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Psychiatry Research Apr 2024A large group of psychiatric patients suffer from auditory hallucinations (AH) despite relevant treatment regimens. In mental health populations, AH tend to be verbal... (Review)
Review
BACKGROUND
A large group of psychiatric patients suffer from auditory hallucinations (AH) despite relevant treatment regimens. In mental health populations, AH tend to be verbal (AVH) and the content critical or abusive. Trials employing immersive virtual reality (VR) to treat mental health disorders are emerging.
OBJECTIVE
The aim of this scoping review is to provide an overview of clinical trials utilizing VR in the treatment of AH and to document knowledge gaps in the literature.
METHODS
PubMed, Cochrane Library, and Embase were searched for studies reporting on the use of VR to target AH.
RESULTS
16 papers were included in this PRISMA scoping review (ScR). In most studies VR therapy (VRT) was employed to ameliorate treatment resistant AVH in schizophrenia spectrum disorders. Only two studies included patients with a diagnosis of affective disorders. The VRT was carried out with the use of an avatar to represent the patient's most dominant voice.
DISCUSSION
The research field employing VR to treat AH is promising but still in its infancy. Results from larger randomized clinical trials are needed to establish substantial evidence of therapy effectiveness. Additionally, the knowledge base would benefit from more profound qualitative data exploring views of patients and therapists.
Topics: Humans; Hallucinations; Schizophrenia; Virtual Reality; Therapy, Computer-Assisted; Mental Health; Virtual Reality Exposure Therapy
PubMed: 38452499
DOI: 10.1016/j.psychres.2024.115834 -
Frontiers in Psychiatry 2024Although schizophrenia has traditionally been interpreted as a disorder of thought, contemporary perspectives suggest that it may be more appropriate to conceptualize it...
Although schizophrenia has traditionally been interpreted as a disorder of thought, contemporary perspectives suggest that it may be more appropriate to conceptualize it as a disorder of language connectivity. The linguistic anomalies present in schizophrenia possess distinctive characteristics that, despite certain connections, are not comparable to aphasic disorders. It is proposed that these anomalies are the result of dysfunctions in verbal self-monitoring mechanisms, which may influence other neuropsychological dimensions. This study set out to examine the neuropsychological dimensions associated with alterations in the neural networks of verbal self-monitoring in schizophrenic language, based on the scientific evidence published to date. Exhaustive searches were conducted in PubMed, Web of Science, and Scopus to identify magnetic resonance studies that evaluated verbal self-monitoring mechanisms in schizophrenia. Of a total of 133 articles identified, 22 were selected for qualitative analysis. The general findings indicated alterations in frontotemporoparietal networks and in systems such as the insula, amygdala, anterior cingulate cortex, putamen, and hippocampus. Despite the heterogeneity of the data, it is concluded that language plays a fundamental role in schizophrenia and that its alterations are linked with other neuropsychological dimensions, particularly emotional and perceptual ones.
PubMed: 38501094
DOI: 10.3389/fpsyt.2024.1356726 -
Arquivos de Neuro-psiquiatria Jan 2024Phantom limb pain (PLP) occurs after amputations and can persist in a chronic and debilitating way. Repetitive transcranial magnetic stimulation (rTMS) is a...
BACKGROUND
Phantom limb pain (PLP) occurs after amputations and can persist in a chronic and debilitating way. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation method capable of influencing brain function and modulating cortical excitability. Its effectiveness in treating chronic pain is promising.
OBJECTIVE
To evaluate the evidence on the efficacy and safety of using rTMS in the treatment of PLP, observing the stimulation parameters used, side effects, and benefits of the therapy.
METHODS
This is a systematic review of scientific articles published in national and international literature using electronic platforms.
RESULTS
Two hundred and fifty two articles were identified. Two hundred and forty six publications were removed because they were duplicated or met the exclusion criteria. After selection, six studies were reviewed, those being two randomized clinical trials and four case reports. All evaluated studies indicated some degree of benefit of rTMS to relieve painful symptoms, even temporarily. Pain perception was lower at the end of treatment when compared to the period prior to the sessions and remained during patient follow-up. There was no standardization of the stimulation parameters used. There were no reports of serious adverse events. The effects of long-term therapy have not been evaluated.
CONCLUSION
There are some benefits, even if temporary, in the use of rTMS to relieve painful symptoms in PLP. High-frequency stimulation at M1 demonstrated a significant analgesic effect. Given the potential that has been demonstrated, but limited by the paucity of high-quality studies, further controlled studies are needed to establish and standardize the clinical use of the method.
Topics: Humans; Transcranial Magnetic Stimulation; Phantom Limb; Chronic Pain
PubMed: 38286434
DOI: 10.1055/s-0044-1779051 -
History of Psychiatry Jun 2024We present a social-historical perspective on the evolution of the voice-hearing phenomenon in Western society. Based upon a systematic search from a selection of nine...
We present a social-historical perspective on the evolution of the voice-hearing phenomenon in Western society. Based upon a systematic search from a selection of nine databases, we trace the way hearing voices has been understood throughout the ages. Originally, hearing voices was considered a gifted talent for accessing the divine, but the progressive influence of monotheistic religion gradually condemned the practice to social marginalization. Later, the medical and psychiatric professions of secular society were instrumental in attaching stigma to both voice hearers and the phenomenon itself, thereby reinforcing social exclusion. More recently, the re-integration of voice hearers into the community by health authorities in various countries appears to have provided a new, socially acceptable setting for the phenomenon.
Topics: Humans; Hallucinations; History, 16th Century; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; History, Ancient; History, Medieval; Psychotic Disorders; Social Stigma; Western World
PubMed: 38424509
DOI: 10.1177/0957154X241231690 -
Explore (New York, N.Y.) 2024Phantom limb pain (PLP) is a distressing consequence commonly encountered by individuals who have undergone amputations. The efficacy of treatment options for PLP is...
Phantom limb pain (PLP) is a distressing consequence commonly encountered by individuals who have undergone amputations. The efficacy of treatment options for PLP is limited. In this study, we present a case of a 64-year-old male who suffered from PLP for a duration of 10 years following an above-the-knee amputation. Despite unsuccessful attempts with painkillers and neurotrophic drugs over the course of a decade, the patient sought relief through Fu's Subcutaneous Needling (FSN), an innovative acupuncture therapy that specifically targets the subcutaneous tissue for pain management. Remarkably, the patient experienced a significant reduction in PLP and subsequently decreased his reliance on medication, as well as experiencing improved sleep after undergoing one session of FSN per day for four consecutive days. A follow-up conducted three years later demonstrated positive treatment outcomes. FSN demonstrated a significant influence on PLP, resulting in reduced analgesic requirements and enhanced quality of life. Therefore, FSN may be recommended as an additional treatment option for PLP. In order to gain a comprehensive understanding of the effects of acupuncture on PLP, a systematic review of relevant literature was conducted in PubMed, Embase, Cochrane Library and Web of Science in recent 20 years (from January 1, 2003 to October 16, 2023), using different combinations of the following terms: (phantom acrodynia), (residual limb pain), (phantom limb pain), (acupuncture), (electroacupuncture), (auriculoacupuncture), and (needling). 9 articles with 18 cases including one randomized controlled trial (n = 8) were obtained. This review provided additional evidence supporting the efficacy and safety of needling therapies for PLP. This systematic review offers additional evidence supporting the effectiveness and safety of needling therapies for PLP. However, there were no precedent reports using FSN treatment for PLP. Hence, this case may provide some implications for clinicians in practice.
Topics: Humans; Male; Phantom Limb; Middle Aged; Acupuncture Therapy; Pain Management; Quality of Life; Amputation, Surgical; Treatment Outcome
PubMed: 38008590
DOI: 10.1016/j.explore.2023.11.011