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Challenges and Opportunities in Mental Health Care for Transitional Age Youth (TAY): Lessons Learned from the COVID-19 Pandemic 过渡年龄青少年(TAY)心理健康护理的挑战与机遇:从 COVID-19 大流行中汲取的经验教训
IF 0.4 Q4 Medicine Pub Date : 2024-01-29 DOI: 10.2174/0122106766287773240110074140
Hyun Jung Kim, Cynthia Wilson, Timothy C. Van Deusen, Hun Millard, Zheala Qayyum, S. Parke
COVID-19, caused by the SARS-CoV-2 virus, began in late 2019. OnMarch 11th, 2020, the World Health Organization (WHO) declared the virus apandemic, and by March 13th, 2020, the United States (US) government declared thepandemic a national emergency and, subsequently, a global pandemic. Since then, theworld has experienced an upheaval affecting every age group in almost every aspectof life. This was particularly true for young people. Globally, a number of studiesindicated that the COVID-19 pandemic has had a significant impact on youth mentalhealth measures. In the US, the Centers for Disease Control and Prevention (CDC)2022 report showed that more than a third of high school students reported that theyexperienced poor mental health during the pandemic, and 44 percent reported feelingpersistently sad or hopeless in the last 12 months. More than half (55 percent)reported experiencing emotional abuse by a parent or other adult at home, and 11percent reported experiencing physical abuse. In addition, more than a quarter (29percent) reported that a parent or other adult in the home lost their job. The pandemicupended not only daily life but also healthcare delivery throughout the world. Its vastimpact on the healthcare system has disproportionately affected transitional age youth(TAY) between 15 to 25 years old. While the pandemic caused unprecedentedchanges and challenges, it was also a learning experience that deepened ourunderstanding of our system of care, its strengths and vulnerabilities. This paper willdiscuss many challenges and opportunities associated with the delivery of psychiatricservices for TAY in college mental health, emergency departments, and inpatient andoutpatient settings, as well as in specialized programs, such as those for earlypsychotic disorders.
由SARS-CoV-2病毒引起的COVID-19始于2019年底。2020 年 3 月 11 日,世界卫生组织(WHO)宣布该病毒为流行病,到 2020 年 3 月 13 日,美国政府宣布该流行病为国家紧急状态,随后宣布为全球大流行病。从那时起,世界经历了一场动荡,几乎影响到每个年龄段的人生活的方方面面。年轻人尤其如此。在全球范围内,许多研究表明,COVID-19 大流行对青少年心理健康措施产生了重大影响。在美国,疾病控制和预防中心(CDC)2022 年的报告显示,超过三分之一的高中生报告说,他们在大流行期间的心理健康状况不佳,44% 的学生报告说,他们在过去 12 个月中一直感到悲伤或绝望。一半以上(55%)的学生表示在家中受到过父母或其他成年人的精神虐待,11% 的学生表示受到过身体虐待。此外,超过四分之一(29%)的人报告说,父母或家中其他成年人失去了工作。大流行不仅影响了日常生活,也影响了世界各地的医疗保健服务。它对医疗保健系统造成的巨大影响对 15 至 25 岁的过渡年龄青年(TAY)的影响尤为严重。虽然这次大流行带来了前所未有的变化和挑战,但同时也是一次学习经历,加深了我们对医疗系统及其优势和弱点的理解。本文将讨论在高校心理健康中心、急诊科、住院和门诊环境中,以及在专门项目(如早期精神障碍项目)中,为 TAY 提供精神科服务所面临的诸多挑战和机遇。
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引用次数: 0
Comparative Association of Substance Use, Psychosocial Factors, and Suicidal Ideation in Turkish Youth 土耳其青少年药物使用、社会心理因素和自杀意念之间的比较关系
IF 0.4 Q4 Medicine Pub Date : 2024-01-29 DOI: 10.2174/0122106766257273240122105336
Parna Prajapati, Ali Unlu, Andres Pumariega
The existing literature on the contribution of substance useand psychosocial risk factors in the development of suicidal ideation in theTurkish youth provides limited information. This study aims to compare therelative association of substance use and psychosocial risk factors with suicidalideations in a sample of high school students in Istanbul.High school students were administered a survey of 66 questions in theschool setting. The total number of students surveyed was 31,604 by the IstanbulDepartment of Education, and the primary questions and their sub-questionsgenerated dependent and independent variables that were used in this study. Therelationship between substance use, psychosocial factors, and suicidal ideationwas explored in this study. Logistic regression was used with independentvariables, such as substance use, light users, and heavy users and dependentvariables as suicidal ideation. The variation explained by this model wascompared to the variation explained by the psychosocial factors (age, gender,school type, immigration status, perceived family affluence, parental education,school grades, self-esteem scale, faith scale, anomie scale, anxiety scale,depression scale, irritability scale, antisocial personality scale, time with peers,time with family, parental involvement, family substance use, and peer influence)while exploring the strength of the associations for each factor.Psychosocial factors explained 33.8 % variance in the dependentvariable, i.e., suicidal ideation, whereas substance use among those participantsexplained only 2.2 % variance in predicting suicidal ideation. Restricting analysesto heavy drug users found a consistently low explained variance of about 1.5 %of suicidal ideation in this population.The psychosocial factors are stronger predictors of suicidal ideationas compared to the substance use risk factors in a sample of Turkish youth.
关于药物使用和社会心理风险因素对土耳其青少年自杀倾向发展的影响,现有文献提供的信息十分有限。本研究旨在比较伊斯坦布尔高中生样本中药物使用和社会心理风险因素与自杀倾向之间的关联。伊斯坦布尔教育局共调查了 31604 名学生,主问题及其子问题产生了本研究中使用的因变量和自变量。本研究探讨了药物使用、社会心理因素和自杀意念之间的关系。采用逻辑回归法,自变量为药物使用、轻度使用者和重度使用者,因变量为自杀意念。该模型所解释的变异与心理社会因素(年龄、性别、学校类型、移民身份、家庭富裕感、父母教育程度、学校成绩、自尊量表、信仰量表、厌世量表、焦虑量表、抑郁量表、易怒量表、反社会人格量表、与同伴相处时间、与家人相处时间、父母参与、家庭药物使用和同伴影响)所解释的变异进行了比较,同时探讨了各因素之间的关联强度。心理社会因素解释了因变量(即自杀意念)中 33.8% 的方差、而这些参与者使用药物的情况仅解释了预测自杀意念的 2.2% 的方差。与药物使用风险因素相比,社会心理因素对土耳其青少年样本中自杀意念的预测作用更强。
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引用次数: 0
ADHD Symptoms Among Adolescents: Factor Structure Based on Mother and Adolescent Self-Ratings 青少年ADHD症状:基于母亲和青少年自我评价的因素结构
Q4 Medicine Pub Date : 2023-11-06 DOI: 10.2174/0122106766260667231024043828
Rapson Gomez, Shaun Watson, Taylor Brown
Background:: At present, there is little data on the factor structure of ADHD symptoms in adolescents, especially as they are organized in the International Classification of Diseases-10 (ICD-10) or the recently proposed ADHD S-1 bifactor model. This study aimed to analyze how mother and adolescent self-ratings of ADHD symptoms align with these models. Methods:: This study utilized confirmatory factor analysis (CFA) on a group of 300 adolescents (ages ranging from 11 to 17 years) to examine the factor structure in terms of mother ratings and adolescent self-ratings of ADHD symptoms (inattention [IA], hyperactivity [HY], and impulsivity [IM]) presented in the Disruptive Behavior Rating Scale (DBRS). Based on existing theory, the study examined five structural ADHD models: (1) DSM-5/ICD-10 one-factor model (with all symptoms loading on a single factor); (2) DSM-5 two-factor model (with IA and HY/IM factors); (3) ICD- 10 three-factor model (with IA, HY, and IM factors); (4) DSM-5 bifactor S – 1 model (with HY/IM as the reference indicators for the general factor); and (5) ICD-10 bifactor S – 1 model (with IM as the reference indicators for the general factor). Additionally, mothers and adolescents completed the five-item hyperactivity scale in the Strengths and Difficulties Questionnaire (SDQ). Results:: The results showed the most support for the ICD-10 three-factor model, with all three factors in this model showing adequate discriminant validity, good omega coefficient reliability values, and significant and positive association with SDQ hyperactivity. Furthermore, it is speculated that the ADHD structure in adolescents might involve a general ADHD factor alongside an IA-specific factor, omitting an HY component. Since the general factor was marked by the IM symptoms, this suggests that ADHD at a latent level could be typified by IA and IM symptoms, excluding HY symptoms. Conclusion:: The theoretical implications of the findings are discussed.
背景:目前,关于青少年ADHD症状因素结构的数据很少,特别是在国际疾病分类-10 (ICD-10)或最近提出的ADHD S-1双因素模型中进行了组织。本研究旨在分析母亲和青少年对ADHD症状的自我评价如何与这些模型相一致。方法:采用验证性因子分析(CFA)对300名年龄在11 ~ 17岁的青少年进行分析,以母亲评分和青少年在破坏性行为评定量表(DBRS)中对ADHD症状(注意力不集中[IA]、多动[HY]、冲动[IM])的自我评分为依据,考察其因素结构。在现有理论的基础上,本研究检验了五种结构性ADHD模型:(1)DSM-5/ICD-10单因素模型(将所有症状加载到单一因素上);(2) DSM-5双因子模型(IA因子和HY/IM因子);(3) ICD- 10三因子模型(IA、HY、IM因子);(4) DSM-5双因子S - 1模型(以HY/IM作为一般因子的参考指标);(5) ICD-10双因子S -1模型(以IM作为一般因子的参考指标)。此外,母亲和青少年还完成了优势与困难问卷(SDQ)中的五项多动量表。结果:ICD-10三因素模型最受支持,该模型的三个因素均具有足够的判别效度,ω系数信度值良好,与SDQ多动呈显著正相关。此外,据推测,青少年ADHD结构可能包括一般ADHD因素和ia特异性因素,而忽略了HY成分。由于一般因素以IM症状为标志,这表明潜伏水平的ADHD可以以IA和IM症状为典型,而不包括HY症状。结论:讨论了研究结果的理论意义。
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引用次数: 0
Social Media and Fear of Missing Out: An Exploration of the Role of Mindfulness, Cognitive Biases and Need to Belong in Chinese College Students 社交媒体与错失恐惧:正念、认知偏差和归属需求在中国大学生中的作用探讨
Q4 Medicine Pub Date : 2023-11-03 DOI: 10.2174/0122106766264988231024052215
Jing Li, Sijia Liu
Background: Fear of Missing Out (FoMO) on social media has emerged as a significant concern, particularly among college students, with implications for mental well-being and internet use. While previous studies have explored various aspects of mindfulness about digital behaviors, the specific link between mindfulness and FoMO, as well as the potential mechanisms involved, remains underexplored. Objective: Guided by the Conservation of Resources (COR) theory and the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, this study investigates the relationship between mindfulness and FoMO among Chinese college students. Additionally, it explores the mediating roles of cognitive bias and the need to belong in understanding how mindfulness influences FoMO. Methods: Data was collected from 748 university students from two universities in China. Participants completed questionnaires assessing mindfulness, cognitive bias, the need to belong, and FoMO. Statistical analyses, including mediation models and bootstrapping, were conducted using SPSS 25.0 and the PROCESS macro version 3.3. Results: The SPSS PROCESS macro Model 4 analysis revealed that the relationships between mindfulness and FoMO (β=-.011, P=.738) and between Attention to Positive Information (API) and FoMO (β=.029, P=.383) were nonsignificant. Mindfulness exhibited negative associations with Attention to Negative Information (ANI) (β=- .250, P<.001) and the need to belong (β=-.254, P<.001) and positive associations with API (β=.268, P<.001). Furthermore, ANI positively correlated with FoMO (β=.182, P<.001), and the need to belong had a significant positive impact on FoMO (β=.503, P<.001). The mediation analysis indicated that the effect of mindfulness on FoMO was fully mediated by ANI and the need to belong, with no direct effect through API. Conclusion: By recognizing mindfulness as a valuable psychological resource, this research offers insights for developing targeted interventions aimed at reducing FoMO and promoting healthier social media engagement among this population. These findings contribute to the broader understanding of the interplay between mindfulness, cognitive processes, motivation, and FoMO, offering guidance for future research and practical interventions.
背景:社交媒体上的“错失恐惧症”(Fear of Missing Out,简称FoMO)已经成为一个重要的问题,尤其是在大学生中,它对心理健康和互联网使用都有影响。虽然之前的研究已经探索了正念与数字行为的各个方面,但正念与FoMO之间的具体联系以及所涉及的潜在机制仍未得到充分探索。目的:以资源保护理论(Conservation of Resources, COR)和人-情感-认知-执行互动模型(Interaction of person - affect - cognitive - execution, I-PACE)为指导,探讨正念与FoMO之间的关系。此外,它还探讨了认知偏见和归属需求在理解正念如何影响FoMO中的中介作用。方法:对全国两所大学的748名大学生进行调查。参与者完成了评估正念、认知偏见、归属感需求和FoMO的调查问卷。使用SPSS 25.0和PROCESS宏3.3版进行统计分析,包括中介模型和bootapping。结果:SPSS PROCESS宏观模型4分析显示,正念与FoMO之间存在显著的关系(β=-)。011, P=.738),积极信息注意(API)与FoMO之间的关系(β=。029, P=.383)无统计学意义。正念与负面信息注意(ANI) (β=- 0.250, P<.001)和归属需求(β=-)呈负相关。254, P<.001),与API呈正相关(β=。268年,术中;措施)。ANI与FoMO呈正相关(β=。182, P<.001),归属需求对FoMO有显著的正向影响(β=。503年,术中;措施)。中介分析表明,正念对FoMO的影响完全由ANI和归属需求介导,API对FoMO没有直接影响。结论:通过认识到正念是一种有价值的心理资源,本研究为开发有针对性的干预措施提供了见解,旨在减少FoMO,促进这一人群更健康的社交媒体参与。这些发现有助于更广泛地理解正念、认知过程、动机和FoMO之间的相互作用,为未来的研究和实际干预提供指导。
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引用次数: 0
A Brief Review of Flourishing Among Adolescents and Young Adults with Mood and Anxiety Disorders 情绪和焦虑障碍在青少年和青壮年中的应用综述
Q4 Medicine Pub Date : 2023-10-24 DOI: 10.2174/0122106766256854231011064239
Tenzin Lhaksampa, Margot Kelly-Hedrick, Melissa Suchanek, Margaret Chisolm, Leslie Miller
Abstract: The onset of common mental illnesses, such as mood and anxiety disorders, often begins in adolescence and young adulthood. While traditional clinical care focuses on reducing psychiatric symptoms, it is important to simultaneously promote positive psychological states (i.e., flourishing). In this brief review, we synthesize the published literature on flourishing among adolescents and young adults with mood and anxiety disorders. Using VanderWeele’s flourishing model domains, we developed search terms that we applied to PubMed, PsycINFO, and Google Scholar databases. We identified four articles that met the inclusion criteria for this review. Each study identified in this review used distinct flourishing scales to examine various flourishing domains. Overall, incorporating techniques to promote positive mental health in clinical care decreased psychiatric symptoms and increased flourishing. More research is needed to examine how incorporating flourishing into clinical care can reduce suffering and promote positive mental health in patients.
摘要:常见的精神疾病,如情绪障碍和焦虑症,往往开始于青春期和青年期。虽然传统的临床护理侧重于减轻精神症状,但同时促进积极的心理状态(即蓬勃发展)也很重要。在这篇简短的综述中,我们综合了已发表的关于情绪和焦虑障碍的青少年和年轻人的繁荣的文献。利用VanderWeele的蓬勃发展的模型域,我们开发了搜索词,我们将其应用于PubMed, PsycINFO和Google Scholar数据库。我们确定了四篇符合本综述纳入标准的文章。本综述中确定的每项研究都使用不同的繁荣尺度来检查不同的繁荣领域。总的来说,在临床护理中结合促进积极心理健康的技术可以减少精神症状并增加繁荣。需要更多的研究来检验如何将蓬勃发展纳入临床护理以减少患者的痛苦并促进积极的心理健康。
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引用次数: 0
Impact of Changing Cannabis Laws on Cannabis Use Disorders, Serious Mental Illness, and Mortality Outcomes in US Youth: A Narrative Review 改变大麻法律对美国青年大麻使用障碍、严重精神疾病和死亡率结果的影响:叙述性回顾
Q4 Medicine Pub Date : 2023-10-11 DOI: 10.2174/0122106766248146231006061511
Christopher Joseph Hammond, Anne E Boustead, Mary A Fristad, Aditya Pawar, Danielle L Steelesmith, Cynthia A Fontanella
Abstract: Youth cannabis use is a major public health crisis. Cannabis laws carry significant health implications for American youth. Relaxing of these laws – through decriminalization, medical and recreational legalization – by a majority of states in the United States (US) over the past 25 years has dramatically shifted societal perceptions and adult use. How cannabis policy changes have affected the population-wide health of US youth and downstream public health implications of cannabis laws remain topics of significant debate. Cannabis is the most commonly used federally-illicit drug by US adolescents and the main drug for which US teens obtain substance use treatment. Adolescent cannabis use is associated with negative long-term consequences for mental health, risk-taking behaviors, and academic/job achievement. As of January 2023, 37 states and the District of Columbia (DC) have enacted medical cannabis laws; of these, 21 states and DC have recreational cannabis laws. Multiple studies have assessed the association between cannabis laws and youth cannabis use; results indicate mostly null effects for medical laws and mixed effects for recreational laws. Little is known about the effects of cannabis laws on mental health and mortality outcomes for American youth. Methodological limitations have made the interpretation of this literature difficult. This article presents a narrative review of current scientific literature investigating the impact of changing cannabis policies on cannabis and other drug use, mental health, and mortality outcomes in US youth. Implications are framed within a larger discussion on national trends in youth drug use, effects of adolescent cannabis exposure on health outcomes, and research-based policymaking.
摘要:青少年使用大麻是一项重大的公共卫生危机。大麻法对美国年轻人的健康有着重大影响。过去25年来,美国大多数州通过非刑事化、医疗和娱乐合法化放宽了这些法律,极大地改变了社会观念和成人使用大麻的情况。大麻政策的变化如何影响美国青年的全民健康以及大麻法对下游公共卫生的影响仍然是重大辩论的主题。大麻是美国青少年最常用的联邦非法药物,也是美国青少年获得药物滥用治疗的主要药物。青少年使用大麻会对心理健康、冒险行为和学业/工作成就产生长期负面影响。截至2023年1月,37个州和哥伦比亚特区颁布了医用大麻法;其中,21个州和华盛顿特区有娱乐性大麻法律。多项研究评估了大麻法律与青少年使用大麻之间的关系;结果表明,对医疗法规的影响基本为零,对娱乐法规的影响是混合的。人们对大麻法对美国青年心理健康和死亡率的影响知之甚少。方法上的限制使得对这些文献的解释变得困难。本文介绍了当前科学文献的叙述回顾,调查改变大麻政策对美国青少年大麻和其他药物使用、心理健康和死亡率结果的影响。所涉问题是在关于全国青少年吸毒趋势、青少年接触大麻对健康结果的影响以及基于研究的政策制定的更广泛讨论中提出的。
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引用次数: 0
Cannabidiol and Depression: Promise and Challenge in Building an Evidence Base 大麻二酚和抑郁症:建立证据基础的希望和挑战
Q4 Medicine Pub Date : 2023-10-04 DOI: 10.2174/0122106766234102230919064455
Amelia D. Moser, Melissa M. Batt, L Cinnamon Bidwell, Roselinde H. Kaiser
Background: Interest in the potential mental health effects of cannabidiol (CBD) has increased recently, with a surge in commercial and pharmaceutical development of CBD products and a concomitant rise in consumer use. However, despite the widespread and growing use of CBD products by adults and adolescents, the mental health effects of CBD remain largely unknown. Objective: The goals of this review are: 1) to briefly review the evidence base for the mental health effects of CBD, using depression as an exemplar, and 2) to systematically outline complementary study designs needed to test CBD effects, together with challenges and special considerations related to each design. Methods: This review integrates empirical findings related to CBD's effects on mental health outcomes with the literature on intervention trial design and current legal regulations pertaining to CBD. Conclusion: Complementary controlled and observational studies of CBD are necessary to substantiate claims of mental health benefits, including for clinical depression and in pediatric populations. Investigators must consider challenges and opportunities specific to CBD as an intervention, including legal regulations, commercial or pharmaceutical product choice, dosing and bioavailability, and safety.
背景:最近,随着CBD产品的商业和制药开发的激增以及消费者使用的增加,人们对大麻二酚(CBD)潜在的心理健康影响的兴趣有所增加。然而,尽管成人和青少年对CBD产品的使用越来越广泛,而且越来越多,但CBD对心理健康的影响在很大程度上仍然未知。目的:本综述的目的是:1)简要回顾CBD对心理健康影响的证据基础,以抑郁症为例;2)系统地概述测试CBD效应所需的补充研究设计,以及与每种设计相关的挑战和特殊考虑。方法:本综述将CBD对心理健康结果影响的实证研究结果与干预试验设计和现行CBD法律法规相关的文献相结合。结论:有必要进行补充性的对照和观察性研究,以证实CBD对心理健康的益处,包括对临床抑郁症和儿科人群的益处。调查人员必须考虑到CBD作为干预措施所特有的挑战和机遇,包括法律法规、商业或制药产品的选择、剂量和生物利用度以及安全性。
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引用次数: 0
Effects of Cannabidiol in Adolescent and Young Adult Depressive and Anxiety Disorders: A Systematic Review of Clinical and Preclinical Research 大麻二酚对青少年抑郁和焦虑症的影响:临床和临床前研究的系统回顾
Q4 Medicine Pub Date : 2023-10-04 DOI: 10.2174/0122106766233339230919143924
Rebecca K. Denson, Julia Brooks, Graziano Pinna, Natania A . Crane
Background: Adolescents and young adults may use cannabidiol (CBD) products in an attempt to reduce depression and anxiety symptoms, despite little research examining this use. This systematic review evaluated preclinical and clinical research on the effects of CBD on depressive and anxiety disorders in adolescence and young adulthood. To provide context, we discuss CBD’s mechanism of action and neurodevelopmental effects. Methods: PubMed was searched for articles published through June 2022. Preclinical or clinical CBD administration studies with N > 1 that examined depressive and/or anxiety disorders were eligible. Results: Initially, 224 publications were identified. After excluding duplicates and applying eligibility criteria, 6 preclinical (depression: n≈133; anxiety: n≈161) and 4 clinical (anxiety: n=113) articles remained. Due to the low number of studies, results were synthesized qualitatively. The Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence were used to rate each study’s evidence. The preclinical effects of CBD on depression-like behavior appear to differ by sex, early life stress, and duration of use. Despite no evidence that CBD exerts anxiolytic effects in preclinical adolescent models, CBD may reduce anxiety symptoms in human adolescents and young adults with anxiety disorders. Conclusion: The existing evidence suggests that CBD may reduce symptoms of anxiety in adolescents and young adults. However, the evidence is sparse and limited by variations in samples and CBD dosing duration. Further research is needed to understand the potential benefits and/or harms of CBD for depression and anxiety disorders in this population. Implications for clinical practice and research are discussed.
背景:青少年和年轻人可能会使用大麻二酚(CBD)产品来减轻抑郁和焦虑症状,尽管很少有研究检查这种使用。本系统综述评估了CBD对青春期和青年期抑郁和焦虑障碍的临床前和临床研究。为了提供背景,我们讨论了CBD的作用机制和神经发育作用。方法:检索PubMed截至2022年6月发表的文章。N >临床前或临床CBD给药研究;1名检查抑郁症和/或焦虑症的患者符合条件。结果:最初,确定了224篇出版物。在排除重复并应用资格标准后,6例临床前抑郁症:n≈133;焦虑:n≈161)和4篇临床(焦虑:n=113)文章。由于研究数量少,结果是定性合成的。牛津循证医学中心2011年证据水平被用于评估每项研究的证据。CBD对抑郁样行为的临床前影响似乎因性别、早期生活压力和使用时间而异。尽管没有证据表明CBD在临床前青少年模型中具有抗焦虑作用,但CBD可能会减轻患有焦虑症的青少年和年轻人的焦虑症状。结论:现有证据表明,CBD可能减轻青少年和年轻人的焦虑症状。然而,证据是稀疏的,并且受到样本和CBD剂量持续时间变化的限制。需要进一步的研究来了解CBD对这一人群的抑郁症和焦虑症的潜在益处和/或危害。对临床实践和研究的意义进行了讨论。
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引用次数: 0
Identifying Cannabidiol (CBD) Research Priorities Relevant to Child and Adolescent Psychiatry 确定与儿童和青少年精神病学相关的大麻二酚(CBD)研究重点
IF 0.4 Q4 Medicine Pub Date : 2023-09-01 DOI: 10.2174/2210676613666230901143219
Leslie Hulvershorn, Sally Weinstein, Kristina Bixler, Olivia K Murray, Michael P Smoker, Christopher Hammond
Cannabidiol (CBD), a plant-derived cannabinoid compound found incannabis, has been readily available in the United States since the legalization ofhemp products in 2018. With all 50 states legalizing some form of CBD, manyproducts have appeared in the marketplace. The American public generallyconsiders CBD a safe and effective way to manage pain, mental health conditions,and other health issues in children and adults, even though CBD has only beenapproved for the treatment of specific types of pediatric seizures. This reportdescribes early findings from preclinical CBD studies, select clinical trials, andnaturalistic observational studies of CBD users and identifies knowledge gaps inthis emerging field, especially those relating to the developmental effects of CBD.The main goal of this report is to identify priorities for future CBD research,particularly those that will benefit the field of child and adolescent psychiatry.
大麻二酚(CBD)是一种植物衍生的大麻素化合物,被发现为大麻二酚,自2018年大麻产品合法化以来,它在美国一直很容易获得。随着50个州都将某种形式的CBD合法化,许多产品出现在市场上。美国公众普遍认为CBD是一种安全有效的治疗儿童和成人疼痛、心理健康状况和其他健康问题的方法,尽管CBD仅被批准用于治疗特定类型的儿童癫痫。本报告描述了CBD使用者的临床前研究、精选临床试验和自然观察性研究的早期发现,并确定了这一新兴领域的知识差距,特别是与CBD发育影响有关的知识差距。本报告的主要目标是确定未来CBD研究的优先事项,特别是那些将有利于儿童和青少年精神病学领域的研究。
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引用次数: 0
Review of the Efficacy and Safety Of Cannabidiol with a Focus on Children and Adolescents in the Treatment of Psychiatric Symptoms and Disorders 大麻二酚治疗儿童和青少年精神病症状和障碍的疗效和安全性综述
IF 0.4 Q4 Medicine Pub Date : 2023-09-01 DOI: 10.2174/2210676613666230901143229
Amanda Sun, Aimee Sullivan, Jarrod Leffler, Christopher Hammond, Leslie Hulvershorn, Leslie Miller
Cannabidiol (CBD) is a plant-derived cannabinoid found in cannabis and hemp plants with broad psychopharmacologic effects and poorly understood mechanisms of action that may include anti-oxidant and anti-inflammatory properties and CNS modulation of endocannabinoid, glutamatergic, and serotonergic neurotransmission. This article reviews existing data on the safety and efficacy of CBD for mental and physical health indications in the pediatric population and for psychiatric disorders in adults, with a focus on clinical trials. Searches of PubMed and PsycINFO for articles through October 2021 focused on clinical trials on “cannabidiol” and “seizure” or “psychiatry” in youth and adults, identifying 686 articles that were then screened and evaluated for relevance. Research into the safety and efficacy of CBD led to the United States Food and Drug Administration's approval of Epidolex, a purified pharmaceutical-grade CBD medicine, for treating drug-resistant seizures in Dravet syndrome, Lennox-Gastaut syndrome and tuberous sclerosis complex. Beyond treatment for rare seizure disorders, CBD has received growing public interest in recent years as a “natural” treatment for various other medical and psychiatric conditions, resulting in a rapidly expanding multi-billion-dollar US market for CBD dietary/health supplements and a growing number of Americans reporting regular use. However, the growing demand and broad claims of purported benefits have greatly outpaced the body of literature substantiating its use. Further, limited safety data in pediatric populations, drug-to-drug interactions between CBD and prescribed medications, and issues related to mislabeling and contamination have blunted enthusiasm for CBD in the pediatric healthcare community and indicate a need for additional research.
大麻二酚(CBD)是一种在大麻和大麻植物中发现的植物衍生的大麻素,具有广泛的精神药理学作用,其作用机制可能包括抗氧化和抗炎特性,以及内源性大麻素、谷氨酸能和血清素能神经传递的中枢神经系统调节。这篇文章回顾了现有的关于CBD在儿童人群的精神和身体健康适应症以及成人精神疾病方面的安全性和有效性的数据,重点是临床试验。到2021年10月,PubMed和PsycINFO对文章的搜索主要集中在青少年和成人的“大麻二酚”和“癫痫”或“精神病学”的临床试验上,确定了686篇文章,然后进行了筛选和相关性评估。对CBD安全性和有效性的研究促使美国食品和药物管理局(Food and Drug Administration)批准了Epidolex,一种纯化的药用级CBD药物,用于治疗Dravet综合征、lenox - gastaut综合征和结节性硬化症的耐药癫痫发作。除了治疗罕见的癫痫发作之外,近年来,CBD作为各种其他医学和精神疾病的“天然”治疗方法引起了越来越多的公众兴趣,导致CBD膳食/保健品在美国的市场迅速扩大,规模达数十亿美元,越来越多的美国人报告经常使用CBD。然而,不断增长的需求和广泛声称的好处大大超过了文献证实其使用的速度。此外,儿科人群中有限的安全性数据,CBD与处方药之间的药物间相互作用,以及与标签错误和污染相关的问题削弱了儿科医疗社区对CBD的热情,表明需要进一步的研究。
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Adolescent Psychiatry
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