Field Of Psychiatry Research Articles

Enhanced visual contrast suppression during peak psilocybin effects: Psychophysical results from a pilot randomized controlled trial.

In visual perception, an effect known as surround suppression occurs wherein the apparent contrast of a center stimulus is reduced when it is presented within a higher-contrast surrounding stimulus. Many key aspects of visual perception involve surround suppression, yet the neuromodulatory processes involved remain unclear. Psilocybin is a serotonergic psychedelic compound known for its robust effects on visual perception, particularly texture, color, object, and motion perception. We asked whether surround suppression is altered under peak effects of psilocybin. Using a contrast-matching task with different center-surround stimulus configurations, we measured surround suppression after 25mg of psilocybin compared with placebo (100mg niacin). Data on harms were collected, and no serious adverse events were reported. After taking psilocybin, participants (n = 6) reported stronger surround suppression of perceived contrast compared to placebo. Furthermore, we found that the intensity of subjective psychedelic visuals induced by psilocybin correlated positively with the magnitude of surround suppression. We note the potential relevance of our findings for the field of psychiatry, given that studies have demonstrated weakened visual surround suppression in both major depressive disorder and schizophrenia. Our findings are thus relevant to understanding the visual effects of psilocybin, and the potential mechanisms of visual disruption in mental health disorders.

Courtesy stigma in the families of patients with severe mental disorders: an obstacle to the recovery process?

The general concept of stigma finds wide application in the field of psychiatry by indicating prejudice, stereotypes and discrimination towards patients diagnosed with psychiatric illness. Among the different declinations of this concept, we find courtesy stigma: a form of stigma by association experienced by people in close contact with the stigmatised person.Those who are most likely to experience this type of discrimination are the family members of the psychiatric patient, as they are particularly connected to the person with mental health problems. This experience contributes to increasing levels of expressed emotion (EE), i.e. the index of the emotional climate within the family.This study is based on two samples: a group of users with a diagnosis of severe mental disorder from the Department of Psychiatry of the University of Campania “Luigi Vanvitelli” and another group of family caregivers. This study aimed to: a) assess the impact of courtesy stigma on the levels of recovery and EE perceived by the patient; b) assess the relationship between the latter and the recovery process.To this end, the RAS-DS (Recovery Assessment Scale - Domains and Stages) and LEE (Level of Expressed Emotion Scale) scales were administered to patients, whereas caregivers were administered the CPMI (Stigma scale for Caregivers of People with Mental Illness) scale.Data processing revealed that high levels of courtesy stigma reported by caregivers not only hinder the patients’ recovery process, but also contribute to increasing EE levels according to the patients. Furthermore, as the EE levels perceived by the patients increase, the recovery levels decrease.

Neurobiological effects of childhood trauma: A literature review

This article is a comprehensive review of past literature focusing on neurobiological effects of childhood trauma. Chronic interpersonal violence in children is common worldwide (De Bellis & Zisk, 2014). Exposure to continuous physical and emotional trauma in childhood undoubtedly has long lasting effects like developing post- traumatic stress disorder (PTSD), dysregulation of the hypothalamic–pituitary–adrenal axis (HPA) axis leading to hormonal issues, among other things, in an individual. A systematic review of these effects can prove beneficial in the field of psychiatry.

Trends in gender and ethnic diversity among US psychiatry residents: A 5-year analysis.

This study aims to analyze trends in gender and ethnic diversity among incoming US psychiatry residents over the past 5 years. Physician diversity improves patient care as minority physicians often serve underserved communities and address health disparities. Increasing the representation of women and underrepresented minorities in medicine is essential for preparing a physician workforce that can effectively care for an increasingly diverse population. This study highlights the importance of efforts to enhance diversity within the field of psychiatry.

The Necessary Rapprochement of Negative Affectivity, Personality Disorder, and Depression.

The relationship between depression and personality has long been a topic of interest in the fields of psychiatry and psychology, but consensus remains elusive. This lack of consensus poses a significant challenge in both diagnosis and treatment, especially in situations when otherwise effective therapies for depression fail. Our article aims to address this issue by reviewing the historical and recent conceptualizations of the relationship between depression and personality pathology. Specifically, we focus on the trait domain of negative affectivity found in the International Classification of Diseases, 11th Edition (ICD-11) and the Alternative Model for Personality Disorders (AMPD) as a connecting link between the two phenomena. We review recent empirical studies evaluating the association of negative affectivity, personality, and depression, along with investigations of the relationship between depressive disorders and personality disorders. Additionally, we describe the Hierarchical Taxonomy of Psychopathology (HiTOP) and the AMPD as organizing frameworks for understanding depression within a broader personality framework. Based on the available evidence, we propose that depressive disorders must be assessed within the context of the patient's personality in order to maximize treatment outcomes. Ultimately, this integrated approach can guide clinicians in developing unified treatment protocols and facilitate early detection and intervention for factors contributing to depression in order to minimize treatment resistance.

Integrating psychiatry into basic clinical skills: A three-year nationwide quantitative assessment of postgraduate training programs.

The aim of this study was to develop quantitative outcome indicators for psychiatric training programs integrated into the General Medicine In-Training Examination (GM-ITE) and to investigate which characteristics correlate with high scores in psychiatry. A nationwide cross-sectional study was conducted over 3 fiscal years (2021-2023). An anonymous online questionnaire was distributed to postgraduate year 1 and 2 residents who completed the GM-ITE. The primary outcome was GM-ITE score, with a particular focus on psychiatry. Multiple-choice questions for the psychiatry field were created by board-certified psychiatrists with various subspecialties, then reviewed and piloted. Multiple regression analysis examined correlations between GM-ITE score and various resident and facility characteristics. A total of 18,226 residents participated over the 3 years, of whom 5%-6% aspired to specialize in psychiatry. Quantitative scores were effective in the psychiatry field across all 3 years. Psychiatry aspirants had lower scores in internal medicine, emergency, and total scores but higher scores in psychiatry. Residents from university hospitals had lower psychiatry scores, while the number of psychiatry beds and supervising psychiatrists did not correlate with higher psychiatry scores. These findings indicate the need for psychiatric training programs distinct from general internal medicine and emergency training. Based on these quantitative psychiatry scores, this study highlights the necessity of improving physical assessment skills during residency for psychiatry aspirants, who score higher in psychiatry. Future research should identify effective training programs and facility practices that lead to higher psychiatry scores among residents, and thereby better integrate psychiatry into basic clinical skills.

Personality disorders in later life: an update

SUMMARY Personality disorders can worsen with age or emerge after a relatively dormant phase in earlier life when roles and relationships ensured that maladaptive personality traits were contained. They can also be first diagnosed in late life, if personality traits become maladaptive as the person reacts to losses, transitions and stresses of old age. Despite studies focusing on late-life personality disorders in recent years, the amount of research on their identification and treatment remains deficient. This article endeavours to provide an understanding of how personality disorders present in old age and how they can be best managed. It is also hoped that this article will stimulate further research into this relatively new field in old age psychiatry. An awareness of late-life personality disorders is desperately needed in view of the risky and challenging behaviours they can give rise to. With rapidly growing numbers of older adults in the population, the absolute number of people with a personality disorder in older adulthood is expected to rise.

Having Reliable Support: A Prerequisite to Promote Sexual and Reproductive Health in Young Women with ADHD.

Living with attention deficit hyperactivity disorder (ADHD) may influence sexual behaviors and intimate relationships in young women, resulting in a higher risk of unwanted pregnancy, sexual victimization, and sexual dysfunction. To develop adequate support, the study aimed to describe conceptions of how to promote sexual and reproductive health (SRH) in young women with ADHD. A secondary analysis using phenomenography was performed on qualitative interview data exploring variations of support. The study involved 15 young women with ADHD, aged 15-29 years, and 16 health care professionals, with various professions, working in the fields of gynecology, youth health, and psychiatry. Having reliable support was conceptualized as fundamental for promoting SRH. Access to information concerning SRH and living with ADHD as well as early support from health care contributed to a reliable support enabling self-knowledge and management of sexual relationships. Trustful relationships in health care were perceived as important because of previous experiences of feeling misunderstood and criticized in life, making them feel comfortable discussing SRH. Clinical encounters with a clear structure were further perceived to make information more accessible and clinics that provided appropriate organizational conditions and collaborated with other clinics were described to enhance the availability of support. This study reveals the need for clinics to provide conditions that ensure SRH support is available, accessible, and free of stigmatization. Early intervention programs for young women with ADHD may be considered, offering guidance on SRH issues in both psychiatric and sexual health clinics.

Psychosis Prognosis Predictor: A continuous and uncertainty-aware prediction of treatment outcome in first-episode psychosis.

Machine learning models have shown promising potential in individual-level outcome prediction for patients with psychosis, but also have several limitations. To address some of these limitations, we present a model that predicts multiple outcomes, based on longitudinal patient data, while integrating prediction uncertainty to facilitate more reliable clinical decision-making. We devised a recurrent neural network architecture incorporating long short-term memory (LSTM) units to facilitate outcome prediction by leveraging multimodal baseline variables and clinical data collected at multiple time points. To account for model uncertainty, we employed a novel fuzzy logic approach to integrate the level of uncertainty into individual predictions. We predicted antipsychotic treatment outcomes in 446 first-episode psychosis patients in the OPTiMiSE study, for six different clinical scenarios. The treatment outcome measures assessed at both week 4 and week 10 encompassed symptomatic remission, clinical global remission, and functional remission. Using only baseline predictors to predict different outcomes at week 4, leave-one-site-out validation AUC ranged from 0.62 to 0.66; performance improved when clinical data from week 1 was added (AUC = 0.66-0.71). For outcome at week 10, using only baseline variables, the models achieved AUC = 0.56-0.64; using data from more time points (weeks 1, 4, and 6) improved the performance to AUC = 0.72-0.74. After incorporating prediction uncertainties and stratifying the model decisions based on model confidence, we could achieve accuracies above 0.8 for ~50% of patients in five out of the six clinical scenarios. We constructed prediction models utilizing a recurrent neural network architecture tailored to clinical scenarios derived from a time series dataset. One crucial aspect we incorporated was the consideration of uncertainty in individual predictions, which enhances the reliability of decision-making based on the model's output. We provided evidence showcasing the significance of leveraging time series data for achieving more accurate treatment outcome prediction in the field of psychiatry.

Is orthorexia nervosa a hidden threat impacting quality of life in IBS patients?

The potential link between functional gastrointestinal disorders and eating disorders has been reported recently. The present study aimed to explore the relationship between orthorexic tendencies and irritable bowel syndrome (IBS)-related quality of life in IBS patients. This cross-sectional study was conducted with 121 IBS patients. The data were collected using Orthorexia Nervosa-11 (ORTO-11) to assess orthorexic tendencies, Irritable Bowel Syndrome Quality of Life Scale (IBS-QoL) to measure quality of life, and Irritable Bowel Syndrome Symptom Severity Score (IBS-SSS) to measure IBS symptoms. Food consumption record was taken to assess diet quality with the Healthy Eating Index 2015 (HEI-2015). The relationship between measured variables was assessed. The mean ORTO-11 score of the patients was 24.76 ± 3.99. Most patients had poor diet quality (52.00%). A moderate positive correlation was found between ORTO-11 and IBS-QoL (model 0, p < 0.005 and model 1, p < 0.001) and a strong negative correlation between IBS-SSS and IBS-QoL (p < 0.001). In conclusion, we can conclude that both altered IBS symptoms and orthorexic tendencies affect the quality of life of irritable bowel patients independently of each other. These findings provide valuable insights into the treatment of IBS and inform clinicians and researchers in the fields of gastroenterology, nutrition, psychiatry,and psychology.

Charcot and hallucinations: A study in insight and blindness

ABSTRACT Jean-Martin Charcot (1825–1893) showed little interest in mental disorders, the domain of nineteenth-century alienists. But hallucinations are not confined to the field of psychiatry, and Charcot, who had once tested the hallucinogenic effects of hashish in his youth, went on to describe hallucinations in the course of various neurological conditions as just another semiological element. Most of his or his disciples’ writings on hallucinations can be found in his work on hysteria. Hallucinations and delusions were part of “grand hysteria” and occurred at the end of the attack (third or fourth phase). Hypnosis or chemical agents could also induce hallucinations. Charcot and his disciples did not go so far as to emphasize the importance of hallucinations when they evoked past trauma, especially sexual trauma. Charcot’s materialistic orientation led him and his disciples—especially D. M. Bourneville (1840–1909), G. Gilles de la Tourette (1857–1904), and the neurologist and artist P. Richer (1849–1833)—to seek hysteria in artistic representations of “possessed women” and in the visions of nuns and mystics. Finally, Charcot recognized the importance of hallucinations in neurological semiology, by means of precise and relevant observations scattered throughout his work. Preoccupied with linking hysteria to neurology, Charcot only scratched the surface of the possible significance of hallucinations in this context, paving the way for the work of his students Pierre Janet (1859–1947) and Sigmund Freud (1856–1939).

Exploring resilience and trauma: a comparative analysis of 'The Comfort Book' and 'The Body Keeps the Score'

In the ever-evolving field of psychiatry, understanding the intricate relationship between mental health, trauma, and recovery remains crucial. Recent literature has offered profound insights into these connections, with particular focus on how individuals navigate their mental health challenges. Two recent works—Matt Haig's The Comfort Book (2021) and Bessel van der Kolk's The Body Keeps the Score (2014)—have garnered significant attention for their distinct yet complementary approaches to addressing psychological well-being. While The Comfort Book provides a reflective, almost meditative guide to fostering resilience in everyday life, The Body Keeps the Score delves deeply into the neurological and physiological impacts of trauma, offering a more clinical yet accessible approach to understanding and treating psychological wounds. This review aims to critically examine how these books contribute to the discourse on mental health, highlighting their relevance to both practitioners and patients in the field of psychiatry. These books, although different in style and scope, serve as valuable resources. They provide readers with practical tools and theoretical knowledge to better understand the complexities of trauma and resilience. The comparative analysis of these works will explore their effectiveness in enhancing our understanding of mental health, resilience, and the journey towards healing.

Psychiatric disorders from EEG signals through deep learning models

Psychiatric disorders present diagnostic challenges due to individuals concealing their genuine emotions, and traditional methods relying on neurophysiological signals have limitations. Our study proposes an improved EEG-based diagnostic model employing Deep Learning (DL) techniques to address this. By experimenting with DL models on EEG data, we aimed to enhance psychiatric disorder diagnosis, offering promising implications for medical advancements. We utilized a dataset of 945 individuals, including 850 patients and 95 healthy subjects, focusing on six main and nine specific disorders. Quantitative EEG data were analyzed during resting states, featuring power spectral density (PSD) and functional connectivity (FC) across various frequency bands. Employing artificial neural networks (ANN), K nearest neighbors (KNN), Long short-term memory (LSTM), bidirectional Long short-term memory (Bi LSTM), and a hybrid CNN-LSTM model, we performed binary classification. Remarkably, all proposed models outperformed previous approaches, with the ANN achieving 96.83 % accuracy for obsessive-compulsive disorder using entire band features. CNN-LSTM attained the same accuracy for adjustment disorder, while KNN and LSTM achieved 98.94 % accuracy for acute stress disorder using specific feature sets. Notably, KNN and Bi-LSTM models reached 97.88 % accuracy for predicting obsessive-compulsive disorder. These findings underscore the potential of EEG as a cost-effective and accessible diagnostic tool for psychiatric disorders, complementing traditional methods like MRI. Our study's advanced DL models show promise in enhancing psychiatric disorder detection and monitoring, with significant implications for clinical application, inspiring hope for improved patient care and outcomes. The potential of EEG as a diagnostic tool for psychiatric disorders is substantial, as it can lead to improved patient care and outcomes in the field of psychiatry.

Association between pathogenic beliefs and personality disorders

Background and objectivesPersonality disorders are significant entities in the field of psychiatry and serve as predisposing factors for Axis I clinical disorder. The Treatment of choice is psychotherapy, and one specific approach is Control Mastery Therapy, which emphasizes addressing Pathogenic beliefs (PB). This study aimed to investigate whether there is a relationship between PB and specific personality disorders and whether these beliefs align with the core features specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM) for that personality disorder. Materials and methodsThis study employed a retrospective cross-sectional design and included 319 participants, comprising individuals receiving treatment at the Psychotherapy Clinic at Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University between 2007 and 2023. All participants were assessed and completed the Structured Clinical Interview for DSM-IV Axis II - Personality Disorders Questionnaire (SCID-II-PQ), Pathogenic Beliefs Scale, and Outcome-Inventory (depression). A generalized linear model (binary logistic regression) was employed, and the predictors included personality disorders. The outcome was the pathogenic belief, and covariates encompassed age, sex, education, clinical diagnosis, and depression score. A sensitivity analysis was conducted to examine the effect on the model when outliers of depressive scores were present. ResultsAfter adjusting for depression, ten personality disorders were found to predict 16 pathogenic beliefs out of the 27 outcomes examined. Notably, histrionic and obsessive-compulsive personality disorders showed no association with specific pathogenic beliefs. Furthermore, certain pathogenic beliefs were predicted by multiple personality disorders, while conversely, some personality disorders were associated with multiple pathogenic beliefs as well. Sensitivity analysis revealed that outliers influenced the relationships between certain disorders and pathogenic beliefs, particularly those with small effect sizes. ConclusionsThe profound impact of pathogenic beliefs intertwined with personality disorders, particularly influenced by childhood trauma and evident in Cluster B and schizotypal disorders, underscores the critical need for targeted psychotherapeutic interventions. Addressing these beliefs directly is key to enhancing treatment efficacy and patient outcomes. Pathogenic belief should be elicited in clinical settings regardless of personality disorder, especially those who experienced depression. Moving forward, rigorous research is imperative to validate and refine therapeutic approaches aimed at reshaping pathogenic beliefs, ensuring they become pivotal in transforming clinical practice and advancing mental health care.

Lamotrigine: A Safe and Effective Mood Stabilizer for Bipolar Disorder in Reproductive-Age Adults.

Lamotrigine belongs to the group of antiepileptic drugs and mood stabilizers, and its action is based on the selective blocking of voltage-deficient sodium channels. The effect of this mechanism is the stabilization of the presynaptic part of the neuronal membrane and subsequent inhibition of the secretion of the neurotransmitters glutamate and aspartate into the postsynaptic part of the neuron. Lamotrigine has been approved by the Food and Drug Administration for the maintenance treatment of adults with bipolar disorder since 1994. In the field of psychiatry, this medicine is also used off-label in the treatment of acute bipolar depression. Studies show promising effects of the use of lamotrigine in bipolar disorder type II with rapid phase change. Bipolar disorder is a common psychiatric problem that most often affects young adults. Lamotrigine is most effective in bipolar disorder in preventing depressive episodes, which dominate the clinical picture of this disease. The latest research focuses on extending its action, to include manic episodes. Lamotrigine, through an unexplained mechanism, can affect the immune system, causing Stevens-Johnson syndrome, hemophagocytic lymphohistiocytosis, and drug reaction with eosinophilia and systemic symptoms syndrome. These are rare, life-threatening adverse effects that require urgent intervention in the form of drug discontinuation and immunosuppressive treatment. Strict contraindications to the use of lamotrigine include sensitivity reactions accompanied by systemic symptoms. Phenotype testing enables screening of patients predisposed to serious hypersensitivity reactions. The aim of the article is to review the indications, contraindications, and adverse effects of lamotrigine in the treatment of bipolar disorder and depression.

From brain cytoarchitectonics to clinical neurology: Polish Institute for Brain Research in Vilnius, 1931-1938.

The Polish Institute for Brain Research was established in Warsaw in 1928 to support scientific research on the brain and its functions. The director of the institute was Maksymilian Rose (1883-1937), a distinguished Polish neurologist and neuroanatomist, a disciple of Oskar Vogt and Korbinian Brodmann. In 1931, the Institute was moved from Warsaw to Vilnius. The Institute was well-known in Europe at the time because of the research in the fields of neuroscience, clinical neurology, and psychiatry, as well as the cytoarchitectonic analysis of social activists' brains-a fashionable, neophrenological way to link the mental functions of deceased geniuses with the cellular composition of their central nervous systems. In 1939, the work of the Institute was interrupted by World War II; some of the preparations and materials were moved from Vilnius to Warsaw, some were stored in Vilnius, and some were lost. In this article, we analyze the primary and secondary sources, some of which were obscure for over 80years, and evaluate the most important scientific achievements of the Polish Institute for Brain Research, as well as its legacy in the early period of modern neuroscience and neurology in interwar Vilnius.

TRANSITION TO THE SPECIAL NEEDS REPORT FOR CHILDREN (SNRC): AN ANALYSIS OF REFERRALS TO CHILD AND ADOLESCENT PSYCHIATRY OVER THE LAST THREE YEARS

Objective: Following the enactment of the Special Needs Report for Children (SNRC) regulation on February 20, 2019, several changes were made to the reporting system. The field of child psychiatry is among the leading specialties issuing SNRC reports. This study aimed to evaluate the psychiatric and other medical diagnoses of cases referred to pediatric and adolescent psychiatry for SNRC, determine their level of needs, and discuss the new regulation in the context of existing literature. Material and Methods: Demographic and clinical characteristics, as well as levels of needs and relevant areas, were retrospectively analyzed for cases aged 0-18 who presented to a university hospital's pediatric and adolescent psychiatry clinic between January 2021 and January 2024. Results: A total of 986 children and adolescents, comprising 331 (33.6%) females and 655 (66.4%) males, with a mean age of 10.27±3.77 years, were included in the study. The most common reason for SNRC referral in the 0-4 age group was speech delay (n=32, 45.1%) while learning difficulties were predominant in other age groups. Analysis of psychiatric diagnoses under SNRC revealed delayed milestone diagnosis as the most common at 45.7% (n=451), followed by specific learning disorder (n=312, 31.6%) and autism spectrum disorder (n=154, 15.6%). Non-psychiatric diagnoses showed that 28.8% (n=284) of cases had at least one accompanying medical disease, including cerebral palsy (n=65, 6.5%), sensorineural hearing loss (n=47, 4.8%), epilepsy (n=37, 3.8%), and Down syndrome (n=21, 2.1%). Additionally, 20% (n=198) of cases exhibited special needs in at least one non-psychiatric area, with motor development being the most common domain (n=125, 63.1%). Conclusion: These findings highlight the diversity of needs among children and adolescents receiving SNRC reports. Accurate evaluation and reporting of special needs in child and adolescent psychiatry are crucial for enhancing individuals' quality of life and providing necessary support.

An international, cross-sectional survey of psychiatry researchers and clinicians: perceptions of complementary, alternative, and integrative medicine.

Psychiatry is a branch of medicine that focuses on mental, behavioral and emotional well-being. Complementary, alternative, and integrative medicine has been an increasingly popular choice for patients with psychiatric disorders, therefore our study aimed to explore the perceptions of psychiatry researchers and clinicians on the use of CAIM. We conducted an online, anonymous, cross-sectional survey for researchers and clinicians who have published their work in psychiatry medical journals that are indexed in MEDLINE. 42,667 researchers and clinicians were sent the link to the survey after extraction of their email addresses from their respective publications. Respondents were asked numerous multiple-choice questions regarding their perceptions on various CAIM therapies, followed by an open-ended question where they could include any additional thoughts. The survey was completed by 987 respondents, with a majority identifying as a researcher (n=447, 46.51%), or as both a researcher and a clinician (n=368, 38.29%) within the field of psychiatry. Most respondents (n=629, 78.04%) perceived mind-body therapies such as meditation, biofeedback, hypnosis, and yoga to be the most promising CAIM therapy for the prevention, treatment, and management of psychiatric diseases. Many participants said that they agree (n=285, 38.14%) that most CAIM therapies in general are safe, however, many disagree that CAIM therapies are effective (n=245, 32.93%). Respondents indicated that there is value to conducting research on CAIM therapies (n=356, 47.91%), and that there should be more funding allocated to researching these therapies (n=265, 35.71%). Respondents were also in agreement that clinicians should receive training on CAIM therapies through formal education (n=295, 39.76%) or supplementary education (n=380, 51.28%). The findings from this study showed that there is great interest and potential in researching CAIM within the field of psychiatry. This information can be used as a basis for further research and to develop tailored educational resources for researchers and clinicians in psychiatry.

Assessing dimensions of thought disorder with large language models: The tradeoff of accuracy and consistency

Natural Language Processing (NLP) methods have shown promise for the assessment of formal thought disorder, a hallmark feature of schizophrenia in which disturbances to the structure, organization, or coherence of thought can manifest as disordered or incoherent speech. We investigated the suitability of modern Large Language Models (LLMs - e.g., GPT-3.5, GPT-4, and Llama 3) to predict expert-generated ratings for three dimensions of thought disorder (coherence, content, and tangentiality) assigned to speech samples collected from both patients with a diagnosis of schizophrenia (n = 26) and healthy control participants (n = 25). In addition to (1) evaluating the accuracy of LLM-generated ratings relative to human experts, we also (2) investigated the degree to which the LLMs produced consistent ratings across multiple trials, and we (3) sought to understand the factors that impacted the consistency of LLM-generated output. We found that machine-generated ratings of the level of thought disorder in speech matched favorably those of expert humans, and we identified a tradeoff between accuracy and consistency in LLM ratings. Unlike traditional NLP methods, LLMs were not always consistent in their predictions, but these inconsistencies could be mitigated with careful parameter selection and ensemble methods. We discuss implications for NLP-based assessment of thought disorder and provide recommendations of best practices for integrating these methods in the field of psychiatry.

From asylums to deinstitutionalization and after: an analytic review.

After a period of institution-based mental health care, in which the asylum system was the way in which the mental patients were treated, deinstitutionalization brought a set of significant changes and transformations in the conceptualization of mental illness and, by extension, the traditional therapeutic settings in which those in most need were assisted. However, this shift in the psychiatric domain was not only accompanied by valued achievements, but also by difficulties and challenges, as has been evidenced today. The aim of this paper is thus to examine the pros and cons of the closure of asylums, and the subsequent implementation of deinstitutionalization over the 60 years or so of such important transformations in the field of psychiatry. In considering this question, I examine in detail recent works of literature based on scholarly knowledge. In addition, I identify various issues involved, as well as ways of confronting these so as to attempt to overcome the difficulties they present. As I show here, the changes in the treatment and care of the mentally ill after asylum and deinstitutionalization brought a new air of hope to patients and their families, but also had undesirable effects. The paper also considers how mental health professionals today try to solve these effects on behalf of patients and society as a whole.