World Psychiatry最新文献

{"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":79.5,"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":"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":"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":60.5,"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":"Genetics for mental health clinicians: a call for a globally accessible and equitable psychiatric genetics education.","authors":"","doi":"10.1002/wps.21173","DOIUrl":"10.1002/wps.21173","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"23 1","pages":"161-163"},"PeriodicalIF":60.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10785985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425854","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":79.5,"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}

{"title":"The WPA Working Group on Intellectual Developmental Disorders: the need for a second paradigm shift.","authors":"Kerim M Munir, Ashok Roy, Afzal Javed","doi":"10.1002/wps.20979","DOIUrl":"10.1002/wps.20979","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":"327-328"},"PeriodicalIF":65.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9077623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45128394","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":"Risk of new-onset psychiatric sequelae of COVID-19 in the early and late post-acute phase.","authors":"Ben Coleman,&nbsp;Elena Casiraghi,&nbsp;Hannah Blau,&nbsp;Lauren Chan,&nbsp;Melissa A Haendel,&nbsp;Bryan Laraway,&nbsp;Tiffany J Callahan,&nbsp;Rachel R Deer,&nbsp;Kenneth J Wilkins,&nbsp;Justin Reese,&nbsp;Peter N Robinson","doi":"10.1002/wps.20992","DOIUrl":"10.1002/wps.20992","url":null,"abstract":"319 half of the originally randomized sample. However, almost half (43.8%) of the omitted participants simply did not receive the assessment needed to diagnose PGD, and another 38% were excluded because it was too soon (six months to one year since the loss) to receive a PGD diagnosis. Further, those assessed showed no differences in demographic or clinical characteristics from participants in the parent study. We endorse continued study of effective treatments for PGD. In the meantime, we believe that clinicians will benefit from knowing that CGT, a strongly validated intervention, can be appropriately re-labeled as prolonged grief disorder therapy (PGDT).","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"21 1","pages":"319-320"},"PeriodicalIF":73.3,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9077621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46561566","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":"Prevention, treatment and care of substance use disorders in times of COVID-19.","authors":"Nora D Volkow, Susan Maua, Giovanna Campello, Vladimir Poznyak, Dzmitry Krupchanka, Wataru Kashino, Anja Busse","doi":"10.1002/wps.20995","DOIUrl":"10.1002/wps.20995","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"21 1","pages":"323-324"},"PeriodicalIF":60.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9077610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45037505","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}