Current Psychiatry Reports最新文献

Purpose of review: This systematic review explores the relationship between personality disorders (PDs) and lethal suicide behavior. Following PRISMA guidelines, the study examines psychological autopsy studies with suicide deaths and identified PDs. Inclusion criteria encompass studies using the psychological autopsy method, reporting PD diagnosis and suicide deaths, in English language and with no temporal restrictions. The search strategy, conducted in PubMed and Embase until December 2nd, 2023, utilized specific terms related to suicide, PD, and psychological autopsy. Quality assessment using the Newcastle Ottawa-Scale for case-control studies was employed.

Recent findings: 56 psychological autopsy studies were included in the systematic review, revealing a prevalence of PDs among suicide deaths, and emphasizing their role as significant suicide risk factors. The review underscores the impact of comorbid PDs and Axis I disorders on suicide risk, particularly if additional stressors are present. Gender differences in PD prevalence are noted, with impulsivity and alcohol abuse identified as universal risk factors. Despite extensive global data collection, limitations include potential methodological variations and biases inherent in psychological autopsy studies. This study, registered in PROSPERO (CRD42022322359), contributes essential insights into the prevalence, characteristics, and risk factors of PDs among suicide deaths.

Purpose of the review: Peripartum depression (PPD), including both depression during pregnancy and postpartum, is the most frequent health disorder during the perinatal period. It is a significant public health issue in many countries due to its prevalence and its impact on women, as well as on their partners and offspring. Here, we will attempt to untangle the most recent studies and publications, considering what it is essential to know in 2024 about PPD as a specific perinatal issue.

Recent findings: PPD appears to be a very heterogeneous disorder in which a complex interplay between different factors contributes to its pathophysiology. Thus, the need to enhance diagnosis and referral through a better understanding of its severity and co-morbidities has emerged as a major public health issue. Indeed, research has consistently shown that PPD negatively impacts parent-infant interactions and infants' cognitive, social, and emotional development. Evidence underlining its global risk has accumulated over the past three decades, but many questions remain, including how these vulnerable offspring developmental trajectories unfold.

Purpose of review: This is a critical review of English language literature (January 2023-June 2024) on psychological trauma amongst forcibly displaced migrant women. The Mental Health and Psychosocial Support (MHPSS) Framework was used to organize multi-layered mental health interventions.

Recent findings: Findings indicate many promising community-based interventions, often delivered by trained lay facilitators. Interventions address: upstream drivers of mental health such as empowerment and economic security, group-based care focused on social connection and well-being, and trauma focused treatment such as Mindfulness Based Interventions, Cognitive Processing Therapy, and Culturally Adapted Cognitive Behavioral Therapy. The variety of (primarily short-term) interventions must be complemented by longitudinal evaluation. Clinicians and care systems should partner with those delivering psychosocial interventions outside of clinical settings. Continued research on the impacts of cumulative and intergenerational trauma amongst refugee women, and intervention research that centers the experiences of marginalized groups (e.g., sexual and gender minority refugees) is needed.

Purpose of review: We evaluated the impact of digital mental health interventions (DMHIs) for college students. We organized findings using the RE-AIM framework to include reach, effectiveness, adoption, implementation, and maintenance.

Recent findings: We conducted a systematic literature review of recent findings from 2019-2024. Our search identified 2,701 articles, of which 95 met inclusion criteria. In the reach domain, student samples were overwhelmingly female and White. In the effectiveness domain, over 80% of DMHIs were effective or partially effective at reducing their primary outcome. In the adoption domain, studies reported modest uptake for DMHIs. In the implementation and maintenance domains, studies reported high adherence rates to DMHI content. While recruitment methods were commonly reported, adaptations and costs of implementation and maintenance were rarely reported. DMHIs for college students are effective for many psychological outcomes. Future work should address diversifying samples and considering implementation in a variety of college settings.

Purpose of review: We review prevalence, etiology, impact on treatment, and best practices for treatment of posttraumatic stress disorder (PTSD) in a substance use disorder (SUD) treatment setting. Recommendations are given related to screening, assessment, and symptom monitoring.

Recent findings: PTSD and SUDs are highly comorbid. This comorbidity is associated with higher acuity, more difficulty completing treatment, and worse prognosis. Integrated treatment is recommended, and trauma-focused psychotherapies combined with pharmacotherapy show particular promise. PTSD is highly prevalent in substance using samples, negatively impacting treatment course and worsening prognosis. This comorbidity has been explained by a variety of models, with self-medication having garnered the most support. Trauma-focused psychotherapies combined with pharmacotherapy demonstrate the most efficacy and are recommended when treating co-occurring SUDs and PTSD. Specifically, prolonged exposure (PE), concurrent treatment of PTSD and SUDs using PE (COPE), and cognitive processing therapy (CPT) have been seen as promising trauma-focused treatments. Investigations into ways to best augment therapy are also underway, both through treatment format and neuromodulation. Several recommendations are given.

Purpose of review: With the growing body of research examining the link between sleep disorders, including insomnia and obstructive sleep apnea (OSA), and the gut microbiome, this review seeks to offer a thorough overview of the most significant findings in this emerging field.

Recent findings: Current evidence suggests a complex association between imbalances in the gut microbiome, insomnia, and OSA, with potential reciprocal interactions that may influence each other. Notably, specific gut microbiome species, whether over- or under-abundant, have been associated with variation in both sleep and mood in patients diagnosed with, e.g., major depressive disorder or bipolar disorder. Further studies are needed to explore the potential of targeting the gut microbiome as a therapeutic approach for insomnia and its possible effects on mood. The variability in current scientific literature highlights the importance of establishing standardized research methodologies.

Purpose of review: This review synthetizes findings reflecting the increasing racial and ethnic inequities in opioid overdose mortality and emphasizes the necessity for tailored interventions as well as other policy-level and structural strategies to stem this trend.

Recent findings: Factors contributing to inequities in overdose mortality include changes in drug supply, persistent social-structural vulnerabilities stemming from structural racism, and inequities in access to medication for opioid use disorder and harm reduction services. Key strategies to address these inequities include the cultural adaptation of evidence-based interventions within an equity-based framework, integrating social determinants of health into addiction treatment, centering anti-racism praxis in addiction research, diversifying the addiction workforce, and integrating structural competency as a tool to restructure education and inform practice. Structural racism must be recognized as a key driver of inequities in substance use outcomes, and this understanding must be integrated into existing models of substance use disorder prevention, treatment, and research.

Purpose of review: This review aims to provide an updated overview of trends in firearm- related deaths, the mental health impact on communities, and clinical and legislative interventions. We examine existing interventions and highlight lesser-known yet impactful strategies, such as incorporating appropriate training in medical education on firearm safety. Additionally, we explore the broader impacts of firearm violence on community mental health and address the disputed topic of whether mental illness is a driving factor behind mass shootings.

Recent findings: The rate of firearm suicides has continued to grow in the United States, even as firearm homicides have slightly declined. While the media often attributes mass shootings to the perpetrator having a mental illness, research indicates such symptoms only account for a small subset of shooters. Recent studies highlight the benefits of incorporating firearm safety into professional medical education, which can reduce barriers for healthcare providers when discussing safe storage practices with patients. While suicide risk is frequently assessed among individuals with mental illnesses due to their heightened risk, other factors should be considered by all clinicians, not just those in mental health. Similarly, certain mental health symptoms may play a role in a small fraction of gun violence, but other risk factors account for most violence risk. Despite the implementation of firearm restriction laws and increased access to mental health resources, gaps remain that must be addressed to reduce not only the rate of suicide by firearm, but also the mental burden the aftermath has on the community.

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.