Psychiatric research and clinical practice最新文献

{"title":"Preliminary Evidence of Efficacy and Target Engagement of Pramipexole in Anhedonic Depression.","authors":"Filip Ventorp,&nbsp;Jesper Lindahl,&nbsp;Danielle van Westen,&nbsp;Jimmy Jensen,&nbsp;Johannes Björkstrand,&nbsp;Daniel Lindqvist","doi":"10.1176/appi.prcp.20210042","DOIUrl":"https://doi.org/10.1176/appi.prcp.20210042","url":null,"abstract":"<p><strong>Objective: </strong>To investigate feasibility and target engagement of high-dose, add-on pramipexole treatment in anhedonic depression.</p><p><strong>Method: </strong>In this open-label pilot study, we included 12 patients with unipolar or bipolar, moderate-to-severe depression and with significant anhedonia symptoms. All patients were on a stable dose of one or a combination of antidepressants and/or mood stabilizers and received 10 weeks of adjunctive pramipexole titrated to a maximum dose of 4.5 mg salt/day. All patients were rated with the Dimensional Anhedonia Rating Scale (DARS), the Montgomery Åsberg Depression Rating (MADRS) and the Snaith Hamilton Pleasure Scale (SHAPS). Serum high-sensitivity C-reactive protein (hs-CRP) was analyzed pre- and post-treatment. Eight patients underwent fMRI pre- and post-treatment and a simplified version of the monetary incentive delay task was used to investigate the effect of treatment on striatal activity during reward anticipation.</p><p><strong>Results: </strong>DARS, MADRS and SHAPS scores all improved significantly over 10 weeks of pramipexole treatment (<i>p</i><0.01). Mean levels of hs-CRP decreased significantly over the course of treatment from mean 3.8 mg/L at baseline to 2.6 mg/L at endpoint (<i>p</i><0.01). There were significant treatment-associated increases in reward related activity in several brain areas including the right lateral putamen, anterior left caudate, left posterior putamen, right dorsal caudate, left anterior putamen, and the right nucleus accumbens.</p><p><strong>Conclusions: </strong>This is the first study to suggest efficacy and target engagement of pramipexole in anhedonic depression. Larger randomized controlled trials are needed to confirm or refute these preliminary findings.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":" ","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/89/RCP2-4-42.PMC9534553.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33502718","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":"Toxoplasmosis and Schizophrenia: A Systematic Review and Meta-Analysis of Prevalence and Associations and Future Directions.","authors":"Despina G Contopoulos-Ioannidis,&nbsp;Maria Gianniki,&nbsp;Angeline Ai-Nhi Truong,&nbsp;Jose G Montoya","doi":"10.1176/appi.prcp.20210041","DOIUrl":"https://doi.org/10.1176/appi.prcp.20210041","url":null,"abstract":"<p><strong>Background: </strong>A potential link between toxoplasmosis with schizophrenia (SCZ) has been extensively studied over the past 2 decades. Our study was aimed to determine whether, beyond an association, the field is primed for randomized clinical trials of anti-<i>Toxoplasma</i> prophylaxis in <i>Toxoplasma</i> seropositive patients with SCZ.</p><p><strong>Methods: </strong>We performed a methodological appraisal of toxoplasmosis-SCZ association studies, a meta-analysis, and a compilation of claims and pathophysiologic hypotheses.</p><p><strong>Results: </strong>We analyzed 66 studies with 11,540 patients with SCZ and 69,491 controls. For patients with SCZ, 54 studies targeted <i>Toxoplasma-</i>IgG seropositivity, 18 targeted <i>Toxoplasma-</i>IgG serointensity, and 17 targeted <i>Toxoplasma-</i>IgM seropositivity. For SCZ-phenotypes, 26 targeted <i>Toxoplasma-</i>IgG seropositivity, six targeted <i>Toxoplasma-</i>IgG serointensity, and three targeted <i>Toxoplasma-</i>IgM seropositivity. Two-thirds of these studies reported a positive association. Statistically significant associations with SCZ were reported in 31/54 studies, 11/18 studies, and 3/17 studies. Significant associations with SCZ-phenotypes were reported in 20/26 studies, 2/6 studies, and 0/3 studies, respectively. <i>Toxoplasma-</i>IgG seropositivity increased the odds of SCZ (OR = 1.91; 95% CI: 1.61-2.27). Heterogeneity across studies was large (<i>I</i> ² = 80.03%). Adjusted analyses for at least age and socioeconomic status/place of residence were done in 17 studies; temporality was addressed only in 4.</p><p><strong>Conclusion: </strong>A large number of observational studies revealed a modest to large association between toxoplasmosis and SCZ. Although important methodological biases were identified, further association studies are unlikely to change this association and are not justified. It is time to test this association in randomized double-blind placebo-controlled clinical trials of first line anti-<i>Toxoplasma</i> prophylaxis in <i>Toxoplasma</i> seropositive patients with SCZ.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":" ","pages":"48-60"},"PeriodicalIF":0.0,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0b/8a/RCP2-4-48.PMC9558922.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40320815","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":"Mental Health Care Provider's Perspectives Toward Adopting a Novel Technology to Improve Medication Adherence.","authors":"Joshua N Liberman,&nbsp;Tigwa Davis,&nbsp;Dawn Velligan,&nbsp;Delbert Robinson,&nbsp;William Carpenter,&nbsp;Chris Jaeger,&nbsp;Heidi Waters,&nbsp;Charles Ruetsch,&nbsp;Felicia Forma","doi":"10.1176/appi.prcp.20210021","DOIUrl":"https://doi.org/10.1176/appi.prcp.20210021","url":null,"abstract":"<p><strong>Objective: </strong>To understand perspectives of mental health care providers regarding barriers and drivers of adopting a medication ingestible event monitoring (IEM) system in clinical practice.</p><p><strong>Methods: </strong>Between April and October 2019, a cross-sectional, online survey was conducted among 131 prescribing clinicians and 119 non-prescribing clinicians providing care to patients with major depressive disorder, bipolar disorder, and schizophrenia.</p><p><strong>Results: </strong>Most prescribing clinicians were physicians (79.4%) while most non-prescribing clinicians (52.9%) were licensed clinical social workers, followed by counselors (30.8%), clinical psychologists (13.4%), and case managers (2.5%). Most respondents (93.2%) reported that clinicians can influence adherence, that the IEM technology was in their patients' best interest (63.6%), and a willingness to beta test the technology (54.8%). Support was positively associated with prescribing clinicians (OR: 2.2; 95% CI: 1.1, 4.5), belief that antipsychotics reduce the health, social, or financial consequences of the condition (OR: 3.8; 95% CI: 1.3, 11.0), concern for patients' well-being without monitoring (OR: 3.3; 95% CI: 1.2, 8.7), and belief the technology will enhance clinical alliance (OR: 3.1; 95% CI: 1.5, 6.3) or improve patient engagement (OR: 3.0; 95% CI: 1.5, 6.2). Support was inversely related to concerns about appropriate follow-up actions (OR: 0.4; 95% CI: 0.2, 0.9) and responsibilities (OR: 0.3; 95% CI: 0.1, 0.8) when using the technology.</p><p><strong>Conclusions: </strong>Our results suggest that IEM sensor technology adoption will depend upon additional evidence that patients will actively engage in the use of the technology, will benefit from the technology through improved outcomes, and that the additional burden placed upon providers is minimal compared to the potential benefit.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":" ","pages":"61-70"},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/73/RCP2-4-61.PMC9558921.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40318737","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":"Trajectories of Depressive and Anxiety Symptoms Across Pregnancy and Postpartum in Selective Serotonin Reuptake Inhibitor-Treated Women.","authors":"Gabrielle A Mesches, Jody D Ciolino, Catherine S Stika, Dorothy K Sit, Katelyn Zumpf, Sheehan Fisher, Crystal T Clark, Alfred L George, Michael J Avram, Laura J Rasmussen-Torvik, Daniel L Erickson, Steven Caritis, Dawn Fischer, Raman Venkataramanan, Maged Costantine, Holly West, Elizabeth Welch, Shannon Clark, Katherine L Wisner, Jacqueline K Gollan","doi":"10.1176/appi.prcp.20210034","DOIUrl":"10.1176/appi.prcp.20210034","url":null,"abstract":"<p><strong>Objective: </strong>Tracking perinatal mood and anxiety disorders is championed by the American Psychiatric Association and the International Marcé Society for Perinatal Mental Health. We conducted this study to examine trajectories of monthly depressive and anxiety symptoms through pregnancy and postpartum.</p><p><strong>Methods: </strong>This is a prospective longitudinal observational cohort study of pregnant women interviewed at baseline (≤18th gestational week), every four weeks through delivery and at 6 and 14 weeks postpartum at three urban academic medical centers (<i>N</i> = 85) and a single rural health center (<i>N</i> = 3) from 2016 to 2020. Pregnant women had at least one prior episode of major depressive disorder, were not in a current episode, and were treated with sertraline, fluoxetine, citalopram, or escitalopram. Of 192 women screened, 88 (46%) women enrolled, and 77 (88%) women completed the postpartum follow-up. Symptom trajectories were generated with scores from the Edinburgh Postnatal Depression Scale, the Quick Inventory of Depressive Symptoms, the Generalized Anxiety Disorder Scale, 7-item, and the Patient-Reported Outcomes Measurement Information System Global Health measure. A semi-parametric, group-based mixture model (trajectory analysis) was applied.</p><p><strong>Results: </strong>Three relatively stable depression trajectories emerged, described as Minimal, Mild, and Subthreshold, in each group across pregnancy. Two of the four anxiety trajectories were stable, including Asymptomatic and Minimal, while the third, termed Breakthrough, was ascending with increasing symptoms and the fourth trajectory, described as Mild, had descending symptoms.</p><p><strong>Conclusions: </strong>Screening for anxiety with depression for pregnant women will yield a comprehensive view of psychiatric symptoms and treatment targets in perinatal women.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"4 2","pages":"32-41"},"PeriodicalIF":0.0,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1c/2b/RCP2-4-32.PMC9558923.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9655498","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":"Issue Information","authors":"","doi":"10.1176/rcp2.1044","DOIUrl":"https://doi.org/10.1176/rcp2.1044","url":null,"abstract":"","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49666046","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":"Mental Health-Related Emergency Department Visits Among Children During The Early COVID-19 Pandemic.","authors":"Juliet Beni Edgcomb, Nicole M Benson, Chi-Hong Tseng, Rohith Thiruvalluru, Jyotishman Pathak, Regina Bussing, Christopher A Harle, Bonnie T Zima","doi":"10.1176/appi.prcp.20210036","DOIUrl":"10.1176/appi.prcp.20210036","url":null,"abstract":"<p><strong>Objective: </strong>To measure univariate and covariate-adjusted trends in children's mental health-related emergency department (MH-ED) use across geographically diverse areas of the U.S. during the first wave of the Coronavirus-2019 (COVID-19) pandemic.</p><p><strong>Method: </strong>This is a retrospective, cross-sectional cohort study using electronic health records from four academic health systems, comparing percent volume change and adjusted risk of child MH-ED visits among children aged 3-17 years, matched on 36-week (3/18/19-11/25/19 vs. 3/16/20-11/22/20) and 12-week seasonal time intervals. Adjusted incidence rate ratios (IRR) were calculated using multivariate Poisson regression.</p><p><strong>Results: </strong>Visits declined during spring-fall 2020 (<i>n</i> = 3892 vs. <i>n</i> = 5228, -25.5%) and during spring (<i>n</i> = 1051 vs. <i>n</i> = 1839, -42.8%), summer (<i>n</i> = 1430 vs. <i>n</i> = 1469, -2.6%), and fall (<i>n</i> = 1411 vs. <i>n</i> = 1920, -26.5%), compared with 2019. There were greater declines among males (28.2% vs. females -22.9%), children 6-12-year (-28.6% vs. -25.9% for 3-5 years and -22.9% for 13-17 years), and Black children (-34.8% vs. -17.7% to -24.9%). Visits also declined for developmental disorders (-17.0%) and childhood-onset disorders (e.g., attention deficit and hyperactivity disorders; -18.0%). During summer-fall 2020, suicide-related visits rose (summer +29.8%, fall +20.4%), but were not significantly elevated from 2019 when controlling for demographic shifts. In contrast, MH-ED use during spring-fall 2020 was significantly reduced for intellectual disabilities (IRR 0.62 [95% CI 0.47-0.86]), developmental disorders (IRR 0.71 [0.54-0.92]), and childhood-onset disorders (IRR 0.74 [0.56-0.97]).</p><p><strong>Conclusions: </strong>The early pandemic brought overall declines in child MH-ED use alongside co-occurring demographic and diagnostic shifts. Children vulnerable to missed detection during instructional disruptions experienced disproportionate declines, suggesting need for future longitudinal research in this population.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"4 1","pages":"4-11"},"PeriodicalIF":0.0,"publicationDate":"2022-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/f6/RCP2-4-4.PMC9115451.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173908","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":"Effects of Sexual Orientation on Spiritual Psychotherapy for Inpatient, Residential & Intensive Treatment.","authors":"Eleanor M Schuttenberg,&nbsp;Alana M Johnston,&nbsp;Mia J Drury,&nbsp;Jennifer T Sneider,&nbsp;Marisa M Silveri,&nbsp;David H Rosmarin","doi":"10.1176/appi.prcp.20210026","DOIUrl":"https://doi.org/10.1176/appi.prcp.20210026","url":null,"abstract":"Objectives Spiritual psychotherapy addresses mental health concerns by integrating spirituality/religion into treatment. There is scant research on how such approaches interact with sexual minority status. We sought to identify and compare how sexual minority and heterosexual patients respond to spiritual psychotherapy. Method We collected data from heterosexual (n = 66) and sexual minority (n = 15) patients who self‐referred to participate in Spiritual Psychotherapy for Inpatient Residential & Intensive Treatment (SPIRIT), a spiritually‐integrated, group‐based, cognitive‐behavioral treatment. Results We did not find significant differences between heterosexual and sexual minority patients across demographic/clinical variables, spiritual/religious characteristics, or effects of SPIRIT. Both groups reported notable perceived benefit of SPIRIT. Conclusions Although not specifically tailored for sexual minority patients, or intended to reconcile spiritual/religious conflicts around sexual identity, programs like SPIRIT may benefit sexual minority patients by providing a safe space to explore both sexual orientation and religious identity. In turn, this may help sexual minority patients develop frameworks to recruit spirituality/religion in the process of coping with distress, as a catalyst for clinical change.","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":" ","pages":"21-27"},"PeriodicalIF":0.0,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/5e/RCP2-4-21.PMC9175756.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40357160","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":"Predicting Poor Outcomes Among Individuals Seeking Care for Major Depressive Disorder.","authors":"Joshua N Liberman,&nbsp;Jacqueline Pesa,&nbsp;Pinyao Rui,&nbsp;Amanda Teeple,&nbsp;Susan Lakey,&nbsp;Emily Wiggins,&nbsp;Brian Ahmedani","doi":"10.1176/appi.prcp.20220011","DOIUrl":"https://doi.org/10.1176/appi.prcp.20220011","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate algorithms to identify individuals with major depressive disorder (MDD) at elevated risk for suicidality or for an acute care event.</p><p><strong>Methods: </strong>We conducted a retrospective cohort analysis among adults with MDD diagnosed between January 1, 2018 and February 28, 2019. Generalized estimating equation models were developed to predict emergency department (ED) visit, inpatient hospitalization, acute care visit (ED or inpatient), partial-day hospitalization, and suicidality in the year following diagnosis. Outcomes (per 1000 patients per month, PkPPM) were categorized as all-cause, psychiatric, or MDD-specific and combined into composite measures. Predictors included demographics, medical and pharmacy utilization, social determinants of health, and comorbid diagnoses as well as features indicative of clinically relevant changes in psychiatric health. Models were trained on data from 1.7M individuals, with sensitivity, positive predictive value, and area-under-the-curve (AUC) derived from a validation dataset of 0.7M.</p><p><strong>Results: </strong>Event rates were 124.0 PkPPM (any outcome), 21.2 PkPPM (psychiatric utilization), and 7.6 PkPPM (suicidality). Among the composite models, the model predicting suicidality had the highest AUC (0.916) followed by any psychiatric acute care visit (0.891) and all-cause ED visit (0.790). Event-specific models all achieved an AUC >0.87, with the highest AUC noted for partial-day hospitalization (AUC = 0.938). Select predictors of all three outcomes included younger age, Medicaid insurance, past psychiatric ED visits, past suicidal ideation, and alcohol use disorder diagnoses, among others.</p><p><strong>Conclusions: </strong>Analytical models derived from clinically-relevant features identify individuals with MDD at risk for poor outcomes and can be a practical tool for health care organizations to divert high-risk populations into comprehensive care models.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"4 4","pages":"102-112"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/69/40/RCP2-4-102.PMC9757499.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10418940","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":"Multidimensional Quality of Life Across the Spectrum of Alcohol Use Behavior.","authors":"Jeremy W Luk,&nbsp;Vijay A Ramchandani,&nbsp;Nancy Diazgranados,&nbsp;Melanie L Schwandt,&nbsp;Tommy Gunawan,&nbsp;David T George,&nbsp;David Goldman","doi":"10.1176/appi.prcp.20220023","DOIUrl":"https://doi.org/10.1176/appi.prcp.20220023","url":null,"abstract":"<p><strong>Objective: </strong>Quality of life (QoL) is inversely associated with alcohol misuse and is a key measure by which recovery from alcohol use disorder (AUD) might be assessed. Yet, the determinants of QoL are scarcely known. The authors examined three ways through which demographic characteristics, familial and early life factors, and psychopathology conferred risks for QoL, including unique direct effects, developmental pathways, and clinical risk Profiles.</p><p><strong>Methods: </strong>Cross-sectional data from 1095 adults (50.4% without AUD; 49.6% with AUD) who participated in the NIAAA Natural History Protocol from January 2015 to March 2022 were analyzed. Multivariable regressions, path analysis, and latent Profile analysis were conducted.</p><p><strong>Results: </strong>AUD was uniquely associated with lower QoL, and adverse effects of child maltreatment history and psychopathology symptoms on QoL were of similar or larger magnitudes. Mediation analysis indicated family history of AUD and child maltreatment history were indirectly associated with lower QoL through higher attention-deficit/hyperactivity disorder symptoms, higher depressive symptoms, and positive AUD diagnosis. Latent Profile analysis of an enriched set of clinical characteristics identified four latent Profiles capturing the full range of alcohol use behavior. Latent Profiles with greater severity of familial and early life factors, psychopathology, and problematic drinking showed dose-response associations with lower levels of physical, psychological, social, and environment QoL.</p><p><strong>Conclusions: </strong>A constellation of developmental and clinical characteristics disproportionately affects individuals with AUD and is negatively associated with QoL domains. To improve QoL, prevention and intervention need to target multiple factors, including history of child maltreatment, comorbid psychopathology, and problematic drinking itself.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"4 4","pages":"92-101"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/00/RCP2-4-92.PMC9757500.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10418941","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":"Revealing Unknown Benefits of Existing Medications to Aid the Discovery of New Treatments for Post-Traumatic Stress Disorder.","authors":"David M Kern,&nbsp;Rachel E Teneralli,&nbsp;Christopher M Flores,&nbsp;Gayle M Wittenberg,&nbsp;James P Gilbert,&nbsp;M Soledad Cepeda","doi":"10.1176/appi.prcp.20210019","DOIUrl":"https://doi.org/10.1176/appi.prcp.20210019","url":null,"abstract":"<p><strong>Objective: </strong>To systematically identify novel pharmacological strategies for preventing or treating post-traumatic stress disorder (PTSD) by leveraging large-scale analysis of real-world observational data.</p><p><strong>Methods: </strong>Using a self-controlled study design, the association between 1399 medications and the incidence of PTSD across four US insurance claims databases covering commercially insured, Medicare eligible, and Medicaid patients was examined. A validated algorithm for identifying PTSD in claims data was used, and medications were identified by their RxNorm ingredient. Medications used to treat PTSD or its symptoms (e.g., antidepressants, antipsychotics) were excluded. Medications associated with ≥30% reduction in risk of PTSD in ≥2 databases were identified.</p><p><strong>Results: </strong>A total of 137,182,179 individuals were included in the analysis. Fifteen medications met the threshold criteria for a potential protective effect on PTSD; six were categorized as \"primary signals\" while the remaining nine were considered \"potential signals\". The primary signals include a beta blocker that has been previously studied for PTSD, and five medications used to treat attention-deficit/hyperactivity disorder. The potential signals include four medications used to treat substance use disorders and five medications used to treat sleep disorders.</p><p><strong>Discussion: </strong>The medications identified in this analysis provide targets for further research in studies that are designed to examine specific hypotheses regarding these medications and the incidence of PTSD. This work may aid in discovering novel therapeutic approaches to treat PTSD, wherein new and effective treatments are badly needed.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":" ","pages":"12-20"},"PeriodicalIF":0.0,"publicationDate":"2021-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4a/0a/RCP2-4-12.PMC9175795.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40357159","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}