Suicide in Older Adults: The Role of Emotions and Cognition
Abstract Suicide in older adults is a significant clinical concern. In this review of recent findings, we concentrate on the role of emotions and cognition in suicide risk and behavior in older adults. We discuss the epidemiology of suicide in older adults, integrate recent findings on non-psychotic major depression, schizophrenia and suicidal ideation, explore the relationship of emotion regulation with suicide, present recent advances on suicide in demented patients, and describe the latest developments on cognition and decision processes in suicide. (Source: Current Psychiatry Reports)
Source: Current Psychiatry Reports - September 18, 2014 Category: Psychiatry Source Type: research

At the Crossroads: The Intersection of Substance Use Disorders, Anxiety Disorders, and Posttraumatic Stress Disorder
This article focuses on recent advances in the understanding and effective treatment of this common and highly complex comorbidity. Prevalence and epidemiological data are introduced, followed by a review of contemporary models of etiology and associative pathways. Conceptualizations of effective treatment approaches are discussed alongside evidence from the past decade of clinical research trials. Highlighted are ongoing questions regarding the benefit of sequential, parallel, and integrated approaches and the necessity of further investigation into the mechanisms underlying treatment efficacy. Lastly, recent contribution...
Source: Current Psychiatry Reports - September 17, 2014 Category: Psychiatry Source Type: research

Ovarian Hormones and Drug Abuse
Abstract There are significant gender differences in course, symptomology, and treatment of substance use disorders. In general data from clinical and preclinical studies of substance use disorders suggest that women are more vulnerable than men to the deleterious consequences of drug use at every phase of the addiction process. In addition data from epidemiologic studies suggest that the gender gap in the prevalence of substance use is narrowing particularly among adolescence. Therefore, understanding the role of estrogen and progesterone in mediating responses to drugs of abuse is of critical importance to wome...
Source: Current Psychiatry Reports - September 16, 2014 Category: Psychiatry Source Type: research

Privacy in the Digital World: Medical and Health Data Outside of HIPAA Protections
Abstract Increasing quantities of medical and health data are being created outside of HIPAA protection, primarily by patients. Data sources are varied, including the use of credit cards for physician visit and medication co-pays, Internet searches, email content, social media, support groups, and mobile health apps. Most medical and health data not covered by HIPAA are controlled by third party data brokers and Internet companies. These companies combine this data with a wide range of personal information about consumer daily activities, transactions, movements, and demographics. The combined data are used for p...
Source: Current Psychiatry Reports - September 14, 2014 Category: Psychiatry Source Type: research

Collaborative Care: Models for Treatment of Patients with Complex Medical-Psychiatric Conditions
Abstract Patients with co-morbidity and multi-morbidity have worse outcomes and greater healthcare needs. Co-morbid depression and other long-term conditions present health services with challenges in delivering effective care for patients. We provide some recent evidence from the literature to support the need for collaborative care, illustrated by practical examples of how to deliver a collaborative/integrated care continuum by presenting data collected between 2011 and 2012 from a London Borough clinical improvement programme that compared co-morbid diagnosis of depression and other long-term conditions and Ac...
Source: Current Psychiatry Reports - September 14, 2014 Category: Psychiatry Source Type: research

Etiology of Autism Spectrum Disorder: A Genomics Perspective
Abstract In recent years, considerable progress has been made in understanding the genomic basis of autism spectrum disorder (ASD). Hundreds of variants have been proposed as predisposing to ASD, and the challenge now is to validate candidates and to understand how gene networks interact to produce ASD phenotypes. Genome-wide association and second-generation sequencing studies in particular have provided important indications about how to understand ASD on a molecular level, and we are beginning to see these experimental approaches translate into novel treatments and diagnostic tests. We review key studies in th...
Source: Current Psychiatry Reports - September 13, 2014 Category: Psychiatry Source Type: research

Risk Factors of Internet Addiction and the Health Effect of Internet Addiction on Adolescents: A Systematic Review of Longitudinal and Prospective Studies
Abstract Internet gaming addiction was included in the latest version of the DSM-V as a possible disorder recently, while debate is still on-going as to whether the condition called “Internet Addiction” (IA) could be fully recognised as an established disorder. The major contention is how well IA could fulfil the validation criteria as a psychiatric disorder as in other well-established behavioural addictions. In addition to various proposed validation criteria, evidence of risk and protective factors as well as development of outcomes from longitudinal and prospective studies are suggested as importa...
Source: Current Psychiatry Reports - September 13, 2014 Category: Psychiatry Source Type: research

Genetics of Opiate Addiction
Abstract Addiction to MOP-r agonists such as heroin (and also addiction to prescription opioids) has reemerged as an epidemic in the twenty first century, causing massive morbidity. Understanding the genetics contributing to susceptibility to this disease is crucial for the identification of novel therapeutic targets, and also for discovery of genetic markers which would indicate relative protection or vulnerability from addiction, and relative responsiveness to pharmacotherapy. This information could thus eventually inform clinical practice. In this review, we focus primarily on association studies of heroin and...
Source: Current Psychiatry Reports - September 11, 2014 Category: Psychiatry Source Type: research

The Interplay Between Sleep and Emotion Regulation: Conceptual Framework Empirical Evidence and Future Directions
The objective of this article is to examine this interplay in adults. This objective is addressed by utilizing a framework that identifies key aspects of the relationship between sleep and emotion. We propose that the connectivity between the emotional centers of the brain — the prefontal cortex and the amygdala — is in part dependent on the homeostatic sleep system such that connectivity between these brain networks is higher when rested and lower when sleep deprived. High connectivity drives more efficient executive functioning, while a disconnect leads to poor executive functioning capacity including emotion...
Source: Current Psychiatry Reports - September 10, 2014 Category: Psychiatry Source Type: research

The Role of Cortisol in First Episode of Psychosis: A Systematic Review
Abstract The stress diathesis hypothesis is currently one of the prevailing models of etiology of psychotic disorders. Cortisol is the most researched stress hormone; yet its role in first episode psychosis (FEP) was only recently investigated. The aim of the present study is to systematically review the evidence on the potential role of cortisol in FEP. Higher cortisol levels in blood samples have been consistently replicated, whereas saliva studies measuring baseline cortisol levels have exhibited divergent results. Moreover, longitudinal studies have revealed a cortisol upregulation in FEP with a subsequent de...
Source: Current Psychiatry Reports - September 9, 2014 Category: Psychiatry Source Type: research

Genetics of Schizophrenia
Abstract The genetic basis of schizophrenia has been a hotly debated research topic for decades, yet recent studies, especially in the past year, have confirmed genetics as the major cause of this complex condition. Psychiatry has come of age: it is perhaps more difficult for the current generation of psychiatrists, to comprehend how the biological root of the condition could have been denied for so long. Here we review how highly collaborative global efforts to pool samples, utilise the very latest advances in genotyping and high throughput sequencing technologies, and application of robust statistical analysis ...
Source: Current Psychiatry Reports - September 9, 2014 Category: Psychiatry Source Type: research

New Developments in the Genetics of Bipolar Disorder
Abstract The last several years have been breakthrough ones in bipolar disorder (BPD) genetics, as the field has identified robust risk variants for the first time. Leading the way have been genome-wide association studies (GWAS) that have assessed common genetic markers across very large groups of patients and controls. These have resulted in findings in genes including ANK3, CACNA1C, SYNE1, ODZ4, and TRANK1. Additional studies have begun to examine the biology of these genes and how risk variants influence aspects of brain and behavior that underlie BPD. For example, carriers of the CACNA1C risk variant have be...
Source: Current Psychiatry Reports - September 7, 2014 Category: Psychiatry Source Type: research

Excess Mortality in Bipolar Disorders
Abstract Bipolar disorder is associated with high mortality, and people with this disorder on average may die 10–20 years earlier than the general population. This excess and premature mortality continues to occur despite a large and expanding selection of treatment options dating back to lithium and now including anticonvulsants, antipsychotics, and evidence-based psychotherapies. This review summarizes recent findings on mortality in bipolar disorder, with an emphasis on the role of suicide (accounting for about 15 % of deaths in this population) and cardiovascular disease (accounting for about ...
Source: Current Psychiatry Reports - September 7, 2014 Category: Psychiatry Source Type: research

Meaning-Centered Psychotherapy: A Form of Psychotherapy for Patients With Cancer
This article describes the creation and evolution of a new psychotherapy devoted to these needs, a therapy termed "meaning-centered psychotherapy.” In this article, a detailed description of meaning-centered psychotherapy is provided. An explanation of the current research findings related to this treatment are also offered, with information about the various group and individual treatments as well as the new expansions for use with cancer survivors or nursing staff. Overall, meaning-centered psychotherapy shows promise for enhancing meaning and spiritual well-being among patients with cancer and offers exciting...
Source: Current Psychiatry Reports - September 4, 2014 Category: Psychiatry Source Type: research

Antagonist Models for Treating Persons With Substance use Disorders
Abstract This paper provides an overview on the status of antagonist models for treating patients with substance use disorders. It begins with an overview describing the ambivalence about stopping or not stopping substance use and how antagonist approaches, combined with psychosocial treatment, are aimed to address it. It then goes on to review data on disulfiram and acamprosate treatment of alcohol dependence and naltrexone treatment of opioid and alcohol dependence. The superior results achieved by extended release formulations are emphasized. The mixed findings on naltrexone treatment for amphetamine dependenc...
Source: Current Psychiatry Reports - September 3, 2014 Category: Psychiatry Source Type: research

Depression and Cardiovascular Disease: An Update on How Course of Illness May Influence Risk
Abstract Depression constitutes a novel and independent risk factor for cardiovascular disease, which despite extensive support in the literature has been underappreciated. While much of the evidence for depression as a risk factor for cardiovascular disease is based on studies following myocardial infarction, the elevated vascular risk conveyed by depression is not confined to periods following acute coronary syndromes. For that matter, the risk appears across mood disorders with evidence for even greater risk in bipolar disorder. This review summarizes the literature linking depressive disorders to cardiovascul...
Source: Current Psychiatry Reports - August 28, 2014 Category: Psychiatry Source Type: research