Frontiers in psychiatry
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Frontiers in psychiatry · Jan 2019
Psychometric Properties and Factor Structure of the Chinese Version of the Hospital Anxiety and Depression Scale in People Living With HIV.
The population of people living with HIV (PLWH) is growing in number and usually results in mental health problems that impact their quality of life. Therefore, valid instruments and screening methods for psychological disorders are of great significance. The Hospital Anxiety and Depression Scale (HADS) reveals good psychometric properties, but shows ambiguous results in factor structure. ⋯ The C-HADS has good psychometric properties in terms of internal reliability and structure validity of a bifactor model. The C-HADS is recommended to be used as a total scale that measures general psychological distress, instead of anxiety and depression separately, when applied to PLWH. Further studies are needed to evaluate criterion validity, the cutoff score, and the effect of wording and scoring of the HADS.
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Frontiers in psychiatry · Jan 2019
Perspective On Excellence in Forensic Mental Health Services: What We Can Learn From Oncology and Other Medical Services.
We propose that excellence in forensic and other mental health services can be recognized by the abilities necessary to conduct randomized controlled trials (RCTs) and equivalent forms of rigorous quantitative research to continuously improve the outcomes of treatment as usual (TAU). Forensic mental health services (FMHSs) are growing, are high cost, and increasingly provide the main access route to more intensive, organized, and sustained pathways through care and treatment. A patient newly diagnosed with a cancer can expect to be enrolled in RCTs comparing innovations with the current best TAU. ⋯ Services can provide each population with a network of centers with access to one center of excellence. Excellence is the standard needed to drive the virtuous circle of research and development that is necessary for teaching, training, and the pursuit of new knowledge and better outcomes. Substantial advances in treatment of severe mental disorders require a drive at a national and international level to create services that meet these standards of excellence and are focused, active, and productive to drive better functional outcomes for service users.
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Frontiers in psychiatry · Jan 2019
ReviewDeep Brain Stimulation for Refractory Obsessive-Compulsive Disorder: Towards an Individualized Approach.
Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder featuring repetitive intrusive thoughts and behaviors associated with a significant handicap. Of patients, 20% are refractory to medication and cognitive behavioral therapy. Refractory OCD is associated with suicidal behavior and significant degradation of social and professional functioning, with high health costs. ⋯ VC/VS-DBS, amSTN-DBS, and ALIC-DBS were also found to improve mood, behavioral adaptability and potentially both, respectively. Because OCD is such a heterogeneous disease with many different symptom dimensions, the ultimate aim should be to find the most appropriate DBS target for a given refractory patient. This quest will benefit from further investigation and understanding of the individual functional connectivity of OCD patients.
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Frontiers in psychiatry · Jan 2019
ReviewPlacebo and Nocebo Effects Across Symptoms: From Pain to Fatigue, Dyspnea, Nausea, and Itch.
Placebo and nocebo effects are, respectively, the helpful and harmful treatment effects that do not arise from active treatment components. These effects have thus far been researched most often in pain. It is not yet clear to what extent these findings from pain can be generalized to other somatic symptoms. ⋯ Individual characteristics do not consistently predict placebo or nocebo effects across symptoms or studies. In sum, many conclusions deriving from placebo and nocebo pain studies do appear to apply to other somatic symptoms, but a number of important differences exist. Understanding what type of learning mechanisms for which symptom are most likely to trigger placebo and nocebo effects is crucial for generalizing knowledge for research and therapies across symptoms and can help clinicians to optimize placebo effects in practice.
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Frontiers in psychiatry · Jan 2019
ReviewSensory Abnormalities in Autism Spectrum Disorders: A Focus on the Tactile Domain, From Genetic Mouse Models to the Clinic.
Sensory abnormalities are commonly recognized as diagnostic criteria in autism spectrum disorder (ASD), as reported in the last edition of the Diagnostic and Statistical Manual of Mental Disorder (DSM-V). About 90% of ASD individuals have atypical sensory experiences, described as both hyper- and hypo-reactivity, with abnormal responses to tactile stimulation representing a very frequent finding. In this review, we will address the neurobiological bases of sensory processing in ASD, with a specific focus of tactile sensitivity. ⋯ In the search for the neurobiological bases of ASD, several mouse models have been generated with knockout and humanized knockin mutations in many ASD-associated genes. Here, we will therefore give a brief overview of the anatomical structure of the mouse somatosensory system, and describe the somatosensory abnormalities so far reported in different mouse models of ASD. Understanding the neurobiological bases of sensory processing in ASD mouse models may represent an opportunity for a better comprehension of the mechanisms underlying sensory abnormalities, and for the development of novel effective therapeutic strategies.