Current Psychiatry Reports最新文献

Purpose of review: We review the published literature on children's coping in disasters, focusing on disaster type, cultural and socio-demographic influences, and the methods used to assess coping.

Recent findings: Disasters affect children and youth in diverse ways, shaped by both disaster type and broader contextual factors. Research has grown considerably over the past two decades, offering insights into adaptive and maladaptive coping in disaster contexts. However, the field remains constrained by several limitations: a lack of consensus on how coping is conceptualized in children, limited standardized measures specific to disaster contexts, and few culturally adapted tools that capture diverse coping processes across settings. A deeper understanding of children's disaster coping can be achieved by addressing gaps in definitions and tools through clearer conceptualization, culturally grounded measures, and longitudinal, multi-systems approaches. Addressing these gaps will help strengthen supports for children facing the increasing frequency and severity of disasters.

Purpose of review: Changes in youth mental health during the pandemic have been well documented globally, but research on how mental health changed when schools returned to in-person learning is just emerging. This review summarizes the available global research on child and youth mental health following school reopening for in-person learning.

Recent findings: Results varied by the mental health indicator being assessed and by subgroups of children and youth, with age-related differences, and possible gender-related influences. Some modifiable risk and protective factors examined included time spent on homework; internet and social media use; physical activity; communication/conflict with others; optimism; social relationships with family, teacher and peers; parental mental health; and inconsistent discipline. Some youth fared better when schools reopened in-person, but for others mental health challenges persisted. Mental health services shifted during the height of the pandemic, and some supports are no longer available. Continued monitoring is needed to help with recovery and resilience.

Purpose of review: Mood in bipolar disorder (BP) fluctuates in complex and unpredictable ways that resist simple explanation. To capture this complexity, researchers have turned to modeling mood dynamics. This review organizes the recent literature around three key questions: How can modeling help phenotype BP? Can models accurately predict future mood? And can modeling clarify mechanisms underlying mood instability?

Recent findings: Models of mood dynamics carry clinically relevant information beyond standard measures, differentiating BP from other disorders and reflecting treatment response and impairment. Yet their ability to forecast mood tends to deteriorate within days, raising the possibility that fleeting predictability may be intrinsic to BP, not simply a technical limitation. Mood also appears to be best represented by two or more continuous latent dimensions, with states like mania and depression appearing as loosely defined regions. However, how mood unfolds over time remains poorly understood, particularly the relative influence of internal dynamics versus external triggers. Looking ahead, two priorities stand out: applying these models in real time to support clinical and research decisions, and validating them systematically through standardized forecasting tasks and shared longitudinal datasets integrating mood and physiological data. Together, these steps can help turn modeling into a practical tool for understanding and managing mood in BP.

Purpose of review: This review considers the available research testing the efficacy of self-guided psychotherapeutic interventions in the management of affective premenstrual disorder (PMD) symptoms.

Recent findings: Recent research confirms that clinician-guided internet-delivered cognitive behavior therapy is effective for the management of PMD symptoms. There is also mounting research suggesting that self-guided psychotherapy interventions are effective for a range of mental health conditions when featuring specific design elements aimed at enhancing engagement and learning. Self-guided psychotherapeutic interventions hold promise for the treatment of PMD symptoms. Integrating such interventions within existing menstrual cycle tracking mobile applications may increase access to affordable and effective mental healthcare. Further research in this area is warranted.

Purpose of review: Members of a technical panel representing Australia, Canada, New Zealand, the UK, and the US collaborated to develop surveys designed to provide military leaders with information to guide decisions early in the COVID-19 pandemic. The goal of this paper is to provide an overview of this collaboration and a review of findings from the resulting body of work.

Recent findings: While surveys pointed to relatively favorable mental health and perceptions of leadership among military personnel early in the pandemic, these observations did not reflect the experiences of personnel deployed in COVID-19 response operations, nor were these observations reflective of later stages of the pandemic. Establishing and leveraging networks that enable the rapid development of employee surveys and sharing of results can serve as a pathway for empowering military leaders in times of crisis. Organizational support and leadership decisions are especially critical for maintaining well-being among personnel during crises.

Purpose of review: Lithium is considered to have substantial benefits and harms, which constitutes a complex clinical challenge. This article aims to cover five putative strategies to maximise the benefits of lithium therapy while concurrently minimising its harms.

Recent findings: The strategies range in terms of their evidence base. Some are supported by long-standing evidence, namely the management of some common and/or severe adverse effects. For others, we are seeing emerging research focus, particularly in the use of lithium in 'sub-therapeutic' doses. In considering gradual titration and variable dosing, as well as innovation to enhance the monitoring of lithium, there is limited evidence which is reviewed. We conclude that optimising lithium therapy is not straightforward and clearly individual patient characteristics must be thoroughly prioritised. However, a general rule for optimising can be to maintain lithium at its lowest therapeutic level for an individual patient, with close monitoring of levels and adverse effects as well as careful titration where clinically indicated.

Purpose of review: The purpose of this review is to explore the psychological effects of disasters on children and adolescents following the 20 years since Hurricane Katrina.

Recent findings: Despite widespread devastation and trauma, many youths demonstrate resilience over time. Initial rates of posttraumatic stress are high, with nearly half of youth showing elevated symptoms. Rates gradually decrease over time; however, depression, anxiety and loneliness often persist long-term. Key predictors of poor mental health included additional trauma and limited resources, while resilience is supported by coping skills and support systems. Schools play a critical role in both early detection and ongoing mental health intervention. Since Hurricane Katrina, technology has emerged as a valuable tool to reduce isolation and provide access to mental health resources. Findings highlight the importance of developmentally informed, sustained interventions that integrate schools, families, communities, and technology to foster resilience and recovery in youth post-disaster.

Purpose of review: This scoping review explores the extent and ways in which mental health assessment tools have been culturally adapted to be fit for purpose in new contexts.

Recent findings: In this review, the majority of recent studies reporting cultural adaptations were conducted in the Eastern Mediterranean, Europe, and Western Pacific. Assessment tools were adapted to 31 target languages, most frequently Arabic, Chinese, Persian and Korean. Most studies reported following a published cultural adaptation guideline; many reported overall positive validation results. Some studies reported needing to make further modifications to the adapted tool during validation and many concluded that further testing was required to increase generalisability. This review found few adaptations of mental health assessment tools for use in African and Latin American countries, representing a significant evidence gap. More research is also needed to analyse the studies' rigour and fidelity to existing adaptation guidelines and to determine the sufficiency of current recommended procedures in achieving cultural equivalence.

Purpose of review: To synthesize recent evidence on psychiatric considerations in breast cancer care, focusing on care delivery, psychotherapy, and medication management.

Recent findings: Distress and psychiatric disorders are common across the breast cancer continuum. Effective care models integrate mental health professionals into oncology settings and leverage telehealth and digital interventions. While multiple psychotherapeutic approaches are beneficial, optimal interventions for specific psychosocial concerns remain unclear. Clinical guidelines caution against combining tamoxifen with strong CYP2D6 inhibitors, though recent evidence challenges the clinical significance of this concern. Benzodiazepines can be used for chemotherapy-related side effects, including nausea and insomnia, though are associated with risk of prolonged use. Psychiatric symptoms are prevalent in breast cancer, impacting health outcomes and quality of life. Routine mental health monitoring and evidence-based psychiatric interventions are integral to care. Further research is needed to refine psychiatric care delivery and optimize interventions across all treatment phases.

Purpose of review: We review recent literature on instrumental reinforcement learning involving decision-making in anorexia nervosa (AN) to understand mechanisms underlying symptoms of AN, such as rigid pursuit of weight loss despite negative consequences.

Recent findings: Relatively consistent findings indicate worse reward- and punishment-based feedback learning in the ill and weight-recovered states that is not observed in remitted samples. Initial studies suggest decreased goal-directed learning in AN, although this needs replication. Similarly, research is needed to clarify mixed findings related to learning under changing rules and the role of fear versus avoidance learning in AN. Growing evidence supports altered reinforcement learning in AN. Most studies examined the impact of outcome valence, changing rules, and habitual vs goal-directed control on learning. Computational modeling approaches can provide nuanced characterization of cognitive processes related to reinforcement learning and contribute to precision medicine efforts that may improve outcomes.