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Dialogues in Clinical Neuroscience最新文献

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Promises and risks of web-based interventions in the treatment of depression
. 网络干预治疗抑郁症的前景和风险
。
IF 8.3 2区 医学 Q1 Medicine Pub Date : 2020-06-01 DOI: 10.31887/DCNS.2020.22.2/uhegerl
Ulrich Hegerl, Caroline Oehler

Major depression (MD) is a highly prevalent and severe disorder with many patients having no access to efficient treatments such as pharmaco- and psychotherapy. Web-based interventions promise to be a method to provide resource-efficient and widespread access to psychotherapeutic support. Meta-analyses summarizing studies that use face-to-face psychotherapy as a comparator provide evidence for equivalent antidepressant efficacy. Web-based interventions seem to be particularly efficacious when they are accompanied by some form of professional guidance. However, they are also associated with a variety of possible risks (eg, suicidal crises can be overlooked) and unwanted effects (eg, increase in rumination and somatization due to self-monitoring) that are so far under-studied. Although some naturalistic studies yield smaller effect sizes than randomized controlled trials (RCTs), well-designed interventions with adequate guidance have been shown to be successfully integrable into routine care.
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重度抑郁症(MD)是一种非常普遍和严重的疾病,许多患者无法获得有效的治疗,如药物和心理治疗。基于网络的干预有望成为一种提供资源高效和广泛获得心理治疗支持的方法。荟萃分析总结了使用面对面心理治疗作为比较的研究,提供了同等抗抑郁疗效的证据。基于网络的干预似乎特别有效,如果它们伴随着某种形式的专业指导。然而,它们也与各种可能的风险(例如,自杀危机可能被忽视)和不必要的影响(例如,由于自我监控而增加的反刍和躯体化)有关,这些迄今为止尚未得到充分研究。虽然一些自然主义研究产生的效应比随机对照试验(rct)小,但设计良好的干预措施和适当的指导已被证明可以成功地整合到日常护理中。
。
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引用次数: 3
The Digital revolution and its Impact on Human brain and behavior 数字革命及其对人类大脑和行为的影响
IF 8.3 2区 医学 Q1 Medicine Pub Date : 2020-06-01 DOI: 10.31887/dcns.2020.22.2
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引用次数: 4
The impact of digital technology use on adolescent well-being
. 数字技术的使用对青少年福祉的影响 .
IF 8.3 2区 医学 Q1 Medicine Pub Date : 2020-06-01 DOI: 10.31887/DCNS.2020.22.2/tdienlin
Tobias Dienlin, Niklas Johannes

This review provides an overview of the literature regarding digital technology use and adolescent well-being. Overall, findings imply that the general effects are on the negative end of the spectrum but very small. Effects differ depending on the type of use: whereas procrastination and passive use are related to more negative effects, social and active use are related to more positive effects. Digital technology use has stronger effects on short-term markers of hedonic well-being (eg, negative affect) than long-term measures of eudaimonic well-being (eg, life satisfaction). Although adolescents are more vulnerable, effects are comparable for both adolescents and adults. It appears that both low and excessive use are related to decreased well-being, whereas moderate use is related to increased well-being. The current research still has many limitations: High-quality studies with large-scale samples, objective measures of digital technology use, and experience sampling of well-being are missing.
.

本综述概述了有关数字技术使用和青少年福祉的文献。总体而言,研究结果表明,总体影响是负面的,但非常小。使用类型不同,影响也不同:拖延和被动使用与更多负面影响有关,而社交和主动使用则与更多正面影响有关。数字技术的使用对短期享乐幸福感(如负面影响)的影响要大于对长期幸福感(如生活满意度)的影响。虽然青少年更容易受到影响,但对青少年和成年人的影响不相上下。低度使用和过度使用似乎都与幸福感下降有关,而适度使用则与幸福感增加有关。目前的研究仍有许多局限性:缺少大规模样本的高质量研究、数字技术使用的客观测量方法以及幸福感的经验取样。.
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引用次数: 0
Fractures in the framework: limitations of classification systems in psychiatry
. 框架中的断裂:精神病学分类系统的局限性
。
IF 8.3 2区 医学 Q1 Medicine Pub Date : 2020-03-01 DOI: 10.31887/DCNS.2020.22.1/rparikh
Munira Kapadia, Maherra Desai, Rajesh Parikh

This article examines the limitations of existing classification systems from the historical, cultural, political, and legal perspectives. It covers the evolution of classification systems with particular emphasis on the DSM and ICD systems. While pointing out the inherent Western bias in these systems, it highlights the potential of misuse of these systems to subserve other agendas. It raises concerns about the reliability, validity, comorbidity, and heterogeneity within diagnostic categories of contemporary classification systems. Finally, it postulates future directions in alternative methods of diagnosis and classification factoring in advances in artificial intelligence, machine learning, genetic testing, and brain imaging. In conclusion, it emphasizes the need to go beyond the limitations inherent in classifications systems to provide more relevant diagnoses and effective treatments.
.

本文从历史、文化、政治和法律的角度考察了现有分类系统的局限性。它涵盖了分类系统的演变,特别强调了DSM和ICD系统。在指出这些制度中固有的西方偏见的同时,它强调了滥用这些制度为其他议程服务的可能性。它引起了人们对当代分类系统诊断类别的可靠性、有效性、合并症和异质性的关注。最后,它假设了在人工智能、机器学习、基因测试和脑成像的进步中,诊断和分类的替代方法的未来方向。总之,它强调需要超越分类系统固有的局限性,以提供更相关的诊断和有效的治疗。
。
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引用次数: 7
The role of RDoC in future classification of mental disorders
. RDoC在未来精神障碍分类中的作用
。
IF 8.3 2区 医学 Q1 Medicine Pub Date : 2020-03-01 DOI: 10.31887/DCNS.2020.22.1/bcuthbert
Bruce N Cuthbert

The Research Domain Criteria (RDoC) project constitutes a translational framework for psychopathology research, initiated by the National Institute of Mental Health in an attempt to provide new avenues for research to circumvent problems emerging from the use of symptom-based diagnostic categories in diagnosing disorders. The RDoC alternative is a focus on psychopathology based on dimensions simultaneously defined by observable behavior (including quantitative measures of cognitive or affective behavior) and neurobiological measures. Key features of the RDoC framework include an emphasis on functional dimensions that range from normal to abnormal, integration of multiple measures in study designs (which can foster computational approaches), and high priority on studies of neurodevelopment and environmental influences (and their interaction) that can contribute to advances in understanding the etiology of disorders throughout the lifespan. The paper highlights key implications for ways in which RDoC can contribute to future ideas about classification, as well as some of the considerations involved in translating basic behavioral and neuroscience data to psychopathology.
.

研究领域标准(RDoC)项目构成了精神病理学研究的转化框架,由国家精神卫生研究所发起,旨在为研究提供新的途径,以避免在诊断疾病时使用基于症状的诊断类别所产生的问题。RDoC的替代方案是关注基于可观察行为(包括认知或情感行为的定量测量)和神经生物学测量同时定义的维度的精神病理学。RDoC框架的主要特征包括强调从正常到异常的功能维度,在研究设计中整合多种测量方法(这可以促进计算方法),以及高度优先考虑神经发育和环境影响(及其相互作用)的研究,这有助于在整个生命周期中理解疾病的病因学。这篇论文强调了RDoC对未来分类思想的重要影响,以及将基本行为和神经科学数据转化为精神病理学所涉及的一些考虑。
。
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引用次数: 49
Classification of Mental Disorders 精神障碍分类
IF 8.3 2区 医学 Q1 Medicine Pub Date : 2020-03-01 DOI: 10.31887/dcns.2020.22.1
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引用次数: 10
Diagnosis as dialogue: historical and current perspectives
. 作为对话的诊断:历史和当前的观点
。
IF 8.3 2区 医学 Q1 Medicine Pub Date : 2020-03-01 DOI: 10.31887/DCNS.2020.22.1/phoff
Paul Hoff, Anke Maatz, Johannes Simon Vetter

Ever since psychiatry emerged as a clinical discipline and field of scientific inquiry in the late 18th century, debates about diagnosis have been at its very heart. Considered by many a requirement for clinical communication as well as for systematic study, others have critiqued psychiatric diagnosis for being modeled on a medical conception of disease that is ill-suited to the specific nature of mental disorders. Based on a review of seminal positions in the conceptual history of psychiatry and an examination of their epistemological underpinnings, we propose to consider diagnosis as dialogue. Such understanding, we argue, can serve as a meta-framework that provides a conceptual and practical umbrella to encourage open-minded conversation across the diverse conceptual and experiential frameworks that are characteristic of psychiatry. In this perspective psychopathology will also reinforce the interpersonal realm as a necessary element of any clinical encounter, be it diagnostic in purpose or otherwise. Current challenges to traditional diagnostic systems like Research Domain Criteria (RDoC) and Hierarchical Taxonomy of Psychopathology (HiTOP) are discussed in light of these considerations.
.

自从精神病学在18世纪后期成为一门临床学科和科学探究领域以来,关于诊断的争论一直是其核心。许多人认为这是临床交流和系统研究的需要,其他人则批评精神病学诊断以疾病的医学概念为模型,不适合精神障碍的具体性质。基于对精神病学概念史上开创性地位的回顾和对其认识论基础的考察,我们建议将诊断视为对话。我们认为,这样的理解可以作为一个元框架,提供一个概念和实践的保护伞,以鼓励精神病学特征的各种概念和经验框架之间的开放对话。从这个角度来看,精神病理学也将加强人际关系领域,作为任何临床接触的必要元素,无论是有目的的诊断还是其他目的。目前传统的诊断系统,如研究领域标准(RDoC)和精神病理学层次分类法(HiTOP)面临的挑战是根据这些考虑来讨论的。
。
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引用次数: 6
Do we need to rethink our current classifications of mental disorders?
. 我们是否需要重新考虑我们目前的精神障碍分类?
。
IF 8.3 2区 医学 Q1 Medicine Pub Date : 2020-03-01 DOI: 10.31887/DCNS.2020.22.1/fthibaut
Florence Thibaut

The traditional categorical classification system and new diagnostic systems will be discussed in this issue.
.

本文将讨论传统的分类分类系统和新的诊断系统。
。
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引用次数: 0
Wernicke-Kleist-Leonhard phenotypes 
of endogenous psychoses: a review of their validity
. 内源性精神病的wernickke - kleist - leonhard表型
:对其有效性的回顾
。
IF 8.3 2区 医学 Q1 Medicine Pub Date : 2020-03-01 DOI: 10.31887/DCNS.2020.22.1/jfoucher
Jack R Foucher, Micha Gawlik, Julian N Roth, Clément de Crespin de Billy, Ludovic C Jeanjean, Alexandre Obrecht, Olivier Mainberger, Julie M E Clauss, Julien Elowe, Sébastien Weibel, Benoit Schorr, Marcelo Cetkovich, Carlos Morra, Federico Rebok, Thomas A Ban, Barbara Bollmann, Mathilde M Roser, Markus S Hanke, Burkhard E Jabs, Ernst J Franzek, Fabrice Berna, Bruno Pfuhlmann

While the ICD-DSM paradigm has been a major advance in clinical psychiatry, its usefulness for biological psychiatry is debated. By defining consensus-based disorders rather than empirically driven phenotypes, consensus classifications were not an implementation of the biomedical paradigm. In the field of endogenous psychoses, the Wernicke-Kleist-Leonhard (WKL) pathway has optimized the descriptions of 35 major phenotypes using common medical heuristics on lifelong diachronic observations. Regarding their construct validity, WKL phenotypes have good reliability and predictive and face validity. WKL phenotypes come with remarkable evidence for differential validity on age of onset, familiality, pregnancy complications, precipitating factors, and treatment response. Most impressive is the replicated separation of high- and low-familiality phenotypes. Created in the purest tradition of the biomedical paradigm, the WKL phenotypes deserve to be contrasted as credible alternatives with other approaches currently under discussion.
.

虽然ICD-DSM范式在临床精神病学方面取得了重大进展,但它对生物精神病学的有用性仍存在争议。通过定义基于共识的疾病而不是经验驱动的表型,共识分类不是生物医学范式的实施。在内源性精神病领域,Wernicke-Kleist-Leonhard (WKL)途径利用终身历时观察的常见医学启发式优化了35种主要表型的描述。在结构效度方面,WKL表型具有较好的信度、预测效度和面效度。WKL表型在发病年龄、熟悉程度、妊娠并发症、诱发因素和治疗反应方面具有显著的差异效度证据。最令人印象深刻的是高熟悉型和低熟悉型的重复分离。在最纯粹的生物医学范式传统中创建的WKL表型值得与目前正在讨论的其他方法作为可靠的替代方案进行对比。
。
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引用次数: 26
Neurodevelopmental disorders-the history and future of a diagnostic concept
. 神经发育障碍-诊断概念的历史和未来
。
IF 8.3 2区 医学 Q1 Medicine Pub Date : 2020-03-01 DOI: 10.31887/DCNS.2020.22.1/macrocq
Deborah J Morris-Rosendahl, Marc-Antoine Crocq

This article describes the history of the diagnostic class of neurodevelopmental disorders (NDDs) up to DSM-5. We further analyze how the development of genetics will transform the classification and diagnosis of NDDs. In DSM-5, NDDs include intellectual disability (ID), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD). Physicians in German-, French- and English-speaking countries (eg, Weikard, Georget, Esquirol, Down, Asperger, and Kanner) contributed to the phenomenological definitions of these disorders throughout the 18th and 20th centuries. These diagnostic categories show considerable comorbidity and phenotypic overlap. NDDs are one of the chapters of psychiatric nosology most likely to benefit from the approach advocated by the National Institute of Mental Health's Research Domain Criteria project. Genetic research supports the hypothesis that ID, ASD, ADHD, schizophrenia, and bipolar disorder lie on a neurodevelopmental continuum. The identification of recurrently observed copy number variants and disruptive gene variants in ASD (eg, CDH8, 16p11.2, SCN2A) led to the adoption of the genotype-first approach to characterize individuals at the etiological level.
.

本文描述了神经发育障碍(ndd)诊断类别的历史,直到DSM-5。我们进一步分析了遗传学的发展将如何改变ndd的分类和诊断。在DSM-5中,ndd包括智力障碍(ID)、自闭症谱系障碍(ASD)和注意力缺陷/多动障碍(ADHD)。在整个18世纪和20世纪,德语、法语和英语国家的医生(例如,Weikard、Georget、Esquirol、Down、Asperger和Kanner)对这些疾病的现象学定义做出了贡献。这些诊断类别显示出相当大的合并症和表型重叠。ndd是精神病学的一个章节,最有可能从国家精神卫生研究所的研究领域标准项目所倡导的方法中受益。基因研究支持这种假设,即ID、ASD、ADHD、精神分裂症和双相情感障碍存在于一个神经发育连续体上。ASD中反复观察到的拷贝数变异和破坏性基因变异(例如,CDH8, 16p11.2, SCN2A)的鉴定导致采用基因型优先的方法在病因水平上表征个体。
。
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引用次数: 121
期刊
Dialogues in Clinical Neuroscience
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