Current Opinion in Psychiatry最新文献

Purpose of review: Using the ecological public health framework, this study aims to systematically review the risk of illicit drug use and its associated negative health outcomes relating to urbanization.

Recent findings: Previous studies have indicated that urbanization associated with increased population density drives segregation of vulnerable communities of low socioeconomic status (SES). Marginalized individuals in segregated communities have increased risk of poor mental health and illicit drug use.

Summary: The results indicated that urban-specific environmental risk factors, individual characteristics and level of social support all influenced risk of drug use, substance use disorder (SUD), overdose, and drug-use associated death. Urban environmental risk factors of economic disparity, marginalization and barriers in accessing healthcare and negative individual characteristics of low education, low income and comorbid diagnosis of mental illness significantly increased risk of drug use. In contrast, better social support reduced the risk of drug use.

Purpose of review: The prevalence of internet addiction among university students has been extensively studied worldwide, however, the findings have been mixed. This meta-analysis aimed to examine the global prevalence of internet addiction in university students and identify its potential moderators.

Recent findings: A total of 101 eligible studies, comprising 128,020 participants across 38 countries and territories, were included. The pooled global prevalence of internet addiction among university students was 41.84% [95% confidence interval (95% CI): 35.89-48.02]. Significant differences in the prevalence were observed across different income levels, regions, periods of COVID-19 pandemic, and cut-off values of the Internet Addiction Test (IAT). Sample size was negatively associated with internet addiction prevalence, while depression prevalence was positively associated with internet addiction prevalence. Male students had a significantly higher risk of internet addiction compared to female students [pooled odd ratio (OR): 1.32, 95% CI: 1.19-1.46].

Summary: This meta-analysis found that the prevalence of internet addiction was high among university students, which had increased since the COVID-19 pandemic. Screening and intervention measures to address internet addiction should prioritize students with an increased risk including male students, those from lowerincome regions and those with depression.

Purpose of review: Obesity and related metabolic disorders are extremely common in psychiatric patients, particularly in those with schizophrenia. Elucidating this link's neurobiology may inform clinicians and researchers of rational therapeutic approaches necessary to optimize clinical outcomes.

Recent findings: Current literature highlights the pivotal role of the inflammation-oxidative stress-insulin resistance loop in the pathophysiology of both metabolic and neuropsychiatric disorders. The concept of 'diabetophrenia' is put forward to highlight the overlapping neurobiological mechanisms underlying metabolic dysfunction and schizophrenia symptoms. Innovative treatments, including the combination of xanomeline with trospium and incretin-based medicines, demonstrate encouraging potential in addressing such complex health challenges.

Summary: The nuanced dynamics of chronic inflammation and psychiatric symptomatology underscore the significance of addressing both metabolic and mental health factors in a cohesive fashion while considering unique psychosocial contexts, dietary preferences, and lifestyle choices. A multidisciplinary strategy is essential for incorporating counseling, dietary interventions, behavioral therapies, and pharmacotherapy into the management of schizophrenia. The ensuing enhanced collaboration among healthcare professionals may render obsolete the prevailing siloed conceptualizations of mental disorders, opening new vistas for generating synergistic insights into the mind-body systems and leading to improved health and quality of life for patients with schizophrenia and other psychiatric conditions.

Purpose of review: There are few studies investigating the effects of urbanization on various anxiety-related conditions in specific population subgroups. This review aims to examine the effects of urbanization through the lens of population subgroups as well as anxiety disorder subtypes.

Recent findings: There was more consistent evidence suggesting that those of a younger age group and from disadvantaged backgrounds (such as lower socioeconomic status, refugee status) may be more vulnerable to posttraumatic stress disorder (PTSD). When we examined the relationship between urbanization and anxiety disorder subtype, the results were largely mixed, with some evidence for the positive association between urbanization and PTSD. Many of the recent studies had been conducted in the context of the recent coronavirus disease 2019 (COVID-19) pandemic.

Summary: The association between urbanicity and anxiety-related disorders in the various subgroups can be influenced by socio-demographic factors. Interventions and policies that aim to ameliorate the effects of urbanicity would need to identify vulnerable individuals early based on social or environmental factors. Given that the short and long-term psychological sequelae of the recent COVID-19 pandemic are still being evaluated, the inter-relationships between urbanization, external factors and specific anxiety disorders await further delineation.

Purpose of review: Nonadherence to medication is prevalent in patients with mental illness. Various factors responsible for it. As a result, there are more hospitalizations, increased risk of suicide and increased cost of care. Thus, there is a need for effective interventions to improve adherence in mentally ill patients.

Recent findings: Adherence to medication includes participation of patient in decision making. Interventions in the recent years help patients through techniques like psychoeducation, motivational interviewing and cognitive behaviour therapy. Interventions involve both patients and caregivers. There is a growing body of research about use of technology -based interventions using smart phones, various applications, digital platforms and artificial intelligence. Recent findings of research indicate that a combination of methods of intervention may be more useful in improving adherence. Some conventional interventions yield good results. Robust research is needed in the field of technology- based interventions.

Summary: Non adherence to medication leads to poorer health outcomes and hampers integration of the patient in the society. A collaborative effort of the team of healthcare providers, the patient and caregivers is the way ahead for better adherence and good quality of life.

Purpose of review: Cognitive impairment in schizophrenia (SCZ) is very common and functionally relevant, being a consistent predictor of the ability to perform critical functional skills and real-world activities, such as residential independence, self-care, productive, and social activities. These impairments are not exclusive to individuals with SCZ; they are also observed in people with bipolar disorder and other mood disorders. Here, we review recent findings in the nature, determinants, and treatment of cognitive impairments with a focus on SCZ and linkage to other closely related conditions.

Recent findings: Recent studies have identified multiple levels of similarity in cognitive functioning across psychiatric conditions and identified a number of efficacious treatments. So much successful work has taken place in training-focused treatment domains that multiple meta-analyses have catalogued the level of gains, the predictors of gains, the optimal strategies, and the durability of improvement. There is also convincing evidence for the first time of pharmacological cognitive enhancement with a mechanism that is plausible for cross-diagnostic impact.

Summary: Clinicians need to consider cognitive functioning and not just in people with SCZ. Available treatments should be considered, including suggesting computerized cognitive and skills training across the full spectrum of conditions and the lifespan. Attending to new developments in pharmacological interventions will be critical, as there is at least one very promising candidate compound approved for the general treatment of SCZ with evidence of wide-ranging benefits. Other medications are in phase 2 and 3 trials and may be approved.

Purpose of review: Worldwide efforts continue to unravel the complex pathological pathways that lead to Alzheimer's disease. The gut-brain-microbiome axis, a communication pathway between the gut, brain and microorganisms, is emerging as a potential mechanism involved in Alzheimer's disease pathogenesis. While the gut microbiome's role in Alzheimer's disease has gained significant attention, the brain microbiome remains relatively unexplored. This review summarizes the latest research on the brain microbiome in Alzheimer's disease.

Recent findings: In the past 4 years, four out of five studies have found bacteria, such as Streptococcus pneumoniae, in postmortem samples of both control and Alzheimer's disease brains, supporting the idea that the brain is not a sterile environment. Two studies report the overabundance of several bacterial phyla, including Proteobacteria and Actinomycetes, in postmortem Alzheimer's disease brains versus controls. One study reported the presence of Borrelia burgdorferi in a subset of Alzheimer's disease cases compared to controls.

Summary: Limitations and challenges persist in studying the brain microbiome, including the lack of standardized assays and data analysis methods, small sample sizes, and inconsistent use of controls for environmental microbial contamination during sample processing. Well designed studies that employ reproducible and rigorous methods are required to elucidate whether microbes are involved in the pathogenesis of Alzheimer's disease.

Purpose of this review: Land-expropriated farmers have become a large and rapidly growing subpopulation in recent decades due to China's unprecedented industrialization and urbanization. Land appropriation has detrimental effects on the mental health of land-lost farmers. However, existing studies have conflicting findings on the severity and types of psychological symptoms among land-lost farmers compared to the general population. This review presents a meta-analysis of cross-sectional studies that assessed the psychological symptoms of land-lost farmers using the Symptom Checklist-90-Revised (SCL-90-R).

Recent findings: Major Chinese- and English-language databases were searched and eight eligible studies reporting the SCL-90-R subscale scores and standard deviations among Chinese land-lost farmers were included. Meta-analysis results showed that, among land-lost farmers, phobia was the most prominent psychological symptom (Cohen's d = 0.55), followed by depression (d = 0.42), somatization (d = 0.38), anxiety (d = 0.35), interpersonal sensitivity (d = 0.29), and hostility (d = 0.25).

Summary: Chinese land-lost farmers exhibit several significant psychological symptoms, including phobia, depression, somatization, anxiety, interpersonal sensitivity, and hostility. These data suggest a pressing need to integrate mental health support into existing social services and policies aimed at assisting land-lost farmers.

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.