Sex Differences in Trauma-Related Psychopathology: a Critical Review of Neuroimaging Literature (2014 –2017)
AbstractPurpose of ReviewSex differences in the epidemiology and clinical presentation of trauma-related psychopathology have long been documented. Multiple underlying mechanisms have been examined, both psychosocial and biological. Among the most promising biological mechanisms are neural substrates of trauma-related psychopathology that have been uncovered in recent years.Recent FindingsNeuroimaging studies of sex-related heterogeneity published over the past 3  years (2014–2017) demonstrate an interaction between sex and type, timing, and load of trauma exposure. These studies suggest that, for males, early t...
Source: Current Psychiatry Reports - November 8, 2017 Category: Psychiatry Source Type: research

The Place of Antipsychotics in the Therapy of Anxiety Disorders and Obsessive-Compulsive Disorders
AbstractPurpose of ReviewThe purpose of this review was to assess and present the findings up to this date on the efficacy of antipsychotics in the treatment of generalized anxiety disorders (GAD), social anxiety disorders (SAD), panic disorders (PD), and obsessive-compulsive disorders (OCD), mostly based on published randomized controlled trials (RCTs) or on open-label studies when RCT were lacking.Recent FindingsQuetiapine could be recommended in patients with GAD. The efficacy of aripiprazole in two open-label studies on patients with antidepressant-refractory GAD should be assessed in RCTs. Despite preliminary positive...
Source: Current Psychiatry Reports - November 7, 2017 Category: Psychiatry Source Type: research

Gender Dysphoria in the Military
AbstractPurpose of ReviewWith the announcement that members of the military who identify as transgender are allowed to serve openly, the need for Department of Defense behavioral health providers to be comfortable in the assessment, diagnosis, and treatment of this population becomes quickly evident. This population has been seeking care in the community and standards have been developed to help guide decision-making, but a comparable document does not exist for the military population.Recent FindingsPreviously published papers were written in anticipation of the policy allowing for open service. The civilian sector has tr...
Source: Current Psychiatry Reports - November 7, 2017 Category: Psychiatry Source Type: research

Pediatric Delirium: Recognition, Management, and Outcome
AbstractPurpose of ReviewThis review seeks to provide an update on the diagnosis, management, and outcome of pediatric delirium.Recent FindingsCare of patients with delirium depends on correct diagnosis and treatment of its underlying cause. A variety of instruments are available to aid diagnosis. Management of delirium currently depends on atypical antipsychotics, while avoiding agents that may precipitate or exacerbate it.While most critically ill children survive delirium, many children die or have worsening function after their illness. The longer the duration of delirium, the more severe its subsequent problems includ...
Source: Current Psychiatry Reports - November 7, 2017 Category: Psychiatry Source Type: research

Impact of Postpartum Mental Illness Upon Infant Development
AbstractPurpose of ReviewThis review evaluates the state of the research regarding the effects of postpartum mental illness on the developing infant. It defines the scope of these disorders in the literature, and includes the impact of disorders referred to as perinatal mood and anxiety disorders (PMADs) on infants.Recent FindingsNew research reveals that PMADs apply to not only mothers, but that fathers can also experience perinatal depression and anxiety. When untreated in a primary caregiver, PMADs adversely affect parental cognitions and beliefs, attachment to the infant, and the growing caregiver-infant relationship. ...
Source: Current Psychiatry Reports - November 6, 2017 Category: Psychiatry Source Type: research

Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Insomnia: an Update of the Literature
AbstractPurpose of ReviewInsomnia is diagnosed when there is dissatisfaction with sleep quantity or quality. It has a prevalence in the general population ranging from 31 to 56%. Insomnia has previously been associated with adult attention-deficit/hyperactivity disorder (ADHD). In this review, we address three topics: (1) the cross-sectional relationship between ADHD and insomnia in adulthood, (2) the longitudinal relationship between ADHD and insomnia, and (3) insomnia as a side effect of pharmacological treatments for adult ADHD.Recent FindingsThree cross-sectional, clinical, and population studies report a prevalence of...
Source: Current Psychiatry Reports - October 30, 2017 Category: Psychiatry Source Type: research

Motor System Pathology in Psychosis
AbstractPurpose of ReviewMotor abnormalities are an intrinsic feature of psychosis. Neurological soft signs, Parkinsonism, dyskinesia, and other motor phenomena are frequently observed in subjects at clinical or genetic risk for psychosis as well as first-episode patients, chronic patients. Here, we review the most recent literature on motor assessments and pathophysiology in psychosis.Recent FindingsInstrumental measures of fine motor performance, balance, spontaneous motor activity, and gesture indicated motor abnormalities in subjects at risk and across stages of schizophrenia. Motor phenomena are associated with distin...
Source: Current Psychiatry Reports - October 30, 2017 Category: Psychiatry Source Type: research

Food Allergy in Patients Seeking Mental Health Care: What the Practicing Psychiatrist Should Know
AbstractPurpose of ReviewThis review provides an overview of food allergy among children and adolescents in the context of its impact on psychosocial functioning, and quality of life (QoL).Recent FindingsThe prevalence of food allergy is increasing. The burden of day to day management of food allergy is significant and can have a negative impact on QoL for both parents of those with food allergy, and the children themselves. This can impact social functioning, academic functioning, and mental health. Children with food allergy experience more bullying than peers. Greater internalizing of symptoms has been identified in ado...
Source: Current Psychiatry Reports - October 30, 2017 Category: Psychiatry Source Type: research

Review of Use and Integration of Mobile Apps Into Psychiatric Treatments
AbstractPurpose of ReviewMental health practitioners should understand the features of current, publicly available apps; the features of novel, research apps; and issues behind the integration of mobile apps and digital health services into clinical workflows.Recent FindingsThe review is based on a research literature and the authors ’ clinical and healthcare administration experiences. Articles searched—on telepsychiatry, telemental health, mobile mental health, informatics, cellular phone, ambulatory monitoring, telemetry, and algorithms—were restricted to 2016 and 2017. Technologies are used in a varie...
Source: Current Psychiatry Reports - October 30, 2017 Category: Psychiatry Source Type: research

Preschool Predictors of ADHD Symptoms and Impairment During Childhood and Adolescence
AbstractPurpose of ReviewThis paper summarizes key, recently published research examining longitudinal outcomes for preschoolers with high levels of inattention and/or hyperactivity/impulsivity.Recent FindingsSymptom trajectories show that hyperactivity/impulsivity declines across childhood. At the group level, the course of inattention appears more variable. However, identification of subgroups of children showing stable, rising, and falling inattention over time is promising. Early ADHD-like symptoms portend risk for academic and social difficulties, as well as comorbid emotional and behavioral problems in childhood and ...
Source: Current Psychiatry Reports - October 30, 2017 Category: Psychiatry Source Type: research

Anxiety Disorders and Obsessive-Compulsive Disorder in Individuals with Autism Spectrum Disorder
AbstractPurpose of ReviewThis review aims to synthesize the most recent research on anxiety disorders and obsessive-compulsive disorder (OCD) in individuals with autism spectrum disorder (ASD) and discuss the relationship between these conditions and challenges for assessment. Furthermore, implications for treatment and future directions are discussed.Recent FindingsResearch suggests that anxiety disorders and OCD are highly prevalent in individuals with ASD. However, the significant overlap of ASD features with anxiety and OCD symptomology makes differential diagnosis of these disorders particularly challenging. Though se...
Source: Current Psychiatry Reports - October 30, 2017 Category: Psychiatry Source Type: research

Social Skills Training and ADHD —What Works?
AbstractPurpose of ReviewMany children and adolescents with attention-deficit/hyperactivity disorder (ADHD) have difficulties in their social skills and peer relationships. Because social problems exacerbate later maladjustment in ADHD populations, it is important to address this serious impairment. Although social skills training (SST) is a common intervention approach, evidence to date suggests that SST has limited efficacy, at least when provided in traditional, clinic-based settings. The current review summarizes recent advances to traditional SST approaches that may potentially enhance their efficacy.Recent FindingsWe...
Source: Current Psychiatry Reports - October 30, 2017 Category: Psychiatry Source Type: research

Reproductive Affective Disorders: a Review of the Genetic Evidence for Premenstrual Dysphoric Disorder and Postpartum Depression
AbstractPurpose of ReviewThe purpose of this study is to review and summarize the literature exploring the genetic basis for premenstrual dysphoric disorder (PMDD) and postpartum depression (PPD).Recent FindingsThere is more evidence for a genetic basis for PPD than for PMDD, but only when PPD is defined as beginning in the immediate postpartum time period.SummaryFamilial, genome-wide linkage and association studies, and candidate gene studies, most in the past 10  years, have examined the genetic etiology of reproductive affective disorders, including PMDD and PPD. The most commonly studied genes include SERT, COMT, ...
Source: Current Psychiatry Reports - October 30, 2017 Category: Psychiatry Source Type: research

Marijuana Use and Organ Transplantation: a Review and Implications for Clinical Practice
AbstractPurpose of ReviewPhysicians of all disciplines must rapidly adjust their clinical practices following the expansion of marijuana legalization across the country. Organ transplantation teams are uniquely struggling in this gray zone with eight states having passed laws explicitly banning the denial of transplant listing based on a patient ’s use of medical marijuana. In this review, we examine the clinical evidence of marijuana use in transplant patients to enable psychiatric providers to meaningfully contribute to the relevant medical and psychiatric aspects of this issue in a unique patient population.Recent...
Source: Current Psychiatry Reports - October 27, 2017 Category: Psychiatry Source Type: research

Managing Psychiatrist-Patient Relationships in the Digital Age: a Summary Review of the Impact of Technology-enabled Care on Clinical Processes and Rapport
AbstractPurpose of ReviewParticipatory medicine and the availability of commercial technologies have given patients more options to view and track their health information and to communicate with their providers. This shift in the clinical process may be of particular importance in mental healthcare where rapport plays a significant role in the therapeutic process.Recent FindingsIn this review, we examined literature related to the impact of technology on the clinical workflow and patient-provider rapport in the mental health field between January 2014 and June 2017. Thirty three relevant articles, of 226 identified articl...
Source: Current Psychiatry Reports - October 27, 2017 Category: Psychiatry Source Type: research

Dementia Risk in Posttraumatic Stress Disorder: the Relevance of Sleep-Related Abnormalities in Brain Structure, Amyloid, and Inflammation
AbstractPurpose of ReviewPosttraumatic stress disorder (PTSD) is associated with increased risk for dementia, yet mechanisms are poorly understood.Recent FindingsRecent literature suggests several potential mechanisms by which sleep impairments might contribute to the increased risk of dementia observed in PTSD. First, molecular, animal, and imaging studies indicate that sleep problems lead to cellular damage in brain structures crucial to learning and memory. Second, recent studies have shown that lack of sleep might precipitate the accumulation of harmful amyloid proteins. Finally, sleep and PTSD are associated with elev...
Source: Current Psychiatry Reports - October 16, 2017 Category: Psychiatry Source Type: research

The Use of Telemedicine and Mobile Technology to Promote Population Health and Population Management for Psychiatric Disorders
This article discusses recent applications in telemedicine to promote the goals of population health and population management for people suffering psychiatric disorders.Recent FindingsThe use of telemedicine to promote collaborative care, self-monitoring and chronic disease management, and population screening has demonstrated broad applicability and effectiveness. Collaborative care using videoconferencing to facilitate mental health specialty consults has demonstrated effectiveness in the treatment of depression, PTSD, and also ADHD in pediatric populations. Mobile health is currently being harnessed to monitor patient ...
Source: Current Psychiatry Reports - October 16, 2017 Category: Psychiatry Source Type: research

Digitally Driven Integrated Primary Care and Behavioral Health: How Technology Can Expand Access to Effective Treatment
AbstractPurpose of ReviewWidespread implementation of integrated primary care and behavioral health is possible, but workforce shortages, competencies to deliver evidence-based approaches, and sufficient reimbursement are lacking. There are numerous telehealth solutions that could be utilized to assist with integration efforts that have the potential to be successfully used alone or in combination. This will require that the developers of such technologies understand the current evidence base for effective integration efforts and apply this knowledge to new solutions.Recent FindingsEvidence-based models of integrated care ...
Source: Current Psychiatry Reports - September 30, 2017 Category: Psychiatry Source Type: research

Impact of Gender on Child and Adolescent PTSD
AbstractPurpose of ReviewThis review examines the recent literature on biological factors that influence sex differences in posttraumatic stress disorder (PTSD) during childhood and adolescence, focusing on neurobiological, hormonal, and genetic factors that may increase risk in girls.Recent FindingsMore than 60% of children and adolescents are exposed to traumatic events, and many develop PTSD. There is increasing recognition of gender differences in PTSD, with women having double the rates of the disorder compared to men. These gender differences in symptoms and their underlying neurobiology appear to emerge during adole...
Source: Current Psychiatry Reports - September 30, 2017 Category: Psychiatry Source Type: research

Molecular and Cellular Effects of Traumatic Stress: Implications for PTSD
AbstractPurpose of ReviewPosttraumatic stress disorder (PTSD) is characterized by hyperarousal and recurrent stressful memories after an emotionally traumatic event. Extensive research has been conducted to identify the neurobiological determinants that underlie the pathophysiology of PTSD. In this review, we examine evidence regarding the molecular and cellular pathophysiology of PTSD focusing on two primary brain regions: the vmPFC and the amygdala.Recent FindingsThis discussion includes a review of the molecular alterations related to PTSD, focusing mainly on changes to glucocorticoid receptor signaling. We also examine...
Source: Current Psychiatry Reports - September 25, 2017 Category: Psychiatry Source Type: research

Genetics of Anorexia Nervosa
AbstractPurpose of ReviewGenetic factors contribute to the etiology of anorexia nervosa (AN). This review synthesizes the current state of knowledge about the genetic etiology of AN, provides directions for future research, and discusses clinical implications for this research.Recent FindingsCandidate gene meta-analyses indicate serotonin genes may be involved in the genetic etiology of AN. Three genome-wide association studies have been conducted and one genome-wide significant locus was identified. Cross-disorder analyses suggest shared genetic risk between AN and several psychiatric, educational, and medical phenotypes....
Source: Current Psychiatry Reports - September 22, 2017 Category: Psychiatry Source Type: research

Depression and Anxiety in Polycystic Ovary Syndrome: Etiology and Treatment
AbstractPurpose of ReviewPolycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women and is associated with an increased prevalence of depression and anxiety symptoms. This review presents potential mechanisms for this increased risk and outlines treatment options.Recent FindingsWomen with PCOS have increased odds of depressive symptoms (OR 3.78; 95% CI 3.03 –4.72) and anxiety symptoms (OR 5.62; 95% CI 3.22–9.80). Obesity, insulin resistance, and elevated androgens may partly contribute to this association. Therefore, in addition to established treatment options, treatment o...
Source: Current Psychiatry Reports - September 20, 2017 Category: Psychiatry Source Type: research

Genomic Disorders in Psychiatry —What Does the Clinician Need to Know?
AbstractPurpose of ReviewThe purpose of this review is to summarize the role of genomic disorders in various psychiatric conditions and to highlight important recent advances in the field that are of potential clinical relevance.Recent FindingsGenomic disorders are caused by large rare recurrent deletions and duplications at certain chromosomal “hotspots” (e.g., 22q11.2, 16p11.2, 15q11-q13, 1q21.1, 15q13.3) across the genome. Most overlap multiple genes, affect development, and are associated with variable cognitive and other neuropsychiatric expression. Although individually rare, genomic disorders collectivel...
Source: Current Psychiatry Reports - September 20, 2017 Category: Psychiatry Source Type: research

A Network-Based Neurobiological Model of PTSD: Evidence From Structural and Functional Neuroimaging Studies
AbstractPurpose of ReviewAlthough a fine-grained understanding of the neurobiology of posttraumatic stress disorder (PTSD) is yet to be elucidated, the last two decades have seen a rapid growth in the study of PTSD using neuroimaging techniques. The current review summarizes important findings from functional and structural neuroimaging studies of PTSD, by primarily focusing on their relevance towards an emerging network-based neurobiological model of the disorder.Recent FindingsPTSD may be characterized by a weakly connected and hypoactive default mode network (DMN) and central executive network (CEN) that are putatively ...
Source: Current Psychiatry Reports - September 19, 2017 Category: Psychiatry Source Type: research

Review of Virtual Reality Treatment in Psychiatry: Evidence Versus Current Diffusion and Use
AbstractPurpose of ReviewThis review provides an overview of the current evidence base for and clinical applications of the use of virtual reality (VR) in psychiatric practice, in context of recent technological developments.Recent FindingsThe use of VR in psychiatric practice shows promise with much of the research demonstrating clinical effectiveness for conditions including post-traumatic stress disorder, anxiety and phobias, chronic pain, rehabilitation, and addictions. However, more research is needed before the use of VR is considered a clinical standard of practice in some areas.SummaryThe recent release of first ge...
Source: Current Psychiatry Reports - September 18, 2017 Category: Psychiatry Source Type: research

Managing Alcohol Use Disorder in Primary Health Care
AbstractPurpose of ReviewThe aim of this study is to summarise the current literature on both the impact and the implementation of primary health care-based screening and advice programmes to reduce heavy drinking, as an evidence-based component of managing alcohol use disorder in primary health care.Recent FindingsSystematic reviews of reviews find conclusive evidence for the impact of primary health care delivered screening and brief advice programmes in reducing heavy drinking. The content, length of advice and which profession delivers the advice seems less important than the actual encounter between provider and patie...
Source: Current Psychiatry Reports - September 14, 2017 Category: Psychiatry Source Type: research

Socially Housed Female Macaques: a Translational Model for the Interaction of Chronic Stress and Estrogen in Aging
We present evidence that aging socially subordinate female macaques that experience chronic psychosocial stress constitute a suitable model to investigate this. First, we review studies showing that estrogen modulates cognition in animal models, as well as studies demonstrating that estrogen ’s action on certain types of cognition is impaired by stress. Next, we discuss data showing that middle-aged socially subordinate female macaques exhibit distinct stress-induced phenotypes, and review our investigations indicating that estrogen modulates behavior and physiology differently in sub ordinate female monkeys.SummaryW...
Source: Current Psychiatry Reports - September 14, 2017 Category: Psychiatry Source Type: research

Unintended Pregnancy, Induced Abortion, and Mental Health
AbstractPurpose of ReviewThe early medical literature on mental health outcomes following abortion is fraught with methodological flaws that can improperly influence clinical practice. Our goal is to review the current medical literature on depression and other mental health outcomes for women obtaining abortions.Recent FindingsThe Turnaway Study prospectively enrolled 956 women seeking abortion in the USA and followed their mental health outcomes for 5  years. The control group was comprised of women denied abortions based on gestational age limits, thereby circumventing the major methodological flaw that had plagued...
Source: Current Psychiatry Reports - September 14, 2017 Category: Psychiatry Source Type: research

New Horizons in Measurement: a Review of Novel and Innovative Approaches to Eating-Disorder Assessment
AbstractPurpose of ReviewEating disorders are serious mental-health concerns that will affect over 30 million individuals in the USA at some point in their lives. Eating disorders occur across the lifespan, in a variety of ethnicities and races, in both men and women, and across the socioeconomic spectrum. Given the prevalence and severity of eating disorders, it is important that clinicians and researchers have access to appropriate assessment tools to aid in the early identification and treatment referral, differential diagnosis, treatment planning, and progress monitoring, and to ensure valid research findings. In this ...
Source: Current Psychiatry Reports - September 11, 2017 Category: Psychiatry Source Type: research

Traumatic Stress and Accelerated Cellular Aging: From Epigenetics to Cardiometabolic Disease
AbstractPurpose of ReviewThe aim of this paper is to review the recent literature on traumatic stress-related accelerated aging, including a focus on cellular mechanisms and biomarkers of cellular aging and on the clinical manifestations of accelerated biological aging.Recent FindingsMultiple lines of research converge to suggest that PTSD is associated with accelerated aging in the epigenome, and the immune and inflammation systems, and this may be reflected in premature onset of cardiometabolic and cardiovascular disease.SummaryThe current state of research paves the way for future work focused on identifying the periphe...
Source: Current Psychiatry Reports - August 29, 2017 Category: Psychiatry Source Type: research

Synaptic Loss and the Pathophysiology of PTSD: Implications for Ketamine as a Prototype Novel Therapeutic
AbstractPurpose of ReviewStudies of the neurobiology and treatment of PTSD have highlighted many aspects of the pathophysiology of this disorder that might be relevant to treatment. The purpose of this review is to highlight the potential clinical importance of an often-neglected consequence of stress models in animals that may be relevant to PTSD: the stress-related loss of synaptic connectivity.Recent FindingsHere, we will briefly review evidence that PTSD might be a “synaptic disconnection syndrome” and highlight the importance of this perspective for the emerging therapeutic application of ketamine as a pot...
Source: Current Psychiatry Reports - August 26, 2017 Category: Psychiatry Source Type: research

VA ’s National PTSD Brain Bank: a National Resource for Research
This article describes the organization and operations of NPBB with specific attention to: tissue acquisition, tissue processing, diagnostic assessment, maintenance of a confidential data biorepository , adherence to ethical standards, governance, accomplishments to date, and future challenges. Established in 2014, NPBB has already acquired and distributed brain tissue to support research on how PTSD affects brain structure and function. (Source: Current Psychiatry Reports)
Source: Current Psychiatry Reports - August 25, 2017 Category: Psychiatry Source Type: research

Update on Mental Health of Infants and Children of Parents Affected With Mental Health Issues
AbstractThis paper highlights the most recent publications, in the field of psychiatry, on offspring of patients with psychiatric illnesses such as schizophrenia and bipolar disorder, and then summarizes what we know about the progeny of adults with mood disorders, the most prevalent of parental disorders. Studies examining personality disorders and contextual factors such as stress and trauma are examined with a focus on the crucial question of development and attachment status in children. Findings converge to reveal that offspring of parents (generally mothers) with most major psychiatric disorders present a higher risk...
Source: Current Psychiatry Reports - August 23, 2017 Category: Psychiatry Source Type: research

Sleep and Dreaming in Posttraumatic Stress Disorder
AbstractPurpose of ReviewSleep disturbances are core features of posttraumatic stress disorder (PTSD). This review aims to characterize sleep disturbances, summarize the knowledge regarding the relationships between trauma exposure and sleep difficulties, and highlight empirically supported and/or utilized treatments for trauma-related nightmares and insomnia.Recent FindingsTrauma-related nightmares and insomnia, and other sleep disorders, are frequently reported among trauma survivors. The roles of fear of sleep, REM density, and decreased parasympathetic activity are beginning to inform the relationship between trauma ex...
Source: Current Psychiatry Reports - August 22, 2017 Category: Psychiatry Source Type: research

Trauma, PTSD, and the Developing Brain
AbstractPurpose of ReviewPTSD in youth is common and debilitating. In contrast to adult PTSD, relatively little is known about the neurobiology of pediatric PTSD, nor how neurodevelopment may be altered. This review summarizes recent neuroimaging studies in pediatric PTSD and discusses implications for future study.Recent FindingsPediatric PTSD is characterized by abnormal structure and function in neural circuitry supporting threat processing and emotion regulation. Furthermore, cross-sectional studies suggest that youth with PTSD have abnormal frontolimbic development compared to typically developing youth. Examples incl...
Source: Current Psychiatry Reports - August 19, 2017 Category: Psychiatry Source Type: research

Understanding Peripartum Depression Through Neuroimaging: a Review of Structural and Functional Connectivity and Molecular Imaging Research
AbstractPurpose of ReviewImaging research has sought to uncover brain structure, function, and metabolism in women with postpartum depression (PPD) as little is known about its underlying pathophysiology. This review discusses the imaging modalities used to date to evaluate postpartum depression and highlights recent findings.Recent FindingsAltered functional connectivity and activity changes in brain areas implicated in executive functioning and emotion and reward processing have been identified in PPD. Metabolism changes involving monoamine oxidase A, gamma-aminobutyric acid, glutamate, serotonin, and dopamine have addit...
Source: Current Psychiatry Reports - August 19, 2017 Category: Psychiatry Source Type: research

Weight and Eating Concerns in Women ’s Reproductive Health
AbstractPurpose of ReviewWomen ’s weight status affects their reproductive functioning, and, likewise, women’s lifetime weight trajectories are influenced by reproductive events. We examine the relationship between polycystic ovary syndrome (PCOS), pregnancy, the postpartum period, and gynecological cancers with weight, body image, and other psychiatric issues.Recent FindingsWomen with overweight or obesity are at higher risk for PCOS, and the mood and anxiety symptoms often comorbid with PCOS are linked to weight as well as the core symptoms of the disorder. Excessive gestational weight gain can influence one ...
Source: Current Psychiatry Reports - August 18, 2017 Category: Psychiatry Source Type: research

Oxytocin and Anxiety Disorders: Translational and Therapeutic Aspects
AbstractPurpose of ReviewThis review aims to evaluate the most recent literature examining the oxytocin (OXT) system ’s role in human anxiety by surveying various fields of preclinical and clinical research supporting this role, and queries whether the OXT system might be a target for novel anxiolytics.Recent FindingsEvidence from the diverse body of literature presented here, from translational research, genetic and neuroimaging studies, to clinical trials of intranasal (IN) OXT reveals a positive association. In addition, some moderators (e.g., sex, specificities to cues) of OXT ’s anxiolytic effects can have...
Source: Current Psychiatry Reports - August 15, 2017 Category: Psychiatry Source Type: research

Should Posttraumatic Stress Be a Disorder or a Specifier? Towards Improved Nosology Within the DSM Categorical Classification System
AbstractPurpose of ReviewSince 1980, posttraumatic stress (PTS) disorder has been controversial because of its origin as a social construct, its discriminating trauma definition, and the Procrustean array of symptoms/clusters chosen for inclusion/exclusion. This review summarizes the history of trauma-related nosology and proposed changes, within current categorical models (trauma definitions, symptoms/clusters, subtypes/specifiers, disorders) and new models.Recent FindingsConsidering that trauma is a risk factor for virtually all mental disorders (particularly depressive, anxiety, dissociative, personality), the multi-fin...
Source: Current Psychiatry Reports - August 15, 2017 Category: Psychiatry Source Type: research

Pediatric Delirium: Evaluation, Management, and Special Considerations
AbstractDelirium describes a syndrome of acute brain dysfunction with severe consequences on patient outcomes, medical cost, morbidity, and mortality. It represents a final common pathway of numerous pathophysiologic disturbances disrupting cerebral homeostasis. The diagnosis is predicated on recognition of the clinical features of the syndrome through ongoing clinical assessment. Early identification can be aided by routine screening, particularly in high-risk populations. Evaluation and management are continuous and simultaneous processes involving a multidisciplinary care team including child psychiatry consultation. Pr...
Source: Current Psychiatry Reports - August 12, 2017 Category: Psychiatry Source Type: research

Dementia Caregiver Burden: a Research Update and Critical Analysis
This article provides an updated review of the determinants of caregiver burden and depression, with a focus on care demands and especially the differential effects of various neuropsychiatric symptoms or symptom clusters. Moreover, studies on caregivers for frontotemporal and Lewy body dementias were referred to in order to identify differences and similarities with the mainstream literature based largely on Alzheimer caregivers.Recent FindingsAs a group, neuropsychiatric symptoms are most predictive of caregiver burden and depression regardless of dementia diagnosis, but the effects appear to be driven primarily by disru...
Source: Current Psychiatry Reports - August 10, 2017 Category: Psychiatry Source Type: research

Effects of Antidepressants on Sleep
AbstractPurpose of ReviewThe aim of this review article was to summarize recent publications on effects of antidepressants on sleep and to show that these effects not only depend on the kind of antidepressant drugs but are also related to the dose, the time of drug administration, and the duration of the treatment.Recent FindingsComplaints of disrupted sleep are very common in patients suffering from depression, and they are listed among diagnostic criteria for this disorder. Moreover, midnocturnal insomnia is the most frequent residual symptom of depression. Thus, all antidepressants should normalize sleep. However, at le...
Source: Current Psychiatry Reports - August 9, 2017 Category: Psychiatry Source Type: research

Neurocognitive Treatments for Eating Disorders and Obesity
AbstractPurpose of ReviewRecent research has highlighted executive function and neurocognitive deficits among individuals with eating and weight disorders, identifying a potential target for treatment. Treatments targeting executive function for eating and weight disorders are emerging. This review aims to summarize the recent literature evaluating neurocognitive/executive function-oriented treatments for eating and weight disorders and highlights additional work needed in this area.Recent FindingsCognitive remediation therapy (CRT) for anorexia nervosa has been the most extensively studied neurocognitive treatment for eat...
Source: Current Psychiatry Reports - July 25, 2017 Category: Psychiatry Source Type: research

Genetics of Schizophrenia: Ready to Translate?
We describe the key findings from whole exome studies to date. These studies are happening against a backdrop of growing understanding of the regulation and expression of genes and better functional tools to investigate molecular mechanisms in model systems.SummaryWe provide an overview of how recent approaches in schizophrenia genetics are converging and consider how they could impact on diagnostics, the development of personalized medicine, and drug discovery. (Source: Current Psychiatry Reports)
Source: Current Psychiatry Reports - July 24, 2017 Category: Psychiatry Source Type: research

A Skill Set for Supporting Displaced Children in Psychological Recovery After Disasters
AbstractHelping children, adolescents, and families displaced following a natural disaster is a daunting task made more challenging by the relatively small research base to inform services and interventions. This paper describes the current literature pertaining to intervention practices used with displaced youth. Where gaps in the literature exist, we pull from the more general research on relocation and post-disaster intervention to assist practitioners in tailoring their efforts. Specifically discussed are ways to enhance youth resilience, to help youth build new social connections and adjust to change and uncertainty w...
Source: Current Psychiatry Reports - July 24, 2017 Category: Psychiatry Source Type: research

Advances in Psychotherapy for Depressed Older Adults
AbstractPurpose of ReviewWe review recent advances in psychotherapies for depressed older adults, in particular those developed for special populations characterized by chronic medical illness, acute medical illness, cognitive impairment, and suicide risk factors. We review adaptations for psychotherapy to overcome barriers to its accessibility in non-specialty settings such as primary care, homebound or hard-to-reach older adults, and social service settings.Recent FindingsRecent evidence supports the effectiveness of psychotherapies that target late-life depression in the context of specific comorbid conditions including...
Source: Current Psychiatry Reports - July 20, 2017 Category: Psychiatry Source Type: research

Psychosocial Issues in Patients with Head and Neck Cancer: an Updated Review with a Focus on Clinical Interventions
AbstractPurpose of ReviewThere are frequent and diverse psychosocial issues that afflict patients with head and neck cancer (HNC) across the illness trajectory, prompting a focus on clinical interventions to prevent and mitigate psychosocial distress. We sought to characterize current understanding on the cause, effects, and interplay of various psychosocial factors in HNC and summarize updated, evidence-based interventions.Recent FindingsThe psychosocial experience of patients with HNC is characterized by a disproportionately high incidence of depression, suicide, continued substance dependence/abuse, and distress related...
Source: Current Psychiatry Reports - July 20, 2017 Category: Psychiatry Source Type: research

Gaze-Based Assessments of Vigilance and Avoidance in Social Anxiety: a Review
This article seeks to provide a review of eye tracking studies examining selective attention biases in social anxiety.Recent FindingsAcross a number of contexts, social anxiety may be associated with a mix of both vigilant and avoidant patterns of attention with respect to the processing of emotional social stimuli. Socially anxious individuals may additionally avoid maintaining eye contact and may exhibit a generalized vigilance via hyperscanning of their environment.SummaryThe findings highlight the utility of eye tracking methods for increasing understanding of the gaze-based biases which characterize social anxiety dis...
Source: Current Psychiatry Reports - July 20, 2017 Category: Psychiatry Source Type: research

Valproic Acid in Women and Girls of Childbearing Age
AbstractPurpose of ReviewThe aim of this paper is to evaluate recent literature on valproic acid (VPA) in women and girls of childbearing age and to emphasize new findings.Recent FindingsRecent research confirms VPAs teratogenicity and risk of hormone disruption. VPA exposure in utero increases the risk for a variety of major congenital malformations (MCMs), reduced IQ and behavioral problems. In girls and women, VPA increases the risk of hormone abnormalities, obesity, and polycystic ovarian syndrome (PCOS). Despite guidelines recommending caution, VPA use continues to be prescribed to reproductive-aged women and girls.Su...
Source: Current Psychiatry Reports - July 20, 2017 Category: Psychiatry Source Type: research

Professional Ethics for Digital Age Psychiatry: Boundaries, Privacy, and Communication
AbstractPurpose of ReviewInternet and social media use continue to expand rapidly. Many patients and psychiatrists are bringing digital technologies into the treatment process, but relatively little attention has been paid to the ethical challenges in doing this. This review presents ethical guidelines for psychiatry in the digital age.Recent FindingsSurveys demonstrate that patients are eager to make digital technologies part of their treatment. Substantial numbers search for professional and personal information about their therapists. Attitudes among psychiatrists about using digital technologies with patients range fro...
Source: Current Psychiatry Reports - July 20, 2017 Category: Psychiatry Source Type: research