Trends in Psychiatry and Psychotherapy最新文献

Objectives: Thus, through a narrative review, this article analyzes how the advancement of technology, the use of digital resources, and social media have impacted the doctor-patient relationship.

Methods: We conducted a scoping review on the relationship between Digital Health Equity and Telemedicine and e-health via Scopus and Pubmed electronic databases. The following inclusion criteria were established: papers on the relationship between digital health equity and telemedicine and e-health, written in English and with no time limits. All study designs were eligible, including those that have utilized qualitative and quantitative methods, methodology, or guidelines reports, except for meta-reviews.

Results: With the advancement of technology and social media, a change in behavior in the population and the doctor-patient relationship was observed. Through the help of digital devices, the increased prevalence of social networks, and asynchronous consultations new opportunities were created to bring doctors and patients closer. The relationship has shifted from face-to-face and paternalistic to virtual communication with shared decisions in recent decades. It was observed that the advancement of technology and the use of digital resources have reshaped the roles of doctors and patients and their relationships.

Conclusion: Technology is the leading cause for an informed, more involved, and responsible patient. However, physicians have conflicting opinions about the use of these technologies. While recognizing its benefits for patients, they are also concerned about digital health and its impact.

Objective: Attention-deficit/hyperactivity disorder (ADHD) affects approximately 7% of children and 5% of adolescents worldwide. ADHD is characterized by inattention, hyperactivity and impulsivity as symptoms. The exact mechanism underlying this disorder is still unclear, but genetic and environmental factors play important roles. In recent years, research and treatment options have increased, including medication and/or therapeutic interventions such as music therapy. There is evidence showing benefits of music therapy on mental health, such as autism spectrum disorder (ASD). However, results regarding ADHD are limited. The aim of this meta-analysis was to verify whether music therapy is an effective tool for improving symptoms in children and adolescents with ADHD.

Methods: In accordance with PRISMA guidelines, we systematically searched the Virtual Health Library, SciELO, PubMed and Cochrane Library databases. This article included original research that investigated the effect of music therapy on hyperactive and impulsive symptoms in children and adolescents with ADHD.

Results: Music therapy was associated with a trend of efficacy involving ADHD symptoms (effect size: 1.18; CI: -3.8 - 0.21; p = 0.08). Additionally, a significant amount of heterogeneity among trials was found (I2 = 92 %). The lack of studies involving music therapy, ADHD and brain imaging, as well as limited investigation of inattention symptoms in studied articles are limitations of this article.

Conclusion: Music therapy is an important therapeutic tool for ADHD. Therefore, future research should include more robust samples and measurement scales, follow-up after experiments and further exploration of the potential connections among ADHD, music therapy, neuroimaging and neuroscientific fields.

Objective: In recent decades, there have been considerable advances in treatment and prevention of acute ischemic stroke (IS). However, even after treatment, approximately two-thirds of patients with IS have some degree of disability that requires rehabilitation, along with an increased likelihood of developing psychiatric disorders, particularly depression. The objective of this study was to determine the predictors of post-stroke depression in a 6-month period in patients with IS.

Methods: Ninety-seven patients with IS without previous depression were included in the study. The study protocol was applied during hospitalization and at 30, 90, and 180 days after hospital discharge. A binary logistic regression was then conducted. Age, sex, marital status, occupation, educational level, thrombolysis, National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) score, Barthel Index (BI), and Mini-Mental State Examination (MMSE) score were included as independent variables.

Results: Of the 97 patients, 24% of patients developed post-stroke depression. In the longitudinal follow-up, an mRS score of > 0 was the lone significant predictor of development of depression (odds ratio [OR] = 5.38; 95% confidence interval [95%CI] 1.25-23.12; p < 0.05).

Conclusion: Our results showed that in patients without previous depression, functional impairment of any degree is associated with a 5-fold greater chance of development of depression in the first 6 months post-stroke compared to patients without functional impairment.

Objective: This study aimed to examine the discriminative capacity of the Dimensional Clinical Personality Inventory 2 (IDCP-2) factors for identifying individuals with elevated borderline personality disorder (BPD) traits within a Brazilian community sample while proposing an optimal cutoff score for distinguishing high BPD trait levels.

Methods: The participant cohort consisted of 1,469 adults who completed assessments, including the Level of Personality Functioning Scale - Brief Form 2.0 (LPFS), the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) (PID-5), the IDCP-2, and the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) - Personality Questionnaire (PQ-SCID-II). We categorized participants into three groups utilizing the traits outlined in the Alternative Model of Personality Disorders (AMPD) from DSM-5 Section III. Furthermore, latent profile analysis based on PID-5 facets revealed the existence of three empirically derived profiles.

Results: Our findings demonstrate that IDCP-2 factors exhibited substantial discriminative power, marked by large effect sizes across most factors. To minimize false negatives, we suggest a conservative cutoff score of 22 as the most effective threshold for identifying individuals with high levels of BPD traits.

Conclusion: The BPD score generated from IDCP-2 factors holds significant promise in clinical practice, offering valuable insights into a patient's propensity to exhibit a BPD profile and providing a comprehensive clinical profile.

Lithium's well-documented efficacy in preventing suicide over the long term prompts consideration of its potential for more rapid antisuicidal effects. However, evidence supporting such acute efficacy is limited. Weighing against its possible rapid benefits are significant concerns regarding lithium's side-effect profile - particularly toxicity, renal impairment, and weight gain - and the often necessary delay in achieving therapeutic levels. Moreover, the multifaceted nature of suicidality complicates identifying short-term outcomes and disentangling lithium's effects on suicidal thoughts from broader reductions in depressive symptoms. While lithium may remain invaluable for some high-risk patients in emergency settings, its routine use as a rapid-acting agent for acute suicidality is currently not well supported.

Psychedelics are a group of psychoactive substances that produce complex and subjective changes to consciousness and carry unique safety considerations. There is a growing body of work investigating the use of psychedelics in mental health treatment alongside increasing socio-cultural and political acceptance. This rapid evolution has prompted corporations to fund psychedelic clinical trials, leading to a potential rise in conflicts of interest in relevant studies and publications. However, the body of evidence for the safety and efficacy of psychedelic-assisted psychotherapy is early. There is concern regarding the introduction of bias in psychedelic clinical trials and the selective reporting of results amidst and beyond corporate involvement. At a crucial time in psychedelic drug reform, this paper explores the safety concerns associated with psychedelics, the potential influences of financial stakeholders on safety outcome reporting and the importance of balanced science communication in maintaining public health and safety.

Objective: Women with premenstrual dysphoric disorder (PMDD) are more likely to report suicide ideation and behavior when compared to women without PMDD. However, there is a lack of studies investigating the risk factors for suicide risk in women with PMDD. Thus, the aim of this study is to assess the factors associated with suicide risk in young women with PMDD.

Methods: This is a cross-sectional study including 128 young women with PMDD who were recruited from the community. PMDD and suicide risk were assessed by trained psychologists using the Mini International Neuropsychiatric Interview (MINI-PLUS). Suicide risk evaluation includes six questions that assess suicidal intention, planning, and previous attempts. Subjects who answer yes to any of the six questions are classified as having current suicide risk.

Results: The prevalence of current suicide risk in women with PMDD was 28.1%. The factors associated with suicide risk in this population were: presenting current panic disorder (odds ratio [OR]: 18.71 [95% confidence interval {95%CI} 1.02-343.27], p = 0.048), a non-white skin color (OR: 4.18 [95%CI 1.28-13.61], p = 0.018), greater severity of depressive symptoms (OR: 1.22 [95%CI 1.12-1.32], p < 0.001), and history of childhood trauma (OR: 1.04 [95%CI 1.01-1.08], p = 0.010).

Conclusion: Our findings indicate that there are key sociodemographic and clinical factors associated with suicide risk in young women with PMDD, enabling clinicians to identify at-risk individuals who could benefit from further screening and interventions.

Objective: Major depressive disorder (MDD) is a prevalent mood disorder characterized by persistent low mood and anhedonia, significantly impacting cognitive function and daily living. Despite available pharmacological treatments, nearly one-third of individuals with MDD do not achieve adequate symptom relief with conventional treatments. The ketogenic diet (KD), a high-fat, low-carbohydrate diet that induces ketosis, has emerged as a potential non-pharmacological intervention for MDD. The objective of this study was to provide a comprehensive perspective on the current knowledge and gaps regarding the potential antidepressant effect of the KD, emphasizing its safety, efficacy, and mechanistic pathways.

Methods: This narrative review synthesizes data from preclinical and clinical studies on the effects of KD on mood, cognitive function, and its potential as an antidepressant. Mechanistic insights from animal and human studies are explored to elucidate possible pathways through which KD may exert its effects on MDD.

Results: Evidence from animal models suggests that KD may reduce depressive-like behaviors and improve cognitive function. Preliminary human studies, including case reports and observational studies, indicate potential benefits such as mood stabilization, increased energy, and reduced depression severity. Proposed mechanisms include immune-inflammatory regulation, correction of mitochondrial dysfunction, and neurotransmitter modulation. However, key gaps remain, particularly regarding the therapeutic window, long-term efficacy, and specific mechanisms of action in MDD.

Conclusions: KD represents a promising avenue for further investigation as a non-pharmacological treatment of MDD. Further research is needed to establish its clinical utility, identify predictors of response, and assess its feasibility as a treatment option for MDD.

Objective: One of the most popular ways to meet new people in the modern world is through dating apps. However, their use may facilitate casual sexual encounters and quick partner changes, both of which are associated with endangering sexual health in different populations. The objective of this study is to describe the use of mobile dating apps among undergraduate students at a major Brazilian public university and investigate its associations with sexual risk behaviors and sociodemographic factors.

Methods: This is a cross-sectional study based on a web survey. The link for participation was made available to students enrolled in undergraduate courses at the eight units of Universidade de São Paulo, Campus Ribeirão Preto. Use of dating apps, sociodemographic/behavioral profile, and sexual risk behaviors were among the variables studied. The distribution of app users was calculated for each variable of interest, and prevalence ratios (PRs) were used for comparisons. PRs were reported with 95% confidence intervals (95%CI).

Results: A total of 487 students participated, with 32.9% reporting using dating apps. Male participants were more likely to use apps. Use of dating apps was associated with having multiple sexual partners and risky behaviors such as smoking, alcohol consumption, and substance abuse.

Conclusion: It is critical to describe the pattern of app use by undergraduate students and understand its influence on sexual health in order to avoid stigmatizing users. Additionally, this information can be helpful to guide the creation of strategies for using these apps as resources to promote health, such as through sharing information regarding sexual health.

Neuroscience-based nomenclature (NbN) is a proposal to provide a nomenclature based on neuroscience and pharmacology instead of the old disease-based classification. The NbN is based on the mechanism of action and pharmacological target and aims to assist in rational prescription, to reduce stigma, and to increase treatment adherence. Currently, the NbN is endorsed by many psychiatric associations, has been adopted by several relevant journals, and is included in major psychiatry textbooks. Therefore, it is important that the NbN is known to psychiatrists.