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Measurement-based psychiatry

Gregory J Boyle
Ullmann et al. recently published a pilot study in Translational Psychiatry in which they report failing to find a statistically significant reduction in either hair cortisol or hair cortisone levels in circumcised men as compared with genitally intact (noncircumcised) men. Based on such null findings, the authors purport to have "refuted the psycho-pathological long-term effects of circumcision" and that the lack of significant results, "add to the growing body of evidence in the literature that male circumcision is not likely psychologically traumatizing across the life-span...
July 30, 2018: Journal of Clinical and Translational Research
Freda F Liu, Molly C Adrian
OBJECTIVE: Despite advances in evidence-based treatments for youth depression in recent decades, overall treatment effects are modest at best, with 30-50% of youth being non-responders. Practice parameters consistently recommend systematic assessment and routine monitoring of depressive symptoms, or measurement-based care (MBC), to enhance youth depression treatment. However, the literature offers few guidelines on how to use assessment results to inform care decisions or detect real and clinically meaningful change...
February 27, 2019: Journal of the American Academy of Child and Adolescent Psychiatry
Marieke R Potijk, Louisa M Drost, Petra J Havinga, Catharina A Hartman, Robert A Schoevers
Depressive and anxiety disorders are highly prevalent and form a substantial burden for individuals and their family members. A recent study showed that approximately two-thirds of the children of patients with severe depressive and/or anxiety disorders develop one of these disorders themselves before 35 years of age. In the Netherlands, various preventive interventions are available for children of parents with mental illnesses. However, the actual reach of interventions is small (< 1% of all children participate)...
2019: Frontiers in Psychiatry
Stephanie J Lewis, Louise Arseneault, Avshalom Caspi, Helen L Fisher, Timothy Matthews, Terrie E Moffitt, Candice L Odgers, Daniel Stahl, Jia Ying Teng, Andrea Danese
BACKGROUND: Despite the emphasis placed on childhood trauma in psychiatry, comparatively little is known about the epidemiology of trauma and trauma-related psychopathology in young people. We therefore aimed to evaluate the prevalence, clinical features, and risk factors associated with trauma exposure and post-traumatic stress disorder (PTSD) in young people. METHODS: We carried out a comprehensive epidemiological study based on participants from the Environmental Risk Longitudinal Twin Study, a population-representative birth-cohort of 2232 children born in England and Wales in 1994-95...
March 2019: Lancet Psychiatry
Colm Healy, Helen Coughlan, James Williams, Mary Clarke, Ian Kelleher, Mary Cannon
BACKGROUND: Psychotic experiences (PEs) are commonly reported in adolescence and are associated with a range of negative outcomes. Few targets for intervention for PEs have been identified. One potential target is self-concept: an individual's beliefs about his/her personal attributes. Improvements in self-concept have been shown to reduce psychotic symptoms in patients with schizophrenia but no study has investigated the relationship between changes in self-concept and risk of PEs in the general population...
February 16, 2019: Journal of Child Psychology and Psychiatry, and Allied Disciplines
Graham M L Eglit, Barton W Palmer, Dilip V Jeste
BACKGROUND: Psychiatry has traditionally focused on studying psychopathology and treating mental illnesses to relieve symptoms and prevent relapse. Positive psychiatry seeks to expand the scope of psychiatry to broader aspects of mental health and well-being among individuals with or without mental illnesses. Positive psychosocial factors such as well-being, resilience, optimism, wisdom, and social support are central to positive psychiatry. AIM: To summarize the emerging science of positive psychiatry, emphasizing the use of measures of positive characteristics and outcomes relevant to mental health...
August 2018: Nordic Journal of Psychiatry
Stephan Debus
Results of PART II to IV are analyzed under the perspective of power theory of the German sociologist Heinrich Popitz. A communication process model - based on enforcement, instrumental and action power - is derived, which could empirically be revised, enhanced and criticized by means of the introduced speech act methods (PART I). From the theoretical point of view all basic features (from PART II to V) structuring communication in jeopardizing situations using alert systems are listed in a schedule.
March 2019: Psychiatrische Praxis
J Edward Fisher, Arippa Ravindran, Ikram Elayan
A survey was undertaken to evaluate juvenile animal studies conducted for drug applications reviewed by the Center for Drug Evaluation and Research between 2009 and 2014. Some conclusions about the nonclinical pediatric safety assessment based on studies performed in support of central nervous system-active compounds are presented here. A total of 44 completed studies from 32 New Drug Applications submitted to the Divisions of Psychiatry and Neurology Products were evaluated. Data on animal species and age range used, endpoints evaluated, and outcomes included in labeling were analyzed...
February 10, 2019: International Journal of Toxicology
Patricia Rubí G
Restless Legs Syndrome (RLS) or Willis-Ekbom Disease is an under-diagnosed chronic and progressive primary sensory-motor disorder. It can lead to severe sleep disturbances, a usual cause of consultation. It is characterized by an urgent need to move the legs in resting situations, a cardinal symptom that is usually accompanied by an unpleasant sensation in legs. These symptoms appear or aggravate at the end of the day and in resting situations and are alleviated with movement. Based on these clinical characteristics, it has been defined as a quiescegenic focal akathisia...
September 2018: Revista Médica de Chile
Tanya Deb, Heidi Lempp, Ioannis Bakolis, Tushar Vince, William Waugh, Claire Henderson
BACKGROUND: Stigma and discrimination are a significant public health concern and cause great distress to people with mental illness. Healthcare professionals have been identified as one source of this discrimination. In this article we describe the protocol of an international, multisite controlled study, evaluating the effectiveness of READ, an anti-stigma training for medical students towards patients with mental illness. READ aims to improve students' ability to minimise perceived discriminatory behaviours and increase opportunities for patients, therefore developing the ability of future doctors to address and challenge mental illness related discrimination...
January 31, 2019: BMC Medical Education
Filipa Sampaio, Marianne Bonnert, Ola Olén, Erik Hedman, Maria Lalouni, Fabian Lenhard, Brjánn Ljótsson, Richard Ssegonja, Eva Serlachius, Inna Feldman
OBJECTIVE: To assess whether exposure-based internet-delivered cognitive-behavioural therapy (internet-CBT) is a cost-effective treatment for adolescents with irritable bowel syndrome (IBS) compared with a waitlist control, from a societal perspective, based on data from a randomised trial. DESIGN: Within-trial cost-effectiveness analysis. SETTING: Participants were recruited from the whole of Sweden via primary, secondary and tertiary care clinics reached through news media and advertising...
January 24, 2019: BMJ Open
Cynthia I Campbell, Constance Weisner, Ingrid A Binswanger, Gwen T Lapham, Brian K Ahmedani, Bobbi Jo H Yarborough, Irina V Haller, Andrea Altschuler, Rulin C Hechter, Amy M Loree, Andrea H Kline-Simon
BACKGROUND: The prevalence of opioid use disorder (OUD) has increased rapidly in the United States and improving treatment access is critical. Among patients with OUD, we examined factors associated with the Healthcare Effectiveness Data and Information Set (HEDIS) performance measures of alcohol and other drug (AOD) treatment initiation and engagement. METHODS: Electronic health record and claims data between October 1, 2014, and August 15, 2015, from 7 health systems were used to identify patients (n = 11,490) with a new index OUD diagnosis (no AOD diagnosis prior <60 days) based on International Classification of Diseases (ICD)-9 codes...
January 24, 2019: Substance Abuse
Ipsita Ray, Alexander I F Simpson
Patients in forensic mental health care have a difficult journey through inpatient rehabilitation and re-integration into the community. Risk assessment guides this progress, usually with clinician-based processes that use structured risk-assessment tools. Patients' understanding of their own risk is important to inform risk assessment and the chances of successful rehabilitation. The emergence of shared decision-making approaches provides an opportunity to consider shared risk assessment and formulation. We reviewed the literature to explore models of patients' involvement in risk assessment and the impact on outcomes in forensic mental health care...
January 18, 2019: Journal of the American Academy of Psychiatry and the Law
Faith R Kelley, Gretchen L Haas, Emily Felber, Michael J Travis, Esa M Davis
OBJECTIVE: Promoting awareness in residency training about the influence of religion on the doctor's and patient's ability to negotiate a patient-centered treatment plan is challenging and yet important for improving the quality of mental health care for religious individuals. This paper aims to explore the use of community partners and non-psychiatry faculty to provide this education within psychiatry residency programs. METHODS: Fifty-one psychiatry residents at an academic psychiatric hospital took part in a 4-h interdisciplinary workshop aimed at improving doctors' overall approach to treating African-American Christian patients...
January 7, 2019: Academic Psychiatry
Dilip V Jeste
Positive psychiatry is the science and practice of psychiatry that focuses on psycho-bio-social study and promotion of well-being and health through enhancement of positive psychosocial factors (such as resilience, optimism, wisdom, and social support) in people with illnesses or disabilities as well as the in community at large (Jeste and Palmer, 2015). It is based on the principles that there is no health without mental health and that mental health can be improved through preventive, therapeutic, and rehabilitative interventions to augment positive psychosocial factors...
December 2018: International Psychogeriatrics
Arno Deister
Mental illnesses regularly impair participation in social life. Therefore it is from a therapeutic point of view very important to offer community-based therapy focused to individual needs. The psychiatric treatment system in Germany, which is currently highly fragmented, must be modified in the sense of a functionally networked structure.Various control aspects are of particular importance. In terms of regional care, there are different care models in Germany. The focus is on "regional budgets", which are implemented in 19 regions in Germany...
December 19, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Manasi Kumar, Mary Wangari Kuria, Caleb Joseph Othieno, Fredrik Falkenström
Background: Psychotherapy and mental health services in Nairobi's public hospitals are increasing. Rather than prematurely imposing psychotherapy protocols developed in Western countries to Kenya, we argue that first studying psychological interventions as they are practiced may generate understanding of which psychological problems are common, what interventions therapists use, and what seems to be effective in reducing psychiatric problems in a lower and middle income country like Kenya...
2018: International Journal of Mental Health Systems
Sofian Berrouiguet, David Ramírez, María Luisa Barrigón, Pablo Moreno-Muñoz, Rodrigo Carmona Camacho, Enrique Baca-García, Antonio Artés-Rodríguez
BACKGROUND: The emergence of smartphones, wearable sensor technologies, and smart homes allows the nonintrusive collection of activity data. Thus, health-related events, such as activities of daily living (ADLs; eg, mobility patterns, feeding, sleeping, ...) can be captured without patients' active participation. We designed a system to detect changes in the mobility patterns based on the smartphone's native sensors and advanced machine learning and signal processing techniques. OBJECTIVE: The principal objective of this work is to assess the feasibility of detecting mobility pattern changes in a sample of outpatients with depression using the smartphone's sensors...
December 10, 2018: JMIR MHealth and UHealth
Yena Lee, Mehala Subramaniapillai, Elisa Brietzke, Rodrigo B Mansur, Roger C Ho, Samantha J Yim, Roger S McIntyre
The etiology of mood disorders is mechanistically heterogeneous, underscoring the need for a dimensional approach to identify and develop targeted treatments in psychiatry. Accumulating evidence implicates inflammation as an important contributor to the pathophysiology of depression and presents the immune system as a viable therapeutic target that may be more proximate to the pathogenic nexus of brain-based disorders in specific subpopulations. Anhedonia is a transdiagnostic (e.g. Parkinson's disease, diabetes mellitus, rheumatic diseases), yet specific, and clinically relevant symptom dimension subserved by well-characterized neurobiological and neurophysiological substrates of the positive valence systems (PVS)...
December 2018: Therapeutic Advances in Psychopharmacology
Antje A T S Reinders, Andre F Marquand, Yolanda R Schlumpf, Sima Chalavi, Eline M Vissia, Ellert R S Nijenhuis, Paola Dazzan, Lutz Jäncke, Dick J Veltman
BACKGROUND: A diagnosis of dissociative identity disorder (DID) is controversial and prone to under- and misdiagnosis. From the moment of seeking treatment for symptoms to the time of an accurate diagnosis of DID individuals received an average of four prior other diagnoses and spent 7 years, with reports of up to 12 years, in mental health services.AimTo investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis...
December 7, 2018: British Journal of Psychiatry: the Journal of Mental Science
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