Cited by No two traumas are alike, and neither are two presentations of <scp>PTSD</scp>

No two traumas are alike, and neither are two presentations of PTSD DOI

World Psychiatry, Год журнала: 2025, Номер 24(1), С. 90 - 91

Опубликована: Янв. 15, 2025

Significant advances have been made in our understanding of post-traumatic stress disorder (PTSD), and translating an overwhelming body research evidence into clinical practice. However, it is time for researchers clinicians to pause reflect on whether true progress has made. Brewin et al1 convincingly distill the complexity defining, assessing, diagnosing, predicting, preventing treating PTSD diverse populations, across several countries, varying socio-political-cultural societal-structural contexts, at different life stages. The review juxtaposes rapid exponential growth knowledge trauma, complex against significant gaps (and possibly "blind spots") that remain. It brings sharp focus need accelerated consensus building a core set evidence-informed integrated phenotypes biotypes, pursuit categorical dimensional solutions parsing out heterogeneity, intervening timeously effectively. Fine-grained characterization biotypes could propel collective global efforts pave way development tailored, measurement-based personalized interventions adults youth with – yield higher response remission rates than current ones. Trauma ubiquitous, but also individual personal, its impact attributions are highly variable. Prevalence vary considerably by population, demography, social determinants, ascertainment method. Several decades taught us relationship between nature traumatic event (e.g., single or repeated, interpersonal non-interpersonal, intentional non-intentional), peri-traumatic responses triggers, resultant non-linear, and, patient level, may follow convoluted trajectory. Similarly, gathered over acute disorder, first introduced DSM-IV as distinctive early-after-trauma diagnosis retained DSM-5, disappointing regards diagnostic utility predicting PTSD2, 3. Despite abundant literature pre-trauma, peri-trauma post-trauma risk protective factors, ability predict apply biological markers genotypic, epigenetic, transcriptomic, endocrine, immune) stratify trauma-exposed individuals remains very limited. Moreover, low- middle-income country populations disproportionately under-represented longitudinal neurobiological studies aim track signatures alongside symptom trajectories4. Also central challenge astounding within-group heterogeneity (in patterning, illness course, treatment outcome) high comorbidity wide range psychiatric disorders physical illnesses. plausible symptom-based subtypes incrementally refine classification PTSD. To date, empirical strides delineating dissociative subtype, only one recognized which point prevalence 38.1% children adolescents PTSD, unique symptom, profile underpinned fairly robust evidence5, 6. There still ongoing debate about dissociation somewhat common phenomenon marker severity, occurrence limited more circumscribed subgroup people diagnosis. specificity subtype needs further interrogation, beyond Global North, culturally settings where phenomena might be linked somatization other culture-bound phenomena. In vein profiles inform targeted, treatments, few sought map type index trauma clusters concerted fashion. Notable recent investigation 4,069 veterans from 2019-2020 National Health Resilience Veterans Study, applied alternative phenotypic model DSM-5 ICD-11 structure plot traumas (categorized violence, combat/captivity, disaster/accident, illness/injury) symptoms7. resulting eight-symptom phenotype comprised internally-generated intrusions distressing memories), externally-generated emotional reactivity cues), avoidance, negative affect, anhedonia, externalizing behaviors, anxious dysphoric arousal. Findings discriminable who experienced violence combat/captivity versus those illness/injury disaster/accident encouraging. cross-sectional design study precludes addressing question these trauma-symptom hold chronic findings will replicated biopsychosocial mechanisms underlie trauma-PTSD require deep exploration. field long invested large-scale costly identify clinically valid, affordable scalable biomarkers can aid screening timely intervention, lead better outcomes. susceptibility markers, some predictive therapeutic biomarkers, evaluated, including polygenic scores regional brain structural morphology. replication testing large samples before their potential realized8. prospect employing question, discovery biomarker panels requisite reliability, specificity, sensitivity reproducibility cost-effective feasible employ point-of-care off. For multiple sampling commencing early after extending year account evolving dynamics symptoms arguably best resilient, chronic, delayed onset, recovery trajectories, enhance causal pathways. predictors normalization perturbations treatment, trials compare psychotherapies, pharmacotherapies combination treatments needed. addition, innovative strategies, such biomarker-stratified designs (to address what all patients well biomarker-defined subgroups) enrichment biomarker-positive PTSD), serve improve efficiency precision. Though appealing, hugely challenging apply. Generative artificial intelligence tools fast change this landscape, benefits extend identifying novel outcomes, bolstering fidelity boosting engagement9. raise host ethical, legal considerations coalface caring compelled grapple with. Finally, seeking transform scientific endeavors prevent, diagnose treat behooves remember no two presentations alike. art providing individual-level care should always sit science.

Язык: Английский

Major depressive disorder DOI

Wolfgang Marx, Brenda W.J.H. Penninx, Marco Solmi

и другие.

Nature Reviews Disease Primers, Год журнала: 2023, Номер 9(1)

Опубликована: Авг. 24, 2023

Язык: Английский

Процитировано

216

Post‐traumatic stress disorder: evolving conceptualization and evidence, and future research directions DOI

C. R. Brewin,

Lukoye Atwoli, Jonathan I. Bisson

и другие.

World Psychiatry, Год журнала: 2025, Номер 24(1), С. 52 - 80

Опубликована: Янв. 15, 2025

The understanding of responses to traumatic events has been greatly influenced by the introduction diagnosis post‐traumatic stress disorder (PTSD). In this paper we review initial versions diagnostic criteria for condition and associated epidemiological findings, including sociocultural differences. We consider evidence reactions occurring in multiple contexts not previously defined as traumatic, implications that these observations have diagnosis. More recent developments such DSM‐5 dissociative subtype ICD‐11 complex PTSD are reviewed, adding there several distinct phenotypes. describe psychological foundations PTSD, involving disturbances memory well identity. A broader focus on identity may be able accommodate group communal influences experience trauma impact resource loss. then summarize current concerning biological with a particular genetic neuroimaging studies. Whereas progress prevention disappointing, is now an extensive supporting efficacy variety treatments established trauma‐focused interventions – cognitive behavior therapy (TF‐CBT) eye movement desensitization reprocessing (EMDR) non‐trauma‐focused therapies, which also include some emerging identity‐based approaches present‐centered compassion‐focused therapies. Additionally, promising neither nor pharmacological, or combine pharmacological approach, 3,4‐methylenedioxymethamphetamine (MDMA)‐assisted psychotherapy. advances priority areas adapting resource‐limited settings across cultural contexts, community‐based approaches. conclude identifying future directions work mental health.

Язык: Английский

Процитировано

Functional neuroimaging as a catalyst for integrated neuroscience DOI

Emily S. Finn, Russell A. Poldrack, James M. Shine

и другие.

Nature, Год журнала: 2023, Номер 623(7986), С. 263 - 273

Опубликована: Ноя. 8, 2023

Язык: Английский

Процитировано

The definition of treatment resistance in anxiety disorders: a Delphi method‐based consensus guideline DOI

Katharina Domschke,

Patrik D. Seuling,

Miriam A. Schiele

и другие.

World Psychiatry, Год журнала: 2024, Номер 23(1), С. 113 - 123

Опубликована: Янв. 12, 2024

Anxiety disorders are very prevalent and often persistent mental disorders, with a considerable rate of treatment resistance which requires regulatory clinical trials innovative therapeutic interventions. However, an explicit definition treatment-resistant anxiety (TR-AD) informing such is currently lacking. We used Delphi method-based consensus approach to provide internationally agreed, consistent clinically useful operational criteria for TR-AD in adults. Following summary the current state knowledge based on international guidelines available systematic review, survey free-text responses 29-item questionnaire relevant aspects TR-AD, online meeting, panel 36 multidisciplinary experts stakeholders voted anonymously written statements three rounds. Consensus was defined as ≥75% agreeing statement. The agreed set 14 recommendations providing detailed pharmacological and/or psychotherapeutic treatment, well potential staging model. also evaluated further regarding epidemiological subgroups, comorbidities biographical factors, terminology vs. "difficult-to-treat" preferences attitudes persons these future research directions. This expected serve systematic, practical guideline aid designing mechanistic studies facilitate purposes. effort could ultimately lead development more effective evidence-based stepped-care algorithms patients disorders.

Язык: Английский

Процитировано

Aggregation-Induced Emission Luminogen: Role in Biopsy for Precision Medicine DOI

Yanhong Duo, Lei Han, Yaoqiang Yang

и другие.

Chemical Reviews, Год журнала: 2024, Номер 124(20), С. 11242 - 11347

Опубликована: Окт. 9, 2024

Biopsy, including tissue and liquid biopsy, offers comprehensive real-time physiological pathological information for disease detection, diagnosis, monitoring. Fluorescent probes are frequently selected to obtain adequate on processes in a rapid minimally invasive manner based their advantages biopsy. However, conventional fluorescent have been found show aggregation-caused quenching (ACQ) properties, impeding greater progresses this area. Since the discovery of aggregation-induced emission luminogen (AIEgen) promoted advancements molecular bionanomaterials owing unique high quantum yield (QY) signal-to-noise ratio (SNR),

Язык: Английский

Процитировано

Sensitivity-Enhancing Strategies of Graphene Field-Effect Transistor Biosensors for Biomarker Detection DOI

Weilong Zhao, Wenhong Zhang, Jun Chen

и другие.

ACS Sensors, Год журнала: 2024, Номер 9(6), С. 2705 - 2727

Опубликована: Июнь 6, 2024

The ultrasensitive recognition of biomarkers plays a crucial role in the precise diagnosis diseases. Graphene-based field-effect transistors (GFET) are considered most promising devices among next generation biosensors. GFET biosensors possess distinct advantages, including label-free, ease integration and operation, ability to directly detect liquid environments. This review summarized recent advances for biomarker detection, with focus on interface functionalization. Various sensitivity-enhancing strategies have been overviewed biosensors, from perspective optimizing graphene synthesis transfer methods, refinement surface functionalization channel layer gate electrode, design biorecognition elements reduction nonspecific adsorption. Further, this extensively explores functionalized antibodies, aptamers, enzymes. It delves into employed detection various diseases (such as cancer, cardiovascular diseases, neurodegenerative disorders, infectious viruses, etc.) along their application integrated microfluidic systems. Finally, issues challenges modulation biosensing interfaces faced by detecting biomarkers.

Язык: Английский

Процитировано

Where do neurodevelopmental conditions fit in transdiagnostic psychiatric frameworks? Incorporating a new neurodevelopmental spectrum DOI

Giorgia Michelini, Christina Carlisi, Nicholas R. Eaton

и другие.

World Psychiatry, Год журнала: 2024, Номер 23(3), С. 333 - 357

Опубликована: Сен. 16, 2024

Features of autism spectrum disorder, attention‐deficit/hyperactivity learning disorders, intellectual disabilities, and communication motor disorders usually emerge early in life are associated with atypical neurodevelopment. These “neurodevelopmental conditions” grouped together the DSM‐5 ICD‐11 to reflect their shared characteristics. Yet, reliance on categorical diagnoses poses significant challenges both research clinical settings (e.g., high co‐occurrence, arbitrary diagnostic boundaries, within‐disorder heterogeneity). Taking a transdiagnostic dimensional approach provides useful alternative for addressing these limitations, accounting underpinnings across neurodevelopmental conditions, characterizing common co‐occurrence developmental continuity other psychiatric conditions. Neurodevelopmental features have not been adequately considered frameworks, although this would fundamental implications practices. Growing evidence from studies structure conditions indicates that cluster together, delineating spectrum” ranging normative impairing profiles. Studies genetic underpinnings, overlapping cognitive neural profiles, similar course efficacy support/treatment strategies indicate validity spectrum. Further, alongside dimensions has utility, as it fuller view an individual's needs strengths, greater prognostic utility than categories. Based compelling body evidence, we argue incorporating new into frameworks considerable potential transforming our understanding, classification, assessment, practices around

Язык: Английский

Процитировано

Wavelet Transform, Reconstructed Phase Space, and Deep Learning Neural Networks for EEG-Based Schizophrenia Detection DOI

Amjed Al Fahoum,

Ala’a Zyout

International Journal of Neural Systems, Год журнала: 2024, Номер 34(09)

Опубликована: Май 17, 2024

This study proposes an innovative expert system that uses exclusively EEG signals to diagnose schizophrenia in its early stages. For diagnosing psychiatric/neurological disorders, electroencephalogram (EEG) testing is considered a financially viable, safe, and reliable alternative. Using the reconstructed phase space (RPS) continuous wavelet transform, researchers maximized differences between nonstationary of normal individuals, which cannot be observed time, frequency, or time-frequency domains. reveals significant information, highlighting more distinguishable features. Then, deep learning network was trained enhance accuracy resulting image classification. The algorithm's efficacy confirmed through three distinct methods: employing 70% dataset for training, 15% validation, remaining testing. followed by 5-fold cross-validation technique leave-one-out classification approach. Each method iterated 100 times ascertain robustness. performance metrics derived from these tests - accuracy, precision, sensitivity, F1 score, Matthews correlation coefficient, Kappa indicated remarkable outcomes. algorithm demonstrated steady across all evaluation strategies, underscoring relevance reliability. outcomes validate system's robustness showcasing capability autonomously differentiate individuals diagnosed with those state health.

Язык: Английский

Процитировано

AI in Neuroimaging and Brain Analysis DOI

Aashish A. Gadgil,

P. Selvakumar,

G. Sabeena Gnanaselvi

и другие.

Advances in psychology, mental health, and behavioral studies (APMHBS) book series, Год журнала: 2025, Номер unknown, С. 185 - 212

Опубликована: Янв. 3, 2025

The integration of AI in neuroimaging offers unprecedented opportunities to enhance our understanding the brain, improve diagnostic accuracy, and personalize treatment strategies for neurological disorders. This capability is particularly significant given increasing volume complexity data generated by modalities such as MRI, CT, PET, EEG. As algorithms evolve, they are not only enhancing image quality acquisition processes but also aiding development biomarkers various conditions. can lead earlier diagnosis intervention, which crucial managing progressive Moreover, AI-driven approaches streamline workflow clinical settings, reducing burden on radiologists enabling more efficient patient management. Despite these opportunities, incorporation presents challenges. Data privacy security paramount concerns, especially when dealing with sensitive information.

Язык: Английский

Процитировано

From Serendipity to Precision: Integrating AI, Multi-Omics, and Human-Specific Models for Personalized Neuropsychiatric Care DOI

Masaru Tanaka

Biomedicines, Год журнала: 2025, Номер 13(1), С. 167 - 167

Опубликована: Янв. 12, 2025

Background/Objectives: The dual forces of structured inquiry and serendipitous discovery have long shaped neuropsychiatric research, with groundbreaking treatments such as lithium ketamine resulting from unexpected discoveries. However, relying on chance is becoming increasingly insufficient to address the rising prevalence mental health disorders like depression schizophrenia, which necessitate precise, innovative approaches. Emerging technologies artificial intelligence, induced pluripotent stem cells, multi-omics potential transform this field by allowing for predictive, patient-specific interventions. Despite these advancements, traditional methodologies animal models single-variable analyses continue be used, frequently failing capture complexities human conditions. Summary: This review critically evaluates transition serendipity precision-based in research. It focuses key innovations dynamic systems modeling network-based approaches that use genetic, molecular, environmental data identify new therapeutic targets. Furthermore, it emphasizes importance interdisciplinary collaboration human-specific overcoming limitations Conclusions: We highlight precision psychiatry’s transformative revolutionizing care. paradigm shift, combines cutting-edge systematic frameworks, promises increased diagnostic accuracy, reproducibility, efficiency, paving way tailored better patient outcomes

Язык: Английский

Процитировано