General hospital psychiatry最新文献

{"title":"Economic evaluation of screening, treatment, and prevention interventions for perinatal mood and anxiety disorders: a systematic review","authors":"Sabrina Alam ,&nbsp;Brian Christman ,&nbsp;Emma McNeill ,&nbsp;Man Tang ,&nbsp;Rong Rong ,&nbsp;Qing Li ,&nbsp;William Hillegass ,&nbsp;Janice Hall ,&nbsp;Laura Wright ,&nbsp;Chisa Lanier ,&nbsp;Xu Xiong ,&nbsp;Lizheng Shi ,&nbsp;Abigail Gamble","doi":"10.1016/j.genhosppsych.2025.11.005","DOIUrl":"10.1016/j.genhosppsych.2025.11.005","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review synthesized evidence on the cost-effectiveness and economic favorability of interventions for the detection, treatment, and prevention of perinatal mood and anxiety disorders (PMADs).</div></div><div><h3>Methods</h3><div>This protocol is registered on PROSPERO (CRD42024528777). PubMed, EMBASE, Web of Science, EconLit, Scopus, PsycINFO, and the National Health Service economic evaluation databases were searched from inception through April 2025. Intervention studies reporting quality-adjusted life years, incremental cost-effectiveness ratios, or equivalent cost analyses during pregnancy or up to one year postpartum were included. Risk of bias was assessed using the Consensus on Health Economics Criteria and Bias in Economic Evaluation checklists. Data were synthesized by study design, intervention type, and economic perspective.</div></div><div><h3>Findings</h3><div>The search identified 3863 records; 1820 deduplicated titles and abstracts, and 75 full texts were assessed for eligibility. Thirty-seven studies were included (<em>n</em> = 218,525 participants). Thirty-two (86.5 %) interventions were cost-effective or economically favorable, including prevention-only (28.1 %), treatment-only (34.3 %), screening-only (18.7 %), and screening plus treatment and/or prevention (18.7 %). Cost-effective evaluations were primarily from the healthcare system (46.8 %) or payer (25 %) perspectives. Twenty-two (68.7 %) cost-effective interventions included time horizons of one year or greater. Five of six (83.3 %) non-cost-effective interventions included time horizons of less than one year. Studies were heterogeneous in design, population, and intervention types.</div></div><div><h3>Interpretation</h3><div>Findings support the integration of PMAD interventions into perinatal clinical care. Evidence-based policy and payment models are needed for scaling sustainable uptake. Research priorities include standardization in economic evaluation methods, longer-term modeling, and inclusion of diverse populations.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 253-274"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of mental health triage systems in reducing psychiatric emergency department admissions","authors":"L.W. Mokhwelepa ,&nbsp;G.O. Sumbane ,&nbsp;R. Mukhinindi","doi":"10.1016/j.genhosppsych.2025.11.007","DOIUrl":"10.1016/j.genhosppsych.2025.11.007","url":null,"abstract":"<div><div>Psychiatric emergency department (PEDs) face significant challenges such as overcrowding, prolonged wait times, and resource constraints, often resulting in suboptimal care. Mental health triage systems have been developed to prioritize urgent cases, optimize resource allocation, and reduce unnecessary admissions, yet their effectiveness remains variably reported. This scoping review aimed to systematically synthesize empirical evidence on the effectiveness of mental health triage systems in reducing psychiatric emergency department admissions and identify factors influencing their success. Following Arksey and O'Malley's framework and PRISMA-ScR guidelines, a comprehensive search was conducted across PubMed, PsycINFO, Scopus, and Web of Science for studies published between 2000 and 2025. Included studies evaluated triage interventions in psychiatric emergency settings with reported outcomes on admission rates. Data were extracted and synthesized narratively. Twenty-three studies from diverse international settings met inclusion criteria. Findings indicate that structured triage systems, particularly nurse-led models employing validated assessment scales, contribute to reductions in avoidable PED admissions. Multi-disciplinary approaches further enhanced decision-making complexity and patient outcomes. Key facilitators included rigorous staff training and integration with community mental health services. Barriers such as inconsistent triage application, limited alternative care options, and staff resistance impeded effectiveness. Mental health triage systems show promise in optimizing psychiatric emergency care by reducing unnecessary admissions and improving prioritization. Their effectiveness depends on standardized protocols, comprehensive training, and strong community linkages. Future research should focus on rigorous, longitudinal evaluations to inform evidence-based triage frameworks.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 294-302"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of probiotic supplements on cognitive function in mild cognitive impairment and Alzheimer’s disease: A meta-analysis of randomized controlled trials","authors":"Tzu-Rong Peng ,&nbsp;Hung-Hong Lin ,&nbsp;Tzu-Ling Tseng ,&nbsp;Ta-Wei Wu","doi":"10.1016/j.genhosppsych.2025.11.004","DOIUrl":"10.1016/j.genhosppsych.2025.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment, encompassing mild cognitive impairment (MCI) and Alzheimer's disease (AD), poses a significant public health challenge worldwide. Emerging evidences suggest that probiotics, through modulation of the gut–brain axis, may improve cognitive function. However, their efficacy in individuals with cognitive impairment remains unclear.</div></div><div><h3>Methods</h3><div>This meta-analysis adhered to PRISMA guidelines, systematically reviewing randomized controlled trials (RCTs) investigating the effects of probiotics for individuals with cognitive impairment. Data were extracted from the PubMed, Embase, and Cochrane databases. Subgroup analyses were conducted based on different measurement scales (MMSE, MoCA, and RBANS), population types (cognitive impairment vs. no cognitive impairment), multiple or single strain and intervention duration. Effect sizes were expressed as standardized mean differences (SMDs) using random-effects models.</div></div><div><h3>Results</h3><div>Fifteen RCTs involving 994 participants were included. Probiotic supplementation significantly improved cognitive function compared to placebo (SMD = 0.57; 95 % CI, 0.19–0.94; <em>P</em> = 0.003). Subgroup analyses revealed that both single-strain and multi-strain probiotics were effective; however, multi-strain probiotics demonstrated greater heterogeneity and variability in efficacy. Cognitive improvements were most pronounced with supplementation durations of at least 12 weeks (SMD = 0.73; 95 % CI, 0.30–1.16; <em>P</em> = 0.0009) and higher probiotic doses (&gt;1 × 10⁹ CFU/g; SMD = 0.93; 95 % CI, 0.36–1.49; <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Probiotic supplementations significantly enhance cognitive function in individuals with cognitive impairment, particularly with single-strain formulations, higher doses, and a minimum duration of 12 weeks.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 284-293"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigma and health: an urgent need in the training of health professionals","authors":"Matías E. Rodríguez-Rivas ,&nbsp;Sanndy Infante","doi":"10.1016/j.genhosppsych.2025.10.019","DOIUrl":"10.1016/j.genhosppsych.2025.10.019","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 235-236"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open-label study of the efficacy, safety and tolerability of Brexanolone in the treatment of adult women with postpartum psychosis","authors":"Riah Patterson ,&nbsp;Holly Krohn ,&nbsp;Elizabeth Richardson ,&nbsp;Cecilia Pearson ,&nbsp;Kai Xia ,&nbsp;Mary Kimmel ,&nbsp;Samantha Meltzer-Brody","doi":"10.1016/j.genhosppsych.2025.10.017","DOIUrl":"10.1016/j.genhosppsych.2025.10.017","url":null,"abstract":"<div><h3>Objective</h3><div>Postpartum psychosis (PPP) is a rare but severe postpartum psychiatric emergency that occurs during a critical time in mother-infant attachment. This study investigated the efficacy, safety, and tolerability of brexanolone, a neuroactive steroid and synthetic form of allopregnanolone, for adult females with PPP.</div></div><div><h3>Methods</h3><div>In this open-label, proof-of-concept study, ten patients with PPP received brexanolone as a single, continuous, 60-h intravenous infusion titrated to a target dose of 90 μg/kg/h over a period of 2.5 days. Primary outcomes were change in total score on the Young Mania Rating Scale (YMRS) and Positive and Negative Syndrome Scale (PANSS); Secondary outcomes included change in Hamilton Depression Rating Scale (HAM<img>D) from baseline to Day 7. Adverse events were monitored. Patients were followed through Day 90.</div></div><div><h3>Results</h3><div>All ten patients completed the treatment protocol without dose reductions and without intolerable adverse side effects. Change in mean PANSS total score from baseline to Day 7 was statistically significant (<em>p</em> = 0.00006; 95 % CI [19.60–38.40]), as were YMRS scores (<em>p</em> = 0.01; 95 % CI [2.69–16.01]) and HAM-D scores (<em>p</em> = 0.0003; 95 % CI [5.22–11.98]).</div></div><div><h3>Conclusions</h3><div>This study suggests the potential for neuroactive steroids as rapid-acting, adjunctive treatment for PPP and provides support for future research to assess the role of neuroactive steroids and synthetic forms of allopregnanolone in the treatment of PPP.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 237-240"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive function among stable schizophrenia patients receiving an mHealth app-based cognitive remediation therapy: randomized controlled trial with mediation analysis","authors":"Min Wen ,&nbsp;Xiaoyao Liu ,&nbsp;Ying He ,&nbsp;Weiguo Xu ,&nbsp;Yongling Zhou ,&nbsp;Juan Liu ,&nbsp;Xiaodan Zhu","doi":"10.1016/j.genhosppsych.2025.10.013","DOIUrl":"10.1016/j.genhosppsych.2025.10.013","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the application effect and underlying mechanisms of mHealth app-based cognitive remediation therapy on the cognitive function of patients with stable schizophrenia.</div></div><div><h3>Methods</h3><div>This study was a randomized controlled trial, patients received either treatment as usual or mHealth app-based cognitive remediation therapy. Guided by the theoretical framework integrating the MCI theoretical model of rehabilitation, we examined the mediating roles of self-efficacy and negative emotion in the relationship between intervention subgroups and cognitive functioning. These outcome indicators were assessed at baseline, the primary endpoint, and the follow-up endpoint. Linear mixed-effects modeling was employed to compare these measures between the two patient groups, with all analyses adhering to the intention-to-treat principle. Mediation analyses were conducted using the PROCESS. The significance of mediation effects was assessed through bias-corrected nonparametric percentile bootstrap analysis.</div></div><div><h3>Results</h3><div>Linear mixed-effects models revealed statistically significant group*time interaction effects at both the primary endpoint (post-intervention) and the follow-up endpoint (3-month post-intervention) for cognitive functioning (<em>P</em> = 0.001), psychiatric symptoms (<em>P</em> &lt; 0.001), self-efficacy (<em>P</em> &lt; 0.001), and negative emotions (<em>P</em> &lt; 0.001). Analysis of these interactions indicated that, compared to the TAU group, the CRT group demonstrated significantly greater improvement in cognitive function and self-efficacy, and significantly greater reduction in psychiatric symptoms and negative emotions over time. Mediation analyses further indicated that self-efficacy scores partially mediated the relationship between the intervention groupings and cognitive function scores (indirect effect of 0.237, 95 % CI [0.073, 0.414]). Similarly, negative emotion scores were found to partially mediate this relationship (indirect effect of 0.154, 95 % CI [0.029, 0.323]).</div></div><div><h3>Conclusion</h3><div>Cognitive remediation therapy delivered through mHealth app for patients with stable schizophrenia has been shown to effectively improve cognitive functioning. Moreover, this intervention may exert an indirect positive effect on cognitive performance mediated by negative emotions and self-efficacy.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 225-234"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between cognitive function and depressive symptoms in Chinese older adults: A cross-lagged panel network analysis","authors":"Shuaichen Li ,&nbsp;Jinglan Tan ,&nbsp;Yanwei Guo ,&nbsp;Junyao Li ,&nbsp;Renqin Hu ,&nbsp;Jiayi Ge ,&nbsp;Yiran Feng ,&nbsp;Wenjing Zhao ,&nbsp;Qinghua Luo","doi":"10.1016/j.genhosppsych.2025.10.016","DOIUrl":"10.1016/j.genhosppsych.2025.10.016","url":null,"abstract":"<div><h3>Background</h3><div>The bidirectional association between depressive symptoms and cognitive decline has been extensively studied in Western populations, yet empirical evidence from non-Western contexts, particularly among Chinese older adults, remains limited. This study aimed to examine the longitudinal and symptom-level dynamics between depressive symptoms and cognitive functioning using a cross-lagged panel network (CLPN) approach.</div></div><div><h3>Methods</h3><div>Data were drawn from two waves (2015, 2018) of the China Health and Retirement Longitudinal Study (CHARLS), including 6824 individuals aged 50 years and above. Cognitive performance was assessed via the China Mini-Mental State Examination (CMMSE), and depressive symptoms were measured using the 8-item Center for Epidemiological Studies Depression Scale (CESD-8). A CLPN model was estimated to identify temporally predictive pathways and symptom-level interactions, with LASSO regularization ensuring model sparsity. Model stability was evaluated through nonparametric bootstrapping.</div></div><div><h3>Results</h3><div>Findings revealed a reciprocal, predominantly negative relationship between cognitive decline and depressive symptoms over time. “Mental State” (orientation, processing, and visuospatial skills) emerged as the central network hub and primary bridge from cognition to depression, while lack of motivation (“ I felt everything was an effort”) was the pivotal bridge symptom from depression to cognition. Specifically, “I felt everything was an effort” predicted subsequent declines in memory function, whereas better mental state predicted reduced depressive symptoms, including feeling depressed, trouble concentrating, and restless sleep. The network model highlighted symptom-specific pathways not observable in traditional latent variable models.</div></div><div><h3>Conclusions</h3><div>This study underscores the clinical and public health value of integrated screening and interventions targeting both depressive symptoms and cognitive impairment in older adults. Motivational deficits and mental state deficits may serve as actionable transdiagnostic targets. Future interventions should be symptom-specific, modular, and culturally sensitive. Longitudinal neurobiological studies are warranted to elucidate underlying mechanisms.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 203-208"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145400436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A guideline-based perspective on neurostimulation in treatment-resistant obsessive-compulsive disorder: An international overview","authors":"Nadine D. Wolf ,&nbsp;Martin Jakobs ,&nbsp;R. Christian Wolf","doi":"10.1016/j.genhosppsych.2025.10.014","DOIUrl":"10.1016/j.genhosppsych.2025.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Obsessive-compulsive disorder (OCD) is a severe psychiatric illness associated with substantial psychosocial burden. Although evidence-based first- and second-line treatments are often effective, a significant proportion of patients continue to experience treatment-resistant symptoms. In such cases, brain neurostimulation is gaining increasing attention. This study aims to provide a structured overview of national and international clinical guidelines for the management of treatment-resistant OCD, with a particular focus on neurostimulation techniques.</div></div><div><h3>Materials and methods</h3><div>Relevant clinical guidelines were identified and compared with respect to their recommendations on various neurostimulatory procedures. Among the approaches examined were transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), Deep Brain Stimulation (DBS), ablative neurosurgical procedures, and further techniques such as transcranial direct current stimulation (tDCS).</div></div><div><h3>Results</h3><div>Across guidelines, DBS is regarded as a potentially effective treatment option for carefully selected, severely affected patients. Its use is restricted to specialized centers and requires an interdisciplinary treatment approach. Ablative procedures are endorsed by certain guidelines solely in exceptionally severe cases. The evidence basis for TMS remains inconsistent, though certain stimulation protocols have shown short-term efficacy. For ECT and tDCS, current evidence is insufficient to support their use in targeting core OCD symptoms.</div></div><div><h3>Conclusions</h3><div>Overall, the reviewed guidelines emphasize the need for clearly defined indications, standardized treatment protocols, and continuous scientific evaluation. Invasive procedures are not considered standard treatment but represent highly specialized therapeutic options within interdisciplinary care frameworks.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 196-202"},"PeriodicalIF":3.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of quetiapine prophylaxis for delirium in hospitalized adult patients: A systematic review and meta-analysis of randomized controlled trials","authors":"Raj Kiran Donthu ,&nbsp;Sneha Mary Minz ,&nbsp;Mamidipalli Sai Spoorthy ,&nbsp;R. Dyuthy ,&nbsp;A. Balaji ,&nbsp;P.S. Sethu ,&nbsp;Libnus B. Varghese ,&nbsp;Shahul Ameen ,&nbsp;Brijesh Sathian ,&nbsp;Vikas Menon","doi":"10.1016/j.genhosppsych.2025.10.011","DOIUrl":"10.1016/j.genhosppsych.2025.10.011","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to compare summary estimates of efficacy and safety of quetiapine versus comparator treatments in preventing delirium among hospitalized adult patients by pooling evidence from parallel-group randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>We searched MEDLINE, Embase, Scopus, and clinical trial registers from inception till January 31st, 2025. Our primary outcome was between-group incidence of delirium. Secondary outcomes included 10-day mortality, duration of hospital stay, duration of delirium, severity of delirium, readmission rates (efficacy outcomes), and reported adverse effects (safety outcomes).</div></div><div><h3>Results</h3><div>Six eligible RCTs (pooled <em>N</em> = 491) were identified; of these, five were included in the meta-analysis. The pooled RR for preventing the incidence of delirium was 0.61 (95 % CI, 0.45–0.83;5 RCTs; I² = 0;<em>p</em> = .001), favoring quetiapine (dose range 12.5-75 mg/day). The SMD for duration of delirium was −1.21 (95 % CI, −2.08 to −0.35; 3 RCTs; I² = 86 %; <em>p</em> = .006), again favoring quetiapine. No significant between-group differences were noted on other outcomes. Adverse effects with quetiapine were absent in four studies and minimal in the other two. The findings were robust to sensitivity analyses.</div></div><div><h3>Conclusion</h3><div>Low-dose quetiapine prophylaxis may be a safe and effective treatment option for preventing delirium. These conclusions are tempered by the small number and size of existing trials.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 192-195"},"PeriodicalIF":3.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of cannabinoid hyperemesis syndrome: A systematic review and treatment algorithm for consultation-liaison psychiatrists","authors":"Jennifer Hsu ,&nbsp;Saurabh Kashyap ,&nbsp;Cheryl Hurd ,&nbsp;Lauren McCormack ,&nbsp;Zachary Herrmann ,&nbsp;Ann C. Schwartz ,&nbsp;Joshua Jackson ,&nbsp;Dustin DeMoss","doi":"10.1016/j.genhosppsych.2025.10.012","DOIUrl":"10.1016/j.genhosppsych.2025.10.012","url":null,"abstract":"<div><h3>Background</h3><div>Cannabinoid Hyperemesis Syndrome (CHS) is a cyclical vomiting syndrome associated with chronic cannabis use and is often resistant to anti-emetics. Despite increasing incidence of suspected CHS, literature regarding its treatment is limited, and there are no established treatment guidelines.</div></div><div><h3>Objectives</h3><div>With the goal of establishing treatment guidelines for consultation-liaison (C-L) psychiatrists managing CHS, the authors systematically reviewed existing literature for pharmacologic treatment strategies using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. With the results of the review, the authors propose a treatment algorithm for CHS.</div></div><div><h3>Methods</h3><div>We searched PubMed, PyschINFO &amp; PsychARTICLES, Embase, and Web of Science from inception to July 2021 to identify literature describing treatment of CHS. We included cases of CHS where patient-level data describing the treatment of CHS was available. Pharmacologic treatments were considered beneficial if the patient's nausea, hyperemesis, and urge to take hot showers resolved. Non-independent review of exclusion criteria assisted in reducing individual bias of the literature.</div></div><div><h3>Results</h3><div>The authors identified 34 eligible articles, consisting of 63 individual cases. Among these articles and cases, capsaicin cream, antipsychotics, and benzodiazepines were reported to improve CHS more effectively than other, more frequently used anti-emetics, such as promethazine, ondansetron, and metoclopramide.</div></div><div><h3>Conclusion</h3><div>An examination of treatment strategies for CHS can allow for more effective care while providing a foundation for further research in treatment. This proposed algorithm is designed to aid in establishing treatment strategies for C-L psychiatrists who assist with managing CHS for patients in general medical settings. The goal of this research is to establish evidence-based treatment guidelines for C-L psychiatrists who are managing patients with CHS in general medical settings. Recognizing the limitations of this algorithm being based on case reports adds to the necessity of further research in this area.</div></div><div><h3>Registration</h3><div>PROSPERO (<span><span>https://www.crd.york.ac.uk/PROSPERO/view/CRD42021254888</span><svg><path></path></svg></span>) registration number CRD42021254888.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 185-191"},"PeriodicalIF":3.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}