Current Opinion in Psychiatry最新文献

Purpose of review: People with mental disorders in Poland have increased standardized mortality ratios (SMRs). This is the first study to assess all-cause mortality in people with mental disorders in Poland during the COVID-19 pandemic.

Recent findings: A nationwide, register-based cohort study utilizing data from the registry of healthcare services (2011-2020) and the all-cause death registry (2021) in Poland was conducted. Individuals who were consulted or hospitalized in public mental healthcare facilities and received at least one diagnosis of mental disorders (ICD-10) from 2011 to 2020 were identified. SMRs were compared between people with a history of mental disorder and the general population. SMRs for the pandemic period were also compared with prepandemic SMRs calculated for 2019.No significant differences in SMRs were observed overall between 2021 and 2019. A minor increase in SMR was observed in 2021 for people treated only in outpatient mental health clinics. In 2021, a significant decrease in SMRs was shown for individuals with diagnoses from groups F10-F19 and F20-F29, and a significant increase in SMRs was observed for those with diagnoses from group F40-F48.

Summary: SMRs for people with any mental disorder in Poland in 2021 remained at comparable levels to those in 2019.

Purpose of review: To provide an update of systematic reviews, meta-analyses and recent clinical outcome studies for personality disorder (PD) in order to investigate the state of the art of the evidence of psychotherapy for personality disorders.

Recent findings: Few outcome studies in patients with Cluster A and Cluster C PD have been conducted, which limits the conclusions which can be drawn. Most recently published research has been conducted with borderline PD. There is limited evidence that dialectical behavior therapy (DBT), mentalization based therapy and schema therapy are more effective than treatment as usual. There is no convincing evidence that long and intensive therapy is more effective than short and less intensive therapy. Drop-out is rather high for patients with borderline PD. Group therapy results in more drop-outs than individual therapy.

Summary: There is a clear need of studies evaluating whether psychotherapies developed for PDs are more effective than CBT for patients with Cluster C PD. Given that studies with patients with Cluster B PD suggest that longer treatment of DBT and mentalization-based treatment is not more effective than shorter treatment this needs to be studied with other evidence-based therapies as well. Serious efforts are needed to evaluate therapies for patients with Cluster A PDs.

Purpose of review: Inequalities in job opportunities between urban and rural regions have driven many parents to move from rural to urban regions with aims to improve household income. Financial and political barriers prevent children from moving with their parents, meaning that their children become left-behind in rural regions. This study aims to meta-analyse the risk of drinking, smoking, illicit drug use and drunk experiences in left behind children (LBC) and non-LBC.

Recent findings: Previous studies have indicated the negative effects of prolonged parental separation on children and adolescent mental health. Parental separation and poor mental health have both been identified as proximal risk factors for substance use in adolescence.

Summary: The results indicated that LBC were at significantly greater risk of drinking, smoking, using illicit drugs, and having drunk experiences. Positive psychology interventions are required to help provide LBC with positive coping strategies against psychological distress. Policy changes to reduce inequalities in job opportunities between urban and rural regions are required to reduce the prevalence of LBC.

Purpose of review: Theoretical models of personality disorders (PDs) highlight the role of adverse childhood experiences (ACEs) in the development and maintenance of personality pathology. This review presents recent studies on the associations between childhood adversity and PDs, while discussing mechanisms and factors that impact these relationships.

Recent findings: Studies point to small to moderate associations between childhood adversity and cluster A, cluster B, and cluster C PDs, and some research suggests that childhood adversity could be a predictor for the onset and development of personality pathology. Most research focuses on borderline PD, while research on other PDs is limited. Some mechanisms that explain these associations have been proposed, with the literature investigating emotion dysregulation, dissociation, avoidance, or psychosocial dysfunction as mediators.

Summary: The consistent associations between ACEs and PDs seems to point that childhood adversity could be a transdiagnostic risk factor for PDs, but research warrants further prospective investigations for causal conclusions, and calls for future research to investigate potential mediators and moderators more thoroughly.

Purpose of review: The rapid proliferation of social media has raised concerns regarding the maladaptive use of these platforms. Individuals exhibiting specific personality traits and disorders may be particularly vulnerable to the adverse outcomes associated with social media addiction. Despite the increasing research attention this topic has received, the relationship between personality traits, personality disorders, and addiction to social media remains fragmented and unclear.

Recent findings: Research has primarily investigated the association between Big Five and Dark Triad model personality traits and social media addiction. Findings indicate that while most of the traits within the Big Five model vary in terms of significance, personality disorders and traits within the Dark Triad, which are generally associated with maladaptive thoughts and behaviors, are positively related to addictive social media use.

Summary: Personality traits and disorders play a vital role in individuals' behavior. Research shows discrepancies in the relationship between certain traits in the Big Five model and social media addiction, warranting further investigation. At the same time, research also underscores the role of social media in potentially exacerbating conditions for those with personality disorders.

Purpose of review: The immune system is of pivotal importance with regard to the development and maintenance of mental illness. Aberrant cytokine levels are significant immune markers, and research is increasingly focusing on the complement system and the gut-brain axis. The efficacy and safety of immunomodulatory interventions are currently the subject of clinical studies. Hence, this review is timeline and relevant to evaluate the latest evidence on the clinical value of immunomodulatory treatments from studies over the past 18 months in schizophrenia, bipolar disorder and unipolar depression.

Recent findings: While conventional psychotropic drugs (antidepressants, antipsychotics, lithium) appear to have immunomodulatory adverse effects, antibiotics (minocycline), nonsteroid anti-inflammatory drugs (celecoxib) and anti-inflammatory therapeutics in particular are the subject of ongoing clinical trials. Integrative medical interventions such as nutritional supplements (e.g., N -acetyl- l -cysteine, polyunsaturated fatty acids) and exercise interventions (e.g., running, yoga) are being evaluated for their immunomodulatory effects and clinical value.

Summary: No evidence-based recommendation can be made for the immunomodulatory treatment of depression, although celecoxib appears to be more effective than minocycline and omega-3 fatty acid. N -acetylcysteine (NAC) may be beneficial for the treatment of bipolar and schizophrenia disorders. However, further translational research is required to confirm these findings.

Purpose of review: Climate change, biodiversity loss, and pollution present a major threat to health. Although emphasis has been put on physical health impacts, evidence on the mental health consequences is now also accumulating quickly. Given the rapid developments in the field, this article provides an expert opinion on the emerging research.

Recent findings: Umbrella reviews are adding more high-level evidence on the associations of environmental crises and mental health. Individual studies are focusing on specific aspects of environmental crises and mental health, shedding light on potential direct links between climate change and mental health. Further studies are aiming to quantify individual burden and societal cost of the environmental crises and mental health nexus and to identify those most at risk for negative mental health outcomes. Many studies focus on eco-emotions, attempting to characterize them further, provide tools for quantification, and to determine their effect on functioning.

Summary: Although the accumulating research on the impacts of environmental change on depression and anxiety is filling important knowledge gaps, important questions remain, for example concerning the risk factors for the development of mental health disorders caused by ecological crises, tailored preventive strategies, and concerning the effects of biodiversity loss on mental health. Health systems need to further develop responses to these environmental crises.

Purpose of review: This review explores the intersection of urbanization, stress, inflammation, diet, lifestyle changes, and digital evolution as key factors influencing depression, emphasizing the necessity for integrative and evolutionary perspectives in mental health and intervention.

Recent findings: Epidemiological studies reveal a dramatic increase in common mental disorders, particularly depression, alongside parallel increases in suicide, unemployment, and divorce rates. Evolutionary perspectives suggest that mechanisms once advantageous for survival, such as stress responses and inflammatory processes, may contribute to mental health challenges in modern urban environments. Moreover, the mental health crisis among generation Z underscores the impact of digital evolution, where the shift from play-based to phone-based childhood contributes significantly to rising depression rates. Recent research highlights the significant role of omega-3 fatty acids, circadian rhythm regulation, mindfulness, and anti-inflammatory lifestyle interventions in mitigating depressive symptoms.

Summary: The interplay between our evolutionary heritage and rapid societal changes has created a "symphony" of factors contributing to depression. Understanding these evolutionary mismatches in stress responses, inflammatory processes, dietary shifts, circadian disruptions, and digitalization provides new insights into the etiology of depression. This holistic approach, conceptualized as "harmonizing the inner orchestra," offers promising avenues for prevention and treatment strategies that address the multifaceted nature of depression in our modern world.