Annals of Clinical Psychiatry最新文献

{"title":"Characteristics of patients who had deep brain stimulation for treatment-resistant depression from among 116,890 inpatients with major depressive disorder.","authors":"Nagy A Youssef,&nbsp;Sonia Ann Marie F Dela Cruz,&nbsp;Patricio Riva-Posse,&nbsp;Rikinkumar S Patel","doi":"10.12788/acp.0045","DOIUrl":"https://doi.org/10.12788/acp.0045","url":null,"abstract":"<p><strong>Background: </strong>The aims of this study were to evaluate the characteristics of patients and the pattern and rate of use of deep brain stimulation (DBS) for major depressive disorder (MDD) in the United States.</p><p><strong>Methods: </strong>Data from the 2012-2014 Nationwide Inpatient Sample (NIS) included 116,890 patients. Patient variables included age, gender, race, median household income, insurance, primary diagnosis, primary procedure, length of stay, and total cost. Hospital variables included ownership, location, teaching status, bed size, and geographic region.</p><p><strong>Results: </strong>Patients who received DBS for MDD were primarily high- income White females with private insurance. The mean age was 49.1 years (SD 7.85). The length of inpatient stay was 1 to 1.6 days. Total cost was highest in the West and lowest in the Northeast. Deep brain stimulation was mostly used by private nonprofit urban teaching hospitals in the South region of the United States.</p><p><strong>Conclusions: </strong>Deep brain stimulation was used in .03% of the total inpatient population with a primary diagnosis of MDD. If efficacy is established in definitive trials, DBS could fill a need for patients with treatment-resistant depression who do not respond to standard therapeutics or electro-convulsive therapy.</p>","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"33 4","pages":"251-257"},"PeriodicalIF":1.3,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39536562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized controlled trial for symptoms of anxiety and depression: Effects of a 1-day acceptance and commitment training workshop.","authors":"Lilian Dindo,&nbsp;Jess G Fiedorowicz,&nbsp;Derrecka M Boykin,&nbsp;Nealy Wooldridge,&nbsp;Janie Myers,&nbsp;Tiwaloluwa Ajibewa,&nbsp;Amy Stroud,&nbsp;Daren Kuwaye,&nbsp;Zhuangzhuang Liu,&nbsp;Gary L Pierce","doi":"10.12788/acp.0046","DOIUrl":"https://doi.org/10.12788/acp.0046","url":null,"abstract":"<p><strong>Background: </strong>Cognitive-behavioral therapies often are recommended for anxiety disorders. However, treatment adherence and compliance are major barriers for these treatments, which are often delivered in 10 to 12 sessions over several months. This randomized controlled trial (trial registration NCT02915874 at www.clinicaltrials.gov) examined the effectiveness and feasibility of a 1-day cognitive-behavioral intervention for mixed anxiety.</p><p><strong>Methods: </strong>A total of 72 adults with moderate-to-high anxiety were randomized into a 1-day acceptance and commitment therapy (ACT) work-shop (n = 44) or treatment as usual (n = 28). Follow-up assessments were conducted 6 and 12 weeks after the workshop. Clinical outcomes were anxiety (primary) and depressive (secondary) symptoms, as measured by the Beck Anxiety Inventory and Beck Depression Inventory-II, respectively. Proposed mediators of ACT-psychological flexibility and commit-ted action-also were examined.</p><p><strong>Results: </strong>Participants assigned to the ACT workshop showed significant improvements in anxiety (beta = -1.13; P = .02) and depression (beta = -1.09; P = .02) after 12 weeks. Consistent with the theoretical model, these clinical improvements were mediated by psychological flexibility and committed action. Notable limitations included the sample size, inability to blind to treatment condition, and a racially and ethnically homogeneous sample.</p><p><strong>Conclusions: </strong>Our 1-day ACT workshop was effective for anxiety with co-occurring depressive symptoms. One-day interventions are a promising alternative to weekly treatments.</p>","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"33 4","pages":"258-269"},"PeriodicalIF":1.3,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39536563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum depression screening: Treatment engagement, barriers to care, and change in depressive symptoms.","authors":"Rachel Vanderkruik,&nbsp;Marlene P Freeman,&nbsp;Lauren D Claypoole,&nbsp;Miranda Arakelian,&nbsp;Anjali J Kaimal,&nbsp;Hiyam Nadel,&nbsp;Lee S Cohen","doi":"10.12788/acp.0044","DOIUrl":"https://doi.org/10.12788/acp.0044","url":null,"abstract":"<p><strong>Background: </strong>Postpartum depression (PPD) is a common condition associated with childbirth, yet many women do not receive the treatment they need. Despite the growing practice of PPD screening, treatment and clinical outcomes among patients identified as likely having PPD remain unclear.</p><p><strong>Method: </strong>Women who were systematically screened and scored ≥12 on the Edinburgh Postnatal Depression Scale (EPDS)-indicative of possible PPD-at their routine 6-week postpartum visit were eligible to participate and were contacted after 3 months for a follow-up interview and assessment.</p><p><strong>Results: </strong>A total of 33 women participated in the study, out of 100 who scored ≥12 on the EPDS. Among the participants, 70% reported they received a referral to a health care provider for PPD, and nearly one-half said that they received psychotherapy and/or were prescribed a psychotropic. The 2 most commonly described barriers to treatment were perceptions of not needing or wanting help and concerns about breastfeeding while taking psychotropics. Nearly 40% of women scored ≥12 on the EPDS at the follow-up interview.</p><p><strong>Conclusions: </strong>Further systematic research on outcomes after PPD screening is needed to ensure that screening translates into meaningfully improved clinical outcomes.</p>","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"33 4","pages":"7-14"},"PeriodicalIF":1.3,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39536565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-life contextualization of exposure therapy using augmented reality: A pilot clinical trial of a novel treatment method.","authors":"Arash Javanbakht,&nbsp;Shantanu Madaboosi,&nbsp;Lana Ruvolo Grasser","doi":"10.12788/acp.0042","DOIUrl":"https://doi.org/10.12788/acp.0042","url":null,"abstract":"<p><strong>Background: </strong>Phobias, including arachnophobia, are common and can be treated with exposure therapy, a method that is limited by a lack of feared objects/situations in clinical settings.</p><p><strong>Methods: </strong>In a pilot parallel randomized controlled trial (RCT) to test the feasibility and efficacy of augmented reality exposure therapy (ARET), 25 men and women ages 18 to 45 with arachnophobia were designated (ABAB block allocation) to ARET for arachnophobia (n = 13) or waitlist control (n = 12). Data were collected at baseline, 1-week, and 1-month follow-up, and single-session ARET occurred immediately following baseline collection for the intervention group.</p><p><strong>Results: </strong>All ARET participants were able to touch a live tarantula or the tank containing it after single-session exposure; the control group remained >1 meter away from the tank. Effects persisted or improved at 1-month followup. The Fear of Spiders Questionnaire (FSQ) and Behavioral Approach Test (BAT) showed large, significant beneficial effects of ARET compared with a waitlist control group (BAT: P < .001, partial eta squared = .542; FSQ: P < .001, partial eta squared = .720).</p><p><strong>Conclusions: </strong>We found ARET can feasibly be delivered using a wearable device running novel software with rapid responses and sustained effects. Replication and expansion of this pilot RCT will further support use of ARET for this and other specific phobias.</p>","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"33 4","pages":"220-231"},"PeriodicalIF":1.3,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39536197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhaled loxapine for acute agitation in a psychiatric emergency service.","authors":"Tyler Ruch,&nbsp;Sharon Nuss,&nbsp;Rajashekar Reddy Yeruva,&nbsp;Yonglin Gao,&nbsp;Gulay Tegin,&nbsp;Christina Terrell,&nbsp;Rif S El-Mallakh","doi":"10.12788/acp.0032","DOIUrl":"https://doi.org/10.12788/acp.0032","url":null,"abstract":"<p><strong>Background: </strong>Rapid control of agitation in medical settings is necessary for safety and provision of care. Inhaled loxapine achieves peak plasma levels within 2 minutes of administration and is FDA-approved for managing acute agitation.</p><p><strong>Methods: </strong>We examined the use of inhaled loxapine vs non-parenteral treatment as usual (TAU) in a psychiatric emergency service for consecutive patients with acute agitation or aggression. Data were collected retrospectively. T tests were used for continuous variables and Chi-square tests were used for categorical data.</p><p><strong>Results: </strong>A total of 61 patients received inhaled loxapine and 29 received TAU. Time to outcome for patients receiving inhaled loxapine was 21 ± 21 minutes compared with 121 ± 206 minutes for TAU (t =-2.61; P = .014). At outcome, 89% of patients treated with loxapine experienced symptom resolution, compared with 69% of TAU (Chi-square = 17.4, P < .0001). Ten percent of patients receiving loxapine had no change in symptoms and 1% had worsening symptoms vs 14% in the TAU group who experienced no change in symptoms (z = 0.5, not significant), and 17% who described worsening symptoms (z = 6153.9, P < .0001).</p><p><strong>Conclusions: </strong>The rapid absorption of inhaled loxapine is associated with a 6-fold faster and more robust symptom control.</p>","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"33 3","pages":"162-167"},"PeriodicalIF":1.3,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39328168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Say yes to the dress (code).","authors":"Jonathan R Scarff","doi":"10.12788/acp.0036","DOIUrl":"https://doi.org/10.12788/acp.0036","url":null,"abstract":"","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"33 3","pages":"e11"},"PeriodicalIF":1.3,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39328175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatry Update 2021 Spring Abstract Compendium.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>No abstract available.</p>","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"33 3S","pages":"1-33"},"PeriodicalIF":1.3,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39316104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life among US young adults during the COVID-19 pandemic: Psychiatric symptoms and emotional experiences to target within clinical practice.","authors":"Cindy H Liu,&nbsp;Emily Zhang,&nbsp;Sunah Hyun,&nbsp;Ga Tin Finneas Wong,&nbsp;Hyeouk Chris Hahm","doi":"10.12788/acp.0033","DOIUrl":"https://doi.org/10.12788/acp.0033","url":null,"abstract":"<p><strong>Background: </strong>The current study aimed to determine the role of psychological experiences during the COVID-19 pandemic (depression, anxiety, loneliness, and COVID-19-related grief and worry) on young adult physical and mental health functioning as measured by health-related quality of life (HRQoL).</p><p><strong>Methods: </strong>Using hierarchical multiple regression analyses, this cross-sectional study examined psychological predictors of physical and mental health functioning among young adults (age 18 to 30 years) from April 13 to September 5, 2020.</p><p><strong>Results: </strong>Pre-existing depression diagnoses (beta = -0.124, P < .001), current depression symptoms (beta = -0.298, P < .001), and COVID-19-related worry (beta = -0.142, P < .001) significantly predicted poorer physical health functioning. Current depression and anxiety symptoms (beta = -0.342 and beta = -0.268), loneliness (beta = -0.135), and COVID-19-related grief (beta = -0.180) predicted lower self-reported mental health functioning (P < .001). Black (beta = -0.072) and Hispanic/Latinx participants (beta = -0.082) were more likely to indicate poorer physical health functioning (P < .01) relative to White participants, whereas women reported poorer mental health relative to men (beta = -0.047, P < .05).</p><p><strong>Conclusions: </strong>This study identifies potential negative impacts of pandemic-related psychological experiences for young adults' health during the COVID-19 pandemic. There is a need to consider mental health symptomatology, COVID-19-related experiences, race, and gender when designing efforts to address long-term implications on health.</p>","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"33 3","pages":"232-240"},"PeriodicalIF":1.3,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39328174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equitable philanthropy.","authors":"Richard Balon","doi":"10.12788/acp.0035","DOIUrl":"https://doi.org/10.12788/acp.0035","url":null,"abstract":"","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"33 3","pages":"145-146"},"PeriodicalIF":1.3,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39316106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-inventing the DSM as a transdiagnostic model: Psychiatric disorders are extensively interconnected.","authors":"Henry A Nasrallah","doi":"10.12788/acp.0037","DOIUrl":"https://doi.org/10.12788/acp.0037","url":null,"abstract":"I t’s time for a necessary paradigm shift in re-conceptualizing the nosology, epidemiology, etiology, and treatment of major psychiatric disorders, including schizophrenia, bipolar disorder, major depressive disorder (MDD), autism spectrum disorder, attentiondeficit/hyperactivity disorder (ADHD), anxiety, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and substance use disorders. For a long time, and prior to the neuroscience revolution that enabled probing the human brain and exploring the neurobiology of psychiatric disorders, the field of psychiatry was descriptive and simplistic. It categorized psychiatric disorders essentially as silos, defined by a set of signs and symptoms. If one or more psychiatric conditions co-occurred with a “primary diagnosis,” they were labeled as “comorbidities,” with no implications of a shared etiology or biology. Amazingly, despite the rapid accrual of evidence of shared developmental or genetic etiopathogenesis, shared dysplasia of the same brain regions on neuroimaging, and improvement with the same class of medications, the DSM-5 and its outdated schema remain the diagnostic “bible of psychiatry,” and comorbidities are not being recognized as genetically overlapping disorders. This archaic model is ripe for change and a major update. Highlights of emerging advances that justify the re-conceptualizing of the nosology of major DSM diagnostic entities, and reinterpreting the comorbidities as evidence of the substantial clinical and biological overlap and interconnectivity of psychiatric brain disorders, include: Neurodevelopmental pathology. Disruption of brain development during fetal life has been well-established across the schizophrenia spectrum syndrome and practically all the so-called comorbidities. Genetic pleiotropy. Approximately 50% of the 22,000 proteincoding genes in the human chromosomes are expressed in the brain during development. Schizophrenia and most psychiatric disorders are heavily genetic. Genetic pleiotropy has been identified across several Henry A. Nasrallah, MD University of Cincinnati College of Medicine Cincinnati, Ohio, USA","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"33 3","pages":"148-150"},"PeriodicalIF":1.3,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39316107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}