Cannabis use and cannabis use disorder

Nature Reviews Disease Primers, Год журнала: 2021, Номер 7(1)

Опубликована: Фев. 25, 2021

Язык: Английский

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Pharmacological and behavioral divergence of ketamine enantiomers: implications for abuse liability

Molecular Psychiatry, Год журнала: 2021, Номер 26(11), С. 6704 - 6722

Опубликована: Апрель 15, 2021

Язык: Английский

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Psychedelics and Other Psychoplastogens for Treating Mental Illness

Frontiers in Psychiatry, Год журнала: 2021, Номер 12

Опубликована: Окт. 4, 2021

Psychedelics have inspired new hope for treating brain disorders, as they seem to be unlike any treatments currently available. Not only do produce sustained therapeutic effects following a single administration, also appear broad potential, demonstrating efficacy depression, post-traumatic stress disorder (PTSD), anxiety substance abuse disorder, and alcohol use among others. belong more general class of compounds known psychoplastogens, which robustly promote structural functional neural plasticity in key circuits relevant health. Here we discuss the importance treatment neuropsychiatric diseases, well evidence that psychedelics are most effective chemical modulators studied date. Furthermore, provide theoretical framework with potential explain why psychedelic long-lasting across wide range disorders. Despite their promise broadly efficacious neurotherapeutics, there several issues associated psychedelic-based medicines drastically limit clinical scalability. We these challenges how might overcome through development non-hallucinogenic psychoplastogens. The other psychoplastogenic marks paradigm shift neuropsychiatry toward approaches relying on selective modulation small molecule drugs. Psychoplastogen research brings us one step closer actually curing mental illness by rectifying underlying pathophysiology disorders like moving beyond simply disease symptoms. However, determining effectively deploy at scale will an important consideration field moves forward.

Язык: Английский

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Management of Depression in Adults

JAMA, Год журнала: 2024, Номер 332(2), С. 141 - 141

Опубликована: Июнь 10, 2024

Importance Approximately 9% of US adults experience major depression each year, with a lifetime prevalence approximately 17% for men and 30% women. Observations Major is defined by depressed mood, loss interest in activities, associated psychological somatic symptoms lasting at least 2 weeks. Evaluation should include structured assessment severity as well risk self-harm, suspected bipolar disorder, psychotic symptoms, substance use, co-occurring anxiety disorder. First-line treatments specific psychotherapies antidepressant medications. A network meta-analysis randomized clinical trials reported cognitive therapy, behavioral activation, problem-solving interpersonal brief psychodynamic mindfulness-based psychotherapy all had medium-sized effects symptom improvement over usual care without (standardized mean difference [SMD] ranging from 0.50 [95% CI, 0.20-0.81] to 0.73 0.52-0.95]). 21 medications small- placebo (SMD 0.23 0.19-0.28] fluoxetine 0.48 0.41-0.55] amitriptyline). Psychotherapy combined medication may be preferred, especially more severe or chronic depression. greater treatment than alone (SMD, 0.30 0.14-0.45]) 0.33 0.20-0.47]). When initial not effective, second-line includes changing medication, adding second antidepressant, augmenting nonantidepressant which have equal likelihood success based on meta-analysis. Collaborative programs, including systematic follow-up outcome assessment, improve effectiveness, 1 reporting significantly compared 0.42 0.23-0.61]). Conclusions Relevance Effective first-line forms 20 Close monitoring improves the success.

Язык: Английский

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An umbrella review of candidate predictors of response, remission, recovery, and relapse across mental disorders

Molecular Psychiatry, Год журнала: 2023, Номер 28(9), С. 3671 - 3687

Опубликована: Сен. 1, 2023

Abstract We aimed to identify diagnosis-specific/transdiagnostic/transoutcome multivariable candidate predictors (MCPs) of key outcomes in mental disorders. conducted an umbrella review (protocol link ), searching MEDLINE/Embase (19/07/2022), including systematic reviews studies reporting on MCPs response, remission, recovery, or relapse, DSM/ICD-defined From published predictors, we filtered MCPs, validating MCP criteria. AMSTAR2/PROBAST measured quality/risk bias reviews/individual studies. included 117 reviews, 403 studies, 299,888 individuals with disorders, testing 796 prediction models. Only 4.3%/1.2% the were at low risk bias. The most frequently targeted outcome was remission (36.9%), least frequent recovery (2.5%). Studies mainly focused depressive (39.4%), substance-use (17.9%), and schizophrenia-spectrum (11.9%) identified numerous within disorders for but none recovery. Transdiagnostic lower disease-specific symptoms (disorders = 5), female sex/higher education 3), quality life/functioning 2). relapse higher younger age/higher anxiety symptoms/global illness severity/ number previous episodes/negative life events Finally, positive trans-outcome depression less negative events/depressive (response, relapse), sex remission) better functioning relapse); schizophrenia, symptoms/higher (remission, substance use disorder, marital status/higher relapse). Male sex, age, more clinical comorbid mental/physical symptoms/disorders poor prognostic factors, while factors social contacts employment, absent events, education, early access/intervention, physical symptoms/conditions, across Current data limitations include high extraction single from Identified can inform future development, validation refinement models

Язык: Английский

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Annual Research Review: Neuroimmune network model of depression: a developmental perspective

Journal of Child Psychology and Psychiatry, Год журнала: 2024, Номер 65(4), С. 538 - 567

Опубликована: Март 1, 2024

Depression is a serious public health problem, and adolescence an ‘age of risk’ for the onset Major Depressive Disorder. Recently, we others have proposed neuroimmune network models that highlight bidirectional communication between brain immune system in both mental physical health, including depression. These draw on research indicating cellular actors (particularly monocytes) signaling molecules cytokines) orchestrate inflammation periphery can directly modulate structure function brain. In brain, inflammatory activity heightens sensitivity to threats cortico‐amygdala circuit, lowers rewards cortico‐striatal alters executive control emotion regulation prefrontal cortex. When dysregulated, particularly under conditions chronic stress, generate feelings dysphoria, distress, anhedonia. This initiate unhealthy, self‐medicating behaviors (e.g. substance use, poor diet) manage which further heighten inflammation. Over time, dysregulation these circuits response may compound each other form positive feedback loop, whereby one organ exacerbates other. We suggest this dynamic joint vulnerability depression, during adolescence. three goals present paper. First, extend developmental framework risk depression Second, examine how perspective help explain high rates comorbidity psychiatric disorders across development, multimorbidity stress‐related medical illnesses. Finally, consider identifying pathways facilitate ‘next generation’ behavioral biological interventions target treat, ideally prevent, youth adolescents.

Язык: Английский

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The interface of depression and diabetes: treatment considerations

Translational Psychiatry, Год журнала: 2025, Номер 15(1)

Опубликована: Янв. 24, 2025

This state-of-the-art review explores the relationship between depression and diabetes, highlighting two-way influences that make treatment challenging worsen outcomes of both conditions. Depression diabetes often co-occur share genetic, lifestyle, psychosocial risk factors. Lifestyle elements such as diet, physical activity, sleep patterns play a role on development management conditions, need for integrated strategies. The evidence suggests traditional strategies focusing either condition in isolation fall short addressing intertwined nature depression. Instead, care models encompassing psychological support medical are recommended to improve efficacy patient adherence. Such require collaboration across multiple healthcare disciplines, including endocrinology, psychiatry, primary care, offer holistic approach care. also identifies significant patient-related barriers effective management, stigma, resistance, health literacy, which be addressed through patient-centered education systems. Future directions research include longitudinal studies diverse populations further elucidate causal relationships exploration novel therapeutic targets, well effectiveness aimed at preventing onset one individuals diagnosed with other.

Язык: Английский

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Large language models improve transferability of electronic health record-based predictions across countries and coding systems

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2025, Номер unknown

Опубликована: Фев. 4, 2025

Abstract Variation in medical practices and reporting standards across healthcare systems limits the transferability of prediction models based on structured electronic health record (EHR) data. We introduce GRASP, a novel transformer-based architecture that enhances generalizability EHR-based by embedding codes into unified semantic space using large language model. applied GRASP to predict onset 21 diseases all-cause mortality over one million individuals from UK Biobank (UK), FinnGen (Finland) Mount Sinai (USA), all harmonized OMOP common data Trained evaluated Sinai, achieved an average ΔC-index was 83% 35% higher than language-unaware models, respectively. also showed significantly correlations with polygenic risk scores for 62% diseases. Notably, mantained robust performance even when datasets were not same model, accurately predicting disease ICD-10-CM without direct mappings OMOP. enables accurate transferable predictions heterogeneous minimal resource requirements.

Язык: Английский

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Directional Effects of Anxiety and Depressive Disorders with Substance Use: a Review of Recent Prospective Research

Current Addiction Reports, Год журнала: 2020, Номер 7(3), С. 344 - 355

Опубликована: Июль 14, 2020

Язык: Английский

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Prevalence of mental disorders in South Asia: A systematic review of reviews

Cambridge Prisms Global Mental Health, Год журнала: 2023, Номер 10

Опубликована: Янв. 1, 2023

Mental disorders are increasing in South Asia (SA), but their epidemiological burden is under-researched. We carried out a systematic umbrella review to estimate the prevalence of mental and intentional self-harm region. Multiple databases were searched reviews reporting at least one disorder from countries SA included. Review data narratively synthesised; primary studies common (CMDs) among adults identified selected subset pooled. included 124 reviews. The majority (

Язык: Английский

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