Current controversies in Psychiatry

BACKGROUND: Uric acid is known for its antioxidant capacity; however, whether uric acid is independently associated with depression in the older population remains controversial. The current study aimed to investigate the association between uric acid and depressive symptoms in older adults according to sex, using a large national sample population. METHODS: Data from the 2016, 2018, and 2020 Korean National Health and Nutrition Examination Surveys were analyzed, and 5609 participants older than 60 years were included in this study...

Functional Disorders are common medical problems both in primary and in secondary health care. The mechanisms that cause symptoms such as primary pain, fatigue, dizziness are still unknown. Various classifications, including ICD-10 or DSM-5, describe these conditions differently, and new proposals are being developed e.g. in ICD-11, RDoC. Many controversies are evoked by lack of unequivocal explanatory theory. The early psychoanalytical concept has been modified by other explanations, such as immunological abnormalities, dysfunction of vegetative system and HPA axis, central sensitization, diverted processes of perception or predictive processes within cognitive homeostasis dysregulation...

Involuntary civil commitment for individuals who are chronically impaired as a result of their substance use remains highly controversial. At present, 37 states have legalized this practice. Increasingly, states are allowing private third-parties, such as friends or relatives of the patient, to petition courts for involuntary treatment. One such approach, modeled on Florida's Marchman Act, does not determine status based on the petitioning party's willingness to commit to pay for care. In contrast, Kentucky's approach, widely known as "Casey's Law," predicates such involuntary commitment on the third party's willingness to commit in advance to pay for the patient's treatment...

There are controversies between the practice of psychiatry, current international standards and mental disorders or conditions with disabilities, framed in social care models. The objective of this work is to provide evidence and analyze the main gaps in mental health such as: the invisibility of some people with disabilities for the design of policies, legislation, or public programs; the predominance of the medical model, in which the substitution of decision-making in informed consent prevails, which violates the rights of legal personality, equality, freedom, security and respect for personal integrity, among others...

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AIMS: Evidence for case-control studies suggests that cannabis use is a risk factor for the development of psychosis. However, there have been limited prospective studies and the direction of this association remains controversial. The primary aim of the present study was to examine the association between cannabis use and the incidence of psychotic disorders in people at clinical high risk of psychosis. Secondary aims were to assess associations between cannabis use and the persistence of psychotic symptoms, and with functional outcome...

We are in a competitive, burgeoning market for journals and currently in a transition to open access publications, with the aim of making research more widely accessible. Where is the place for practice-based journals in this new and evolving world of publishing? The recent growth of CAMH in terms of Impact Factor, downloads and submissions suggests there is a need for such journals. Professionals are swamped with research findings, often contradictory, sometimes inflammatory, with little time to explore the meaning of these findings within the real world...

The optimal management of cavernous malformations (CMs) remains controversial. Over the past decade, stereotactic radiosurgery (SRS) has gained wider acceptance in the management of CMs, especially in those with deep location, eloquence, and where surgery is of high risk. Unlike arteriovenous malformations (AVMs), there is no imaging surrogate endpoint to confirm CM obliteration. Clinical response to SRS can only be gauged by a reduction in long-term CM hemorrhage rates. There is concern that the long-term benefits of SRS and the reduced rehemorrhage rate after a latency period of 2 years may only be a reflection of natural history...

In the mammalian brain information processing and storage rely on the complex coding and decoding events performed by neuronal networks. These actions are based on the computational ability of neurons and their functional engagement in neuronal assemblies where precise timing of action potential firing is crucial. Neuronal circuits manage a myriad of spatially and temporally overlapping inputs to compute specific outputs that are proposed to underly memory traces formation, sensory perception, and cognitive behaviors...

There is considerable interest in exploring effects of coronavirus disease 2019 (COVID-19) pandemic on mental health. Suicide is one of the leading causes of mortality worldwide and changes in daily life brought by the pandemic may be additional risk factors in people with pre-existing mental disorders. This rapid PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) scoping review aims to identify and analyze current evidence about the relation between COVID-19 pandemic outbreak, along with COVID-19 disease and severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection, and suicide in individuals with previously diagnosed mental disorders...

Noninvasive brain stimulation and neuroimaging have revolutionized human neuroscience with a multitude of applications, including diagnostic subtyping, treatment optimization, and relapse prediction. It is therefore particularly relevant to identify robust and clinically valuable brain biomarkers linking symptoms to their underlying neural mechanisms. Brain biomarkers must be reproducible (i.e., have internal reliability) across similar experiments within a laboratory and be generalizable (i.e., have external reliability) across experimental setups, laboratories, brain regions, and disease states...

Inositol is a natural sugar-like compound, commonly present in many plants and foods. It is involved in several biochemical pathways, most of them controlling vital cellular mechanisms, such as cell development, signaling and nuclear processes, metabolic and endocrine modulation, cell growth, signal transduction, etc. In this narrative review, we focused on the role of inositol in human brain physiology and pathology, with the aim of providing an update on both potential applications and current limits in its use in psychiatric disorders...

INTRODUCTION: Numerous studies have found an association between autoimmune diseases of the nervous system (ADNS) and schizophrenia (SCZ), but the findings remain controversial. We conducted the first meta-analysis to summarize the current evidence from cohort studies that evaluated the association between ADNS and SCZ. METHODS: PubMed, Web of Science, and Embase were comprehensively searched until May 30, 2022 for articles on the association between ADNS and SCZ...

PURPOSE OF REVIEW: To review the literature pertaining to the assessment and treatment of avoidant/restrictive food intake disorder (ARFID) ten years following its introduction to DSM-5. RECENT FINDINGS: Several structured clinical interviews for assessing ARFID have been developed, each with its own strengths and limitations. There is no clear leading self-report measure for tracking treatment progress and outcome in ARFID. Medical assessment is comprised of examining anthropometrics, vitamin deficiencies, and other comorbidities...

BACKGROUND: Article 115 of the Swiss Penal Code (StGB) permits physician-assisted dying (PAD), provided it is not performed for "selfish reasons," and thus, occupies a special role in international comparison. However, the Swiss federal law does not regulate who exactly is entitled to access PAD, and there is no universal agreement in the concerned professional societies. Additional uncertainty arises when assessing the wish for PAD of a mentally ill person compared to a somatically ill person...

Background: Carotid endarterectomy (CEA) has been the standard therapy for carotid artery stenosis (CAS). Modified eversion carotid endarterectomy (mECEA) was recently introduced to treat CAS. However, the short-term safety and long-term efficacy of mECEA are still controversial among studies. This systematic review aims to summarize the current literatures about safety and efficacy of mECEA in treating CAS. Methods: A systematic review of mECEA was conducted in the main bibliographic databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement...

Breastfeeding is the best way of feeding infants. It is recommended by national, European and worldwide scientific associations. The advantages of breastfeeding for both the child and the mother have been proven by research. It is widely known that most Polish women start to breastfeed immediately after delivery, however, with each month, the percentage of infants given breast milk exclusively is decreasing. One of the frequent causes of breastfeeding cessation reported by women is the necessity of pharmacotherapy...

In recent decades, there has been a steady increase in the number of people, including adolescents, undergoing medical body modification (MBM) to alter their physically healthy bodies in invasive and nearly irreversible ways through medical treatment (e.g. surgery). While MBM is often recommended for youth with persisting gender dysphoria (GD), in body dysmorphic disorder (BDD) it has been considered contraindicated. Here, we outline the current controversies surrounding MBM practice and recommendations in adolescents with GD versus those with BDD in order to better understand under what circumstances we may or may not support adolescents who want to change their bodies medically and often irreversibly...

Introduction: Sleep has different patterns followed worldwide and can be influenced by social, cultural, and environmental factors. Daytime napping is commonly practiced in different parts of the world with controversial results of its effect on glucose metabolism. The current study aims to examine the association of afternoon napping and night sleep duration with metabolic derangements. Methods: This is a cross-sectional study involving young adults and middle-aged subjects...

Dissociative Identity Disorders (DIDs) are controversial psychiatric conditions encountered in clinical practice and nosology. DID as described in the international classifications has little similarity with the clinical picture of "DID" met in current youth psychiatry. From this Perspective, we hypothesize that this current clinical presentation does not satisfy the categorical criteria of the international classifications. Based on the two terminological challenges related to the definition of DID (i.e., the notion of dissociative disorders and the different meanings of the term identity ), we propose to differentiate two distinct entities from each other...