Sex Offender Risk Assessment: Where Are We and Where Are We Going?
AbstractPurpose of ReviewRisk assessment is one of the most ubiquitous tasks in the criminal justice system, informing virtually every decision made about offenders. This review, intended for researchers and practitioners, outlines some of the most important recent advances, emerging issues, and recommendations in sex offender risk assessment.Recent FindingsThe underlying nature and purpose of risk scales is reviewed, with implications for how we should evaluate them. Limits of recidivism probability estimates are discussed, and efforts to advance a common language for describing risk levels are highlighted. Advances in ri...
Source: Current Psychiatry Reports - May 19, 2018 Category: Psychiatry Source Type: research

Youth Responses to School Shootings: a Review
AbstractPurpose of ReviewThis paper aims to synthesize research relating to youth responses to school shootings between 2014 and 2017. The main questions it addresses are how such events impact young people psychologically, and what risk or protective factors may contribute to different trajectories of recovery?Recent FindingsRecent research suggests that most young people exposed to school shootings demonstrate resilience, exhibiting no long-term dysfunction. However, a minority will experience severe and chronic symptoms. The likelihood of experiencing clinically significant reactions is influenced by pre-trauma function...
Source: Current Psychiatry Reports - May 19, 2018 Category: Psychiatry Source Type: research

Startling Differences: Using the Acoustic Startle Response to Study Sex Differences and Neurosteroids in Affective Disorders
AbstractPurpose of ReviewNeuroactive steroid hormones, such as estradiol and progesterone, likely play a role in the pathophysiology of female-specific psychiatric disorders such as premenstrual dysphoric disorder (PMDD) and postpartum depression and may contribute to the marked sex differences observed in the incidence and presentation of affective disorders. However, few tools are available to study the precise contributions of these neuroactive steroids (NSs). In this review, we propose that the acoustic startle response (ASR), an objective measure of an organism ’s response to an emotional context or stressor, is...
Source: Current Psychiatry Reports - May 18, 2018 Category: Psychiatry Source Type: research

Toward an Emerging Role for Motivational Interviewing in Primary Care
AbstractPurpose of ReviewImplementing Motivational Interviewing (MI) in primary care settings has been problematic due in part to persistent gaps in knowledge. Examples include poor understanding of how to effectively train persons to conduct MI, or of which aspects of MI-related communication are associated with better outcomes for patients. This review describes how recent research findings addressing the knowledge gaps support a growing role for MI in primary care.Recent FindingsTwo trials of MI training combined classroom time with ongoing coaching and feedback, resulting in enhanced MI ability relative to a control ar...
Source: Current Psychiatry Reports - May 18, 2018 Category: Psychiatry Source Type: research

What Does Sex Have to Do with It? The Role of Sex as a Biological Variable in the Development of Posttraumatic Stress Disorder
AbstractPurpose of ReviewThis review highlights the neurobiological aspects of sex differences in posttraumatic stress disorder (PTSD), specifically focusing on the physiological responses to trauma and presents evidence supporting hormone and neurosteroid/peptide differences from both preclinical and clinical research.Recent FindingsWhile others have suggested that trauma type or acute emotional reaction are responsible for women ’s disproportionate risk to PTSD, neither of these explanations fully accounts for the sex differences in PTSD. Sex differences in brain neurocircuitry, anatomy, and neurobiological process...
Source: Current Psychiatry Reports - May 18, 2018 Category: Psychiatry Source Type: research

Ethical Issues in Conducting Research With Children and Families Affected by Disasters
AbstractPurpose of ReviewWe review topical evidence on ethical issues in conducting disaster research with children and families affected by natural disasters, with an emphasis on analyzing specific vulnerabilities associated with children and families affected by disasters, identifying significant findings and trends of ethical guidelines and approaches, and discussing key observations into ethical research in a disaster setting.Recent FindingsCurrent evidence indicates that there is a wide range of research methods for child disaster studies. Vulnerability as a concept in child disaster studies is more prevalent with sev...
Source: Current Psychiatry Reports - May 18, 2018 Category: Psychiatry Source Type: research

Diagnosis and Treatment of Borderline Personality Disorder in the College Mental Health Setting
AbstractPurpose of ReviewThe impact of borderline personality disorder (BPD) on college students is not well studied, and there is currently little data about its phenomenology or treatment in this population. We review the available literature regarding evidence-based treatment for BPD on college campuses, as well as best-practice guidelines for the treatment of mental illness in the college setting. Diagnostic disclosure and psychoeducation are proposed as practical first steps in improving the treatment landscape.Recent FindingsPreliminary studies of targeted treatment for BPD on college campuses are promising. They sug...
Source: Current Psychiatry Reports - May 18, 2018 Category: Psychiatry Source Type: research

Posttraumatic Growth as a Response to Natural Disasters in Children and Adolescents
AbstractPurpose of ReviewThis review examines factors thought to be associated with posttraumatic growth (PTG) (demographic variables, exposure, and family and social processes) among youth exposed to natural disasters, describes the relationship between PTG and posttraumatic stress, and discusses psychological processes (rumination and coping) linked to PTG.Recent FindingsGuided by PTG theory and the literature on PTG in adults, research has revealed relationships between PTG and child, environmental, and family and social factors among youth though the results are mixed. Youth ’s subjective exposure to disasters, t...
Source: Current Psychiatry Reports - May 16, 2018 Category: Psychiatry Source Type: research

Medical Comorbidities in Bipolar Disorder
AbstractPurpose of ReviewBipolar disorder (BD) medical comorbidity presents significant clinical and public health concerns with serious impact on health. The aim of this article is to present an updated narrative review of original research articles (case control, longitudinal cohort, and cross-sectional studies) and meta-analyses published in English language journals from January 2013 to May 2017 focusing on general medical comorbidity in BD, including the added risks of iatrogenic factors relevant to the treatment of BD.Recent FindingsWe found numerous patterns of association between BD and various medical disorders in...
Source: Current Psychiatry Reports - May 7, 2018 Category: Psychiatry Source Type: research

The Psychological Effects of Climate Change on Children
AbstractPurpose of ReviewWe review recent evidence on the psychological effects of climate change on children, covering both direct and indirect impacts, and discuss children ’s psychological adaptation to climate change.Recent FindingsBoth the direct and flow-on effects of climate change place children at risk of mental health consequences including PTSD, depression, anxiety, phobias, sleep disorders, attachment disorders, and substance abuse. These in turn can lead to problems with emotion regulation, cognition, learning, behavior, language development, and academic performance. Together, these create predispositio...
Source: Current Psychiatry Reports - April 11, 2018 Category: Psychiatry Source Type: research

Advances in Pharmacotherapy of Late-Life Depression
AbstractPurpose of SummaryThis paper reviews recent research on late-life depression (LLD) pharmacotherapy, focusing on updated information for monotherapy and augmentation treatments. We then review new research on moderators of clinical response and how to use the information for improved efficacy.Recent FindingsA recent review shows that sertraline, paroxetine, and duloxetine were superior to placebo for the treatment of LLD. There is concern that paroxetine could have adverse outcomes in the geriatric population due to anticholinergic properties; however, studies show no increases in mortality, dementia risk, or cognit...
Source: Current Psychiatry Reports - April 7, 2018 Category: Psychiatry Source Type: research

Psychological Pain, Depression, and Suicide: Recent Evidences and Future Directions
AbstractPurpose of ReviewThe definition of psychological pain is complex. It is a lasting unpleasant and unsustainable feeling characterized by a perception of inability or deficiency of the self, as well as frustrated psychological needs and social disconnection. The aim of our review was to summarize the most recent and updated findings supporting the role of psychological pain in the pathophysiology of depression and suicidal behavior. We also explored the relationship between psychological and physical pain in depression and suicide.Recent FindingsPsychological pain is a prominent dimension of depressive disorder and h...
Source: Current Psychiatry Reports - April 5, 2018 Category: Psychiatry Source Type: research

Recent Genetics and Epigenetics Approaches to PTSD
AbstractPurpose of ReviewFollowing a life-threatening traumatic exposure, about 10% of those exposed are at considerable risk for developing posttraumatic stress disorder (PTSD), a severe and disabling syndrome characterized by uncontrollable intrusive memories, nightmares, avoidance behaviors, and hyperarousal in addition to impaired cognition and negative emotion symptoms. This review will explore recent genetic and epigenetic approaches to PTSD that explain some of the differential risk following trauma exposure.Recent FindingsA substantial portion of the variance explaining differential risk responses to trauma exposur...
Source: Current Psychiatry Reports - April 5, 2018 Category: Psychiatry Source Type: research

The Function of Play for Coping and Therapy with Children Exposed to Disasters and Political Violence
The objectives were to identify specific characteristics and patterns of children ’s play following events of political violence or disasters, examine their associations with risk and resilience, and explore their implications for preventive and therapeutic intervention.Recent FindingsPatterns of individual, dyadic, and social play are associated with measures of children ’s adaptation following collective traumatic events. Modifying the traditional child-centered play therapy, by integrating CBT principles or including parents, may increase efficacy.SummaryPreventive interventions in the aftermath of collectiv...
Source: Current Psychiatry Reports - April 5, 2018 Category: Psychiatry Source Type: research

Omega-3 Supplementation as a Dietary Intervention to Reduce Aggressive and Antisocial Behavior
This article describes the current state of the research regarding omega-3 supplementation and aggressive/antisocial behavior from intervention studies, with an emphasis on randomized controlled trials.Recent FindingsThe current evidence base indicates a small effect size (approximatelyd = .20) for the efficacy of increased omega-3 intake in reducing aggressive and antisocial behavior in children and adults. How precisely omega-3 supplementation results in such behavioral improvement is an open question, although upregulation of dysfunctional prefrontal regions is one candidate mediator.SummaryDirections for ...
Source: Current Psychiatry Reports - April 5, 2018 Category: Psychiatry Source Type: research

A Review on the General Stability of Mood Disorder Diagnoses Along the Lifetime
AbstractPurpose of ReviewThe purpose of this review is to review the most recent literature regarding diagnostic stability of mood disorders, focusing on epidemiological, clinical-psychopathological, and neurobiological data for unipolar and bipolar affective disorders.Recent FindingsUnipolar depression follows a chronic course in at least half of all cases and presents a considerable diagnostic stability across all age ranges. Studies using latent class analysis are allowing improved profiling of depressive subtypes and assessment of their prevalence. Advances have been made in our understanding of the neurobiological und...
Source: Current Psychiatry Reports - April 2, 2018 Category: Psychiatry Source Type: research

Interoception and Its Interaction with Self, Other, and Emotion Processing: Implications for the Understanding of Psychosocial Deficits in Borderline Personality Disorder
AbstractPurpose of ReviewWe review evidence for the potential importance of interoception, i.e., the processing of signals arising from inside the body, for deficient psychosocial functioning in borderline personality disorder (BPD).Recent FindingsEvidence suggests that variability in interoception interacts with higher-order psychological functions such as self, other, and emotion processing. These domains are characteristically impaired in BPD, suggesting a likely causal role of disturbed interoception in the etiology of the disorder. The inability to identify and describe one ’s own emotional states represents a p...
Source: Current Psychiatry Reports - March 28, 2018 Category: Psychiatry Source Type: research

Suicidality in Subjects With Anxiety or Obsessive-Compulsive and Related Disorders: Recent Advances
AbstractPurpose of ReviewHistorically, anxiety disorders have not been considered as important determinants of suicide, but in the last years, many works have challenged this assumption. Here, we will review the available evidence on the relationship between suicide and anxiety disorders (e.g., obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, panic disorder, and body dysmorphic disorder), with special emphasis on findings published in the last years.Recent FindingsOverall, anxiety disorders increase the risk of suicide. Specifically, 16% of patients with social anxiety disorder r...
Source: Current Psychiatry Reports - March 28, 2018 Category: Psychiatry Source Type: research

Stress Response Modulation Underlying the Psychobiology of Resilience
AbstractPurpose of ReviewThis review focuses on the relationship between resilience and the ability to effectively modulate the stress response. Neurobiological and behavioral responses to stress are highly variable. Exposure to a similar stressor can lead to heterogeneous outcomes —manifesting psychopathology in one individual, but having minimal effect, or even enhancing resilience, in another. We highlight aspects of stress response modulation related to early life development and epigenetics, selected neurobiological and neurochemical systems, and a number of emotional, cognitive, psychosocial, and behavioral fac...
Source: Current Psychiatry Reports - March 28, 2018 Category: Psychiatry Source Type: research

Recent Progress in Pharmacogenomics of Antipsychotic Drug Response
AbstractPurpose of ReviewPharmacogenomics (PGx) of antipsychotic drug response is an active area of research in the past few years. We reviewed recent PGx studies with an emphasis of development of new methodologies and new research directions.Recent FindingsTraditional candidate gene approach continues to generate evidence to support the associations of antipsychotic response with genes coding for drug targets such asDRD2. Genome-wide association studies have found a few novel genes that may be associated with drug efficacy and adverse events. Recent application of polygenic risk score makes it possible to combine many ge...
Source: Current Psychiatry Reports - March 27, 2018 Category: Psychiatry Source Type: research

Shared Decision-Making: a Systematic Review Focusing on Mood Disorders
This study aims to provide a review of the randomized controlled studies evaluating the effects of shared decision-making (SDM) intervention in comparison to care as usual in patients with mood disorders.Recent FindingsOf the 14 randomized controlled studies identified, only three 6-month studies evaluated the interest of SDM interventions using decision aids in depressed patients. All of them showed that the intervention effectively improved patient satisfaction and engagement in the decision-making process. Only one study in patients with bipolar disorder (BD) showed improvement of depressive symptoms, functioning, and q...
Source: Current Psychiatry Reports - March 27, 2018 Category: Psychiatry Source Type: research

Launching Anxious Young Adults: A Specialized Cognitive-Behavioral Intervention for Transitional Aged Youth
AbstractPurpose of ReviewThere has been growing clinical and research attention to the unique developmental stage of emerging adulthood. This stage is a time of significant change and growth for all individuals, as it includes identity exploration, emotional, behavioral, and financial independence from caregivers, and completion of educational or vocational requirements.Recent FindingsAnxiety disorders are the most common mental health diagnoses among emerging adults, and individuals suffering from these disorders often experience compounding functional impairments across health, financial, and social domains. While eviden...
Source: Current Psychiatry Reports - March 27, 2018 Category: Psychiatry Source Type: research

Cultural Aspects in Symptomatology, Assessment, and Treatment of Personality Disorders
AbstractPurpose of ReviewThis review discusses cultural trends, challenges, and approaches to assessment and treatment of personality traits and disorders. Specific focus include current developments in the Asian, Italian, Iranian, and Australian societies, as well as the process of acculturation, following moves between cultures with the impact on healthy and disordered personality function.Recent FindingsEach culture with its specific history, dimensions, values, and practices influences and gears the individual and family or group in unique ways that affect personality functioning. Similarly, each culture provides means...
Source: Current Psychiatry Reports - March 26, 2018 Category: Psychiatry Source Type: research

Sex Offender Management Policies and Evidence-Based Recommendations for Registry Reform
AbstractPurpose of ReviewThe goal of this paper is to improve evidence-based sex offender management systems through an understanding of the research findings related to the stated goals and unintended consequences of such laws.Recent FindingsAssessment tools using factors derived from research studies can improve the identification of higher-risk sex offenders, so that more intensive or restrictive interventions can be tailored to those who pose the highest threat to community safety. After substantial time offense-free in the community, even higher-risk offenders become less likely to reoffend, suggesting that registrati...
Source: Current Psychiatry Reports - March 21, 2018 Category: Psychiatry Source Type: research

Weighing the Risks: the Management of Bipolar Disorder During Pregnancy
AbstractPurpose of ReviewThe management of bipolar disorder during pregnancy requires difficult treatment decisions be made by both women and their clinicians. There is little consensus on management despite the high prevalence of bipolar disorder in reproductive-aged women. In this review, we have summarized the available literature and discuss the balancing of risks associated with treatment decisions.Recent FindingsCohort studies have shown a high relapse rate in women with bipolar disorder who discontinue mood-stabilizing medications. The risks of fetal medication exposure have been assessed in multiple database studie...
Source: Current Psychiatry Reports - March 17, 2018 Category: Psychiatry Source Type: research

Cannabinoid Receptors, Mental Pain and Suicidal Behavior: a Systematic Review
The objective of the present article is to review all available information on the relationship between cannabinoid receptors (CB1 and CB2 receptors), and SB and/or psychological pain.Recent FindingsOur review is limited by the small number and heterogeneity of studies identified: (1) an autopsy study describing elevated levels of CB1 receptor activity in the prefrontal cortex and suicide in both depression and alcoholism and (2) studies supporting the involvement of both CB1 and CB2 receptors in the regulation of neuropathic pain and stress-induced analgesia.SummaryWe conclude that cannabinoid receptors, particularly CB1 ...
Source: Current Psychiatry Reports - March 15, 2018 Category: Psychiatry Source Type: research

Sex Differences in the Treatment of Sexual Dysfunction
AbstractPurpose of ReviewSex differences in the treatment of sexual dysfunction are partly due to neurobiological differences, as well as, the central and peripheral physiological effects of hormones and neurotransmitter actions on reproductive systems in men and women. Differences in epidemiology of complaints and diagnostic considerations, variance in medical comorbidities, and interference from related medications also contribute to the need for different strategies for treatments of sexual dysfunction according to gender.Recent FindingsFlibanserin and ospemifene are new medication treatment options that may help some w...
Source: Current Psychiatry Reports - March 14, 2018 Category: Psychiatry Source Type: research

Possible Pharmacodynamic and Pharmacokinetic Drug-Drug Interactions That Are Likely to Be Clinically Relevant and/or Frequent in Bipolar Disorder
This article should provide clinicians with an understanding of how polypharmacy can contribute to pharmacokinetic and pharmacodynamic drug-drug interactions (DDIs).Recent FindingsThe pharmacokinetics and pharmacodynamics of lithium and other mood stabilizers (valproate, lamotrigine, carbamazepine, oxcarbazepine, and eslicarbazepine), antipsychotics, and selective serotonin reuptake inhibitors (SSRIs) were reviewed and summarized in the first four tables describing their pharmacokinetic and pharmacodynamic mechanisms.SummaryFour tables summarized the DDIs which are likely to be clinically relevant in adults with bipolar di...
Source: Current Psychiatry Reports - March 12, 2018 Category: Psychiatry Source Type: research

Lifelong Learning for Clinical Practice: How to Leverage Technology for Telebehavioral Health Care and Digital Continuing Medical Education
AbstractPurpose of ReviewPsychiatric practice continues to evolve and play an important role in patients ’ lives, the field of medicine, and health care delivery. Clinicians must learn a variety of clinical care systems and lifelong learning (LLL) is crucial to apply knowledge, develop skills, and adjust attitudes. Technology is rapidly becoming a key player—in delivery, lifelong learning, and educ ation/training.Recent FindingsThe evidence base for telepsychiatry/telemental health via videoconferencing has been growing for three decades, but a greater array of technologies have emerged in the last decade (e.g....
Source: Current Psychiatry Reports - March 12, 2018 Category: Psychiatry Source Type: research

An International Approach to Enhancing a National Guideline on Driving and Dementia
AbstractPurpose of ReviewThe purpose of this study was to update a national guideline on assessing drivers with dementia, addressing limitations of previous versions which included a lack of developmental rigor and stakeholder involvement.MethodsAn international multidisciplinary team reviewed 104 different recommendations from 12 previous guidelines on assessing drivers with dementia in light of a recent review of the literature. Revised guideline recommendations were drafted by consensus. A preliminary draft was sent to specialist physician and occupational therapy groups for feedback, using an a priori definition of 90%...
Source: Current Psychiatry Reports - March 12, 2018 Category: Psychiatry Source Type: research

Refining Suicide Prevention: a Narrative Review on Advances in Psychotherapeutic Tools
AbstractPurpose of ReviewSince psychotherapies for suicide prevention are receiving increasing attention, our purpose was to evaluate the related literature [meta-analyses and reviews on their effect on suicidal outcomes (A), perspective reviews concerning specific socio-demographic and clinical features (B), original studies with particular interest (C)] published over the last 3  years.Recent Findings(A) Across different diagnoses, particularly, efficacious psychotherapies were cognitive behavioral therapy-based ones and interventions directly addressing suicidal thoughts and behaviors during the treatment. When the...
Source: Current Psychiatry Reports - March 8, 2018 Category: Psychiatry Source Type: research

Presentation and Neurobiology of Anhedonia in Mood Disorders: Commonalities and Distinctions
AbstractPurpose of ReviewTo focus on the clinical and behavioral presentation of anhedonia in mood disorders, as well as the differences and commonalities in the underlying neurocircuitry.Recent FindingsEvidence suggests that depression is characterized by hypofunction of the reward system, while bipolar disorder manifests dysregulation of the behavioral activation system that increases goal-directed reward behavior. Importantly, strong evidence does not exist to suggest significant differences in anhedonia severity between depressed unipolar and bipolar patients, suggesting that there are more nuanced fluctuations in rewa...
Source: Current Psychiatry Reports - March 8, 2018 Category: Psychiatry Source Type: research

Psychiatry and Pain Management: at the Intersection of Chronic Pain and Mental Health
AbstractPurpose of ReviewChronic pain impacts millions of people in the USA. At the heart of the problem of chronic pain remains the complex psychosocial aspects associated with living with chronic pain. Given the overlap between chronic pain and mental health, a promising treatment approach is to improve how we integrate psychiatry into pain management.Recent FindingsTreatment of chronic pain and comorbid mental health issues requires a multidisciplinary approach. Advancements in how pain is understood, especially centralized pain, have helped inform both pharmacological and behavioral interventions for pain. Given the gr...
Source: Current Psychiatry Reports - March 5, 2018 Category: Psychiatry Source Type: research

Sex Differences in Autism Spectrum Disorder: a Review
AbstractPurpose of ReviewNeurodevelopmental disorders disproportionately affect males. The mechanisms underlying male vulnerability or female protection are not known and remain understudied. Determining the processes involved is crucial to understanding the etiology and advancing treatment of neurodevelopmental disorders. Here, we review current findings and theories that contribute to male preponderance of neurodevelopmental disorders, with a focus on autism.Recent FindingsRecent work on the biological basis of the male preponderance of autism and other neurodevelopmental disorders includes discussion of a higher genetic...
Source: Current Psychiatry Reports - March 5, 2018 Category: Psychiatry Source Type: research

Advances in Drug Discovery and Development in Geriatric Psychiatry
This article reviews recent advances in drug discovery and development for geriatric psychiatry. Drug discovery for disorders of the central nervous system is a long and challenging process, with a high attrition rate from the preclinical stages through to marketing a compound. Developing drugs for geriatric neuropsychiatric conditions presents additional challenges, due to the complexity of the symptoms, comorbid diagnoses, and the variability of the population. Despite there being limited success over the past two decades, a number of new approaches have identified potential targets for preclinical development and ultima...
Source: Current Psychiatry Reports - March 5, 2018 Category: Psychiatry Source Type: research

Human Genetics of Addiction: New Insights and Future Directions
AbstractPurpose of ReviewWith the advent of the genome-wide association study (GWAS), our understanding of the genetics of addiction has made significant strides forward. Here, we summarize genetic loci containing variants identified at genome-wide statistical significance (P 
Source: Current Psychiatry Reports - March 5, 2018 Category: Psychiatry Source Type: research

Media Effects in Youth Exposed to Terrorist Incidents: a Historical Perspective
AbstractPurpose of ReviewThis paper reviews the evidence on the relationship between contact with media coverage of terrorist incidents and psychological outcomes in children and adolescents while tracing the evolution in research methodology.Recent FindingsStudies of recent events in the USA have moved from correlational cross-sectional studies examining primarily television coverage and posttraumatic stress reactions to longitudinal studies that address multiple media forms and a range of psychological outcomes including depression and anxiety.SummaryStudies of events in the USA —the 1995 Oklahoma City bombing, the...
Source: Current Psychiatry Reports - March 5, 2018 Category: Psychiatry Source Type: research

Advances and Barriers for Clinical Neuroimaging in Late-Life Mood and Anxiety Disorders
AbstractPurpose of ReviewMood and anxiety disorders are very commonly experienced by older adults and are becoming a growing concern due to the rapidly aging global population. Recent advances in neuroimaging may help in improving outcomes in late-life mood and anxiety disorders. The elucidation of mechanisms contributing to late-life mental health disorders may ultimately lead to the identification of novel therapeutic interventions. Alternatively, clinically validated imaging biomarkers may allow for the prediction of treatment response and identification of better therapeutic approaches in late-life mood and anxiety dis...
Source: Current Psychiatry Reports - March 1, 2018 Category: Psychiatry Source Type: research

Transcranial Magnetic Stimulation (TMS) in the Elderly
This article aims to review select applications of Transcranial Magnetic Stimulation (TMS) that have significant relevance in geriatric psychiatry.Recent FindingsSmall study sizes and parameter variability limit the generalizability of many TMS studies in geriatric patients. Additionally, geriatric patients have unique characteristics that can moderate the efficacy of TMS. Nonetheless, several promising experimental applications in addition to the FDA-approved indication for major depression have emerged. Cognitive impairment, neuropathic pain, and smoking cessation are experimental applications with special significance t...
Source: Current Psychiatry Reports - February 10, 2018 Category: Psychiatry Source Type: research

Psychiatric Aspects of Acute Porphyria: a Comprehensive Review
AbstractPurpose of ReviewThe aim of this paper is to review psychiatric manifestations, comorbidities, and psychopharmacological management in individuals with acute porphyria (AP).Recent FindingsRecent literature begins to clarify associations between AP, schizophrenia, bipolar disorder, and other psychopathology.SummaryBroad psychiatric symptoms have been associated to acute porphyria (AP) and correspond to a spectrum of heterogeneous manifestations such as anxiety, affective alterations, behavioral changes, personality, and psychotic symptoms. These symptoms may be difficult to identify as being related to porphyria sin...
Source: Current Psychiatry Reports - February 2, 2018 Category: Psychiatry Source Type: research

Health Policy and Dementia
AbstractPurpose of ReviewThe anticipated number of persons with dementia continues to grow, and the US has insufficiently planned to provide and pay for care for this large population.Recent FindingsA number of significant clinical trials aiming to prevent or cure dementia, including Alzheimer ’s disease, have not demonstrated success. Because of the lack of efficacious treatments, and the fact that brain changes associated with dementia may begin decades before symptoms, we can predict that efforts to cure or prevent dementia will not succeed in time for millions of people in the baby boomer generation.SummaryBecaus...
Source: Current Psychiatry Reports - February 1, 2018 Category: Psychiatry Source Type: research

Treating Hallucinations and Delusions Associated With Parkinson ’s Disease Psychosis
AbstractPurpose of ReviewWe discuss features of Parkinson ’s disease psychosis (PDP) including symptomology and pathophysiology. Treatment options, including non-pharmacologic strategies, dose reduction of offending agents, and the addition of non-dopaminergic antipsychotics, are addressed. The efficacy of second-generation antipsychotics and novel agent s is examined.Recent FindingsPimavanserin, a 5-HT2A/C receptor inverse agonist with no other receptor activity, has shown efficacy and tolerability and is now FDA approved for PDP treatment. Research into novel targets is ongoing.SummaryPDP is a morbid complication o...
Source: Current Psychiatry Reports - January 27, 2018 Category: Psychiatry Source Type: research

Mind-Body Therapies for Late-Life Mental and Cognitive Health
AbstractPurpose of ReviewA growing body of research supports the use of mind-body therapies (MBTs) as minimally invasive and effective approaches for the management of late-life mood and cognitive disorders.Recent FindingsRecent randomized controlled trials and meta-analyses indicate that MBTs are effective for enhancing well-being, mood, sleep, and cognition in older adults. Evidence suggests that mindful movement (e.g., yoga, tai chi, walking meditation) may even outperform conventional physical exercise with regard to effects on quality of life, mood, and cognitive functioning.SummaryPractitioners may recommend MBTs as ...
Source: Current Psychiatry Reports - January 25, 2018 Category: Psychiatry Source Type: research

Ethical, Legal and Forensic Issues in Geriatric Psychiatry
ConclusionsEthical, legal and forensic issues among older are not uncommon and complicate the care of these vulnerable individuals. (Source: Current Psychiatry Reports)
Source: Current Psychiatry Reports - January 25, 2018 Category: Psychiatry Source Type: research

Reflections on Recent Research Into Animal-Assisted Interventions in the Military and Beyond
AbstractPurpose of ReviewThe purpose of the present review was threefold: to address the current state of Animal-Assisted Interactions (AAI) within the military; to summarize recent literature (within the past three years) in the field of AAI; and to discuss trends in AAI research since 2014.Recent FindingsWith regard to AAI within the military, several canine interaction programs have been utilized to assist service members in coping with various issues. Therapy dogs have been deployed with Combat-Operational Stress Control units; they have been integrated into medical clinics and behavioral health treatment programs in g...
Source: Current Psychiatry Reports - November 25, 2017 Category: Psychiatry Source Type: research

ADHD and Anxiety: Clinical Significance and Treatment Implications
AbstractIn comparison to the DSM formulation of ADHD, we have proposed that ADHD in adults should be divided into Inattentive and Emotional Dysregulation Presentations. Under both systems, there is potential overlap with generalized anxiety disorder (GAD). We compared data from four distinct populations: ADHD clinical trials, GAD clinical trials, an ADHD clinic, and a forensic clinic. Approximately 25% of patients in each population had comorbid ADHD and anxiety. Comorbid subjects reported more childhood ADHD symptoms and higher scores on ADHD scales and were more likely to fit criteria for ADHD Emotional Dysregulation Pre...
Source: Current Psychiatry Reports - November 20, 2017 Category: Psychiatry Source Type: research

Psychiatric Sequelae of Concussions
AbstractPurpose of ReviewThe purpose of this study was to review the frequency, risk factors, phenomenology, and course of prolonged recovery from concussion and of psychiatric sequelae in pediatric populations.Recent FindingsYouth with prolonged recovery from concussions have higher initial symptoms, a history of multiple and/or recent concussions, and a tendency to somatization. Depression, post-traumatic stress disorder, behavioral disorders, and perhaps, suicidal behavior disorder are more common as both short- and longer-term sequelae of concussions. The weight of evidence supports a graduated return to function as co...
Source: Current Psychiatry Reports - November 17, 2017 Category: Psychiatry Source Type: research

Use of Ketamine in Elderly Patients with Treatment-Resistant Depression
AbstractPurpose of ReviewThe purpose of this paper is to provide a review of the use of ketamine as an antidepressant for treatment-resistant depression (TRD) in the geriatric population. Available treatment options for late-life treatment-resistant depression are limited and include electroconvulsive therapy and transcranial magnetic stimulation as well as possible pharmacologic augmentation. Ketamine has been shown to be a promising treatment in TRD; however, data regarding the use of ketamine in the elderly includes only five case reports.Recent FindingsWe discuss the use of ketamine for late-life TRD and present two ca...
Source: Current Psychiatry Reports - November 15, 2017 Category: Psychiatry Source Type: research

Late-Onset ADHD: Understanding the Evidence and Building Theoretical Frameworks
AbstractPurpose of ReviewThe traditional definition of Attention-Deficit/Hyperactivity Disorder (ADHD), assuming onset in childhood, has been challenged by evidence from four recent birth-cohort studies that reported most adults with ADHD lacked a childhood categorical ADHD diagnosis.Recent FindingsLate onset of symptoms was evaluated in the long-term follow-up of the Multimodal Treatment study of ADHD (MTA). In most cases, other factors were present that discounted the late onset of ADHD symptoms and excluded the diagnosis of ADHD.SummaryWe offer two theoretical frameworks for understanding the ADHD trajectory throughout ...
Source: Current Psychiatry Reports - November 13, 2017 Category: Psychiatry Source Type: research

Major Mental Illness in Those Who Sexually Abuse
AbstractPurpose of ReviewThere is evidence showing an increasing prevalence of mental illness in those in conflict with the law. However, there are many factors affecting the detection, treatment, and management of criminals who are mentally ill.Recent FindingsSex offenders with major mental illness present many challenges to those providing treatment and management services. For example, it is important to consider whether sexually offensive behavior is the cause of criminal behavior or whether it is reflective of an antisocial orientation. Recent evidence suggests it may help better understand and inform risk assessment ...
Source: Current Psychiatry Reports - November 9, 2017 Category: Psychiatry Source Type: research