Towards a youth mental health paradigm: a perspective and roadmap

Molecular Psychiatry, Journal Year: 2023, Volume and Issue: 28(8), P. 3171 - 3181

Published: Aug. 1, 2023

Abstract Most mental disorders have a typical onset between 12 and 25 years of age, highlighting the importance this period for pathogenesis, diagnosis, treatment ill-health. This perspective addresses interactions risk protective factors brain development as key pillars accounting emergence psychopathology in youth. Moreover, we propose that novel approaches towards early diagnosis interventions are required reflect evolution emerging psychopathology, service models, knowledge exchange science practitioners. Taken together, transformative intervention paradigm research clinical care could significantly enhance health young people initiate shift prevention severe disorders.

Language: Английский

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The synaptic hypothesis of schizophrenia version III: a master mechanism

Molecular Psychiatry, Journal Year: 2023, Volume and Issue: 28(5), P. 1843 - 1856

Published: April 11, 2023

Abstract The synaptic hypothesis of schizophrenia has been highly influential. However, new approaches mean there a step-change in the evidence available, and some tenets earlier versions are not supported by recent findings. Here, we review normal development from structural functional imaging post-mortem studies that this is abnormal people at risk with schizophrenia. We then consider mechanism could underlie changes update hypothesis. Genome-wide association have identified number variants converging on pathways regulating elimination, formation plasticity, including complement factors microglial-mediated pruning. Induced pluripotent stem cell demonstrated patient-derived neurons show pre- post-synaptic deficits, signalling alterations, elevated, complement-dependent elimination structures compared to control-derived lines. Preclinical data environmental linked schizophrenia, such as stress immune activation, can lead synapse loss. Longitudinal MRI patients, prodrome, divergent trajectories grey matter volume cortical thickness controls, PET shows vivo for lower density patients Based evidence, propose version III This multi-hit model, whereby genetic and/or render synapses vulnerable excessive glia-mediated triggered during later neurodevelopment. loss disrupts pyramidal neuron function cortex contribute negative cognitive symptoms disinhibits projections mesostriatal regions dopamine overactivity psychosis. It accounts typical onset adolescence/early adulthood, its major factors, symptoms, identifies potential synaptic, microglial targets treatment.

Language: Английский

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The schizophrenia syndrome, circa 2024: What we know and how that informs its nature

Schizophrenia Research, Journal Year: 2023, Volume and Issue: 264, P. 1 - 28

Published: Dec. 12, 2023

Language: Английский

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Ethical challenges in contemporary psychiatry: an overview and an appraisal of possible strategies and research needs

World Psychiatry, Journal Year: 2024, Volume and Issue: 23(3), P. 364 - 386

Published: Sept. 16, 2024

Psychiatry shares most ethical issues with other branches of medicine, but also faces special challenges. The Code Ethics the World Psychiatric Association offers guidance, many mental health care professionals are unaware it and principles supports. Furthermore, following codes ethics is not always sufficient to address dilemmas arising from possible clashes among their principles, continuing changes in knowledge, culture, attitudes, socio‐economic context. In this paper, we identify topics that pose difficult challenges contemporary psychiatry; may have a significant impact on clinical practice, education research activities; require revision profession's ethics. These include: relationships between human rights care, training; legislation; digital early intervention end‐of‐life decisions by people conditions; conflicts interests training research; role lived experience family/informal supporters shaping agenda policy, training. For each topic, highlight concerns, suggest strategies them, call attention risks these entail, gaps be narrowed further research. We conclude that, order effectively current psychiatry, need rethink policies, services, training, methods ethics, concurrent input range stakeholders, open minded discussions, new models an adequate organizational capacity roll‐out implementation across routine contexts,

Language: Английский

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Can artificial intelligence be the future solution to the enormous challenges and suffering caused by Schizophrenia?

Schizophrenia, Journal Year: 2025, Volume and Issue: 11(1)

Published: Feb. 28, 2025

This study evaluated the potential of artificial intelligence (AI) in diagnosis, treatment, and prognostic assessment schizophrenia (SZ) explored collaborative directions for AI applications future medical innovations. SZ is a severe mental disorder that causes significant suffering imposes challenges on patients. With rapid advancement machine learning deep technologies, has demonstrated notable advantages early diagnosis high-risk populations. By integrating multidimensional biomarkers linguistic behavior data patients, can provide further objective precise diagnostic criteria. Moreover, it aids formulating personalized treatment plans, enhancing therapeutic outcomes, offering new strategies patients with treatment-resistant SZ. Furthermore, excels developing individualized which enables identification disease progression, accurate prediction trajectory, timely adjustment strategies, thereby improving prognosis facilitating recovery. Despite immense management, its role as an auxiliary tool must be emphasized, clinical judgment compassionate care from healthcare professionals remaining crucial. Future research should focus optimizing human–machine interactions to achieve efficient application management. The in-depth integration technology into practice will advance field SZ, ultimately quality life outcomes

Language: Английский

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New and emerging treatments for schizophrenia: a narrative review of their pharmacology, efficacy and side effect profile relative to established antipsychotics

Neuroscience & Biobehavioral Reviews, Journal Year: 2021, Volume and Issue: 132, P. 324 - 361

Published: Nov. 24, 2021

Language: Английский

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Negative symptoms in children and adolescents with early-onset psychosis and at clinical high-risk for psychosis: systematic review and meta-analysis

The British Journal of Psychiatry, Journal Year: 2023, Volume and Issue: 223(1), P. 282 - 294

Published: May 17, 2023

Early-onset psychosis (EOP) refers to the development of a first episode before 18 years age. Individuals at clinical high risk for (CHR-P) include adolescents and young adults, although most evidence has focused on adults. Negative symptoms are important prognostic indicators in psychosis. However, research focusing children is limited.

Language: Английский

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Global COVID-19 vaccine acceptance level and its determinants: an umbrella review

BMC Public Health, Journal Year: 2024, Volume and Issue: 24(1)

Published: Jan. 2, 2024

Abstract Background The COVID-19 vaccination is essential for reducing disease burden on a worldwide scale. success of this strategy will largely depend how well vaccines are received. Previous reviews had produced contradictory results, and there been no umbrella review. Therefore, the objective review was to combine data regarding vaccination’s global acceptance rate its contributing factors. Methods Using PRISMA guideline, PubMed, Embase, Scopus, Web Sciences, Cochrane Database Systematic Reviews, Scopus Google Scholar which reported vaccine and/or determinants were searched. quality included studies assessed using Assessment Multiple Reviews (AMSTAR). A weighted inverse variance random-effects model applied find pooled estimates. subgroup analysis, heterogeneity, publication bias sensitivity analysis also assessed. Result Twenty-two SRM with 10,433,306 study participants included. globally found be 60.23 (95% CI: 58.27, 62.18). In low-income countries, level 54.07(50.31, 57.83) while magnitude 64.32 (62.24,66.40) among across globe. Higher education (AOR =1.96; 95% CI:1.20, 2.73), good knowledge (2.20; CI:1.36, 3.03), favourable attitude =4.50; CI:2.89, 6.12), previous history infection =3.41; CI:1.77, 5.06), male sex =1.62; CI:1.47, 1.77), chronic =1.54; CI:1.18, 1.90) predictors acceptance. Conclusion highly varied unacceptably low particularly in countries. education, knowledge, attitude, COVID-19, sex, factors rate. collaborative effort stakeholders such as policymakers, campaign program planners needed improve vaccine.

Language: Английский

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Identification and treatment of individuals with childhood-onset and early-onset schizophrenia

European Neuropsychopharmacology, Journal Year: 2024, Volume and Issue: 82, P. 57 - 71

Published: March 15, 2024

Approximately 8 % of patients with schizophrenia are diagnosed before age 18, and 18 experience their first symptoms 18. This narrative review explores the management early-onset (EOS) childhood-onset (COS) from diagnosis to transition adult care settings. Early in children adolescents is essential for improving outcomes, but delays common due overlapping developmental phenomena other psychiatric conditions, including substance use, lack clinicians' awareness. Once diagnosed, antipsychotic treatment key, specific second-generation agents generally being preferred better tolerability broader efficacy evidence-base youth. Dosing should be carefully individualized, considering age-related differences drug metabolism side effect liability. Clinicians must vigilant detecting early non-response consider switching or dose escalation when appropriate. Since illness onset a consistent risk factor treatment-resistant (TRS), clinicians need competent diagnosing TRS using clozapine. COS EOS associated cognitive deficits impaired functioning, psychosocial interventions considered improve overall functioning quality life. Good long-term outcomes depend on continuous engagement, successful transitioning pediatric requires careful planning, preparation, collaboration between clinicians. Targeting functional life addition symptom remission can patient well-being. Comprehensive evaluations, age-specific assessments, targeted needed address unique challenges COS.

Language: Английский

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Duration of Untreated Psychosis and Outcomes in First-Episode Psychosis: Systematic Review and Meta-analysis of Early Detection and Intervention Strategies

Schizophrenia Bulletin, Journal Year: 2024, Volume and Issue: 50(4), P. 771 - 783

Published: March 16, 2024

Abstract Background The role of duration untreated psychosis (DUP) as an early detection and intervention target to improve outcomes for individuals with first-episode is unknown. Study Design PRISMA/MOOSE-compliant systematic review identify studies until February 1, 2023, a control group, reporting DUP in both groups. Random effects meta-analysis evaluate (1) differences detection/intervention services vs the (2) efficacy strategies regarding eight real-world at baseline (service entry), (3) on ten follow-up. We conducted quality assessment, heterogeneity, publication bias, meta-regression analyses (PROSPERO: CRD42020163640). Results From 6229 citations, 33 were retrieved. group achieved small reduction (Hedges’ g = 0.168, 95% CI 0.055–0.283) group. had better functioning levels (g 0.281, 0.073–0.488) baseline. Both groups did not differ total psychopathology, admission rates, life, positive/negative/depressive symptoms, employment rates (P > .05). Early interventions improved life 0.600, 0.408–0.791), 0.427, 0.135–0.718), negative symptoms 0.417, 0.153–0.682), relapse 0.364, 0.117–0.612), admissions 0.335, 0.198–0.468), psychopathology 0.298, 0.014–0.582), depressive 0.268, 0.008–0.528), 0.180, 0.065–0.295) follow-up but positive or remission Conclusions Comparing targeting groups, impact other correlates limited. However, was significant relevant outcomes, underscoring importance supporting worldwide.

Language: Английский

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