Showing papers in "International Review of Psychiatry in 2020"
TL;DR: Federal and state legislatures should apply a public health framework and consider the possible downstream effects of marijuana policy change on paediatric health including potential benefits from decriminalization and negative health outcomes evidenced by increases in cannabis-related motor vehicle accidents, emergency department visits, and hospitalizations.
Abstract: Decriminalization, medicalization, and legalization of cannabis use by a majority of U.S. states over the past 25 years have dramatically shifted societal perceptions and use patterns among America...
72 citations
TL;DR: Research in this field would benefit from use of longitudinal designs, objective and timely measures of SM use, research on the mechanisms of the association between SM use and depression and suicidality, and research in clinical populations to inform clinical practice.
Abstract: There have been increases in adolescent depression and suicidal behaviour over the last two decades that coincide with the advent of social media (SM) (platforms that allow communication via digital media), which is widely used among adolescents. This scoping review examined the bi-directional association between the use of SM, specifically social networking sites (SNS), and depression and suicidality among adolescents. The studies reviewed yielded four main themes in SM use through thematic analysis: quantity of SM use, quality of SM use, social aspects associated with SM use, and disclosure of mental health symptoms. Research in this field would benefit from use of longitudinal designs, objective and timely measures of SM use, research on the mechanisms of the association between SM use and depression and suicidality, and research in clinical populations to inform clinical practice.
66 citations
TL;DR: It is indicated that smart technology during the Health Emergency period was important for the meaning in life of older populations, mostly by facilitating meaningful relations, rewarding activities and spirituality.
Abstract: The exponential increase of the older segment of the population is coinciding with the growing challenges of a digital society in different socio-cultural contexts. This exploratory study aims to a...
47 citations
TL;DR: It is proposed that the future of psychotherapy needs to be based on the more inclusive and integrative framework of existential positive psychology (PP 2.0), which emphasizes flourishing through suffering.
Abstract: The unprecedented changes in our society because of COVID-19 and the fourth industrial revolution (4IR) shows that our healthcare system and the medical approach to psychotherapy can no longer meet the mental health needs of society. This paper first described the negative impact of COVID-19 and 4IR on our mental health. Then, following a brief critique of the medical model, this paper proposes that the future of psychotherapy needs to be based on the more inclusive and integrative framework of existential positive psychology (PP 2.0), which emphasizes flourishing through suffering. Finally, the paper emphasizes Viktor Frankl's cure and Wong's integrative meaning therapy. It concludes that integrative meaning therapy represents the future of psychotherapy, because it is situated in the area of interactions of at least three traditions: Clinical psychology, existential psychology, and positive psychology. This integrative model is holistic, recognising humans as bio-psycho-social-spiritual beings and considers several theoretical perspectives in both diagnosis and treatment.
37 citations
TL;DR: An overview of the work of the Collective Intelligence Network Support Unit is used to highlight the power and potential of collaborative groups and the need for the development of collaborative infrastructures that reinforce solidarity, collective empowerment, and collective intelligence.
Abstract: This paper introduces readers to collaborative positive psychology, a natural complement to transdisciplinary systems science. Consistent with second wave positive psychology models (PP2.0), collaborative positive psychology highlights how negative emotions (e.g. sadness, guilt, shame, anger, anxiety) can act as key drivers of positive transformation in collaborative groups, providing a catalyst for critical systems thinking and collective responses to shared problems. Collaborative positive psychology emphasises pathways from the recognition of collective problems to problem-focused and method-driven responding supporting sustainable wellbeing. Key principles of collaborative PP include solidarity, empowerment, and teamwork, with a specific focus on the application of collective intelligence (CI) methods to address shared complex problems. An overview of the work of the Collective Intelligence Network Support Unit (CINSU) is used to highlight the power and potential of collaborative groups. Collaborative positive psychology highlights the need for the development of collaborative infrastructures that reinforce solidarity, collective empowerment, and collective intelligence.
25 citations
TL;DR: This study provides the most comprehensive evidence of augmenters’ effectiveness for TRD, and GRADE recommendations can be used to guide guidelines to optimize treatment choices, and supports the use of NMDA-targeting medications such as ketamine.
Abstract: Most interventions for treatment-resistant depression (TRD) are added as augmenters. We aimed to determine the relative effectiveness of augmentation treatments for TRD. This systematic review and ...
24 citations
TL;DR: A review of the literature on paediatric suicide screening, risk assessment and treatment to inform clinical practice and suicide prevention efforts shows that universal screening is strongly recommended, feasible and acceptable, and that there are screening tools that have been validated with youth.
Abstract: The number of children and adolescents dying by suicide is increasing over time. Patterns for who is at risk are also changing, leading to a need to review clinical suicide prevention progress and ...
22 citations
TL;DR: Findings show that Merkel’s wellness is particularly strong in terms of spirituality and self-direction, and suggestions are proposed how to expand the WoW in the context of latest positive psychology developments and with regard to socio-cultural changes within contemporary societies.
Abstract: Holistic wellness theories conceptualise wellness as a multidimensional and synergistic construct. The term wellness refers to a way of life oriented towards optimal health and wellbeing in which body, mind, and spirit are integrated by the individual to live life fully within the human and natural community. The proposed Wheel of Wellness Model incorporate five life tasks that are influenced by seven life forces that are, in turn, influenced by global events. In this study, the model is employed to explore the life of Angela Merkel from a psychobiographical and holistic wellness perspective. Merkel was purposively selected as an extraordinary leader who demonstrated exceptional coping abilities and wellness. Findings show that Merkel's wellness is particularly strong in terms of spirituality and self-direction. Suggestions are proposed how to expand the WoW in the context of latest positive psychology developments and with regard to socio-cultural changes within contemporary societies.
15 citations
TL;DR: The relationship between age of first exposure (AFE) to fighting sports and brain structure, cognitive performance, and clinical neuropsychiatric symptoms is examined to inform clinicians, governing bodies, parents, and athletes of the risks associated with beginning to compete in fighting sports at a young age.
Abstract: It has long been established that fighting sports such as boxing and mixed martial arts can lead to head injury. Prior work from this group on the Professional Fighters Brain Health Study found that exposure to repetitive head impacts is associated with lower brain volumes and decreased processing speed in fighters. Current and previously licensed professional fighters were recruited, divided into active and retired cohorts, and matched with a control group that had no prior experience in sports with likely head trauma. This study examined the relationship between age of first exposure (AFE) to fighting sports and brain structure (MRI regional volume), cognitive performance (CNS Vital Signs, iComet C3), and clinical neuropsychiatric symptoms (PHQ-9, Barratt Impulsiveness Scale). Brain MRI data showed significant correlations between earlier AFE and smaller bilateral hippocampal and posterior corpus callosum volumes for both retired and active fighters. Earlier AFE in active fighters was correlated with decreased processing speed and decreased psychomotor speed. Retired fighters showed a correlation between earlier AFE and higher measures of depression and impulsivity. Overall, the results help to inform clinicians, governing bodies, parents, and athletes of the risks associated with beginning to compete in fighting sports at a young age.
14 citations
TL;DR: An update, as well as a putative systematization, of current views and opinions about this nosological entity in the light of the recent progress in the clinic, psychopathology and psycho-neurobiology are given.
Abstract: In 1880, Jules Cotard described a peculiar syndrome after observing the case of a 43-year-old woman, which was characterized by melancholic anxiety, delusions of damnation or possession, a higher propensity to suicide ideation and deliberate self-harm, analgesia, hypochondriac thoughts of non-existence or ruin of several organs, of the whole body, of the soul, of divinity, and the idea of immortality or inability to die. Several expansions and reinterpretations have been made of the so-called Cotard's syndrome, which is often encompassed in different neurological and psychiatric disorders, complicating and worsening their symptomatic frameworks and making more difficult their treatments. However, the nosographic characterization of Cotard's syndrome remains elusive and is not now classified as a separate disorder in both ICD and DSM-5. Here, we try to give an update, as well as a putative systematization, of current views and opinions about this nosological entity in the light of the recent progress in the clinic, psychopathology and psycho-neurobiology.
14 citations
TL;DR: Following TBI among older adults, screening and education on sleep disorders should be considered, and TBI was associated with an increased risk of insomnia and any sleep disorder in fully adjusted DID models.
Abstract: Sleep disturbances are common sequelae of traumatic brain injury (TBI) that are associated with poorer recovery. This is important among older adults, who fare worse following TBI relative to young...
TL;DR: A critical review of the literature on the neuropsychological functioning in ageing NFL players included 22 articles published between 2013 and 2019, of which 13 reported on neuroradiological imaging and four focused on dose-response relationships of repetitive head injury on cognitive outcomes.
Abstract: Recent discovery of chronic traumatic encephalopathy in former National Football League (NFL) players has led to a surge of papers investigating cognitive functioning in these former athletes. This critical review of the literature focused on the neuropsychological functioning in these ageing athletes, and included 22 articles published between 2013 and 2019, of which 13 reported on neuroradiological imaging and four focused on dose-response relationships of repetitive head injury on cognitive outcomes. Four studies suggest higher prevalence of MCI and neurodegenerative disease among NFL retirees, although a quantifiable risk and prevalence of cognitive impairment and dementia in these players remains unknown. Decreased verbal memory has been found in some players across multiple studies, though with unknown clinical significance due to small sample sizes, unreported effect sizes, and absence of longitudinal data. Studies investigating a dose-response relationship between cognitive decline and head injury have generated mixed findings utilizing various measures of head injury exposure. Neuroradiological findings are inconsistent, but suggest that some NFL players may be at greater risk for reduced white matter integrity. Future research is needed to understand the relationship between sports-related concussions and the risk of long-term cognitive decline and neurodegenerative disease in ageing NFL players.
TL;DR: Catatonia was buried within the confines of schizophrenia for over a century— deterring study, appropriate diagnosis and treatment for many years, but is becoming more recognized clinically and in ongoing research.
Abstract: Catatonia was buried within the confines of schizophrenia for over a century- deterring study, appropriate diagnosis and treatment for many years. With revised changes in the classification of this distinct neuropsychiatric syndrome, it is becoming more recognized clinically and in ongoing research. Catatonia occurs among various psychiatric, metabolic or neurologic conditions. It may present in many forms, including neuroleptic malignant syndrome. Treatment with benzodiazepines or electroconvulsive therapy usually produces dramatic and rapid response, although systematic, randomized trials are lacking. The role of antipsychotic agents in treatment is controversial as they may worsen the syndrome. An important unresolved clinical question is the diagnosis and treatment of catatonia in the setting of delirium.
TL;DR: How the different classification systems do not seem to have been successful in their attempts to delineate the blurred line between depression and anxiety is summarized, before questioning whether a dialogue with a more phenomenological or psychopathological approach could be helpful in understanding the articulation between both affective phenomena.
Abstract: The delineation of anxiety and depression as well as the relation between anxiety and depression are still subject of debate. Many patients suffering from depression also suffer from anxiety, and many patients with anxiety suffer or will suffer from depression. The co-occurrence or co-morbidity is higher than what could be expected based on their respective prevalences, and even pushed some authors to call it cothymia. This epidemiological and clinical reality results in many conceptual hesitations. We first will summarize how the different (versions of the) classification systems do not seem to have been successful in their attempts to delineate the blurred line between depression and anxiety, before questioning whether a dialogue with a more phenomenological or psychopathological approach could be helpful in understanding the articulation between both affective phenomena, as well as in bridging neurobiological research and clinical practice.
TL;DR: The need for further research to characterise the peculiar pathophysiological framework of this syndrome (compared with major depressive disorder) and to better define evidences about tailored-treatment options and their effectiveness is identified.
Abstract: Dysthymia is a psychopathological construct historically described and often reconsidered through the centuries. Its first description is dated back to 400 b.C., when Hippocrates proposed his theory about the 'black bile' and the melancholic temperament. The concept of dysthymia (dys-, 'ill', thymia-, 'emotions') has been largely elaborated in the XIX and XX centuries by Burton, Cullen, Schneider, Kretschmer, Akiskal and other authors, and recently re-formulated in the various editions of the modern Diagnostic and Statistical Manual of Mental Disorders under different diagnostic labels: neurotic depression, dysthymic disorder, persistent depressive disorder. Beyond the nosology, dysthymia issues some other challenges, including the need for further research to characterise the peculiar pathophysiological framework of this syndrome (compared with major depressive disorder) and to better define evidences about tailored-treatment options and their effectiveness.
TL;DR: The purpose of this article is to review PsyCap applications and its implications for the practice of psychiatry, especially within the context of 4IR and the second wave of Positive Psychology (PP 2.0).
Abstract: COVID-19 is altering the world, impacting every facet of life, and driving an associated global paradigm shift. Threats to our individual, family, team, community, and global well-being consume our attention at the potential price of our well-being and performance. The time to respond with scientific approaches to protect our most precious assets - people - is now. COVID-19, unstable geopolitical systems, and accelerated scientific and technological breakthroughs are characteristic of what has been identified as a Fourth Industrial Revolution (4IR). This 4IR is placing a premium on solutions that are validated to increase well-being, especially those that simultaneously significantly increase performance. Psychological Capital or simply PsyCap has emerged as a leading evidence-based positive approach to human development, drawing from previously largely untapped psychological resources (Hope, Efficacy, Resilience and Optimism or the HERO within). Although there is an extensive, growing body of PsyCap academic research in all levels of analysis and domains, there is still a void in PsyCap's applications within psychiatry. The purpose of this article is to review PsyCap applications and its implications for the practice of psychiatry, especially within the context of 4IR and the second wave of Positive Psychology (PP 2.0). Specific attention is given to evidence-based, non-stigma applications for the effective practice of psychiatry.
TL;DR: TBI moderates AD diagnostic accuracy, and possible AD misdiagnosis can mislead patients, influence treatment decisions, and confound research study designs.
Abstract: Traumatic brain injury (TBI) and Alzheimer’s disease (AD) bear a complex relationship, potentially increasing risk of one another reciprocally. However, recent evidence suggests post-TBI dementia e...
TL;DR: Findings indicate that, among community-dwelling adults 5 years post-TBI, there are significant differences in participation between age groups across the lifespan, with younger adults generally having higher levels of participation.
Abstract: Participation restrictions, including restrictions in employment, recreational activities, and social interactions, and depression are common after traumatic brain injury (TBI) and can profoundly a...
TL;DR: Treatment must take into account the special features of embitterment including often aggressive rejection of help, to refer to wisdom psychology and transfer this in ‘wisdom psychotherapy’.
Abstract: Injustice, breach of trust, and humiliation are social stressors which can result in embitterment, known to everybody and which has been described in the Bible (Cain and Abel) or by Aristotle in the Nicomachean Ethics. It has been discussed by several authors since the early days of psychiatric classification. In the textbook 'Psychiatry' by E. Kraepelin a full chapter is devoted to 'querulant delusion', named a reactive psychosis, which can be discriminated from endogenous psychosis or personality disorders. Core symptoms are embitterment, negativism, helplessness, self blame, unspecific somatic symptoms, phobic avoidance of persons or situations related to the event, intrusions, phantasies of revenge and aggression. Another name is 'Posttraumatic Embitterment Disorder' according to the leading emotion. This severe mental disorder has by and large been ignored over the years by health professionals. In ICD-11 the term embitterment is mentioned for the first time in the category '6B43 adjustment disorder'. Embitterment can be measured with the 'Bern Embitterment Inventory (BVI)' and the 'Post-Traumatic Embitterment Self-rating Scale (PTED scale)'. Treatment must take into account the special features of embitterment including often aggressive rejection of help. A promising treatment approach is, to refer to wisdom psychology and transfer this in 'wisdom psychotherapy'.
TL;DR: Contrary to expectation, older adults showed equivalent outcome trajectories to younger persons across time, a compelling finding when viewed in light of the majority opinion that older adults are at risk for significantly worse outcomes.
Abstract: This study longitudinally examined age differences across multiple outcome domains in individuals diagnosed with acute mild traumatic brain injury (mTBI). A sample of 447 adults meeting VA/DoD crit...
TL;DR: The population distribution in the United States is changing from a broad base of younger individuals with few individuals living to older adulthood to a much more even distribution throughout the population throughout the century.
Abstract: The population distribution in the United States is changing from a broad base of younger individuals with few individuals living to older adulthood to a much more even distribution throughout the ...
TL;DR: It is concluded that it would be of great interest to brush up the neglected MDSs in order to improve knowledge on the underlying mechanisms of delusion and brain functioning.
Abstract: Capgras and Fregoli syndromes are two psychotic and complex conditions also known as Delusional Misidentification Syndromes (DMSs). Their description dates back to the beginning of XX century, and many explanatory models have been formulated through myths, psychoanalytical and psychological hypotheses, as well as neurobiological proposals. Even if DMSs are not fully considered in the modern diagnostic manuals, they still remain intriguing phenomena to be clinically observed and explained. Also, the employment of psychotropics and physical techniques in the treatment of such conditions is not supported by robust evidences and this may encourage further studies. We conclude that it would be of great interest to brush up the neglected MDSs in order to improve our knowledge on the underlying mechanisms of delusion and brain functioning.
TL;DR: Significant differences emerged between parent and child report of sleep, nightmares, concentration, and irritability problems, suggesting the need for multiple informants in PTSD screening.
Abstract: Trauma exposure is highly prevalent among children globally, and is associated with elevated rates of PTSD. The goal of this study was to systematically evaluate the effects of multiple informants ...
TL;DR: This study aimed to investigate the role of post-concussive symptoms, mood, post-traumatic stress disorder, and depression in elderly patients after mild traumatic brain injury.
Abstract: Elderly patients are at increased risk for persistent complaints after mild traumatic brain injury (MTBI). This study aimed to investigate the role of post-concussive symptoms, mood, post-traumatic...
TL;DR: Overlap of symptoms in melancholic and nonmelancholic depression, based on DSM criteria, may limit distinction of melancholia; alternative definitions can be sought, and psychomotor retardation is a particularly strong differentiating feature.
Abstract: Many efforts have been made to develop coherent and clinically useful categories of depressive illness, especially to facilitate prediction of morbidity and guide treatment-response. They include proposals to resurrect the ancient concept of melancholia, as a form of severe depression with particular symptomatic and proposed psychobiological characteristics. However, modern research is inconsistent in supporting differences between melancholic and nonmelancholic depression. In our recent study of over 3200 patient-subjects with DSM-5 major depressive episodes with/without melancholic characteristics, and matched for illness severity, prevalence of melancholic features was 35.2% with remarkably few clinical and demographic differences between melancholic and nonmelancholic subjects. Also, our systematic review of trials comparing melancholic and nonmelancholic subjects found little difference in responses to antidepressant treatments. These findings indicate that the concept of melancholia may have limited value for clinical prediction and treatment-selection. Overlap of symptoms in melancholic and nonmelancholic depression, based on DSM criteria, may limit distinction of melancholia; alternative definitions can be sought, and psychomotor retardation is a particularly strong differentiating feature. For now, however, melancholia seems best considered a state-dependent depression-type strongly associated with greater symptomatic severity, rather than a distinct syndrome. Its DSM-5 current status as a depression-type specifier seems appropriate, and it may be a logical target for genetic and other biomedical studies.
TL;DR: Echoing ongoing critical arguments, authors suggest that a ‘help-as-war’ metaphor is a category with potential value to contribute to such advancement, an approach that has important theoretical and pragmatic implications for researchers and practitioners.
Abstract: This paper provides ethnographic evidence on how coloniality shapes the making of Latin American psychologists. A critical ethnography was conducted at a psychology training institution in Ecuador, consisting of twelve months of participant observation; forty-one semi-structured interviews; and analysis of academic discourse, photos, videos and relevant social media content. The research was guided by the tradition of Critical Psychology - specifically Liberation Psychology - and Critical Discourse Analysis. Findings suggest the pervasiveness of coloniality in the making of Ecuadorian psychologists and, hypothetically, of others in Latin America and the wider Global South. Interpretations also highlight the non-essentialist, non-dichotomist, 'messy' nature of such processes, a consideration which may advance current ethical and analytical debates on decolonisation. Echoing ongoing critical arguments, authors suggest that a 'help-as-war' metaphor is a category with potential value to contribute to such advancement, an approach that has important theoretical and pragmatic implications for researchers and practitioners.
TL;DR: Instagram could be an interesting tool to consider when the aim is to enhance wellbeing and manage common mental health problems in the short-, medium- and long-term.
Abstract: The 4th Industrial Revolution has provided several digital platforms through which to disseminate scalable and cost-effective interventions (e.g. Apps and Social media). Instagram, a popular visual-ethnographic social media platform, could be employed to implement and scale interventions aimed at aiding individuals in discovering meaning in life and gratitude through capturing and reflecting upon photographs of meaningful moments. The purpose of this study was to evaluate the long-term effectiveness of a brief photo-ethnographic meaningful-moments intervention aimed at enhancing wellbeing (life satisfaction) and managing common mental health problems (stress/depression/anxiety) through Instagram. A 4 × 1 treatment-only intervention design was used to assess the immediate and long-term changes in meaning, gratitude, life satisfaction, and depression/stress/anxiety. Within-person development on the subscales was evaluated with Bayesian level and shape models. The results showed significant improvements in all factors directly after the intervention. Over the long term, significant changes with baseline measures for the presence of meaning, appreciation for others, and life satisfaction was found. Participants also reported a significant but small change in depression over the long term. Instagram could therefore be an interesting tool to consider when the aim is to enhance wellbeing and manage common mental health problems in the short-, medium- and long-term.
TL;DR: The present comprehensive review aims at investigating Ekbom’s syndrome, from a historical, epidemiological, clinical and therapeutic perspective, by providing diagnostic-treatment strategies in managing this condition in routine psychiatric clinical settings.
Abstract: Ekbom's syndrome represents a relatively uncommon neuropsychiatric condition characterized by the recurrent and bizarre fixed delusional belief to be infested by small organisms or even unanimated materials ('Morgellons disease'), without any objective evidence of infestation/parasitosis. The condition, mainly diagnosed in a nonpsychiatric setting, is supposed to be largely underestimated and, hence, undermanaged. The present comprehensive review aims at investigating Ekbom's syndrome, from a historical, epidemiological, clinical and therapeutic perspective, by providing diagnostic-treatment strategies in managing this condition in routine psychiatric clinical settings. The prototypical patient is a middle-aged woman (or a younger subject in those cases in which substance and/or alcohol abuse is implicated), often single, divorced or widowed (loneliness component and social withdrawal), who has already consulted several specialists due to skin lesions associated with a firm and delusional belief to be infested. The identification and diagnosis are challenging due to poor patient's insight, poor knowledge and collaboration between specialists and differential diagnoses to be considered before asking for a psychiatric referral. Management and treatment strategies mainly derive from isolated case reports or observational studies with a small sample size. Further randomized clinical trials should be performed to evaluate the efficacy of newer antipsychotic drugs, including long-acting injectable formulations.
TL;DR: There is still much work to be done to advance the evidence-base for acute psychiatric care for youth particularly in defining and assessing an effective admission.
Abstract: Higher level or acute psychiatric care for youth is intended to be active but short-term treatment focussing on crisis stabilisation, assessment, safety monitoring, and longer-term treatment planning. The focus of this article is on describing common challenges and the effort to address these challenges through new approaches to acute psychiatric care for children and adolescents. The review finds that (1) inpatient paediatric psychiatry beds are in high demand and often difficult to access, (2) there are a number of common challenges these units face including managing length of stays, readmissions, and adverse events, and (3) there are encouraging therapeutic approaches adapted for this setting. There is still much work to be done to advance the evidence-base for acute psychiatric care for youth particularly in defining and assessing an effective admission. Paediatric psychiatry patients are a vulnerable population and call for our best tools to be put to use to improve the quality and safety of care.
TL;DR: An online self-administered 15-item questionnaire successfully recruited 47 WPA member countries or regions to provide responses about training provisions of psychiatric education at undergraduate, postgraduate, and post-qualified levels in their respective countries.
Abstract: This World Psychiatric Association (WPA) global survey of its WPA member society presidents using an online self-administered 15-item questionnaire successfully recruited 47 WPA member countries or...