Post-COVID condition: a focus on psychiatric symptoms and diagnoses in patients with cognitive complaints
Cognitive and psychiatric symptoms are frequently reported after SARS-CoV-2 infection, but their interplay has been only partially explored. We investigated frequency and severity of psychiatric symptoms in patients with persistent cognitive complaints after COVID-19.
A comparison between community and treatment-seeking samples of hoarding disorder
Hoarding disorder studies are primarily based on persons who seek treatment and demonstrate good insight. The aim of the present study is to evaluate whether there are differences between community and treatment-seeking samples of individuals with hoarding disorder (HD).
Characterizing the relationship between psychosis and violence in the forensic psychiatric population: a systematic review
The relationship between psychosis and violence is often construed focusing on a narrow panel of factors; however, recent evidence suggests violence might be linked to a complex interplay of biopsychosocial factors among forensic psychiatric patients with psychosis (FPPP). This review describes violence incidents in FPPP, the factors associated with violence, and relevant implications.
Rumination and altered reactivity to sensory input as vulnerability factors for developing post-traumatic stress symptoms among adults with autistic traits - CORRIGENDUM
Effects of esketamine combined with dexmedetomidine on postoperative delirium and quality of recovery in elderly patients undergoing thoracoscopic radical lung cancer surgery: a randomized controlled trial
This study aimed to investigate the effects of esketamine (Esk) combined with dexmedetomidine (Dex) on postoperative delirium (POD) and quality of recovery (QoR) in elderly patients undergoing thoracoscopic radical lung cancer surgery.
Ketamine for the Treatment of Psychiatric Disorders: A Systematic Review and Meta-Analysis
Inadequate response to first- and second-line pharmacological treatments for psychiatric disorders is commonly observed. Ketamine has demonstrated efficacy in treating adults with treatment-resistant depression (TRD), with additional off-label benefits reported for various psychiatric disorders. Herein, we performed a systematic review and meta-analysis to examine the therapeutic applications of ketamine across multiple mental disorders, excluding mood disorders.
Ayahuasca: pharmacology, safety, and therapeutic effects
Ayahuasca is a botanical hallucinogen traditionally used for therapeutic and ritual purposes by indigenous groups from Northwestern Amazonian countries such as Brazil, Peru, Colombia, and Ecuador. Ayahuasca is made by the decoction of two plants, which are rich in the 5-HT1A/2A partial agonist dimethyltryptamine or DMT (from the leaves of the bush) and β-carbolines such as harmine, from the stalks of the vine. There is an increasing interest in the possible therapeutic effects of ayahuasca, especially for psychiatric disorders (major depression, posttraumatic stress disorder, and substance use disorder). This review summarizes information on the pharmacology, safety, and therapeutic potentials of ayahuasca. Although human experimental and naturalist studies published until now suggest a good safety and tolerability profile, often associated with improvements in depressive and anxious symptoms, there are few controlled studies, with small sample sizes, using only single doses, and with short follow-ups. Potential benefits of ayahuasca should be evaluated in larger samples in both experimental and observational studies and using different doses in controlled trials.
The historical opposition to psychedelic research and implications for credibility in psychiatry
Psychedelics are a group of psychoactive substances that alter consciousness and produce marked shifts in sensory perception, cognition, and mood. Although psychedelics have been used by indigenous communities for centuries, they have only recently been investigated as an adjunctive therapeutic tool in psychotherapy. Since the early twentieth century, psychedelic-assisted psychotherapy has been explored for the treatment of several neuropsychiatric conditions characterized by rigid thought patterns and treatment resistance. However, this rapidly emerging field of neuroscience has evolved alongside opposition in several areas, including the affiliation with mid-twentieth century counterculture movements, media sensationalization, legislative restriction, and scientific criticisms such as "breaking the blind" and "excessive enthusiasm." This perspective article explores the historical opposition to psychedelic research and the implications for the credibility of the field. In the midst of psychedelic drug policy reform, drawing lessons from historical events will contribute to clinical research efforts in psychiatry.
Visual release hallucinations presenting as psychosis - a scoping review
Visual release hallucinations are perceptual disturbances that occur in individuals who have experienced vision loss. Almost 50 million people worldwide are believed to experience visual release hallucinations, yet they are profoundly underdiagnosed. Although first described within the Charles Bonnet syndrome, the paradigm underlying this syndrome precludes their consideration in many populations, such as those with underlying psychiatric illness or dementia. Consequently, visual release hallucinations have rarely been studied in patients presenting with psychosis. We conducted a scoping review to determine whether visual-release hallucinations occur in psychotic patients.
Criteria and diagnostic scale of the post-combat delayed response (tension) syndrome
War participation risks mental disorders. Ukrainian combatants in Anti-Terrorist Operation/Joint Forces Operation since 2014 receive psychiatric care. Some show unique symptoms, not fitting recognized disorders, termed post-combat delayed response (tension) syndrome. The aim of this study was to establish diagnostic criteria and develop a scale of differential diagnosis of post-combat delayed response (tension) syndrome.
Comparing two transitioning strategies to paliperidone palmitate once-every-6-months
A double-blind, randomized, active-controlled, parallel-group, noninferiority trial (NCT03345342) demonstrated that paliperidone palmitate once-every-6-months (PP6M) was noninferior to paliperidone palmitate once-every-3-months (PP3M) in preventing relapse in clinically stable adults with schizophrenia. This post hoc analysis assessed efficacy and safety following transition to PP6M from paliperidone once-monthly (PP1M) versus PP3M.
Association of multiple sclerosis with psychiatric disorders and homelessness among veterans in the United States Department of Veterans Affairs healthcare system
To describe and compare the prevalence of psychosocial and psychiatric disorders among veterans with multiple sclerosis (MS) and a propensity-score-matched group of veterans without MS, and to identify sociodemographic and clinical characteristics associated with comorbid psychosocial and psychiatric problems among veterans with MS.
Evidence-based treatment for schizophrenia: a personal perspective
My name is Bethany Yeiser, and I am an individual living with schizophrenia. My schizophrenia has been in full remission since 2008, thanks to treatment with clozapine, the vastly underutilized medication for refractory schizophrenia.
Failure to treat: an American policy perspective
Throughout its two and a half centuries in existence, US mental health policy has repeatedly failed people living with schizophrenia. The failures are cyclical-the inhumane conditions uncovered in the first 75 years of existence were addressed with the construction of state asylums to deliver moral treatment. One hundred years later, the asylums were themselves revealed to be inhumane. Deinstitutionalization, the response to the failure of asylums starting in the 1960s, now drives outcomes such as homelessness, incarceration, and early death for people living with psychotic illnesses. In all cases, well-intentioned policy reform has failed at the level of implementation, largely due to a lack of accountability. The result has been a consistent failure to adequately treat people living with schizophrenia, which is now understood to be a highly treatable condition. As the country passes into a quarter millennium in existence, reform is once again underway. Unlike other points in history, there is good news. Other countries, such as Italy, have successfully leveraged reform to achieve greatly improved outcomes. Understanding US history and the successful implementation of policy change in other countries is imperative and teaches us that accountability in implementation is necessary to break the cycle of policy failure.
Efficacy of vortioxetine versus desvenlafaxine in the treatment of functional impairment in patients with major depressive disorder: Results from the multinational VIVRE study
In VIVRE (NCT04448431), vortioxetine was associated with significantly higher rates of symptomatic and functional remission, better daily and social functioning, and greater treatment satisfaction than desvenlafaxine in patients with major depressive disorder (MDD) and partial response to selective serotonin reuptake inhibitor (SSRI) therapy. This analysis further explored the relative improvement in patient functioning with vortioxetine versus desvenlafaxine.
Can total electrical energy (TEED) after subthalamic DBS alter verbal fluency in Parkinson's disease patients? A preliminary evidence
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves motor outcomes in Parkinson's disease (PD) but may have adverse long-term effects on specific cognitive domains. The aim of this study was to investigate the association between total electrical energy (TEED) delivered by DBS and postoperative changes in verbal fluency.
Clinical management model for impulse control disorders in Parkinson's disease
Over the last decade, we have gained a better understanding of impulse control disorder in Parkinson's disease (PD-ICD), a medication complication in PD. Researchers were aware of its complexity and took efforts to learn more about its diagnostic and treatment possibilities. Nevertheless, clinical management for it is currently neglected. We conducted a narrative overview of literature published from 2012 to October 2023 on various aspects of clinical management for PD-ICD. A potential "susceptibility-catalytic-stress" model in the development of PD-ICD was proposed and a profile encoding predictors for PD-ICD was created. Based on these predictors, some methods for prediction were recently developed for better prediction, such as the polymorphic dopamine genetic risk score and the clinic-genetic ICD-risk score. A variety of treatment options, including dose reduction of dopamine receptor agonists (DAs), DAs removal, DAs switch, and add-on therapy, are investigated with inconsistent reports. Based on current findings, we developed a clinical management model prototype centered on prevention, consisting of prediction, prevention, follow-up and monitoring, therapy, and recurrence prevention, for clinical reference, and further proposed 4 key clinical management principles, including standardization, prediction centered, persistence, and whole course.
What is the neurobiology of schizophrenia?
Schizophrenia spectrum disorders are brain diseases that are developmental dementias (dementia praecox). Their pathology begins in utero with psychosis most commonly becoming evident in adolescence and early adulthood. It is estimated they afflict the U.S. population at a prevalence rate of approximately 0.8%. Genetic studies indicate that these brain diseases are about 80% determined by genes and about 20% determined by environmental risk factors. Inheritance is polygenic with some 270 gene loci having been identified as contributing to the risk for schizophrenia. Interestingly, many of the identified gene loci and gene polymorphisms are involved in brain formation and maturation. The identified genetic and epigenetic risks give rise to a brain in which neuroblasts migrate abnormally, assume abnormal locations and orientations, and are vulnerable to excessive neuronal and synaptic loss, resulting in overt psychotic illness. The illness trajectory of schizophrenia then is one of loss of brain mass related to the number of active psychotic exacerbations and the duration of untreated illness. In this context, molecules such as dopamine, glutamate, and serotonin play critical roles with respect to positive, negative, and cognitive domains of illness. Acutely, antipsychotics ameliorate active psychotic illness, especially positive signs and symptoms. The long-term effects of antipsychotic medications have been debated; however, the bulk of imaging data suggest that antipsychotics slow but do not reverse the illness trajectory of schizophrenia. Long-acting injectable antipsychotics (LAI) appear superior in this regard. Clozapine remains the "gold standard" in managing treatment-resistant schizophrenia.
Efficacy of esketamine for perinatal depression: a systematic review and meta-analysis
Postpartum depression (PPD), now referred to as perinatal depression, is a prevalent and debilitating mood disorder that reduces health-related quality of life (HRQoL) and psychosocial functioning. Esketamine, which is efficacious in adults with treatment-resistant depression and individuals with depression and suicidality, is also analgesic in pain management during childbirth labour. Herein, we investigate the efficacy of prophylactic esketamine in reducing the incidence of PPD.
A clinical algorithm for diagnosis and treatment of insomnia in adults: an updated review
Difficulty falling asleep and/or maintaining sleep are common complaints in patients visiting medical clinics. Insomnia can occur alone or in combination with other medical or psychiatric disorders. Diagnosis and management of insomnia at times are perplexing. This updated study review aimed at a clinical algorithm for diagnosis and treatment of insomnia in adults. We developed an easy-to-apply algorithm to diagnose and manage insomnia that can be used by general practitioners and non-sleep specialists. To this end, our team reviewed the previous studies to determine the prevalence, evaluation, and treatment of insomnia. We used the results to develop a clinical algorithm for diagnosing and managing insomnia.Insomnia occurs in a short (less than 3 months duration) or chronic form (≥3 months duration). Insomnia management includes both pharmacological and non-pharmacological interventions. There is ample research evidence for the impact of a variety of non-pharmacological treatments, but both types of treatments can be used for each patient. If there are any contradictions in the diagnosis process, therapists should use objective instruments, such as polysomnography, but they should not be in a hurry to use these instruments.
Liberty or life: mental health care in Australia
This article reviews the development of mental health and psychiatric services in Australia for the international reader. The development of relevant legislation, health-care systems, and the effectiveness of treatment for people with schizophrenia is reviewed. Gaps in service delivery and future directions are considered.