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Dialogues in Clinical Neuroscience

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https://www.readbyqxmd.com/read/29302228/cannabis-cannabinoids-and-health
#1
Genevieve Lafaye, Laurent Karila, Lisa Blecha, Amine Benyamina
Cannabis (also known as marijuana) is the most frequently used illicit psychoactive substance in the world. Though it was long considered to be a "soft" drug, studies have proven the harmful psychiatric and addictive effects associated with its use. A number of elements are responsible for the increased complications of cannabis use, including the increase in the potency of cannabis and an evolution in the ratio between the two primary components, Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (toward a higher proportion of Δ9-THC), Synthetic cannabinoid (SC) use has rapidly progressed over the last few years, primarily among frequent cannabis users, because SCs provide similar psychoactive effects to cannabis...
September 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/29302227/treatment-of-opioid-dependence-with-buprenorphine-current-update
#2
Michael Soyka
Opioid maintenance treatment is the first-line approach in opioid dependence. Both the full opioid agonist methadone (MET) and the partial agonist buprenorphine (BUP) are licensed for the treatment of opioid dependence. BUP differs significantly from MET in its pharmacology, side effects, and safety issues. For example, the risk of respiratory depression is lower than with MET. The risk of diversion and injection of BUP have been reduced by also making it available as a tablet containing the opioid antagonist naloxone...
September 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/29302226/minding-the-brain-the-role-of-pharmacotherapy-in-substance-use-disorder-treatment
#3
Dakwar Elias, Herbert D Kleber
With its medicalization as a brain-based disease, addiction has come to be regarded as amenable to biomedical treatment approaches, most commonly pharmacotherapy. Various vulnerabilities are recognized to contribute to maladaptive substance use, and have been linked to diverse neurobiological alterations that may be targeted with pharmacotherapy: withdrawal, craving and cue reactivity, and aberrant reward processing are the most significant. Here, we summarize current thinking regarding pharmacotherapy for substance-use disorders, grouping medications by the type of vulnerability they propose to address and providing insight into their neurobiological mechanisms...
September 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/29302225/clinical-neuropsychiatric-considerations-regarding-nonsubstance-or-behavioral-addictions
#4
Marc N Potenza
Over the past several decades, non-substance-use behaviors like gambling, gaming, and sex have received greater consideration as possible foci of addictions. In this article, I will review the recent history and current status of non-substance or behavioral addictions. A main focus will involve gambling and gambling disorder, given that the latter is currently the sole non-substance addictive disorder described in the main text of the current (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)...
September 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/29302224/tobacco-use-disorder-and-treatment-new-challenges-and-opportunities
#5
Douglas Ziedonis, Smita Das, Celine Larkin
Tobacco use remains a global problem, and options for consumers have increased with the development and marketing of e-cigarettes and other new nicotine and tobacco products, such as "heat-not-burn" tobacco and dissolvable tobacco. The increased access to these new products is juxtaposed with expanding public health and clinical intervention options, including mobile technologies and social media. The persistent high rate of tobacco-use disorders among those with psychiatric disorders has gathered increased global attention, including successful approaches to individual treatment and organizational-level interventions...
September 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/29302223/the-prescription-opioid-epidemic-a-review-of-qualitative-studies-on-the-progression-from-initial-use-to-abuse
#6
Theodore J Cicero, Matthew S Ellis
Most research designed to answer the "why" of the prescription opioid epidemic has relied on structured interviews, which rigidly attempt to capture the complex reasons people use opioids. In contrast this systematic literature review focuses on peer-reviewed studies that have used a qualitative approach to examine the development of an opioid-use disorder from the point of initial exposure. Rather than simply providing a "high," opioids reportedly relieve psychological/emotional problems or provide an escape from life stressors...
September 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/29302222/animal-models-of-addiction
#7
Rainer Spanagel
In recent years, animal models in psychiatric research have been criticized for their limited translational value to the clinical situation. Failures in clinical trials have thus often been attributed to the lack of predictive power of preclinical animal models. Here, I argue that animal models of voluntary drug intake-under nonoperant and operant conditions-and addiction models based on the Diagnostic and Statistical Manual of Mental Disorders are crucial and informative tools for the identification of pathological mechanisms, target identification, and drug development...
September 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/29302221/genetics-of-addictive-behavior-the-example-of-nicotine-dependence
#8
Philip Gorwood, Yann Le Strat, Nicolas Ramoz
The majority of addictive disorders have a significant heritability-roughly around 50%. Surprisingly, the most convincing association (a nicotinic acetylcholine receptor CHRNA5-A3-B4 gene cluster in nicotine dependence), with a unique attributable risk of 14%, was detected through a genome-wide association study (GWAS) on lung cancer, although lung cancer has a low heritability. We propose some explanations of this finding, potentially helping to understand how a GWAS strategy can be successful. Many endophenotypes were also assessed as potentially modulating the effect of nicotine, indirectly facilitating the development of nicotine dependence...
September 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/29302220/a-brief-review-of-the-genetics-and-pharmacogenetics-of-opioid-use-disorders
#9
Wade Berrettini
Increased physician prescribing of opioids to treat chronic nonprogressive pain has been accompanied by an increase in opioid addiction. Twin studies of opioid addiction are consistent with an inherited component of risk, approximately 50%. Several genome-wide association study (GWAS) reports indicate that genetic risk for opioid addiction is conveyed by many alleles of small effect (odds ratios <1.5). These reports have detected alleles in potassium-ion-channel genes (KCNC1 and KCNG2) and in a glutamate receptor auxiliary protein (CNIH3)...
September 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/29302219/individual-differences-in-the-neuropsychopathology-of-addiction
#10
Olivier George, George F Koob
Drug addiction or substance-use disorder is a chronically relapsing disorder that progresses through binge/intoxication, withdrawal/negative affect and preoccupation/anticipation stages. These stages represent diverse neurobiological mechanisms that are differentially involved in the transition from recreational to compulsive drug use and from positive to negative reinforcement. The progression from recreational to compulsive substance use is associated with downregulation of the brain reward systems and upregulation of the brain stress systems...
September 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/29302218/addictive-behaviors-where-do-we-stand-and-where-are-we-going
#11
Florence Thibaut, Margret Hoehe
Tobacco and alcohol use remain the most prevalent addictive behaviors reported and the leading risk factors for global burden of disease, injury, and death. Considering addiction as a chronically relapsing brain disorder has opened up the way for biomedical treatment approaches.
September 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/28867944/cognitive-behavioral-therapy-for-generalized-anxiety
#12
Lucas Borza
As a form of therapy, cognitive behavioral therapy (CBT) is more than a mere "toolbox." CBT allows us to better understand how the human mind is functioning because it is based on neuroscience and experimental and scientific psychology. At the beginning, the Diagnostic and Statistical Manual of Mental Disorders (DSM) was "nontheoretical," but nowadays (the most recent version being DSM-5), it is increasingly based on CBT paradigms (with the insertion of important notions such as cognitions and behaviors). This Brief Report presents what we currently know about generalized anxiety disorder (GAD) and how we can treat this condition by nonpharmaceutical means...
June 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/28867943/oxytocin-and-social-functioning
#13
Candace Jones, Ingrid Barrera, Shaun Brothers, Robert Ring, Claes Wahlestedt
Social anxiety is a form of anxiety characterized by continuous fear of one or more social or performance situations. Although multiple treatment modalities (cognitive behavioral therapy, selective serotonin reuptake inhibitors/selective norepinephrine reuptake inhibitors, benzodiazepines) exist for social anxiety, they are effective for only 60% to 70% of patients. Thus, researchers have looked for other candidates for social anxiety treatment. Our review focuses on the peptide oxytocin as a potential therapeutic option for individuals with social anxiety...
June 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/28867942/behavioral-methods-to-study-anxiety-in-rodents
#14
Kimberly R Lezak, Galen Missig, William A Carlezon
Stress is a precipitating factor for anxiety-related disorders, which are among the leading forms of psychiatric illness and impairment in the modern world. Rodent-based behavioral tests and models are widely used to understand the mechanisms by which stress triggers anxiety-related behaviors and to identify new treatments for anxiety-related disorders. Although substantial progress has been made and many of the key neural circuits and molecular pathways mediating stress responsiveness have been characterized, these advances have thus far failed to translate into fundamentally new treatments that are safer and more efficacious in humans...
June 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/28867941/affective-neuroimaging-in-generalized-anxiety-disorder-an-integrated-review
#15
Gregory A Fonzo, Amit Etkin
Affective neuroimaging has contributed to our knowledge of generalized anxiety disorder (GAD) through measurement of blood oxygenation level-dependent (BOLD) responses, which facilitate inference on neural responses to emotional stimuli during task-based functional magnetic resonance imaging (fMRI). In this article, the authors provide an integrated review of the task-based affective fMRI literature in GAD. Studies provide evidence for variable presence and directionality of BOLD abnormalities in limbic and prefrontal regions during reactivity to, regulation of, and learning from emotional cues...
June 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/28867940/genetics-of-generalized-anxiety-disorder-and-related-traits
#16
Michael G Gottschalk, Katharina Domschke
This review serves as a systematic guide to the genetics of generalized anxiety disorder (GAD) and further focuses on anxiety-relevant endophenotypes, such as pathological worry fear of uncertainty, and neuroticism. We inspect clinical genetic evidence for the familialityl heritability of GAD and cross-disorder phenotypes based on family and twin studies. Recent advances of linkage studies, genome-wide association studies, and candidate gene studies (eg, 5-HTT, 5-HT1A, MAOA, BDNF) are outlined. Functional and structural neuroimaging and neurophysiological readouts relating to peripheral stress markers and psychophysiology are further integrated, building a multilevel disease framework...
June 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/28867939/biological-markers-of-generalized-anxiety-disorder
#17
Eduard Maron, David Nutt
Generalized anxiety disorder (GAD) is a prevalent and highly disabling mental health condition; however, there is still much to learn with regard to pertinent biomarkers, as well as diagnosis, made more difficult by the marked and common overlap of GAD with affective and anxiety disorders. Recently, intensive research efforts have focused on GAD, applying neuroimaging, genetic, and blood-based approaches toward discovery of pathogenetic and treatment-related biomarkers. In this paper, we review the large amount of available data, and we focus in particular on evidence from neuroimaging, genetic, and neurochemical measurements in GAD in order to better understand potential biomarkers involved in its etiology and treatment...
June 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/28867938/environmental-transmission-of-generalized-anxiety-disorder-from-parents-to-children-worries-experiential-avoidance-and-intolerance-of-uncertainty
#18
Evin Aktar, Milica Nikolić, Susan M Bögels
Generalized anxiety disorder (GAD) runs in families. Building on recent theoretical approaches, this review focuses on potential environmental pathways for parent-to-child transmission of GAD. First, we address child acquisition of a generalized pattern of fearful/anxious and avoidant responding to potential threat from parents via verbal information and via modeling. Next, we address how parenting behaviors may contribute to maintenance of fearful/anxious and avoidant reactions in children. Finally, we consider intergenerational transmission of worries as a way of coping with experiential avoidance of strong negative emotions and with intolerance of uncertainty...
June 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/28867937/epidemiology-of-anxiety-disorders-from-surveys-to-nosology-and-back
#19
Dan J Stein, Kate M Scott, Peter de Jonge, Ronald C Kessler
On the basis of epidemiological survey findings, anxiety disorders are the most prevalent mental disorders around the world and are associated with significant comorbidity and morbidity. Such surveys rely on advances in psychiatric nosology and may also contribute usefully to revisions of the nosology. There are a number of questions at the intersection of psychiatric epidemiology and nosology. This review addresses the following: What is the prevalence of anxiety disorders and how do we best explain cross-national differences in prevalence estimates? What are the optimal diagnostic criteria for anxiety disorders, and how can epidemiological data shed light on this question? What are the comorbidities of anxiety disorders, and how do we best understand the high comorbidities seen in these conditions? What is the current treatment gap for anxiety disorders, and what are the implications of current understandings of psychiatric epidemiology and nosology for policy-making relevant to anxiety disorders? Here, we emphasize that anxiety disorders are the most prevalent of the psychiatric conditions, and that rather than merely contrasting cross-national prevalence in anxiety disorders, it is more productive to delineate cross-national themes that emerge about the epidemiology of these conditions...
June 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/28867936/cultural-aspects-of-anxiety-disorders-in-india
#20
Maherra Khambaty, Rajesh M Parikh
Cultural factors have influenced the presentation, diagnoses, and treatment of anxiety disorders in India for several centuries. This review covers the antecedents, prevalence, phenomenology, and treatment modalities of anxiety disorders in the Indian cultural context. It covers the history of the depiction of anxiety in India and the concept of culture in the classification of anxiety disorders, and examines the cultural factors influencing anxiety disorders in India. We review the prevalence and phenomenology of various disorders, such as generalized anxiety disorder, panic disorder, social anxiety, and phobic disorder, as well as culture-specific syndromes such as dhat and koro in India...
June 2017: Dialogues in Clinical Neuroscience
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