Annals of Clinical Psychiatry最新文献_第2页

Psychiatry Update 2023 Spring Abstract Compendium. 精神病学2023春季更新摘要纲要。

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-08-01

引用次数: 0

Differences in clinical presentations of patients seeking care for treatment-resistant depression across sexual orientations and gender identities. 不同性取向和性别认同的难治性抑郁症患者寻求治疗的临床表现差异

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-08-01 DOI: 10.12788/acp.0112

Isabel Benjamin, Rachel Hershenberg, Kate D Dorrell, Amanda C Tan, Patricio Riva-Posse, William M McDonald, Adriana P Hermida, Andrea Crowell, Brian A Feinstein

{"title":"Differences in clinical presentations of patients seeking care for treatment-resistant depression across sexual orientations and gender identities.","authors":"Isabel Benjamin, Rachel Hershenberg, Kate D Dorrell, Amanda C Tan, Patricio Riva-Posse, William M McDonald, Adriana P Hermida, Andrea Crowell, Brian A Feinstein","doi":"10.12788/acp.0112","DOIUrl":"https://doi.org/10.12788/acp.0112","url":null,"abstract":"Background: Sexual and/or gender minority (SGM) individuals experience higher rates and greater severity of depressive disorders than non-SGM persons. SGM individuals are more likely than non-SGM individuals to seek mental health treatment and to present to treatment with unique characteristics that should be accounted for when considering treatment recommendations. Patients seeking care for treatment-resistant depression (TRD) are offered a variety of evidence-based interventions ranging in modality and invasiveness (eg, psychotherapy and neuromodulation).Methods: The current study used data from a TRD clinical research program to examine whether SGM (N = 52) and non-SGM (N = 202) patients differed in their clinical presentations and the treatment recommendations offered to them.Results: We found that SGM patients were younger, had a more severe history of childhood trauma, and reported greater current suicidality than non-SGM patients. There were no significant differences in treatment recommendations between groups.Conclusions: This study adds to nascent literature investigating clinical characteristics of SGM populations seeking mental health care and provides foundational evidence for the unique treatment considerations necessary for SGM individuals seeking treatment for TRD. Research into whether treatment outcomes differ for SGM and non-SGM individuals with TRD is encouraged, given clinical differences in trauma history and suicidality.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 3","pages":"199-208"},"PeriodicalIF":1.3,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9960662","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}

引用次数: 0

High-dose armodafinil in treatment-refractory bipolar depression. 大剂量阿莫达非尼治疗难治性双相抑郁症。

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-08-01 DOI: 10.12788/acp.0113

Wan Y Kwok, Victoria Stephens, Henry A Nasrallah

{"title":"High-dose armodafinil in treatment-refractory bipolar depression.","authors":"Wan Y Kwok, Victoria Stephens, Henry A Nasrallah","doi":"10.12788/acp.0113","DOIUrl":"https://doi.org/10.12788/acp.0113","url":null,"abstract":"Background: Bipolar depression is a serious neuropsychiatric disorder associated with a high risk of morbidity and suicidality. Standard antidepressants approved for treating major depressive disorder fail to exert efficacy in bipolar depression. Although 5 agents have been developed for the treatment of bipolar depression, treatment resistance is still observed in some patients, and requires off-label pharmacotherapy. Modafinil and armodafinil have been reported to improve treatment-resistant bipolar depression, but with inconsistent results.Methods: We present a case of a 65-year-old woman with severe bipolar depression who failed to respond to electroconvulsive therapy and IV ketamine but later responded to high-dose armodafanil.Results: The patient responded to high-dose armodafinil (gradually titrated to 1,000 mg/d) and achieved remission with good tolerability for 5 years. Recently, she contracted COVID-19 and developed muscular weakness. After a lengthy workup, we became concerned for myopathy as an adverse effect from armodafinil. The patient's dose of armodafinil was significantly reduced and she subsequently became very depressed and functionally disabled before improving again when armodafinil 1,000 mg/d was reinstated.Conclusions: We propose that some of the negative results seen in research of armodafinil for bipolar depression may be due to the use of low doses (100 to 200 mg/d), and higher doses may be needed for adequate response in treatment-resistant bipolar depression.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 3","pages":"195-198"},"PeriodicalIF":1.3,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9960663","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}

引用次数: 0

Characteristics and experiences of professionals providing 9/11 mental health services. 9/11心理健康服务专业人员的特点与经验

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-08-01 DOI: 10.12788/acp.0118

Carol S North, Samina Mahesar, Karen J Meltzer, David E Pollio

{"title":"Characteristics and experiences of professionals providing 9/11 mental health services.","authors":"Carol S North, Samina Mahesar, Karen J Meltzer, David E Pollio","doi":"10.12788/acp.0118","DOIUrl":"https://doi.org/10.12788/acp.0118","url":null,"abstract":"Background: After disasters, mental health professionals might be called upon to help address the emotional consequences of the disaster among survivors and other affected groups, but the clinicians themselves could be affected. This exploratory study examined the experiences of 60 mental health professionals, most of whom provided mental health care to individuals affected by the September 11, 2001 terrorist attacks (9/11), and/or experienced 9/11 sequelae themselves.Methods: Participants completed structured interviews 3 and/or 6 years after the disaster, with full diagnostic assessment of psychiatric disorders and questions specific to their personal and professional post-9/11 experience.Results: Providing postdisaster care was somewhat stressful initially, but long-term effects were more positive than negative, with overall benefit to many personal lives. Most found their clients' 9/11 stories emotionally upsetting, yet characterized their 9/11 mental health work as positive. Work satisfaction increased by 3-fold, but this effect was transitory. One-third had postdisaster psychopathology, but most was pre-existing and therefore not a product of disaster-related stressors.Conclusions: Although most mental health professionals initially found the emotional difficulty of their work increased after 9/11, this negative effect had largely dissipated over the years. Opportunities for disaster mental health training and initial logistical support could benefit these professionals.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 3","pages":"178-187"},"PeriodicalIF":1.3,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9958591","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}

引用次数: 0

Stressors and coping mechanisms among pregnant women with psychiatric disorders during the COVID-19 pandemic. COVID-19大流行期间精神障碍孕妇的压力源和应对机制

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-08-01 DOI: 10.12788/acp.0106

Rebecca S Hock, Anna Feeney, Heather A Harmon, Phoebe S Caplin, Lauren A Kobylski, Ella T Rossa, Adele C Viguera, Lee S Cohen, Marlene P Freeman

{"title":"Stressors and coping mechanisms among pregnant women with psychiatric disorders during the COVID-19 pandemic.","authors":"Rebecca S Hock, Anna Feeney, Heather A Harmon, Phoebe S Caplin, Lauren A Kobylski, Ella T Rossa, Adele C Viguera, Lee S Cohen, Marlene P Freeman","doi":"10.12788/acp.0106","DOIUrl":"https://doi.org/10.12788/acp.0106","url":null,"abstract":"Background: Women with psychiatric disorders are vulnerable to relapse in pregnancy, and the COVID-19 pandemic has presented an additional stressor.Methods: Data came from a supplemental study offered to women enrolled in the Massachusetts General Hospital Center for Women's Mental Health National Pregnancy Registry for Psychiatric Medications. Registry participants were also invited to complete an email questionnaire relating to their experiences of pregnancy during the pandemic. Prepartum experiences of 230 respondents were analyzed.Results: The most common diagnoses in this group were depression (30%), anxiety disorders (29%), and bipolar affective disorder (17%). Common stressors included changes in employment, greater childcare and/or schooling responsibilities, more conflict in the household, and increased isolation. Participants reported negative impacts and/or coping mechanisms associated with the pandemic, such as sleep problems, reduced physical activity, changes in eating, and greater amounts of screen time. Positive impacts and/or coping mechanisms were also reported, including more quality time with family, more time in nature, and being more appreciative of aspects of life previously taken for granted.Conclusions: Our findings suggest that the COVID-19 pandemic has had an overall negative psychosocial impact on many pregnant women with preexisting psychiatric disorders. We also observed positive coping mechanisms, which could be drawn on as sources of resilience.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 3","pages":"148-156"},"PeriodicalIF":1.3,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9960660","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}

引用次数: 0

A longitudinal follow-up study of Oklahoma City bombing survivors in the first quarter century after the disaster. 对俄克拉荷马城爆炸案幸存者在灾难发生后的前25年进行的纵向跟踪研究。

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-05-01 DOI: 10.12788/acp.0095

Carol S North, Katy McDonald, David E Pollio

{"title":"A longitudinal follow-up study of Oklahoma City bombing survivors in the first quarter century after the disaster.","authors":"Carol S North, Katy McDonald, David E Pollio","doi":"10.12788/acp.0095","DOIUrl":"https://doi.org/10.12788/acp.0095","url":null,"abstract":"Background: This study is one of the longest postdisaster prospective longitudinal studies of disaster-related psychopathology, completed nearly a quarter century after a terrorist bombing, and the longest follow-up study ever conducted using full diagnostic assessment in highly exposed disaster survivors.Methods: Oklahoma City bombing survivors (87% injured) were randomly selected from a state survivor registry and interviewed approximately 6 months postdisaster (N = 182; 71% participation) and again nearly 25 years later (N = 103; 72% participation). Interviews were conducted using the Diagnostic Interview Schedule (a structured interview assessing full diagnostic criteria) for panic disorder, generalized anxiety disorder, and substance use disorder at baseline and also for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) at follow-up. The Disaster Supplement assessed disaster trauma exposure and subjective experience.Results: At follow-up, 37% of participants exhibited bombing-related PTSD (34% at baseline) and 36% had MDD (23% at baseline). More new cases of PTSD than MDD developed over time. Nonremission rates were 51% for bombing-related PTSD and 33% for MDD. One-third of participants reported long-term nonemployability.Conclusions: The presence of long-term medical problems among survivors parallels the persistence of psychopathology. Ongoing medical problems might have contributed to psychiatric morbidity. Because no major variables predicted remission from bombing-related PTSD and MDD, all survivors with postdisaster psychopathology likely need access to long-term evaluation and care.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 2","pages":"93-100"},"PeriodicalIF":1.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9580541","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}

引用次数: 0

Learning and achievement characteristics of sheltered homeless population subgroups. 庇护流浪人口亚群的学习与成就特征。

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-05-01 DOI: 10.12788/acp.0108

Carol S North, Melissa Black, Sheila Gokul, David E Pollio, Faith M Scofield, Paul J Handal, Barry A Hong

{"title":"Learning and achievement characteristics of sheltered homeless population subgroups.","authors":"Carol S North, Melissa Black, Sheila Gokul, David E Pollio, Faith M Scofield, Paul J Handal, Barry A Hong","doi":"10.12788/acp.0108","DOIUrl":"https://doi.org/10.12788/acp.0108","url":null,"abstract":"Background: There is little systematic information about intelligence and academic achievement among sheltered homeless adults. This study adds descriptive data on intelligence and academic achievement, examines discrepancies across these concepts, and explores the associations among demographic and psychosocial characteristics in the context of intelligence categories and discrepancies.Methods: We studied intelligence, academic achievement, and discrepancies between IQ and academic achievement among 188 individuals experiencing homelessness who were systematically recruited from a large, urban, 24-hour homeless recovery center. Participants completed structured interviews, urine drug testing, the Wechsler Abbreviated Scale of Intelligence, and the Wide Range Achievement Test, 4th edition.Results: Average full-scale intelligence was low average (90) but higher than scores obtained in other studies of homeless populations. Academic achievement was lower than average (82 to 88). Performance/math deficits in the higher intelligence group indicate functional difficulties that could have contributed to homeless risk.Conclusions: The low-normal intelligence and below-average achievement scores are not extreme enough to warrant immediate attention and intervention for most individuals. Systematic screening during entry into homeless services might identify learning strengths and weaknesses, presenting modifiable factors that could be addressed in focused educational/vocational interventions.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 2","pages":"157-166"},"PeriodicalIF":1.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10149611","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}

引用次数: 0

Temperament in trichotillomania and skin picking disorder. 毛手毛脚症和抠皮症的气质。

IF 1.5 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-05-01 DOI: 10.12788/acp.0096

Jon E Grant, Stephanie Valle, Ibrahim Aslan, Eve K Chesivoir, Samuel R Chamberlain

{"title":"Temperament in trichotillomania and skin picking disorder.","authors":"Jon E Grant, Stephanie Valle, Ibrahim Aslan, Eve K Chesivoir, Samuel R Chamberlain","doi":"10.12788/acp.0096","DOIUrl":"10.12788/acp.0096","url":null,"abstract":"Background: Trichotillomania (TTM) and skin picking disorder (SPD) result in significant psychosocial burden. Despite this burden, however, risk factors related to the development of these disorders remain unclear. The present study assessed temperament in a well-characterized sample of adults with TTM or SPD.Methods: A total of 202 adults age 18 to 65 were enrolled; 44 had TTM, 30 had SPD, and 128 served as controls. Participants completed the self-report Tridimensional Personality Questionnaire (TPQ) to examine the severity of TTM and SPD symptoms, quality of life, and temperament. Group differences were characterized and correlations with other measures were examined.Results: Compared to controls, those with TTM or SPD scored significantly higher on harm avoidance and its subscales, with TTM associated with higher scores than SPD. Those with TTM or SPD scored significantly higher on only 1 measure of novelty seeking (extravagance). Higher TPQ harm avoidance correlated with worse hair pulling severity and worse quality of life.Conclusions: The temperament traits of participants with TTM or SPD differed in significant ways from controls; those with TTM or SPD generally demonstrated similar trait profiles. A dimensional approach to the personalities of those with TTM or SPD may offer insight and provide clues to treatment strategies.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 2","pages":"87-92"},"PeriodicalIF":1.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An accelerated course of TMS using intermittent theta burst for veterans with major depressive disorder: A case series. 使用间歇性θ波爆发的经颅磁刺激加速过程对患有重度抑郁症的退伍军人:一个病例系列。

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-05-01 DOI: 10.12788/acp.0110

Zachary D Zuschlag, Laura Bajor, Kimberly Van Trees, Sean Philips, Greg Sullivan, Christine Burke, F Andrew Kozel

{"title":"An accelerated course of TMS using intermittent theta burst for veterans with major depressive disorder: A case series.","authors":"Zachary D Zuschlag, Laura Bajor, Kimberly Van Trees, Sean Philips, Greg Sullivan, Christine Burke, F Andrew Kozel","doi":"10.12788/acp.0110","DOIUrl":"https://doi.org/10.12788/acp.0110","url":null,"abstract":"Background: Transcranial magnetic stimulation (TMS) is a neuro-modulation technique for treatment-resistant major depressive disorder (MDD). Standard TMS protocols for MDD involve once-daily treatment for 6 to 9 weeks. We report a case series of an accelerated TMS protocol for outpatient MDD treatment.Methods: From July 2020 through January 2021, patients deemed appropriate candidates for TMS treatment were offered an accelerated TMS protocol consisting of intermittent theta burst stimulation (iTBS) applied to the left dorsolateral prefrontal cortex, localized by the Beam F3 method, and consisting of 5 treatments daily for 5 days. Assessment scales were obtained as part of standard clinical care.Results: A total of 19 veterans received the accelerated protocol and 17 completed treatment. Statistically significant mean reductions from baseline to end of treatment were observed across all assessment scales. Remission and response rates, as defined by changes in Montgomery-Åsberg Depression Rating Scale scores, were 47.1% and 64.7%, respectively. Treatments were well tolerated without unexpected or serious adverse events.Conclusions: This case series details the safety and efficacy of an accelerated iTBS TMS protocol consisting of 25 treatments over 5 days. Improved depressive symptoms were observed, with remission and response rates similar to standard TMS protocols of daily TMS for ≥6 weeks.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 2","pages":"110-117"},"PeriodicalIF":1.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573808","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}

引用次数: 2

Prolonged psychosis with reformulated methamphetamine. 重新配制的甲基苯丙胺延长精神病。

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-05-01 DOI: 10.12788/acp.0104

Elizabeth Yeske, Sarah McQuaide, Tyler Q Ruch, Brenda L Goetz, Rif S El-Mallakh, Christina L Terrell

引用次数: 1