Our objective is to examine current existing literature regarding common mental health issues and psychiatric comorbidity in individuals presenting with gender dysphoria (GD).
The therapeutic options for neurobehavioral disorders are still limited, and in many cases, they lack a satisfactory balance between efficacy and side effects.This work aims to review current evidence regarding the potential contribution of psychedelics and hallucinogens to the discovery of new drugs for treating different psychiatric disorders.Ayahuasca/N,N-dimethyltryptamine (DMT), lysergic acid diethylamide (LSD), and psilocybin have evidence supporting their use in depression, and psilocybin and ayahuasca have also shown good results in treatment-resistant depression. In randomized controlled trials (RCTs) conducted with anxious patients, there were symptomatic improvements with psilocybin and LSD. Psilocybin diminished Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores in a small obsessive- compulsive disorder (OCD) sample. The evidence is less robust regarding substance use disorders, but it suggests a possible role for LSD and psilocybin in alcohol use disorders and for psilocybin in tobacco addiction. In a clinical setting, these substances seem to be safe and well-tolerated. Their mechanisms of action are not fully elucidated, but there seems to be a preponderant role of 5-hydroxytryptamine (5HT) 2A agonism, as well as connectivity changes within the default mode network (DMN) and amygdala and some other molecular modifications.The studies underlying the conclusions have small samples and are heterogeneous in their methods. However, the results suggest that the use of psychedelics and hallucinogens could be considered in some disorders. More studies are needed to reinforce their evidence as potential new drugs.
Objectives: Pediatric preoperative anxiety (PPOA) has been a concerning matter for the past decades with a high prevalence and several adverse outcomes branching into social, developmental, behavioral and perioperative fields. The management of anxious children is a priority for minimizing PPOA of the upmost importance. The aim of the study was to assess the levels of preoperative anxiety and their relation to a group of selected variables in a pediatric population being submitted to ambulatory surgery under general anesthesia.
Methods: Children’s anxiety was assessed using the modified Yale Preoperative Anxiety Scale-Short Version at the preoperative holding area (Time 1) and at the operation room during induction of anesthesia (Time 2). A cutoff value of 30 was used to differentiate anxious children from non-anxious children (scores ≤ 30). Results: 67 children were included in the study. 9 (13.4%) were anxious children at T1 and 24 (35.8%) at T2. A gender difference was not present (p=0.634 for T1, p=0.303 for T2), but the boys presented higher scores at both times and tend to have a significant increase from T1 to T2 (p=0.049). An overall change in the anxiety status from T1 to T2 does not tend to occur (p=0.01). Younger children tend to have higher scores although not statistically significant. No statistical significant difference was found between the remaining variables.
Conclusions: The prevalence of anxious children presented is lower than the estimated worldwide and reveals both the result of correct practices and best use of resources. However, the scarcity of national studies exploring this topic renders an indication to implement similar future studies, with larger samples and further studying of the potential predisposing and contributing variables. The never-ending purpose should be to institute more customized programs for minimizing PPOA by means of multimodal combinations of anxiolytic practices.
A successful U.K designed inter-professional education programme at the interface of cancer, mental health and end of life care was adapted in collaboration with healthcare professionals in Sri Lanka to a series of half day workshops reflecting local priorities about management of mental illness co-morbidity in cancer patients.This study aims to evaluate the effectiveness of education programme by analysis of pre v post intervention changes to participant knowledge, confidence and attitudes to co-morbid mental disorder in cancer patients, in different environments across Sri Lanka.
Background: The development of SexTech (Sexuality + Technology) has profoundly altered the way relationships are experienced, and an accessible example of that, which has millions of users, is the dating apps (Tinder, Grindr, and Bumble), which can locate partners with common interests nearby. Aim: To determine whether the use of dating apps is associated with higher levels of stress, anxiety, or depression and to assess the main motivations for using dating apps in young people. Methods: An online questionnaire addressed to university students was designed with an initial part aimed at collecting the sociodemographic data of the sample, a second part to address motivations for the use of dating applications, and a third part designed to evaluate the anxiety and depression scores of the participants. Outcomes: This study had two main outcomes: anxiety and depression scores measured using the Depression, Anxiety, and Stress Scale (DASS-21). Results: Four hundred and ninety-seven people participated in the study, with an average age of 21.8 years. Seventy percent were female. Thirty-four percent of the students use or have used these applications. Recent users showed a statistically significantly higher depression score than non-users. However, the ones who ever used dating apps did not report significantly higher scores than non-users. Homosexual participants have a statistically significantly higher anxiety and depression score than heterosexual. The most stated reason for using apps was “meeting new people,” followed by “entertainment” and “curiosity.” Clinical Implications: To promote mental health and sex education, have more tools to respond to topics related to sexuality and technology. Strengths and Limitations: The DASS-21 questionnaire is an adequate tool for screening for anxiety and depression disorders. However, other methods should be added to establish a formal diagnosis. The methodology applied in this research allowed us to establish an association between variables but not causality. In any case, we argue that our results shed light on the impact that the much-used dating apps have on mental health and the main reasons for their use. Conclusion: Being a user of dating apps does not seem to impact mental health; however, recent use and belonging to a minority constitute predictors of more anxiety and depression symptoms.
Abstract Purpose of Review To evaluate the effectiveness of psychostimulant augmentation of antidepressants in the treatment of depression in adults. Recent Findings In our analysis of 13 RCTs involving 2478 participants, psychostimulant augmentation demonstrated a statistically significant reduction in depressive symptom severity compared to placebo augmentation ( N = 1827; SMD = − 0.18; 95% CI (− 0.36, − 0.01); p = 0.04, I 2 = 65%). However, we did not observe a significant increase in remission rates ( N = 1709; OR = 1.30; 95% CI (0.97, 1.75); p = 0.08, I 2 = 32%). Summary Depression, a pressing global health issue, is typically treated with antidepressant monotherapy, offering limited relief. Our study introduces a potential breakthrough: psychostimulant augmentation of antidepressants, which significantly alleviates depressive symptoms. Nevertheless, larger high-quality trials evaluating a wider range of drugs are necessary to further explore and strengthen our findings.
The present work reviews current evidence regarding the contribution of machine learning to the discovery of new drug targets.Scientific articles from PubMed, SCOPUS, EMBASE, and Web of Science Core Collection published until May 2021 were included in this review.The most significant areas of research are schizophrenia, depression and anxiety, Alzheimer´s disease, and substance use disorders. ML techniques have pinpointed target gene candidates and pathways, new molecular substances, and several biomarkers regarding psychiatric disorders. Drug repositioning studies using ML have identified multiple drug candidates as promising therapeutic agents.Next-generation ML techniques and subsequent deep learning may power new findings regarding the discovery of new pharmacological agents by bridging the gap between biological data and chemical drug information.
Introduction Delirium is characterized by fluctuating disturbance of consciousness, inattention, reduced awareness, hallucinations or delusions, occurring in 20% of hospital admissions. Central nervous system symptoms are the main form of neurologic injury in patients with COVID-19 and a significant portion of these patients presents with delirium. COVID-19 infection’s course and symptoms, as well as patient comorbidities can facilitate its onset, which is exacerbated by the frequent need for higher doses of sedation to suppress severe cough. Objectives To summarize the most recent practices for management of delirium in COVID-19 infected patients, with emphasis on the psychopharmacology approach. Methods Selective literature review via PubMed search, using the terms “delirium, neurological disorders, psychopharmacology and COVID-19”. Results COVID-19 associated delirium can be presented in its hyperactive type with exuberant agitation, but also with additional clinical features such as rigidity, akinetic mutism, abulia and alogia. Psychopharmacological approaches may be needed for patients with agitation when there’s intractable stress or risk to self or others. In this group of patients, melatonin, alfa-2 agonists and low potency antipsychotics have been used as first line treatment. Trazodone, valproate, dopamine agonists, amantadine can be used. Other approaches such as correction of vitamin deficiencies and remdesivir can also play a role. Conclusions Delirium remains frequently unrecognized. In the pandemic context of COVID-19 it is important to consider this infection as a cause of delirium and mind the misdiagnosis as a psychiatric condition. One should look for atypical features and be more thoughtful about the psychopharmacological approach.
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