-
Generative artificial intelligence in mental health care: potential benefits and current challenges World Psychiatry (IF 73.3) Pub Date : 2024-01-12 John Torous, Charlotte Blease
The potential of artificial intelligence (AI) in health care is being intensively discussed, given the easy accessibility of programs such as ChatGPT. While it is usually acknowledged that this technology will never replace clinicians, we should be aware of imminent changes around AI supporting: a) routine office work such as billing, b) clinical documentation, c) medical education, and d) routine
-
The public mental health revolution must privilege lived experience voices and create alliances with affected communities World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Helen L. Fisher
The paper by Kirkbride et al in this issue of the journal1 presents a masterful and comprehensive overview of the existing evidence demonstrating associations between an array of adverse social experiences and circumstances and the development and persistence of mental ill-health. It proceeds by providing a rallying cry for a revolution to topple the dominant focus of psychiatrists and resource-allocation
-
Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Falk Leichsenring, Peter Fonagy, Nikolas Heim, Otto F. Kernberg, Frank Leweke, Patrick Luyten, Simone Salzer, Carsten Spitzer, Christiane Steinert
Borderline personality disorder (BPD) was introduced in the DSM-III in 1980. From the DSM-III to the DSM-5, no major changes have occurred in its defining criteria. The disorder is characterized by instability of self-image, interpersonal relationships and affects. Further symptoms include impulsivity, intense anger, feelings of emptiness, strong abandonment fears, suicidal or self-mutilation behavior
-
Functional magnetic resonance imaging in schizophrenia: current evidence, methodological advances, limitations and future directions World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Aristotle N. Voineskos, Colin Hawco, Nicholas H. Neufeld, Jessica A. Turner, Stephanie H. Ameis, Alan Anticevic, Robert W. Buchanan, Kristin Cadenhead, Paola Dazzan, Erin W. Dickie, Julia Gallucci, Adrienne C. Lahti, Anil K. Malhotra, Dost Öngür, Todd Lencz, Deepak K. Sarpal, Lindsay D. Oliver
Functional neuroimaging emerged with great promise and has provided fundamental insights into the neurobiology of schizophrenia. However, it has faced challenges and criticisms, most notably a lack of clinical translation. This paper provides a comprehensive review and critical summary of the literature on functional neuroimaging, in particular functional magnetic resonance imaging (fMRI), in schizophrenia
-
The need for a consensual definition of mental health World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Silvana Galderisi
The first conceptualization of mental health can be traced back to 1948, when J.C. Flugel, Chairman of the First International Congress of Mental Health, proposed to define it as “a condition which permits the optimal development, physical, intellectual and emotional, of the individual, so far as this is compatible with that of other individuals”. In 1950, at the second session of the Expert Committee
-
Functional neurological disorder: defying dualism World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Jon Stone, Ingrid Hoeritzauer, Laura McWhirter, Alan Carson
Functional neurological disorder (FND) is classified in the DSM-5-TR as “functional neurological symptom disorder (conversion disorder)” and in the chapter on mental disorders of the ICD-11 as “dissociative neurological symptom disorder”. Neurologists, who most commonly make the initial diagnosis, are usually barely aware of such classification systems, and use a variety of terms – such as “functional”
-
Euthanasia for unbearable suffering caused by a psychiatric disorder: improving the regulatory framework World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Marc De Hert, Kristof Van Assche
Medical assistance in dying (MAID) – defined as voluntary euthanasia and/or physician-assisted suicide – for people with a terminal illness is becoming available in more jurisdictions around the world. By contrast, MAID in people with a non-terminal illness and, more specifically, in people with a psychiatric disorder remains a controversial topic. Belgium is one of the very few countries where euthanasia
-
Physician-assisted death for psychiatric disorders: ongoing reasons for concern World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Paul S. Appelbaum
Physician-assisted death (PAD) – i.e., the prescription and administration of lethal medications by physicians – is increasingly available as an option for people struggling with psychiatric disorders. Although PAD was initially promoted as a means of easing suffering for people with terminal conditions, a growing number of jurisdictions have extended access to all causes of intractable and severe
-
The social determinants of mental health and disorder: evidence, prevention and recommendations World Psychiatry (IF 73.3) Pub Date : 2024-01-12 James B. Kirkbride, Deidre M. Anglin, Ian Colman, Jennifer Dykxhoorn, Peter B. Jones, Praveetha Patalay, Alexandra Pitman, Emma Soneson, Thomas Steare, Talen Wright, Siân Lowri Griffiths
People exposed to more unfavourable social circumstances are more vulnerable to poor mental health over their life course, in ways that are often determined by structural factors which generate and perpetuate intergenerational cycles of disadvantage and poor health. Addressing these challenges is an imperative matter of social justice. In this paper we provide a roadmap to address the social determinants
-
Addressing social determinants of mental health: a new era for prevention interventions World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Crick Lund
Kirkbride et al1 provide a comprehensive overview of the social determinants of mental health. Their paper reviews the evidence for the causal influence of those determinants on population mental health and demonstrates the potential for prevention interventions that address those determinants across the life course. They argue convincingly that we stand at the threshold of a new era in prevention
-
Challenges in implementing interventions to address the social determinants of mental health World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Ronald C. Kessler
It is easy to agree with Kirkbride et al1 that a causal link exists between social factors and later mental health. Indeed, when the term “social factors” is defined as broadly as it is in their paper to include biological exposures due to the physical environment, we know from population genetics that social factors (i.e., the environment) are the most important causes (i.e., heritability is less
-
Revitalizing the role of social determinants in mental health World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Jai L. Shah
Amidst long arcs of the pendulum between attention to psychosocial and neurobiological factors in mental health, substantive progress now depends on these two approaches being seen as complementary and synergistic rather than contradictory. From this launchpad, Kirkbride et al's paper1 is an impressive, high-level and up-to-date overview regarding the role of social determinants in mental health and
-
The need to bring community, policy makers and researchers to the table in prevention programs World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Margarita Alegria
Kirkbride et al's outstanding paper1 updates recommendations from the perspective of social determinants of health to mitigate the onset of mental disorders and lay out a roadmap for an effective prevention plan. They explain that the maldistribution of essential social determinants is not random, is shaped by policy and by those in power, and could reproduce intergenerational inequities in people's
-
Advancing quantitative evaluation of social determinants of mental health and intervention effects: the need for community risk assessments World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Katherine M. Keyes
Kirkbride et al1 provide a comprehensive, rigorous and thoughtful overview of the literature on social determinants of mental health, focusing on evidence for both causal effects of determinants and effectiveness of interventions. They also put forward a series of recommendations, focusing on how to prioritize prevention and intervention that attends to social justice and poverty alleviation with more
-
The changing nature of work in the 21st century as a social determinant of mental health World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Ichiro Kawachi
An extensive literature has documented the association of psychosocial work stressors – e.g., job strain, effort-reward imbalance, organizational injustice, long working hours, job insecurity, shift work, workplace harassment and bullying – with mental health problems1-4. However, the implications for population mental health of the changing nature of work in the 21st century have not been sufficiently
-
Some priorities in targeting social determinants to achieve prevention of mental disorders World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Brian O'Donoghue
Kirkbride et al1 provide convincing evidence of a causal relationship between social determinants and poorer mental health outcomes. The extent, complexity and prevalence of these determinants could lead to hopelessness at the prospect of addressing the inequalities and inequities involved. However, the authors instil hope and optimism by providing examples of interventions delivered at the family
-
Deconstructing the social determinants of mental health World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Oye Gureje
Social factors have an important impact on the onset of and recovery from mental illness1. Where individuals live, how they live and what factors impinge on their living, including their access to nutrition, to housing, to recreation, as well as their pattern of interactions with other people around them, have consequences and relevance for their emotions and behaviours. The fact that humans are social
-
Effectiveness and cost-effectiveness of online recorded recovery narratives in improving quality of life for people with non-psychotic mental health problems: a pragmatic randomized controlled trial World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Mike Slade, Stefan Rennick-Egglestone, Rachel A. Elliott, Chris Newby, Clare Robinson, Sean P. Gavan, Luke Paterson, Yasmin Ali, Caroline Yeo, Tony Glover, Kristian Pollock, Felicity Callard, Stefan Priebe, Graham Thornicroft, Julie Repper, Jeroen Keppens, Melanie Smuk, Donna Franklin, Rianna Walcott, Julian Harrison, Roger Smith, Dan Robotham, Simon Bradstreet, Steve Gillard, Pim Cuijpers, Marianne
Narratives describing first-hand experiences of recovery from mental health problems are widely available. Emerging evidence suggests that engaging with mental health recovery narratives can benefit people experiencing mental health problems, but no randomized controlled trial has been conducted as yet. We developed the Narrative Experiences Online (NEON) Intervention, a web application providing self-guided
-
The definition of treatment resistance in anxiety disorders: a Delphi method-based consensus guideline World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Katharina Domschke, Patrik D. Seuling, Miriam A. Schiele, Borwin Bandelow, Neeltje M. Batelaan, Wicher A. Bokma, Igor Branchi, Karl Broich, Julius Burkauskas, Simon J.C. Davies, Bernardo Dell'Osso, Harry Fagan, Naomi A. Fineberg, Toshi A. Furukawa, Stefan G. Hofmann, Sean Hood, Nathan T.M. Huneke, Milan Latas, Nicky Lidbetter, Vasilios Masdrakis, R. Hamish McAllister-Williams, Antonio E. Nardi, Stefano
Anxiety disorders are very prevalent and often persistent mental disorders, with a considerable rate of treatment resistance which requires regulatory clinical trials of innovative therapeutic interventions. However, an explicit definition of treatment-resistant anxiety disorders (TR-AD) informing such trials is currently lacking. We used a Delphi method-based consensus approach to provide internationally
-
Outcomes in people with eating disorders: a transdiagnostic and disorder-specific systematic review, meta-analysis and multivariable meta-regression analysis World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Marco Solmi, Francesco Monaco, Mikkel Højlund, Alessio M. Monteleone, Mike Trott, Joseph Firth, Marco Carfagno, Melissa Eaton, Marco De Toffol, Mariantonietta Vergine, Paolo Meneguzzo, Enrico Collantoni, Davide Gallicchio, Brendon Stubbs, Anna Girardi, Paolo Busetto, Angela Favaro, Andre F. Carvalho, Hans-Christoph Steinhausen, Christoph U. Correll
Eating disorders (EDs) are known to be associated with high mortality and often chronic and severe course, but a recent comprehensive systematic review of their outcomes is currently missing. In the present systematic review and meta-analysis, we examined cohort studies and clinical trials published between 1980 and 2021 that reported, for DSM/ICD-defined EDs, overall ED outcomes (i.e., recovery, improvement
-
Current evidence on the efficacy of mental health smartphone apps for symptoms of depression and anxiety. A meta-analysis of 176 randomized controlled trials World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Jake Linardon, John Torous, Joseph Firth, Pim Cuijpers, Mariel Messer, Matthew Fuller-Tyszkiewicz
The mental health care available for depression and anxiety has recently undergone a major technological revolution, with growing interest towards the potential of smartphone apps as a scalable tool to treat these conditions. Since the last comprehensive meta-analysis in 2019 established positive yet variable effects of apps on depressive and anxiety symptoms, more than 100 new randomized controlled
-
Sleep and circadian rhythm disturbances: plausible pathways to major mental disorders? World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Ian B. Hickie, Jacob J. Crouse
The Mental Health Priority Area of the Wellcome Trust recently posited that sleep and circadian rhythm disturbances (SCRDs) are a plausible nexus for linking aspects of the biology, phenomenology, course and treatment of major mood, anxiety and psychotic disorders1. This emphasis fits well with the currently spreading trend to develop more effective and scalable forms of indicated prevention, early
-
Sex differences need to be considered when treating women with psychotropic drugs World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Iris E. Sommer, Bodyl A. Brand, Clementine C.M. Stuijt, Daan J. Touw
In a period in which they keep on struggling for equal chances in several fields, women still need to strive for a medical treatment which takes sex differences into account. Medical practice has long been implicitly led by the notion that only reproductive organs differ between the sexes. Yet, significant sex differences have been clearly documented in blood, immune system, liver, kidneys, stomach
-
The need to focus on perfectionism in suicide assessment, treatment and prevention World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Gordon L. Flett, Paul L. Hewitt
Perfectionists are people who not only want to be perfect; they also need to seem perfect. Several decades of global research on perfectionism have identified a host of worrisome realities. First, meta-analytic evidence indicates that perfectionism is on the rise among young people1. Second, perfectionism is associated with mental health problems, but also with physical health issues and early mortality2
-
Can a practical process-oriented strategy prevent suicidal ideation and behavior? World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Steven C. Hayes, Jacqueline Pistorello
For several decades, research-based efforts have sought broadly applicable suicide prevention methods. A recent umbrella review of meta-analyses or systematic reviews of primary prevention found some limited evidence for multicomponent programs tailored for specific populations, and the possible value of restricting access to lethal means such as guns or pesticides, but concluded that there is “insufficient
-
Cumulative remission rate after sequential treatments in depression: reappraisal of the STAR*D trial data World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Hitoshi Sakurai, Hisashi Noma, Koichiro Watanabe, Hiroyuki Uchida, Toshi A. Furukawa
The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) was a seminal clinical trial of 4,041 outpatients with major depressive disorder (MDD), examining the effectiveness of sequential treatment steps1. One of the key findings of the study was that the theoretical cumulative remission rate up to four treatment steps was 67% among those who initiated antidepressant treatment1. Although
-
How should psychotherapy proceed when adjoined with psychedelics? World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Marc J. Weintraub, David J. Miklowitz
Over the past few years, research and public interest in psychedelic agents – such as psilocybin and 3,4-methylenedioxymethamphetamine (MDMA) – for mental health purposes has skyrocketed. The therapeutic approach to the use of these agents involves three components: preparation, drug administration, and integration. This bundled treatment has been termed psychedelic-assisted therapy (PAT). The basic
-
Violence in schizophrenia: triangulating the evidence on perpetration risk World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Daniel Whiting, Gautam Gulati, John R. Geddes, Kimberlie Dean, Seena Fazel
The question of the nature and magnitude of the association between schizophrenia and risk of violence perpetration has been the subject of considerable research and wider public interest. It is a complex relationship, and important to clarify for people with mental illness and their families, with implications for health policy, mental health law, criminal justice, and public mental health. It therefore
-
Management of generalized anxiety disorder and panic disorder in general health care settings: new WHO recommendations World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Brandon Gray, Biksegn Asrat, Elaine Brohan, Neerja Chowdhury, Tarun Dua, Mark van Ommeren
Mental, neurological and substance use (MNS) disorders are highly prevalent and account for a significant burden of disease1. However, in many countries, there is a gap between the need for MNS services and the available health system capacity and resources. The World Health Organization (WHO)'s mhGAP Action Programme was launched to address this gap by developing recommendations for the identification
-
Genetics for mental health clinicians: a call for a globally accessible and equitable psychiatric genetics education World Psychiatry (IF 73.3) Pub Date : 2024-01-12
The field of psychiatric genetics has evolved rapidly over the past decades, leading to major advancements in our understanding of the genetic architecture of mental disorders. Dozens of genes have been definitively linked to neurodevelopmental disorders (NDDs), and hundreds of genetic loci have been significantly associated with psychiatric diseases and/or traits (e.g., schizophrenia, neuroticism)
-
The dynamic paradigm of illness in psychopathology World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Giovanni Stanghellini
Medical thought oscillates between two representations of illness. According to the first, illness enters or leaves the organism as through a door, by either adding something that should not be there, or removing something that should be there. Infection is the paradigm of illness as a pathogenic addition; haemorrhage is the paradigm of illness as a pathogenic removal of something which is needed.
-
The WPA Action Plan 2023-2026 World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Danuta Wasserman
Building on the Association's foundational activities, the WPA Action Plan 2023-2026 aspires to enhance the mental and physical well-being of psychiatric patients, psychiatric staff, and the broader public. The staggering statistic that one in every eight individuals globally grapples with a mental disorder1 warrants continuous improvement in preventing and treating these disorders. Alarmingly, despite
-
One world, one profession: psychiatry World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Saul Levin
I am honored to assume the role of WPA Secretary General and excited to work even more closely alongside colleagues and friends whom I have come to know in my role as Chief Executive Officer (CEO) and Medical Director of the American Psychiatric Association (APA) over the last decade. I am retiring from the APA in May 2024, but my passion and dedication to the work we do in support of our patients
-
Action Plan of the WPA Secretary for Scientific Meetings (2023-2026) World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Edmond H. Pi
It seems now an appropriate time to reflect upon all what the WPA has achieved regarding scientific meetings during the triennium 2020-2023. From the very beginning of that triennium, the COVID-19 pandemic has disrupted the organization of medical conferences across the entire world. However, the WPA has strived together and advanced in terms of holding high-quality scientific meetings1, 2. Since 2021
-
WPA Section on Perinatal Psychiatry and Infant Mental Health: a report on recent activities World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Miri Keren, Gisele Apter
The field of perinatal psychiatry and infant mental health bridges adult, parent, infant and child psychiatry, and includes the growing area of developmental psychopathology1, 2. Human infants are born with potentialities already visible at birth and during the peripartum, when a complex emotional communication takes place with their caregivers. Expanding epigenetic and nurture-nature interaction studies
-
Designing and delivering mental health literacy strategies in elite sport World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Paul Gorczynski, David Baron
At the 2005 World Congress of Psychiatry in Cairo, the WPA Executive Committee approved the establishment of a new Scientific Section dedicated to Exercise and Sport. This was the first truly global organized sports psychiatry organization, which was followed by the development of the International Society for Sports Psychiatry. In the subsequent twenty years, the attention to physical exercise as
-
WPA Volunteering Programme: lessons learnt so far World Psychiatry (IF 73.3) Pub Date : 2024-01-12 Egor Chumakov, Sophia Thomson, John Allan, Marc H.M. Hermans, Jacques van Hoof, Peter Hughes, Bernardo Ng, Martha Savage, Roger M.K. Ng
Capacity building has been one of the priorities of the WPA Action Plan 2020-20231-3. In order for the Association's efforts to be more effective, Working Groups started formulating plans, and pilot projects were established4-11. The WPA Working Group on Volunteering was organized to share and enhance clinical knowledge and skills for improved patient care12-14. This Working Group is made up of psychiatrists
-
Understanding depression beyond the “mind-body” dichotomy World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Mario Maj
In both the ICD-11 and the DSM-5, the core symptoms of depression are reported to be depressed mood (e.g., feeling sad, down or hopeless) and markedly diminished interest or pleasure in activities. However, in the ICD-10 diagnostic guidelines, a third core symptom was also identified: “fatigue or low energy”. In two regions of the world (Latin America and East Asia), “fatigue” is the most commonly
-
The challenges of defining and managing treatment-resistant depression in research and practice World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Maurizio Fava
McIntyre et al1, in their excellent paper appearing in this issue of the journal, successfully tackle a critical issue in the field of depression: how should we define treatment-resistant depression (TRD) and how can we best manage it? They point out that a consensus definition of TRD with demonstrated predictive utility in terms of clinical decision-making and health outcomes does not currently exist
-
The lived experience of depression: a bottom-up review co-written by experts by experience and academics World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Paolo Fusar-Poli, Andrés Estradé, Giovanni Stanghellini, Cecilia Maria Esposito, René Rosfort, Milena Mancini, Peter Norman, Julieann Cullen, Miracle Adesina, Gema Benavides Jimenez, Caroline da Cunha Lewin, Esenam A. Drah, Marc Julien, Muskan Lamba, Edwin M. Mutura, Benny Prawira, Agus Sugianto, Jaleta Teressa, Lawrence A. White, Stefano Damiani, Candida Vasconcelos, Ilaria Bonoldi, Pierluigi Politi
We provide here the first bottom-up review of the lived experience of depression, co-written by experts by experience and academics. First-person accounts within and outside the medical field were screened and discussed in collaborative workshops involving numerous individuals with lived experience of depression, family members and carers, representing a global network of organizations. The material
-
Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Michael Berk, Ole Köhler-Forsberg, Megan Turner, Brenda W.J.H. Penninx, Anna Wrobel, Joseph Firth, Amy Loughman, Nicola J. Reavley, John J. McGrath, Natalie C. Momen, Oleguer Plana-Ripoll, Adrienne O'Neil, Dan Siskind, Lana J. Williams, Andre F. Carvalho, Lianne Schmaal, Adam J. Walker, Olivia Dean, Ken Walder, Lesley Berk, Seetal Dodd, Alison R. Yung, Wolfgang Marx
Populations with common physical diseases – such as cardiovascular diseases, cancer and neurodegenerative disorders – experience substantially higher rates of major depressive disorder (MDD) than the general population. On the other hand, people living with MDD have a greater risk for many physical diseases. This high level of comorbidity is associated with worse outcomes, reduced adherence to treatment
-
Community care for people with mental illness: challenges emerging in the 2020s and consequent recommendations World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Norman Sartorius
The later years of the 20th and the beginning of the 21st century – coinciding with deinstitutionalization and shift to managing mental health problems outside of hospitals – have been characterized by several socioeconomic trends which are of major importance for the strategies of community mental health care1, 2. The rampant urbanization is one of these trends. All the predictions are in agreement
-
Family psychoeducation in the early stages of mood and psychotic disorders World Psychiatry (IF 73.3) Pub Date : 2023-09-15 David J. Miklowitz
When combined with pharmacotherapy, family psychoeducation and skills training are key strategies for preventing, delaying or minimizing the severity of illness episodes in major psychiatric disorders1-3. High levels of expressed emotion – as indicated by critical comments, hostility and/or emotional overinvolvement from caregivers – are associated with high rates of recurrence in patients with schizophrenia
-
Putting psychological interventions first in primary health care World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Mark van Ommeren, Sian Lewis, Edith van't Hof, Kenneth Carswell
Task-sharing – in which specialists train, supervise and support non-specialist health care providers – is proven to be acceptable, feasible and effective in scaling up mental health care for depressive and anxiety disorders1. In this perspective, we focus on reasons for and barriers to task-sharing of psychological interventions in primary health care. We also cover what the World Health Organization
-
Challenges in improving mental health literacy at population level World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Claire Henderson
The expression “mental health literacy” was introduced in 1997 by Jorm et al1, referring to “knowledge and beliefs about mental disorders which aid their recognition, management or prevention”. Compared to contemporaneous programmes aiming to reduce stigma and discrimination related to mental illness, this construct reflected a broader and positively framed public mental health goal. However, the concept
-
Treatment-resistant depression: definition, prevalence, detection, management, and investigational interventions World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Roger S. McIntyre, Mohammad Alsuwaidan, Bernhard T. Baune, Michael Berk, Koen Demyttenaere, Joseph F. Goldberg, Philip Gorwood, Roger Ho, Siegfried Kasper, Sidney H. Kennedy, Josefina Ly-Uson, Rodrigo B. Mansur, R. Hamish McAllister-Williams, James W. Murrough, Charles B. Nemeroff, Andrew A. Nierenberg, Joshua D. Rosenblat, Gerard Sanacora, Alan F. Schatzberg, Richard Shelton, Stephen M. Stahl, Madhukar
Treatment-resistant depression (TRD) is common and associated with multiple serious public health implications. A consensus definition of TRD with demonstrated predictive utility in terms of clinical decision-making and health outcomes does not currently exist. Instead, a plethora of definitions have been proposed, which vary significantly in their conceptual framework. The absence of a consensus definition
-
Recent developments pertaining to treatment-resistant depression: a 40-year perspective World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Michael E. Thase
With the increasing recognition that major depressive disorder (MDD) is one of the world greatest public health problems1, 2, there have recently been concerted efforts to ensure that people suffering from this condition are promptly recognized, accurately diagnosed, and vigorously treated. Indeed, a relatively wide range of proven treatments are now available to help depressed people, and health care
-
Treatment-resistant depression invites persistent reflection World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Gordon Parker
As admirably detailed by McIntyre et al1, most definitions of treatment-resistant depression (TRD) weight failure to respond to a set of antidepressant medications and other physical treatment options. Is this the optimal paradigm when major depressive episodes may be caused not only by biological factors, but also by social and psychological ones? Wouldn't we expect, for example, that a woman depressed
-
Challenges of research on treatment-resistant depression: a clinician's perspective World Psychiatry (IF 73.3) Pub Date : 2023-09-15 A. John Rush
I think we should be grateful to McIntyre et al1 for their extraordinarily thorough and balanced review of treatment-resistant depression (TRD). They note that this condition poses a plethora of clinical research challenges. Here I offer a few suggestions that might make research more cost-efficient and clinically generalizable. First, we should develop tools to systematically identify treatable causes
-
Does treatment-resistant depression need psychotherapy? World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Myrna M. Weissman
Congratulations are well deserved for this review by 27 psychiatric leaders, representing 14 countries, including 294 references1. This highly researched, well-written paper describes the characteristics of treatment-resistant depression (TRD), including prevalence, risks, clinical features, costs, public health burden, management and treatments. Despite the wealth of information provided, lingering
-
From treatment resistance to sequential treatments of depression World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Pim Cuijpers
McIntyre et al1 provide an excellent overview of “treatment-resistant depression” (TRD) and of the ways future research can contribute to a better knowledge on how to handle the many patients with depression who do not respond to treatment. However, I argue here that the notion of TRD is based on a misconception of the effects of treatments in depression, and that it is much better to focus research
-
Complexities of treatment-resistant depression: cautionary notes and promising avenues World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Toshi A. Furukawa
Depressive episodes can be of mild intensity and transient, but – especially in tertiary care settings – they are often chronic and/or relapsing. As clinicians we often see people towards the latter end of this spectrum, including “treatment-resistant depression” (TRD), and spend much of our efforts in treating them. McIntyre et al1 competently and comprehensively review the TRD definition, prevalence
-
The psychedelic experience and treatment-resistant depression World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Guy M. Goodwin
Interest in the use of serotonergic agonists such as psilocybin in treatment-resistant depression (TRD) has grown more quickly than the evidence on which to base a final opinion, as emphasized by McIntyre et al1 in their review. Psilocybin, once metabolized to psilocin, activates 5-HT2A receptors, enhancing GABA function in local circuits in the cortex and increasing connectivity between functional
-
Treatment-resistant depression: where to find hope? World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Daniel Souery
McIntyre et al's paper1 is not just another literature review on the topic of treatment-resistant depression (TRD). It puts everyone in agreement and offers a concrete basis for a constructive reflection on the subject. More than that, it invites us to approach TRD in all its facets, the most complex but also those still unsuspected. Since the 1970s, the scientific literature on TRD has abounded with
-
20-year trajectories of positive and negative symptoms after the first psychotic episode in patients with schizophrenia spectrum disorder: results from the OPUS study World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Marie Starzer, Helene Gjervig Hansen, Carsten Hjorthøj, Nikolai Albert, Merete Nordentoft, Trine Madsen
This study aimed to identify the 20-year trajectories of positive and negative symptoms after the first psychotic episode in a sample of patients with an ICD-10 diagnosis of schizophrenia spectrum disorder, and to investigate the baseline characteristics and long-term outcomes associated with these trajectories. A total of 373 participants in the OPUS trial were included in the study. Symptoms were
-
Transdiagnostic risk of mental disorders in offspring of affected parents: a meta-analysis of family high-risk and registry studies World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Rudolf Uher, Barbara Pavlova, Joaquim Radua, Umberto Provenzani, Sara Najafi, Lydia Fortea, Maria Ortuño, Anna Nazarova, Nader Perroud, Lena Palaniyappan, Katharina Domschke, Samuele Cortese, Paul D. Arnold, Jehannine C. Austin, Michael M. Vanyukov, Myrna M. Weissman, Allan H. Young, Manon H.J. Hillegers, Andrea Danese, Merete Nordentoft, Robin M. Murray, Paolo Fusar-Poli
The offspring of parents with mental disorders are at increased risk for developing mental disorders themselves. The risk to offspring may extend transdiagnostically to disorders other than those present in the parents. The literature on this topic is vast but mixed. To inform targeted prevention and genetic counseling, we performed a comprehensive, PRISMA 2020-compliant meta-analysis. We systematically
-
World Health Organization's low-intensity psychosocial interventions: a systematic review and meta-analysis of the effects of Problem Management Plus and Step-by-Step World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Sarah K. Schäfer, Lea M. Thomas, Saskia Lindner, Klaus Lieb
Many societies have been recently exposed to humanitarian and health emergencies, which have resulted in a large number of people experiencing significant distress and being at risk to develop mental disorders such as depression, anxiety and post-traumatic stress disorder. The World Health Organization has released a series of scalable psychosocial interventions for people impaired by distress in communities
-
Adverse childhood experiences: a meta-analysis of prevalence and moderators among half a million adults in 206 studies World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Sheri Madigan, Audrey-Ann Deneault, Nicole Racine, Julianna Park, Raela Thiemann, Jenney Zhu, Gina Dimitropoulos, Tyler Williamson, Pasco Fearon, Jude Mary Cénat, Sheila McDonald, Chloe Devereux, Ross D. Neville
Exposure to adverse childhood experiences (ACEs), including maltreatment and family dysfunction, is a major contributor to the global burden of disease and disability. With a large body of international literature on ACEs having emerged over the past 25 years, it is timely to now synthetize the available evidence to estimate the global prevalence of ACEs and, through a series of moderator analyses
-
How computational psychiatry can advance the understanding and treatment of obsessive-compulsive disorder World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Isaac Fradkin, Helen Blair Simpson, Raymond J. Dolan, Jonathan D. Huppert
The behavioral repertoires of patients with obsessive-compulsive disorder (OCD) often appear puzzling and irrational. For example, an OCD patient who just locked a door might repeatedly return and check that it is locked. Similarly, a patient might continue washing and rewashing his hands, waiting for a vague “just-right” feeling before deciding to stop. Numerous models have been proposed to explain
-
Attentional biases in anxiety and depression: current status and clinical considerations World Psychiatry (IF 73.3) Pub Date : 2023-09-15 Jan De Houwer, Ernst H.W. Koster
Cognitive models of anxiety and depression postulate that these conditions are marked by negative attentional biases, i.e. increased or exaggerated attention to disorder-relevant negative information. These biases are not regarded as mere correlates of these disorders, but are thought to play a major role in their development and maintenance. Temperamental factors such as neuroticism are thought to