Editorial Board, iii
Contributors, v
Preface: Advances: Carrying the Momentum, xxi
Deepak Prabhakar
Sports
Impact of Bullying on Recovery from Sport-Related Concussion
Raphaela Shea Fontana, Timothy Ryan Parker, and Aaron Slone Jeckell
Sport-related concussion (SRC) has emerged as an important public health concern. Similarly, the issue of bullying in sport (BiS) has gained more awareness as a psychosocial stressor that can impact performance and participation levels. The aim of this review article is to identify how bullying may impact an athlete’s recovery after sustaining SRC. We postulate that BiS after SRC can impact disclosure rates, influence the return to play (RTP) process, or precipitate early retirement from sport. Acknowledgment and understanding of this potential risk factor are critical as we continue to address the identification and management of concussion.
Introduction, 1
Sport-related concussion, 1
Bullying in sport, 2
Internal and external pressures experienced after sport-related concussion, 2
Premature return to play, 3
Premature retirement, 4
Recommendations, 4
Summary, 5
Clinical care points, 5
Disclosure, 6
Lesbian, Gay, Bisexual, Trans, and Queer Mental Health in Elite Sport: A Review
Paul Gorczynski, Claudia L. Reardon, and Cindy Miller Aron
Within elite sport, very little is known about the mental health symptoms and disorders of lesbian, gay, bisexual, trans, and queer (LGBTQ+) identifying athletes, their experiences with accessing treatment, or their journeys through recovery. Individuals who identify as LGBTQ + are more likely to experience mental health symptoms and disorders, and nonaccidental violence, compared with others. Mental health researchers and providers who work with LGBTQ + identifying elite athletes are in positions to improve knowledge and pathways to mental health services, address and minimize barriers to mental health services, and enhance mental health service delivery.
Introduction/background, 9
Methods, 10
General information, 10
Discussion, 12
Summary, 13
Clinics care points, 13
Disclosure, 13
Psychiatric Treatment Preferences for the Management of Postconcussion Symptoms: A Survey and Brief Literature Review
Aaron Slone Jeckell, Lydia J. Mckeithan, Aaron M. Yengo-Kahn, and Katherine A. Gifford
Some athletes who experience a sport-related concussion (SRC) develop new or worsened neuropsychiatric symptoms. A survey was disseminated among a group of psychiatrists to evaluate their preferences for treating such symptoms. Our findings demonstrated that providers see a wide range of individuals who have experienced concussion. Preferences for the management of SRC-related symptoms vary among providers and are not associated with patient volume, despite confidence being correlated with volume. The wide variability in treatment preferences and lack of confidence among low volume providers reinforces the need for robust studies and evidence-based guidelines for the management of concussion-related neuropsychiatric symptoms.
Introduction, 17
Methods, 18
Results, 19
Demographics and Experience, 19
Treatment Preferences, 19
Treatment Duration, 19
Discussion, 23
Treatment Preferences by Patient Volume and Subspecialty, 23
The need for consensus guidelines, 24
Summary, 25
Clinics care points, 25
Disclosure, 25
Neurosciences
Neuropsychiatric Aspect of Posterior Cortical Atrophy
Chuang-Kuo Wu
The clinical diagnosis of posterior cortical atrophy (PCA) has been established for more than 3 decades. Yet, this diagnostic entity only has obtained valuable academic attention in recent years. The cognitive profile of PCA is well documented and underlying pathology is extensively investigated. By contrast, the neuropsychiatric manifestation of PCA is rarely discussed in the medical literature. Based on the longitudinal observational study, this author has noted 3 stages or aspects of neuropsychiatric presentation of PCA through the disease course. More importantly, without effective treatment, neuropsychiatric symptoms play a major role in causing caregiver burden.
Introduction, 29
Diagnosis of posterior cortical atrophy, 29
Neuropathology of posterior cortical atrophy, 31
Challenges of managing posterior cortical atrophy regarding its neuropsychiatric issues, 32
Mood Symptom Stage, 34
Neglect/Anton's Syndrome Stage, 34
Psychosis Stage, 35
Management, 35
Summary, 35
Clinics care points, 35
Psychedelics for Alzheimer's Disease Palliative Care
Kaitlin R. McManus, Regan Patrick, Meg I. Striepe, Mia J. Drury, Rosain Ozonsi, Brent P. Forester, and Marc S. Weinberg
Psychedelic compounds (psilocybin, lysergic acid diethylamide, ayahuasca) paired with psychotherapy offer great potential for addressing multiple aspects of unmet palliative care needs for aging patients with Alzheimer's disease and their caregivers. In this review, the authors integrate recent findings from psychedelic and psychedelic-assisted therapy clinical research with key domains of Alzheimer's disease palliative care, from neurobehavioral symptom management to social and spiritual aspects of care in patients and their caregivers. In doing so, they provide a framework for approaching use of these exciting compounds in the Alzheimer's disease population, while recognizing some of the practical challenges faced.
Introduction, 37
Psychological and Psychiatric Care, 38
Psychiatric Care for Neurobehavioral Symptoms of Alzheimer's Disease, 38
Psychedelic Effects on Neurobehavioral Symptoms, 38
Psychedelics for Palliation of AD-Related Neurobehavioral Symptoms, 39
Safety of Psychedelics in Individuals with AD, 39
Social Care , 41
Social Aspects of Care in AD, 41
Psychedelics and Social Care, 41
Psychedelics and Social Care for AD, 41
Spiritual, Religious, and Existential Aspects of Care, 42
Spiritual Care and Well-Being in AD, 42
Psychedelics and Spiritual Care, 42
Psychedelics and Spiritual Care for AD, 43
Summary, 43
Funding, 44
Clinics care points, 44
Disclosure, 44
The Therapeutic Potential of Restoring Gamma Oscillations in Alzheimer’s Disease
Arianna Ferretti, Kassidy Rogers-Healion, and Aryandokht Fotros
A growing body of research supports an important role in the effect of brain waves and their dynamics on cognitive function. Studies have shown there are differences between the brain rhythms of patients with Alzheimer’s disease (AD) and healthy individuals, namely reduction of gamma waves. In this article, we will review the current research about the significance of these changes in brain oscillations and a proposed biological mechanism for decreased oscillations in the gamma frequency. Additionally, we discuss the efforts to stimulate neural networks at this frequency to alleviate symptoms and prevent neurodegeneration.
Introduction, 47
Asynchrony and network connectivity in Alzheimer’s disease: findings from electroencephalogram human and animal studies, 48
Mechanisms of network oscillations and altered hippocampal-cortical connections in Alzheimer's disease, 49
Network abnormalities in neuropsychiatric disorders, 50
Potential therapeutic use of gamma entrainment, 51
Summary, 53
Clinics care points, 54
Disclosure, 54
Psychotherapeutics
Advances in Psychotherapy with Internet-Based Cognitive Behavioral Therapy for Anxiety and Obsessive-Compulsive Disorder
Allie N. Townsend, Alyssa G. Hertz, Johann M. D’Souza, and Andrew D. Wiese
Advances in modern technology have contributed to the recent evolution of virtual therapy options for anxiety disorders and obsessive-compulsive disorder (OCD). This article discusses videoconferencing, self-help, and Internet-based cognitive behavioral therapy (ICBT) for anxiety disorders and OCD. Empirical support for ICBT for panic disorder, social anxiety disorder, generalized anxiety disorder, health anxiety, and OCD is reviewed, as are variables associated with treatment outcomes. Globally, ICBT for anxiety disorders and OCD is an efficacious treatment yet lack of patient engagement is a significant barrier. Lastly, clinical implications and future directions are identified to promote research that further improves these technological interventions.
Background, 57
Cognitive behavioral therapy, 58
Internet-based treatment, 59
Videoconferencing, 60
Self-help, 60
Internet-based cognitive behavioral therapy, 60
Internet-based cognitive behavioral therapy for anxiety disorders, 61
Internet-based cognitive behavioral therapy for obsessive-compulsive disorder, 61
Outcome-associated variables, 62
Intensive Internet-based cognitive behavioral therapy, 63
Treatment perception, 63
Clinical implications, limitations, future directions, 63
Summary, 65
Clinics care points, 65
Disclosure, 65
Advances in Psychotherapy for Older Adults Using Video-to-Home Treatment
Jennifer Freytag, Hilary N. Touchett, Jennifer L. Bryan, Jan A. Lindsay, and Christine E. Gould
Providing telemental health services to older adults has become especially important during the COVID-19 pandemic. Video-to-home (VTH) treatment is an effective treatment modality; research shows that older adults are open to using VTH. However, there are unique barriers to using VTH with older adults. Barriers include access to technology, acceptance of technology, and physical and cognitive limitations. Additional concerns include establishing rapport with older patients and the policy and ethical concerns surrounding the use of VTH. Methods of addressing these barriers have been developed, and more research is needed to develop evidence-based VTH practice.
Introduction/background, 71
Video-to-home as a treatment modality for older adults, 72
Discussion, 72
Addressing Barriers to Widespread Use of Video-to-Home, 72
Summary, 75
Clinics care points, 76
Disclosure . 76
Recent Advances in Psychotherapy with Virtual Reality: Closing the Research-to-Practice Gap
Joey Ka-Yee Essoe, Ainsley K. Patrick, Katlyn Reynolds, Abigael Schmidt, Kesley A. Ramsey, and Joseph F. McGuire
With consumer devices becoming increasingly affordable, virtual reality (VR) bears therapeutic promise for psychiatry and psychotherapy. Nevertheless, there remains a research-to-practice gap as advances in VR technology outpace clinical research: VR therapeutics practical for day-to-day clinical care remain largely unavailable, inaccessible, or unaffordable. This article returns to three foundational promises of VR: enhancing treatments already feasible in the clinic, making feasible treatments impractical in the clinic, and making possible “impossible” treatments in the clinic. These are discussed in terms of current state of research; whether VR therapeutics are available, accessible, and affordable to frontline clinicians; limitations; and areas of growth via practical examples. This is followed by a discussion on clinical research approach to further bridge the research-to-practice gap: first, using in research only VR devices that are practical for frontline clinics, and second, developing VR-therapeutics with scalability and excellence in mind—through optimization and a team-science approach.
Introduction, 79
The promises of virtual reality, 80
Promise 1. Enhance treatments already feasible in the clinic, 80
Promise 2. Make feasible treatments that are not practical in the clinic, 83
Limitations and challenges, 85
Promise 3. Making possible treatments that are not possible in the clinic, 86
Discussion: bridging the research-to-practice gap, 87
Using portable consumer devices in research , 88
Summary, 89
Clinics care points, 90
Disclosure , 90
Affective Computing in Psychotherapy
Rahul Khanna, Nicole Robinson, Meaghan O’Donnell, Harris Eyre, and Erin Smith
Affective computing, the discipline aimed at enabling computers to interpret, express, and modify emotion, is rapidly maturing. Although not aimed exclusively at health care, the technology holds promise to increase our understanding of psychotherapy, train future generations of clinicians, and directly deliver care alongside human therapists. It may also enhance autonomous therapy systems to deliver care in a stepped-care model. This article reviews the principles of, and recent advances in, affective computing for psychotherapy. It outlines emerging and potential applications and pitfalls, concluding with steps toward ethical development and clinical adoption.
Background, 95
Emerging Trends in Psychotherapy, 95
Introducing Affective Computing, 96
Current state of affective computing applied to therapy, 98
Exploring Underlying Mechanisms, 98
Supporting Human-Delivered Therapy, 98
Delivering Autonomous Therapy, 99
Clinical integration, 99
Therapists as Key Partners, 99
High-Quality Data and Expert Evaluation, 100
Appropriate Incentives , 100
Precision Psychology, 101
Managing Errors, 101
The path forward for clinical affective computing, 102
Summary, 103
Clinics care points, 103
Disclosure, 104
Women's Mental Health
Perimenopause and Mental Health: Implications for the Assessment and Treatment of Women at Midlife
Nicole Leistikow and Milena H. Smith
Perimenopause is a 4- to 9-year window of risk before menopause in which women may experience new onset or worsening of psychiatric symptoms, particularly depression. Therefore, primary care assessment of women at midlife should include routine depression screening. In addition, psychiatric evaluations of midlife women should also screen for symptoms of perimenopause, including hot flashes and night sweats; sleep disturbance; cognitive complaints; sexual, vaginal, and urinary problems; and joint pain, with concerning symptoms receiving further workup or appropriate referral. Treatment of perimenopausal depression should include treatment of contributing perimenopausal symptoms and consideration of agents with efficacy for vasomotor symptoms.
Clinical vignette, 107
Introduction, 107
Clinical vignette postscript, 114
Clinics care points, 115
Disclosure, 115
Infertility and Its Association with Depression, Anxiety, and Emotional Distress: A Current Review
Neha Shroff Hudepohl and Kelsey Smith
Infertility is a complex medical phenomenon with the potential for profound impact on mental health. The relationship between infertility and mental health is bidirectional, with interactions in pathophysiology and treatment. Evidence suggests that depression, anxiety, and emotional distress are more prevalent in those undergoing infertility evaluation and assisted reproductive technology, and that the presence of these mental health conditions may have an impact on the outcomes of evaluation and treatment. Evidence-based treatment approaches in the context of infertility are often administered by infertility centers directly. Screening and referral for appropriate treatment can improve outcomes for patients with infertility.
Introduction, 119
Prevalence, cause, and evaluation of infertility, 120
Prevalence/Incidence, 120
Causes of Infertility, 120
Evaluation, 120
Mental health and infertility, 122
Screening, 122
Clinical Course, 123
Therapeutic Options, 126
Special Populations, 127
Summary, 128
Clinics care points, 128
Disclosure, 129
Child and Adolescent
Intensive Treatments for Youth with Obsessive-Compulsive Disorder and Anxiety Disorders
Caitlyn E. Maye, Caitlin M. Pinciotti, and Eric A. Storch
Anxiety disorder and obsessive-compulsive disorder (OCD) in youth are prevalent and debilitating. Without effective treatment, prolonged symptoms can have significant adverse outcomes later in life. Currently, effective treatments for anxiety disorders often use a cognitive behavioral therapy (CBT) approach. Specifically, for youth with OCD, the gold-standard, evidence-based cognitive behavioral treatment is CBT with exposure and response prevention. Although CBT reduces symptoms and improves overall functioning for youth with OCD or anxiety, this treatment is not effective for all youth.
Introduction, 133
Treatment of obsessive-compulsive disorder and anxiety disorders, 134
Intensive treatment for youth with OCD and anxiety disorders, 134
Variability within intensive treatment, 136
Telehealth within intensive treatment, 137
Future directions, 137
Summary, 138
Clinics care points, 138
Funding details, 138
Disclosure, 138
Moving Beyond the Clinic: Leveraging Telehealth Strategies to Address Youth Mental Health Challenges
Gabrielle F. Freitag, Anya E. Urcuyo, and Jonathan S. Comer
Telehealth treatment formats for youth mental health problems use synchronous interactive communication technologies (eg, videoconferencing) to facilitate real-time interactions between patients/families and providers. Recent years have witnessed a sharp uptick in the evaluation, acceptance, and use of telehealth approaches, and the COVID-19 pandemic pushed telehealth into the clinical mainstream. Against this backdrop, we provide an overview of telehealth practice in youth mental health care, focusing on the rationale, history, practice trends, and supporting evidence. We discuss key administrative, ethical, and policy-related considerations and controversies for telehealth providers working with children and families.
Introduction, 141
Telehealth and youth mental health care: History, empirical support, and trends, 142
Telehealth: A Brief History, 142
Modern Telehealth Trends in Mental Health Care, 143
Key considerations and cautions for telehealth practice with children and families, 144
Telehealthâs Long-Term Regulatory Landscape Remains Unclear, 144
Alliance and processes in telehealth, 146
Cultural Considerations, Digital Divides, and Ongoing Disparities in Telehealth, 148
Are we expanding the reach of care yet? Telehealth rhetoric versus reality, 149
Summary and concluding thoughts, 149
Clinics care points, 150
Disclosure, 150
Common Treatment Elements of Manualized Evidence-Based Treatments for Youth Anxiety Disorders
Sandra L. Cepeda, Hannah L. Grassie, and Jill Ehrenreich-May
This review aims to provide a descriptive evaluation on the commonalities and differences across 15 evidence-based treatment protocols for childhood anxiety, with emphasis on guiding clinicians in mapping a personalized treatment plan that most fits a given child and family. The reviewed treatment approaches contain overlapping strategies that are common to theoretical frameworks of cognitive behavioral therapy, mindfulness, and acceptance and commitment therapy. This review suggests that most practitioners may select materials from any of the included programs, but are encouraged to provide at minimum techniques of psychoeducation, cognitive flexibility, and exposure-based strategies to youth with anxiety.
Introduction, 155
Overview of anxiety disorders in youth, 155
Approach, 156
Common treatment strategies, 162
Educational techniques, 162
Cognitive techniques, 166
Behavioral techniques, 167
Caregiver-focused techniques, 169
Summary and discussion, 170
Clinics care points, 170
Disclosure, 170
Geriatrics
Promotion of Psychological Well-Being in Later Life and Prevention of Late-Life Mental Disorders
Nancy A. Pachana
The prevention of mental health disorders in later life is greatly facilitated by the active promotion of positive mental well-being across the lifespan, but particularly in later life. A lifespan perspective is vital to helping older individuals achieve psychological well-being and includes the individual’s history and context as well as proximal (ie, life events) and distal (ie, biological) influences. An individual’s cultural context is increasingly recognized as vital in the context of clinical assessment and treatment. Life transitions may negatively impact well-being; interventions to restore wellbeing in such instances should work toward the patient’s own life goals. A clear and shared understanding of the individual’s history, context, and their own views of their aging can facilitate effective interventions.
Introduction, 173
Cultural considerations for mental well-being in later life, 174
Promotion of psychological well-being through life transitions, 175
Contextual approaches to the promotion of mental well-being in later life, 176
Interventions to prevent psychological disorders in later life, 178
Summary, 179
Clinics care points, 179
Addressing Mental Health in Aged Care Residents: A Review of Evidence-Based Psychological Interventions and Emerging Practices
Sunil Bhar, Deborah Koder, Hemalatha Jayaram, Mark Silver, and Tanya Davison
The prevalence of mental health conditions in residential aged care facilities is substantially higher than in the community. Yet, most research into evidence-based treatments for late life mental health conditions has involved older adults living in the community, rather than aged care residents. This article provides clinicians with an overview of evidence-based psychological interventions and emerging approaches for supporting the mental health of aged care residents, as well as recommendations for how to customize the delivery of such interventions within this environment.
Mental health conditions in residential aged care facilities, 184
Interventions for supporting mental health of aged care residents, 184
Cognitive Behavioral Therapy, 184
Reminiscence Therapy, 186
Intergenerational Programs, 187
Technology-assisted treatments, 187
Delivering psychology services in residential aged care settings, 188
Focus on Engagement as an Early Therapeutic Goal, 188
Be creative in Individualizing Treatment, 188
Adopt a Systemic Model of Care, 188
Summary, 188
Clinics care points , 189
Disclosure, 189
Advances in the Psychological Management of Older Adult Mental Health
Viviana M. Wuthrich, Jessamine T-H. Chen, and Diana Matovic
The most common mental disorders in later life are unipolar mood disorders, anxiety disorders, and substance use disorders. This review outlines the key information needed for the psychological management of common mental disorders in older adults, as well as the challenges pertaining to the recognition and treatment of mental disorders in later life. Some differences in the prevalence of geriatric mental disorders as well as differences in the clinical presentation of mental disorders require minor modification to the assessment and treatment of symptoms. However, there are more similarities than differences in the overall assessment and treatment techniques needed to work with this population.
Introduction, 193
Prevalence of Common Mental Disorders, 193
Risk Factors, 194
Prognosis, 194
Age-Related Emotion Regulation Changes, 195
Clinical assessment, 196
Diagnostic Issues, 196
Clinical management, 198
Efficacy and Effectiveness, 198
Cognitive Behavioral Therapy Strategies, 198
Complications of Medical and Other Mental Comorbidities and Management, 204
Advances in Psychological Therapies, 204
Cognitive Decline, 204
Challenges in the field, 205
Reduced Access to Treatment, 205
Telehealth Psychological Interventions, 206
Discussion, 206
Summary, 206
Clinics care points, 207
Disclosure, 207
Education and Clinical Practice
Training and Education Related to Suicide Prevention
Zheala Qayyum, Samantha M. Taylor, and Marguerite Reid Schneider
Suicide is a large and growing public health problem. While mental health providers certainly have a key role to play in suicide prevention, the data support more universal screening for potential suicidality. There is an emergent need to educate all health care professionals broadly to create a health care system that can more universally deliver compassionate preventative care and treatment of suicidal patient. Suicide prevention education must include practical skills for using evidence-based tools for a complete assessment, triage, and treatment planning following a positive screen, and skills for basic brief interventions for those individuals with suicidality not requiring urgent inpatient care, including safety planning and lethal means restriction. The experience of losing a patient to suicide can have a profound effect on providers, especially when it occurs during training. Therefore, it is essential that institutions develop comprehensive programming for responding to a suicide when one takes place.
Introduction, 211
Core knowledge: risk and protective factors for suicidality, 212
Identifying those at highest risk: suicide screening, 213
Further assessment of acute risk: tools for following up on a positive screen, 213
Interventions for suicidality, 214
Postvention and its role in prevention , 214
Impact of Suicide Death on Treating Clinicians , 214
Postvention: response after a suicide death, 215
Recommendations and guidelines, 216
Discussion, 216
Clinics care points, 217
Disclosure , 217
Neurostimulation and Women’s Health
Deval Zaveri, Monica Rettenmier, and Patricia Carlson
We intend to review the available neurostimulation treatments in psychiatry, namely, Electroconvulsive, therapy, Transcranial Magnetic Stimulation, Deep Brain Stimulation, and Vagal Nerve Stimulation. The article briefly outlines the indications, techniques, for each of these treatment modalities, with a focus on women’s health, special consideration for women’s reproductive mental health when using these treatment approaches.
Introduction, 221
Discrepancies between overall mental health diagnosis, treatments, and outcomes between men and women, 222
Electroconvulsive therapy, 222
Efficacy in Depression, 222
Delivery of Treatment, 222
Adverse Effects and Management, 223
Special Considerations, 223
Repetitive transcranial magnetic stimulation , 224
Indications, 224
Safety and side effect profile, 224
Contraindications and cautions, 224
Special Consideration for Women, 224
Summary, 225
Vagal nerve stimulation, 225
Delivery of Treatment, 225
Indications, 226
Safety and side effect profile, 226
Special considerations in women, 226
Summary, 227
Deep brain stimulation , 227
Delivery of Treatment, 227
Indications , 227
Safety and side effect profile, 227
Special Considerations in Women, 227
Summary, 228
Clinics care points, 228
Disclosure , 228
The Interface Between Psychiatry and Palliative Medicine
Avani Prabhakar and Lisa MacLean
Palliative medicine provides an interdisciplinary approach to meet the needs of the patient and their family at any stage of serious illness regardless of their prognosis or stage of illness and works in collaboration with the primary treating team with the intention of improving quality of life and minimizing suffering for patients and their families throughout the illness journey. This article aims to explore the interface of palliative medicine and psychiatry and the suggestion that consultation-liaison psychiatry is one way to address the specialized needs of the terminally ill patient with psychiatric needs.
Introduction, 231
The links between palliative medicine and psychiatry, 233
Teaching palliative care to psychiatry clinicians, 234
Teaching psychiatry to palliative medicine specialists, 235
An emerging discipline: palliative care psychiatry, 236
One potential solution: role of the consultation-liaison psychiatrist in end-of-life care, 236
Summary, 237
Clinics care points, 237
Disclosure, 237
Introduction to Dialectical Behavior Therapy for Psychiatrists and Psychiatry Residents
Andrea L.B. Gottlieb, Christopher L. Klinger, and Daniela Sampaio
Comprehensive dialectical behavior therapy (DBT) is effective in treating emotion dysregulation and associated behavioral problems and well supported in psychotherapy literature. Psychiatrists often interact with patients in DBT programs and for whom DBT principles are warranted. DBT is a set of principles, strategies, and skills that can be applied to not only psychotherapy but also psychiatric care of patients with chronic emotion dysregulation. This article provides key points to help with an introduction to comprehensive DBT in order to benefit psychiatrists in their care of such patients.
Introduction, 241
What is dialectical behavior therapy?, 241
Dialectical behavior therapy is a set of flexible principles, 242
Summary of efficacy and effectiveness of dialectical behavior therapy, 242
Benefits of training psychiatrists in dialectical behavior therapy, 242
Dialectical behavior therapy modes, 242
Dialectical behavior therapy stages and targets, 243
Comprehensive dialectical behavior therapy versus dialectical behavior therapy–informed treatment, 244
Dialectical behavior therapy orientation to psychiatric managemen, t 245
Role of the psychiatrist in comprehensive dialectical behavior therapy, 245
Psychiatry training modalities, 245
Traditional psychiatry residency training, 245
Didactic learning, 246
Observational learning , 246
Practical learning, supervision, and consultation, 246
Dialectical behavior therapy principles and strategies, 246
Biosocial theory, 246
Validation, 247
Behavioral assessment and management, 247
Summary, 249
Clinics care points, 249
Disclosure, 249
Recent Advances in Psychopharmacology
Alexander J. Poznanski and Esther Akinyemi
There is a better understanding of mental illness and the potential underlying mechanisms leading to new medications with novel mechanisms of action. The new medications seek to reduce side effects while optimizing efficacy. Attention-deficit hyperactivity disorder, mood disorders, movement disorders, neurocognitive disorders, psychotic disorders, sexual disorders, and sleep disorders have all had newly approved medications in the last 5 years. Some of the new indications are of older medications being explored for other indications. This article describes these medications, the trials supporting them, and relevant clinical information about each medication.
Introduction, 253
Aducanumab, 254
Clinical Trials, 254
Bremelanotide, 254
Clinical Trials, 254
Brexanolone, 254
Clinical Trials, 255
Cariprazine, 255
Clinical Trials, 256
Daridorexant and lemborexant, 256
Clinical Trials, 256
Deutetrabenazine and valbenazine, 256
Clinical Trials, 257
Esketamine, 257
Clinical Trials , 257
Lofexidine, 258
Clinical Trials, 258
Lumateperone tosylate, 258
Clinical Trials, 258
Olanzapine/samidorphan, 259
Clinical Trials, 259
Pimavanserin, 259
Clinical Trials, 260
Pitolisant , 260
Clinical Trials, 260
Serdexmethylphenidate/dexmethylphenidate, 260
Clinical Trials, 260
Solriamfetol, 260
Clinical Trials, 261
Viloxazine, 261
Clinical Trials, 261
Discussion, 261
Summary, 262
Clinical care points, 262
Disclosure, 262
