World Psychiatry最新文献

{"title":"Discovering informative biomarkers in psychiatry.","authors":"Carol A Tamminga","doi":"10.1002/wps.21084","DOIUrl":"https://doi.org/10.1002/wps.21084","url":null,"abstract":"World Psychiatry 22:2 June 2023 ophrenia and comorbid cannabis use disorder. This finding highlights the malleable nature of biological markers in the context of highly prevalent comorbidities (i.e., substance use disorders) which cooccur not only with schizophrenia but also with several other neurodevelopmental and mental disorders. Altogether, the insights from the AbiDargham et al’s review and the advances, limitations and opportunities discussed here suggest that, along with the excitement that novel approaches and technologies will likely bring to the biomarker discovery field, we need to remain mindful of the inherent challenges, particularly the biopsychosocial nature of psychiatric disorders and the multiple sources of interand intraindividual variability influencing clinical outcomes. We also need to work towards research endeavours that are better poised to address these challenges via collaboration between biological and psychosocial scientists, concerted largescale international efforts to improve and harmonize both biological and behavioural measures (as well as their underpinning ontologies), and incorporation of people’s living experiences into our definitions and measurements of biomarkers.","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/PMC10168152/pdf/WPS-22-270.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9436371","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}

{"title":"Searching for biomarkers in the fluidity of mental ill-health.","authors":"Antonio Verdejo-Garcia","doi":"10.1002/wps.21083","DOIUrl":"https://doi.org/10.1002/wps.21083","url":null,"abstract":"World Psychiatry 22:2 June 2023 ply of earlier clozapine utilization, it is not about earlier utilization for all. Rather, the biomarker would guide earlier utilization by clinicians only for that group of patients with a SCI value that indexes likely nonresponse to conventional antipsychotics. A trial such as this one, if successful, would have the potential to change prescribing and regulatory guidelines specifically for patients assessed by the SCI as likely not to respond to conventional antipsychotics. This could mean that a biomarker in psychiatry would have realworld impact, when currently there is no such case. An opportunity could exist in the same trial to incorporate melanocortin 4 receptor genotype, which confers a nearly fivefold increased risk of weight gain in relation to antipsychotic exposure. Similarly, while agranulocytosis is rare, an allele in the HLADQB1 gene carries a ~15 fold increased risk of this potentially lethal event. Therefore, one could stratify patients on multiple biomarkers, maximizing potential gains and minimizing potential harms, in the same clinical trial. Costeffectiveness analyses could further strengthen the case. Saving even one day in hospital would likely offset the costs of the magnetic resonance imaging (MRI) and genetic tests. If we are serious about getting biomarkers into clinical practice, the biomarker/ biological field and the psychiatric services field should work together for successful implementation. Engaging patients and family members with lived experience would be important. A parent who has wit nessed his/her teenager or young adult child recovering from early psychosis thanks to the use of a given biomarker would be a powerful advocate, providing a lived experience voice that could help support the scale and spread (i.e., the implementation) of that biomarker into clinical practice. In addition, engaging policy makers who may have a say in health system incentives early in the process, as well as the relevant regulatory agencies, would be wise. Practice change is notoriously difficult. Even the implementation of measurementbased care in mental health clinics, e.g. us ing a scale routinely to guide treatment decisions, may be a challenge. If we have the data to bring MRI results or a genetic test into the clinic, the challenge of implementation may be even greater. Fortunately, in relation to the SCI biomarker example in early psychosis, the presence of networks of clinics that are part of a learning health system – e.g. via EPINET in the US, as well as similar initiatives in Canada, Australia and elsewhere – could be as good of an environment as we might hope for to propel successful translational efforts into clinical practice. In that sense, the time is now as well, and the broader notion of precision medicine, implementation science, and a learning health care system has been described, and could be applied in psychiatry. Much of the focus of the comprehensive review by AbiDhargam e","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/PMC10168163/pdf/WPS-22-268.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442541","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}

{"title":"Cognitive enhancement interventions are effective for schizophrenia: why not provide them early?","authors":"Matcheri S Keshavan, Shaun M Eack","doi":"10.1002/wps.21091","DOIUrl":"https://doi.org/10.1002/wps.21091","url":null,"abstract":"World Psychiatry 22:2 June 2023 youth and adults with mental health conditions or intellectual disabilities face among the highest rates of stigma and exclusion. Yet, the SDG monitoring process has collected little data on access to quality education for children with disabilities overall, and even less on the experience of children with mental health conditions. Meanwhile, data available from other sources suggest that we have far to go: our study of policies in 193 countries found that over onethird fail to even guarantee integrated education along with individualized supports for children with disabilities, and much less specifically address the needs of children with mental health conditions. Regarding employment, the SDG indicators require tracking average wages and unemployment rates for workers with disabilities, but data are currently only available for the latter; similarly, though indicator 10.2.1 calls for data on income inequality by disability, measures are currently unavailable. Moreover, there are no specific efforts to monitor improvements in inclusive employment for people with mental health conditions. Again, these gaps are concerning, given other research indicating that many countries fall short: our center’s data show that, as of 2021, only 46% of countries worldwide explicitly guaranteed reasonable accommodations for workers with mental and/or in tellectual disabilities. It is not too late for the SDGs to provide an opportunity for accelerating progress in preventing poor mental health, treating mental health conditions, and improving the quality of life of people living with mental health conditions. To do that, however, we need to measure annually not only the suicide mortality rate, but also comprehensive coverage of mental health services in national health systems; the density of the mental health care workforce; the accessibility of essential mental health therapeutics; and the extent to which countries are ensuring the full inclusion of people with mental health conditions in education and employment. Only by specifically prioritizing and tracking progress for mental health prevention, treatment and equal rights can we create a world where meeting mental health needs is not an afterthought, where explicit and implicit discrimination is eliminated, and where all people can lead full and healthy lives.","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/PMC10168164/pdf/WPS-22-326.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442879","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}

{"title":"WPA scientific publications in the triennium 2020-2023.","authors":"Michel Botbol","doi":"10.1002/wps.21108","DOIUrl":"https://doi.org/10.1002/wps.21108","url":null,"abstract":"","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/PMC10168139/pdf/WPS-22-347.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442885","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}

{"title":"Implementation of self-binding directives: recommendations based on expert consensus and input by stakeholders in three European countries.","authors":"Matthé Scholten, Simone Agnes Efkemann, Mirjam Faissner, Marleen Finke, Jakov Gather, Tania Gergel, Astrid Gieselmann, Lia van der Ham, Georg Juckel, Laura van Melle, Gareth Owen, Sarah Potthoff, Lucy A Stephenson, George Szmukler, Astrid Vellinga, Jochen Vollmann, Yolande Voskes, Anna Werning, Guy Widdershoven","doi":"10.1002/wps.21095","DOIUrl":"https://doi.org/10.1002/wps.21095","url":null,"abstract":"World Psychiatry 22:2 June 2023 ing informal workers, and those who work in small­ and medium­ sized enterprises and in low­ and middle­ income countries. A WHO and International Labour Organization joint policy brief was released alongside the guidelines to support stakehold­ ers in their application. This brief provides a roadmap to improve mental health at work through creating an enabling environment for prevention of exposure to risks, protection and promotion of mental health at work, and support for people with mental health conditions to participate and thrive at work.","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/PMC10168143/pdf/WPS-22-332.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9436374","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}

{"title":"Childhood gender non-conformity, sexual orientation and mental health problems among 18 to 89 year-old Danes.","authors":"Josefine B Andresen, Christian Graugaard, Mikael Andersson, Mikkel K Bahnsen, Morten Frisch","doi":"10.1002/wps.21096","DOIUrl":"https://doi.org/10.1002/wps.21096","url":null,"abstract":"","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/PMC10168161/pdf/WPS-22-334.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9436377","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}

{"title":"Therapist-supported Internet-based cognitive behaviour therapy yields similar effects as face-to-face therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis.","authors":"Erik Hedman-Lagerlöf,&nbsp;Per Carlbring,&nbsp;Frank Svärdman,&nbsp;Heleen Riper,&nbsp;Pim Cuijpers,&nbsp;Gerhard Andersson","doi":"10.1002/wps.21088","DOIUrl":"https://doi.org/10.1002/wps.21088","url":null,"abstract":"<p><p>Providing therapist-guided cognitive behaviour therapy via the Internet (ICBT) has advantages, but a central research question is to what extent similar clinical effects can be obtained as with gold-standard face-to-face cognitive behaviour therapy (CBT). In a previous meta-analysis published in this journal, which was updated in 2018, we found evidence that the pooled effects for the two formats were equivalent in the treatment of psychiatric and somatic disorders, but the number of published randomized trials was relatively low (n=20). As this is a field that moves rapidly, the aim of the current study was to conduct an update of our systematic review and meta-analysis of the clinical effects of ICBT vs. face-to-face CBT for psychiatric and somatic disorders in adults. We searched the PubMed database for relevant studies published from 2016 to 2022. The main inclusion criteria were that studies had to compare ICBT to face-to-face CBT using a randomized controlled design and targeting adult populations. Quality assessment was made using the Cochrane risk of bias criteria (Version 1), and the main outcome estimate was the pooled standardized effect size (Hedges' g) using a random effects model. We screened 5,601 records and included 11 new randomized trials, adding them to the 20 previously identified ones (total n=31). Sixteen different clinical conditions were targeted in the included studies. Half of the trials were in the fields of depression/depressive symptoms or some form of anxiety disorder. The pooled effect size across all disorders was g=0.02 (95% CI: -0.09 to 0.14) and the quality of the included studies was acceptable. This meta-analysis further supports the notion that therapist-supported ICBT yields similar effects as face-to-face CBT.</p>","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/PMC10168168/pdf/WPS-22-305.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442538","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}

{"title":"Violence and schizophrenia: the role of social determinants of health and the need for early intervention.","authors":"Paolo Fusar-Poli, Charlene Sunkel, Carlos A Larrauri, Peter Keri, Patrick D McGorry, Graham Thornicroft, Vikram Patel","doi":"10.1002/wps.21074","DOIUrl":"10.1002/wps.21074","url":null,"abstract":"","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/PMC10168150/pdf/WPS-22-230.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442540","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}

{"title":"COVID-19 and psychiatrists' responsibilities: an update of the WPA position paper.","authors":"Donna E Stewart,&nbsp;Danuta Wasserman,&nbsp;Paul S Appelbaum","doi":"10.1002/wps.21103","DOIUrl":"https://doi.org/10.1002/wps.21103","url":null,"abstract":"World Psychiatry 22:2 June 2023 congresses in Europe, Asia, Africa and the Americas during the current triennium. When approaching the conclusion of the triennium, we continue to face challenges following the global crises and their consequential impact on mental health. The WPA, however, stands motivated and inspired by the commitment and hard work of our fellow professionals when dealing with such difficult situations. The WPA looks forward to the future with enthusiasm and confidence, convinced that it will be able to transform new challenges into opportunities. Let’s shape the future of psychiatry and mental health together.","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/PMC10168153/pdf/WPS-22-342.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442883","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}

{"title":"Long-term efficacy of antipsychotic drugs in initially acutely ill adults with schizophrenia: systematic review and network meta-analysis.","authors":"Stefan Leucht,&nbsp;Johannes Schneider-Thoma,&nbsp;Angelika Burschinski,&nbsp;Natalie Peter,&nbsp;Dongfang Wang,&nbsp;Shimeng Dong,&nbsp;Maximilian Huhn,&nbsp;Adriani Nikolakopoulou,&nbsp;Georgia Salanti,&nbsp;John M Davis","doi":"10.1002/wps.21089","DOIUrl":"https://doi.org/10.1002/wps.21089","url":null,"abstract":"<p><p>Most acute phase antipsychotic drug trials in schizophrenia last only a few weeks, but patients must usually take these drugs much longer. We examined the long-term efficacy of antipsychotic drugs in acutely ill patients using network meta-analysis. We searched the Cochrane Schizophrenia Group register up to March 6, 2022 for randomized, blinded trials of at least 6-month duration on all second-generation and 18 first-generation antipsychotics. The primary outcome was change in overall symptoms of schizophrenia; secondary outcomes were all-cause discontinuation; change in positive, negative and depressive symptoms; quality of life, social functioning, weight gain, antiparkinson medication use, akathisia, serum prolactin level, QTc prolongation, and sedation. Confidence in the results was assessed by the CINeMA (Confidence in Network Meta-Analysis) framework. We included 45 studies with 11,238 participants. In terms of overall symptoms, olanzapine was on average more efficacious than ziprasidone (standardized mean difference, SMD=0.37, 95% CI: 0.26-0.49), asenapine (SMD=0.33, 95% CI: 0.21-0.45), iloperidone (SMD=0.32, 95% CI: 0.15-0.49), paliperidone (SMD=0.28, 95% CI: 0.11-0.44), haloperidol (SMD=0.27, 95% CI: 0.14-0.39), quetiapine (SMD=0.25, 95% CI: 0.12-0.38), aripiprazole (SMD=0.16, 95% CI: 0.04-0.28) and risperidone (SMD=0.12, 95% CI: 0.03-0.21). The 95% CIs for olanzapine versus aripiprazole and risperidone included the possibility of trivial effects. The differences between olanzapine and lurasidone, amisulpride, perphenazine, clozapine and zotepine were either small or uncertain. These results were robust in sensitivity analyses and in line with other efficacy outcomes and all-cause discontinuation. Concerning weight gain, the impact of olanzapine was higher than all other antipsychotics, with a mean difference ranging from -4.58 kg (95% CI: -5.33 to -3.83) compared to ziprasidone to -2.30 kg (95% CI: -3.35 to -1.25) compared to amisulpride. Our data suggest that olanzapine is more efficacious than a number of other antipsychotic drugs in the longer term, but its efficacy must be weighed against its side effect profile.</p>","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/PMC10168166/pdf/WPS-22-315.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9436366","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}