Efficacy and Safety of Transcranial Alternating Current Stimulation Compared to Transcranial Direct Current Stimulation in the Treatment of Psychiatric & Neurological Disorders: A Systematic Review of Head-to-head Trials

Clinical Practice Guidelines for the Use of Transcranial Direct Current Stimulation in Psychiatry.

This chapter reviews how disturbed sleep and circadian rhythms relate to psychiatric and neurological disorders. Nighttime sleep disturbances, daytime hypersomnia, and disrupted circadian rhythms occur in the majority of people with psychiatric or neurological disorders. Evidence supporting that sleep and brain disorders have a bidirectional relationship, such as sleep disturbances increasing the risk of developing neuropsychiatric disorders and neuropsychiatric disorders disrupting sleep, is reviewed. This chapter also discusses how sleep and circadian rhythms play a key role in cognitive and emotional processes tightly linked to neurological and psychiatric disorders, and that not all forms of sleep and circadian rhythms disruption are equally associated with the different types of psychiatric or neurological disorders. This chapter also reviews how medications used to improve sleep are used to treat psychiatric or neurological disorders, and how therapies used to treat psychiatric or neurological disorders can differentially improve or disrupt sleep.

Background: Cognitive Remediation or Rehabilitation Treatment (CRT) is a psychosocial treatment method against cognitive deficits and their functional consequences. CRT is implemented in various disorders ranging from brain injury to neurological and mental disorders and is associated with positive results in terms of cognitive and social functioning. Similarly, the investigation of the effects of CRT in schizophrenia has shown that it could improve cognition and everyday functioning and that it might also be beneficial for the other clusters of symptoms of the disorder (positive and negative symptoms). Objective: To present the origins, process of development and characteristics of a CRT program for individuals with psychoses (schizophrenia and other psychotic disorders, bipolar disorder with psychotic features and bipolar depression, etc.), along with the experience of its pilot implementation and its perspectives under limited financial and human resources. Methods: The article will discuss the theoretical basis of a CRT program for patients with psychosis. It will also present the consecutive steps of its development, its structure and its pilot implementation. Finally, it will discuss its future perspectives. Results: The program is based on the experience from animal and human studies and on principles including interdisciplinary therapeutic team work, individualization of therapy, frequent practice of cognitive tasks, use of strategies and psychological support. It aims at the improvement of everyday functioning of individuals with psychoses through the enhancement of their cognition. It is preceded and followed by sessions assessing cognitive performance, symptoms and functioning and comprises 40 individual training sessions with a frequency of at least two sessions per week. The training sessions are divided into two parts including a) a cognitive exercises module and b) a social cognition module. Cognitive exercises include a program designed for elderly suffering from mild cognitive impairment and additional cognitive tasks involving the main cognitive domains of impaired performance in schizophrenia. The social cognition module has been arisen from a program administered to patients hospitalized in an acute psychiatric ward with the aim to facilitate and accelerate their discharge. The perspectives of the CRT program include the development of group training sessions and public awareness activities and the creation of similar CRT Units in Mental Health Centres and other Health Settings. Given that both the cognitive impairments and the methods used for their treatment have common features across different mental or neurological disorders (e.g. non-psychotic depression, dementia, brain injury, substance use disorders), they also include the implementation of the program onr individuals presenting with cognitive impairments beyond psychoses. Conclusions: The development of CRT programs in the context of a National Health Service and under conditions of limited funding is feasible and could satisfy unmet needs of patients having cognitive difficulties regardless of their aetiology.

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The World Health Organization (WHO) is revising the ICD-10 classification of mental and behavioural disorders, under the leadership of the Department of Mental Health and Substance Abuse and within the framework of the overall revision framework as directed by the World Health Assembly. This article describes WHO's perspective and priorities for mental and behavioural disorders classification in ICD-11, based on the recommendations of the International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders. The WHO considers that the classification should be developed in consultation with stakeholders, which include WHO member countries, multidisciplinary health professionals, and users of mental health services and their families. Attention to the cultural framework must be a key element in defining future classification concepts. Uses of the ICD that must be considered include clinical applications, research, teaching and training, health statistics, and public health. The Advisory Group has determined that the current revision represents a particular opportunity to improve the classification's clinical utility, particularly in global primary care settings where there is the greatest opportunity to identify people who need mental health treatment. Based on WHO's mission and constitution, the usefulness of the classification in helping WHO member countries, particularly low- and middle-income countries, to reduce the disease burden associated with mental disorders is among the highest priorities for the revision. This article describes the foundation provided by the recommendations of the Advisory Group for the current phase of work.

Mental and neurological disorders and risk of COVID-19 susceptibility, illness severity and mortality: A systematic review, meta-analysis and call for action

Whither Neuropsychiatry?

Identifying psychiatric and neurological comorbidities associated with hoarding disorder through network analysis

Neuroinflammation represents a common trait in the pathology and progression of the major psychiatric and neurodegenerative disorders. Neuropsychiatric disorders have emerged as a global crisis, affecting 1 in 4 people, while neurological disorders are the second leading cause of death in the elderly population worldwide (WHO, 2001; GBD 2016 Neurology Collaborators, 2019). However, there remains an immense deficit in availability of effective drug treatments for most neurological disorders. In fact, for disorders such as depression, placebos and behavioral therapies have equal effectiveness as antidepressants. For neurodegenerative diseases such as Parkinson’s disease and Alzheimer’s disease, drugs that can prevent, slow, or cure the disease have yet to be found. Several non-traditional avenues of drug target identification have emerged with ongoing neurological disease research to meet the need for novel and efficacious treatments. Of these novel avenues is that of neuroinflammation, which has been found to be involved in the progression and pathology of many of the leading neurological disorders. Neuroinflammation is characterized by glial inflammatory factors in certain stages of neurological disorders. Although the meta-analyses have provided evidence of genetic/proteomic upregulation of inflammatory factors in certain stages of neurological disorders. Although the mechanisms underpinning the connections between neuroinflammation and neurological disorders are unclear, and meta-analysis results have shown high sensitivity to factors such as disorder severity and sample type, there is significant evidence of neuroinflammation associations across neurological disorders. In this review, we summarize the role of neuroinflammation in psychiatric disorders such as major depressive disorder, generalized anxiety disorder, post-traumatic stress disorder, and bipolar disorder, as well as in neurodegenerative disorders, such as Parkinson’s disease and Alzheimer’s disease, and introduce current research on the potential of immunomodulatory imide drugs (IMiDs) as a new treatment strategy for these disorders.

Persistent Auditory Hallucinations That Are Unresponsive to Antipsychotic Drugs

Neuropsychiatric disorders and COVID-19 – Authors' reply

Comments on "Psychopathology in Neuropsychiatry: DSM and Beyond"

Comments on “Psychopathology in Neuropsychiatry: DSM and Beyond”

Traditionally, apathy has been viewed as a symptom indicating loss of interest or emotions. This paper evaluates evidence that neuropsychiatric disorders also produce a syndrome of apathy. Both the symptom and the syndrome of apathy are of conceptual interest because they signify loss of motivation. An apathy syndrome is defined as a syndrome of primary motivational loss, that is, loss of motivation not attributable to emotional distress, intellectual impairment, or diminished level of consciousness. Loss of motivation due to disturbance of intellect, emotion, or level of consciousness defines the symptom of apathy. Neuropsychiatric literature dealing with apathy is reviewed within the framework of three approaches to defining the concept of a syndrome. Clinical and investigative approaches for evaluating apathy when it occurs in association with other syndromes are described.

The effect of changes in society, economy and public health on the disease burden of neurological, mental and substance use disorders: a global longitudinal study