World Psychiatry最新文献

{"title":"Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention.","authors":"Nora D Volkow,&nbsp;Carlos Blanco","doi":"10.1002/wps.21073","DOIUrl":"https://doi.org/10.1002/wps.21073","url":null,"abstract":"<p><p>Substance use disorders (SUDs) are highly prevalent and exact a large toll on individuals' health, well-being, and social functioning. Long-lasting changes in brain networks involved in reward, executive function, stress reactivity, mood, and self-awareness underlie the intense drive to consume substances and the inability to control this urge in a person who suffers from addiction (moderate or severe SUD). Biological (including genetics and developmental life stages) and social (including adverse childhood experiences) determinants of health are recognized factors that contribute to vulnerability for or resilience against developing a SUD. Consequently, prevention strategies that target social risk factors can improve outcomes and, when deployed in childhood and adolescence, can decrease the risk for these disorders. SUDs are treatable, and evidence of clinically significant benefit exists for medications (in opioid, nicotine and alcohol use disorders), behavioral therapies (in all SUDs), and neuromodulation (in nicotine use disorder). Treatment of SUDs should be considered within the context of a Chronic Care Model, with the intensity of intervention adjusted to the severity of the disorder and with the concomitant treatment of comorbid psychiatric and physical conditions. Involvement of health care providers in detection and management of SUDs, including referral of severe cases to specialized care, offers sustainable models of care that can be further expanded with the use of telehealth. Despite advances in our understanding and management of SUDs, individuals with these conditions continue to be stigmatized and, in some countries, incarcerated, highlighting the need to dismantle policies that perpetuate their criminalization and instead develop policies to ensure support and access to prevention and treatment.</p>","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"203-229"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168177/pdf/WPS-22-203.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9436379","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":"Candidate biomarkers in psychiatric disorders: state of the field.","authors":"Anissa Abi-Dargham, Scott J Moeller, Farzana Ali, Christine DeLorenzo, Katharina Domschke, Guillermo Horga, Amandeep Jutla, Roman Kotov, Martin P Paulus, Jose M Rubio, Gerard Sanacora, Jeremy Veenstra-VanderWeele, John H Krystal","doi":"10.1002/wps.21078","DOIUrl":"10.1002/wps.21078","url":null,"abstract":"<p><p>The field of psychiatry is hampered by a lack of robust, reliable and valid biomarkers that can aid in objectively diagnosing patients and providing individualized treatment recommendations. Here we review and critically evaluate the evidence for the most promising biomarkers in the psychiatric neuroscience literature for autism spectrum disorder, schizophrenia, anxiety disorders and post-traumatic stress disorder, major depression and bipolar disorder, and substance use disorders. Candidate biomarkers reviewed include various neuroimaging, genetic, molecular and peripheral assays, for the purposes of determining susceptibility or presence of illness, and predicting treatment response or safety. This review highlights a critical gap in the biomarker validation process. An enormous societal investment over the past 50 years has identified numerous candidate biomarkers. However, to date, the overwhelming majority of these measures have not been proven sufficiently reliable, valid and useful to be adopted clinically. It is time to consider whether strategic investments might break this impasse, focusing on a limited number of promising candidates to advance through a process of definitive testing for a specific indication. Some promising candidates for definitive testing include the N170 signal, an event-related brain potential measured using electroencephalography, for subgroup identification within autism spectrum disorder; striatal resting-state functional magnetic resonance imaging (fMRI) measures, such as the striatal connectivity index (SCI) and the functional striatal abnormalities (FSA) index, for prediction of treatment response in schizophrenia; error-related negativity (ERN), an electrophysiological index, for prediction of first onset of generalized anxiety disorder, and resting-state and structural brain connectomic measures for prediction of treatment response in social anxiety disorder. Alternate forms of classification may be useful for conceptualizing and testing potential biomarkers. Collaborative efforts allowing the inclusion of biosystems beyond genetics and neuroimaging are needed, and online remote acquisition of selected measures in a naturalistic setting using mobile health tools may significantly advance the field. Setting specific benchmarks for well-defined target application, along with development of appropriate funding and partnership mechanisms, would also be crucial. Finally, it should never be forgotten that, for a biomarker to be actionable, it will need to be clinically predictive at the individual level and viable in clinical settings.</p>","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"236-262"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168176/pdf/WPS-22-236.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9452393","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":"The time is now to start evaluating biomarkers in the clinic.","authors":"Aristotle Voineskos","doi":"10.1002/wps.21082","DOIUrl":"https://doi.org/10.1002/wps.21082","url":null,"abstract":"267 methods. Applying a reverse engineering approach, working backwards from treatment outcome heterogeneity to identify treatmentselection biomarkers (which may not have any direct causal role in the pathophysiology of disease), has already proven to be valid and potentially productive . The clinical utility of such biomarkers rests on their potential to allow practitioners to move beyond the current trialanderror standard, thus shortening time to remission and minimizing exposure to potential adverse effects. Application of treatmentselection biomarkers would further transcend the concept of “clinical stages” of treatment resistance, enabling patients to proceed immediately to more intensive treatments that, under current care models, are withheld until the patient demonstrates nonresponse to standard treatments. Researchers should remain mindful of the seductive nature of the classical forward","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"267-268"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168165/pdf/WPS-22-267.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9436373","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 meetings 2020-2023.","authors":"Edmond H Pi","doi":"10.1002/wps.21106","DOIUrl":"https://doi.org/10.1002/wps.21106","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"345-346"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168158/pdf/WPS-22-345.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442888","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":"Biomarkers for clinical use in psychiatry: where are we and will we ever get there?","authors":"Lakshmi N Yatham","doi":"10.1002/wps.21079","DOIUrl":"10.1002/wps.21079","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"263-264"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168147/pdf/WPS-22-263.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9436368","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":"Mental health for all: fostering healthy lifestyles.","authors":"Danuta Wasserman","doi":"10.1002/wps.21102","DOIUrl":"https://doi.org/10.1002/wps.21102","url":null,"abstract":"343 known, psychiatrists should be familiar with strategies known to improve coping, such as selfmanagement, mindfulness meditation, cognitive behavioural therapy, and supportive therapies. The burgeoning number of people needing psychiatric treatment because of the COVID19 pandemic has strained already in adequate mental health services. Access to mental health care has become more difficult, due to restrictive measures and the shortage of staff and other resources. Digital technologies have offered an immediate solution to continue delivering mental health treatment. Nevertheless, the lack of legal and ethical regulation, standardization and preparation has posed several challenges to the largescale application of telepsychiatry. Recognition of the opportunity to increase access to mental health care has led the WPA to develop global guidelines for telepsychiatry. Public health agencies’ commitment to increasing mental health awareness and selfhelp during the pandemic has also enhanced interest in other digital mental health interventions, such as those based on mobile apps, sensor data, social media, and virtual reality. The integration of these interventions into realworld clinical practice requires ongoing progress. Even as the pandemic fades, the psychological burdens of long COVID will create new needs for care. Furthermore, the easing of restrictions and the “return to the new normality” will require coping with new sourc es of stress. Governments, insurers and other funders should support increased re sourc es for mental health services, commen surate with the growth in demand for treat ment. Longerterm solutions, including a commitment to augmenting the mental health work force, are also needed. Our recommendations for action are the following:","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"343-344"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168156/pdf/WPS-22-343.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442887","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":"Mental health literacy for supporting children: the need for a new field of research and intervention.","authors":"Laura M Hart,&nbsp;Anthony F Jorm,&nbsp;Catherine L Johnson,&nbsp;Lucy A Tully,&nbsp;Emma Austen,&nbsp;Karen Gregg,&nbsp;Amy J Morgan","doi":"10.1002/wps.21099","DOIUrl":"https://doi.org/10.1002/wps.21099","url":null,"abstract":"World Psychiatry 22:2 June 2023 health collaborations; ii) developing mental health services tailored to address the trauma and other consequences of the Russian war; iii) providing medications and other resources to treat patients with mental health needs; iv) developing remote tele­ mental health ser­ vices, making treatment available for all; v) preparing to re­ build Ukrainian facilities, services, and education systems, so that Ukrain­ ians can benefit from the skills and resources of modern psychiatric practice; vi) establishing research programs, so that Ukrainians and people of other countries can learn from these circumstances and be better prepared, if such events occur in the future. World leaders in the mental health and general health fields should: a) support the process of bringing war crimes prosecutions before the War Crimes Tribunal in The Hague, and human rights violations before the European Court of Human Rights, as part of the recovery process for Ukraine’s collective trauma; b) recognize and address the special needs of children and young families (i.e., i) provide safety and security for all children, including shielding them from the atrocities of war, trafficking, and emotional and phys ­ ical damage; ii) provide parent guidance and support for families who are displaced or facing the trauma of injury, war crimes, and death; iii) help children maintain contact with family members from whom they have been separated; iv) build online facilities to re­ establish supportive social networks for developing youth; v) sustain virtual Ukrainian schools, so that children who had to leave homeland can continue their intellectual and social development, while also giving them the tools and hopes for a future in Ukraine; vi) provide evidence­ based general interventions that give com­ fort and promote resilience, such as mindfulness training and ev i ­ dence­ based single­ session interventions); c) never forget: the Rus­ sian war; the Ukrainian people; the threats to all of us; the need to promote healthy development, mental health, and peace. There is great power in unity. Now is the time to stand together. A strong way to support resilience and recovery is for medical and mental health professionals to speak in one voice supporting the end of this and other wars.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"338-339"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168171/pdf/WPS-22-338.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9436372","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":"The price of peace in our time.","authors":"Irina Pinchuk,&nbsp;Bennett L Leventhal,&nbsp;Tsuyoshi Akiyama,&nbsp;Hartmut Berger,&nbsp;Isabelle Secret Bobolakis,&nbsp;Rebecca W Brendel,&nbsp;Kirsten Catthoor,&nbsp;Jana Chihai,&nbsp;Eka Chkonia,&nbsp;Geert Dom,&nbsp;Dominika Dudek,&nbsp;Adrian James,&nbsp;Afzal Javed,&nbsp;Marina Kupchik,&nbsp;Ramune Mazaliauskiene,&nbsp;Pavel Mohr,&nbsp;Lars Lien,&nbsp;Vinay Lakra,&nbsp;Andreas Meyer-Lindenberg,&nbsp;Erich Seifritz,&nbsp;György Szekeres,&nbsp;Norbert Skokauskas","doi":"10.1002/wps.21109","DOIUrl":"https://doi.org/10.1002/wps.21109","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"337-338"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168169/pdf/WPS-22-337.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442881","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":"Prevalence and trends of common mental disorders from 2007-2009 to 2019-2022: results from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS), including comparison of prevalence rates before vs. during the COVID-19 pandemic.","authors":"Margreet Ten Have,&nbsp;Marlous Tuithof,&nbsp;Saskia van Dorsselaer,&nbsp;Frederiek Schouten,&nbsp;Annemarie I Luik,&nbsp;Ron de Graaf","doi":"10.1002/wps.21087","DOIUrl":"https://doi.org/10.1002/wps.21087","url":null,"abstract":"<p><p>Up-to-date information on the prevalence and trends of common mental disorders is relevant to health care policy and planning, owing to the high burden associated with these disorders. In the first wave of the third Netherlands Mental Health Survey and Incidence Study (NEMESIS-3), a nationally representative sample was interviewed face-to-face from November 2019 to March 2022 (6,194 subjects; 1,576 interviewed before and 4,618 during the COVID-19 pandemic; age range: 18-75 years). A slightly modified version of the Composite International Diagnostic Interview 3.0 was used to assess DSM-IV and DSM-5 diagnoses. Trends in 12-month prevalence rates of DSM-IV mental disorders were examined by comparing these rates between NEMESIS-3 and NEMESIS-2 (6,646 subjects; age range: 18-64 years; interviewed from November 2007 to July 2009). Lifetime DSM-5 prevalence estimates in NEMESIS-3 were 28.6% for anxiety disorders, 27.6% for mood disorders, 16.7% for substance use disorders, and 3.6% for attention-deficit/hyperactivity disorder. Over the last 12 months, prevalence rates were 15.2%, 9.8%, 7.1%, and 3.2%, respectively. No differences in 12-month prevalence rates before vs. during the COVID-19 pandemic were found (26.7% pre-pandemic vs. 25.7% during the pandemic), even after controlling for differences in socio-demographic characteristics of the respondents interviewed in these two periods. This was the case for all four disorder categories. From 2007-2009 to 2019-2022, the 12-month prevalence rate of any DSM-IV disorder significantly increased from 17.4% to 26.1%. A stronger increase in prevalence was found for students, younger adults (18-34 years) and city dwellers. These data suggest that the prevalence of mental disorders has increased in the past decade, but this is not explained by the COVID-19 pandemic. The already high mental disorder risk of young adults has particularly further increased in recent years.</p>","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"275-285"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168151/pdf/WPS-22-275.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10299631","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":"The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders - an umbrella review based on updated criteria.","authors":"Falk Leichsenring, Allan Abbass, Nikolas Heim, John R Keefe, Steve Kisely, Patrick Luyten, Sven Rabung, Christiane Steinert","doi":"10.1002/wps.21104","DOIUrl":"10.1002/wps.21104","url":null,"abstract":"<p><p>To assess the current status of psychodynamic therapy (PDT) as an empirically supported treatment (EST), we carried out a pre-registered systematic umbrella review addressing the evidence for PDT in common mental disorders in adults, based on an updated model for ESTs. Following this model, we focused on meta-analyses of randomized controlled trials (RCTs) published in the past two years to assess efficacy. In addition, we reviewed the evidence on effectiveness, cost-effectiveness and mechanisms of change. Meta-analyses were evaluated by at least two raters using the proposed updated criteria, i.e. effect sizes, risk of bias, inconsistency, indirectness, imprecision, publication bias, treatment fidelity, and their quality as well as that of primary studies. To assess the quality of evidence we applied the GRADE system. A systematic search identified recent meta-analyses on the efficacy of PDT in depressive, anxiety, personality and somatic symptom disorders. High quality evidence in depressive and somatic symptom disorders and moderate quality evidence in anxiety and personality disorders showed that PDT is superior to (inactive and active) control conditions in reducing target symptoms with clinically meaningful effect sizes. Moderate quality evidence suggests that PDT is as efficacious as other active therapies in these disorders. The benefits of PDT outweigh its costs and harms. Furthermore, evidence was found for long-term effects, improving functioning, effectiveness, cost-effectiveness and mechanisms of change in the aforementioned disorders. Some limitations in specific research areas exist, such as risk of bias and imprecision, which are, however, comparable to those of other evidence-based psychotherapies. Thus, according to the updated EST model, PDT proved to be an empirically-supported treatment for common mental disorders. Of the three options for recommendation provided by the updated model (i.e., \"very strong\", \"strong\" or \"weak\"), the new EST criteria suggest that a strong recommendation for treating the aforementioned mental disorders with PDT is the most appropriate option. In conclusion, PDT represents an evidence-based psychotherapy. This is clinically important since no single therapeutic approach fits all psychiatric patients, as shown by the limited success rates across all evidence-based treatments.</p>","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"286-304"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168167/pdf/WPS-22-286.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442890","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}