Current Psychiatry Reports最新文献

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.

Purpose of the review: To narratively review recent literature addressing interventions aimed at reducing detrimental mental health effects of problematic social media use (PSMU) among adolescents aged 10-20.

Recent findings: The narrative review identified varying strengths and weaknesses of different types of interventions, which included therapy-based interventions (i.e., cognitive dissonance, self-compassion, mindfulness), media literacy, and social media limits. Moreover, features varied across interventions (i.e., duration, peer involvement, delivery format, setting). Programs that teach adolescents cognitive or behavioral strategies to engage with social media in a healthy manner appear to be more effective at improving long-term well-being than interventions that completely restrict social media use or warn adolescents of its negative effects. Tailoring interventions to the specific contextual factors salient to an individual or group may maximize the effectiveness and long-term impact of reducing PMSU and improving overall well-being. Future research should focus on longitudinal data to evaluate sustained intervention impacts.

Purpose of review: We review the literature on the interconnections between diabetes and mental health disorders, such as depression and anxiety, highlighting recent findings and potential integrative medicine (IM) interventions for improving patient care in individuals with both comorbidities.

Recent findings: Underscore the bidirectional relationship between diabetes and depression, with each condition exacerbating the other with associated poorer clinical outcomes. Pathophysiological mechanisms like hypothalamic-pituitary-adrenal (HPA) axis dysregulation and chronic inflammation contribute significantly. IM approaches, including mind-body therapies, dietary modifications, and herbal medicine, show promise in enhancing both glycemic control and mental health well-being. IM offers a holistic, patient-centered approach potentially improving care for individuals with diabetes and mental health disorders. While evidence supports the efficacy of various integrative therapies, further rigorous research is needed to standardize these interventions and ensure their effective integration into conventional medical practice.

Purpose of review: This review presents new research pertinent to youth suicide prevention with a focus on suicide risk screening; therapeutic interventions, including Crisis Lifeline services; the identification of proximal risk or warning signs; and guidelines for youth discussions of suicide-related concerns on social media.

Recent findings: Universal screening for youth suicide risk is feasible in healthcare settings, identifies previously unrecognized risk, and has sufficient sensitivity and specificity for the prediction of suicide attempts. Recent large scale intervention trials have neither identified new effective treatments nor ways to make current treatments more effective. In other recent studies, however, youth and parents have independently identified suicidal communications, withdrawal from people and/or usual activities, and sleep problems as acute warning signs. Universal screening for youth suicide risk is recommended in healthcare settings. It identifies previously unrecognized risk at a reasonable cost. Regarding therapeutic interventions, additional research is needed to identify subgroups of youth that may benefit from specific interventions and to personalize these interventions for improved effectiveness in a way that is feasible and scalable in real world settings. Finally, research has identified acute or proximal warning signs for adolescent suicide attempts, and widescale dissemination of this information is recommended..

Purpose of the review: This review examines the role of advanced practice providers (APPs), such as nurse practitioners and physician assistants, in psychiatric practice and related supervision considerations.

Recent findings: The number of psychiatric APPs has increased significantly in recent years, with data indicating substantial workforce expansion. APPs receive substantially fewer supervised clinical hours in training than psychiatrists. Current literature suggests that APPs report perceived feelings of inadequacy in their initial practice years, reinforcing the need for structured supervision and post-graduate training programs. Standardized best practices for APP supervision remain largely undefined. The authors critically examined recent literature related to APP practice in psychiatry and provide recommendations for a multi-tiered supervision model, ongoing competency assessments and quality monitoring, and organizational oversight to support successful integration of APPs into psychiatric practice. Future research and evaluation should focus on assessing the efficacy of supervision strategies and their impact on APP clinical outcomes.

Purpose of review: This review focuses on recent research (primarily published between 2020-2024) describing unique aspects of communication in autistic adults. We review research on communication-related outcomes, as well as four communication topics frequently cited as important to autistic people (literal and non-literal language, augmentative and alternative communication, nonverbal communication, and double empathy).

Recent findings: A substantial proportion of autistic adults do not develop fluent language by adulthood. Autistic adults frequently experience communication barriers impacting relationships, employment, and health. These barriers arise from multiple sources (e.g., language, nonverbal communication, and unaccommodating environments and communication partners). Thus, it is essential to take a multifaceted approach to supporting autistic adults to ensure their communication success. We conclude that it is vital for clinicians and researchers to understand how autistic traits commonly manifest in adults and to accept and accommodate communication differences as they arise. To that end, we offer specific recommendations to help clinicians and researchers strengthen their interactions with the autistic people in their lives.

Purpose of the review: We review recently published literature about the mental health of college students, as well as current court cases litigating colleges' liability for student mental health and safety.

Recent findings: College students experienced a dramatic increase in mental health symptoms during the early phase of the COVID-19 pandemic, with clinically significant increases in anxiety and depression. Meanwhile, in contrast to the past when colleges were mostly immune to liability for harm to students, a major shift occurred with the courts beginning to recognize colleges as having a legally defined "special relationship" to protect students from foreseeable harm. Recently, court cases in many states have expanded the circumstances under which colleges have a responsibility to protect students from themselves and from each other, and to foster students' mental health. The past few years have constituted a changing landscape for colleges with regard to their legal responsibilities related to student mental health. As college students experienced worsening mental health distress, recent court cases increased colleges' liability to ensure safety and create a supportive environment for students' mental health.