American Journal of Psychiatry最新文献

{"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":"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":"Correcting Overestimations in Self-Harm Visit Data: Response From Bommersbach and Colleagues.","authors":"Tanner J Bommersbach, Mark Olfson, Taeho Greg Rhee","doi":"10.1176/appi.ajp.20240577r","DOIUrl":"https://doi.org/10.1176/appi.ajp.20240577r","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"182 2","pages":"219-220"},"PeriodicalIF":15.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073350","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}

{"title":"2024 Articles of Import and Impact.","authors":"","doi":"10.1176/appi.ajp.25182001","DOIUrl":"https://doi.org/10.1176/appi.ajp.25182001","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"182 2","pages":"151-154"},"PeriodicalIF":15.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073339","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":"Esketamine Treatment for Depression in Adults: A PRISMA Systematic Review and Meta-Analysis.","authors":"Konstantinos N Fountoulakis,Athanasios Saitis,Alan F Schatzberg","doi":"10.1176/appi.ajp.20240515","DOIUrl":"https://doi.org/10.1176/appi.ajp.20240515","url":null,"abstract":"OBJECTIVEIntranasal esketamine has been approved as an adjunctive therapy for treatment-resistant major depressive disorder with acute suicidal ideation and behavior. The authors conducted a systematic review and meta-analysis of the available data on its efficacy against depression and suicidality as well as its side effects.METHODSMEDLINE was searched with the keyword \"esketamine\" on March 24, 2024, using the PRISMA method. Data processing and statistical analysis were performed with R, version 4.3.3, and the meta-analysis was performed with the METAFOR package.RESULTSOf 1,115 articles initially identified, 87 were included for analysis and discussion. At weeks 2-4, randomized controlled trials were mostly negative or failed; however, the meta-analysis returned a weak but significant positive effect for depression (effect size range, 0.15-0.23 at weeks 2-4), similar to augmentation strategies with atypical antipsychotics for treatment-resistant depression. The effect size concerning suicidality was not significant at any time point. The sensitivity analysis produced the same results.CONCLUSIONSThe study findings suggest that esketamine's efficacy as an add-on to antidepressants is modest in treatment-resistant depression (similar to augmentation strategies with atypical antipsychotics) and is absent against suicidality itself. These findings need to be considered in light of esketamine's abuse potential and the fact that long-term effects are still not fully known. Some alarming signs concerning deaths and emerging suicidality during the testing phase are discussed, along with other regulatory issues.","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"11 1","pages":"appiajp20240515"},"PeriodicalIF":17.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056697","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":"Randomized Controlled Trial of the Effects of High-Dose Ondansetron on Clinical Symptoms and Brain Connectivity in Obsessive-Compulsive and Tic Disorders.","authors":"Emily R Stern,Katherine A Collins,Laura B Bragdon,Goi Khia Eng,Nicolette Recchia,Barbara J Coffey,Evan Leibu,James W Murrough,Russell H Tobe,Dan V Iosifescu,Katherine E Burdick,Wayne K Goodman","doi":"10.1176/appi.ajp.20240294","DOIUrl":"https://doi.org/10.1176/appi.ajp.20240294","url":null,"abstract":"OBJECTIVESensory phenomena (SP) are aversive sensations driving repetitive behaviors in obsessive-compulsive disorder (OCD) and Tourette's disorder that are not well addressed by standard treatments. SP are related to the functioning of an interoceptive-sensorimotor circuit that may be modulated by the 5-HT3 receptor antagonist ondansetron. The present study employed an experimental medicine approach to test the effects of 4 weeks of high-dose ondansetron compared to placebo on SP severity and brain connectivity in a cohort of individuals with OCD and/or Tourette's disorder.METHODSOf 51 participants who completed the study, 27 were assigned to receive 24 mg/day of ondansetron and 24 to receive placebo. Analyses examined changes in SP severity and, for participants with OCD, overall OCD severity from baseline to final visit. Functional MRI data were collected at both visits for analysis of intrinsic functional connectivity metrics characterizing global correlation (reflecting area \"hubness\") and local correlation (reflecting near-neighbor coherence).RESULTSThere were no significant differences between ondansetron and placebo in the reduction of SP or overall OCD severity in the full sample. In a subsample of participants with OCD taking concomitant serotonin reuptake inhibitors (SRIs), ondansetron was associated with a significant decrease in overall OCD severity and global connectivity of the medial sensorimotor cortex compared with placebo. Longitudinal reductions in SP severity were related to decreases in right sensorimotor hubness in both groups, and to brainstem local coherence only in participants taking ondansetron.CONCLUSIONSThere was no effect of high-dose ondansetron on SP. However, when used as an augmentation to SRIs, ondansetron reduced overall OCD severity, which may be related to changes in the \"hubness\" of the sensorimotor cortex. Ondansetron's ability to modulate brainstem connectivity may underlie its variable effectiveness in reducing SP.","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"11 1","pages":"appiajp20240294"},"PeriodicalIF":17.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056705","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":"Spaced Transcranial Direct Current Stimulation for Major Depression.","authors":"Maxime Couture,Véronique Desbeaumes Jodoin,Emma Bousseau,Arash Sarshoghi,Michael A Nitsche,Daniel M Blumberger,Chantal Bolduc,Cory R Weissman,Lawrence G Appelbaum,Zafiris J Daskalakis,Mohsen Poorganji,Paul Lespérance,Jean-Philippe Miron","doi":"10.1176/appi.ajp.20240083","DOIUrl":"https://doi.org/10.1176/appi.ajp.20240083","url":null,"abstract":"OBJECTIVEThis study investigated spaced transcranial direct current stimulation for major depressive disorder, focusing on feasibility.METHODSIn a prospective open-label study, 30 participants with major depressive disorder were enrolled to receive a 50-session transcranial direct current stimulation (tDCS) treatment over 2 weeks. The feasibility, safety, tolerability, and preliminary therapeutic effects of this tDCS protocol were assessed using the 17-item Hamilton Depression Rating Scale (HAM-D-17) and the Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline and 1-week and 4-week follow-ups, as well as with the 6-item HAM-D (HAM-D-6) daily during treatment.RESULTSThe protocol demonstrated good feasibility, with a retention rate of 93.3% and an adherence rate of 99.7%. There were no serious adverse events. The most common side effect was a mild tingling and itching sensation during stimulation (100%) and temporary skin redness following stimulation (100%). Additionally, 64.3% of participants presented with mild irritative contact dermatitis, which had disappeared by the 1-week follow-up for most participants and completely resolved by the 4-week follow-up for the remaining cases; this was not treatment limiting and did not require specific treatment. HAM-D-17 scores decreased from a mean of 21.3 (SD=3.0) at baseline to 15.3 (SD=6.3) at 1 week and 13.2 (SD=7.1) at 4 weeks. Depressive symptom severity, as measured by the HAM-D-17, showed significant reductions over time, with similar trends observed on the MADRS. HAM-D-6 scores highlighted important differences between response groups, particularly during the later stages of treatment, suggesting a potential for differential response patterns between the 1-week and 4-week follow-ups.CONCLUSIONSThe protocol was feasible, safe, and well-tolerated and led to significant reductions in depressive symptoms. These results will need to be validated in a sham-controlled randomized trial. The inclusion of neurophysiological measures in future trials for purposes of biological target engagement might also contribute to our understanding of underlying mechanisms and biomarker discovery.","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"39 1","pages":"appiajp20240083"},"PeriodicalIF":17.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056704","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}