Trends in Psychiatry and Psychotherapy最新文献

{"title":"Transcranial Direct Current Stimulation as a Therapeutic Approach for Anxiety and Related Markers: Comprehensive Systematic Review.","authors":"Flávia de Moraes, Nathali Dalzochio, Filipe Reis Teodoro Andrade, André R Brunoni, Arthur França de Souza, Wolnei Caumo, Rosa Maria Martins de Almeida","doi":"10.47626/2237-6089-2024-0950","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-0950","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aims to assess the effects of transcranial electrical stimulation (tES) on adults with anxiety. It focuses on evaluating physiological markers like heart rate variability (HRV), electroencephalogram (EEG), cortisol, and Interleukin-6 (IL-6) levels alongside various rating scales.</p><p><strong>Methods: </strong>The review process, adhering to PRISMA guidelines, involved a thorough literature search across databases such as Embase, Scopus, PsycINFO, PubMed, and Web of Science. The risk of bias and quality of studies was evaluated using the JADAD scale. In total, 34 articles were meticulously chosen and analyzed by independent reviewer pairs.</p><p><strong>Results: </strong>The review included 34 studies, encompassing 1567 participants aged between 18 to 65. The findings were mixed: while 19 studies reported a reduction in anxiety symptoms, 10 found no significant differences, and 4 did not report changes in anxiety. Two studies were inconclusive.</p><p><strong>Conclusions: </strong>The review highlights a lack of standardized protocols for using tDCS in treating anxiety. The methodological quality of most studies was critically low, per PRISMA guidelines. There was considerable variation in methodological approaches across the studies, indicating a need for standardization in the research of anxiety treatment using tES.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276109","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":"SOSkin: a randomized clinical trial of on-line cognitive-behavioral therapy for Skin Picking Disorder.","authors":"Alice Castro Menezes Xavier, Clarissa Prati, Anita Castro Menezes Xavier, Murilo G Brandão, Alice Barbieri Ebert, Malu Joyce de A Macedo, Maria João Baptista Fernandes, Gisele Gus Manfro, Carolina Blaya Dreher","doi":"10.47626/2237-6089-2025-1083","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1083","url":null,"abstract":"<p><strong>Background: </strong>Cognitive Behavioral Therapy (CBT) is an effective treatment for Skin Picking Disorder (SPD). However, since individuals have limited access to CBT, telepsychotherapy can overcome this barrier.</p><p><strong>Objective: </strong>Evaluate the efficacy of a self-guided digital CBT intervention for SPD.</p><p><strong>Methods: </strong>This controlled clinical trial randomized 163 patients with SPD to receive 4 weeks of online CBT (SOSkin) or a control intervention (videos about quality of life). Primary outcome was the improvement in the Skin Picking Scale-Revised (SPS-R) and secondary outcomes were the improvement in Dermatology Life Quality Index Scale (DLQI), Generalized Anxiety Disorder Assessment Scale (GAD-7), and Patient Health Questionnaire-9 Scale (PHQ-9). Instruments were applied at baseline, middle and end of intervention and at 1 and 3 months of follow up. SOSkin usability was evaluated using the System Usability Scale (SUS). Data were analyzed using the Generalized Estimating Equations model (GEE).</p><p><strong>Conclusion: </strong>There was no difference between groups in completion rates. SOSkin has excellent usability. Both groups improved the SPS-R and the DLQI scores after treatment and at the follow-up assessments. We found a significant time*group interaction in favor of CBT on SPS-R. Effect size of the intervention compared to control over SPS-R was small after treatment and at the follow-ups; over the DLQI was moderate after treatment and small at the follow-ups. CBT was superior to control on SPS-R when we compared the percentage of change from baseline. CBT was superior to control condition over DLQI at the end of treatment and at 1 month follow-up.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233626","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":"Topiramate Therapy in Cocaine Use Disorder: A Systematic Review and meta-analysis of Randomized Controlled Trials.","authors":"Sridevi Shanmugam, Saravana Arunkumar, Vishal Agrawal, Praveen Kumar","doi":"10.47626/2237-6089-2025-1117","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1117","url":null,"abstract":"<p><strong>Background: </strong>Despite the global burden of cocaine use, no pharmacological agent has received regulatory approval for the treatment of cocaine use disorder (CUD). This study aims to systematically evaluate efficacy and safety of topiramate, with a focus on its impact on treatment retention, cocaine use and abstinence, craving reduction, and safety in individuals diagnosed with CUD.</p><p><strong>Methods: </strong>To identify all relevant studies, a comprehensive search strategy was employed across several electronic databases. The search strategy focused on terms related to CUD and topiramate from January 1, 2000, to December 31, 2024. Eligible studies included randomized controlled trials comparing topiramate with placebo, standard treatments, or non-pharmacological interventions.</p><p><strong>Results: </strong>Ten studies were included in the current review. Meta-analysis revealed a statistically significant benefit of topiramate compared to control in promoting cocaine abstinence (Risk Ratio [95% Confidence Interval] = 2.83 [1.68-4.76]; p<0.05). However, no statistically significant difference was observed between topiramate and control groups regarding craving reduction (standardized mean difference = -0.28 [-1.92-1.36]). Overall, treatment retention outcomes across the included studies were mixed favoring topiramate with no statistical difference between two cohorts in dropout rates (RR = 0.94 [0.69 - 1.28]). The risk of adverse events was comparable between the topiramate and control groups (RR = 1.06 [0.91-1.23]; p = 0.44).</p><p><strong>Conclusion: </strong>Topiramate may aid early abstinence and reduce cocaine use in individuals with CUD, with generally favorable treatment retention and tolerability. However, its effect on craving reduction appears limited, and further robust studies are needed to confirm its long-term efficacy and safety.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233699","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":"Impulsivity and Alcohol and Other Drugs Among Adult Inmates: A Systematic Review.","authors":"Maria Verônica Schmitz Wingen, Victor Hugo Vieira Benvindo, Nathali Boeira Dalzochio, Rosa Maria Martins de Almeida","doi":"10.47626/2237-6089-2025-1131","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1131","url":null,"abstract":"<p><strong>Objective: </strong>A substantial proportion of the incarcerated population is imprisoned for substance-related offenses, including illegal possession and drug-induced violent crimes. Given this context, this study aimed to investigate, through a systematic review of the literature, the relationship between impulsivity and the use of alcohol and other drugs among incarcerated adults, considering the contributions of cognitive neuroscience to understanding this association in populations characterized by deviant behavior.</p><p><strong>Methods: </strong>This systematic review, conducted in accordance with PRISMA guidelines, examined 547 studies retrieved from PsycInfo, PubMed/Medline, Embase, SCOPUS, and Web of Science.</p><p><strong>Results: </strong>After applying the inclusion and exclusion criteria, nine studies were selected for full analysis. The findings revealed a significant association between impulsivity and a history of substance use, especially in cases involving higher levels of consumption. Low educational attainment was also a prevalent characteristic among the analyzed samples.</p><p><strong>Conclusions: </strong>These findings underscore the importance of prevention and intervention strategies that integrate neuropsychological and educational components as fundamental elements of treatment and social reintegration efforts.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233632","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":"Autism Spectrum Disorders and Personality Disorders: Differential Diagnosis or Comorbidity?","authors":"Tiago Figueiredo, Leonardo Caixeta","doi":"10.47626/2237-6089-2025-1104","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1104","url":null,"abstract":"<p><strong>Objective: </strong>The clinical overlap between autism spectrum disorder (ASD) and Personality Disorders (PDs) poses significant diagnostic challenges. Shared features-such as social communication difficulties, rigidity, and emotional dysregulation-often lead to misdiagnosis or delayed diagnosis, especially in adults and underrepresented populations (e.g., women).</p><p><strong>Methods: </strong>This narrative review synthesizes current evidence on the differential diagnosis and comorbidity of ASD and PDs to guide clinical practice.</p><p><strong>Results: </strong>Findings highlight substantial symptom overlap, particularly in social cognition and emotional regulation. For instance, both ASD and Schizotypal PD may exhibit social withdrawal, while ASD and Borderline PD share impulsivity and identity disturbances-though with distinct etiologies (neurodevelopmental vs. trauma-related).</p><p><strong>Conclusions: </strong>Clinicians must adopt a developmental perspective to disentangle ASD from PDs, integrating longitudinal history, neuropsychological testing, and multidisciplinary evaluations. Future research should prioritize biomarker-based diagnostics and tailored interventions for comorbid presentations.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201709","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":"Efficacy and Safety of Eye Movement Desensitization and Reprocessing (EMDR) in Patients with Psychosis: A Systematic Review of Randomized Controlled Trials.","authors":"Omnia M Ahmed, Gehad Khalaf, Khalid Radwan Alsaadany, Ayman Zaroug, Ahmed Hatem Ibrahim, Hafsat Nasir, Shrouk M Elghazaly","doi":"10.47626/2237-6089-2025-1099","DOIUrl":"10.47626/2237-6089-2025-1099","url":null,"abstract":"<p><strong>Background: </strong>Recent evidence regarding the multifactorial etiology of psychosis suggests that it can be trauma-induced. Therefore, there is a growing interest in using trauma-focused interventions to treat patients with psychosis and a history of traumatic events. Eye Movement Desensitization and Reprocessing (EMDR) is an approved, effective therapy for post-traumatic stress disorder (PTSD), but its use in the presence of psychotic features is still under scrutiny.</p><p><strong>Objectives: </strong>To assess the safety of EMDR in individuals with psychosis and co-morbid PTSD and evaluate its effectiveness in reducing psychotic and trauma-related symptoms.</p><p><strong>Methods: </strong>Relevant randomized controlled trials (RCTs) were obtained from six databases using an extensive search strategy. Eligible studies were identified based on our inclusion and exclusion criteria, and then quality was assessed. Data was extracted from each study and narratively synthesized.</p><p><strong>Results: </strong>: Four RCTs were included in our review, with an additional report for one. EMDR was generally superior to TAU and the WL condition in improving symptoms of psychosis and PTSD. It led to consistent improvements in clinician and patient-rated PTSD symptoms and was particularly effective in reducing psychotic negative symptoms (PANSS-N) and paranoid thinking (GPTS). However, improvements in delusions and auditory hallucinations (PSYRATS-D and AH) were mostly insignificant. No serious adverse events related to the therapy itself were reported in any of the trials.</p><p><strong>Conclusion: </strong>Overall, EMDR promises to be a safe and effective therapy in people with psychosis and PTSD. Large-scale trials with longer follow-up periods are needed to confirm our findings.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139080","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":"Does a lifestyle-based intervention improve sleep quality in individuals with major depressive disorder? A randomized controlled trial.","authors":"Maria Luiza de Morais Barros, Vagner Deuel de O Tavares, Geovan Menezes de Sousa, Geissy Lainny de Lima-Araujo, Felipe B Schuch, Brendon Stubbs, Raissa Nóbrega de Almeida, Jaime Eduardo Hallak, Emerson Arcoverde, Nicole Leite Galvão-Coelho","doi":"10.47626/2237-6089-2025-1120","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1120","url":null,"abstract":"<p><strong>Background: </strong>Major Depressive Disorder (MDD) is a leading cause of global disability, contributing to substantial individual, social, and economic burdens. While antidepressant therapy remains the cornerstone of treatment, complementary lifestyle-based interventions, such as multimodal exercise and mindfulness, have shown promise in alleviating mood symptoms. However, their specific impact on sleep quality, a critical therapeutic target in MDD, remains underexplored.</p><p><strong>Methods: </strong>In a 12-week randomized controlled trial, 88 patients with MDD were assigned to three groups: pharmacotherapy alone (control group-CG), pharmacotherapy plus home-based multimodal exercise (exercise group-EG), or pharmacotherapy plus home-based mindfulness training (mindfulness group-MF). Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) at baseline, week 5, and week 12.</p><p><strong>Results: </strong>A Linear Mixed-Model (LMM) was performed, and significant group-by-time interactions were observed. At baseline, the EG exhibited lower PSQI scores compared to the MF (p=.002, d=.75) and CG (p=.001, d=.83). At week 5, the EG continued to show superior sleep quality relative to mindfulness (p=.018, d=.64) and CG (p=.001, d=.89). At week 12, the MF also demonstrated better sleep quality than the CG (p=.002, d=.80). All groups improved over time, with exercise yielding rapid benefits and MF showing progressive, sustained improvements.</p><p><strong>Conclusion: </strong>Lifestyle-based interventions enhance sleep quality in MDD when combined with antidepressant therapy. Multimodal exercise offers immediate improvements, while mindfulness provides gradual, long-term benefits. These findings underscore the value of adjunctive lifestyle interventions in MDD management and highlight the need for further research into their long-term efficacy and potential synergistic effects.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034390","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":"Increased use of psychiatric drugs in Brazil over the years: evidence from a country-wide dataset.","authors":"Alana Castro Panzenhagen, Augusto Cezar Sartori Maffini, Raul Dantas, Ken Shimomura, Maria Letícia Rodrigues Ikeda, Daniel Pens Gelain, Flávio Milman Shansis, José Cláudio Fonseca Moreira","doi":"10.47626/2237-6089-2024-0914","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-0914","url":null,"abstract":"<p><strong>Objectives: </strong>Stressful events can impact the incidence of psychiatric disorders and, therefore, psychiatric drug use. However, it is not clear whether psychiatric drug use is stable or not across the Brazilian population over time. The aim of this study was to investigate trends in psychiatric drug sales in Brazil over the years, using sales data from private-sector pharmacies as a proxy for psychiatric drug consumption.</p><p><strong>Methods: </strong>This is a non-interventional pharmacoepidemiological study using routinely collected health data from 2015 to 2021. The primary outcome was the amount of psychiatric drugs sold, corresponding to an individual or entity purchase recorded in the national system.</p><p><strong>Results: </strong>We found an overall annual increase in psychiatric drug sales in the last few years (Z = -2748·7, p = 2·2 x 10-16). Antidepressants and antipsychotics are by far the top seller psychiatric drugs. The south and southeast regions of Brazil and the state of Pará simultaneously show high levels of psychiatric drug sales, COVID-19 confirmed cases, and per capita income. We have raised hypotheses that might help explain the variations in psychiatric drug consumption. We provide evidence of a growing psychiatric drug sale over the years, likely reflecting an increase in psychiatric disorders or symptoms.</p><p><strong>Conclusion: </strong>The trend reported here indicates an association between increased psychiatric drug sales and recent socioeconomic and health crises, including the COVID-19 pandemic, but causality cannot be established. This is possibly just the beginning of a major nationwide challenge that deserves attention going forward so that effective measures are implemented.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001623","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":"Cognitive virtual games and cortisol: a prisma-based systematic review.","authors":"Santiago David Vásquez-Hidalgo, Lorrane Ribeiro de Souza, Bruno da Silva Santos, Rosa Maria Martins de Almeida","doi":"10.47626/2237-6089-2024-1008","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-1008","url":null,"abstract":"<p><strong>Objective: </strong>Over the last decades, gaming has become a popular way to spend time and connect with people worldwide, engaging millions of users. Literature has shown that games and competition in gaming are closely linked to physiological stress responses. The aim of this systematic review was to determine if cognitive virtual games are also linked with stress responses and to investigate this interplay.</p><p><strong>Methods: </strong>Following the PRISMA protocol, five databases were used, including EMBASE, PubMed, PsycInfo, SCOPUS and Web of Science. The PICO strategy was employed to formulate the research question. The search was performed by three independent investigators using a predefined protocol registered on the PROSPERO database (CRD42022384921).</p><p><strong>Findings: </strong>Following these procedures, 30 eligible empirical studies were considered for the review, which included 39 cognitive games, because some studies used more than one game in their research. Fourteen of the selected studies showed significantly increased cortisol levels after playing virtual cognitive games, twelve studies reported a decrease in cortisol levels while the remaining four showed both, increase and decrease cortisol depending on variables such as gender differences, age or type of game. This highlights the complex relationship between virtual cognitive games and cortisol modulation.</p><p><strong>Conclusion: </strong>Our results provided a comprehensive view of the intricate interplay between virtual cognitive games and cortisol dynamics, acknowledging both the potential stress-inducing and stress-alleviating effects of gaming. The implications of these findings go beyond entertainment, emphasizing the need for a nuanced understanding of the psychophysiological mechanisms involved.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973670","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":"\"Acceptance and Commitment Therapy for Patients with Cardiovascular Disease\": the Role of Group Dynamics Integration, Digitalization, and Follow-up.","authors":"Al Halik, Budi Astuti, Farida Agus Setiawati","doi":"10.47626/2237-6089-2025-1138","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1138","url":null,"abstract":"","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973724","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}