Psilocybin-Assisted Therapy Found to Improve Depression, Offer Other Benefits
A study on the safety and efficacy of psilocybin-assisted therapy in a therapeutic setting in 24 participants with major depressive disorder found that the hallucinogen provided rapid and substantial antidepressant effects lasting up to one year with no serious adverse effects. The long-term efficacy and safety of such treatment, however, are not known. The 24 participants were randomised to either an immediate or eight-week delayed treatment protocol, involving a combination of psilocybin sessions and supportive psychotherapy. Each participant received two doses of psilocybin and were followed for up to a year.
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Comparing Detection of Alzheimer’s and Vascular Disease–Related Cognitive Impairment With Brief Cognitive Screens
The study compared the accuracy of the Mini-Mental State Examination (MMSE) with its modified version (3MS) in distinguishing healthy older adults from adults with cognitive impairment due to suspected Alzheimer’s disease (AD) or vascular disease (VaD).The 3MS demonstrated superior detection of cognitive impairment. The extent of this enhanced detection was influenced by the suspected etiology of cognitive impairment. The 3MS and MMSE had comparable discrimination of AD and HC. With respect to VaD, the 3MS showed superior discriminability compared to the MMSE. Overall, results support the adoption of the 3MS over that of the MMSE. The 3MS is a superior (and free) tool for detecting cognitive impairment in geriatric populations. Its use is recommended for first-line screening of cognitive symptoms in older adult populations, especially those with concern for VaD.
Pathological Lying: Psychotherapists’ Experiences and Ability to Diagnose
Pathological lying has been discussed in the research literature for more than a century, mostly in case studies. Recent research has supported pathological lying as a diagnostic entity, although it remains absent from nosological systems. The current study aimed to survey practitioners about their experiences working with clients who engage in pathological lying and to examine practitioners’ abilities to diagnose pathological lying. Most practitioners reported clinical experience with patients exhibiting pathological lying, although such patients made up a small proportion of their caseloads. Clinicians described these patients as lying with great frequency and indicated that lying caused marked distress and impaired functioning in social, occupational, financial, and legal domains. The behavior typically had begun during adolescence and had continued for ≥5 years. Respondents reported usually offering a diagnosis other than pathological lying, such as a personality disorder. By using a published definition of pathological lying, respondents (N=156) were able to reliably identify cases of pathological lying portrayed in clinical vignettes and were able to consistently discriminate between pathological lying and both related and unrelated disorders.
Crisis Psychotherapy Treatment of a Cancer Survivor With Suicidal Ideation During the COVID-19 Pandemic
This case illustrates how crisis psychotherapy provided by telephone was used to effectively deliver evidence-based health care during the pandemic to a cancer patient living in poverty. In our discussion of Ms. C, we considered the role of disaster psychiatry interventions to manage distress and maintain functioning. Specifically, we followed the five principles of disaster psychiatry while adhering to psycho-oncology guidelines for assessing and treating distress. Although no clinical trials of disaster psychiatry interventions were found in the literature, strong justification exists for these empirically supported, expert-identified principles, which include promoting a sense of safety (e.g., developing adaptive cognitions and coping skills, use of grounding techniques), promotion of calming (e.g., breathing and relaxation techniques, psychoeducation, and normalization of stress responses), promoting self-efficacy (e.g., cognitive-behavioural therapy techniques that foster patient autonomy and mastery over stressors), promoting connectedness (e.g., by increasing emotional and practical support), and instilling hope (e.g., interventions aimed at decatastrophising, future planning, setting novel and achievable expectations).
Diagnosing Prescription Opioid Use Disorder in Patients Using Prescribed Opioids for Chronic Pain
The diagnostic criteria for opioid use disorder, originally developed for heroin, did not anticipate the surge in prescription opioid use and the resulting complexities in diagnosing prescription opioid use disorder (POUD), including differentiation of pain relief (therapeutic intent) from more common drug use motives, such as to get high or to cope with negative affect. The authors examined the validity of the Psychiatric Research Interview for Substance and Mental Disorders, DSM-5 opioid version, an instrument designed to make this differentiation. Results - Adapting POUD measures for pain relief (therapeutic intent) improved validity. Studies should investigate the clinical utility of differentiating between therapeutic and nontherapeutic intent in evaluating POUD diagnostic criteria