Avoidant/Restrictive Food Intake Disorder: a Three-Dimensional Model of Neurobiology with Implications for Etiology and Treatment
AbstractPurpose of ReviewDSM-5 defined avoidant/restrictive food intake disorder (ARFID) as a failure to meet nutritional needs leading to low weight, nutritional deficiency, dependence on supplemental feedings, and/or psychosocial impairment. We summarize what is known about ARFID and introduce a three-dimensional model to inform research.Recent FindingsBecause ARFID prevalence, risk factors, and maintaining mechanisms are not known, prevailing treatment approaches are based on clinical experience rather than data. Furthermore, most ARFID research has focused on children, rather than adolescents or adults. We hypothesize ...
Source: Current Psychiatry Reports - July 17, 2017 Category: Psychiatry Source Type: research

Impaired Redox Control in Autism Spectrum Disorders: Could It Be the X in GxE?
AbstractPurpose of ReviewThis review aims to provide a brief description of the complex etiology of autism spectrum disorders (ASD), with special emphasis on the recent findings of impaired redox control in ASD, and to suggest a possible model of oxidative stress-specific gene-environment interaction in this group of disorders.Recent FindingsRecent findings point out to the significance of environmental, prenatal, and perinatal factors in ASD but, at the same time, are in favor of the potentially significant oxidative stress-specific gene-environment interaction in ASD. Available evidence suggests an association between bo...
Source: Current Psychiatry Reports - July 6, 2017 Category: Psychiatry Source Type: research

The Impact of Natural Disasters on Youth: A Focus on Emerging Research beyond Internalizing Disorders
AbstractPurpose Of ReviewThis paper reviews youth outcomes following exposure to natural disaster, with a focus on three relatively understudied outcomes: externalizing behavior problems, physical health, and posttraumatic growth. Recent, high-impact studies focusing on each outcome are summarized.Recent FindingsStudies highlighted in this review utilize innovative and comprehensive approaches to improve our current understanding of youth broad-based physical and mental health outcomes beyond PTSD. The review concludes with recommendations to advance the field of youth disaster research by exploring how disasters may impac...
Source: Current Psychiatry Reports - July 6, 2017 Category: Psychiatry Source Type: research

Eating Disorders and the Intestinal Microbiota: Mechanisms of Energy Homeostasis and Behavioral Influence
AbstractPurpose of ReviewWe reviewed and evaluated recently published scientific studies that explored the role of the intestinal microbiota in eating disorders.Recent FindingsStudies have demonstrated that the intestinal microbiota is a contributing factor to both host energy homeostasis and behavior —two traits commonly disrupted in patients with eating disorders. To date, intestinal microbiota research in eating disorders has focused solely on anorexia nervosa (AN). Initial studies have reported an atypical intestinal microbial composition in patients with AN compared to healthy controls. Ho wever, the impact of t...
Source: Current Psychiatry Reports - July 5, 2017 Category: Psychiatry Source Type: research

Timeline of Intergenerational Child Maltreatment: the Mind –Brain–Body Interplay
AbstractPurpose of ReviewStill obscure mechanisms of intergenerational child maltreatment (ITCM) have been investigated partially, from various psychological and biological perspectives and from various time perspectives. This review is aimed at integrating the findings on different temporal ITCM pathways, emphasizing the mind –brain–body interplay.Recent FindingsPsychological mediators of ITCM involve attachment, mentalization, dissociation, social information processing, personality traits, and psychiatric disorders. Neurobiological findings mostly refer to the neural correlates of caregiving and attachment b...
Source: Current Psychiatry Reports - June 30, 2017 Category: Psychiatry Source Type: research

Eating Disorders and Disordered Weight and Shape Control Behaviors in Sexual Minority Populations
AbstractPurpose of ReviewThis review summarized trends and key findings from empirical studies conducted between 2011 and 2017 regarding eating disorders and disordered weight and shape control behaviors among lesbian, gay, bisexual, and other sexual minority (i.e., non-heterosexual) populations.Recent FindingsRecent research has examined disparities through sociocultural and minority stress approaches. Sexual minorities continue to demonstrate higher rates of disordered eating; disparities are more pronounced among males. Emerging data indicates elevated risk for disordered eating pathology among sexual minorities who are...
Source: Current Psychiatry Reports - June 29, 2017 Category: Psychiatry Source Type: research

Treating Eating Disorders at Higher Levels of Care: Overview and Challenges
AbstractHigher levels of care (HLC) —including inpatient hospitalization, residential treatment, partial hospitalization, and intensive outpatient treatment—are frequently utilized within routine care for eating disorders. Despite widespread use, there is limited research evaluating the efficacy of HLC, as well as clinical issues related to care in these settings. This review describes the different levels of care for eating disorders and briefly reviews the most up-to-date guidelines and research regarding how to choose a level of care. In addition, as HLC approaches for ED continue to be developed and refined...
Source: Current Psychiatry Reports - June 27, 2017 Category: Psychiatry Source Type: research

Sleep and Psychiatric Disorders in Persons With Mild Traumatic Brain Injury
AbstractMild traumatic brain injury (mTBI) frequently challenges the integrity of sleep function by affecting multiple brain areas implicated in controlling the switch between wakefulness and sleep and those involved in circadian and homeostatic processes; the malfunction of each causes a variety of disorders. In this review, we discuss recent data on the dynamics between disorders of sleep and mental/psychiatric disorders in persons with mTBI. This analysis sets the stage for understanding how a variety of physiological, emotional and environmental influences affect sleep and mental activities after injury to the brain. C...
Source: Current Psychiatry Reports - June 27, 2017 Category: Psychiatry Source Type: research

Update on the Epidemiology, Diagnosis, and Treatment of Mania in Older-Age Bipolar Disorder
AbstractPurpose of ReviewThe population over age 60 is growing more rapidly than the general population. Given the projected increase and need for data that can inform treatment, this review provides a brief description of newer publications focused on mania in older-age bipolar disorder (OABD), including epidemiology, diagnosis, and treatments.Recent FindingsAge cutoffs to define OABD range from 50 to 65  years. OABD clinical presentation and course of illness is highly variable, often characterized by mood episode recurrence, medical comorbidity, cognitive deficits, and impaired functioning. There is little pharmaco...
Source: Current Psychiatry Reports - June 24, 2017 Category: Psychiatry Source Type: research

Update on Psychological Trauma, Other Severe Adverse Experiences and Eating Disorders: State of the Research and Future Research Directions
AbstractPurpose of ReviewThis paper provides an updated review of the literature on the relationship between psychological trauma exposure, other severe adverse experiences, and eating disorders.Recent FindingsTrauma exposure and other severe adverse experiences (e.g., emotional abuse) in both childhood and adulthood are associated with eating disorders. The relationship between traumatic and other adverse experiences and eating disorders appears to be mediated by emotional and behavioral dysregulation, as well as by cognitive factors such as self-criticism. Biological vulnerabilities may also be relevant to this relations...
Source: Current Psychiatry Reports - June 17, 2017 Category: Psychiatry Source Type: research

Insomnia as a Precipitating Factor in New Onset Mental Illness: a Systematic Review of Recent Findings
AbstractPurposeWe aimed to systematically review recent publications (01/2014 –03/2017) with longitudinal designs allowing for the assessment of the prospective risk of insomnia on new onset mental illness in key conditions: anxiety, depression, bipolar disorder, posttraumatic stress disorder, substance use disorders, and suicide.Recent FindingsA literature yielded 1859 unique articles meeting search criteria were identified; 16 articles met all selection criteria and reviewed with some studies reporting on more than one mental health outcome. Overall, the review supports the hypothesis that insomnia is a predictor o...
Source: Current Psychiatry Reports - June 14, 2017 Category: Psychiatry Source Type: research

Genetics of Depression: Progress at Last
AbstractPurpose of ReviewWe will describe the success of recent genome-wide association studies that identify genetic variants associated with depression and outline the strategies used to reduce heterogeneity and increase sample size.Recent FindingsThe CONVERGE consortium identified two genetic associations by focusing on a sample of Chinese women with recurrent severe depression. Three other loci have been found in Europeans by combining cohorts with clinical diagnosis and measures of depressive symptoms to increase sample size. 23andMe identified 15 loci associated with depression using self-report of clinical diagnosis...
Source: Current Psychiatry Reports - June 13, 2017 Category: Psychiatry Source Type: research

Autism Spectrum Disorder in Anorexia Nervosa: An Updated Literature Review
ConclusionsThe wide range of diagnostic tools, methodologies and populations studied make it difficult to determine the prevalence of ASD in AN. Despite this, studies consistently report over-representation of symptoms of ASD in AN. Co-morbid AN and ASD may require more intensive treatment or specifically tailored interventions. Future longitudinal research and female-specific diagnostic tools would help elucidate the relationship between these two disorders. (Source: Current Psychiatry Reports)
Source: Current Psychiatry Reports - May 24, 2017 Category: Psychiatry Source Type: research

Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review
AbstractThis review is designed to systematically examine the available evidence about virtual reality exposure therapy ’s (VRET) efficacy for phobias, critically describe some of the most important challenges in the field and discuss possible directions. Evidence reveals that virtual reality (VR) is an effective treatment for phobias and useful for studying specific issues, such as pharmacological compounds and be havioral manipulations, that can enhance treatment outcomes. In addition, some variables, such as sense of presence in virtual environments, have a significant influence on outcomes, but further research i...
Source: Current Psychiatry Reports - May 24, 2017 Category: Psychiatry Source Type: research

Addressing the Needs of Preschool Children in the Context of Disasters and Terrorism: Assessment, Prevention, and Intervention
AbstractPurpose of ReviewThe goal of this paper is to review the research literature regarding the needs of preschoolers in the context of disasters and terrorism with the aim of understanding the existing methods for assessment, prevention, and intervention to provide recommendations and point out required research and development.Recent FindingsWe differentiate between screening tools that provide initial evaluation and assessment tools for diagnosing preschooler children ’s pathology and review possible interventions that address the preschool child’s needs before, during, and after the incident itself. We a...
Source: Current Psychiatry Reports - May 23, 2017 Category: Psychiatry Source Type: research

Psychiatric Illness and Parasomnias: a Systematic Review
This article summarizes knowledge regarding the relationships between psychiatric disorders and parasomnias, and possible confounds. A systematic search of the literature in the past 10  years identified 19 articles.Recent FindingsThere were significantly elevated rates of parasomnias in psychiatric disorders (average prevalence of nightmares was 38.9%, sleep paralysis 22.3%, SRED 9.9%, sleepwalking 8.5%, and RBD 3.8%). Medication usage was only one of many risk factors (other sleep disorders, medical comorbidities, and substance abuse) which were associated with parasomnias.SummaryA strong association exists between ...
Source: Current Psychiatry Reports - May 22, 2017 Category: Psychiatry Source Type: research

Addressing the Needs of Preschool Children in the Context of Disasters and Terrorism: Clinical Pictures and Moderating Factors
AbstractPurpose of ReviewThis paper surveys the existent theoretical and research literature regarding the needs of preschool children in the context of disasters and terrorism with the aim of understanding (a) the consequences of such events for young children and (b) the main moderating variables influencing the event-consequence association to learn how to enhance their resilience.Recent FindingsConsequences include a variety of emotional, behavioral, and biological outcomes. Implications for refugee children are discussed. Main moderating variables were mother ’s sensitivity and mother’s PTSD symptoms.Summa...
Source: Current Psychiatry Reports - May 22, 2017 Category: Psychiatry Source Type: research

Brain-Derived Neurotrophic Factor Expression in Individuals With Schizophrenia and Healthy Aging: Testing the Accelerated Aging Hypothesis of Schizophrenia
AbstractPurpose of ReviewSchizophrenia has been hypothesized to be a syndrome of accelerated aging. Brain plasticity is vulnerable to the normal aging process and affected in schizophrenia: brain-derived neurotrophic factor (BDNF) is an important neuroplasticity molecule. The present review explores the accelerated aging hypothesis of schizophrenia by comparing changes in BDNF expression in schizophrenia with aging-associated changes.Recent FindingsIndividuals with schizophrenia show patterns of increased overall mortality, metabolic abnormalities, and cognitive decline normally observed later in life in the healthy popula...
Source: Current Psychiatry Reports - May 22, 2017 Category: Psychiatry Source Type: research

Anticipating the Ethical Challenges of Psychiatric Genetic Testing
This article identifies anticipated ethical challenges for patients, psychiatrists, and genetic counselors and makes recommendations for addressing them.Recent FindingsMany of the ethical challenges of psychiatric genetic testing are likely to stem from failures to comprehend the nature and implications of test results. Recent studies have identified gaps in the knowledge base of psychiatrists and genetic counselors, which limit their abilities to provide patients with appropriate education. A small number of studies have demonstrated the value of counseling in empowering patients to deal with relevant genetic information....
Source: Current Psychiatry Reports - May 22, 2017 Category: Psychiatry Source Type: research

Update on Barriers to Pharmacotherapy for Opioid Use Disorders
AbstractPurpose of ReviewThe recent heroin and prescription opioid misuse epidemic has led to a sharp increase in the number of opioid overdose deaths in the USA. Notwithstanding the availability of three FDA-approved medications (methadone, buprenorphine, and naltrexone) to treat opioid use disorder, these medications are underutilized. This paper provides an update from the recent peer-reviewed literature on barriers to the use of these medications.FindingsThese barriers are interrelated and can be categorized as financial, regulatory, geographic, attitudinal, and logistic. While financial barriers are common to all thre...
Source: Current Psychiatry Reports - May 19, 2017 Category: Psychiatry Source Type: research

Sleep in Children with Autism Spectrum Disorder
AbstractThe purposes of this paper are to provide an overview of the state of the science of sleep in children with autism spectrum disorder (ASD), present hypotheses for the high prevalence of insomnia in children with ASD, and present a practice pathway for promoting optimal sleep. Approximately two thirds of children with ASD have chronic insomnia, and to date, the strongest evidence on promoting sleep is for sleep education, environmental changes, behavioral interventions, and exogenous melatonin. The Sleep Committee of the Autism Treatment Network (ATN) developed a practice pathway, based on expert consensus, to captu...
Source: Current Psychiatry Reports - May 13, 2017 Category: Psychiatry Source Type: research

Depressive Spectrum Disorders in Cancer: Diagnostic Issues and Intervention. A Critical Review
AbstractDepressive spectrum disorders, including major depression, persistent depression, minor and sub-syndromal depression, and other forms of depressive conditions, such as demoralization, are among the most common psychiatric consequences of cancer patients, affecting up to 60% of patients. In spite of the negative effects and the burden for cancer patients and their families, these disorders often remain under-recognized and undertreated. The present review aims at summarizing the relevant data concerning the diagnostic challenges within the depressive spectrum disorders among cancer patients. Also, the most relevant ...
Source: Current Psychiatry Reports - May 9, 2017 Category: Psychiatry Source Type: research

Biomarkers of Suicide Attempt Behavior: Towards a Biological Model of Risk
AbstractPurpose of ReviewThe rising suicide rate in the USA will not be reversed without improved risk assessment and prevention practices. To date, the best method for clinicians to assess a patient ’s risk for suicide is screening for past suicide attempts in the patient and their family. However, neuroimaging, genomic, and biochemical studies have generated a body of findings that allow description of an initial heuristic biological model for suicidal behavior that may have predictive value .Recent FindingsWe review studies from the past 3  years examining potential biological predictors of suicide attempt be...
Source: Current Psychiatry Reports - May 3, 2017 Category: Psychiatry Source Type: research

Men, Muscles, and Eating Disorders: an Overview of Traditional and Muscularity-Oriented Disordered Eating
AbstractPurpose of ReviewThere is growing recognition that eating disorder (ED) symptoms, particularly those of a muscularity-oriented nature, are more common in men than previously understood. The purpose of the current review is to describe contemporary directions and implications of research on traditional and muscularity-oriented ED symptoms among males.Recent FindingsEvidence indicates that ED symptoms occur in a substantial minority of men. Importantly, recent research has focused on muscularity-oriented body image and disordered eating in males, demonstrating the prevalence, correlates, and consequences of maladapti...
Source: Current Psychiatry Reports - May 3, 2017 Category: Psychiatry Source Type: research

Addressing the Needs of Children and Youth in the Context of War and Terrorism: the Technological Frontier
AbstractThis paper reviews recent literature on the mental health needs of youth in the context of war and terrorism. A human rights lens is used to explore issues of accessibility and sustainability in service utilization during times of crisis. The authors present the evolution of services over the last several decades, progressing through individual, school-based, and community-wide interventions by exploring models that focus on symptom reduction and building resilience. This paper highlights the benefits and limitations of traditional intervention methods and proposes a new frontier of intervention development and res...
Source: Current Psychiatry Reports - April 26, 2017 Category: Psychiatry Source Type: research

Sex Differences in Obesity and Mental Health
AbstractPurpose of ReviewThe purposes of this study were to examine the relationships between obesity and a wide range of mental health issues and to identify where sex differences exist and may vary across disorders.Recent FindingsResearch on sex differences in the relationship between obesity and psychiatric disorders is more abundant in some areas, such as depression and eating disorders, than others, such as anxiety, trauma, and substance use. However, for most of the disorders, their relationships with obesity and sex are complex and are usually moderated by additional variables. Thus, studies that find stronger relat...
Source: Current Psychiatry Reports - April 24, 2017 Category: Psychiatry Source Type: research

Challenges and Opportunities in Global Mental Health: a Research-to-Practice Perspective
AbstractPurpose of ReviewGlobally, the majority of those who need mental health care worldwide lack access to high-quality mental health services. Stigma, human resource shortages, fragmented service delivery models, and lack of research capacity for implementation and policy change contribute to the current mental health treatment gap. In this review, we describe how health systems in low- and middle-income countries (LMICs) are addressing the mental health gap and further identify challenges and priority areas for future research.Recent FindingsCommon mental disorders are responsible for the largest proportion of the glo...
Source: Current Psychiatry Reports - April 19, 2017 Category: Psychiatry Source Type: research

Current Reports on Perinatal Intimate Partner Violence
AbstractPurpose of ReviewThe purpose of this study was to review the literature on perinatal intimate partner violence, focusing on recent knowledge to guide mental health professionals on the best approaches to identify and treat women exposed to perinatal intimate partner violence.Recent FindingsRisk factors have been broadened from individual victim and perpetrator factors to include relationship, community, and societal factors which interact together. Better information is now available on how to identify, document, and treat women exposed to violence around the time of conception, pregnancy, and the postpartum period...
Source: Current Psychiatry Reports - April 17, 2017 Category: Psychiatry Source Type: research

Sexual Behavior Among Persons With Cognitive Impairments
AbstractAlthough the cognitively impaired are frequently included in heterogeneous studies of problematic sexual behavior, the epidemiology, etiology, and approach to assessment and treatment of persons with dementia and intellectual disability are distinct from those of the general population. The incidence of inappropriate sexual behavior among the intellectually disabled is 15 –33%; however, the nature tends to be more socially inappropriate than with violative intent. Limited sociosexual education is a large contributor, and better addressing this area offers a target for prevention and treatment. A thorough clin...
Source: Current Psychiatry Reports - April 17, 2017 Category: Psychiatry Source Type: research

Anxiety Disorders and Temperament —an Update Review
AbstractPurpose of ReviewThe review focused on associations between temperament dimensions and clinical features in different anxiety disorders, likewise in obsessive-compulsive disorder in clinical samples of adults. A literature search was conducted in the Medline and PsycINFO databases covering the years 2010 –2016. A systematic review and grading of the level of evidence for an association between temperament dimension scores and clinical features in each disorder were performed.Recent FindingsTwenty papers reporting 18 different studies were included. Five of the papers focused on panic disorder (PD), five on so...
Source: Current Psychiatry Reports - April 17, 2017 Category: Psychiatry Source Type: research

Addressing the Needs of Children With Disabilities Experiencing Disaster or Terrorism
AbstractPurpose of ReviewThis paper reviews the empirical literature on psychosocial factors relating to children with disabilities in the context of disaster or terrorism.Recent FindingsResearch indicates adults with disabilities experience increased exposure to hazards due to existing social disparities and barriers associated with disability status. However, studies on the psychological effects of disaster/terrorism on children with pre-existing disabilities are exceedingly few and empirical evidence of the effectiveness of trauma-focused therapies for this population is limited. Secondary adversities, including social ...
Source: Current Psychiatry Reports - April 12, 2017 Category: Psychiatry Source Type: research

Cannabis, Cannabinoids, and Sleep: a Review of the Literature
AbstractPurpose of ReviewThe current review aims to summarize the state of research on cannabis and sleep up to 2014 and to review in detail the literature on cannabis and specific sleep disorders from 2014 to the time of publication.Recent FindingsPreliminary research into cannabis and insomnia suggests that cannabidiol (CBD) may have therapeutic potential for the treatment of insomnia. Delta-9 tetrahydrocannabinol (THC) may decrease sleep latency but could impair sleep quality long-term. Novel studies investigating cannabinoids and obstructive sleep apnea suggest that synthetic cannabinoids such as nabilone and dronabino...
Source: Current Psychiatry Reports - March 27, 2017 Category: Psychiatry Source Type: research

Sleep Disturbance in Posttraumatic Stress Disorder: Epiphenomenon or Causal Factor?
AbstractPurpose of ReviewThe goal of this review is to integrate recent findings on sleep disturbance and PTSD, examine sleep disturbance as a causal factor in the development of PTSD, and identify future directions for research, treatment, and prevention.Recent FindingsRecent research highlights a relationship between both objective and subjective sleep disturbance and PTSD across diverse samples. Sleep disturbance also predicts PTSD over time. Finally, treatments targeting sleep disturbance lead to decreased PTSD symptoms, while standard PTSD treatments conclude with residual sleep disturbance.SummarySleep disturbance ma...
Source: Current Psychiatry Reports - March 20, 2017 Category: Psychiatry Source Type: research

Circadian Rhythm Dysregulation in Bipolar Spectrum Disorders
AbstractPurpose of ReviewWe review recent evidence for circadian rhythm dysregulation in bipolar spectrum disorders (BSDs). We examine evidence for endogenous abnormalities in the biological clock and disruptions in the external entrainment of circadian rhythms in BSDs. We also address whether circadian dysregulation provides vulnerability to onset of BSD and evidence for a new integration of reward and circadian dysregulation in BSD.Recent FindingsRelative circadian phase delay (e.g., later melatonin peak, evening chronotype) is associated with BSD, particularly in the depressive phase. More consistent evidence supports i...
Source: Current Psychiatry Reports - March 20, 2017 Category: Psychiatry Source Type: research

Non-suicidal Self-Injury in Adolescence
AbstractPurpose of ReviewNon-suicidal self-injury (NSSI) is a common mental health threat among adolescents. This review aims to present the current literature on epidemiology, etiology, and therapeutic approaches with a focus on the period of adolescence.Recent FindingsNSSI is widespread among adolescents both in community as well as in clinical settings with lifetime prevalence rates between 17 and 60% in recent studies. It is influenced by multiple factors including social contagion, interpersonal stressors, neurobiological background, as well as emotional dysregulation and adverse experiences in childhood.SummaryThere ...
Source: Current Psychiatry Reports - March 17, 2017 Category: Psychiatry Source Type: research

Understanding Negative Self-Evaluations in Borderline Personality Disorder —a Review of Self-Related Cognitions, Emotions, and Motives
In conclusion, although explicit self-esteem is widely studied as a global and trait-like feature of BPD, there is a strong lack of studies that take the complexity of the construct self-est eem into account. Further studies on alterations in self-related processes are required to deepen our understanding of impairments of the self-concept in BPD and enable the improvement of psychosocial therapeutic approaches. (Source: Current Psychiatry Reports)
Source: Current Psychiatry Reports - March 13, 2017 Category: Psychiatry Source Type: research

Behavioral Health Integration in Large Multi-group Pediatric Practice
AbstractThere is increasing interest in methods to improve access to behavioral health services for children and adolescents. Children ’s Community Pediatric Behavioral Health Service (CCPBHS) is an integrated behavioral health service whose method of (a) creating a leadership team with empowered administrative and clinical stakeholders who can act on a commitment to change and (b) having a clear mission statement with integrated administrative and clinical care processes can serve as a model for implementing integration efforts within the medical home. Community Pediatrics Behavioral Health Service (CPBHS) is a sust...
Source: Current Psychiatry Reports - March 13, 2017 Category: Psychiatry Source Type: research

Accelerated Resolution Therapy (ART): a Review and Research to Date
AbstractPurpose of ReviewTo describe and summarize published research on accelerated resolution therapy (ART), a promising and relatively new psychotherapy with the potential to offer rapid and effective resolution of a wide range of psychiatric symptoms. Unlike most evidence-based psychotherapies, ART is a predominately imaginative therapy that relies upon the rescripting of distressing events and metaphors as one of its key therapeutic elements.Recent FindingsThe number of studies conducted on ART is limited, primarily consisting of one randomized, controlled trial (RCT) with 57 subjects and two large cohort studies invo...
Source: Current Psychiatry Reports - March 13, 2017 Category: Psychiatry Source Type: research

Psychotherapy for Borderline Personality Disorder: Progress and Remaining Challenges
ConclusionOur review indicated that patients with various severities benefited from psychotherapy; more intensive therapies were not significantly superior to less intensive therapies; enhancing emotion regulation processes and fostering more coherent self-identity were important mechanisms of change; therapies had been extended to patients with BPD and posttraumatic stress disorder; and more research was needed to be directed at functional outcomes. (Source: Current Psychiatry Reports)
Source: Current Psychiatry Reports - March 7, 2017 Category: Psychiatry Source Type: research

Impulsivity and Cluster B Personality Disorders
AbstractPurpose of ReviewImpulsivity is a multifaceted construct and an important personality trait in various mental health conditions. Among personality disorders (PDs), especially cluster B PDs are affected. The aims of this review are to summarize the relevant findings of the past 3  years concerning impulsivity in cluster B PDs and to identify those subcomponents of self-reported impulsivity and experimentally measured impulse control that are most affected in these disorders.Recent FindingsAll studies referred to antisocial (ASPD) or borderline PD (BPD), and none were found for narcissistic or histrionic PD. In ...
Source: Current Psychiatry Reports - March 1, 2017 Category: Psychiatry Source Type: research

Towards Precision Addiction Treatment: New Findings in Co-morbid Substance Use and Attention-Deficit Hyperactivity Disorders
AbstractAttention-deficit hyperactivity disorder (ADHD) and substance use disorders (SUDs) may have common etiologies. ADHD is more prevalent in patients with substance use disorders, and this pattern is consistent across different substances of abuse. Individuals with SUDs and ADHD exhibit significant variations in their clinical presentations. The developmental trajectory of ADHD to SUDs is complex: ADHD symptoms appear first in some patients but not in others. Many patients present with a heterogeneous collection of psychiatric and substance use co-morbidities, and these symptoms change over time. ADHD symptom severity ...
Source: Current Psychiatry Reports - March 1, 2017 Category: Psychiatry Source Type: research

Hypersomnolence, Hypersomnia, and Mood Disorders
AbstractRelationships between symptoms of hypersomnolence, psychiatric disorders, and hypersomnia disorders (i.e., narcolepsy and idiopathic hypersomnia) are complex and multidirectional. Hypersomnolence is a common complaint across mood disorders; however, patients suffering from mood disorders and hypersomnolence rarely have objective daytime sleepiness, as assessed by the current gold standard test, the Multiple Sleep Latency Test. An iatrogenic origin of symptoms of hypersomnolence, and sleep apnea syndrome must be considered in a population of psychiatric patients, often overweight and treated with sedative drugs. On ...
Source: Current Psychiatry Reports - February 27, 2017 Category: Psychiatry Source Type: research

Circadian Rhythms and Substance Abuse: Chronobiological Considerations for the Treatment of Addiction
AbstractReward-related learning, including that associated with drugs of abuse, is largely mediated by the dopaminergic mesolimbic pathway. Mesolimbic neurophysiology and motivated behavior, in turn, are modulated by the circadian timing system which generates ∼24-h rhythms in cellular activity. Both drug taking and seeking and mesolimbic dopaminergic neurotransmission can vary widely over the day. Moreover, circadian clock genes are expressed in ventral tegmental area dopaminergic cells and in mesolimbic target regions where they can directly modulate reward-related neurophysiology and behavior. There also exists a re...
Source: Current Psychiatry Reports - February 11, 2017 Category: Psychiatry Source Type: research

Pediatric Somatic Symptom Disorders
AbstractSomatic symptom disorder (SSD) is a common disorder encountered in pediatric medicine. It involves the presentation of physical symptoms that are either disproportionate or inconsistent with history, physical examination, laboratory, and other investigative findings. SSDs result in significant impairment with considerable increase in healthcare utilization, school absenteeism, and the potential for unnecessary diagnostic evaluation and treatment intervention. Patients and families often feel dismissed and may worry that a serious condition has been missed. Primary care providers are frequently frustrated due to a l...
Source: Current Psychiatry Reports - February 11, 2017 Category: Psychiatry Source Type: research

The Role of Nutritional Supplements in the Treatment of ADHD: What the Evidence Says
AbstractAttention-deficit hyperactivity disorder (ADHD) is a common behavioral disorder in children and adolescents and may persist into adulthood. Insufficient nutritional supply of long-chain polyunsaturated fatty acids (LC-PUFAs) and other components including various minerals has been suggested to play a role in the development of ADHD symptoms. This review presents the evidence regarding the role of nutritional PUFA, zinc, iron, and magnesium supplements in the treatment of ADHD with a focus on the critical evaluation of the relevant literature published from 2014 to April 2016. The evaluation of therapeutic nutrition...
Source: Current Psychiatry Reports - February 7, 2017 Category: Psychiatry Source Type: research

The Need to Take a Staging Approach to the Biological Mechanisms of PTSD and its Treatment
AbstractDespite the substantial body of neurobiological research, no specific drug target has been developed to treat PTSD and there are substantial limitations with the available interventions. We propose that advances are likely to depend on the development of better classification of the heterogeneity of PTSD using a staging approach of disease. A primary rationale for staging is to highlight the probability that distinct therapeutic approaches need to be utilised according to the degree of biological progression of the disorder. Prospective studies, particularly of military populations, provide substantial evidence abo...
Source: Current Psychiatry Reports - February 7, 2017 Category: Psychiatry Source Type: research

Juvenile Huntington ’s Disease: Diagnostic and Treatment Considerations for the Psychiatrist
AbstractJuvenile Huntington ’s disease (JHD) is a neurodegenerative disease with onset prior to the age of 21. While it accounts for a relatively small proportion of Huntington’s disease (HD) diagnoses, its impact is significant on the quality of life for those affected. Clinicians may be unaware that HD can present in chi ldhood and adolescence, delaying diagnosis. HD develops due to an expanded CAG repeat in the huntington gene. Rigidity, dystonia, and seizures are more common in JHD. Cognitive changes such as executive function impairments and decline in school performance are common. The burden of psychiatr...
Source: Current Psychiatry Reports - February 7, 2017 Category: Psychiatry Source Type: research

Use of Stimulants in Bipolar Disorder
AbstractSeveral international guidelines indicate stimulants, including methylphenidate (MPH), amphetamines and derivatives, modafinil, and armodafinil among the second-third-line choices for bipolar depression. Efficacy of stimulants has been also reported for the management of residual depressive symptoms such as fatigue and sleepiness and for the management of affective, cognitive, and behavioral symptoms in children and adult bipolar patients with comorbid ADHD. Few case reports show positive results with MPH in the treatment of resistant mania. Finally, MPH might be an option in some bipolar forms observed in psychiat...
Source: Current Psychiatry Reports - February 1, 2017 Category: Psychiatry Source Type: research

Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder
AbstractDissociation involves disruptions of usually integrated functions of consciousness, perception, memory, identity, and affect (e.g., depersonalization, derealization, numbing, amnesia, and analgesia). While the precise neurobiological underpinnings of dissociation remain elusive, neuroimaging studies in disorders, characterized by high dissociation (e.g., depersonalization/derealization disorder (DDD), dissociative identity disorder (DID), dissociative subtype of posttraumatic stress disorder (D-PTSD)), have provided valuable insight into brain alterations possibly underlying dissociation. Neuroimaging studies in bo...
Source: Current Psychiatry Reports - January 30, 2017 Category: Psychiatry Source Type: research

Treating Mental Health and Substance Use Disorders in Adolescents: What Is on the Menu?
AbstractSpecific treatments targeting adolescents with substance use disorders (SUDs) have been developed over the last couple of decades. Despite these developmentally tailored treatments, long-term abstinence rates remain relatively low among adolescents receiving care. Research over the last decade has increasingly focused on adolescents with comorbid substance use and psychiatric disorders, in recognition of the barriers caused by inadequate treatment of co-occurring psychiatric disorders. Treatments targeting dually diagnosed youth are now regarded as essential to improving SUD treatment outcomes, but remain underutil...
Source: Current Psychiatry Reports - January 25, 2017 Category: Psychiatry Source Type: research