American Journal of Psychiatry最新文献

{"title":"Psychedelics in Psychiatry: Oh, What A Trip!","authors":"Gregory A Fonzo, Charles B Nemeroff, Ned Kalin","doi":"10.1176/appi.ajp.20241025","DOIUrl":"https://doi.org/10.1176/appi.ajp.20241025","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"182 1","pages":"1-5"},"PeriodicalIF":15.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913722","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":"Research and Implementation of Psychedelic-Assisted Therapy in the Veterans Health Administration.","authors":"Aaron S Wolfgang, Vetisha L McClair, Paula P Schnurr, Paul E Holtzheimer, Josh D Woolley, Christopher S Stauffer, R Cameron Wolf, Leith J States, David M Benedek, Vincent F Capaldi, John Bradley, Matthew A Fuller, Miriam J Smyth, Eric D A Hermes, Wendy Tenhula, Ilse R Wiechers","doi":"10.1176/appi.ajp.20240751","DOIUrl":"https://doi.org/10.1176/appi.ajp.20240751","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"182 1","pages":"17-20"},"PeriodicalIF":15.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913724","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":"Psilocybin: From Psychiatric Pariah to Perceived Panacea.","authors":"Gregory A Fonzo, Aaron S Wolfgang, Bryan R Barksdale, John H Krystal, Linda L Carpenter, Nina V Kraguljac, Adrienne Grzenda, William M McDonald, Alik S Widge, Carolyn I Rodriguez, Charles B Nemeroff","doi":"10.1176/appi.ajp.20230682","DOIUrl":"10.1176/appi.ajp.20230682","url":null,"abstract":"<p><strong>Objective: </strong>The authors critically examine the evidence base for psilocybin administered with psychological support/therapy (PST) in the treatment of psychiatric disorders and offer practical recommendations to guide future research endeavors.</p><p><strong>Methods: </strong>PubMed was searched for English-language articles from January 1998 to November 2023, using the search term \"psilocybin.\" A total of 1,449 articles were identified and screened through titles and abstracts. Of these, 21 unique open-label or randomized controlled trials (RCTs) were identified that examine psilocybin for the treatment of obsessive-compulsive and related disorders (N=2), anxiety/depression associated with a cancer diagnosis (N=5), major depressive disorder (MDD; N=8), substance use disorders (N=4), anorexia (N=1), and demoralization (i.e., hopelessness, helplessness, and poor coping) in AIDS survivors (N=1).</p><p><strong>Results: </strong>The most developed evidence base is for the treatment of MDD (three double-blind RCTs with positive signals spanning a range of severities). However, the evidence is tempered by threats to internal and external validity, including unsuccessful blinding, small samples, large variability in dosing and PST procedures, limited sample diversity, and possibly large expectancy effects. Knowledge of mechanisms of action and predictors of response is currently limited.</p><p><strong>Conclusions: </strong>The evidence is currently insufficient to recommend psilocybin with PST as a psychiatric treatment. Additional rigorously designed clinical trials are needed to definitively establish efficacy in larger and more diverse samples, address dosing considerations, improve blinding, and provide information on mechanisms of action and moderators of clinical response. Head-to-head comparisons with other evidence-based treatments will better inform the potential future role of psilocybin with PST in the treatment of major psychiatric disorders.</p>","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"182 1","pages":"54-78"},"PeriodicalIF":15.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewers for <i>The American Journal of Psychiatry</i>.","authors":"","doi":"10.1176/appi.ajp.24181012","DOIUrl":"https://doi.org/10.1176/appi.ajp.24181012","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"181 12","pages":"1131-1134"},"PeriodicalIF":15.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765616","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":"Identifying Genetically Inferred Effects Linking Posttraumatic Stress Disorder to Women's Health, Lipid Disorders, and Malaria Medications.","authors":"Gita A Pathak, Frank R Wendt, Adam X Maihofer, Kerry J Ressler, Murray B Stein, Karestan C Koenen, Caroline M Nievergelt, Renato Polimanti","doi":"10.1176/appi.ajp.20230832","DOIUrl":"10.1176/appi.ajp.20230832","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":" ","pages":"1127-1130"},"PeriodicalIF":15.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387309","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":"Discrimination Exposure, Neural Reactivity to Stress, and Psychological Distress.","authors":"Devon K Grey, Juliann B Purcell, Kristen N Buford, Mark A Schuster, Marc N Elliott, Susan Tortolero Emery, Sylvie Mrug, David C Knight","doi":"10.1176/appi.ajp.20220884","DOIUrl":"10.1176/appi.ajp.20220884","url":null,"abstract":"<p><strong>Objective: </strong>Discrimination exposure has a detrimental impact on mental health, increasing the risk of depression, anxiety, and posttraumatic stress. The impact discrimination exposure has on mental health is likely mediated by neural processes associated with emotion expression and regulation. However, the specific neural processes that mediate the relationship between discrimination exposure and mental health remain to be determined. The present study investigated the relationship adolescent discrimination exposure has with stress-elicited brain activity and mental health symptoms in young adulthood.</p><p><strong>Methods: </strong>A total of 301 participants completed the Montreal Imaging Stress Task while functional MRI data were collected. Discrimination exposure was measured four times from ages 11 to 19, and stress-elicited brain activity and psychological distress (depression, anxiety, posttraumatic stress) were assessed in young adulthood (age 20).</p><p><strong>Results: </strong>Stress-elicited dorsolateral and dorsomedial prefrontal cortex (PFC), inferior parietal lobule (IPL), and hippocampal activity varied with discrimination exposure. Activity within these brain regions varied with the cumulative amount and trajectory of discrimination exposure across adolescence (initial exposure, change in exposure, and acceleration of exposure). Depression, anxiety, and posttraumatic stress symptoms varied with discrimination exposure. Stress-elicited activity within the dorsolateral PFC and the IPL statistically mediated the relationship between discrimination exposure and psychological distress.</p><p><strong>Conclusions: </strong>The findings suggest that adolescent discrimination exposure may alter the neural response to future stressors (i.e., within regions associated with emotion expression and regulation), which may in turn modify susceptibility and resilience to psychological distress. Thus, differences in stress-elicited neural reactivity may represent an important neurobiological mechanism underlying discrimination-related mental health disparities.</p>","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":" ","pages":"1112-1126"},"PeriodicalIF":15.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543057","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":"Centering Agency and Choice in Moving Toward Social Justice in Mental Health: Reflections on Childhood Maltreatment, Psychiatric Symptoms, and Homelessness.","authors":"Ana Carolina Florence, Ezra Susser","doi":"10.1176/appi.ajp.20240956","DOIUrl":"https://doi.org/10.1176/appi.ajp.20240956","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"181 12","pages":"1039-1041"},"PeriodicalIF":15.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765580","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":"Correction to McClure et al.","authors":"","doi":"10.1176/appi.ajp.20230508correction","DOIUrl":"https://doi.org/10.1176/appi.ajp.20230508correction","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"181 12","pages":"1134"},"PeriodicalIF":15.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765586","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":"An Honest Reckoning With the Amygdala and Mental Illness.","authors":"Andrew S Fox, Alexander J Shackman","doi":"10.1176/appi.ajp.20240941","DOIUrl":"10.1176/appi.ajp.20240941","url":null,"abstract":"<p><p>Anxiety disorders are a leading source of human misery, morbidity, and premature mortality. Existing treatments are far from curative for many, underscoring the need to clarify the underlying neural mechanisms. Although many brain regions contribute, the amygdala has received the most intense scientific attention. Over the past several decades, this scrutiny has yielded a detailed understanding of amygdala function, but it has failed to produce new clinical assays, biomarkers, or cures. Rising to this urgent public health challenge demands an honest reckoning with the functional-neuroanatomical complexity of the amygdala and a shift from theories anchored on \"the amygdala\" to models centered on specific amygdala nuclei and cell types. This review begins by examining evidence from studies of rodents, monkeys, and humans for the \"canonical model,\" the idea that the amygdala plays a central role in fear- and anxiety-related states, traits, and disorders. Next, the authors selectively highlight work indicating that the canonical model, while true, is overly simplistic and fails to adequately capture the actual state of the evidentiary record, the breadth of amygdala-associated functions and illnesses, or the complexity of the amygdala's functional architecture. The authors describe the implications of these facts for basic and clinical neuroimaging research. The review concludes with some general recommendations for grappling with the complexity of the amygdala and accelerating efforts to understand and more effectively treat amygdala-related psychopathology.</p>","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"181 12","pages":"1059-1075"},"PeriodicalIF":15.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance and Limitations of Null Findings.","authors":"Dan J Stein, Jack van Honk, Paul M Thompson","doi":"10.1176/appi.ajp.20240957","DOIUrl":"https://doi.org/10.1176/appi.ajp.20240957","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"181 12","pages":"1033-1035"},"PeriodicalIF":15.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765620","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}