placebo) was only 6% in mild depression, which corresponds to a number needed to treat (NNT) of 16. In very severe depression, the risk difference was 25% (NNT=4); in severe depression, it was 9% (NNT=11). These results were recently confirmed in a large individual patient data metaanalysis of 232 trials with more than 73,000 patients. Fur thermore, a recent pragmatic placebocontrolled trial confirmed that antidepressants are not very effective in patients with mild depression seen in primary care: with an average PHQ9 score of 12, the NNT was only 12.5. It is also well known that many patients in primary care who use antidepressants are not willing to stop their medication, even when it is clearly not working, because they are afraid that they will get worse. Much of the confusion about the effects of medications in de pressed patients seen in primary care is due to an earlier Cochrane review, reporting that the NNT was 8.5 for tricyclic antidepres sants and 6.5 for selective serotonin reuptake inhibitors, which would be considered a reasonable clinical effect by most clinicians. However, the problem with that review was that the included trials focused on patients with severe to very severe depression, thus be ing not representative of the majority of patients with depression seen in primary care. The abovementioned metaanalyses and pragmatic trial provide a much better evidence of the effects of an tidepressants in this population. Even for patients with more severe depression seen in primary care, antidepressants may not be the best treatment at the first visit. Many of the few patients who initially present in primary care with a severe depression get better over time with or without medication. Indeed, the abovementioned Cochrane review found a median re sponse rate of 42% with pill placebo. So, what to do at the first visit in primary care with a patient who presents with a depressive condition? Most treatment guidelines, such as those of the National Institute for Health and Care Excel lence (NICE), recommend watchful waiting o","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":null,"pages":null},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168160/pdf/WPS-22-340.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9436364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The post-traumatic growth approach to psychological trauma. 创伤后成长法治疗心理创伤。

IF 73.3 1区医学

World Psychiatry Pub Date : 2023-06-01 DOI: 10.1002/wps.21093

Richard G Tedeschi

引用次数: 0