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Find links to recent articles on clinical psychiatry

London
Joined August 2019
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Trends in Psychiatry retweeted
🚨 Medical history rewritten: 19-year-old becomes the youngest person diagnosed with Alzheimer's. In a medical first that has stunned the scientific community, doctors have diagnosed a 19-year-old with Alzheimer’s disease, marking the youngest confirmed case in history. His symptoms began at just 17 with concentration issues and reading difficulties, eventually progressing to severe memory loss where his recall scores were over 80% lower than his peers. Most strikingly, the teenager possessed no known genetic mutations or family history of the disease, defying the usual patterns found in early-onset cases which typically involve inherited triggers. The diagnosis was confirmed through brain scans showing damage to the hippocampus and spinal fluid tests revealing classic Alzheimer’s biomarkers. This case disrupts the traditional understanding of the disease as one reserved for the elderly or those with rare genetic predispositions. Researchers now believe that unknown biological pathways may trigger the condition, suggesting that Alzheimer’s can manifest much earlier than previously imagined. This discovery opens a challenging new frontier in neurology, demanding a re-evaluation of how the disease develops across different age groups. Source: Jia, J., Zhang, Y., Shi, Z., Yin, R., Wang, S., & Ji, Y. A 19-Year-Old Patient with Probable Alzheimer's Disease. Journal of Alzheimer's Disease.
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In this meta-analysis, patients with Bipolar Disorder who were treated with lithium had a 49% lower risk of developing dementia compared with patients with Bipolar Disorder who were not treated with lithium @chrisaikenmd @CarlatPsych pubmed.ncbi.nlm.nih.gov/3195…
Lithium lowered dementia risk 13% in 5-year, non-randomized study of older adults with #bipolar, compared to anticonvulsants: pubmed.ncbi.nlm.nih.gov/4164… Evidence grade moderate (4/10): chrisaikenmd.com/ebm Unproven, but a larger trial is underway in dementia.
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Camouflaging is when people on #autism spectrum mask symptoms or imitate normal interactions to avoid standing out. It can work, but it's also a cause of distress, as new study finds: pubmed.ncbi.nlm.nih.gov/4112… How do you manage this side effect of social skills training?
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1/ Highlights from this crucially important paper: About 7 out of 10 patients who get “evidence-based therapy” for depression are still depressed after treatment Of the 3 that get well, about half would have gotten well without treatment No significant differences between types of therapy (the “dodo bird verdict”) “Third wave” therapies (eg, ACT) no better than plain old CBT, or any other form of treatment From the paper: “Most patients do not respond or remit after therapy, and more effective treatments are clearly needed” So… can someone please explain to me again why these treatments are routinely called “evidence-based therapy?”
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Yet more evidence that haloperidol is not a sedative. RCT to ⬇️ agitation in palliative care #delirium 1⃣haloperidol 2⃣lorazepam 3⃣halop + loraz 4⃣placebo Haloperidol monotherapy was not more efficacious than placebo in reducing RASS. doi.org/10.1001/jamaoncol.20…
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Generative artificial intelligence (Gen-#AI) #chatbots hold promise for building highly personalized, effective #mentalhealth treatments at scale, while also addressing user engagement and retention issues common among digital therapeutics. ai.nejm.org/doi/full/10.1056…
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Light therapy treats depression, bulimia, PTSD, and in this small RCT it improved depression in schizophrenia: pubmed.ncbi.nlm.nih.gov/4008… [in an earlier trial, light improved negative symptoms] I've updated my light therapy guide with new LED boxes: chrisaikenmd.com/lighttherap…
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SAINT-TMS brings 70-90% with treat resistant depression to remission. How? 10 sessions a day with fMRI guided magnet over 5 days. This new study claims similar results with 3 sessions/day and no fMRI, but with remission rates of 34%, I'm not convinced: pubmed.ncbi.nlm.nih.gov/4004…
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The menstrual cycle is an overlooked vital sign in psychiatry. 🧵1/13
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Ondansetron succesfully augmented SSRIs in 3 randomized trials of OCD (4 mg/d). It also did that in this new trial, but it failed to improve a related phenomena (sensory discomfort associated with OCD or tics), which was the primary outcome: pubmed.ncbi.nlm.nih.gov/3987…
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New from us, and first study from the PhD of Dr @ElliePChrys Delusional Themes are More Varied Than Previously Assumed academic.oup.com/schizophren… A global meta-analysis of the prevalence of delusional themes in psychosis, examining association with clinical features and culture
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Antidepressants did not cause mania (or prevent #depression) in this 1 year observational study of 979 people with #bipolar: pubmed.ncbi.nlm.nih.gov/3894… However, they only looked at hospitalized cases, and did not separate bipolar I from II.
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Skipping breakfast is associated with an increased odds of depression. 🧵1/8
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Review lists saffron's results from small, randomized trials: > Beat placebo in #depression, cognition, insomnia > Equaled standard meds in #anxiety, #ADHD, #OCD > Well tolerated pubmed.ncbi.nlm.nih.gov/3842… Recommended products (surprisingly, low cost): moodtreatmentcenter.com/prod…
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Cariprazine (Vraylar) treats #bipolar #depression/mania, but failed to prevent them in new, large placebo-controlled monotherapy trial: pubmed.ncbi.nlm.nih.gov/3860… Despite set-ups favoring drug: > Drug stopped early (at ~2 mths, not 6-12 mth) > Enriched design > Industry sponsorship
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Some reason for concern here. Sure, it will track with escalating use but it’s still a valid phenomenon: sciencedirect.com/science/ar…
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❗️Check out our new paper❗️ Prevalence of anxiety, depression, and PTSD is higher in families of patients with ICU delirium. Providing families with appropriate support contributes to reduction of unfavorable emotional states. @WesElyMD @AnnachiaraMarr nature.com/articles/s41598-0… – at Szczecin, Poland
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Review Article: Wearable Technology in Clinical Practice for Depressive Disorder nej.md/3Tw8MIx #DigitalHealth
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#Lithium and IV #ketamine rose to top for both efficacy and tolerability in treatment-resistant #depression in new network metaanalysis of 22 trials, surpassing esketamine (Spravato) and aripiprazole (Abilify) pubmed.ncbi.nlm.nih.gov/3794… More updates: podcasts.apple.com/us/podcas…
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New study pulls together 198 symptoms of early psychosis from 14 rating scales pubmed.ncbi.nlm.nih.gov/3794… Surprisingly, first line treatment for early "prodromal" #psychosis = psychotherapy/omega-3, not antipsychotics. Learn more: thecarlatreport.com/articles…
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