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Use of Digital Mental Health for Marginalized and Underserved Populations
AbstractPurpose of reviewDigital mental health (DMH) interventions provide opportunities to alleviate mental health disparities among marginalized populations by overcoming traditional barriers to care and putting quality mental health services in the palm of one ’s hand. While progress has been made towards realizing this goal, the potential for impactful change has yet to be realized. This paper reviews current examples of DMH interventions for certain marginalized and underserved groups, namely, ethnic and racial minorities including Latinx and African- Americans, rural populations, individuals experiencing homelessne...
Source: Current Treatment Options in Psychiatry - July 4, 2019 Category: Psychiatry Source Type: research

Towards the Design of Ethical Standards Related to Digital Mental Health and all Its Applications
AbstractPurpose of the reviewDigital health technologies offer tremendous potential in increasing access to services and augmenting existing services. Utilizing these technologies, however, poses new ethical considerations for clinicians, researchers, and healthcare organizations. These issues have been particularly apparent recently with several public instances of misuse of digitally available personal data. Responsibility for ethics is distributed among creators, end users, and purveyors which has meant that this aspect of digital technology production and use tends to be thought of as someone else ’s problem.Recent f...
Source: Current Treatment Options in Psychiatry - July 4, 2019 Category: Psychiatry Source Type: research

The Future of Peer Support in Digital Psychiatry: Promise, Progress, and Opportunities
AbstractPurposeThis selective review highlights promising findings and future opportunities relevant to digital peer support services. This review considered literature published in peer-reviewed scholarly journals within the past 36  months.Recent findingsDigital peer support spans multiple technology modalities: peer-delivered and smartphone-supported interventions, peer-supported asynchronous technology, artificial peer support, informal peer-to-peer support via social media, video games, and virtual worlds. Digital peer support is an emerging area of research that shows promise in improving mental health symptoms, med...
Source: Current Treatment Options in Psychiatry - June 19, 2019 Category: Psychiatry Source Type: research

Recent Developments in Digital Mental Health Interventions for College and University Students
AbstractPurposeMental health problems are prevalent among university students. Insufficient resources at student health centers and other barriers to treatment result in low rates of students receiving treatment, potentially impacting academic performance and long-term health. Digital mental health interventions have been proposed as a means of reducing the treatment gap, given their potential for flexibility, cost-effectiveness, and stigma reduction.Recent FindingsRandomized controlled trials (RCTs) of short-term online interventions based on cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and...
Source: Current Treatment Options in Psychiatry - June 13, 2019 Category: Psychiatry Source Type: research

Brief Novel Therapies for PTSD: Written Exposure Therapy
AbstractPurpose of ReviewWritten exposure therapy (WET) is a five-session exposure-based intervention for the treatment of post-traumatic stress disorder (PTSD). WET was developed through a series of systematic evaluations of the expressive writing procedure. It is an efficient intervention, requiring limited patient and therapist time, and no between-session assignments. The treatment results in statistically and clinically significant symptom change among individuals, including veterans, with PTSD.Recent FindingsWET has been shown to be non-inferior to cognitive processing therapy (CPT), a more intensive form of PTSD tre...
Source: Current Treatment Options in Psychiatry - June 4, 2019 Category: Psychiatry Source Type: research

Dealing With Complexity and Comorbidity: Comorbid PTSD and Substance Use Disorders
AbstractPurpose of reviewPosttraumatic stress disorder (PTSD) and substance use disorders (SUD) are highly comorbid, and the presence of both disorders is associated with lower treatment effect sizes and higher dropout from treatment than one disorder alone. This review examines recent research on treatments for patients with comorbid PTSD/SUD, as well as recent work on psychological mechanisms that may contribute to both disorders.Recent findingsSeveral studies have shown that trauma-focused treatments, such as Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE), are effective for redu...
Source: Current Treatment Options in Psychiatry - May 30, 2019 Category: Psychiatry Source Type: research

New-generation Antipsychotics and Cardiovascular Risk
AbstractPurpose of ReviewTo critically review the current landscape of literature on cardiotoxicity of “new-generation antipsychotics,” defined as those approved by the Food and Drug Administration in the last 10 years.Recent FindingsThere is a paucity of data regarding the cardiovascular risks of these medications. Based on the investigations that have been published, iloperidone appears to be the greatest risk of corrected QT prolongation followed by asenapine whereas lurasidone, cariprazine, and brexpiprazole were not found to have significant effects on corrected QT. However, the evidence was low quality. In terms ...
Source: Current Treatment Options in Psychiatry - May 20, 2019 Category: Psychiatry Source Type: research

Brief Novel Therapies for PTSD —Treatment of PTSD in Primary Care
AbstractPurposeThe prevalence of posttraumatic stress disorder (PTSD) among patients in primary care clinics is higher than that of the general population and many people prefer to get mental health care in primary care, creating a unique opportunity to identify and treat the disorder. Current treatment guidelines recommend psychotherapy as a first-line treatment for PTSD; however, there is a limited amount of research examining effective psychotherapy treatment protocols for PTSD within primary care. This review aims to examine the existing literature for the treatment of PTSD in primary care and discuss ongoing dissemina...
Source: Current Treatment Options in Psychiatry - May 13, 2019 Category: Psychiatry Source Type: research

Augmenting the Treatment of PTSD with Ketamine —a Review
AbstractPurposePosttraumatic stress disorder (PTSD) is a debilitating psychiatric disorder with a lifetime prevalence of 6.1% in the general adult population. Clinical guidelines for the treatment of PTSD suggest the use of trauma-focused psychotherapies such as prolonged exposure (PE) and cognitive-behavioral therapy (CBT). As a second-level intervention, these guidelines suggest the use of psychotropic medications, mainly selective serotonin reuptake inhibitors (SSRIs). To date, however, studies have shown that both psychotherapeutic and psychopharmacologic treatments have limited efficacy, with remission rates around 40...
Source: Current Treatment Options in Psychiatry - May 9, 2019 Category: Psychiatry Source Type: research

Dealing with Complexity and Comorbidity: Opportunity for Transdiagnostic Treatment for PTSD
AbstractPurpose of reviewThis review synthesizes literature on transdiagnostic treatments for PTSD and trauma-related psychopathology over the last 3  years and discusses their application across diverse contexts.Recent findingsGlobal and domestic studies suggest that a transdiagnostic approach has the potential to address many challenges providers encounter when treating traumatized populations. Existing research shows that transdiagnostic approaches (including the Unified Protocol, Common Elements Treatment Approach, and Modular Approach to Therapy for Children) are effective across low- and high-resourced settings, pop...
Source: Current Treatment Options in Psychiatry - May 8, 2019 Category: Psychiatry Source Type: research

Current State of the Problem: Opioid Overdose Rates and Deaths
AbstractPurpose of reviewOverdose deaths have increased significantly over the last 5  years. This review analyzes the severity and nature of the epidemic, its impact on society, factors driving the increase in mortality, special populations disproportionately affected, and solutions to decrease overdose deaths. A thorough understanding of opioid overdose rates and deaths position t he reader to respond most effectively in their sphere of influence.Recent findingsFinal statistics for 2017 show a continued worsening of the epidemic. Recent studies focus on the evolving role of synthetic fentanyl, risk factors for fatal ove...
Source: Current Treatment Options in Psychiatry - May 7, 2019 Category: Psychiatry Source Type: research

Adjusting the Timeframe of Evidence-Based Therapies for PTSD-Massed Treatments
This article will review the existing literature on massed psychotherapies for PTSD, including only the treatments highly recommended by the current PTSD treatment guidelines that have been modified to an intensive format.Recent FindingsThe literature supporting massed treatment formats for PTSD is limited to date. Two randomized clinical trials (RCTs) provide the strongest evidence for efficacy for prolonged exposure and cognitive therapy for PTSD, and preliminary studies of cognitive processing therapy and eye movement desensitization and reprocessing are promising.SummaryCurrent results suggest that massed formats of ex...
Source: Current Treatment Options in Psychiatry - May 6, 2019 Category: Psychiatry Source Type: research

Augmenting Treatment for Posttraumatic Stress Disorder and Co-Occurring Conditions with Oxytocin
AbstractPurpose of ReviewThe goal of this manuscript is to review the extant literature examining the neurobiological and behavioral mechanisms underlying the potential utility of intranasal oxytocin as a novel pharmacologic intervention for the treatment of posttraumatic stress disorder (PTSD) and for the treatment of comorbid PTSD and alcohol and substance use disorders.Recent FindingsResearch indicates that intranasal oxytocin is a low-cost and easily accessible medication with an excellent safety profile. Oxytocin holds promise for facilitating more effective PTSD treatment, particularly when used in combination with e...
Source: Current Treatment Options in Psychiatry - April 28, 2019 Category: Psychiatry Source Type: research

Multidisciplinary Treatment for Individuals at Clinical High Risk of Developing Psychosis
AbstractPurposeOne of the goals of identifying youth identified, based on clinical symptoms, as being at risk for developing psychosis, is to find ways to prevent or even delay the onset of the illness. Over the past 20  years, relatively few randomized control trials (RCTs), including both pharmacological and psychosocial interventions, have been conducted and often with inconsistent results. Several recent meta-analyses suggest that there are few treatments if any that might be effective and that no one treatmen t is seen as being more effective than any other treatment. This review aims to examine the existing RCTs and...
Source: Current Treatment Options in Psychiatry - January 31, 2019 Category: Psychiatry Source Type: research

Use of Antipsychotic Drugs During Pregnancy
AbstractPurpose of reviewAntipsychotics are frequently prescribed to women of childbearing age and are increasingly prescribed during pregnancy. A small, but growing, body of research on implications for pregnancy and infant outcomes is available to inform the risks and benefits of in utero exposure to antipsychotics. This review examines the existing published research on the use of common typical and atypical antipsychotics in pregnancy and the implications for pregnancy and infant outcomes.Recent findingsThe majority of studies do not show associations with major malformations and antipsychotic use in pregnancy, with th...
Source: Current Treatment Options in Psychiatry - January 30, 2019 Category: Psychiatry Source Type: research