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Psychological Medicine Dec 2023Psychotropic medication efficacy and tolerability are critical treatment issues faced by individuals with psychiatric disorders and their healthcare providers. For some... (Review)
Review
Psychotropic medication efficacy and tolerability are critical treatment issues faced by individuals with psychiatric disorders and their healthcare providers. For some people, it can take months to years of a trial-and-error process to identify a medication with the ideal efficacy and tolerability profile. Current strategies (e.g. clinical practice guidelines, treatment algorithms) for addressing this issue can be useful at the population level, but often fall short at the individual level. This is, in part, attributed to interindividual variation in genes that are involved in pharmacokinetic (i.e. absorption, distribution, metabolism, elimination) and pharmacodynamic (e.g. receptors, signaling pathways) processes that in large part, determine whether a medication will be efficacious or tolerable. A precision prescribing strategy know as pharmacogenomics (PGx) assesses these genomic variations, and uses it to inform selection and dosing of certain psychotropic medications. In this review, we describe the path that led to the emergence of PGx in psychiatry, the current evidence base and implementation status of PGx in the psychiatric clinic, and finally, the future growth potential of precision psychiatry via the convergence of the PGx-guided strategy with emerging technologies and approaches (i.e. pharmacoepigenomics, pharmacomicrobiomics, pharmacotranscriptomics, pharmacoproteomics, pharmacometabolomics) to personalize treatment of psychiatric disorders.
Topics: Humans; Pharmacogenetics; Psychiatry; Mental Disorders; Psychotropic Drugs; Algorithms
PubMed: 37772416
DOI: 10.1017/S0033291723002817 -
The American Journal of Geriatric... Mar 2024The goal of this overview is to help clinicians develop basic proficiency with the terminology of deep learning and understand its fundamentals and early applications.... (Review)
Review
The goal of this overview is to help clinicians develop basic proficiency with the terminology of deep learning and understand its fundamentals and early applications. We describe what machine learning and deep learning represent and explain the underlying data science principles. We also review current promising applications and identify ethical issues that bear consideration. Deep Learning is a new type of machine learning that is remarkably good at finding patterns in data, and in some cases generating realistic new data. We provide insights into how deep learning works and discuss its relevance to geriatric psychiatry.
Topics: Humans; Aged; Mental Health; Deep Learning; Machine Learning; Geriatric Psychiatry
PubMed: 38142162
DOI: 10.1016/j.jagp.2023.11.008 -
JPMA. the Journal of the Pakistan... Oct 2023
Topics: Humans; Attitude; Students, Medical; Psychiatry; Attitude of Health Personnel; Surveys and Questionnaires; Health Knowledge, Attitudes, Practice
PubMed: 37876100
DOI: 10.47391/JPMA.9024 -
Missouri Medicine 2023The Department of Psychiatry at Washington University has been innovating psychiatric education during the second millennium at all levels of training - undergraduate...
The Department of Psychiatry at Washington University has been innovating psychiatric education during the second millennium at all levels of training - undergraduate medical, general residency, and child and adolescent psychiatry (CAP) fellowship training. Undergraduate medical education now occurs in three phases. The 18-month pre-clerkship phase is divided into seven multidisciplinary modules that span basic, social, and clinical sciences. Psychiatry is part of the seven-week long Brain and Behavior module. The yearlong second phase includes a six-week traditional psychiatry clerkship-like experience bracketed by an introductory foundational week and a one-week consolidation period. The third phase is 18 months in length and provides in-depth exploration of both clinical and non-clinical areas. The residency training program has enlarged the number of residents undergoing training and simultaneously greatly expanded the clinical exposure to include rotations in eating disorders and perinatal psychiatry. In addition, our residents can choose to enhance their training in either our research or leadership focused options, both of which are also available to trainees in our child and adolescent program. Additionally, our CAP trainees are exposed to several unique areas including eating disorders and substance use disorders. We believe that these innovations across the educational spectrum allow us to prepare our learners for the practice of psychiatry in the 21 century.
Topics: Adolescent; Child; Humans; Washington; Universities; Psychiatry; Internship and Residency; Curriculum
PubMed: 37609462
DOI: No ID Found -
Australasian Psychiatry : Bulletin of... Aug 2023The principles of gender equity are important to achieve the Royal Australian and New Zealand College of Psychiatrists (the College) strategic goals. (1) To present the... (Review)
Review
OBJECTIVES
The principles of gender equity are important to achieve the Royal Australian and New Zealand College of Psychiatrists (the College) strategic goals. (1) To present the data on gender equity, (2) To describe how the action plan was developed, (3) To discuss how this work aligns with a commitment to inclusion and diversity.
METHODS
Firstly, the formation of a working group with representation from across the College. Secondly, undertaking a data snapshot and discussion paper on gender equity to support consultation. Thirdly, reviewing similar action plans, a literature review, and undertaking broad consultation across the College. Finally, collating data using a thematic analysis to support the development of an action plan.
RESULTS
Data obtained on gender equity identified clear gaps in leadership roles, academic activities and awards. Our review and consultation identified themes focused on gaps in gender equity including a role for organisational leadership approach. Together this has then informed an action plan for gender equity for the College.
CONCLUSIONS
There are no simple solutions that will solve gender inequity; this requires systemic solutions to achieve meaningful change. However, the development of the action plan is a significant step towards addressing the current gender inequities.
Topics: Humans; Gender Equity; Australia; Population Groups; Leadership; Psychiatry
PubMed: 37400962
DOI: 10.1177/10398562231186126 -
Journal of the American Academy of... Jul 2023JAACAP Connect, our developmental journal, began publishing in 2014 to support "the development of writing and editing skills among members of the American Academy of...
JAACAP Connect, our developmental journal, began publishing in 2014 to support "the development of writing and editing skills among members of the American Academy of Child and Adolescent Psychiatry." JAACAP Connect "is dedicated to engaging trainees and practitioners in the process of continuous and applied career learning through readership, authorship, and publication experiences that emphasize translation of research findings into the day-to-day clinical practice of child and adolescent psychiatry." Over the past 8 years, dozens of new or early career authors have worked closely with JAACAP Connect editors to develop manuscripts into published articles.
Topics: Child; Humans; Adolescent; Publishing; Authorship; Writing; Learning; Adolescent Psychiatry
PubMed: 37030422
DOI: 10.1016/j.jaac.2023.03.013 -
The American Journal of Geriatric... Jan 2024Neuropsychiatric symptoms (NPS) are common manifestations of neurodegenerative disorders and are often early signs of those diseases. Among those neurodegenerative... (Review)
Review
Neuropsychiatric symptoms (NPS) are common manifestations of neurodegenerative disorders and are often early signs of those diseases. Among those neurodegenerative diseases, TDP-43 proteinopathies are an increasingly recognized cause of early neuropsychiatric manifestations. TDP-43-related diseases include frontotemporal dementia (FTD), amyotrophic lateral sclerosis (ALS), and Limbic-Predominant Age-Related TDP-43 Encephalopathy (LATE). The majority of TDP-43-related diseases are sporadic, but a significant proportion is hereditary, with progranulin (GRN) mutations and C9orf72 repeat expansions as the most common genetic etiologies. Studies reveal that NPS can be the initial manifestation of those diseases or can complicate disease course, but there is a lack of awareness among clinicians about TDP-43-related diseases, which leads to common diagnostic mistakes or delays. There is also emerging evidence that TDP-43 accumulations could play a role in late-onset primary psychiatric disorders. In the absence of robust biomarkers for TDP-43, the diagnosis remains primarily based on clinical assessment and neuroimaging. Given the association with psychiatric symptoms, clinical psychiatrists have a key role in the early identification of patients with TDP-43-related diseases. This narrative review provides a comprehensive overview of the pathobiology of TDP-43, resulting clinical presentations, and associated neuropsychiatric manifestations to help guide clinical practice.
Topics: Humans; Amyotrophic Lateral Sclerosis; DNA-Binding Proteins; Frontotemporal Dementia; Neurodegenerative Diseases; Psychiatry
PubMed: 37741764
DOI: 10.1016/j.jagp.2023.08.017 -
Annals of the Royal College of Surgeons... Nov 2023
Topics: Humans; Medical Errors; Confidentiality
PubMed: 37906974
DOI: 10.1308/rcsann.2023.0080 -
Nutrients Oct 2023The intricate connection between eating behaviors and sleep habits is often overlooked in clinical practice, despite their profound interdependence. Sleep plays a key... (Review)
Review
The intricate connection between eating behaviors and sleep habits is often overlooked in clinical practice, despite their profound interdependence. Sleep plays a key role in modulating psychological, hormonal and metabolic balance and exerting an influence on food choices. Conversely, various eating disorders may affect sleep continuity, sometimes promoting the development of sleep pathologies. Neurologists, nutritionists and psychiatrists tend to focus on these issues separately, resulting in a failure to recognize the full extent of the clinical conditions. This detrimental separation can lead to underestimation, misdiagnosis and inappropriate therapeutic interventions. In this review, we aim to provide a comprehensive understanding of the tangled relationship between sleep, sleep pathologies and eating disorders, by incorporating the perspective of sleep experts, psychologists and psychiatrists. Our goal is to identify a practical crossroad integrating the expertise of all the involved specialists.
Topics: Humans; Sleep; Feeding and Eating Disorders; Psychiatry; Neurology; Nutritional Status
PubMed: 37892563
DOI: 10.3390/nu15204488 -
European Child & Adolescent Psychiatry Oct 2023
PubMed: 37740094
DOI: 10.1007/s00787-023-02293-7