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UK Medical Cannabis Registry: a case series analyzing clinical outcomes of medical cannabis therapy for generalized anxiety disorder patients. 英国医用大麻登记处:分析医用大麻治疗广泛性焦虑症患者临床疗效的病例系列。
IF 2.1 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-01 Epub Date: 2024-02-02 DOI: 10.1097/YIC.0000000000000536
Adam Li, Simon Erridge, Carl Holvey, Ross Coomber, Daniela Barros, Urmila Bhoskar, Matthieu Crews, Lorna Donnelly, Muhammad Imran, Laura Korb, Gracia Mwimba, Simmi Sachdeva-Mohan, James J Rucker, Mikael H Sodergren

This study aims to analyze changes in health-related quality of life (HRQoL) and safety in patients with generalized anxiety disorder (GAD) prescribed a homogenous selection of cannabis-based medicinal products (CBMPs). Patients prescribed Adven CBMPs (Curaleaf International, UK) for GAD were identified from the UK Medical Cannabis Registry. Primary outcomes were changes in patient-reported outcome measures (PROMs) from baseline up to 12 months, including GAD-7, Single-Item Sleep Quality Scale (SQS), and EQ-5D-5L. Adverse events were recorded using CTCAE version 4.0. A total of 120 patients were identified for inclusion, of which 38 (31.67%), 52 (43.33%), and 30 (25.00%) were prescribed oils, dried flower, and both formulations of CBMP. Associated improvements in GAD-7, SQS, and EQ-5D-5L at 1, 3, 6, and 12 months were observed compared to baseline ( P  < 0.010). There were 24 (20.00%) patients who reported 442 (368.33%) adverse events, most of which were mild (n = 184, 41.63%) and moderate (n = 197, 44.57%). This study reports an association between initiation of a homogeneous CBMP therapy and improvements in anxiety severity and HRQoL in individuals with GAD. Moreover, therapy was well-tolerated at 12 months follow-up. Further investigation through randomized controlled trials will ultimately be required to determine causation.

本研究旨在分析广泛性焦虑症(GAD)患者在处方同类大麻药用产品(CBMPs)时健康相关生活质量(HRQoL)和安全性方面的变化。处方 Adven CBMPs(Curaleaf International,英国)治疗 GAD 的患者来自英国医用大麻登记处。主要结果是患者报告的结果指标(PROMs)从基线到 12 个月的变化,包括 GAD-7、单项睡眠质量量表 (SQS) 和 EQ-5D-5L。不良事件采用 CTCAE 4.0 版进行记录。共有 120 名患者被纳入研究,其中 38 人(31.67%)、52 人(43.33%)和 30 人(25.00%)分别服用了CBMP的精油、干花和两种制剂。与基线相比,在 1、3、6 和 12 个月时,观察到 GAD-7、SQS 和 EQ-5D-5L 均有相关改善(P<0.05)。
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引用次数: 0
Venlafaxine for tramadol dependence and medical cannabis therapy for generalized anxiety disorder. 文拉法辛治疗曲马多依赖症和医用大麻治疗广泛性焦虑症。
IF 2.1 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-01 Epub Date: 2024-09-25 DOI: 10.1097/YIC.0000000000000567
Alessandro Serretti
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引用次数: 0
Suicide in prison in the North of Italy (1993-2022): a case-control study examining differences between suicides inside and outside prison. 意大利北部监狱中的自杀事件(1993-2022 年):一项病例对照研究,探讨监狱内外自杀事件的差异。
IF 2.1 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-09 DOI: 10.1097/YIC.0000000000000569
Raffaella Calati, Stefano Tambuzzi, Rosa Gravagnuolo, Livio Muscatiello, Maria Elena Magrin, Franca Crippa, Fabio Madeddu, Riccardo Zoja, Guendalina Gentile

Prisoners constitute a group at suicide risk, showing higher relative rates of suicides than the general population. However, there is limited knowledge about the characteristics of those who die by suicide in Italian prisons. Based on the total sample of suicides of the Institute of Forensic Medicine of Milan (1993-2022), suicides in prison (N = 120) were matched by age and gender with cases that occurred outside prison (N = 300) and compared with them. The considered variables were sociodemographic, clinical, and suicide-related. Univariate analyses and logistic regression model were performed. In univariate analyses, suicides in prison showed higher rates of ethnicity different from white Caucasian, lower rates of depression, higher rates of alcoholism, addiction, respiratory system diseases, hepatitis, and amyotrophic lateral sclerosis, lower use of any medication, and in particular psychotropic medications, and a higher percentage of violent suicide method versus nonviolent compared to suicides outside prison. In the logistic regression model, ethnicity, depression, and addiction were the only features differentiating suicides in prison from ones outside prison. Particular attention should be paid to inmates with non-white ethnicity and those with addiction. Ensuring adequate access to psychiatric care and implementing comprehensive suicide prevention strategies within Italian prisons is crucial.

囚犯是一个面临自杀风险的群体,其相对自杀率高于普通人群。然而,人们对意大利监狱中自杀死亡者的特征了解有限。根据米兰法医研究所(1993-2022 年)的所有自杀样本,按年龄和性别将监狱中的自杀者(N = 120)与监狱外的自杀者(N = 300)进行比对,并将两者进行比较。考虑的变量包括社会人口学变量、临床变量和自杀相关变量。研究人员进行了单变量分析和逻辑回归模型分析。在单变量分析中,与监狱外自杀者相比,监狱内自杀者的种族不同于白种人的比例较高,抑郁症比例较低,酗酒、成瘾、呼吸系统疾病、肝炎和肌萎缩侧索硬化症的比例较高,使用任何药物,尤其是精神药物的比例较低,暴力自杀方式与非暴力自杀方式的比例较高。在逻辑回归模型中,种族、抑郁和毒瘾是区分狱内自杀和狱外自杀的唯一特征。应特别关注非白人囚犯和有毒瘾的囚犯。在意大利监狱中确保充分的精神病治疗机会并实施全面的自杀预防策略至关重要。
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引用次数: 0
Cariprazine as a maintenance treatment in dual schizophrenia: a 6-month observational study in patients with schizophrenia and cannabis use disorder. 卡哌嗪作为双重精神分裂症的维持治疗:对精神分裂症和大麻使用障碍患者进行的为期 6 个月的观察研究。
IF 2.1 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-25 DOI: 10.1097/YIC.0000000000000568
Nestor Szerman, Pablo Vega, Carlos Roncero, Lola Peris, Lara Grau-López, Ignacio Basurte-Villamor

Schizophrenia is often associated with substance use disorders, particularly cannabis use disorder (CUD). However, treatments frequently fail to address both conditions simultaneously. This study aimed to evaluate the antipsychotic effectiveness of cariprazine in patients with both schizophrenia and CUD in a real-world setting. A 6-month observational study was conducted on 58 patients diagnosed with schizophrenia and CUD, treated with cariprazine. Antipsychotic effectiveness was measured using the Positive and Negative Syndrome Scale and the Clinical Global Impression-Schizophrenia Scale, along with the Improvement and Severity scales. Cannabis consumption and addiction severity were assessed using the Cannabis Abuse Screening Test and the Severity of Dependence Scale, while functioning was evaluated with the Sheehan Disability Inventory. Cariprazine treatment resulted in significant improvements in schizophrenia symptoms (Positive and Negative Syndrome Scale change: -47.88 points, P < 0.0001; Clinical Global Impression-Schizophrenia Scale change: -8.26 points, P < 0.0001). Cannabis use and dependence also decreased (Cannabis Abuse Screening Test change: -7.0 points, P < 0.0001; Severity of Dependence Scale change: -7.88 points, P < 0.0001), alongside improvements in functioning (Sheehan Disability Inventory change: -9.48 points, P < 0.0001). These results suggest that cariprazine is effective for both schizophrenia and CUD, though further research is needed to confirm these findings.

精神分裂症通常与药物使用障碍有关,尤其是大麻使用障碍(CUD)。然而,治疗方法往往无法同时解决这两种情况。本研究旨在评估卡哌嗪在真实世界环境中对精神分裂症和 CUD 患者的抗精神病疗效。研究对 58 名被诊断为精神分裂症和 CUD 的患者进行了为期 6 个月的观察研究,这些患者均接受了卡哌嗪治疗。研究使用阳性和阴性综合征量表、临床总体印象-精神分裂症量表以及改善和严重程度量表来衡量抗精神病药物的疗效。大麻消耗量和成瘾严重程度采用大麻滥用筛查测试和依赖严重程度量表进行评估,功能则采用希恩残疾量表进行评估。卡哌嗪治疗可显著改善精神分裂症症状(阳性和阴性综合量表变化:-47.88分,P < 0.0001;临床总体印象-精神分裂症量表变化:-8.26分,P < 0.0001)。大麻使用和依赖也有所减少(大麻滥用筛查测试变化:-7.0分,P < 0.0001;依赖严重程度量表变化:-7.88分,P < 0.0001),同时功能也有所改善(希恩残疾量表变化:-9.48分,P < 0.0001)。这些结果表明,卡哌嗪对精神分裂症和 CUD 均有效,但还需要进一步的研究来证实这些发现。
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引用次数: 0
The impact of efficacy of long-acting injectable antipsychotics on caregivers' burden of patients with schizophrenia. 长效注射抗精神病药物的疗效对精神分裂症患者护理负担的影响。
IF 2.1 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-01 Epub Date: 2024-02-22 DOI: 10.1097/YIC.0000000000000539
Enrico Capuzzi, Cecilia Quitadamo, Alice Caldiroli, Massimo Clerici, Massimiliano Buoli
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引用次数: 0
The effect of early or late initiation of long-acting antipsychotics on the caregiver burden in schizophrenia. 早或晚服用长效抗精神病药物对精神分裂症患者照顾者负担的影响。
IF 2.1 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-01 Epub Date: 2023-11-23 DOI: 10.1097/YIC.0000000000000524
Dilara Çırakman, Ersin Hatice Karslıoğlu, Neşe Burcu Bal, Ali Çayköylü

The effective treatment in the early stages of schizophrenia is of critical importance to improve the prognosis. Schizophrenia affects patients' relatives too. The effects of early or late initiation of long-acting injectable antipsychotics (LAI-APs) on the patient have been shown, yet their effects on the caregiver are still unknown. We aimed to determine how the time of initiation of LAI-APs affects the caregiver burden by comparing the patients who were started on LAI-APs in the first 5 years of diagnosis and those who were started at a later period. Patients were classified as 'early-LAI' and 'late-LAI' according to the time of initiation of a LAI-AP. Their caregivers were also classified as the same way, as 'caregiver-early' and 'caregiver-late' and were compared in terms of caregiver burden. The quality of life, depression, anxiety, and caregiver burden scores of the caregiver-late group were significantly worse. The time of initiation of LAI-APs and the functioning levels of the patients were found to be determinant factors for the caregiver burden. This is the first study to investigate the effects of LAI-AP's initiation time on the caregivers to our knowledge. The use of LAI-APs in the early stages is associated with better outcomes for the caregiver.

精神分裂症早期的有效治疗对改善预后至关重要。精神分裂症也会影响患者的亲属。早期或晚期注射长效抗精神病药物(LAI-APs)对患者的影响已被证实,但对护理人员的影响尚不清楚。我们的目的是通过比较在诊断前5年开始使用ai - ap的患者和在诊断后5年开始使用ai - ap的患者,来确定开始使用ai - ap的时间如何影响照顾者的负担。根据开始LAI-AP的时间将患者分为“早期lai”和“晚期lai”。他们的照顾者也被分类为“早照顾者”和“晚照顾者”,并在照顾者负担方面进行比较。照顾者迟到组的生活质量、抑郁、焦虑和照顾者负担得分明显更差。开始使用ai - ap的时间和患者的功能水平是护理者负担的决定因素。据我们所知,这是第一个调查ai - ap启动时间对照顾者影响的研究。在早期阶段使用ai - ap与护理人员的更好结果相关。
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引用次数: 0
Type 2 diabetes mellitus is associated with manic morbidity in elderly patients with mood disorders. 2型糖尿病与老年情绪障碍患者的躁狂发病率有关。
IF 2.1 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-01 Epub Date: 2023-10-21 DOI: 10.1097/YIC.0000000000000515
Francesco Weiss, Giulio Emilio Brancati, Camilla Elefante, Alessandra Petrucci, Teresa Gemmellaro, Lorenzo Lattanzi, Giulio Perugi

The association between mood disorders, especially bipolar disorder (BD), and metabolic disorders, is long known. However, to which extent metabolic disorders affect the course of mood disorders in late life is still open to inquiring. To assess the impact of type 2 diabetes mellitus (T2DM) on late-life mood disorders a retrospective chart review was performed. Elderly depressive patients (≥ 65 years) diagnosed with Major Depressive Disorder (N = 57) or BD (N = 43) and followed up for at least 18 months were included and subdivided according to the presence of T2DM comorbidity. Vascular encephalopathy (39.1% vs. 15.6%, P  = 0.021) and neurocognitive disorders (21.7% vs. 5.2%, P  = 0.028), were more frequently reported in patients with T2DM than in those without. Patients with T2DM showed a greater percentage of follow-up time in manic episodes (r = -0.23, P  = 0.020) and a higher rate of manic episode(s) during follow-up (21.7% vs. 5.2%, P  = 0.028) than those without. When restricting longitudinal analyses to patients with bipolar spectrum disorders, results were confirmed. In line with the well-known connection between BD and metabolic disorders, our data support an association between T2DM and unfavorable course of illness in the elderly with BD.

情绪障碍,尤其是双相情感障碍(BD)和代谢障碍之间的联系是众所周知的。然而,代谢障碍在多大程度上影响晚年情绪障碍的进程仍有待探究。为了评估2型糖尿病(T2DM)对晚年情绪障碍的影响,进行了回顾性图表审查。诊断为重度抑郁症的老年抑郁症患者(≥65岁)(N = 57)或BD(N = 43)并随访至少18个月,并根据T2DM合并症的存在进行细分。血管性脑病(39.1%对15.6%,P = 0.021)和神经认知障碍(21.7%对5.2%,P = 0.028)在T2DM患者中的报告频率高于在没有T2DM的患者中。T2DM患者躁狂发作的随访时间百分比更高(r = -0.23,P = 0.020)和随访期间较高的躁狂发作率(21.7%对5.2%,P = 0.028)。当将纵向分析局限于双相情感障碍患者时,结果得到了证实。与众所周知的BD与代谢紊乱之间的联系一致,我们的数据支持T2DM与老年BD患者的不良病程之间的关联。
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引用次数: 0
Towards a replicable protocol to identify patients with psychiatric disorders at higher risk of developing dementia. 制定一个可复制的方案,以识别罹患痴呆症风险较高的精神障碍患者。
IF 2.1 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-01 Epub Date: 2024-02-13 DOI: 10.1097/YIC.0000000000000542
Veronika Matuskova, Martin Vyhnalek
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引用次数: 0
It is ethical to publish successful case reports about patient with treatment-resistant depression. 发表关于耐药抑郁症患者的成功病例报告是合乎道德的。
IF 2.1 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-01 Epub Date: 2024-01-15 DOI: 10.1097/YIC.0000000000000525
Anne Sauvaget, Samuel Bulteau, Andrew Laurin
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引用次数: 0
The impact of mild behavioral impairment on the prognosis of geriatric depression: preliminary results. 轻度行为障碍对老年抑郁症预后的影响:初步结果。
IF 2.1 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-01 Epub Date: 2023-11-15 DOI: 10.1097/YIC.0000000000000521
Camilla Elefante, Giulio Emilio Brancati, Gabriele Pistolesi, Salvatore Amadori, Samuele Torrigiani, Filippo Baldacci, Roberto Ceravolo, Zahinoor Ismail, Lorenzo Lattanzi, Giulio Perugi

Our study aimed to examine how the presence of Mild Behavioral Impairment (MBI) symptoms influenced the outcome of late-life depression (LLD). Twenty-nine elderly (≥ 60 years) depressive patients, including eleven (37.9%) with MBI, were recruited and followed-up on average for 33.41 ± 8.24 weeks. Psychiatric symptoms severity and global functioning were assessed, respectively, using the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF) scale. BPRS total score significantly decreased from baseline to follow-up ( P  < 0.001, d = 1.33). The presence of MBI had no significant effect on mood and cognitive symptoms improvement. On the contrary, while a significant increase in GAF score was observed in patients without MBI ( P  = 0.001, d = 1.01), no significant improvement of global functioning was detected in those with MBI ( P  = 0.154, d = 0.34) after 6-month follow-up. The presence of MBI in patients with LLD may negatively affect long-term outcome, slowing or preventing functional improvement.

本研究旨在探讨轻度行为障碍(MBI)症状的存在如何影响晚年抑郁症(LLD)的预后。招募29例老年(≥60岁)抑郁症患者,其中11例合并MBI(37.9%),平均随访时间为33.41±8.24周。分别使用简短精神病评定量表(BPRS)和整体功能评估量表(GAF)评估精神症状严重程度和整体功能。BPRS总得分从基线到随访显著下降(P
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引用次数: 0
期刊
International Clinical Psychopharmacology
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