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Current Psychiatry Reports

Ruth A Lanius, Jenna E Boyd, Margaret C McKinnon, Andrew A Nicholson, Paul Frewen, Eric Vermetten, Rakesh Jetly, David Spiegel
Dissociative experiences have been associated with increased disease severity, chronicity, and, in some cases, reduced treatment response across trauma-related and other psychiatric disorders. A better understanding of the neurobiological mechanisms through which dissociative experiences occur may assist in identifying novel pharmacological and non-pharmacological treatment approaches. Here, we review emerging work on the dissociative subtype of posttraumatic stress disorder (PTSD), and other trauma-related disorders providing evidence for two related overarching neurobiological models of dissociation, the defense cascade model of dissociation and Mobb's threat detection model...
November 7, 2018: Current Psychiatry Reports
David Wolinsky, Karina Drake, Jolene Bostwick
PURPOSE OF REVIEW: To explore the most recent developments in the effective diagnosis and treatment of neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD). RECENT FINDINGS: The clinical diagnosis of NPS in AD is facilitated by the use of the Neuropsychiatric Inventory (NPI). CT and MRI scans can be useful for detecting structural changes indicating AD. Other promising diagnostic methodologies that are less frequently used in the clinical setting include positron emission tomography (PET) scans for detecting amyloid and blood tests for detecting serum biomarkers...
October 27, 2018: Current Psychiatry Reports
Annie L Ryder, Patrick M Azcarate, Beth E Cohen
PURPOSE OF REVIEW: We review evidence linking PTSD to physical health symptoms and specific disorders, highlighting areas with multiple studies and objective measures of disease states when available. We also examine evidence for biological, behavioral, and psychosocial mechanisms underlying these associations and discuss the clinical implications of recent research. RECENT FINDINGS: Recent meta-analyses have found that evidence is particularly strong for increased risk of cardiovascular, metabolic, and musculoskeletal disorders among patients with PTSD...
October 26, 2018: Current Psychiatry Reports
Laramie E Duncan, Bryna N Cooper, Hanyang Shen
PURPOSE OF REVIEW: The purpose of this review is to contextualize findings from the first 25 years of PTSD genetics research, focusing on the most robust findings and interpreting results in light of principles that have emerged from modern genetics studies. RECENT FINDINGS: Genome-wide association studies (GWAS) encompassing tens of thousands of participants enabled the first molecular genetic heritability and genetic correlation estimates for PTSD in 2017. In 2018, highly promising loci for PTSD were reported, including variants in and near the CAMKV, KANSL1, and TCF4 genes...
October 23, 2018: Current Psychiatry Reports
Rachel Kimerling, Monica C Allen, Laramie E Duncan
PURPOSE OF REVIEW: This review highlights recent research on sex- and gender-related factors in the prevalence, symptom expression, and treatment of PTSD. Further discoveries about the underlying mechanisms of sex and gender effects have the potential to shape innovative directions for research. RECENT FINDINGS: The prevalence of PTSD is substantially higher among women, but women show a modest advantage with respect to treatment response. There is evidence of greater heritability among females...
October 22, 2018: Current Psychiatry Reports
Nicole Sussman, Sandra M DeJong
PURPOSE OF REVIEW: Adolescents' use of digital technologies is constantly changing and significantly influences and reflects their mental health and development. Technology has entered the clinical space and raises new ethical dilemmas for mental health clinicians. After an update on this shifting landscape, including a brief review of important literature since 2014, this article will demonstrate how core ethical principles may be applied to clinical situations with patients, using vignettes for illustration...
October 13, 2018: Current Psychiatry Reports
Stephanie N Cripps, Marvin S Swartz
PURPOSE OF REVIEW: Assisted outpatient treatment (AOT) is an outpatient court-ordered treatment for people with severe mental illness (SMI) whose care needs are often unmet in the community due, in part, to treatment non-adherence. AOT is controversial, and the goal of this review is to provide an update on recent research, the status of AOT in the United States, and future directions for research and implementation. RECENT FINDINGS: Several recent studies have demonstrated that it is not just a lack of access to appropriately intensive care that prevents some individuals with SMI from engaging in and benefiting from treatment and that AOT can improve engagement and patient outcomes over and above the provision of care...
October 13, 2018: Current Psychiatry Reports
Richard A Bryant
PURPOSE OF REVIEW: The aim of this review is to provide a summary of the current evidence pertaining to the course of acute and chronic posttraumatic stress, the diagnosis of acute stress disorder (ASD), and treatment of acute stress disorder and prevention of posttraumatic stress disorder (PTSD). RECENT FINDINGS: Although acute stress disorder was introduced partly to predict subsequent PTSD, longitudinal studies indicate that ASD is not an accurate predictor of PTSD...
October 13, 2018: Current Psychiatry Reports
Barbara Schulte Holthausen, Ute Habel
PURPOSE OF REVIEW: This review aims to give an overview on the current literature on sex differences in personality disorders and to highlight the potential of dimensional approaches. RECENT FINDINGS: Empirical findings on sex differences in personality disorders are inconsistent and appear to be highly dependent on study settings. Current studies have mainly focused on borderline and antisocial personality disorder and the question whether these are sex-specific representations of a common substrate...
October 11, 2018: Current Psychiatry Reports
Elizabeth Hampson
PURPOSE OF REVIEW: Working memory (WM) is a key process that is integral to many complex cognitive tasks, and it declines significantly with advancing age. This review will survey recent evidence supporting the idea that the functioning of the WM system in women is modulated by circulating estrogens. RECENT FINDINGS: In postmenopausal women, increased estrogen concentrations may be associated with improved WM function, which is evident on WM tasks that have a high cognitive load or significant manipulation demands...
October 11, 2018: Current Psychiatry Reports
Hillary B Nguyen, Alexis M Chavez, Emily Lipner, Liisa Hantsoo, Sara L Kornfield, Robert D Davies, C Neill Epperson
PURPOSE OF REVIEW: With increasing numbers of transgender and gender non-binary individuals presenting for care, knowing how to elucidate the mental health and cognitive outcomes of gender-affirming hormone therapy (GAHT) is necessary. This article reviews the present literature covering GAHT effects on mood, behavioral health, and cognition in these individuals and offers research priorities to address knowledge gaps. RECENT FINDINGS: Although there are some conflicting data, GAHT overwhelmingly seems to have positive psychological effects in both adolescents and adults...
October 11, 2018: Current Psychiatry Reports
Scott H Waltman, David Shearer, Bret A Moore
PURPOSE OF REVIEW: Post-traumatic nightmares (PTN) are a common and enduring problem for individuals with post-traumatic stress disorder (PTSD) and other clinical presentations. PTN cause significant distress, are associated with large costs, and are an independent risk factor for suicide. Pharmacological and non-pharmacological treatment options for PTN exist. A previous review in this journal demonstrated that Prazosin, an alpha blocker, was a preferred pharmacological treatment for PTN and imagery rescripting therapy (IRT) was a preferred non-pharmacological treatment...
October 11, 2018: Current Psychiatry Reports
Sarah A Owens, Tory Eisenlohr-Moul
PURPOSE OF REVIEW: Risk for suicidal behavior may fluctuate across the menstrual cycle. Here, we use the RDoC framework to review potential mechanisms by which the cycle may increase acute suicide risk. RECENT FINDINGS: The menstrual cycle impacts the majority of RDoC constructs linked to suicide risk, particularly among hormone-sensitive women, such as those with premenstrual dysphoric disorder or premenstrual exacerbation of a psychiatric disorder. Despite this, there are no published studies examining suicidal ideation, planning, or behavior longitudinally across the cycle...
October 6, 2018: Current Psychiatry Reports
Nakita Natala, Ruth Owusu-Antwi, Gordon Donnir, Kwabena Kusi-Mensah, Heidi Burns, Sarah Mohiuddin, Thomas Fluent, Michelle Riba, Gregory Dalack
PURPOSE OF REVIEW: Improving child and adolescent mental health (CAMH) is a priority worldwide. The majority of children with psychiatric conditions in low-middle-income countries (LMIC), like Ghana, receive no treatment due largely to limited resources and few CAMH training opportunities. The Komfo Anokye Teaching Hospital (KATH) and University of Michigan (UM) established a partnership to expand CAMH training for general psychiatrists in Ghana. Lessons learned from the early stages of the collaboration can serve as an adaptable roadmap for similar efforts to expand CAMH training in LMIC...
September 27, 2018: Current Psychiatry Reports
Jessie N Rice, Carrie B Gillett, Nasuh M Malas
PURPOSE OF REVIEW: Psychotropics are prescribed to youth at rapidly growing rates and may negatively impact bone health. Little awareness exists of this association among prescribing providers. Childhood and adolescence are critical times for bone development. Understanding these effects and their management is important to informed psychotropic use. RECENT FINDINGS: Through a variety of mechanisms, antidepressants, benzodiazepines, mood stabilizers, neuroleptics, and stimulants may all negatively impact pediatric bone health...
September 24, 2018: Current Psychiatry Reports
Amanda E Bennett, Judith S Miller, Natalie Stollon, Raghuram Prasad, Nathan J Blum
PURPOSE OF REVIEW: This article discusses common issues surrounding transition to adulthood in youth with autism spectrum disorder (ASD). We review recent evidence on co-occurring medical and mental health conditions and topics of education and employment, sexuality and relationships, independent living, and financial support. RECENT FINDINGS: Transitioning individuals with ASD have increased risk for several medical and behavioral health comorbidities and should be routinely screened for co-occurring conditions...
September 21, 2018: Current Psychiatry Reports
Susanna Sutherland, Steven M Brunwasser
PURPOSE OF REVIEW: To evaluate the degree to which recent studies provide evidence that the effects of prenatal maternal stress (PNMS) on child health outcomes vary depending on the child's biological sex. In this review, we used a broad definition of stress, including negative life events, psychological stress, and established stress biomarkers. We identified 50 peer-reviewed articles (published January 2015-December 2017) meeting the inclusion criteria. RECENT FINDINGS: Most articles (k = 35) found evidence of either sex-specific associations (significant in one sex but not the other) or significant PNMSx stress interactions for at least one child health outcome...
September 18, 2018: Current Psychiatry Reports
Baillie Frizell, Julie A Dumas
PURPOSE OF REVIEW: Previous literature has shown inconsistent findings regarding the effects of neurosteroids on the brain in postmenopausal women. The goal of this paper is to examine how and whether advances in neuroimaging have helped elucidate the relationship between the withdrawal of and/or treatment with neurosteroids and cognition at menopause. RECENT FINDINGS: Neuroimaging techniques such as structural and functional MRI have been used in recent studies to examine the relationship between neurosteroids and brain structure and functioning...
September 17, 2018: Current Psychiatry Reports
Jaimie L Gradus
PURPOSE OF REVIEW: This review summarizes the increasing public health concern about PTSD and suicide, and the population-based studies that have examined this association. Further, we discuss methodological issues that provide important context for the examination of this association. RECENT FINDINGS: The majority of epidemiologic studies have shown that PTSD is associated with an increased risk of suicide; however, a notable minority of studies have documented a decreased risk of suicide among persons with PTSD...
September 17, 2018: Current Psychiatry Reports
Timothy E Wilens, Benjamin M Isenberg, Tamar A Kaminski, Rachael M Lyons, Javier Quintero
PURPOSE OF REVIEW: Extensive research has been conducted on attention-deficit/hyperactivity disorder (ADHD) in children and adults; however, less is known about ADHD during the transition from childhood to adulthood. Transitional aged youth (TAY) with ADHD represents a particularly vulnerable population as their newfound independence and responsibility often coincides with the development of comorbid disorders. The purpose of this review is to provide an update on the evaluation, diagnosis, and treatment of TAY-ADHD...
September 17, 2018: Current Psychiatry Reports
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