Psychiatric services (Washington, D.C.)最新文献

{"title":"Neighborhood Opportunity and Mental Health-Related Hospitalization Rates Among Children and Youths in 12 U.S. States.","authors":"Ankita T Gupta, Matthew Hall, Mert Sekmen, Derek J Williams, Alison R Carroll, Sabrina E Carro, Heather Kreth, David P Johnson, Kelsey A B Gastineau, James W Antoon, Katherine S Spencer, Alison Herndon, Stephanie K Doupnik","doi":"10.1176/appi.ps.20250548","DOIUrl":"https://doi.org/10.1176/appi.ps.20250548","url":null,"abstract":"<p><strong>Objective: </strong>Using the Child Opportunity Index (COI) 3.0 and mental health-related hospitalization rates among children and youths, the authors examined whether hospitalization rates were significantly associated with neighborhood conditions.</p><p><strong>Methods: </strong>In this cross-sectional, population-based study, the authors analyzed mental health-related hospitalizations among children and youths (5-24 years) from 12 U.S. states by using data from the 2021 State Inpatient Databases and U.S. Census. The exposure was ZIP code-level COI 3.0, with an outcome of mental health hospitalization incidence rate per 10,000 population. Mental health hospitalizations included a primary psychiatric diagnosis indexed in the <i>DSM-5</i>. Hospitalization rates were estimated overall, by state, and by 10 psychiatric diagnosis categories. Differences across COI quintiles were examined with negative binomial regression models.</p><p><strong>Results: </strong>Among 21,156,318 children and youths, 157,641 were hospitalized for mental health problems, corresponding to an incidence rate of 74.5 per 10,000 population. The hospitalization rate (per 10,000 children and youths) was highest in the very low-COI quintile (incidence rate=76.9, 95% CI=73.4-80.5) and lowest in the very high-COI quintile (incidence rate=67.3, 95% CI=64.8-69.9). Trends were consistent within psychiatric diagnosis categories, except for anxiety disorders, which showed a positive correlation between COI level and hospitalization rates. Hospitalization rates varied significantly among states (ranging from 34 to 135 per 10,000 youths, in Oregon and Kentucky, respectively).</p><p><strong>Conclusions: </strong>Children and youths residing in lower-opportunity neighborhoods had higher mental health-related hospitalization rates, which varied by state and psychiatric diagnosis. Future research to understand the reasons for these variations across COI levels could inform programs to avoid mental health-related hospitalizations.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20250548"},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motivational Interviewing and Cognitive-Behavioral Therapy to Aid Community Integration for Veterans With Past Homelessness.","authors":"L Felice Reddy, Shirley M Glynn, Julio Iglesias, Catherine A Sugar, Michael F Green","doi":"10.1176/appi.ps.20250293","DOIUrl":"https://doi.org/10.1176/appi.ps.20250293","url":null,"abstract":"<p><strong>Objective: </strong>Community integration is a key outcome for individuals with a history of homelessness after they attain permanent housing. The goals of finding purpose, meaning, and belonging in one's community-despite their importance in predicting mental well-being and housing stability-are frequently elusive for recently housed individuals. This study aimed to evaluate a novel psychosocial intervention that combines two evidence-based practices, motivational interviewing (MI) and cognitive-behavioral therapy (CBT), to improve motivation and functional outcomes related to community integration.</p><p><strong>Methods: </strong>Sixty veterans with a recent history of homelessness who were admitted to a U.S. Department of Veterans Affairs supportive housing program in the past year were included in a randomized controlled trial comparing the 12-session MI-CBT treatment with treatment as usual. Participants were assessed at four time points during the study period, which included 24 weeks of active treatment and 12 weeks of follow-up. The primary outcome measures were motivational deficits (negative symptoms), level of behaviors consistent with motivational change, and social and work functioning.</p><p><strong>Results: </strong>Compared with participants in the control group, participants who received MI-CBT showed significantly greater improvement (p<0.05) in motivational deficits over the 12-week acute treatment period. Their gains relative to baseline were maintained at follow-up.</p><p><strong>Conclusions: </strong>MI-CBT yields improvements in motivational deficits. Implications for future studies and for improving generalizability of the motivational negative symptom gains to daily functioning domains are discussed.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20250293"},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impending Psychiatrist Shortage: Projected Deficiencies in the U.S. Adult Psychiatry Workforce.","authors":"Jason Silvestre, Sydney Seeger, Charles A Reitman, Benoit Dubé","doi":"10.1176/appi.ps.20250467","DOIUrl":"https://doi.org/10.1176/appi.ps.20250467","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to analyze the supply, demand, and adequacy of psychiatrists serving adults (PSAs) in the United States.</p><p><strong>Methods: </strong>The authors performed a cross-sectional analysis of full-time equivalent (FTE) PSAs, using the Health Workforce Simulation Model. Supply was defined as the number of FTE physicians, demand as the number of FTE physicians needed under status quo and improved access scenarios, and adequacy as supply over demand.</p><p><strong>Results: </strong>From 2024 to 2037, the national supply of PSAs was projected to decrease by 12.3% (p<0.001), whereas demand was projected to increase by 43.7% (p<0.001). As a result, PSA workforce adequacy was projected to decrease under status quo (from 70.2% to 42.8%, p<0.001) and improved access (from 49.3% to 29.3%, p<0.001) scenarios.</p><p><strong>Conclusions: </strong>Critical PSA workforce shortages were identified, including states affected the most severely. Efforts in education and government are needed to improve PSA workforce adequacy.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20250467"},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Weight Loss Among Adults With Mental Illness: A Secondary Analysis of a Randomized Clinical Trial.","authors":"Matthew Chinman, Tianxiu Wang, Jessica R Dodge, David A Frank, Jennifer L McCoy, Amy N Cohen","doi":"10.1176/appi.ps.20250605","DOIUrl":"https://doi.org/10.1176/appi.ps.20250605","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed associations of motivation factors and precursor health behaviors with weight loss in the CoachToFit program for adults with mental illness.</p><p><strong>Methods: </strong>This is a secondary analysis of a randomized trial comparing CoachToFit and usual care over 6 months at a Veterans Affairs medical center. Inclusion criteria were body mass index ≥30 kg/m² and diagnosis of major depressive disorder, bipolar disorder, or schizophrenia. Exclusion criteria were history of bariatric surgery or recent psychiatric hospitalization. The sample (N=256) had a mean±SD age of 53.5±13.0 years; 176 (69%) were male, 178 (70%) were White, and 199 (78%) were diagnosed as having major depressive disorder. Participants were assessed at baseline and at 6 months (postintervention) on weight, motivation factors (efficacy for healthy eating and exercise, confidence to improve health, importance assigned to weight loss, and stage of change for weight control), and precursor health behaviors (daily cups of sugary drinks consumed and physical activity days per week and minutes per day). The study assessed the relationships between study group and multiple motivation factors and precursor health behaviors and associations between weight loss and change over time on those factors.</p><p><strong>Results: </strong>Compared with usual care, CoachToFit significantly improved efficacy for eating healthily, exercising, and making healthy changes. CoachToFit (vs. usual-care) participants reported nearly 1 additional day of physical activity per week and had nearly twice the odds of being in a higher category of exercise minutes.</p><p><strong>Conclusions: </strong>Physical activity and confidence for health improvement are important factors for weight loss programs among adults with mental illness.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20250605"},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long COVID in Populations With Serious Mental Illness: Clinical and Policy Implications.","authors":"Lucy Ogbu-Nwobodo, Alison R Hwong, Karly Murphy, Matthew L Goldman, James W Dilley","doi":"10.1176/appi.ps.20240457","DOIUrl":"10.1176/appi.ps.20240457","url":null,"abstract":"<p><p>As the world recovers from the height of the COVID-19 pandemic with ongoing plans for a strengthened behavioral health infrastructure-from crisis services to long-term care-one of the health conditions that has emerged is long COVID. This multisystem condition is characterized by persistent symptoms that develop after the acute phase of COVID-19 infection. Although the full clinical and scientific understanding of long COVID's neuropsychiatric impact is still evolving, a sizable cohort of patients has emerged with various long-term and often confusing symptoms, which can include cognitive impairment, mood dysregulation (e.g., anxiety or depression), sleep disturbances, posttraumatic symptoms, and chronic fatigue. Recognizing long COVID's debilitating impact on quality of life and wide-ranging societal consequences, the authors sought to summarize current knowledge about long COVID among individuals with a preexisting serious mental illness and to propose care and treatment recommendations for clinicians and public policy makers.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"449-456"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147314733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing Life-Saving Services.","authors":"Lisa B Dixon, Howard H Goldman","doi":"10.1176/appi.ps.26077012","DOIUrl":"https://doi.org/10.1176/appi.ps.26077012","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":"77 5","pages":"383-384"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radical Recovery as a Blueprint for Rebuilding Trust.","authors":"Javeed Sukhera","doi":"10.1176/appi.ps.20250650","DOIUrl":"https://doi.org/10.1176/appi.ps.20250650","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":"77 5","pages":"488-489"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advocating for Immigrant Mothers: A Call to Action in Perinatal Psychiatry.","authors":"Marcela Almeida, Melisa Granoff, Shireen Cama","doi":"10.1176/appi.ps.20250267","DOIUrl":"10.1176/appi.ps.20250267","url":null,"abstract":"<p><p>Immigrant mothers face increased risk for perinatal psychiatric disorders, yet their needs are often overlooked. Challenges compounded by migration stress, exclusionary policies, economic hardship, and systemic discrimination remain largely invisible in clinical training, research, and health systems design. The authors explore how immigration status, systemic inequities, and current policies contribute to disparities in care. Using community models, health systems research, and patient narratives, they call for services that reflect the lived realities of immigrant mothers. Recommendations include culturally responsive care, cross-sector collaboration, and policy reform. Centering immigrant mothers' experiences is essential to promoting equity and improving outcomes across the perinatal period.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"429-433"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma-Informed Care in Forensic and Secure Settings: A Systematic Scoping Review.","authors":"Casey Roberts, Crystal McMullen, Govind Krishnamoorthy, Michael Ireland","doi":"10.1176/appi.ps.20250199","DOIUrl":"10.1176/appi.ps.20250199","url":null,"abstract":"<p><strong>Objective: </strong>Trauma-informed care (TIC) is widely advocated in forensic and secure mental health settings, yet implementation outcomes and effectiveness are poorly characterized. In this scoping review, the authors aimed to synthesize measurable outcomes of TIC training and implementation programs for service users and staff and to identify legal, policy, and institutional facilitators and barriers.</p><p><strong>Methods: </strong>The authors searched six databases (PubMed, PsycInfo, the Psychology and Behavioral Sciences Collection, CINAHL, Scopus, and Google Scholar) for English-language empirical studies (January 1999-February 2025) in forensic mental health, juvenile justice, or correctional settings. Two reviewers double-screened a random subset (5% of titles and abstracts and 10% of full texts). Data were narratively synthesized.</p><p><strong>Results: </strong>Of 2,465 records, 12 met inclusion criteria. Eight studies examined staff outcomes only, four included youths, and none reported adult service user outcomes. Immediate posttraining gains in staff knowledge and confidence were common, and perceived safety improved when TIC was embedded in the organization's culture rather than implemented as isolated training. Facilitators included multitiered leadership, concurrent staff and service user engagement, and sustained organizational investment. Barriers included tensions with security protocols, resource constraints, and punitive cultures.</p><p><strong>Conclusions: </strong>Evidence for TIC in forensic settings is sparse and methodologically limited, with no adult service user outcomes and few study designs supporting causal inference. Preliminary, low-certainty signals suggest benefits for perceived safety when TIC is integrated into an organization's culture. Rigorous comparative studies that include adult perspectives and measure sustained clinical outcomes are needed to establish effectiveness.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"441-448"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Executive Order on \"Crime and Disorder\": An Affront to Policy, Law, and Ethics.","authors":"Benjamin A Barsky, Arthur Caplan, Dominic Sisti","doi":"10.1176/appi.ps.20250505","DOIUrl":"10.1176/appi.ps.20250505","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"386-387"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}