Focus (American Psychiatric Publishing)最新文献

{"title":"Challenges and Opportunities in Using Cognitive Screeners for Adolescents and Young Adults With Bipolar Disorder.","authors":"Rebekah S Huber, Sally Weinstein, Aimee E Sullivan, Melissa M Batt, Jennifer Vande Voort, Melinda Westlund Schreiner, Funlola Are, Ioanna Douka, Melissa DelBello, Manpreet K Singh, Leslie Hulvershorn, Ramnarine Boodoo, Christopher J Hammond, James R Brasic, Neera Ghaziuddin, Richard Dopp, Leslie Miller","doi":"10.1176/appi.focus.20240045","DOIUrl":"10.1176/appi.focus.20240045","url":null,"abstract":"<p><p>Adolescents and young adults with bipolar disorder often experience cognitive deficits that hinder academic performance and social interactions, affecting long-term outcomes. Identifying cognitive impairments is crucial for improving clinical management of bipolar disorder. Use of cognitive screeners is recommended to identify cognitive difficulties and for ongoing assessment. Although cognitive screeners are effective with adults, their use with adolescents and young adults is limited. This project assessed clinicians' attitudes and practices regarding cognitive screening of adolescents and young adults with bipolar disorder. The National Network of Depression Centers (NNDC) Child and Adolescent Mood Disorders Task Group developed a survey for clinicians treating adolescents and young adults (ages 14-25) with bipolar disorder, evaluating their knowledge of and attitudes toward cognitive screening and barriers to implementation. A total of 163 clinicians across 23 NNDC sites completed the survey. Most recognized the impact of cognitive deficits on functioning (87%) and treatment response (76%). More than 90% reported that cognitive assessments would be beneficial; however, 78% were unaware of available tools, and 64% reported barriers to implementation. Findings highlight a need for clinician education and addressing barriers to implementation. This article outlines the importance of using screeners in treatment of adolescents and young adults with bipolar disorder and provides practical information for using screeners and recommendations for implementation.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 2","pages":"125-132"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Opportunities in Examining and Addressing Intersectional Stigma and Health.","authors":"Janet M Turan, Melissa A Elafros, Carmen H Logie, Swagata Banik, Bulent Turan, Kaylee B Crockett, Bernice Pescosolido, Sarah M Murray","doi":"10.1176/appi.focus.25023006","DOIUrl":"10.1176/appi.focus.25023006","url":null,"abstract":"<p><strong>Background: </strong>'Intersectional stigma' is a concept that has emerged to characterize the convergence of multiple stigmatized identities within a person or group, and to address their joint effects on health and wellbeing. While enquiry into the intersections of race, class, and gender serves as the historical and theoretical basis for intersectional stigma, there is little consensus on how best to characterize and analyze intersectional stigma, or on how to design interventions to address this complex phenomenon. The purpose of this paper is to highlight existing intersectional stigma literature, identify gaps in our methods for studying and addressing intersectional stigma, provide examples illustrating promising analytical approaches, and elucidate priorities for future health research.</p><p><strong>Discussion: </strong>Evidence from the existing scientific literature, as well as the examples presented here, suggest that people in diverse settings experience intersecting forms of stigma that influence their mental and physical health and corresponding health behaviors. As different stigmas are often correlated and interrelated, the health impact of intersectional stigma is complex, generating a broad range of vulnerabilities and risks. Qualitative, quantitative, and mixed methods approaches are required to reduce the significant knowledge gaps that remain in our understanding of intersectional stigma, shared identity, and their effects on health.</p><p><strong>Conclusions: </strong>Stigmatized identities, while often analyzed in isolation, do not exist in a vacuum. Intersecting forms of stigma are a common reality, yet they remain poorly understood. The development of instruments and methods to better characterize the mechanisms and effects of intersectional stigma in relation to various health conditions around the globe is vital. Only then will healthcare providers, public health officials, and advocates be able to design health interventions that capitalize on the positive aspects of shared identity, while reducing the burden of stigma.Appeared originally in <i>BMC Medicine 2019; 17:7</i>.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 1","pages":"70-84"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical Considerations Related to Stigma in Mental Health Aspects of Treating Substance Use Disorders.","authors":"Jacob M Appel","doi":"10.1176/appi.focus.20240033","DOIUrl":"10.1176/appi.focus.20240033","url":null,"abstract":"","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 1","pages":"61-65"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Are the Barriers, Facilitators and Interventions Targeting Help-Seeking Behaviours for Common Mental Health Problems in Adolescents? A Systematic Review.","authors":"Antonia Aguirre Velasco, Ignacio Silva Santa Cruz, Jo Billings, Magdalena Jimenez, Sarah Rowe","doi":"10.1176/appi.focus.25023003","DOIUrl":"10.1176/appi.focus.25023003","url":null,"abstract":"<p><strong>Background: </strong>Increasing rates of mental health problems among adolescents are of concern. Teens who are most in need of mental health attention are reluctant to seek help. A better understanding of the help-seeking in this population is needed to overcome this gap.</p><p><strong>Methods: </strong>Five databases were searched to identify the principal barriers, facilitators and interventions targeting help-seeking for common mental health problems in adolescents aged 10-19 years. The search was performed in June 2018 and updated in April 2019. Two independent screening processes were made using the eligibility criteria. Quality assessment of each study was performed, and findings summarised using a narrative synthesis.</p><p><strong>Results: </strong>Ninety studies meet the inclusion criteria for this review for barrier and facilitators (<i>n</i> = 54) and interventions (<i>n</i> = 36). Stigma and negative beliefs towards mental health services and professionals were the most cited barriers. Facilitators included previous positive experience with health services and mental health literacy. Most interventions were based on psychoeducation, which focused on general mental health knowledge, suicide and self-harm, stigma and depression. Other types of interventions included the use of multimedia and online tools, peer training and outreach initiatives. Overall, the quality of studies was low to medium and there was no general agreement regarding help-seeking definition and measurements.</p><p><strong>Conclusion: </strong>Most of the interventions took place in an educational setting however, it is important to consider adolescents outside the educational system. Encouraging help-seeking should come with the increased availability of mental health support for all adolescents in need, but this is still a major challenge for Child and Adolescent Mental Health Services. There is also a need to develop shared definitions, theoretical frameworks and higher methodological standards in research regarding help-seeking behaviours in adolescents. This will allow more consistency and generalisability of findings, improving the development of help-seeking interventions and ensuring timely access to mental health treatments.Appeared originally in <i>BMC Psychiatry 2020; 20:293</i>.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 1","pages":"98-118"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eradicating Stigma: Where We're Going.","authors":"","doi":"10.1176/appi.focus.25023001","DOIUrl":"10.1176/appi.focus.25023001","url":null,"abstract":"","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 1","pages":"66-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Story of the Stop Stigma Together Campaign: A National Movement to Stop the Stigma of Mental and Substance Use Disorders.","authors":"Seth Kahan","doi":"10.1176/appi.focus.20240027","DOIUrl":"10.1176/appi.focus.20240027","url":null,"abstract":"","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 1","pages":"55-60"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stopping Mental Illness Stigma: Changing Attitudes, Language, and Policies.","authors":"Glen E Kreiner","doi":"10.1176/appi.focus.20240036","DOIUrl":"10.1176/appi.focus.20240036","url":null,"abstract":"<p><p>Stigma has been a pervasive and stubborn part of the mental illness landscape, but it need not be. This article explores the nature of mental health stigma, where it comes from, how it is manifested, how it harms people, and what can be done about it. The article articulates the need to clearly understand three major levels of mental health stigma-structural (e.g., laws and policies in society, institutions, and organizations), social (e.g., biases and attitudes toward others), and self (e.g., beliefs and feelings that those with mental health conditions have about themselves). Psychiatrists, psychologists, medical doctors, and counselors have, unfortunately, too often reinforced these mental health stigmas through policies, practices, and discourse. This article provides tips and strategies for collective and individual stigma reduction, with a particular focus on what mental health practitioners can do attitudinally, linguistically, and behaviorally.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 1","pages":"2-8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions to Reduce Discrimination and Stigma: The State of the Art.","authors":"Petra C Gronholm, Claire Henderson, Tanya Deb, Graham Thornicroft","doi":"10.1176/appi.focus.25023004","DOIUrl":"10.1176/appi.focus.25023004","url":null,"abstract":"<p><strong>Background: </strong>There is a rich literature on the nature of mental health-related stigma and the processes by which it severely affects the life chances of people with mental health problems. However, applying this knowledge to deliver and evaluate interventions to reduce discrimination and stigma in a lasting way is a complex and long-term challenge.</p><p><strong>Methods: </strong>We conducted a narrative synthesis of systematic reviews published since 2012, and supplemented this with papers published subsequently as examples of more recent work.</p><p><strong>Results: </strong>There is evidence for small to moderate positive impacts of both mass media campaigns and interventions for target groups in terms of stigma-related knowledge, attitudes, and intended behaviour in terms of desire for contact. However, the limited evidence from longer follow-up times suggests that it is not clear whether short-term contact interventions have a lasting impact.</p><p><strong>Conclusions: </strong>The risk that short-term interventions may only have a short-term impact suggests a need to study longer term interventions and to use interim process and outcome data to improve interventions along the way. There is scope for more thorough application of intergroup contact theory whenever contact is used and of evidence-based teaching and assessment methods when skills training is used for target groups.Appeared originally in <i>Soc Psychiatry Psychiatr Epidemiol 2017; 52:249-258</i>.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 1","pages":"85-93"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence Scribes in Psychiatry.","authors":"Patrick Buckley, Yanshan Wang, Priya Gopalan","doi":"10.1176/appi.focus.20240024","DOIUrl":"10.1176/appi.focus.20240024","url":null,"abstract":"<p><p>Artificial intelligence (AI) scribes for clinical documentation are likely to be among the first AI tools to affect the day-to-day practice of psychiatry, yet many psychiatrists are unfamiliar with them. This article introduces psychiatrists to AI scribes, including their potential benefits and risks. AI scribes may enhance efficiency, reduce physician burnout, and improve patient-physician rapport by automating documentation processes. Key concerns include privacy, accuracy, and the ability to capture nuanced patient communication. Initial recommendations for responsibly integrating AI scribes into psychiatric practice are provided, emphasizing the importance of balancing technological benefits with careful oversight.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 1","pages":"44-48"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meeting the Challenge of Stigma.","authors":"Darrell G Kirch","doi":"10.1176/appi.focus.20240048","DOIUrl":"10.1176/appi.focus.20240048","url":null,"abstract":"","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}