Current Psychiatry Reports最新文献

Purpose of review: We review recent research on interventions, services and supports for children on the autism spectrum, examining both advancements and setbacks.

Recent findings: Progress has included an increase in quantity and rigor of intervention science, as well as a broadening of disciplines and perspectives engaged in the examination of early interventions, including their effectiveness, social validity and the contextual determinants of implementation outcomes. Setbacks have included the decrease in research involving children on the autism spectrum who have co-occurring profound intellectual disability, minimal or no spoken language, and who require constant assistance with daily living activities. This trend is alarming because it contributes to the marginalization and unmet needs of children who need intervention the most. Additionally, access to early intervention services is unequal and complicated by the misalignment of policy with the evolving evidence base in the field. The recent growth in the depth and breadth of knowledge related to autism early intervention means that policies, practices, advocacy efforts and research directions can be grounded on a more comprehensive evidence base and societal appraisal of autism. Nevertheless, these indisputable markers of success co-exist with conflicting narratives that hinder the establishment of a cohesive agenda to tackle inequities experienced by marginalized subgroups. Reconciliation of conflicting narratives requires a nuanced and compassionate appraisal of sources of tensions and heterogeneity of needs within the autism spectrum.

Purpose of review: Here we synthesise key recent (2021-2024) research that aims to understand the experience of autistic people, both staff and students, who navigate the Higher Education (HE) environment.

Recent findings: Autistic students and staff continue to experience a lack of flexible, consistent and personalised support within the HE context, and tensions remain between the benefits of disclosure and the discrimination that may result. Significant missed opportunities remain for greater social, emotional and practical supports for autistic members of the HE community. Distinct barriers to both access and 'flourishing' for autistic people within HE remain. Personal narratives continue to describe a range of both positive and negative experiences within HE, yet it remains clear that HE may be inherently hostile in its setup, and that it takes a great deal of effort to fight against this.

Background: As the war in the Middle East intensifies, the support and well-being of healthcare practitioners (HCPs) become paramount to sustaining an effective healthcare system capable of serving the diverse Israeli population.

Methods: In collaboration with the integrative medicine (IM) team, we initiated a treatment intervention with the goal to relieve war-related HCPs concerns.

Results: This trilogy of narratives highlights the multifaceted experiences of HCPs in Israel during times of conflict. The director of internal medicine ward with his conventional medical and leadership expertise, provides stability and order. The IM practitioner offers holistic healing and care. The nurse reflects on her experience of being cared for.

Conclusions: These narratives illustrate the adaptability and resilience of healthcare professionals who navigate their roles with dedication and compassion, ensuring that amidst the strife, the human spirit remains cared for and supported.

Purpose of review: Autistic individuals experience disproportionate stigma across the life course in interpersonal, healthcare, and educational contexts. These experiences contribute to negative health and healthcare outcomes for this population. This paper seeks to describe autistic individuals' experiences of stigma and marginalization; discuss frameworks such as Campinha-Bacote's innovative concept of cultural competemility and its relevance to autistic populations; offer recommendations to healthcare providers based on this framework; and apply theory to practice in a case study.

Recent findings: Autistic individuals increasingly understand autism as an important aspect of their identity. There are, however, few culturally informed healthcare efforts that reflect this understanding. As a result, efforts to address stigma-related health disparities for this population have limited effectiveness. In this manuscript, we highlight opportunities within clinical encounters, medical training, healthcare offices and systems, and research to provide higher quality culturally informed care to autistic populations and address stigma-related health disparities.

Purposeof review: This review discusses the importance of abortion care and access for mental wellbeing for people seeking abortion, abortion providers, and trainees. The recent Dobbs v. Jackson case has jeopardized the physical and mental health of millions.

Recent findings: Much of the data regarding mental health impacts of abortion access comes from the Turnaway Study. This study supports that abortion does not cause negative mental health effects and being denied abortion is detrimental to mental health, physical health, and has negative socioeconomic impacts. Other recent studies support that the Dobbs decision continues to disproportionately harm historically marginalized groups. Additionally, there is more anxiety and depression reported in states with abortion restrictions. Many obstetrician gynecologists are moving away from restricted states and report moral distress due to restrictions. Many medical students are choosing not to apply to obstetrics and gynecology residency programs in states with abortion restrictions. Access to abortion care is important for mental and physical health, and socioeconomic well-being for people seeking abortion. Restrictive bans negatively affect people seeking abortion, as well as healthcare providers and trainees.

Purpose of review: This review includes recent literature on adverse childhood experiences (ACEs) and perinatal mental health. We summarize key findings, including meta-analytic reviews and emerging data on broad risks for psychopathology, mechanistic pathways, protective factors, and ACEs screening within clinical care contexts.

Recent findings: ACEs are associated with small to moderate risks for perinatal depression and anxiety. There is increasing evidence ACEs are also associated with other mental health concerns and transdiagnostic symptoms during pregnancy and postpartum. Possible mechanistic factors include a range of biological and psychosocial variables. Unique effects of benevolent childhood experiences (BCEs) on perinatal mental health are also notable. Continued emphasis on associations between ACEs and perinatal mental health concerns beyond depression and anxiety is needed. More empirical attention to mechanistic and protective factors, including benevolent childhood experiences, is also warranted. Although ACEs screening in clinical settings may be feasible and acceptable, implementation should occur within a healing centered engagement framework.

Purpose of review: Clinicians treating patients with borderline personality disorder (BPD) experience concerns about risk for adverse events that can lead to litigation or complaints to administrative boards. This paper's goal is to outline steps to ensure the safety of both the patient and clinician.

Recent findings: Review of available data confirms that psychiatry is a subspeciality with relatively low risk for malpractice litigation, but high risk for complaints to administrative agencies. Examination of litigation and complaints suggests that familiar challenges in work with patients with BPD are frequently cited. Risk management considerations have been impacted in recent years by changes in psychiatric training, health care delivery, and regulations about patient information transparency. Concurrently, empirically validated treatments for BPD have been refined and disseminated. Clinicians can address safety concerns by adapting established risk management guidance with an appreciation of key elements of BPD.

Purpose of the review: We review the literature and examine the impact of traumatic stress experienced by children and youth crossing the US-Mexico Border and discuss the psychological effects of trauma incurred in this population, observing various traumatic stressors and their implications on both short and long-term mental health outcomes. Additionally, we discuss existing interventions and treatment approaches while also emphasizing the need for greater awareness, new interventions, and further research.

Recent findings: Over the past several decades, there has been a significant increase in the number of undocumented youth crossing the US-Mexico border into the United States and these individuals experience various traumatic stressors throughout the pre-migration, migration, and post-migration phases. Research on these stressors and their impact on mental health, however, remain limited and access to appropriate mental health care and interventions continues to be inadequate. It is crucial to understand the impact of trauma experienced by youth crossing the US-Mexico border, as it significantly influences their mental health outcomes. Additional research and targeted mental health interventions are necessary to alleviate the disparities in care experienced by these children. Further research is needed to improve awareness and understanding of the problem, develop targeted and effective interventions, and improve overall outcomes.

Purpose of review: Cannabis sativa and constituent cannabinoids are in widespread use for the treatment of sleep disorders where many patients desire pharmacotherapy. Previous reviews highlight a lack of high-quality evidence to support the efficacy and long-term safety of cannabinoids in various conditions. We aim to provide an update of recent original research evaluating cannabinoid-based therapeutics in sleep disorders.

Recent findings: We identified twenty-one recent studies of cannabinoids for insomnia, subjective sleep impairment, obstructive sleep apnoea, rapid eye movement sleep behaviour disorder, and restless legs syndrome. We note trends towards the use of minor cannabinoids, studies using decentralised approaches and increased utilisation of objective measures in clinical trials. The evidence-base does not match widespread use of cannabinoids for the treatment of sleep disorders. There is a growing need for adequately funded well-designed clinical trials with longer treatment durations and decent sample sizes to inform both the clinician and patient.

Purpose of the review: This narrative review examines the efficacy, mechanisms and safety of mind-body medicine (MBM) in the treatment of depression. We reviewed the potential effects of various MBM interventions such as yoga, tai chi, qigong, mindfulness-based interventions and nutrition on clinical and subthreshold depressive symptoms.

Recent findings: Current studies indicate a growing interest in the use of MBM for psychiatric disorders, including depression. MBM interventions demonstrate efficacy in reducing depressive symptoms with fewer adverse effects and costs compared to pharmacological treatments. MBM has significant potential to improve mental health outcomes for depression. These interventions encourage self-care and stress management through behavioural, exercise, relaxation and nutritional approaches. While existing data are promising, further, more rigorous studies are required to confirm long-term effectiveness and to determine the role of MBM in comprehensive depression treatment strategies.