Current Psychiatry Reports最新文献

Purpose of review: In this narrative review, we discuss evidence for psilocybin- and LSD-assisted treatment of alcohol use disorder (AUD) and major depressive disorder (MDD). We describe limitations of psychedelic research and posit methodological considerations when designing a trial in patients with both disorders.

Recent findings: In AUD, a growing evidence base for psilocybin treatment shows a promising beneficial and sustained effect on measures of drinking frequency. In MDD, a recent meta-analysis has demonstrated that psilocybin therapy provides a large and consistent reduction in depressive symptoms compared to no treatment. Co-occurrence of MDD and AUD is quite prevalent, and this comorbidity exacerbates symptomatology of the two individual disorders and complicates their treatment. Theoretically, patients presenting with both AUD and MDD would benefit from an integrated therapy that could treat MDD and AUD simultaneously. We believe that more research into the efficacy of psilocybin in patients with both AUD and MDD is warranted and justified.

Purpose of review: This review aims at reporting the current evidence of the impact of COVID-19 pandemic on grief in children.

Recent findings: Evidence from the scientific literature shows that the severity of grief in children is impacted by numerous risk factors which can lead to prolonged grief disorder (PGD). Among these risk factors are the unpredictability of the death, the lack of understanding about what is happening by the child, the global insecurity raised by the context of the pandemic or again the impossibility for the child to find comfort with his peers due to the lock-down. No medical-based approach has proven efficient on PGD in children. However, cognitive based therapy can lower the severity of the symptoms. Future efforts should focus on developing therapeutic strategies to specifically fit the needs of children with PGD, in the context of a major crisis such as this pandemic.

Purpose of review: The purpose of the current review was to detail changes in children's diet, eating behavior, and weight in the context of the COVID-19 pandemic.

Recent findings: Global changes in children's diets and eating behavior occurred during the pandemic. Both undernutrition and obesity were prominent concerns. Obese children and those from low socioeconomic status families were particularly vulnerable. The COVID-19 pandemic increased longstanding global concern about child nutrition, both undernutrition and obesity. The pandemic and extended home confinement were associated with changes in children's food consumption, eating behavior, and ultimately weight. These changes were related to factors beyond food intake itself and included decreased physical activity, altered routines and schedules, sleep behaviors, and social concerns, among others. The findings have implications for both public health and clinical practice.

Purpose of review: Substance use among adolescents and young adults remains a critical public health concern, with patterns shifting dramatically in recent years. This narrative review examines trends in substance use behaviors during and following the COVID-19 pandemic.

Recent findings: Epidemiologic evidence shows declines in the proportion of youth who are using most substances but intensified consumption patterns with rising levels of disorder among adolescents who use substances. This picture may reflect the greater potency, availability and accessibility of substances, vulnerabilities related to poor mental health, minoritization, as well as social factors including pandemic stressors, commercial and regulatory forces - in short, features of the agent (substance), host (person), and environment (context), consistent with a public health formulation. Understanding trends in youth substance use and related problems, especially in the context of contributing factors, is critical for informing clinical care strategies and public health interventions to improve outcomes for youth across diverse populations.

Purpose of review: This review aims to evaluate the current psychiatric applications and limitations of machine learning (ML), defined as techniques used to train algorithms to improve performance at a task based on data. The review emphasizes the clinician's role in ensuring equitable and effective patient care and seeks to inform mental health providers about the importance of clinician involvement in these technologies.

Recent findings: ML in psychiatry has advanced through electronic health record integration, disease phenotyping, and remote monitoring through mobile applications. However, these applications face challenges related to health equity, privacy, translation to practice, and validation. Clinicians play crucial roles in ensuring data quality, mitigating biases, promoting algorithm transparency, guiding clinical implementation, and advocating for ethical and patient-centered use of ML tools. Clinicians are essential in addressing the challenges of ML, ensuring its ethical application, and promoting equitable care, thus improving the effectiveness of ML in practice.

Purpose of review: This article critically reviews the impact of Social and Emotional Learning (SEL) on traumatized children's academic and social outcomes, focusing on studies from the past three years across diverse contexts. It emphasizes the need for culturally sensitive, trauma-informed programs that cater to various settings, while also exploring the critical roles of parents and educators in SEL implementation. Additionally, the paper highlights challenges in deploying SEL in crisis-affected regions and offers strategies to address systemic barriers.

Recent findings: Recent studies show that SEL interventions significantly foster emotional regulation, resilience, empathy, and social integration, vital for personal well-being and successful social adaptation. However, the effect of SEL on academic performance, particularly in literacy and numeracy, remains inconsistent. Cultural adaptation of SEL programs is critical to their success, especially in non-Western settings, with a growing focus on trauma-informed approaches to address the needs of children affected by crises, including the COVID-19 pandemic. Despite these benefits, challenges such as resource limitations, lack of policy support, and the need for educator training continue to impede effective SEL implementation. SEL offers a vital framework for supporting traumatized children, particularly in crisis-affected regions. This review explores five key themes: the enhancement of emotional regulation and social integration, the necessity of cultural adaptation, the involvement of parents and educators, the challenges of implementing SEL in crisis contexts, and the importance of developing trauma-informed policies. The article also identifies future research directions, emphasizing the need for systemic reforms and culturally adapted SEL models.

Purpose of review: Newborns and infants in the neonatal intensive care unit (NICU) may be at uniquely high risk of developing delirium. Because there is a dearth of NICU-focused literature, providers must rely on evidence derived from older children and infants in other care settings to guide management. The literature was rigorously reviewed to highlight evidence specific to newborns and infants and is summarized here.

Recent findings: Delirium likely occurs in newborns and infants at similar or higher rates than what is seen in other care settings. Recent literature calls particular attention to the lack of assessment tools validated in a NICU setting. Evidence for the evaluation and management of delirium in the NICU is lacking. More study specific to the NICU is needed to build consensus toward best practice.

Purpose of review: This review summarizes recent advances in research on the neurobiology of borderline personality disorder (BPD) according to structural brain imaging investigations and resting-state and task-based functional brain activation studies.

Recent findings: Extending established findings on differences in regional brain volumes and cortical thickness between BPD and healthy controls, recent research illuminates shared and distinct brain structural characteristics compared to other psychiatric diagnoses, and uncovers relations of these brain structures with transdiagnostic symptoms and clinical features. Resting-state functional brain imaging studies reveal disruptions among adolescents and adults with BPD in frontolimbic and default-mode networks, which primarily underlie affect regulation and self-referential processes, respectively. Recent task-based functional brain imaging research builds on existing neurobiological understanding of emotion and cognition in BPD by revealing novel intersections with interpersonal- and stress-related processes. Studies of psychological and pharmacological interventions suggest possible effects on neural regions underlying emotion processing and behavioral control. Recent advances in neurobiological research on BPD underscore the pathophysiology of affective, behavioral and self-interpersonal symptoms, with growing interest in adolescents with BPD and the impacts of psychological and biological interventions. Corresponding with the increased prominence of alternative dimensional models of personality disorder in recent years, there is a gradual rise in studies examining the relationships of brain structures and functional brain activation with BPD-relevant symptom dimensions, including within transdiagnostic samples.

In this narrative essay, a traditional Chinese medicine (TCM) practitioner describes the challenge of treating three survivors of a terror attack, all of whom were presenting various symptoms of acute stress disorder (ASD). Working in new and exceptionally demanding circumstances - with thousands of people injured in an extensive and direct terror attack, with relatives taken hostages and entire communities evacuated from their homes - the practitioner looked for an effective treatment strategy to alleviate symptoms of stress response. He found it in the interface between TCM and the function of the autonomic nervous system.