Asian journal of psychiatry最新文献

This review, in light of the Socio-Cultural Erosion Theory, addresses the alarming deterioration in mental health among Iranian youth. According to this theory, rapid socio-cultural changes, economic instability, and pervasive influences of digital media create a drift between traditional values and modern expectations that are detrimental to mental health. The major risk factors identified in order of significance were, in descending order, economic hardship, academic stress, cultural pressures, and digital exposure. It is for this reason that evidence-based, practical interventions are proposed through policy reforms, educational changes, and community-based support to assist youth in Iran in meeting these challenges. The need is for solutions that are embedded within the specific cultural, economic, and social contexts of Iran to promote resilience and mental well-being.

Neuroscience-based Nomenclature (NbN) is a pharmacologically-driven classification of psychotropics, aiming to revise the current indication-based classification (antipsychotics, antidepressants, anxiolytics etc.). Whereas the number of psychotropics has risen dramatically over the years, the current nomenclature preserves a rather narrow categorization that overlooks the rich neurobiological knowledge accumulated to date. The current classification is confusing for the patients ("Why am I getting an 'antipsychotic' for my depression, Doctor? am I psychotic?"), and consequently interfering with optimal care. To address this issue, leading organizations in psychopharmacology have collaborated to introduce a classification which is based on pharmacological domains (neurotransmitters) and mode of action. This approach may relieve patients from confusing labels and help clinicians plan the next pharmacological step from a neuroscientific prism. NbN has earned endorsements from significant psychiatric bodies (including the American Psychiatric Association and the European Psychiatric Association) and has been incorporated into highly ranked peer-reviewed journals, textbooks, and educational programs. It is accessible through a free app, offering an easy-to-navigate database for professionals, as well as specialized versions for child and adolescent psychiatry and for patient and family education. By bridging the gap between complex neurobiological research and clinical practice, NbN may enhance evidence-based prescription practice and serve as an educational resource. Despite its inherent challenges, this initiative may represent a step towards integrating neuroscience into everyday psychiatric care, making it more understandable and relevant for all involved.

Background: Schizophrenia is a severe mental illness associated with significantly elevated mortality rates. However, factors related to the mortality risk among people with schizophrenia in low and middle-income countries remain to be examined. This study aims to explore the clinical factors for all-cause mortality in people with schizophrenia.

Methods: We conducted a 9-year retrospective cohort study on people with schizophrenia in Guangzhou, China. Cox proportional hazards regression analysis and competing risk analysis was used to identify clinical factors associated with all-cause mortality and specific-cause mortality. A propensity score matching method was performed to minimize the impact of confounding factors.

Results: The overall age-standardized mortality rate in people with schizophrenia between 2013 and 2021 was 1606.04 per 100,000 person-years. We found that medical expenses not covered by medical insurance (adjusted hazard ratio [aHR]: 2.49 [95 % CI: 2.21-2.82]), relatively-stable (aHR: 1.18 [95 % CI: 1.01-1.38]) and unstable illness (aHR: 2.65 [95 % CI: 1.90-3.68]), history of non-continuous treatment (aHR: 1.35 [95 % CI: 1.25-1.46]), and no treatment history (aHR: 1.41 [95 % CI: 1.29-1.55]) were associated with a higher risk of all-cause mortality. Frequent hospital stays (once: aHR: 0.46 [95 % CI: 0.42-0.50], more than once: aHR: 0.23 [95 % CI: 0.21-0.26]) and a family history of mental disorders (aHR: 0.50 [95 % CI: 0.40-0.64]) were associated with a lower risk of mortality.

Conclusion: We identified clinical factors associated with all-cause mortality. Targeted interventions should be developed to reduce the mortality risk in people with schizophrenia.

Deep Brain Stimulation is a form of neurostimulation where electrical stimulation is delivered via intracranial electrodes over specific subcortical targets. It has been increasingly used as an alternative to ablative procedures for psychiatric disorders refractory to standard treatments. This review describes the common psychiatric indications for DBS, the current evidence base, putative mechanisms, and future directions.