2 Minute Medicine ® - Psychiatry

1. Chronic pain syndromes including fibromyalgia, dry eye disease, and irritable bowel syndrome showed no significant association with quantitative sensory testing modalities or inflammatory markers Evidence Rating Level: 3 (Average) Chronic pain is a widespread and highly heterogenous group if diseases that requires a method of pain phenotyping and measurement. Chronic pain syndromes (CPS) are a cluster of conditions including fibromyalgia, dry eye disease (DED), and irritable bowel syndrome (IBS). CPS show genetic and symptomology overlap in the TwinsUK cohort...

1. Perturbation-based balance training only showed moderate physical benefits in the short term (<6 months) but no benefits in physical, cognitive, or sociopsychological measures after 6 months Evidence Rating Level: 1 (Excellent)  As we age, there is an increased risk of falls and fall-related injuries due to physical and cognitive deterioration. This can also cause psychological consequences such as fear of falling leading to loss of independence which can greatly reduce the quality of life for older adults...

1. Six-year follow-up data reveal that ME/CFS patients treated with cyclophosphamide reported greater and more lasting improvements than those treated with rituximab or placebo. Evidence Rating Level: 2 (Good)   Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a disease with unknown etiology, no validated biomarker, and no approved effective treatment. In the past, some ME/CFS patients with cancer have reported that their cancer drug treatment, which included the cytotoxic drug cyclophosphamide or rituximab, unexpectedly had beneficial effects on their ME/CFS symptoms...

Associations of sugar intake, high-sugar dietary pattern, and the risk of dementia: a prospective cohort study of 210,832 participants : https://read.qxmd.com/read/39020335 1. A population-based cohort study showed that there was a significant association between high dietary sugar content and an increased risk of developing dementia.  Evidence Rating Level: 1 (Excellent)  Dementia is increasing rapidly around the world and is a serious public health concern. Although some progress has been made regarding treatment targeting amyloid-related pathologies, there are still steps that must be taken...

1. Patients with bulimia nervosa randomized to receive web-based cognitive behavioural therapy (CBT) were observed to experience fewer bulimic episodes and binge-eating episodes compared to control, and may be a viable and more accessible alternative to in-person CBT.  Evidence Rating Level: 1 (Excellent)  Despite 1-2% of the global population being affected by bulimia nervosa (BN) during their lifetime, accessing evidence-based treatments can be difficult due to logistical barriers. Cognitive behavioural therapy (CBT) has been shown to be a viable intervention for BN...

1. Serum interleukin-1β (IL-1β) and interleukin-6 (IL-6) levels were higher in obsessive-compulsive disorder (OCD) patients compared to healthy controls. Evidence Rating Level: 3 (Average) Emerging evidence suggests immune dysregulation to be involved in the pathogenesis of obsessive-compulsive disorder (OCD). Interleukin-1β (IL-1β) and interleukin-6 (IL-6) are crucial pro-inflammatory cytokines for regulating immune responses; however, their role in OCD is unclear. This case-control study of 58 OCD patients and 30 age-sex-matched healthy controls (HCs) (mean age = 32...

1. Transcranial direct current stimulation (tDCS) led to improvement in the learning of complex rhythmic movements via stimulation of the primary motor cortex Evidence Rating Level: 1 (Excellent) Motor learning is a key component of everyday functioning from simple tasks like pressing a button to more complex, coordinated tasks like playing an instrument. Motor skills can be learned during a single practice session (online) or after the session (offline). Various areas of the brain a responsible for motor learning depending on the task...

1. Acceptance and Commitment Therapy in patients with coronary heart disease does not affect short-term biological indicators of risk but does improve psychological well-being timelines Evidence Rating Level: 1 (Excellent) This randomized controlled trial aimed to evaluate the efficacy of Acceptance and Commitment Therapy (ACT) on biological and psychological well-being of patients with coronary heart disease. The control group received the usual care (UC) of a 6-week multidisciplinary outpatient cardiac rehabilitation program which includes physical exercise, educational counselling, and medical exams...

1. Adults with chronic low back pain (CLBP) randomized into a 6-week pain intervention education program were observed to have significantly relieved burden of pain-related disability and overall pain intensity when combined with the physiotherapeutic standard of care. 2. Measures of self-reported well being also improved significantly more in the pain education group compared to the control group.  Evidence Rating Level: 1 (Excellent) Chronic low back pain (CLBP) is a pervasive condition contributing significantly to pain-related disability worldwide...

1. Post-traumatic stress disorder (PTSD) symptoms were associated with higher levels of chronic pain, pain catastrophizing, and pain interference amongst U.S. veterans. 2. No significant gender differences were found in the associations between PTSD symptoms and pain outcomes.  Evidence Rating Level: 2 (Good)  Post-traumatic stress disorder (PTSD) and chronic pain are highly prevalent comorbid conditions in both veterans and civilians. Patients dually burdened by both PTSD and chronic pain experience more severe psychiatric impairments and incur a greater cost to the healthcare system...

1. In post-stroke patients, endovascular thrombectomy (EVT) was associated with favourable outcomes on 5 separate cognitive tests that showed benefits to global cognitive function.  Evidence Rating Level: 2 (Good)  Endovascular thrombectomy (EVT) is a highly effective treatment for large vessel occlusion strokes that can improve functional neurologic outcomes. While EVT reduces infarct volume, cognitive outcomes have not been well-studied. To validate the quality of EVT therapy, patients were randomized to be treated either with the standard medical therapy or with standard medical therapy and EVT...

1. In this retrospective cohort study, exposure to antiseizure medications was associated with a higher incidence of autism spectrum disorder (ASD) compared to general population data. 2. Restricted to children born to mothers with epilepsy, valproate, but not topiramate and lamotrigine, was associated with an increased risk of ASD compared to no medication exposure. Evidence Rating Level: 2 (Good) Study Rundown: Most female adults with epilepsy receive antiseizure medications throughout pregnancy. Prenatal exposure to valproate is associated with neurodevelopmental disorders such as ASD and attention deficit hyperactivity disorder...

The Latest A first-in-human, double-blind phase 1 clinical trial funded by Reunion Neuroscience Inc. investigated the safety, tolerability, and pharmacological profile of RE104, a proprietary psychedelic prodrug the company hopes to investigate in the treatment of postpartum depression (PPD). In this study, 48 healthy participants were enrolled across 6 dose levels ranging from 5.5 mg to 44 mg. In general, RE104 was safe and well tolerated by all study participants. Nausea, asymptomatic sinus tachycardia, headache, and restlessness were the most commonly reported adverse effects (AE)...

1. In a cohort of individuals, those diagnosed with an opioid use disorder (OUD), anxiety, or depression that were associated with a Comprehensive Primary Care Plus (CPC+) practice had increased utilization of mental health services and substance use treatment.  2. Although CPC+ practices had higher utilization, the costs were not significantly different from non-CPC+ practices.  Evidence Rating Level: 2 (Good) Many individuals have been negatively affected by the COVID-19 pandemic, both those affected by the disease and the decline in mental health experienced secondary to lockdowns...

1. In a cohort study in South Korea, prenatal opioid use did not significantly increase the risk of neuropsychiatric disorders in infants.  2. The risk of a neuropsychiatric disorder was increased by long-term opioid use, greater doses, and use during the first trimester.  Evidence Rating Level: 2 (Good)  Prenatal opioid exposure is generally contraindicated in pregnancy, though chronic pain and addiction can still lead to exposure.  Currently, the association between opioid exposure and subsequent neuropsychiatric disorders in infants is poorly characterized...

1. In a cohort of patients with varying lung function assessed through values of FVC and FEV 1 , and no previous depression, participants with the lowest lung function had increased depression levels, compared to individuals with better levels of lung function.  Evidence Rating Level: 1 (Excellent)  Depression is a mental health condition that contributes to disability-adjusted life years and may lead to an increased risk of developing negative health outcomes. Identifying a cost-effective strategy to prevent depression is needed, as the current ones are costly and have limited efficacy...

Evidence Rating Level: 2 (Average) The role of inflammation in the pathogenesis of many psychiatric illnesses is an ongoing area of research. Schizophrenia is classified as a severe mental illness that affects approximately 0.5% of the American population. Understanding the physiological mechanisms underlying schizophrenia can help researchers create targeted therapies for this life-altering illness. The specific inflammatory markers underlying the pathophysiology of schizophrenia remain to be further explored...

Evidence Rating Level: 2 (Good) Depression affects around 8% of the total adult American population. The pathophysiology underlying this common mental health disorder remains under investigation. Previous research has shown inflammation to be associated with depression. However, further research remains to be conducted to clarify the specific inflammatory markers associated with depression. This cohort study conducted in China measured the plasma cytokines of 82 participants. Participants over the age of 18 and confirmed DSM-V diagnosis of depression by a psychiatrist were included...

Evidence Rating Level: 1 (Excellent) Chest pain is one of the most concerning presenting symptoms in the clinical setting. The differential diagnosis of chest pain includes highly concerning life-threatening diseases from pulmonary embolism to myocardial infarction. Fifty percent of chest pain presentations to the emergency department, however, are typically non-cardiac chest pains (NCCP). The association of chest pains with heart disease makes symptoms very distressing to patients. This is termed cardiac anxiety (CAx)...

1. This retrospective study found that the use of medications for alcohol use disorder (MAUD) (including naltrexone, acamprosate, and disulfiram) at discharge from hospital significantly reduced 30-day all-cause mortality, 30-day return to hospital for any reason, and improved rates of primary care and mental health follow-up post-discharge. Evidence Rating Level: 2 (Good) Alcohol use disorder (AUD) affects 29 million adults in the United States and is a leading cause of preventable mortality. Current Food and Drug Administration (FDA) guidelines recommend both behavioural and pharmacologic interventions for AUD, often referred to as medications for AUD (MAUD)...