Current Psychiatry Reports最新文献

Purpose of review: Sleep disturbances are prevalent among those with comorbid substance use disorders (SUD), significantly impacting the initiation, maintenance and relapse of these conditions.

Recent findings: This review explores the latest research on the reciprocal relationship between sleep and substance misuse, the effects of treating sleep on substance use outcomes, and the potential therapeutic uses of cannabis for sleep disorders in people with and without SUDs. Understanding these interactions may be critical for augmenting current treatment strategies aimed at improving sleep disturbances and recovery outcomes in individuals with SUDs.

Purpose of the review: This narrative review examines the newest findings from clinical trials of chronotherapeutics for psychiatric disorders. We reviewed the potential effects of the most commonly-studied chronotherapeutics such as bright light therapy, dark therapy, melatonin, and chronotherapy on the psychiatric disorders of depression, bipolar disorder, and anxiety disorders.

Recent findings: The preponderance of recent clinical trials in chronotherapeutics has focused on bright light therapy in depression. However, there is an emerging body of preliminary studies testing chronotherapeutics in other psychiatric disorders, including bipolar disorder and post-traumatic stress disorder. Chronotherapeutics hold potential to improve sleep in adults with psychiatric conditions as well as psychiatric symptoms. Although the most recent literature demonstrates the promise of these interventions, the current body of work is limited by small sample sizes and relatively few studies outside of depression. Larger-scale trials are needed to refine treatment protocols, develop personalized treatment approaches, and inform dissemination. Studies in psychiatric conditions besides depression are particularly needed.

Purpose of review: We aimed to investigate the recent understanding of the frequent coexistence of obsessive-compulsive disorder (OCD) and major depression (MDD), exploring both clinical and mechanistic perspectives. Our focus was on deriving conclusions with therapeutic implications.

Recent findings: While biological factors contribute to the development of OCD-MDD, the comorbidity seems to be primarily induced by the convergence of symptoms that complicate the course of OCD. Tailored cognitive-behavioral therapy programs, specifically addressing MDD, alongside SSRI medication, may prove beneficial for patients experiencing moderate to severe forms of this comorbidity. The review underscores the significance of comorbidity from both diagnostic and therapeutic perspectives. However, existing research has yet to offer a clear understanding of the underlying mechanisms. Further research in the field, notably coming from network studies, could enrich our practice by helping to target specific dimensions that underly OCD-MDD comorbidity.

Purpose of review: Systematic review to identify the most promising experimental approaches to modify prenatal alcohol and cigarette use published since 2019.

Recent findings: 20 studies met review criteria. Among the five approaches to prenatal alcohol use, a study comparing brief intervention or brief advice to treatment as usual in Argentina, and a practice change intervention to include evidence-based assessment and intervention of prenatal alcohol use in Australia were noteworthy. Five different strategies to modify cigarette use included diverse samples and settings. An innovative approach that was rigorously evaluated was conducted in Hong Kong where an intervention with brief advice, a nicotine sample, and active referral to smoking cessation service resulted in doubling the odds of biochemically validated abstinence from nicotine in expectant fathers when compared to an attention control condition. Prenatal alcohol and cigarette smoking are common in the US and pending effective intervention strategies that may be informed by international research.

Purpose of review: We examine the deleterious effects on emotional development and mental health of college students wrought by the COVID-19 pandemic. In the era of climate change, political polarization, and global pandemics, some students are likely exposed to public disasters either on campus or at home at any given time.

Recent findings: The worsening incidence and severity of mental health symptoms foreshadowed a youth mental health crisis of unanticipated proportions. Post disaster, the treatment of physical illness typically takes precedence to the exclusion of preventive mental health measures. Even though the mental health effects of mass trauma are more pervasive and last longer than physical symptoms, mental health experts did not have a prominent place at the table of the COVID-19 response teams beyond their traditional role in the care of individual students. We conclude with a review of best practices for psychological first aid, and highlight the need for disaster response training for psychiatrists.

Purpose of review: Habits, characterized by automaticity and insensitivity to outcomes, may be key to the persistence of maladaptive behaviors in anorexia nervosa (AN). This review examines the status of habit research in AN, focusing on insights from task-based assessments.

Recent findings: Findings indicate dysfunction in the frontostriatal circuits associated with habitual and goal-directed behaviors, with some studies linking neural disturbances to habit measures or clinically relevant behaviors. Heightened habitual tendencies in AN have consistently been reported using self-reports, while research utilizing experimental paradigms has yielded mixed results and efforts to capture real-world habits in AN remain limited. Some experimental paradigms appear more sensitive than others, but all face challenges associated with studying habits in the lab. Promising new approaches will need to be adopted and efforts made to capture real-world habits. Understanding which habits are problematic, when in illness and for whom they dominate, could make good on the promise of habit-focused treatments for AN.

Purpose of review: This review includes research on sexual burglary to highlight the distinct behaviours of such offenders. Only recently has there been a thorough examination of the decision-making that goes into this hybrid crime, and the potential for these individuals to progress to more serious and violent criminal acts.

Recent findings: Work on sexual burglary has found that decisions made during the crime commission reflect rational decision-making and organization, despite previous research suggesting that sexual crimes are mostly impulsive. Furthermore, these rational choices may lead to the development of expertise in sexual burglary, with offenders learning how to avoid detection and engage in forensic awareness strategies. The knowledge that sexual burglars are expert decision-makers has important implications, as these behaviours may lead to more violent and lethal sexual crimes. Identifying these offenders through their decisions and crime characteristics is key to potentially deterring or preventing future offending.

Purpose of review: There is a mental health crisis affecting youth, and the utility of existing treatments is often limited by lack of effectiveness and tolerability. The aim of this review is to report on outcomes of clinical trials for psilocybin-assisted psychotherapy for adults with depression and MDMA-assisted psychotherapy for adults with post-traumatic stress disorder (PTSD) and discuss recommendations for exploring these treatments in adolescent populations.

Recent findings: There have been encouraging data supporting the use of psilocybin-assisted psychotherapy for depression, including previously treatment-resistant symptoms. MDMA-assisted psychotherapy is showing similar promise in treating PTSD, with excellent response and remission rates that appear durable. However, no studies have looked at the use of these treatments in younger patients. The safety and efficacy of psychedelic- and MDMA-assisted psychotherapies should be investigated in adolescents, especially considering the burden of untreated and undertreated psychiatric illness in youth, and the benefits of a potentially earlier, more effective, and more tolerable recovery process. Research and implementation should be tailored to the needs of this population, and equity and access should be considered at every stage. In this novel and rapidly evolving landscape, the psychiatric community is encouraged to advocate for safe, appropriate, and inclusive inquiry into, and application and scaling of these treatment models in adolescent patients.

Purpose of review: This review summarizes recent studies examining average self-compassion scores in adults with symptoms of anxiety and mood disorders. We compare these findings with our own data to help establish norms for the Self-Compassion Scale (SCS) and to explore treatment implications for patients with these disorders.

Recent findings: Several studies have demonstrated that adults with symptoms of anxiety and mood disorders have lower self-compassion scores compared to control groups, though many of these studies have established findings based on self-reported symptoms. Our study, involving patients at a large academic medical center with diagnoses confirmed on clinical interview, aligns with these overall findings. This reinforces the conclusion that anxiety and mood disorders are associated with lower self-compassion scores. Adults with anxiety and mood disorders demonstrate lower self-compassion scores than control groups. Incorporating self-compassion interventions into treatment may reduce symptoms and improve outcomes for these individuals.

Purpose of review: Through an overview of invasive lobular carcinoma (ILC), this review highlights the unique complexities the diagnosis and treatment of this disease represents, followed by psychological considerations for both patients and providers. Perspectives from members of the multidisciplinary treatment team are included.

Recent findings: A cancer diagnosis can be difficult for patients and their families and can also have a significant impact on the treatment team. Prior work related specifically to ILC is limited. Each member of the multidisciplinary team faces unique challenges when treating patients with ILC. This can manifest in a variety of ways and recognizing the complexities specific to this diagnosis can be helpful when considering strategies to mitigate provider burn out and secondary injury. ILC is a variant of breast cancer with a distinct set of diagnostic and treatment challenges. Recognition of patient and provider challenges specific to this diagnosis is important for future research considerations and stress mitigation management strategies.