Annals of Clinical Psychiatry最新文献

{"title":"Multiple facets of conflict of interest.","authors":"R. Balon","doi":"10.12788/acp.0070","DOIUrl":"https://doi.org/10.12788/acp.0070","url":null,"abstract":"For most physicians, the phrase “conflict of interest” (COI) usually refers to a financial COI, such as physicians receiving payments from a pharmaceutical company. Financial COI is the most frequently discussed COI, and the one disclosed at the end of articles in professional journals. However, financial COI is not the only COI an individual may have. The recent debate about the origin of the virus that causes COVID-19 and the possibility that it escaped from a laboratory in Wuhan, China, revealed another facet of COI—the impact of ideology and personal belief. Some researchers strongly opposed the lab leak theory and attacked those who proposed it. For many, the fact that President Donald J. Trump proposed the virus originated in China was argument enough to label the lab leak theory as yet another conspiracy theory. Additionally, there is what I call “ideological bias” or “ideological COI,” eg, some of the opponents of the lab leak theory were probably impacted by the fact that their reputation would be ruined if it turned out to be true. Unbelievably, Facebook and Wikipedia initially banned any suggestion that the virus may had leaked from the Wuhan laboratory. Interestingly, with President Trump’s departure from office, more people were willing to entertain the possibility that the virus that causes COVID-19 escaped from the laboratory and were willing to investigate this theory. I believe this tale does not paint a very laudatory picture of many scientists and the state of present-day science. It also raises serious questions about nonfinancial COIs. I believe that compared to financial COIs, nonfinancial COIs have a similar, if not worse, impact on scientific conduct. As a profession, psychiatry has focused on discussing and disclosing financial COIs. Yet, there are numerous nonfinancial pressures and COIs. As Korn wrote, “These pressures ... include the desire for faculty advancement, to compete successfully and repetitively for sponsored research funding, to receive academic accolades from professional peers and win Richard Balon, MD Departments of Psychiatry and Behavioral Neurosciences and Anesthesiology Wayne State University Detroit, Michigan, USA","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"59 1","pages":"73-75"},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83963000","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":"Association between headache and suicidality: An analysis of universal suicide screening data at a large urban county hospital.","authors":"Charles Ho, Lilian Cole, Kaylee Davis-Bordovsky, A. Eichenberger, Anna Faubion, Matthew Faubion, Colette Kendrick, Neema Khonsari, Joshua Lampley, Adeeb Masood, K. Nuako, Eduardo Rivera Mirabal, Natalie Spiller, Joshua Walther, Bernice N. Yau, M. Yung, J. Raitt, A. Kulikova, C. North, Kimberly Roaten, E. Brown","doi":"10.12788/acp.0068","DOIUrl":"https://doi.org/10.12788/acp.0068","url":null,"abstract":"BACKGROUND\u0000Identifying individuals at increased risk of suicide is important, particularly those who present for treatment for nonpsychiatric chief complaints who may go undetected. It has been found that pain symptoms, such as headache, are associated with suicide, although this association requires further characterization. This study examined specific components of suicidality in relation to headache subtypes.\u0000\u0000\u0000METHODS\u0000This study retrospectively reviewed 2,832,835 nonpsychiatric adult clinical encounters at a large county hospital, where a standardized suicide risk screening tool, the Columbia-Suicide Severity Rating Scale (C-SSRS), was universally implemented. The C-SSRS assesses specific components of suicidality: wish to be dead and suicidal ideation, method, intent, plan, and action. Multivariate logistic regressions were performed to assess the association between headache, as well as headache subtype (migraine, tension, or cluster), and each component of suicidality.\u0000\u0000\u0000RESULTS\u0000There were significant positive associations between presenting with a headache and 2 specific components of suicidality: wish to be dead and suicidal action. Individuals with tension headache may have a lower risk of wishing to be dead compared to those with migraine and cluster headaches.\u0000\u0000\u0000CONCLUSIONS\u0000The association of headaches with specific elements of sui-cidality demonstrates the potential yield of identification of suicide risk among individuals with nonpsychiatric presentations.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"36 1","pages":"114-122"},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87405013","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":"Deconstructing childhood conduct and adult antisocial criteria for the diagnosis of antisocial personality disorder.","authors":"C. North, Vinay Kotamarti, D. Pollio","doi":"10.12788/acp.0063","DOIUrl":"https://doi.org/10.12788/acp.0063","url":null,"abstract":"BACKGROUND\u0000Antisocial personality disorder (ASPD) is a serious psychiatric disorder that can be incapacitating and costly to individuals and society. The ASPD diagnosis has 2 main components, childhood conduct problems and adult antisocial behaviors, with specific age requirements. The nosological effects of these criteria on population subgroups defined by these aspects of the criteria have not been fully explored.\u0000\u0000\u0000METHODS\u0000Data for ASPD were analyzed for 3,498 individuals in the St Louis, Missouri, site of the Epidemiologic Catchment Area study of general population psychiatric disorders collected in the early 1980s using structured diagnostic interviews for DSM-III criteria. Effects of the criteria on population subgroups defined by various combinations of the criteria were examined.\u0000\u0000\u0000RESULTS\u0000Earlier-onset conduct disorder was more severe than later-onset childhood conduct disorder, with more total childhood and adult symptoms and negative psychosocial adult outcomes (substance use disorders, criminality, and homelessness). Three subgroups with adult antisocial behaviors (differentiated by no conduct disorder, later-onset conduct disorder, and earlier-onset conduct disorder meeting ASPD criteria) were similar in numbers of adult antisocial symptoms, but the ASPD subgroup had more negative psychosocial adult outcomes.\u0000\u0000\u0000CONCLUSIONS\u0000These findings provide evidence for and against reconsideration of the 15-year age-of-onset requirement for conduct symptoms in ASPD criteria.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"7 1","pages":"97-105"},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87219293","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":"The psychiatrist in scrubs.","authors":"M. Morrissette","doi":"10.12788/acp.0066","DOIUrl":"https://doi.org/10.12788/acp.0066","url":null,"abstract":"Comments on the article, It is time for a dress code in psychiatry by R. Balon and M. K. Morreale (2020). I read with great interest the editorial by Balon and Morreale, in which a cogent case is put forth regarding the ramifications of a psychiatrist's attire on the psychiatrist-patient relationship and perceptions of psychiatric treatment. As a child and adolescent psychiatrist who provides consultation to a pediatric emergency department, the topic of appropriate attire for psychiatrists has been especially salient at a time when I, and my colleagues working in the emergency department, have been required to wear scrubs, a face mask, and eye protection when assessing and treating patients as part of hospital practices intended to mitigate the spread of COVID-19. Recent scholarly literature has highlighted potential challenges in the formation of a therapeutic alliance stemming from the use of face masks in psychiatric practice. Our choice of attire is among the manifold factors that influence our interactions with patients, and even when this choice is removed, it is essential that we remain attuned to the potential impacts of our appearances. (PsycInfo Database Record (c) 2022 APA, all rights reserved)","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"58 1","pages":"138"},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86955561","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":"Antidepressant effect of prolonged twice-weekly intranasal esketamine treatments after nonresponse to electroconvulsive therapy in a patient with treatment-resistant depression.","authors":"Audrey Evers, Matthew Klein, Amy Aloysi, James Murrough, Manish K Jha","doi":"10.12788/acp.0055","DOIUrl":"https://doi.org/10.12788/acp.0055","url":null,"abstract":"Presents a case report of a woman with depressive episodes, which began in early 2019 and was worsened by the change of her long-standing antidepressant regimen of fluoxetine to mirtazapine. Subsequently, she received 12 right unilateral ultrabrief pulse electroconvulsive therapy (ECT) treatments without any benefit. She experienced no benefit from 4 additional trials of antidepressants and during our evaluations over several weeks, her mood remained severely depressed. After 6 treatments, she experienced >50% reduction in her depression. However, her esketamine treatments were paused for 8 weeks due to COVID-19. Her depression worsened and a 4-week-long course of twice-weekly treatments was initiated, which resulted in a >50% reduction in her depression. After switching to weekly maintenance treatments, her symptoms of low mood, anhedonia, and suicidal ideation returned to her pre-treatment baseline. As she had responded well to twice-weekly treatments, the frequency of treatments was increased. In summary, this patient responded to twice-weekly esketamine treatments, experienced symptomatic worsening after switching to weekly treatments, but was able to attain remission with prolonged twice-weekly treatments. (PsycInfo Database Record (c) 2022 APA, all rights reserved)","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":" ","pages":"61-64"},"PeriodicalIF":1.3,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39632126","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":"Oppositional defiant disorder: Evidence-based review of behavioral treatment programs.","authors":"Mandeep Kaur,&nbsp;Augustus Floyd,&nbsp;Ana-Maria Balta","doi":"10.12788/acp.0056","DOIUrl":"https://doi.org/10.12788/acp.0056","url":null,"abstract":"BACKGROUND\u0000Oppositional defiant disorder (ODD) is a common clinical condition seen among children and adolescents in behavioral health settings. In this article, we review behavioral treatment programs and their clinical use in managing ODD.\u0000\u0000\u0000METHODS\u0000We searched PubMed, PsycInfo, and Scopus from 2000 to 2020 using the terms \"oppositional defiant disorder\" and \"treatment.\" We found 1,665 articles, including clinical trials, review articles, and case control studies of evidence-based ODD treatments in patients age <18. Articles were screened to identify literature focusing on evidence-based behavioral treatment programs for ODD.\u0000\u0000\u0000RESULTS\u0000The literature search revealed abundant evidence supporting the role of behavioral treatment programs for managing ODD and other disruptive behavior disorders. In this review, we discuss the most recent findings on established and effective strategies, including Parent Management Training, Parent-Child Interaction Therapy, Collaborative Problem Solving, Incredible Years program, Triple-P Positive Parenting Program, Start Now and Plan program, and Coping Power Program.\u0000\u0000\u0000CONCLUSIONS\u0000ODD can cause significant distress to patients and their caregivers. Familiarity with behavioral treatment programs provides clinicians with tools for managing this condition in clinical settings.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":" ","pages":"44-58"},"PeriodicalIF":1.3,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39801272","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":"Skin picking disorder: Does a person's sex matter?","authors":"Jon E Grant, Samuel R Chamberlain","doi":"10.12788/acp.0049","DOIUrl":"10.12788/acp.0049","url":null,"abstract":"<p><strong>Background: </strong>Skin picking disorder (SPD) is characterized by recurrent picking with scarring or tissue damage. Although research suggests that less than one-half of people with SPD are male, there is little clinical information about men with SPD.</p><p><strong>Methods: </strong>We recruited 95 non-treatment-seeking adults as part of a cross-sectional study of SPD. Men (n = 17) and women (n = 78) with SPD were compared on clinical and cognitive measures. Sex differences in the demographic and clinical characteristics, skin picking sites, and presence of comorbidities were examined using analysis of variance for continuous variables and likelihood ratio Chi-square tests for categorical variables.</p><p><strong>Results: </strong>Men were significantly more likely than women to report a first-degree relative with skin picking or hair pulling disorders (P = .0174). Men were less likely to pick from their scalps and backs and picked from fewer sites. Men and women did not significantly differ on skin picking severity, disability, impulsivity, or quality of life.</p><p><strong>Conclusions: </strong>These data indicate that SPD is similarly impairing for men and women, but men may have higher familial loading and a somewhat different distribution and frequency of picking sites. Sex differences in SPD merit more detailed consideration in larger samples, including addressing potentially higher genetic/familial loading in males.</p>","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":" ","pages":"15-20"},"PeriodicalIF":1.5,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7612641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39801269","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}

{"title":"Anxiety, depression, and rejection towards parents among individuals who grew up in a hoarded home.","authors":"Andrew G Guzick,&nbsp;Suzanne Chabaud,&nbsp;Cecilia Garrett,&nbsp;Eric A Storch","doi":"10.12788/acp.0053","DOIUrl":"https://doi.org/10.12788/acp.0053","url":null,"abstract":"<p><strong>Background: </strong>Limited research has investigated parent-child conflict and mental health among adult children of parents with hoarding problems.</p><p><strong>Methods: </strong>Four hundred fourteen participants who reported clinically significant parental hoarding completed assessments of parental hoarding characteristics (clutter, insight, difficulty discarding), feelings of rejection towards their parent, depression, and generalized anxiety. These latter 3 variables were retrospectively rated across childhood (age 0 to 12), adolescence (age 13 to 20), young adulthood (age 21 to 29), and adulthood (age ≥30 years). Path analyses assessed mediated relationships.</p><p><strong>Results: </strong>More than one-half of respondents endorsed clinically significant generalized anxiety, and more than one-third endorsed clinically significant depressive symptoms across ages, with highest rates during adolescence. Parental insight was related to rejection across ages, and clutter was related to rejection from adolescence through adulthood. Rejection was significantly positively related to depressive symptoms and generalized anxiety in childhood and adolescence and to depressive symptoms in young adulthood. Poor insight was significantly indirectly related to depressive symptoms through rejection across childhood and adolescence and to generalized anxiety in childhood.</p><p><strong>Conclusions: </strong>Results suggest that parental hoarding may be a risk factor for anxiety and depression. Feelings of rejection towards parents may account for the link between parental hoarding and psychological distress, particularly between poor insight and depressive symptoms.</p>","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"34 1","pages":"77-88"},"PeriodicalIF":1.3,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10728291","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 Winter","authors":"","doi":"10.12788/acp.0060","DOIUrl":"https://doi.org/10.12788/acp.0060","url":null,"abstract":"","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"1 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41658801","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":"Quality of life in trichotillomania: An assessment of specific life domains.","authors":"Stephanie Valle,&nbsp;Jon E Grant","doi":"10.12788/acp.0052","DOIUrl":"https://doi.org/10.12788/acp.0052","url":null,"abstract":"<p><strong>Background: </strong>The Quality of Life Inventory (QOLI) gauges importance and satisfaction ratings in areas of life such as work, health, and family. An examination of QOLI scores among individuals with trichotillomania (TTM), a hair-pulling disorder, might provide insight on domain-specific interventions to counteract factors that may be contributing to lower quality-of-life (QOL) scores.</p><p><strong>Methods: </strong>Three hundred thirty-three adults with TTM and 90 healthy controls (age 18 to 65) completed the QOLI and various symptom severity measures. We compared participants with TTM with controls on their overall QOLI scores as well as on QOL subdomains using independent sample t tests with a Bonferroni correction.</p><p><strong>Results: </strong>Participants with TTM had significantly lower overall QOL compared with controls (t [421] = 7.858, P < .001). Additionally, participants with TTM reported significantly lower QOL scores in the following areas of their lives: health, self-esteem, goals and values, play, learning, creativity, helping, love, friends, children, and home (all P < .003).</p><p><strong>Conclusions: </strong>Lower overall QOL and in specific domains of life highlight the complexity of overall life satisfaction measures in people with TTM. Further research may provide direction on future interventions and insight for family and/or friends supporting individuals with TTM.</p>","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":" ","pages":"27-32"},"PeriodicalIF":1.3,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39801271","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}