Pub Date : 2024-06-10DOI: 10.3389/fpsyt.2024.1385947
Shu H. Yau, Kaylynn Choo, Jane Tan, Olivia Monson, Stephanie Bovell
Augmentative alternative communication (AAC) devices or systems are often prescribed to minimally verbal or nonspeaking autistic individuals and other individuals with complex communication needs to facilitate communication or as an alternative to spoken language. AAC use can result in communication gains and improved quality of life for minimally verbal or nonspeaking individuals. Despite this, AAC abandonment is high, limiting societal participation of the individual on the autism spectrum with complex communication needs. Our study is a novel exploration of the barriers of AAC use from a multi-stakeholder perspective, and a qualitative analysis of similarities and differences between stakeholders. We conducted semi-structured interviews and focus groups with 30 parent-carers, educators and clinicians currently supporting AAC users in Western Australia and analysed the data using reflexive thematic analysis. Barriers from each stakeholder group were coded, resulting in 17 subthemes forming five main themes common to all stakeholders: Stakeholder Knowledge, Stakeholder Attitudes and Stigma, Resources, AAC User Engagement, and Device Fit. Contrasting perspectives included actual and perceived stigma associated with AAC use (parent-carers vs clinicians); different struggles with resources and knowledge (parent-carers vs clinicians and educators); and a lack of clinician communication in the processes that determined AAC-fit for school environments (educators only). Findings are discussed in the context of improving inter-stakeholder collaboration and capacity building in Australian health service and practice to better support minimally verbal or nonspeaking autistic individuals and individuals with complex communication needs. Suggestions are also offered for communication partner training.
{"title":"Comparing and contrasting barriers in augmentative alternative communication use in nonspeaking autism and complex communication needs: multi-stakeholder perspectives","authors":"Shu H. Yau, Kaylynn Choo, Jane Tan, Olivia Monson, Stephanie Bovell","doi":"10.3389/fpsyt.2024.1385947","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1385947","url":null,"abstract":"Augmentative alternative communication (AAC) devices or systems are often prescribed to minimally verbal or nonspeaking autistic individuals and other individuals with complex communication needs to facilitate communication or as an alternative to spoken language. AAC use can result in communication gains and improved quality of life for minimally verbal or nonspeaking individuals. Despite this, AAC abandonment is high, limiting societal participation of the individual on the autism spectrum with complex communication needs. Our study is a novel exploration of the barriers of AAC use from a multi-stakeholder perspective, and a qualitative analysis of similarities and differences between stakeholders. We conducted semi-structured interviews and focus groups with 30 parent-carers, educators and clinicians currently supporting AAC users in Western Australia and analysed the data using reflexive thematic analysis. Barriers from each stakeholder group were coded, resulting in 17 subthemes forming five main themes common to all stakeholders: Stakeholder Knowledge, Stakeholder Attitudes and Stigma, Resources, AAC User Engagement, and Device Fit. Contrasting perspectives included actual and perceived stigma associated with AAC use (parent-carers vs clinicians); different struggles with resources and knowledge (parent-carers vs clinicians and educators); and a lack of clinician communication in the processes that determined AAC-fit for school environments (educators only). Findings are discussed in the context of improving inter-stakeholder collaboration and capacity building in Australian health service and practice to better support minimally verbal or nonspeaking autistic individuals and individuals with complex communication needs. Suggestions are also offered for communication partner training.","PeriodicalId":506619,"journal":{"name":"Frontiers in Psychiatry","volume":"113 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141361188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-10DOI: 10.3389/fpsyt.2024.1364845
Aurelie M. Athan
The concept of matrescence, akin to adolescence but for mothers, has gained increasing attention in perinatal psychiatry, marking a paradigm shift towards understanding the holistic development of mothers. Matrescence encompasses the myriad psychological, social, cultural, and existential changes which occur as women transition into motherhood. Despite advances in maternal mental health, a bias towards pathologizing maternal experiences persists in research and practice. This commentary advocates for the integration of matrescence into perinatal psychiatry, drawing from the work of Dana Raphael and contemporary scholarship. Matrescence offers a strengths-based framework that acknowledges both the challenges and opportunities of motherhood, emphasizing the normative aspects of a mother’s self-development. By adopting matrescence terminology and nosology, clinicians and researchers can enhance traditional psychiatric classifications. Additionally, matrescence underscores the importance of considering ecological systems and historical factors in maternal well-being, highlighting the need for comprehensive and compassionate healthcare services. Embracing matrescence as a fundamental concept in perinatal psychiatry holds promise for improving maternal mental health outcomes and promoting the flourishing of mothers worldwide.
{"title":"A critical need for the concept of matrescence in perinatal psychiatry","authors":"Aurelie M. Athan","doi":"10.3389/fpsyt.2024.1364845","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1364845","url":null,"abstract":"The concept of matrescence, akin to adolescence but for mothers, has gained increasing attention in perinatal psychiatry, marking a paradigm shift towards understanding the holistic development of mothers. Matrescence encompasses the myriad psychological, social, cultural, and existential changes which occur as women transition into motherhood. Despite advances in maternal mental health, a bias towards pathologizing maternal experiences persists in research and practice. This commentary advocates for the integration of matrescence into perinatal psychiatry, drawing from the work of Dana Raphael and contemporary scholarship. Matrescence offers a strengths-based framework that acknowledges both the challenges and opportunities of motherhood, emphasizing the normative aspects of a mother’s self-development. By adopting matrescence terminology and nosology, clinicians and researchers can enhance traditional psychiatric classifications. Additionally, matrescence underscores the importance of considering ecological systems and historical factors in maternal well-being, highlighting the need for comprehensive and compassionate healthcare services. Embracing matrescence as a fundamental concept in perinatal psychiatry holds promise for improving maternal mental health outcomes and promoting the flourishing of mothers worldwide.","PeriodicalId":506619,"journal":{"name":"Frontiers in Psychiatry","volume":"104 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141361240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-10DOI: 10.3389/fpsyt.2024.1412637
José Manuel Montes, Luis Agüera-Ortiz, Anna Mané, Jose Martinez-Raga, Luis Gutiérrez-Rojas
The care of people with schizophrenia (PWS) is usually provided in an outpatient setting by community mental health teams. However, PWS frequently require inpatient treatment because of a wide array of clinical, personal and/or social situations. Unfortunately, to our knowledge, there are no guidelines available to help psychiatrists in the decision-making process on hospital discharge for PWS. The aim of this project was to develop an expert consensus on discharge criteria for PWS after their stay in an acute inpatient psychiatric unit.Using a modified Delphi method a group of 42 psychiatrists throughout Spain evaluated four areas of interest regarding this issue: clinical symptomatology, treatment-related factors, follow-up health care units after discharge, and physical health and monitoring.After two rounds, among the 64 statements, a consensus was reached for 59 (92.2%) statements. In three (17.7%) of the 17 statements on ‘clinical symptomatology’ and 2 (13.3%) of the 15 statements on ‘follow-up health care units after discharge’, a consensus was not reached; in contrast, a consensus was reached for all statements concerning ‘treatment-related factors’ and those concerning ‘physical health and monitoring’. The consensus results highlight the importance for discharge of the control of symptoms rather than their suppression during admission and of tolerability in the selection of anantipsychotic.Although there is a lack of relevant data for guiding the discharge of PWS after hospitalization in an acute inpatient psychiatric unit, we expect that this consensus based on expert opinion may help clinicians to take appropriate decisions.
{"title":"Clinical decision-making before discharge in hospitalized persons with schizophrenia: a Spanish Delphi expert consensus","authors":"José Manuel Montes, Luis Agüera-Ortiz, Anna Mané, Jose Martinez-Raga, Luis Gutiérrez-Rojas","doi":"10.3389/fpsyt.2024.1412637","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1412637","url":null,"abstract":"The care of people with schizophrenia (PWS) is usually provided in an outpatient setting by community mental health teams. However, PWS frequently require inpatient treatment because of a wide array of clinical, personal and/or social situations. Unfortunately, to our knowledge, there are no guidelines available to help psychiatrists in the decision-making process on hospital discharge for PWS. The aim of this project was to develop an expert consensus on discharge criteria for PWS after their stay in an acute inpatient psychiatric unit.Using a modified Delphi method a group of 42 psychiatrists throughout Spain evaluated four areas of interest regarding this issue: clinical symptomatology, treatment-related factors, follow-up health care units after discharge, and physical health and monitoring.After two rounds, among the 64 statements, a consensus was reached for 59 (92.2%) statements. In three (17.7%) of the 17 statements on ‘clinical symptomatology’ and 2 (13.3%) of the 15 statements on ‘follow-up health care units after discharge’, a consensus was not reached; in contrast, a consensus was reached for all statements concerning ‘treatment-related factors’ and those concerning ‘physical health and monitoring’. The consensus results highlight the importance for discharge of the control of symptoms rather than their suppression during admission and of tolerability in the selection of anantipsychotic.Although there is a lack of relevant data for guiding the discharge of PWS after hospitalization in an acute inpatient psychiatric unit, we expect that this consensus based on expert opinion may help clinicians to take appropriate decisions.","PeriodicalId":506619,"journal":{"name":"Frontiers in Psychiatry","volume":"125 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141362685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-10DOI: 10.3389/fpsyt.2024.1431389
L. Peled-Avron, Jacob S. Aday, Amilia Lydia Kalafateli, Holly K. Hamilton, Joshua D. Woolley
{"title":"Editorial: Down the rabbit hole – the psychological and neural mechanisms of psychedelic compounds and their use in treating mental health and medical conditions","authors":"L. Peled-Avron, Jacob S. Aday, Amilia Lydia Kalafateli, Holly K. Hamilton, Joshua D. Woolley","doi":"10.3389/fpsyt.2024.1431389","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1431389","url":null,"abstract":"","PeriodicalId":506619,"journal":{"name":"Frontiers in Psychiatry","volume":"101 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141361590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-10DOI: 10.3389/fpsyt.2024.1322434
D. J. Heal, J. Gosden, Sharon L. Smith
Various countries and US States have legalized cannabis, and the use of the psychoactive1 and non-psychoactive cannabinoids is steadily increasing. In this review, we have collated evidence from published non-clinical and clinical sources to evaluate the abuse, dependence and associated safety risks of the individual cannabinoids present in cannabis. As context, we also evaluated various synthetic cannabinoids. The evidence shows that delta-9 tetrahydrocannabinol (Δ9-THC) and other psychoactive cannabinoids in cannabis have moderate reinforcing effects. Although they rapidly induce pharmacological tolerance, the withdrawal syndrome produced by the psychoactive cannabinoids in cannabis is of moderate severity and lasts from 2 to 6 days. The evidence overwhelmingly shows that non-psychoactive cannabinoids do not produce intoxicating, cognitive or rewarding properties in humans. There has been much speculation whether cannabidiol (CBD) influences the psychoactive and potentially harmful effects of Δ9-THC. Although most non-clinical and clinical investigations have shown that CBD does not attenuate the CNS effects of Δ9-THC or synthetic psychoactive cannabinoids, there is sufficient uncertainty to warrant further research. Based on the analysis, our assessment is cannabis has moderate levels of abuse and dependence risk. While the risks and harms are substantially lower than those posed by many illegal and legal substances of abuse, including tobacco and alcohol, they are far from negligible. In contrast, potent synthetic cannabinoid (CB1/CB2) receptor agonists are more reinforcing and highly intoxicating and pose a substantial risk for abuse and harm. 1 “Psychoactive” is defined as a substance that when taken or administered affects mental processes, e.g., perception, consciousness, cognition or mood and emotions.
{"title":"A critical assessment of the abuse, dependence and associated safety risks of naturally occurring and synthetic cannabinoids","authors":"D. J. Heal, J. Gosden, Sharon L. Smith","doi":"10.3389/fpsyt.2024.1322434","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1322434","url":null,"abstract":"Various countries and US States have legalized cannabis, and the use of the psychoactive1 and non-psychoactive cannabinoids is steadily increasing. In this review, we have collated evidence from published non-clinical and clinical sources to evaluate the abuse, dependence and associated safety risks of the individual cannabinoids present in cannabis. As context, we also evaluated various synthetic cannabinoids. The evidence shows that delta-9 tetrahydrocannabinol (Δ9-THC) and other psychoactive cannabinoids in cannabis have moderate reinforcing effects. Although they rapidly induce pharmacological tolerance, the withdrawal syndrome produced by the psychoactive cannabinoids in cannabis is of moderate severity and lasts from 2 to 6 days. The evidence overwhelmingly shows that non-psychoactive cannabinoids do not produce intoxicating, cognitive or rewarding properties in humans. There has been much speculation whether cannabidiol (CBD) influences the psychoactive and potentially harmful effects of Δ9-THC. Although most non-clinical and clinical investigations have shown that CBD does not attenuate the CNS effects of Δ9-THC or synthetic psychoactive cannabinoids, there is sufficient uncertainty to warrant further research. Based on the analysis, our assessment is cannabis has moderate levels of abuse and dependence risk. While the risks and harms are substantially lower than those posed by many illegal and legal substances of abuse, including tobacco and alcohol, they are far from negligible. In contrast, potent synthetic cannabinoid (CB1/CB2) receptor agonists are more reinforcing and highly intoxicating and pose a substantial risk for abuse and harm. 1 “Psychoactive” is defined as a substance that when taken or administered affects mental processes, e.g., perception, consciousness, cognition or mood and emotions.","PeriodicalId":506619,"journal":{"name":"Frontiers in Psychiatry","volume":"118 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141361812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-10DOI: 10.3389/fpsyt.2024.1379396
Catherine E. B. Brown, Karyn E. Richardson, Bengianni Halil-Pizzirani, Sam Hughes, Lou Atkins, Joseph Pitt, Murat Yücel, Rebecca A. Segrave
Regular exercise has the potential to enhance university students’ mental and cognitive health. The PEAK Mood, Mind and Marks program (i.e., PEAK) is a neuroscience-informed intervention developed using the Behaviour Change Wheel to support students to exercise three or more times per week to benefit their mental and cognitive health. This pilot study assessed the impact of PEAK on exercise, mental and cognitive health, and implementation outcomes.PEAK was delivered to 115 undergraduate university students throughout a 12-week university semester. The primary outcome was weekly exercise frequency. Secondary outcomes were: time spent engaged in moderate-vigorous exercise, sedentary behaviour and perceived mental health and cognitive health. All were measured via online self-report questionnaires. Qualitative interviews with 15 students investigated influences on engagement, the acceptability and appropriateness of PEAK, and its mechanisms of behaviour change. Paired t-tests, Wilcoxon Signed-Rank tests and template analysis were used to analyse quantitative and qualitative data, respectively.On average, 48.4% of students engaged in the recommended frequency of three or more exercise sessions per week. This proportion decreased towards the end of PEAK. Sedentary behaviour significantly decreased from baseline to end-point, and moderate-vigorous exercise significantly increased among students’ who were non-exercisers. Mental wellbeing, stress, loneliness, and sense of belonging to the university significantly improved. There were no significant changes in psychological distress. Concentration, memory, and productivity significantly improved. Sixty-eight percent of students remained engaged in one or more components of PEAK at end-point. Qualitative data indicated students found PEAK to be acceptable and appropriate, and that it improved aspects of their capability, opportunity, and motivation to exercise.Students are receptive to an exercise-based program to support their mental and cognitive health. Students exercise frequency decreased; however, these figures are likely a conservative estimate of students exercise engagement. Students valued the neuroscience-informed approach to motivational and educational content and that the program’s goals aligned with their academic goals. Students identified numerous areas PEAK’s content and implementation can be optimised, including use of a single digital delivery platform, more opportunities to connect with peers and to expand the content’s cultural inclusivity.
定期锻炼有可能增强大学生的心理和认知健康。PEAK Mood, Mind and Marks 计划（即 PEAK）是一项以神经科学为基础的干预措施，采用行为改变轮来支持学生每周锻炼三次或三次以上，以有益于他们的心理和认知健康。这项试点研究评估了 PEAK 对运动、心理和认知健康以及实施结果的影响。PEAK 在为期 12 周的大学学期中对 115 名本科大学生进行了干预。主要结果是每周的锻炼频率。次要结果包括：参与中等强度运动的时间、久坐行为以及心理健康和认知健康感知。所有结果均通过在线自我报告问卷进行测量。对 15 名学生进行的定性访谈调查了参与的影响因素、PEAK 的可接受性和适宜性及其行为改变机制。对定量和定性数据的分析分别采用了配对 t 检验、Wilcoxon Signed-Rank 检验和模板分析。在 PEAK 结束时，这一比例有所下降。从基线到终点，久坐不动的行为明显减少，而在不运动的学生中，中等强度的运动明显增加。心理健康、压力、孤独感和对大学的归属感明显改善。心理压力没有明显变化。注意力、记忆力和工作效率明显提高。68%的学生在终点时仍然参与了 PEAK 的一个或多个组成部分。定性数据显示，学生们认为 PEAK 是可以接受的，也是合适的，它提高了他们锻炼的能力、机会和动力。学生的运动频率有所下降；不过，这些数字很可能是对学生运动参与度的保守估计。学生们重视以神经科学为依据的激励和教育内容，并认为该计划的目标与他们的学业目标相一致。学生们指出，PEAK 的内容和实施有许多可以优化的地方，包括使用单一的数字交付平台、提供更多与同伴交流的机会以及扩大内容的文化包容性。
{"title":"PEAK Mood, Mind, and Marks: a pilot study of an intervention to support university students’ mental and cognitive health through physical exercise","authors":"Catherine E. B. Brown, Karyn E. Richardson, Bengianni Halil-Pizzirani, Sam Hughes, Lou Atkins, Joseph Pitt, Murat Yücel, Rebecca A. Segrave","doi":"10.3389/fpsyt.2024.1379396","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1379396","url":null,"abstract":"Regular exercise has the potential to enhance university students’ mental and cognitive health. The PEAK Mood, Mind and Marks program (i.e., PEAK) is a neuroscience-informed intervention developed using the Behaviour Change Wheel to support students to exercise three or more times per week to benefit their mental and cognitive health. This pilot study assessed the impact of PEAK on exercise, mental and cognitive health, and implementation outcomes.PEAK was delivered to 115 undergraduate university students throughout a 12-week university semester. The primary outcome was weekly exercise frequency. Secondary outcomes were: time spent engaged in moderate-vigorous exercise, sedentary behaviour and perceived mental health and cognitive health. All were measured via online self-report questionnaires. Qualitative interviews with 15 students investigated influences on engagement, the acceptability and appropriateness of PEAK, and its mechanisms of behaviour change. Paired t-tests, Wilcoxon Signed-Rank tests and template analysis were used to analyse quantitative and qualitative data, respectively.On average, 48.4% of students engaged in the recommended frequency of three or more exercise sessions per week. This proportion decreased towards the end of PEAK. Sedentary behaviour significantly decreased from baseline to end-point, and moderate-vigorous exercise significantly increased among students’ who were non-exercisers. Mental wellbeing, stress, loneliness, and sense of belonging to the university significantly improved. There were no significant changes in psychological distress. Concentration, memory, and productivity significantly improved. Sixty-eight percent of students remained engaged in one or more components of PEAK at end-point. Qualitative data indicated students found PEAK to be acceptable and appropriate, and that it improved aspects of their capability, opportunity, and motivation to exercise.Students are receptive to an exercise-based program to support their mental and cognitive health. Students exercise frequency decreased; however, these figures are likely a conservative estimate of students exercise engagement. Students valued the neuroscience-informed approach to motivational and educational content and that the program’s goals aligned with their academic goals. Students identified numerous areas PEAK’s content and implementation can be optimised, including use of a single digital delivery platform, more opportunities to connect with peers and to expand the content’s cultural inclusivity.","PeriodicalId":506619,"journal":{"name":"Frontiers in Psychiatry","volume":"113 52","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141360938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-07DOI: 10.3389/fpsyt.2024.1383138
Hendrikje Bloemert, Bram B. Sizoo, Elisabeth W. M. Verhoeven, Aartjan Beekman, B. van Meijel
Although some adults with autism spectrum disorder (ASD) require intensive and specialized ASD treatment, there is little research on how these adults experience the recovery process. Recovery is defined as the significant improvement in general functioning compared to the situation prior to treatment.This qualitative study describes the recovery process from the perspective of adults on the autism spectrum during intensive inpatient treatment. Semi-structured interviews (n = 15) were carried out and analyzed according to the principles of grounded theory.Our results indicate that, given the specific characteristics of autism, therapeutic interventions and goal-oriented work cannot be carried out successfully, and the recovery process cannot begin, if no good working relationship has been established, and if care is not organized in ways that a person on the autism spectrum finds clear and predictable.
{"title":"Recovery of adults with autism spectrum disorder during intensive inpatient treatment: a qualitative study","authors":"Hendrikje Bloemert, Bram B. Sizoo, Elisabeth W. M. Verhoeven, Aartjan Beekman, B. van Meijel","doi":"10.3389/fpsyt.2024.1383138","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1383138","url":null,"abstract":"Although some adults with autism spectrum disorder (ASD) require intensive and specialized ASD treatment, there is little research on how these adults experience the recovery process. Recovery is defined as the significant improvement in general functioning compared to the situation prior to treatment.This qualitative study describes the recovery process from the perspective of adults on the autism spectrum during intensive inpatient treatment. Semi-structured interviews (n = 15) were carried out and analyzed according to the principles of grounded theory.Our results indicate that, given the specific characteristics of autism, therapeutic interventions and goal-oriented work cannot be carried out successfully, and the recovery process cannot begin, if no good working relationship has been established, and if care is not organized in ways that a person on the autism spectrum finds clear and predictable.","PeriodicalId":506619,"journal":{"name":"Frontiers in Psychiatry","volume":" 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141374748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-07DOI: 10.3389/fpsyt.2024.1365119
Li Ren, Jian Yu, Hengsheng Chen, Jie Luo, Feng Lv, Su Min
Accompanied by a rapid and effective antidepressant effect, electroconvulsive shock (ECS) can also induce learning and memory impairment. Our previous research reported that metaplasticity is involved in this process. However, the mechanisms still remain unclear. This study investigated the role of Ih current in the metaplastic changes and learning and memory impairment induced by ECS in depressive rats.Depressive rats received ECS after modelling using chronic unpredictable. ZD7288, a type of Ih current inhibitor was used to verify the effect of Ih current. The sucrose preference test and Morris water maze were used for behavior testing. Changes in metaplasticity was assessed with the LTD/LTP threshold by stimulation at different frequencies. Spontaneous and evoked action potentials (APs) were measured to confirm difference of neuronal excitability. Additionally, the amplitude of Ih current was analyzed.ECS exerts antidepressant effect, but also induce spatial learning and memory dysfunction. ECS up-regulates the LTD/LTP threshold. In rats treated with ECS, the frequency of spontaneous and evoked APs is significantly reduced. In addition, ECS induces changes in the intrinsic properties of AP, including a decrease of AP-half width and peak amplitude, and an increase in AP time to peak and post-hyperpolarization potential amplitude. In particular, ECS increases both instantaneous and steady-state Ih currents. However, Inhibition of Ih current with ZD7288 results in a relief of learning and memory impairment and a decrease in threshold, as well as a significant reversal of whole-cell electrophysiological changes.ECS-induced learning and memory impairment is caused by neuronal hypoexcitability mediated metaplasticity, and upregulation of LTD/LTP threshold by an increase in Ih current.
伴随着快速有效的抗抑郁作用，电休克（ECS）也会诱发学习和记忆障碍。我们之前的研究报告称，元弹力参与了这一过程。然而，其机制仍不清楚。本研究探讨了 Ih 电流在抑郁大鼠元弹力变化及 ECS 诱发的学习和记忆障碍中的作用。抑郁大鼠在使用慢性不可预测模型后接受了 ECS，并使用一种 Ih 电流抑制剂 ZD7288 来验证 Ih 电流的作用。行为测试采用蔗糖偏好测试和莫里斯水迷宫。通过不同频率的刺激，以LTD/LTP阈值评估元弹性的变化。测量自发和诱发动作电位（APs）以确认神经元兴奋性的差异。ECS具有抗抑郁作用，但也会诱发空间学习和记忆功能障碍。ECS能上调LTD/LTP阈值。经 ECS 治疗的大鼠，自发和诱发 APs 频率明显降低。此外，ECS 还会诱导 AP 固有特性的变化，包括 AP 半宽度和峰值振幅的降低，以及 AP 达峰时间和超极化后电位振幅的增加。特别是，ECS 增加了瞬时和稳态 Ih 电流。然而，用 ZD7288 抑制 Ih 电流可缓解学习和记忆障碍，降低阈值，并显著逆转全细胞电生理变化。ECS 引起的学习和记忆障碍是由神经元低兴奋性介导的变态反应和 Ih 电流增加导致的 LTD/LTP 阈值上调引起的。
{"title":"Alteration of hyperpolarization-activated cation current-mediated metaplasticity contributes to electroconvulsive shock-induced learning and memory impairment in depressed rats","authors":"Li Ren, Jian Yu, Hengsheng Chen, Jie Luo, Feng Lv, Su Min","doi":"10.3389/fpsyt.2024.1365119","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1365119","url":null,"abstract":"Accompanied by a rapid and effective antidepressant effect, electroconvulsive shock (ECS) can also induce learning and memory impairment. Our previous research reported that metaplasticity is involved in this process. However, the mechanisms still remain unclear. This study investigated the role of Ih current in the metaplastic changes and learning and memory impairment induced by ECS in depressive rats.Depressive rats received ECS after modelling using chronic unpredictable. ZD7288, a type of Ih current inhibitor was used to verify the effect of Ih current. The sucrose preference test and Morris water maze were used for behavior testing. Changes in metaplasticity was assessed with the LTD/LTP threshold by stimulation at different frequencies. Spontaneous and evoked action potentials (APs) were measured to confirm difference of neuronal excitability. Additionally, the amplitude of Ih current was analyzed.ECS exerts antidepressant effect, but also induce spatial learning and memory dysfunction. ECS up-regulates the LTD/LTP threshold. In rats treated with ECS, the frequency of spontaneous and evoked APs is significantly reduced. In addition, ECS induces changes in the intrinsic properties of AP, including a decrease of AP-half width and peak amplitude, and an increase in AP time to peak and post-hyperpolarization potential amplitude. In particular, ECS increases both instantaneous and steady-state Ih currents. However, Inhibition of Ih current with ZD7288 results in a relief of learning and memory impairment and a decrease in threshold, as well as a significant reversal of whole-cell electrophysiological changes.ECS-induced learning and memory impairment is caused by neuronal hypoexcitability mediated metaplasticity, and upregulation of LTD/LTP threshold by an increase in Ih current.","PeriodicalId":506619,"journal":{"name":"Frontiers in Psychiatry","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141373251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-07DOI: 10.3389/fpsyt.2024.1366575
Gaëtan Leschallier De Lisle, Antoine Oudin, A. Bourla, Florian Ferreri, Stéphane Mouchabac
In our times of smartphone ubiquity, mobile applications are an inescapable daily life tool, including in health care. Music therapy has already proven its worth, notably in mental health. Hence, we were interested in the mobile app format for this type of therapy, its level of evidence, how to use it in daily psychiatric care and the leads for future research and innovation.This study carries out a systematic review of scientific literature of this topic on two search engines, PubMed and PubPsych, using these key-words: [(web-application) OR (web-app) OR (smartphone) OR (apps) OR (app)) AND ((music) OR (music therapy) OR (melody)].Out of a total of 282 studies found by keyword, 31 are included in this review. Several outcomes emerge. These studies relate to existing applications like Music Care, Calm or Unwind, on application prototypes or a potential use of music streaming applications on health care. They involve many different populations and clinical situations, including in hospital environments, for patients with chronic illnesses, different age ranges or for the general population. These musical interventions show a significant effect mainly for anxious symptoms, but also for depression, sleep disorders, pain and other psychiatric or psycho-somatic syndromes. These applications have no significant adverse effects.This review shows that music therapy apps have several potentials for improving mental health care. It could assist psychiatric usual care and could potentially lower medication intake. Nevertheless, the studies on the topic are limited and recent but they open prospects for future research.
{"title":"Musicotherapy mobile applications: what level of evidence and potential role in psychiatric care? A systematic review","authors":"Gaëtan Leschallier De Lisle, Antoine Oudin, A. Bourla, Florian Ferreri, Stéphane Mouchabac","doi":"10.3389/fpsyt.2024.1366575","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1366575","url":null,"abstract":"In our times of smartphone ubiquity, mobile applications are an inescapable daily life tool, including in health care. Music therapy has already proven its worth, notably in mental health. Hence, we were interested in the mobile app format for this type of therapy, its level of evidence, how to use it in daily psychiatric care and the leads for future research and innovation.This study carries out a systematic review of scientific literature of this topic on two search engines, PubMed and PubPsych, using these key-words: [(web-application) OR (web-app) OR (smartphone) OR (apps) OR (app)) AND ((music) OR (music therapy) OR (melody)].Out of a total of 282 studies found by keyword, 31 are included in this review. Several outcomes emerge. These studies relate to existing applications like Music Care, Calm or Unwind, on application prototypes or a potential use of music streaming applications on health care. They involve many different populations and clinical situations, including in hospital environments, for patients with chronic illnesses, different age ranges or for the general population. These musical interventions show a significant effect mainly for anxious symptoms, but also for depression, sleep disorders, pain and other psychiatric or psycho-somatic syndromes. These applications have no significant adverse effects.This review shows that music therapy apps have several potentials for improving mental health care. It could assist psychiatric usual care and could potentially lower medication intake. Nevertheless, the studies on the topic are limited and recent but they open prospects for future research.","PeriodicalId":506619,"journal":{"name":"Frontiers in Psychiatry","volume":" 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141374841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-07DOI: 10.3389/fpsyt.2024.1397813
Letian Ma, Zuying Liu, Lijun Fu, Jiaming Fan, Cunlong Kong, Tao Wang, Huilian Bu, Qingying Liu, Jingjing Yuan, Xiaochong Fan
Frailty has been associated with mental illness (MI) observational studies, but the causal relationship between these factors remains uncertain. We aimed to assess the bidirectional causality between frailty and MI by two-sample Mendelian randomization (MR) analyses.To investigate the causal relationship among them, summary statistics of frailty index (FI) and six types of MI: anxiety, depression, affective disorder, mania, schizophrenia, and obsessive-compulsive disorder (OCD) were included in this MR study. This MR analysis was performed using inverse variance weighting (IVW), MR-Egger regression, and weighted median. The stability of the results was evaluated using Cochran’s Q test, MR-Egger intercept test, Funnel Plots, and leave-one-out analysis.Genetic predisposition to FI was significantly associated with increased anxiety (odds ratio [OR] = 1.62, 95% confidence interval [CI] 1.13-2.33, P = 8.18E-03), depression (OR = 1.88, 95% CI 1.30-2.71, P = 8.21E-04), affective disorder (OR = 1.70, 95% CI 1.28-2.27, P = 2.57E-04). However, our study findings do not demonstrate a causal relationship between FI and mania (OR = 1.02, 95% CI 0.99-1.06, P = 2.20E-01), schizophrenia (OR = 1.02, 95% CI 0.07-0.86, P = 9.28E-01). In particular, although the IVW results suggest a potential causal relationship between FI and OCD (OR = 0.64, 95% CI 0.07-0.86, P = 2.85E-02), the directions obtained from the three methods we employed ultimately show inconsistency. Therefore, the result must be interpreted with caution. The results of the reverse MR analysis indicated a statistically significant and causal relationship between anxiety (OR = 1.06, 95% CI 1.01-1.11, P = 2.00E-02), depression (OR = 1.14, 95% CI 1.04-1.26, P = 7.99E-03), affective disorder (OR = 1.15, 95% CI 1.09-1.21, P = 3.39E-07), and schizophrenia (OR = 1.02, 95% CI 1.01-1.04, P = 1.70E-03) with FI. However, our findings do not provide support for a link between mania (OR = 1.46, 95% CI 0.79-2.72, P = 2.27E-01), OCD (OR = 1.01, 95% CI 1.00-1.02, P = 2.11E-01) and an increased risk of FI.The MR results suggest a potential bidirectional causal relationship between FI and anxiety, depression, and affective disorder. Schizophrenia was found to be associated with a higher risk of FI. The evidence was insufficient to support a causal relationship between Fl and other Ml. These findings offer new insights into the development of effective management strategies for frailty and MI.
观察研究发现，虚弱与精神疾病（MI）有关，但这些因素之间的因果关系仍不确定。为了研究它们之间的因果关系，本研究将虚弱指数（FI）和六种精神疾病（焦虑症、抑郁症、情感障碍、躁狂症、精神分裂症和强迫症）的汇总统计数据纳入了 MR 研究。本次磁共振分析采用了逆方差加权法（IVW）、磁共振-艾格回归法和加权中位法。结果的稳定性通过 Cochran's Q 检验、MR-Egger 截距检验、漏斗图和leave-one-out 分析进行评估。遗传易感性与焦虑（几率比 [OR] = 1.62，95% 置信区间 [CI] 1.13-2.33，P = 8.18E-03）、抑郁（OR = 1.88，95% 置信区间 [CI] 1.30-2.71，P = 8.21E-04）和情感障碍（OR = 1.70，95% 置信区间 [CI] 1.28-2.27，P = 2.57E-04）的增加明显相关。然而，我们的研究结果并未证明 FI 与躁狂症（OR = 1.02，95% CI 0.99-1.06，P = 2.20E-01）、精神分裂症（OR = 1.02，95% CI 0.07-0.86，P = 9.28E-01）之间存在因果关系。特别是，尽管 IVW 的结果表明 FI 与强迫症之间存在潜在的因果关系（OR = 0.64，95% CI 0.07-0.86，P = 2.85E-02），但我们采用的三种方法最终得到的方向并不一致。因此，必须谨慎解释这一结果。反向 MR 分析结果表明，焦虑（OR = 1.06，95% CI 1.01-1.11，P = 2.00E-02）、抑郁（OR = 1.14，95% CI 1.04-1.26，P = 7.99E-03）、情感障碍（OR = 1.15，95% CI 1.09-1.21，P = 3.39E-07）和精神分裂症（OR = 1.02，95% CI 1.01-1.04，P = 1.70E-03）与 FI 之间存在明显的因果关系。然而，我们的研究结果并不支持躁狂症（OR = 1.46，95% CI 0.79-2.72，P = 2.27E-01）、强迫症（OR = 1.01，95% CI 1.00-1.02，P = 2.11E-01）与 FI 风险增加之间的联系。研究发现，精神分裂症与较高的 FI 风险有关。证据不足以支持Fl与其他Ml之间的因果关系。这些发现为制定针对虚弱和心肌缺血的有效管理策略提供了新的见解。
{"title":"Bidirectional causal relational between frailty and mental illness: a two-sample Mendelian randomization study","authors":"Letian Ma, Zuying Liu, Lijun Fu, Jiaming Fan, Cunlong Kong, Tao Wang, Huilian Bu, Qingying Liu, Jingjing Yuan, Xiaochong Fan","doi":"10.3389/fpsyt.2024.1397813","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1397813","url":null,"abstract":"Frailty has been associated with mental illness (MI) observational studies, but the causal relationship between these factors remains uncertain. We aimed to assess the bidirectional causality between frailty and MI by two-sample Mendelian randomization (MR) analyses.To investigate the causal relationship among them, summary statistics of frailty index (FI) and six types of MI: anxiety, depression, affective disorder, mania, schizophrenia, and obsessive-compulsive disorder (OCD) were included in this MR study. This MR analysis was performed using inverse variance weighting (IVW), MR-Egger regression, and weighted median. The stability of the results was evaluated using Cochran’s Q test, MR-Egger intercept test, Funnel Plots, and leave-one-out analysis.Genetic predisposition to FI was significantly associated with increased anxiety (odds ratio [OR] = 1.62, 95% confidence interval [CI] 1.13-2.33, P = 8.18E-03), depression (OR = 1.88, 95% CI 1.30-2.71, P = 8.21E-04), affective disorder (OR = 1.70, 95% CI 1.28-2.27, P = 2.57E-04). However, our study findings do not demonstrate a causal relationship between FI and mania (OR = 1.02, 95% CI 0.99-1.06, P = 2.20E-01), schizophrenia (OR = 1.02, 95% CI 0.07-0.86, P = 9.28E-01). In particular, although the IVW results suggest a potential causal relationship between FI and OCD (OR = 0.64, 95% CI 0.07-0.86, P = 2.85E-02), the directions obtained from the three methods we employed ultimately show inconsistency. Therefore, the result must be interpreted with caution. The results of the reverse MR analysis indicated a statistically significant and causal relationship between anxiety (OR = 1.06, 95% CI 1.01-1.11, P = 2.00E-02), depression (OR = 1.14, 95% CI 1.04-1.26, P = 7.99E-03), affective disorder (OR = 1.15, 95% CI 1.09-1.21, P = 3.39E-07), and schizophrenia (OR = 1.02, 95% CI 1.01-1.04, P = 1.70E-03) with FI. However, our findings do not provide support for a link between mania (OR = 1.46, 95% CI 0.79-2.72, P = 2.27E-01), OCD (OR = 1.01, 95% CI 1.00-1.02, P = 2.11E-01) and an increased risk of FI.The MR results suggest a potential bidirectional causal relationship between FI and anxiety, depression, and affective disorder. Schizophrenia was found to be associated with a higher risk of FI. The evidence was insufficient to support a causal relationship between Fl and other Ml. These findings offer new insights into the development of effective management strategies for frailty and MI.","PeriodicalId":506619,"journal":{"name":"Frontiers in Psychiatry","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141372986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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