Current Treatment Options in Psychiatry Current Treatment Options in Psychiatry RSS feedThis is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

The Treatment of Refractory Generalized Anxiety Disorder
AbstractPurposePurpose Generalized anxiety disorder (GAD) is one of the most common anxiety disorders, afflicting approximately 6% of the general population in their lifetime. It has a chronic and episodic course, requiring a long-term treatment approach. A variety of pharmacological agents and psychological treatments have been shown to be efficacious as GAD treatments; however, remission effect sizes for first-line treatments are small. This review aims to examine the existing evidence for next-step pharmacological and psychological treatments for individuals who remain symptomatic after first-line treatment.Recent Findi...
Source: Current Treatment Options in Psychiatry - October 23, 2017 Category: Psychiatry Source Type: research

Management of Treatment - Resistant Obsessive - Compulsive Disorder
Opinion StatementPurpose of review Many individuals with obsessive-compulsive disorder (OCD) do not fully respond to first-line treatments (psychotherapy consisting of exposure and response prevention [EX/RP] and serotonin reuptake inhibitor [SRI] pharmacotherapy). These cases are often considered “treatment-resistant” OCD. In this article, we offer a heuristic guide for treating clinicians for such cases.Recent findings Clinical options for treatment-resistant OCD include augmenting first-line treatments with medications, psychotherapy, and neuromodulatory approaches. These augmentation and novel monotherapy intervent...
Source: Current Treatment Options in Psychiatry - October 10, 2017 Category: Psychiatry Source Type: research

PTSD, Anger, and Trauma-Informed Intimate Partner Violence Prevention
Opinion StatementDespite a large and growing literature showing high rates of prior trauma exposure and posttraumatic stress disorder (PTSD) among those who engage in intimate partner violence (IPV), there has been a lack of trauma-informed interventions developed for this population. This review discusses the latest background research and clinical developments in the area of trauma-informed IPV intervention. We discuss how recent evidence points to the relevance of trauma-related social information processing biases and anger in the etiology of IPV perpetration, and a promising intervention that targets social informatio...
Source: Current Treatment Options in Psychiatry - August 9, 2017 Category: Psychiatry Source Type: research

Heart Rate Variability Responses to a Standardized Virtual Reality Exposure in Veterans with PTSD
Opinion StatementPurpose In this article, we present data incorporating heart rate variability (HRV) into a graded virtual reality protocol performed in both a combat environment and an active control (classroom) environment, for combat Veterans with and without PTSD.Recent Findings Exposure therapy for PTSD has proven effective. There is increasing interest in the use of virtual reality exposure therapy (VRET)-customized environments incorporating auditory, visual, and olfactory sensory modalities, to augment exposure-based treatment for PTSD. Particularly for combat Veterans, VRET may offer the advantage of a more realis...
Source: Current Treatment Options in Psychiatry - August 8, 2017 Category: Psychiatry Source Type: research

The Primary Role of Mental Health Treatment in Resolution of Persistent Post-concussive Symptoms
Opinion statementSymptoms that persist beyond the expected period of recovery following a mild traumatic brain injury (mTBI)/concussion are strongly linked to non-neurologic variables, notably mental health conditions such as posttraumatic stress disorder (PTSD), particularly among Iraq and Afghanistan Veterans. Despite acknowledgement of poor recovery in a sizeable minority of concussion cases and the strong contribution of psychological factors to this presentation, treatment of comorbid, and likely primary, mental health conditions, is not as widely practiced as the evidence would support. The attention drawn to TBI as ...
Source: Current Treatment Options in Psychiatry - August 5, 2017 Category: Psychiatry Source Type: research

Understanding Anxiety in Borderline Personality Disorder
Opinion StatementThere is substantial evidence that borderline personality disorder and anxiety disorders not only co-occur but also mutually influence their outcomes and treatment responses. Both share a significant neurobiological overlap including abnormalities in the limbic system, hypothalamic pituitary adrenal axis, serotoninergic transporter and glucocorticoid transporter genes, and an atypical regulation of the autonomic nervous system. Anxiety should be systematically assessed in patients with borderline personality disorder using dimensional instruments that capture not only the psychological aspects of the disor...
Source: Current Treatment Options in Psychiatry - August 3, 2017 Category: Psychiatry Source Type: research

The Treatment of Antisocial Personality Disorder
Opinion statementPurpose of Review Antisocial personality disorder (ASPD) is defined by its pattern of socially irresponsible, exploitative, and guiltless behavior. The disorder is common and costly to society. ASPD starts in childhood or early adolescence when it is diagnosed as conduct disorder. If the symptoms persist past age 18, the diagnosis changes to ASPD. The disorder moderates with advancing age and many individuals will no longer meet criteria for the disorder as older adults.Recent Findings The treatment of ASPD is challenging and complicated by a dearth of research evidence. There are no medications approved b...
Source: Current Treatment Options in Psychiatry - August 3, 2017 Category: Psychiatry Source Type: research

Association of Self-Report Measures with PTSD and Depression in Veterans
AbstractPurpose of review Self-report measures are common in clinical and research practice. These questionnaires permit fast evaluation of symptom severity and change over time and are sometimes used to identify the presence of possible psychiatric disorders. However, these measures may be less syndrome-specific than previously believed. In Iraq and Afghanistan-era veterans, the PTSD Checklist (PCL) and Beck Depression Inventory-II (BDI-II) are commonly used both clinically and in research due to high rates of posttraumatic stress disorder (PTSD) and depression. Clarity regarding the presumed specificity of such measures ...
Source: Current Treatment Options in Psychiatry - July 31, 2017 Category: Psychiatry Source Type: research

Relevance of Attachment Theory to Parenting Concerns Among Veterans With TBI
Opinion statementTraumatic brain injury (TBI) is considered the signature injury of the Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (heretofore referred to as OEF/OIF/OND) US military conflicts. TBI can result in a myriad of cognitive, emotional, behavioral, and social-relational symptoms that can negatively influence one ’s ability to parent. Additional factors can negatively impact the well-being of military families facing TBI, further increasing child-parent relationship strain: (1) high base rates of comorbid psychiatric conditions; (2) unique demographic characteristics of OEF/OIF/ON...
Source: Current Treatment Options in Psychiatry - July 24, 2017 Category: Psychiatry Source Type: research

Pharmacogenomics of Antipsychotic Drugs
Opinion statementPharmacogenomic research of antipsychotic drug (APD) response continued to produce interesting findings in the past few years. Several genetic markers have been shown to be reliably associated with APD responses including efficacy and drug-induced adverse reactions. For APD treatment response,DRD2 has been shown to predict symptom reduction and APD efficacy. For APD-induced weight gain, a recent meta-analysis supports the associations withHTR2C andMC4R variants, as well as several other genetic markers. For clozapine-induced agranulocytosis, an independent sample has confirmed the association withHLA-DQB1....
Source: Current Treatment Options in Psychiatry - May 2, 2017 Category: Psychiatry Source Type: research

The Role of 5-HT2a/2c Receptors in Nociception and Opioid Antinociception: a Review of the Preclinical Literature
In conclusion, although the preclinical literature poses a potentially interesting role for the 5-HT2a/2c receptors in nociception, their interaction with the MOR is unclear and needs further preclinical evaluation. (Source: Current Treatment Options in Psychiatry)
Source: Current Treatment Options in Psychiatry - April 25, 2017 Category: Psychiatry Source Type: research

Hormones and Neuropeptide Receptor Heteromers in the Ventral Tegmental Area. Targets for the Treatment of Loss of Control of Food Intake and Substance Use Disorders
Opinion StatementHormones and neuropeptides represent biological correlates of internal homeostatic signals detected and integrated in the hypothalamus, which establishes a robust functional connection with the ventral tegmental area (VTA). The hypothalamus-VTA connection determines the ability of these signals to influence central dopaminergic neurotransmission and, therefore, their ability to increase responsiveness to their reward-associated stimuli and to establish appropriate associative learning. The hypothalamus also provides the main source of the multiple neuropeptides that are released in the VTA. With volume tra...
Source: Current Treatment Options in Psychiatry - April 22, 2017 Category: Psychiatry Source Type: research

The ABCD Study of Neurodevelopment: Identifying Neurocircuit Targets for Prevention and Treatment of Adolescent Substance Abuse
This study will provide a rich open-access dataset on longitudinal interactions of neurodevelopment, environmental exposures, and childhood psychopathology that confer addiction risk. The ABCD twin study will further clarify genetic versus experiential influences (e .g., substance use) on neurodevelopmental and psychosocial outcomes. Neurocircuitry thought to regulate mood and behavior has been directly normalized by administration of psychoactive medications and by cognitive therapies in adults. Because of this, we contend that ABCD project data will be a cruc ial resource for prevention and treatment of SUD in adolescenc...
Source: Current Treatment Options in Psychiatry - April 20, 2017 Category: Psychiatry Source Type: research

Antagonist Treatment for Opioid Dependence: Promise and Hurdles
Opinion statementRelapse rates among treatment-seeking opioid-addicted individuals are extremely high but can be markedly reduced by agonist-based maintenance therapies such as methadone or buprenorphine. However, these therapies are not always available due to a limited number of providers, waiting lists to access treatment, or laws that prevent their use. In addition, some persons do not want agonist-based therapy because they do not like its subjective effects, tried it with less than optimal results, and had trouble stopping it when they felt ready or because family or other external pressures oppose it. For these indi...
Source: Current Treatment Options in Psychiatry - April 20, 2017 Category: Psychiatry Source Type: research

Pregnancy and the Opioid Epidemic
Opinion StatementThe USA is currently experiencing related epidemics of opioid misuse, use disorder, (over) prescribing, and overdose. We review the current literature on opioid use disorder (OUD) during pregnancy including intrapartum and postpartum considerations, breastfeeding, neonatal abstinence syndrome, and contraception. Screening for OUD in pregnancy should be universal, and pregnant women with opioid use disorder should have access to opioid pharmacotherapy. Pharmacotherapy with opioid agonists, methadone, or buprenorphine remains the standard of care for treating opioid use disorder in pregnancy. Medically assis...
Source: Current Treatment Options in Psychiatry - April 19, 2017 Category: Psychiatry Source Type: research