Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists

BACKGROUND: Patients placed in seclusion for behavioral dyscontrol often perceive that the health care team is treating them inappropriately. These patients may express their indignation in many ways. To better characterize these behaviors, we conducted a study of protest behaviors in a psychiatric emergency service. METHODS: Video surveillance of seclusion room occupants is routinely reviewed as part of our safety protocol. For 1 month in 2022, we noted the frequency and timing of potential protest behaviors such as disrobing and evacuation...

BACKGROUND: Suicide is a leading cause of death in adolescents. Problematic internet use (PIU) has been associated with suicidal behavior in this age group. To assess this association, we reviewed population-based studies that examined the relationship between PIU and suicidal behavior. METHODS: We searched PubMed, PsycINFO, and Web of Science for studies published in English from 1995 through 2021. Only studies with the stated aim to examine the relationship between PIU and suicidal behavior in participants age 13 through 18 were included...

BACKGROUND: The aims of this study were to develop a mobile mental health application (app) to scan the symptoms of anxiety, depression, and related factors during pregnancy; examine the effect of the app on pregnant women; and determine the factors related to using such an app. METHODS: A software platform called Perinatal Anxiety Depression Monitoring Platform (PADIP) was developed. This study included 320 pregnant women: 160 in the PADIP group and 160 in the control group...

BACKGROUND: The association between low vitamin D levels and mental illness has been described in earlier research. The aim of our study was to examine the association between vitamin D levels with psychotic symptoms among hospitalized patients. METHODS: A total of 1,456 patient records from an academic psychiatric hospital were examined. Vitamin D levels were classified as normal (>30 ng/mL); insufficient (20 to 30 ng/mL); and deficient (<20 ng/mL). We then analyzed the association among vitamin D groups and symptoms of psychosis...

BACKGROUND: Body-focused repetitive behaviors (BFRBs) are highly prevalent conditions at the border of psychiatry and dermatology. Using a newly developed scale, the Generic BFRB scale (GBS-36), we aimed to compare 4 prominent BFRBs in terms of phenomenology, age at onset, and other illness-related aspects. METHODS: A sample of 391 individuals with different forms of BFRBs completed the GBS-36, the Patient Health Questionnaire-9 (depression), and the World Health Organization Quality of Life-BREF global item (quality of life)...

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BACKGROUND: Trichotillomania is a common psychiatric disorder classified as an obsessive-compulsive and related condition in DSM-5. Despite being first described in the 1800s, little is known about its phenomenology and clinical presentation. Most information about trichotillomania is based on small samples. METHODS: Clinical and demographic data were collected from 858 individuals with trichotillomania who participated in research studies that used in-person assessments with validated instruments...

BACKGROUND: Trichotillomania is a common psychiatric disorder, but little is known about whether or how it differs in people with minority sexual identities. We sought to understand whether lesbian, gay, bisexual, and other individuals differ from heterosexual individuals in terms of hair pulling and associated characteristics. METHODS: A total of 207 participants age 18 to 64 with trichotillomania undertook clinical evaluations. Those who identified as sexual minorities were compared to those who identified as heterosexuals on clinical measures, comorbidities, impulsivity, and stress responses...

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BACKGROUND: Sexual and/or gender minority (SGM) individuals experience higher rates and greater severity of depressive disorders than non-SGM persons. SGM individuals are more likely than non-SGM individuals to seek mental health treatment and to present to treatment with unique characteristics that should be accounted for when considering treatment recommendations. Patients seeking care for treatment-resistant depression (TRD) are offered a variety of evidence-based interventions ranging in modality and invasiveness (eg, psychotherapy and neuromodulation)...

BACKGROUND: After disasters, mental health professionals might be called upon to help address the emotional consequences of the disaster among survivors and other affected groups, but the clinicians themselves could be affected. This exploratory study examined the experiences of 60 mental health professionals, most of whom provided mental health care to individuals affected by the September 11, 2001 terrorist attacks (9/11), and/or experienced 9/11 sequelae themselves. METHODS: Participants completed structured interviews 3 and/or 6 years after the disaster, with full diagnostic assessment of psychiatric disorders and questions specific to their personal and professional post-9/11 experience...

BACKGROUND: Catatonia due to a general medical condition may result from a variety of causes, including substance intoxication and withdrawal. Stimulants are occasionally associated with catatonia, though there has been little investigation of methamphetamine's relationship to catatonia. Here we present 5 cases of catatonia associated with methamphetamine use and a systematic review of the associated literature from 1943 to 2020. METHODS: We performed a systematic review of the literature and present 5 cases of catatonia evaluated using the Bush-Francis Catatonia Rating Scale and KANNER catatonia rating scale...

BACKGROUND: Bipolar depression is a serious neuropsychiatric disorder associated with a high risk of morbidity and suicidality. Standard antidepressants approved for treating major depressive disorder fail to exert efficacy in bipolar depression. Although 5 agents have been developed for the treatment of bipolar depression, treatment resistance is still observed in some patients, and requires off-label pharmacotherapy. Modafinil and armodafinil have been reported to improve treatment-resistant bipolar depression, but with inconsistent results...

BACKGROUND: Most studies of depression treatment rely on measures of symptom severity to evaluate outcome. We hypothesized that many patients would consider themselves to have benefitted significantly from treatment despite not being considered a responder according to a measure of depression symptom severity (ie, 50% reduction in symptom score). METHODS: In our study, 854 patients with major depressive disorder completed the Remission from Depression Questionnaire, a self-report measure that assesses several constructs patients consider to be relevant for assessing treatment outcome...

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BACKGROUND: Posttraumatic stress disorder (PTSD) is not recognized as an indication for electroconvulsive therapy (ECT). However, research indicates promise for this treatment modality. To elucidate the effects of ECT for treating PTSD, prospective research is needed. The first step in assessing the feasibility of such research is to determine if many patients being treated with ECT have comorbid PTSD. This study examined the PTSD comorbidity rates and compared demographic data among patients with major depressive disorder (MDD) who were treated with ECT vs patients with MDD who were not treated with ECT...

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BACKGROUND: Women with psychiatric disorders are vulnerable to relapse in pregnancy, and the COVID-19 pandemic has presented an additional stressor. METHODS: Data came from a supplemental study offered to women enrolled in the Massachusetts General Hospital Center for Women's Mental Health National Pregnancy Registry for Psychiatric Medications. Registry participants were also invited to complete an email questionnaire relating to their experiences of pregnancy during the pandemic...