International Review of Psychiatry最新文献

This narrative review examines the integration of Artificial Intelligence (AI) tools into forensic psychiatry in Africa, highlighting possible opportunities and challenges. Specifically, AI may have the potential to augment screening in prisons, risk assessment/management, and forensic-psychiatric treatment, alongside offering benefits for training and research purposes. These use-cases may be particularly advantageous in contexts of forensic practice in Africa, where there remains a need for capacity building and service improvements in jurisdictions affected by distinctive sociolegal and socioeconomic challenges. However, AI can also entail ethical risks associated with misinformation, privacy concerns, and an overreliance on automated systems that need to be considered within implementation and policy planning. Equally, the political and regulatory backdrop surrounding AI in countries in Africa needs to be carefully scrutinised (and, where necessary, strengthened). Accordingly, this review calls for rigorous feasibility studies and the development of training programmes to ensure the effective application of AI in enhancing forensic-psychiatric services in Africa.

Substance Use Disorders (SUD) lead to a collection of health challenges such as overdoses and clinical diseases. Populations that are vulnerable and lack straightforward treatment access are vulnerable to significant economic and social effects linked to SUD. The ongoing advances in technology, especially Artificial Intelligence (AI), promise new ways to reduce the effects of SUD, refine treatment standards, and minimize the risk of relapse through tailored treatment plans. Recent innovations in functional neuroimaging techniques, such as fMRI, have led to the ability to detect brain patterns associated with drug use, and biomarkers in blood testing provide crucial diagnostic support. In addition, digital platforms applied for behavioral assessment supported by AI and natural language processing improve the early recognition of substance consumption trends, allowing for targeted interventions reliant on real-time data. Using pharmacogenetics and resources like mobile apps and wearable devices makes the development of care programs that continuously track substance use, mental health, and physical changes possible. At the core of ethical issues related to the application of AI for SUD are the rights of patients to have their privacy protected to ensure that all people justly have access to these technologies. The advancement of AI models provides significant possibilities to support clinical judgment and enhance patient outcomes.

In recent years, the presence of digital devices has become a significant factor in the daily lives of young adults, profoundly influencing their social interactions and interpersonal relationships. This phenomenon, termed technoference refers to the intrusion of technology into personal relationships, often leading to disruptions in communication, increased conflict, and changes in the dynamics of social support systems. This study aims to investigate the impact of technoference on the social dynamics of young adults in Bangalore, India, focusing on the effects of digital device usage on personal interactions. A qualitative framework analysis was conducted using data from semi-structured interviews with 36 young adults aged 18 to 30 years. The mean age of the 36 participants was 26.0 years, with a relatively balanced gender distribution (61.1% male, 38.9% female). The analysis revealed several key themes, including communication breakdowns, conflict escalation due to technology, family support dynamics amidst digital interference, diverse phone usage habits, varying degrees of awareness regarding the impact of technology, and strategies for managing time and setting boundaries around device use. The study validates the presence of technoference within the community and its significant implications for interpersonal relationships among young adults in Bangalore.

Dissociative therapies are being increasingly explored for their psychiatric applications, although questions remain about how they work and how best to use them. In exploring these questions, this review highlights six key areas of clinical relevance: (1) The possible contributions of functional unblinding when interpreting efficacy data; (2) The degree to which the therapeutic effects of dissociative therapies can be distinguished from the transient forms of relief seen with recreational drug use; (3) Understanding the construct of dissociation as it is tasked with describing the function of dissociative drugs; (4) The investigation of subjective drug effects as predictors of therapeutic outcome; (5) Similarities and differences in the effects of dissociative and classic psychedelics; and (6) The anticipated need for judicious prescribing/deprescribing resources as dissociative therapies proliferate.

Psychedelics have shown early evidence for a range of benefits and low harm profiles in extant research. However, adverse effects (AEs) research in psychedelics has been limited, leading to underspecified AE profiles, inconsistent measurement, and potential undercounting of AEs. The development of safe, effective psychedelic therapies and treatments for AEs when they occur requires a thorough assessment of psychedelic-related AEs, their phenomenology, risk factors, and longitudinal duration. This article proposes that research on meditation-related AEs, which overlap in important ways with the phenomenological and contextual characteristics of psychedelic-related AEs, has engaged many methodological challenges present in the study of psychedelic-related AEs. Thus, meditation-related AE research offers thematic and methodological insights that are valuable to psychedelic AE research. An integrative review of extant AE research in both psychedelics and meditation is provided, and an agenda for leveraging meditation research to advance the investigation of psychedelic AEs is recommended. This includes the utility of meditation-related AEs as a comparator condition for psychedelic-related AEs, as well as recommendations for the adoption of (1) detailed and comprehensive, (2) user-informed, (3) impact-based, (4) standardized, (5) unbiased, and (6) representative measures of AEs and (7) examining factors that influence their impacts and trajectories.

The renewed interest in psychedelics as treatments for mental health disorders is often referred to as the "Psychedelic Renaissance." This article assesses whether this resurgence truly constitutes a paradigm shift in psychiatry, as some proponents claim, or if it should be viewed as an integration of existing therapeutic approaches. We explore historical contexts, noting that psychedelics were extensively researched in the mid-20th century and argue that many of the current claims about their novelty overlook prior knowledge and research from that period. While psychedelics do introduce novel aspects, such as rapid therapeutic effects and unique modes of action, we challenge the idea of a full paradigm shift, suggesting that these developments are better understood as enhancements to existing frameworks rather than a wholesale replacement. We emphasize the importance of integrating psychedelics within a broader bio-psycho-social model of psychiatry, combining pharmacological, psychological, and contextual factors. The therapeutic potential of psychedelics in psychotherapy has previously been described as working as "nonspecific amplifiers" of psychological processes, rather than introducing entirely new mechanisms. We suggest a balanced, integrative approach that incorporates psychedelics into existing mental health care models, cautioning against "psychedelic exceptionalism" and the risk of overselling their potential as a revolutionary treatment.

Psychedelic compounds continue gaining scientific and regulatory traction as potential new treatments for psychiatric disorders. While most psychiatrists will likely not work directly with these compounds, psychedelic research practices provide insights that may improve conventional psychiatric care. Through its emphasis on 'set and setting' (mindset and environment, respectively), psychedelic research highlights the importance of non-pharmacologic factors maximizing therapeutic outcomes. While psychedelics and serotonergic antidepressants are distinctly different in their subjective experience, new findings suggest mechanistic overlap between them. Both have been found to modulate neurotrophins, enhance neuroplasticity, and reopen critical periods of learning, molded by the environmental context in which they are administered.

This paper will argue that by integrating insights from psychedelic research (particularly set and setting), depression treatment outcomes in traditional psychiatric settings can improve by optimizing non-pharmacological factors in treatment, including the provision of high-quality psychotherapy.