Psychiatric research and clinical practice最新文献

{"title":"Understanding Onset, Dynamic Transitions, and Associated Inequality Risk Factors for Adverse Posttraumatic Neuropsychiatric Sequelae After Trauma Exposure.","authors":"Chiyoung Lee, Stacey L House, Francesca L Beaudoin, Thomas C Neylan, Gari D Clifford, Sarah D Linnstaedt, Laura T Germine, Scott L Rauch, John P Haran, Alan B Storrow, Christopher Lewandowski, Paul I Musey, Phyllis L Hendry, Sophia Sheikh, Brittany E Punches, Robert A Swor, Lauren A Hudak, Jose L Pascual, Mark J Seamon, Erica Harris, Claire Pearson, David A Peak, Robert M Domeier, Niels K Rathlev, Brian J O'Neil, Paulina Sergot, Leon D Sanchez, Steven E Bruce, John F Sheridan, Steven E Harte, Karestan C Koenen, Ronald C Kessler, Samuel A McLean, Qing Yang, Xinming An","doi":"10.1176/appi.prcp.20240017","DOIUrl":"10.1176/appi.prcp.20240017","url":null,"abstract":"<p><strong>Objective: </strong>Several gaps remain in the understanding of the onset, dynamic transitions, and associated risk factors of adverse posttraumatic neuropsychiatric sequelae (APNS) in the acute post-trauma window. Based on serial assessments of symptoms from a large cohort study, we identified homogeneous statuses across multiple APNS symptom domains and investigated the dynamic transitions among these statuses during the first 2 months after trauma exposure. Furthermore, we studied how symptom onset and transitions are affected by equity-relevant characteristics.</p><p><strong>Methods: </strong>The analysis was based on 2557 participants enrolled in the Advancing Understanding of RecOvery afteR traumA (AURORA). APNS symptoms comprised pain, depression, sleep discontinuity, nightmares, avoidance, re-experience, anxiety, hyperarousal, somatic symptoms, and mental fatigue. We identified the homogeneous status of APNS symptoms at baseline, 1 month, and 2 months, and explored transition probabilities among these statuses using latent transition analysis. Equity-relevant characteristics included gender, race, education, family income, childhood trauma, and area deprivation.</p><p><strong>Results: </strong>Three homogeneous statuses-low-, moderate-, and severe-symptom-were identified. While the majority of trauma survivors with severe- or moderate-symptom status maintained the same status over time, some transitioned to a less severe symptom status, particularly within the first month. Specifically, females, non-whites, and those with higher childhood trauma were associated with a decreased likelihood of transitioning to a less severe symptom status. From one to 2 months, lower income was associated with a decreased likelihood of transitioning from moderate-to low-symptom status.</p><p><strong>Conclusions: </strong>The findings can inform early intervention strategies for APNS, potentially reducing health disparities among trauma survivors.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"7 1","pages":"53-62"},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766074","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 Dual Trajectories of Depressive Symptoms and Social Support-A Population-Based Cohort Study Among Swedish Adults Across 23 Years.","authors":"Julia Ortmann, Jette Möller, Yvonne Forsell, Yajun Liang","doi":"10.1176/appi.prcp.20240063","DOIUrl":"10.1176/appi.prcp.20240063","url":null,"abstract":"<p><strong>Objective: </strong>Depression often follows a recurrent or chronic course influenced by various factors. Social support is associated with depression both by quantity and quality, however, the concurrent change with depression is unclear. This study aimed to determine the trajectories of depressive symptoms and social support over 23 years as well as their interrelationship.</p><p><strong>Methods: </strong>We analyzed data from 6787 participants of a Swedish population-based cohort study at four time points and across 23 years. Depressive symptoms were assessed using the Major Depression Inventory and social support was assessed with the Interview Schedule for Social Interaction. The trajectories of depressive symptoms and social support were determined using group-based dual trajectory modeling. Multinomial logistic regression analysis assessed the association between the trajectories of depressive symptoms and social support.</p><p><strong>Results: </strong>Six trajectories of depressive symptoms and three trajectories of social support were identified. The trajectories were highly associated. Individuals without depressive symptoms were likely to have a stable high availability of social support, and those with persistent depressive symptoms were likely to experience a stable low availability of social support.</p><p><strong>Conclusions: </strong>Our findings imply that social support should be considered in the management of depressive symptoms.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"7 1","pages":"44-52"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766072","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":"20-Year Trajectories of Substance-Use Service Utilization by Ontario's Muslim-Majority Country Immigrants.","authors":"Ahmed N Hassan, Fardowsa Ahmed, Haley Golding, Luke Mondor, Taaha Muhammad, Marwa Azab, Jibran Khokhar, Heba Ragheb, Allie Ali, Nazila Isgandarova, Abd Alfatah Tawakkal, Refik Saskin","doi":"10.1176/appi.prcp.20240090","DOIUrl":"10.1176/appi.prcp.20240090","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to conduct a population-level study on substance use treatment utilization among immigrants from Muslim-majority countries (MMC) and non-MMC, compared with Canadian-born individuals in Ontario.</p><p><strong>Methods: </strong>A population-based, repeated measures cross-sectional study was conducted. Additionally, individuals with at least one contact with substance use services were followed. Negative binomial models were run to compare the rate ratio of the number of repeated healthcare visits per person per year of follow-up by subpopulation group. This study included three separate populations (Canadian-born, immigrants from MMC, and immigrants from non-MMC) residing in Ontario, Canada. All individuals residing in Ontario on the first day of each calendar year from January 2003 to December 2022 were included. Data were collected from three major sources: outpatient visits, emergency department visits, and inpatient hospitalizations.</p><p><strong>Results: </strong>In 2022, immigrants from MMC (<i>n</i> = 561,937) and non-MMC (<i>n</i> = 2,138,307) groups had lower substance-use service utilization across all service types compared with Canadian individuals (<i>n</i> = 12,178,607). Comparing 2022 to 2003, the most significant increase in utilizing hospitalization was for MMC immigrants (RR: 3.0; 95% CI: 2.1-4.4; <i>p</i> < 0.01) and the lowest increase in outpatient service utilization was in MMC immigrants (RR: 1.8; 95% CI: 1.5-2.0; <i>p</i> < 0.01). The rates of repeated service utilization among those who initiated contact with outpatient services in the MMC and non-MMC groups were significantly less than Canadian-born individuals.</p><p><strong>Conclusions: </strong>Immigrants from MMC and non-MMC with substance use disorders may utilize service only at critical stages, thereby jeopardizing treatment success.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"7 1","pages":"32-43"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766035","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":"Exploring Connections Between Living Situations and Antipsychotic Prescribing Practices for People With Intellectual Disabilities.","authors":"Eion Plenn, Calista Long, Samantha Acri, Cheryl Richardson","doi":"10.1176/appi.prcp.20240050","DOIUrl":"10.1176/appi.prcp.20240050","url":null,"abstract":"<p><strong>Objective: </strong>Antipsychotic prescribing practices in people with intellectual disabilities (ID) have sparked growing concerns about appropriateness and potential risks. The connection between living situations and antipsychotic prescribing practices in this population is a crucial but underexplored area. This study aims to investigate the association between living situation and antipsychotic prescriptions among people with ID.</p><p><strong>Methods: </strong>This retrospective chart review included 112 adults with ID who received care from 2019 to 2021. The investigation examined participants' living situations and assessed antipsychotic prescription rates, antipsychotic class, the presence of a corresponding mental health diagnoses, and polypharmacy. Statistical analyses included univariate and multivariate tests to assess the relationship between living situations and antipsychotic prescriptions, controlling for relevant covariates.</p><p><strong>Results: </strong>Univariate analysis revealed a significant association between living situation and antipsychotic prescriptions (<i>p</i> < 0.05), with patients in non-familial support homes and group homes more likely to receive antipsychotics. However, multivariate analysis did not confirm this association after adjusting for other variables. Male gender (OR = 4.207, 95% confidence interval (CI) 1.721-10.286) and total medication count (OR = 1.101, 95% CI 1.038-1.169) emerged as significant predictors of antipsychotic prescriptions.</p><p><strong>Conclusions: </strong>These findings highlight the complexity of antipsychotic prescribing practices among people with ID. While living situation initially appeared to influence prescription patterns, multivariate analysis suggests the importance of considering other factors. Gender and medication count emerge as significant predictors, underscoring the need for tailored interventions and closer monitoring in this population.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"7 1","pages":"25-31"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766066","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":"Psychiatrists' Experiences, Training Needs, and Preferences Regarding Prescription and Management of HIV Pre-exposure Prophylaxis (PrEP) Within Psychiatric Care.","authors":"Samuel R Bunting, Brian A Feinstein, Nitin Vidyasagar, Allison Wilson, John Schneider, Dustin A Ehsan, Aniruddha Hazra","doi":"10.1176/appi.prcp.20240069","DOIUrl":"10.1176/appi.prcp.20240069","url":null,"abstract":"<p><strong>Background: </strong>People living with mental illness (PLWMI) experience a disproportionate prevalence and incidence of HIV. Preventing HIV among PLWMI is a priority for multiple domestic public health agencies. As key clinicians for this group, psychiatrists may have an important role to play in increasing PrEP use among PLWMI.</p><p><strong>Methods: </strong>A national survey of psychiatrists (<i>N</i> = 880) about integrating PrEP prescription into psychiatric practice was conducted between November 2022-October 2023. Specifically, we inquired about experiences with PrEP prescription, patient request for PrEP, and interest in prescribing PrEP. We also inquired about barriers to PrEP prescription in psychiatry and preferred models for implementing PrEP prescription in psychiatry.</p><p><strong>Results: </strong>We found that 19.3% of psychiatrists had received a request for PrEP from a patient, 17.3% had prescribed, and 53.9% were interested in prescribing. The greatest percentage of psychiatrists who prescribed PrEP were practicing primarily in inpatient psychiatry (28.8%). Practicing in one of the federal <i>Ending the HIV Epidemic</i> (EHE) priority jurisdictions (aOR = 2.08 [1.23-3.54], <i>p</i> = 0.003) and greater self-confidence in PrEP-related tasks (aOR = 2.10 [1.67-2.65], <i>p</i> < 0.001) were associated with higher likelihood of PrEP prescription. Limited knowledge of PrEP was the barrier endorsed by the greatest percentage of psychiatrists (76.3%). Most preferred a hypothetical model in which a psychiatrist prescribed an initial course of PrEP with prompt primary care or infectious disease follow-up (63.1%).</p><p><strong>Conclusion: </strong>Most psychiatrists were interested in prescribing PrEP. Training is needed to enable PrEP implementation in psychiatric practice including development of collaborative practice models to engage psychiatrists across a diversity of settings.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"6 4","pages":"151-163"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820364","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":"Psilocybin and Motor Function: A Triple‐Blind, Dose‐Finding Study in Healthy Participants","authors":"C.S.K. Bhagavan, Richard Kanaan, Olivia Carter, Glenn Nielsen, David Berlowitz, Sara Issak, Sabine Braat, Sophie Zaloumis, Zachary Attard, Georgina Oliver, Deanne Mayne, David McKernon, Greg Roebuck, James Rucker, Matthew Butler, Alexander Bryson","doi":"10.1176/appi.prcp.20240047","DOIUrl":"https://doi.org/10.1176/appi.prcp.20240047","url":null,"abstract":"","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813314","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 Reporting of Race and Ethnicity in the Conduct Disorder Literature: A Time‐Sensitive Review","authors":"Tashalee R Brown, Madeline O. Jansen, Binx Yezhe Lin, Cynthia E. Rogers, K. Y. Xu","doi":"10.1176/appi.prcp.20240009","DOIUrl":"https://doi.org/10.1176/appi.prcp.20240009","url":null,"abstract":"","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":" 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141828047","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":"Anxiety and Depression Among Adults and Children With Celiac Disease: A Meta‐Analysis of Different Psychiatry Scales","authors":"Mostafa Hossam-Eldin Moawad, Ibrahim Serag, M. Shalaby, Mohamed Smail Aissani, M. A. Sadeq, Nada Ibrahim Hendi, Bashaer Elawfi, Reem Mohammed Farouk Ghorab, Naydeen Mostafa, Nancy Ibrahim, Hasnaa Ali Hassan Abdelrhem, Ahmed Hassan A. Rady, M. Alkasaby","doi":"10.1176/appi.prcp.20230076","DOIUrl":"https://doi.org/10.1176/appi.prcp.20230076","url":null,"abstract":"","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"21 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141653512","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":"Diagnosing Adolescent Substance Use and Co-Occurring Disorders Using the Global Appraisal of Individual Needs Quick Version-4.","authors":"Justine W Welsh, Rebecca M Durham, Siara I Sitar, Kathryn C Modisette, Barbara D Estrada, Michael L Dennis","doi":"10.1176/appi.prcp.20230078","DOIUrl":"10.1176/appi.prcp.20230078","url":null,"abstract":"<p><strong>Objective: </strong>Early identification of substance use during adolescence is imperative to reduce the risk of morbidity and mortality. The aim of this study was to determine the utility of the Global Appraisal of Individual Needs-Quick Version 4 (GAIN-Q4) at diagnosing substance use disorders (SUDs) in adolescents.</p><p><strong>Methods: </strong>The GAIN-Q4 was developed from the GAIN-Quick Version 3 by adding items from the original measure (GAIN-I) to diagnose SUDs and provide level of care recommendations. Prevalence, sensitivity (SE), specificity, Cohen's kappa, and percent agreement between the GAIN-I and GAIN-Q4 were calculated for substance use and mental health (MH) diagnoses. The GAIN-I was administered to adolescents aged 12-17 and adults across levels of care and service settings from 2002 to 2018. The sample included 101,897 adolescents (71.50% male; average age 15.59, SD = 1.25 years) and 204,711 adults aged 18 and older (61.72% male; average age 34.24; SD = 11.67).</p><p><strong>Results: </strong>Nearly half of adolescents (43%) had at least one SUD and one MH diagnosis based on the GAIN-Q4. The sensitivity and specificity of the GAIN-Q4 for diagnosing any SUD in adolescents was 89% and 93%, respectively. There was 90% agreement between the GAIN-Q4 and GAIN-I for any SUD (Cohen's kappa of 0.80). Sensitivities for all SUD subtypes were >90%.</p><p><strong>Conclusions: </strong>The GAIN-Q4 is excellent at identifying adolescents with problems related to co-occurring MH and SUDs (SE = 97%). The GAIN-Q4 is a reliable instrument for the diagnosis of SUDs in adolescents and has the potential to facilitate appropriate allocation of treatment resources.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05001399.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"6 4","pages":"143-150"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820360","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":"Medical, Psychiatric, and Sociodemographic Predictors of Clozapine Initiation at an Academic Medical Center.","authors":"Kathleen Shangraw, Christian Schmutz, Tom Dowdle, Ryan Kelley, Caleb Porter, Merrick Reynolds, Zachary Schwartz, Olivia Sutton, Brent Kious","doi":"10.1176/appi.prcp.20240056","DOIUrl":"10.1176/appi.prcp.20240056","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Clozapine is an effective yet underutilized treatment for treatment-resistant schizophrenia spectrum disorders. This study aimed to identify factors affecting clozapine prescribing patterns among patients with treatment-resistant schizophrenia and schizoaffective disorder at an academic medical center.</p><p><strong>Study design: </strong>This retrospective combined cohort and case-control study examined demographic, socioeconomic, medical and psychiatric characteristics to determine predictors of clozapine initiation. Eligible patients had a diagnosis of schizophrenia or schizoaffective disorder with at least two prior antipsychotic trials and were admitted to a University of Utah inpatient psychiatric facility (1/2014-3/2021). Patients who did and did not receive clozapine during the index hospitalization were compared in cohort and case-control study arms.</p><p><strong>Study results: </strong>Twelve percent (59/477) of the cohort received clozapine during the index admission. Among the cohort (<i>n</i> = 477), Black patients were twice as likely to receive clozapine than White and Hispanic patients (OR 2.18, 95% CI 1.20-3.97, <i>p</i> = 0.008). In the case-control analysis, patients with a greater number of previous psychiatric admissions (OR 1.14, <i>p</i> = 0.079) and antipsychotic trials (OR 1.40, <i>p</i> = 0.038) had greater odds of receiving clozapine. Homelessness was identified as a predictor against clozapine use (OR 2.77, <i>p</i> = 0.014).</p><p><strong>Conclusions: </strong>This is the first study to identify homelessness as a predictor against clozapine use, which raises important clinical and ethical considerations. Our findings also add to the literature on clozapine prescribing discrepancies among ethnic-minority patients. Overall, clozapine remains underutilized as the gold-standard treatment for treatment-resistant schizophrenia-spectrum disorders, reinforcing a need to improve evidence-based prescribing.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"6 3","pages":"104-111"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683809","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}