Psychiatric research and clinical practice最新文献_第7页

The Failed Concept of Treatment Resistance. 失败的抗药性概念。

Psychiatric research and clinical practice Pub Date : 2024-06-21 eCollection Date: 2024-01-01 DOI: 10.1176/appi.prcp.20240073

H Paul Putman

{"title":"The Failed Concept of Treatment Resistance.","authors":"H Paul Putman","doi":"10.1176/appi.prcp.20240073","DOIUrl":"10.1176/appi.prcp.20240073","url":null,"abstract":"The use of the term \"treatment resistance\" (TR) in psychiatry has blossomed over the last two decades, with 20%-60% of all cases now labeled as such. Remaining effective treatment options, however, can be identified for two-thirds of these cases. There is no consensus on definition or criteria for TR within any diagnostic category, and literature review supports a broad range of individual causes of treatment failure (TF), rather than an actual entity of TR. Application of the TR label inhibits a practitioner's search for the true cause(s) of TF, a disservice to the trust patients place in us and their hope for recovery. It also threatens to worsen prognosis by unnecessarily extending the length of an index or recurrent episode, and increases the risk of death and burden of disease by prolonging categorical and functional impairments. We must view TF as a stage of treatment, still expecting and seeking eventual remission, rather than applying TR as an endpoint and an unsanctioned pseudo diagnosis. We must always recall that the clinical tasks we face are inherently complex; routine solutions are unlikely to fit and often lead to TF. The actual value we offer our patients is our problem-solving skill and our willingness to be with them through the difficulties of reaching their goals. We can address so-called TR, or, rather, TF by confirming our diagnostic validity and accuracy, the thoroughness of our evaluations and monitoring efforts, the clarity of our therapeutic guidance, and the quality of our therapeutic alliances.","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"6 3","pages":"112-114"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683840","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}

引用次数: 0

“Catching Chain” With Medicaid: The Impact of Medicaid Access on Opioid Overdose Mortality in Adults Released From State Detention 利用医疗补助计划 "抓住链条"：医疗补助对州拘留所释放成年人阿片类药物过量死亡率的影响

Psychiatric research and clinical practice Pub Date : 2024-06-06 DOI: 10.1176/appi.prcp.20230080

Liba Blumberger, William Calo, Daniel J. Mallinson, Guodong Liu, Douglas L. Leslie

引用次数: 0

Recency of Suicide Attempt, Ideation, and Reattempt in the Emergency Department: Managing Youth With a Past Attempt. 急诊科中自杀未遂、自杀意念和再次自杀的发生率：管理曾经自杀未遂的青少年。

Psychiatric research and clinical practice Pub Date : 2024-05-29 eCollection Date: 2024-01-01 DOI: 10.1176/appi.prcp.20240006

August X Wei, Annabelle M Mournet, Jeffrey A Bridge, Donna A Ruch, Maryland Pao, Lisa M Horowitz

{"title":"Recency of Suicide Attempt, Ideation, and Reattempt in the Emergency Department: Managing Youth With a Past Attempt.","authors":"August X Wei, Annabelle M Mournet, Jeffrey A Bridge, Donna A Ruch, Maryland Pao, Lisa M Horowitz","doi":"10.1176/appi.prcp.20240006","DOIUrl":"10.1176/appi.prcp.20240006","url":null,"abstract":"Objective: This study describes recency of suicide attempt (SA) and suicidal ideation (SI) at index emergency department (ED) visit and post-ED-discharge reattempt among pediatric patients.Methods: Secondary analysis from the ED Screen for Teens at Risk for Suicide study included patients ages 12-17 who reported a past SA during screening and received a phone call 3-month post-ED-discharge assessing reattempt. Logistic regressions tested past SA/SI recency as predictors of reattempt. Descriptive statistics on SA/SI recency and reattempt are provided.Results: Sample included 351 patients reporting a past SA during screening (70% cisgender female, 59% White, 53% psychiatric chief complaint, mean [SD] age = 15.3 [1.5]). 17% (60/351) reattempted suicide post-ED-discharge. Compared to patients who attempted over a year ago, patients with recent SA within 3 months, especially 1 week before screening, had greater odds of reattempting (3 months: p < 0.05, adjusted odds ratio [adjOR] = 3.1 [1.1-10.4]; 1 week: p < 0.01, adjOR = 4.8 [1.7-16.2]). Patients with recent SI within 24 h before screening had greater odds of reattempting than those with no recent SI (adjOR = 2.8 [1.1-7.6]; p < 0.05). 94% (64/68) of patients with a SA from over a year ago and no recent SI did not reattempt at follow-up.Conclusions: Pediatric ED patients have greater risk of reattempting suicide post-discharge if their last SA was within the past 3 months-especially 1 week-and when most recent SI occurred within 24 h. Conversely, patients reporting SA over a year ago with no recent SI may require less immediate intervention. Findings support universal suicide risk screening and clinical pathways that use recency of SA to inform disposition.","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"6 3","pages":"87-93"},"PeriodicalIF":0.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683810","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}

引用次数: 0

History of Suicidality and Pandemic Outcomes: Longitudinal Associations with Anxiety Symptoms, Depressive Symptoms, and Problematic Drinking 自杀史与大流行病结果：与焦虑症状、抑郁症状和问题性饮酒的纵向关系

Psychiatric research and clinical practice Pub Date : 2024-05-02 DOI: 10.1176/appi.prcp.20230067

J. Luk, Matthew F. Thompson, Laura A. Novak, B. Stangl, M. Schwandt, David Goldman, V. Ramchandani, N. Diazgranados

引用次数: 0

Adapting Virtual Reality‐Based Mental Health Interventions for Equitable Global Use: Proof of Concept 调整基于虚拟现实的心理健康干预措施，实现全球公平使用：概念验证

Psychiatric research and clinical practice Pub Date : 2024-04-23 DOI: 10.1176/appi.prcp.20230054

Ana F Trueba, Cristina Crespo-Andrade, Maria Sol Garces, Camila Alejandra Merino Larrea, Nicolas A. Alvarez Frank, Boyu Ren, Hailey V. Cray, Julia Kimball, Rebecca Dickinson, I. Vahia

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Quality of Life and Functioning Impairments Across Psychiatric Disorders in Adults Presenting for Outpatient Psychiatric Evaluation and Treatment 接受精神科门诊评估和治疗的成人不同精神疾病的生活质量和功能障碍

Psychiatric research and clinical practice Pub Date : 2024-04-08 DOI: 10.1176/appi.prcp.20230064

W. Ishak, James Mirocha, J. Dang, Brigitte Vanle, Benjamin Metrikin, Kaleab K. Tessema, I. Danovitch

引用次数: 0

Analysis of Hospitals Switching From a “Danger to Self” Question to Universal Columbia‐Suicide Severity Rating Scale Screening: Impact on Screenings, Identification of Suicide Risk, and Documented Psychiatric Care 从 "对自身的危险 "问题到通用哥伦比亚自杀严重程度分级表筛查的医院分析：对筛查、自杀风险识别和记录精神病护理的影响

Psychiatric research and clinical practice Pub Date : 2024-04-03 DOI: 10.1176/appi.prcp.20230068

Ellis C. Dillon, Sien Deng, Martina Li, Qiwen Huang, Ernell de Vera, Jacqueline Pesa, Tam Nguyen, Anna Kiger, Daniel F. Becker, Kristen Azar

{"title":"Analysis of Hospitals Switching From a “Danger to Self” Question to Universal Columbia‐Suicide Severity Rating Scale Screening: Impact on Screenings, Identification of Suicide Risk, and Documented Psychiatric Care","authors":"Ellis C. Dillon, Sien Deng, Martina Li, Qiwen Huang, Ernell de Vera, Jacqueline Pesa, Tam Nguyen, Anna Kiger, Daniel F. Becker, Kristen Azar","doi":"10.1176/appi.prcp.20230068","DOIUrl":"https://doi.org/10.1176/appi.prcp.20230068","url":null,"abstract":"Sutter Health launched system‐wide general population standardized suicide screening with the Columbia‐Suicide Severity Rating Scale (C‐SSRS) screen (triage) version in 23 hospitals in 2019, replacing a one‐question “danger to self” (DTS) assessment. This study analyzed the impact of C‐SSRS implementation on screening rates, positive screenings, and documented psychiatric care within 90 days for all patients and a subgroup diagnosed with Major Depressive Disorder (MDD).Adults seen at hospitals in the pre‐period (July 1, 2017−June 30, 2019) and post‐period (July 1, 2019−December 31, 2020) were identified using electronic health records. Outcomes were compared using chi‐square statistics and interrupted time series (ITS) models.Pre‐period, 92.8% (740,984/798,653) of patients were screened by DTS versus 84.6% (504,015/595,915) by C‐SSRS in the post‐period. Positive screening rates were 1.5% pre‐period and 2.2% post‐period, and 9.2% pre‐period versus 10.8% post‐period for those with MDD. Among individuals with positive screenings, 64.0% (pre‐period) had documented follow‐up psychiatric care versus 52.5% post‐period and 66.4% of those with moderate or high‐risk. Among all patients seen there was an overall increase in documentation of psychiatric care within 90 days (0.87% pre‐ to 0.96% post‐period). ITS models revealed a 9.6% decline in screening, 1.3% increase in positive screenings, and 12.9% decline in documented psychiatric care following C‐SSRS implementation (all p < 0.01).Following implementation, there was meaningful increase in suicide risk identification, and an increase in the proportion of patients with documented psychiatric care. Observed relative declines in screening warrant future research examining opportunities and barriers to general population C‐SSRS use.","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"54 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140748697","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}

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Neuroinflammatory Alterations in Treatment‐Resistant Depression Secondary to Long COVID by Repetitive Transcranial Magnetic Stimulation (rTMS): A Case Report 重复经颅磁刺激（rTMS）导致的长期 COVID 治疗耐药抑郁症的神经炎症性改变：病例报告

Psychiatric research and clinical practice Pub Date : 2024-04-01 DOI: 10.1176/appi.prcp.20230053

Shun Igarashi, Kyoji Okita, Daisuke Hayashi, Ryuichi Yamazaki, Yuki Matsuda, Takamasa Noda, Koichiro Watanabe, S. Kito

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Bring It Up: An Adapted Collaborative Care Model for Depression in a Safety‐Net Primary Care Clinic 提出来：安全网初级保健诊所针对抑郁症的改良协作护理模式

Psychiatric research and clinical practice Pub Date : 2024-01-22 DOI: 10.1176/appi.prcp.20230060

Lisa Ochoa‐Frongia, Maria E. Garcia, Tamara Bendahan, Andrea N. Ponce, Cristina Calderon, Margo Pumar, Karen Yee, Dean Schillinger, Rachel Loewy, Christina Mangurian

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Identifying Trends in Firearm Suicide Among American Indian and Alaska Native Young Men, 1999-2020. 确定 1999-2020 年美国印第安人和阿拉斯加原住民年轻男性持枪自杀的趋势。

Psychiatric research and clinical practice Pub Date : 2023-12-27 eCollection Date: 2024-01-01 DOI: 10.1176/appi.prcp.20230052

Amelia C Mueller-Williams, Mark S Kaplan

引用次数: 0