Current Psychiatry Reports最新文献

Purpose of review: Binge-eating disorder (BED) is associated strongly with obesity and heightened rates of psychiatric, somatic, and psychosocial/functional impairments. BED is infrequently diagnosed or treated with empirically-supported interventions. This review covers weight management interventions for BED, with a specific focus on clinician-led behavioral lifestyle and/or pharmacological treatments; self-directed "dieting" and inappropriate weight-loss approaches are not considered.

Recent findings: Emerging research has provided further empirical support for behavioral lifestyle weight management (BLWM) for patients with BED at higher weights. Rigorous trials have reported outcomes that approximate those of specialist treatments such as CBT for reducing binge-eating and eating-disorder psychopathology plus also producing modest weight-loss. BED, obesity, and chronic medical conditions are associated strongly and attaining modest weight-loss can be an important consideration for patients with BED at higher weights and their clinicians. Recent research has supported the effectiveness of certain clinician-led BLWM interventions and addressed concerns regarding their benefits/risks.

Purpose of review: This narrative case report examines the application of Integrative Oncology (IO) in the care of a young adult patient with glioblastoma multiforme (GBM), an aggressive primary brain tumor associated with significant symptom burden and poor prognosis.

Recent findings: The patient was managed through Cyprus' first national IO program, which incorporated evidence-based complementary interventions, including acupuncture, exercise rehabilitation, guided meditation, nutritional counseling, and music-centered activities. A personalized IO care plan was developed to address fatigue, emotional distress, and functional limitations. The integration of songwriting as a therapeutic tool supported emotional resilience and legacy-building during disease progression. This case illustrates how IO can enhance quality of life, emotional well-being, and patient engagement in young adults facing advanced cancer. The findings highlight the potential role of creative expression within IO frameworks and support broader implementation of multidisciplinary supportive care services in oncology settings.

Purpose of review: Kratom products have been available in the US for over a decade. Initially, these products were almost entirely made from kratom leaf material and formulated in powders, capsules, or tablets. Recently, more diverse kratom products and derivatives have been marketed and sold, including extracts, concentrates, and isolates. This review focuses on the differing symptom presentation of products containing concentrated or isolated kratom-derived alkaloids that may cause substantial risks to consumers.

Recent findings: Recently, several concentrated or semi-synthetic products have entered the market that are advertised as kratom, but which pharmacologically bear little similarity to traditional kratom. Although the alkaloid content naturally ranges from 2 to 5% in native leaf material, it can be up to 60% in concentrated extracts. Most concerning are the products containing pure, isolated 7-hydroxymitragynine and mitragynine pseudoindoxyl. These derivatives of kratom alkaloids are not naturally present in leaf material, but function as more potent opioid agonists than morphine. Products marketed as kratom but containing much higher alkaloid concentrations than found in the natural kratom leaf, or semi-synthetic isolates of highly potent alkaloid derivatives not typically found in the plant, represent a growing public health concern. There is minimal clinical research to assess their safety or regulation to ensure safe manufacturing practices. Limited pre-clinical data indicate that these products pose a greater risk of toxicity, drug interactions, and physiologic dependence. And based on misleading advertising, consumers may be unaware of the differences and increased risks associated with these products compared with traditional whole leaf kratom.

Purpose of review: There is increasing interest and exploration in tailoring eating disorder (ED) treatment for emerging adults/transition-age youth. This review provides a narrative update on research findings from 2021 to 2025.

Recent findings: There has been continued development of ED-focused family therapy approaches for emerging adults, and we have also started to see the tailoring of existing individual treatments (e.g., Cognitive Behavioural Therapy (CBT), Maudsley Model of Anorexia Nervosa Treatment) for this age group. A notable development is the implementation and evaluation of treatments or service pathways aiming to deliver timely and accessible intervention to emerging adults: the First Episode Rapid Early Intervention for ED (FREED) service model and care pathway continues its scale and spread, and shorter forms of treatment, such as CBT-Ten, have been successfully delivered via both FREED and general mental health early intervention pathways. There has been a marked increase in ED treatment innovation and evaluation for emerging adults over the last few years. As of yet, it remains unclear if there is a single 'best' treatment approach for this age group. Anecdotally, there appears to be a shift away from exclusively family or individual oriented treatments. Future research should advance inclusive, developmentally aligned treatments for emerging adults by addressing peer support, youth engagement, and gaps in care models. Interventions must be adaptable across formats and populations while integrating seamlessly within existing systems through personalized, context-responsive strategies.

Purpose of review: Through a multidimensional lens, we review the literature on the link between anxiety-related processes, hypothalamic-pituitary-adrenal (HPA) axis functioning (with a particular focus on cortisol), and their neural correlates, using the Research Domain Criteria (RDoC) framework. This approach aims to capture the complexity of these processes by addressing their heterogeneity, multidimensionality, and underlying neurobiological mechanisms.

Recent findings: Within the RDoC framework, dysregulated cortisol (whether excessively elevated or blunted) has been linked to disruptions in different processes of the negative valence, positive valence, cognitive, social, arousal, and sensorimotor systems. These effects are associated with distinct neural substrates, including limbic, striatal, and prefrontal control areas. Different processes and neurobiological responses interact in complex, bidirectional ways, and understanding these interdependencies is essential for capturing the full nature of anxiety-related processes. These findings reinforce the value of adopting a multidimensional, RDoC-based framework, which allows for a more integrative and mechanistic understanding of mental health.

Purpose of review: This report provides an overview on the relative lack of eating disorders training for healthcare students and providers, the impact of these gaps, and efforts underway to enhance eating disorders education.

Recent findings: The training and knowledge gap in eating disorders is well-established for healthcare students and providers across disciplines, and negatively impacts attitudes about eating disorders, timely diagnosis, and referral. There is strong evidence of enthusiasm for more education on this topic. Several educational resources have been developed in the last decade, only some of which have been formally evaluated. Programmatic evaluation studies suggest even limited amounts of enhanced training, including brief, asynchronous, digital resources, can improve knowledge, confidence, and attitudes about eating disorders for trainees and experienced clinicians. More research is needed to assess educational impact on clinician behavior.

Purpose of review: This review aims to examine the evolving literature on virtual reality (VR) technology in the treatment of anxiety-related disorders. We explore recent evidence across categories of anxiety-related disorders, focusing on the advantages and limitations of VR as a means of delivering exposure therapy. Finally, we propose recommendations for incorporating VR in current clinical practice and areas for future innovation.

Recent findings: VR-based exposure therapy (VRET) is the dominant application of VR for anxiety-related disorders. Growing evidence shows that it is a well-accepted intervention that is superior to waitlist conditions, especially for phobias, social anxiety, and post-traumatic stress disorder; however, more investigation is needed into how VRET compares to conventional treatment modalities. Recent innovations include successful self-directed VRET programs, augmenting VRET with neuromodulation, and beginning exploration of therapeutic processes in the delivery of VRET. Notable limitations include limited comparison to standard treatment and lack of standardization of VRET protocol, which limits translatability. VRET shows promise in enhancing treatment models for anxiety-related disorders, but uniformization of software and delivery protocols will be a key next step.