American Journal of Psychiatry最新文献

{"title":"Using Genetically Diverse Rats to Identify Individual Differences in Addiction-Related Behaviors and Brain Activity.","authors":"Ginevra D'Ottavio, Kenichiro Negishi, Yavin Shaham","doi":"10.1176/appi.ajp.20241030","DOIUrl":"https://doi.org/10.1176/appi.ajp.20241030","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"182 2","pages":"145-148"},"PeriodicalIF":15.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Advances in Behavioral Addictions: From Fundamental Research to Clinical Practice.","authors":"Matthias Brand, Stephanie Antons, Beata Bőthe, Zsolt Demetrovics, Naomi A Fineberg, Susana Jimenez-Murcia, Daniel L King, Gemma Mestre-Bach, Tania Moretta, Astrid Müller, Elisa Wegmann, Marc N Potenza","doi":"10.1176/appi.ajp.20240092","DOIUrl":"10.1176/appi.ajp.20240092","url":null,"abstract":"<p><p>Gambling disorder is the only behavioral addiction recognized as a clinical disorder in DSM-5, and Internet gaming disorder is included as a condition requiring further research. ICD-11 categorizes gambling and gaming disorders as disorders due to addictive behaviors. Additional behavioral addictions may include compulsive sexual behavior disorder, compulsive buying-shopping disorder, and problematic use of social media. This narrative review summarizes the current state of knowledge regarding these five (potential) disorders due to addictive behaviors. All five (potential) disorders are clinically relevant and prevalent. Behavioral addictions frequently co-occur with other mental and behavioral problems, such as depression, anxiety, and attention deficit hyperactivity disorder. Validated diagnostic instruments exist, with empirical support varying across conditions. No medications have approved indications from regulatory bodies for behavioral addictions, and cognitive-behavioral therapy has the most empirical support for efficacious treatment. Given that behavioral addictions are prevalent, frequently co-occur with psychiatric disorders, may often go undiagnosed and untreated, and have been linked to poorer treatment outcomes, active screening and treatment are indicated. Public health considerations should be expanded, and impacts of modern technologies should be investigated more intensively. Treatment optimization involving pharmacotherapy, psychotherapy, neuromodulation, and their combination warrants additional investigation.</p>","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":" ","pages":"155-163"},"PeriodicalIF":15.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Varenicline, Bupropion, Nicotine Patch, and Placebo on Treating Smoking Among Persons With Current or Past Major Depressive Disorder: Secondary Analysis of a Double-Blind, Randomized, Placebo-Controlled Trial.","authors":"George Kypriotakis, Paul M Cinciripini, Charles E Green, David Lawrence, Robert M Anthenelli, Jennifer A Minnix, Diane Beneventi, Chad Morris, Maher Karam-Hage, Janice A Blalock","doi":"10.1176/appi.ajp.20230855","DOIUrl":"10.1176/appi.ajp.20230855","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to compare the safety and efficacy of the leading smoking cessation medications among individuals with current versus past major depressive disorder (MDD).</p><p><strong>Methods: </strong>This was a secondary analysis of a randomized, double-blind trial over 12 weeks with varenicline or bupropion, followed by a 12-week assessment, in participants ages 18-75 with past (N=2,174) or current (N=451) MDD or without psychiatric disorders (N=4,028). Interventions included 12 weeks of pharmacotherapy with placebo, nicotine replacement therapy (NRT; nicotine patch), bupropion, or varenicline, and brief counseling. The primary safety outcome was occurrence of one or more moderate to severe neuropsychiatric adverse events. Efficacy was assessed as biochemically verified continuous abstinence during weeks 9-12.</p><p><strong>Results: </strong>Among all 6,653 participants, the risk of neuropsychiatric adverse events did not differ by medication within the past-MDD, current-MDD, or nonpsychiatric cohorts. The MDD cohorts had higher risk difference (p<0.001) for neuropsychiatric adverse events compared with the nonpsychiatric cohort (past-MDD cohort, risk difference=-0.03, 95% CI=-0.05, -0.02; current-MDD cohort, risk difference=-0.02, 95% CI=-0.05, 0.00). Within the past-MDD cohort, the odds ratios compared with placebo were 3.0 (95% CI=2.0, 4.5) for varenicline, 2.1 (95% CI=1.6, 2.7) for bupropion, and 2.1 (95% CI=1.4, 3.2) for NRT. Within the current-MDD cohort, varenicline differed from placebo (odds ratio=2.67, 95% CI=1.2, 6.15) and NRT (odds ratio=2.93, 95% CI=1.2, 7.2).</p><p><strong>Conclusions: </strong>All medications were generally safe in both MDD cohorts. NRT and bupropion were not more effective than placebo for those with current MDD. Varenicline plus counseling may be the best treatment for individuals with past or current MDD, given its greater efficacy, similar risk of adverse events, and, for those with current depression, reductions in anxiety and depression while trying to quit smoking.</p>","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":" ","pages":"174-186"},"PeriodicalIF":15.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correcting Overestimations in Self-Harm Visit Data.","authors":"Abid Rizvi","doi":"10.1176/appi.ajp.20240577","DOIUrl":"https://doi.org/10.1176/appi.ajp.20240577","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"182 2","pages":"219"},"PeriodicalIF":15.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco Use Is Associated With Mental Illness and Substance Use Problems-Now What?","authors":"Judith J Prochaska","doi":"10.1176/appi.ajp.20241089","DOIUrl":"https://doi.org/10.1176/appi.ajp.20241089","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"182 2","pages":"137-138"},"PeriodicalIF":15.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights From the Residents' Journal: December 2024.","authors":"","doi":"10.1176/appi.ajp.25182002","DOIUrl":"https://doi.org/10.1176/appi.ajp.25182002","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"182 2","pages":"221"},"PeriodicalIF":15.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Associations Between Tobacco Product Use and Mental Health and Substance Use Problems Among U.S. Adolescents and Adults.","authors":"Kevin P Conway, Emmanuella Michel, Sam Eig, Jian-Ping He, Kathleen R Merikangas","doi":"10.1176/appi.ajp.20230988","DOIUrl":"https://doi.org/10.1176/appi.ajp.20230988","url":null,"abstract":"<p><strong>Objective: </strong>The authors examined prospective associations between tobacco product use and mental health and substance use problems among U.S. adolescents and adults.</p><p><strong>Methods: </strong>Covariate-adjusted models using discrete-time survival analysis of five annual waves (2013-2014 to 2018-2019) were used to examine the links between specific tobacco product use and mental health and substance use problems among adolescent and adult participants in the nationally representative Population Assessment of Tobacco and Health study. The sample included up to 32,320 adults and 13,651 adolescents.</p><p><strong>Results: </strong>Among adolescents, externalizing problems predicted cigarette, electronic nicotine delivery system (ENDS), and hookah use. Sex-specific findings were found for female subjects (internalizing problems predicted cigarette, ENDS, and cigar use) and male subjects (externalizing problems predicted cigar and smokeless tobacco use). Among adults, cigarette use predicted internalizing and externalizing problems; ENDS use was associated bidirectionally with internalizing problems. Across age groups, use of each tobacco product predicted substance use problems, and substance use problems predicted ENDS use.</p><p><strong>Conclusions: </strong>Intervening when mental health problems are seen among adolescents may minimize tobacco uptake. Likewise, preventing tobacco use may curtail substance use problems, and treatment of substance use problems may reduce tobacco use. Findings highlight the critical need to incorporate the bidirectionality among mental health, tobacco use, and substance use into prevention and treatment efforts.</p>","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"182 2","pages":"164-173"},"PeriodicalIF":15.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco, Alcohol, Heroin, Binge Eating, and Behavioral Addictions.","authors":"Ned H Kalin","doi":"10.1176/appi.ajp.20241111","DOIUrl":"https://doi.org/10.1176/appi.ajp.20241111","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"182 2","pages":"133-136"},"PeriodicalIF":15.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Varenicline as a First-Line Treatment for Individuals With Current Major Depressive Disorder Who Smoke Cigarettes.","authors":"Andrea H Weinberger, Marc L Steinberg","doi":"10.1176/appi.ajp.20241064","DOIUrl":"https://doi.org/10.1176/appi.ajp.20241064","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"182 2","pages":"139-141"},"PeriodicalIF":15.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct Behavioral Profiles and Neuronal Correlates of Heroin Vulnerability Versus Resiliency in a Multi-Symptomatic Model of Heroin Use Disorder in Rats.","authors":"Brittany N Kuhn, Nazzareno Cannella, Ayteria D Crow, Veronica Lunerti, Arkobrato Gupta, Stephen J Walterhouse, Carter Allen, Reda M Chalhoub, Eric Dereschewitz, Analyse T Roberts, Mackenzie Cockerham, Angela Beeson, Rusty W Nall, Abraham A Palmer, Gary Hardiman, Leah C Solberg Woods, Dongjun Chung, Roberto Ciccocioppo, Peter W Kalivas","doi":"10.1176/appi.ajp.20230623","DOIUrl":"10.1176/appi.ajp.20230623","url":null,"abstract":"<p><strong>Objective: </strong>The behavioral and diagnostic heterogeneity within the opioid use disorder (OUD) diagnosis is not readily captured in current animal models, limiting the translational relevance of the mechanistic research that is conducted in experimental animals. The authors hypothesized that a nonlinear clustering of OUD-like behavioral traits would capture population heterogeneity and yield subpopulations of OUD vulnerable rats with distinct behavioral and neurocircuit profiles.</p><p><strong>Methods: </strong>Over 900 male and female heterogeneous stock rats, a line capturing genetic and behavioral heterogeneity present in humans, were assessed for several measures of heroin use and rewarded and non-rewarded seeking behaviors. A nonlinear stochastic block model clustering analysis was used to assign rats to OUD vulnerable, intermediate, and resilient clusters. Additional behavioral tests and circuit analyses using c-fos protein activation were conducted on the vulnerable and resilient subpopulations.</p><p><strong>Results: </strong>OUD vulnerable rats exhibited greater heroin taking and seeking behaviors relative to those in the intermediate and resilient clusters. Akin to human OUD diagnosis, further vulnerable rat subclustering revealed subpopulations with different combinations of behavioral traits, including sex differences. Lastly, heroin cue-induced neuronal patterns of circuit activation differed between resilient and vulnerable phenotypes. Behavioral sex differences were recapitulated in patterns of circuitry activation, including preferential engagement of extended amygdala stress circuitry in males and cortico-striatal drug cue-seeking circuitry in females.</p><p><strong>Conclusion: </strong>Using a nonlinear clustering approach in rats, the analysis captured behavioral diagnostic heterogeneity reflective of human OUD diagnosis. OUD vulnerability and resiliency were associated with distinct neuronal activation patterns, posing this approach as a translational tool in assessing neurobiological mechanisms underpinning OUD.</p>","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":" ","pages":"198-208"},"PeriodicalIF":15.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}