World Psychiatry最新文献

{"title":"Treatment of substance use disorders in prison settings: statement by the UNODC-WHO Informal Scientific Network, UN Commission on Narcotic Drugs.","authors":"Nora D Volkow, Orlando Scoppetta, Anja Busse, Vladimir Poznyak, Dzmitry Krupchanka, Giovanna Campello","doi":"10.1002/wps.21210","DOIUrl":"10.1002/wps.21210","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"23 2","pages":"294-295"},"PeriodicalIF":73.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11083877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900223","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 definition of treatment resistance in anxiety disorders: a Delphi method-based consensus guideline.","authors":"Katharina Domschke, Patrik D Seuling, Miriam A Schiele, Borwin Bandelow, Neeltje M Batelaan, Wicher A Bokma, Igor Branchi, Karl Broich, Julius Burkauskas, Simon J C Davies, Bernardo Dell'Osso, Harry Fagan, Naomi A Fineberg, Toshi A Furukawa, Stefan G Hofmann, Sean Hood, Nathan T M Huneke, Milan Latas, Nicky Lidbetter, Vasilios Masdrakis, R Hamish McAllister-Williams, Antonio E Nardi, Stefano Pallanti, Brenda W J H Penninx, Giampaolo Perna, Steve Pilling, Stefano Pini, Andreas Reif, Soraya Seedat, Gemma Simons, Shrikant Srivastava, Vesta Steibliene, Dan J Stein, Murray B Stein, Michael van Ameringen, Anton J L M van Balkom, Nic van der Wee, Peter Zwanzger, David S Baldwin","doi":"10.1002/wps.21177","DOIUrl":"10.1002/wps.21177","url":null,"abstract":"<p><p>Anxiety disorders are very prevalent and often persistent mental disorders, with a considerable rate of treatment resistance which requires regulatory clinical trials of innovative therapeutic interventions. However, an explicit definition of treatment-resistant anxiety disorders (TR-AD) informing such trials is currently lacking. We used a Delphi method-based consensus approach to provide internationally agreed, consistent and clinically useful operational criteria for TR-AD in adults. Following a summary of the current state of knowledge based on international guidelines and an available systematic review, a survey of free-text responses to a 29-item questionnaire on relevant aspects of TR-AD, and an online consensus meeting, a panel of 36 multidisciplinary international experts and stakeholders voted anonymously on written statements in three survey rounds. Consensus was defined as ≥75% of the panel agreeing with a statement. The panel agreed on a set of 14 recommendations for the definition of TR-AD, providing detailed operational criteria for resistance to pharmacological and/or psychotherapeutic treatment, as well as a potential staging model. The panel also evaluated further aspects regarding epidemiological subgroups, comorbidities and biographical factors, the terminology of TR-AD vs. \"difficult-to-treat\" anxiety disorders, preferences and attitudes of persons with these disorders, and future research directions. This Delphi method-based consensus on operational criteria for TR-AD is expected to serve as a systematic, consistent and practical clinical guideline to aid in designing future mechanistic studies and facilitate clinical trials for regulatory purposes. This effort could ultimately lead to the development of more effective evidence-based stepped-care treatment algorithms for patients with anxiety disorders.</p>","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"23 1","pages":"113-123"},"PeriodicalIF":60.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10785995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425865","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":"Effectiveness and cost-effectiveness of online recorded recovery narratives in improving quality of life for people with non-psychotic mental health problems: a pragmatic randomized controlled trial.","authors":"Mike Slade, Stefan Rennick-Egglestone, Rachel A Elliott, Chris Newby, Clare Robinson, Sean P Gavan, Luke Paterson, Yasmin Ali, Caroline Yeo, Tony Glover, Kristian Pollock, Felicity Callard, Stefan Priebe, Graham Thornicroft, Julie Repper, Jeroen Keppens, Melanie Smuk, Donna Franklin, Rianna Walcott, Julian Harrison, Roger Smith, Dan Robotham, Simon Bradstreet, Steve Gillard, Pim Cuijpers, Marianne Farkas, Dror Ben Zeev, Larry Davidson, Yasuhiro Kotera, James Roe, Fiona Ng, Joy Llewellyn-Beardsley","doi":"10.1002/wps.21176","DOIUrl":"10.1002/wps.21176","url":null,"abstract":"<p><p>Narratives describing first-hand experiences of recovery from mental health problems are widely available. Emerging evidence suggests that engaging with mental health recovery narratives can benefit people experiencing mental health problems, but no randomized controlled trial has been conducted as yet. We developed the Narrative Experiences Online (NEON) Intervention, a web application providing self-guided and recommender systems access to a collection of recorded mental health recovery narratives (n=659). We investigated whether NEON Intervention access benefited adults experiencing non-psychotic mental health problems by conducting a pragmatic parallel-group randomized trial, with usual care as control condition. The primary endpoint was quality of life at week 52 assessed by the Manchester Short Assessment (MANSA). Secondary outcomes were psychological distress, hope, self-efficacy, and meaning in life at week 52. Between March 9, 2020 and March 26, 2021, we recruited 1,023 participants from across England (the target based on power analysis was 994), of whom 827 (80.8%) identified as White British, 811 (79.3%) were female, 586 (57.3%) were employed, and 272 (26.6%) were unemployed. Their mean age was 38.4±13.6 years. Mood and/or anxiety disorders (N=626, 61.2%) and stress-related disorders (N=152, 14.9%) were the most common mental health problems. At week 52, our intention-to-treat analysis found a significant baseline-adjusted difference of 0.13 (95% CI: 0.01-0.26, p=0.041) in the MANSA score between the intervention and control groups, corresponding to a mean change of 1.56 scale points per participant, which indicates that the intervention increased quality of life. We also detected a significant baseline-adjusted difference of 0.22 (95% CI: 0.05-0.40, p=0.014) between the groups in the score on the \"presence of meaning\" subscale of the Meaning in Life Questionnaire, corresponding to a mean change of 1.1 scale points per participant. We found an incremental gain of 0.0142 quality-adjusted life years (QALYs) (95% credible interval: 0.0059 to 0.0226) and a £178 incremental increase in cost (95% credible interval: -£154 to £455) per participant, generating an incremental cost-effectiveness ratio of £12,526 per QALY compared with usual care. This was lower than the £20,000 per QALY threshold used by the National Health Service in England, indicating that the intervention would be a cost-effective use of health service resources. In the subgroup analysis including participants who had used specialist mental health services at baseline, the intervention both reduced cost (-£98, 95% credible interval: -£606 to £309) and improved QALYs (0.0165, 95% credible interval: 0.0057 to 0.0273) per participant as compared to usual care. We conclude that the NEON Intervention is an effective and cost-effective new intervention for people experiencing non-psychotic mental health problems.</p>","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"23 1","pages":"101-112"},"PeriodicalIF":73.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10785987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425849","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":"How should psychotherapy proceed when adjoined with psychedelics?","authors":"Marc J Weintraub, David J Miklowitz","doi":"10.1002/wps.21170","DOIUrl":"10.1002/wps.21170","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"23 1","pages":"157-158"},"PeriodicalIF":60.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10786002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425855","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":"Current evidence on the efficacy of mental health smartphone apps for symptoms of depression and anxiety. A meta-analysis of 176 randomized controlled trials.","authors":"Jake Linardon, John Torous, Joseph Firth, Pim Cuijpers, Mariel Messer, Matthew Fuller-Tyszkiewicz","doi":"10.1002/wps.21183","DOIUrl":"10.1002/wps.21183","url":null,"abstract":"<p><p>The mental health care available for depression and anxiety has recently undergone a major technological revolution, with growing interest towards the potential of smartphone apps as a scalable tool to treat these conditions. Since the last comprehensive meta-analysis in 2019 established positive yet variable effects of apps on depressive and anxiety symptoms, more than 100 new randomized controlled trials (RCTs) have been carried out. We conducted an updated meta-analysis with the objectives of providing more precise estimates of effects, quantifying generalizability from this evidence base, and understanding whether major app and trial characteristics moderate effect sizes. We included 176 RCTs that aimed to treat depressive or anxiety symptoms. Apps had overall significant although small effects on symptoms of depression (N=33,567, g=0.28, p<0.001; number needed to treat, NNT=11.5) and generalized anxiety (N=22,394, g=0.26, p<0.001, NNT=12.4) as compared to control groups. These effects were robust at different follow-ups and after removing small sample and higher risk of bias trials. There was less variability in outcome scores at post-test in app compared to control conditions (ratio of variance, RoV=-0.14, 95% CI: -0.24 to -0.05 for depressive symptoms; RoV=-0.21, 95% CI: -0.31 to -0.12 for generalized anxiety symptoms). Effect sizes for depression were significantly larger when apps incorporated cognitive behavioral therapy (CBT) features or included chatbot technology. Effect sizes for anxiety were significantly larger when trials had generalized anxiety as a primary target and administered a CBT app or an app with mood monitoring features. We found evidence of moderate effects of apps on social anxiety (g=0.52) and obsessive-compulsive (g=0.51) symptoms, a small effect on post-traumatic stress symptoms (g=0.12), a large effect on acrophobia symptoms (g=0.90), and a non-significant negative effect on panic symptoms (g=-0.12), although these results should be considered with caution, because most trials had high risk of bias and were based on small sample sizes. We conclude that apps have overall small but significant effects on symptoms of depression and generalized anxiety, and that specific features of apps - such as CBT or mood monitoring features and chatbot technology - are associated with larger effect sizes.</p>","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"23 1","pages":"139-149"},"PeriodicalIF":60.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10785982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425846","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 social determinants of mental health and disorder: evidence, prevention and recommendations.","authors":"James B Kirkbride, Deidre M Anglin, Ian Colman, Jennifer Dykxhoorn, Peter B Jones, Praveetha Patalay, Alexandra Pitman, Emma Soneson, Thomas Steare, Talen Wright, Siân Lowri Griffiths","doi":"10.1002/wps.21160","DOIUrl":"10.1002/wps.21160","url":null,"abstract":"<p><p>People exposed to more unfavourable social circumstances are more vulnerable to poor mental health over their life course, in ways that are often determined by structural factors which generate and perpetuate intergenerational cycles of disadvantage and poor health. Addressing these challenges is an imperative matter of social justice. In this paper we provide a roadmap to address the social determinants that cause mental ill health. Relying as far as possible on high-quality evidence, we first map out the literature that supports a causal link between social determinants and later mental health outcomes. Given the breadth of this topic, we focus on the most pervasive social determinants across the life course, and those that are common across major mental disorders. We draw primarily on the available evidence from the Global North, acknowledging that other global contexts will face both similar and unique sets of social determinants that will require equitable attention. Much of our evidence focuses on mental health in groups who are marginalized, and thus often exposed to a multitude of intersecting social risk factors. These groups include refugees, asylum seekers and displaced persons, as well as ethnoracial minoritized groups; lesbian, gay, bisexual, transgender and queer (LGBTQ+) groups; and those living in poverty. We then introduce a preventive framework for conceptualizing the link between social determinants and mental health and disorder, which can guide much needed primary prevention strategies capable of reducing inequalities and improving population mental health. Following this, we provide a review of the evidence concerning candidate preventive strategies to intervene on social determinants of mental health. These interventions fall broadly within the scope of universal, selected and indicated primary prevention strategies, but we also briefly review important secondary and tertiary strategies to promote recovery in those with existing mental disorders. Finally, we provide seven key recommendations, framed around social justice, which constitute a roadmap for action in research, policy and public health. Adoption of these recommendations would provide an opportunity to advance efforts to intervene on modifiable social determinants that affect population mental health.</p>","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"23 1","pages":"58-90"},"PeriodicalIF":73.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10786006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425871","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":"Functional neurological disorder: defying dualism.","authors":"Jon Stone, Ingrid Hoeritzauer, Laura McWhirter, Alan Carson","doi":"10.1002/wps.21151","DOIUrl":"10.1002/wps.21151","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"23 1","pages":"53-54"},"PeriodicalIF":60.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10785980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425852","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":"Management of generalized anxiety disorder and panic disorder in general health care settings: new WHO recommendations.","authors":"Brandon Gray, Biksegn Asrat, Elaine Brohan, Neerja Chowdhury, Tarun Dua, Mark van Ommeren","doi":"10.1002/wps.21172","DOIUrl":"10.1002/wps.21172","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"23 1","pages":"160-161"},"PeriodicalIF":73.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10785994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425856","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":"Cumulative remission rate after sequential treatments in depression: reappraisal of the STAR*D trial data.","authors":"Hitoshi Sakurai, Hisashi Noma, Koichiro Watanabe, Hiroyuki Uchida, Toshi A Furukawa","doi":"10.1002/wps.21169","DOIUrl":"10.1002/wps.21169","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"23 1","pages":"156-157"},"PeriodicalIF":60.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10785965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425845","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":"Functional magnetic resonance imaging in schizophrenia: current evidence, methodological advances, limitations and future directions.","authors":"Aristotle N Voineskos, Colin Hawco, Nicholas H Neufeld, Jessica A Turner, Stephanie H Ameis, Alan Anticevic, Robert W Buchanan, Kristin Cadenhead, Paola Dazzan, Erin W Dickie, Julia Gallucci, Adrienne C Lahti, Anil K Malhotra, Dost Öngür, Todd Lencz, Deepak K Sarpal, Lindsay D Oliver","doi":"10.1002/wps.21159","DOIUrl":"10.1002/wps.21159","url":null,"abstract":"<p><p>Functional neuroimaging emerged with great promise and has provided fundamental insights into the neurobiology of schizophrenia. However, it has faced challenges and criticisms, most notably a lack of clinical translation. This paper provides a comprehensive review and critical summary of the literature on functional neuroimaging, in particular functional magnetic resonance imaging (fMRI), in schizophrenia. We begin by reviewing research on fMRI biomarkers in schizophrenia and the clinical high risk phase through a historical lens, moving from case-control regional brain activation to global connectivity and advanced analytical approaches, and more recent machine learning algorithms to identify predictive neuroimaging features. Findings from fMRI studies of negative symptoms as well as of neurocognitive and social cognitive deficits are then reviewed. Functional neural markers of these symptoms and deficits may represent promising treatment targets in schizophrenia. Next, we summarize fMRI research related to antipsychotic medication, psychotherapy and psychosocial interventions, and neurostimulation, including treatment response and resistance, therapeutic mechanisms, and treatment targeting. We also review the utility of fMRI and data-driven approaches to dissect the heterogeneity of schizophrenia, moving beyond case-control comparisons, as well as methodological considerations and advances, including consortia and precision fMRI. Lastly, limitations and future directions of research in the field are discussed. Our comprehensive review suggests that, in order for fMRI to be clinically useful in the care of patients with schizophrenia, research should address potentially actionable clinical decisions that are routine in schizophrenia treatment, such as which antipsychotic should be prescribed or whether a given patient is likely to have persistent functional impairment. The potential clinical utility of fMRI is influenced by and must be weighed against cost and accessibility factors. Future evaluations of the utility of fMRI in prognostic and treatment response studies may consider including a health economics analysis.</p>","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"23 1","pages":"26-51"},"PeriodicalIF":60.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10786022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425851","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}