Publications by authors named "Fineberg N"

Article Synopsis
  • Gambling disorder is the only recognized behavioral addiction in DSM-5, while Internet gaming disorder is noted for further research; other potential disorders include compulsive sexual behavior, compulsive shopping, and social media issues.
  • These disorders are clinically relevant and often coexist with conditions like depression and anxiety, with validated diagnostic tools available but no approved medications for treatment.
  • Cognitive-behavioral therapy shows the most promise, highlighting the need for active screening and public health efforts, along with further research into treatment methods that combine various therapeutic approaches.
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Background: Vaccine hesitancy has gained heightened relevance amid the COVID-19 pandemic, underscoring the urgency of understanding its determinants. This study explores the association between Covid-19 vaccine hesitancy, mental health variables and inflexible thinking.

Methods: A convenience sample of 252 UK adults was assessed online between June 2021-July 2022 (when Covid-19 lockdown restrictions had finally eased).

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Article Synopsis
  • Our increasing reliance on digital platforms can adversely affect mental health, raising concerns about online interactions.
  • There's ongoing discussion about the responsibilities of public health and psychiatry in addressing these issues.
  • Clinicians have a key role in evaluating internet use and taking action to mitigate harmful effects on mental well-being.
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This study investigates the goal/habit imbalance theory of compulsion in obsessive-compulsive disorder (OCD), which postulates enhanced habit formation, increased automaticity, and impaired goal/habit arbitration. It directly tests these hypotheses using newly developed behavioral tasks. First, OCD patients and healthy participants were trained daily for a month using a smartphone app to perform chunked action sequences.

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Background: This systematic review and meta-analysis explored the relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder (OCD).

Methods: We searched Pubmed, Scopus, Cochrane Library and PsychINFO databases until February 2023 for studies comparing patients with OCD and healthy controls on cognitive tests of compulsivity and impulsivity. The study followed PRISMA guidelines and was pre-registered on PROSPERO (CRD42021299017).

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Background: A significant proportion of people with clozapine-treated schizophrenia develop 'checking' compulsions, a phenomenon yet to be understood.

Aims: To use habit formation models developed in cognitive neuroscience to investigate the dynamic interplay between psychosis, clozapine dose and obsessive-compulsive symptoms (OCS).

Method: Using the anonymised electronic records of a cohort of clozapine-treated patients, including longitudinal assessments of OCS and psychosis, we performed longitudinal multi-level mediation and multi-level moderation analyses to explore associations of psychosis with obsessiveness and excessive checking.

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Patients with obsessive compulsive disorder (OCD) randomised to sertraline, manualised cognitive behavioural therapy (CBT), or combination (sertraline + CBT), underwent cognitive assessment. Cognitive testing was conducted at baseline and at week 16. The stop signal reaction time task (SSRT) was used to evaluate motor impulsivity and attentional flexibility was evaluated using the intra/extra-dimensional set shifting task.

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Background: The nature of cognitive flexibility deficits in obsessive-compulsive disorder (OCD), which historically have been tested with probabilistic reversal learning tasks, remains elusive. Here, a novel deterministic reversal task and inclusion of unmedicated patients in the study sample illuminated the role of fixed versus uncertain rules/contingencies and of serotonergic medication. Additionally, our understanding of probabilistic reversal was enhanced through theoretical computational modeling of cognitive flexibility in OCD.

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Anxiety disorders are very prevalent and often persistent mental disorders, with a considerable rate of treatment resistance which requires regulatory clinical trials of innovative therapeutic interventions. However, an explicit definition of treatment-resistant anxiety disorders (TR-AD) informing such trials is currently lacking. We used a Delphi method-based consensus approach to provide internationally agreed, consistent and clinically useful operational criteria for TR-AD in adults.

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Aims: This study sought to synthesize prevalence rates of problematic internet use (PIU) during the COVID-19 pandemic in the general adult (age over 18 years old) population and to investigate its possible moderators.

Methods: A preregistered systematic literature review using the PubMed/MEDLINE, EBSCOhost/PsycINFO, Web of Science, Cochrane Library, GSK Clinical Study Register, and ClinicalTrials.gov databases was conducted.

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Objectives: Obsessive-compulsive disorder (OCD) is a chronic and debilitating psychiatric condition, with diagnosed patients typically experiencing moderate or severe symptoms. This study evaluated the cost-of-illness (CoI) of OCD in the UK, capturing the annual costs accrued to the National Health Service (NHS) and Personal Social Services (PSS), people with OCD, caregivers and society.

Methods: The UK OCD population was estimated and stratified by age group (children, adults, elderly), symptom severity (mild, moderate, severe) and treatment received (including no treatment).

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Article Synopsis
  • * This article reviews studies from the International College of Obsessive-Compulsive Spectrum Disorders, utilizing a decade's worth of data from a Snapshot database that includes information from over 500 OCD patients worldwide.
  • * Findings highlight diverse demographic and clinical traits related to OCD, such as age, gender, smoking habits, onset age, illness duration, comorbidities, suicidal behaviors, and treatment methods, revealing notable variations across different countries.
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The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) are short self-report questionnaires used to screen and assess depression and anxiety severity in medical and community samples. However, little is known about their psychometric properties in individuals with anxiety and mood disorders (AMD) This study evaluated the psychometric properties of the PHQ-9 and GAD-7 in individuals with AMD. Individuals (n = 244, mean age 39.

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Background: Transcranial direct current stimulation (tDCS) is a non-invasive form of neurostimulation with potential for development as a self-administered intervention. It has shown promise as a safe and effective treatment for obsessive compulsive disorder (OCD) in a small number of studies. The two most favourable stimulation targets appear to be the left orbitofrontal cortex (L-OFC) and the supplementary motor area (SMA).

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Article Synopsis
  • A systematic review and meta-analysis was conducted to evaluate the effectiveness of exercise in reducing OCD symptoms, involving a search of multiple databases until March 2022.
  • The analysis included 6 trials with a total of 92 participants, revealing a significant decrease in OCD symptoms, along with reductions in anxiety and depression associated with exercise.
  • Although the results indicate exercise may be beneficial for OCD treatment, the overall quality of the studies was low, highlighting the need for more rigorous and larger-scale randomized controlled trials to confirm these findings.
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Objective: The aim of this study was to complete a scoping review of the published literature describing the relationship between mental fatigue and various psychiatric disorders, to better understand its frequency and clinical impact, and to provide recommendations for future clinical research.

Methods: A scoping review using PubMed/MEDLINE, Cochrane and PsychArticles databases was conducted using the keywords 'mental fatigue', 'mental tiredness' or 'mental exhaustion', and completed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols Extension for Scoping Reviews 2018 checklist.

Results: We extracted 10 studies fulfilling our inclusion criteria from a total of 2937 publications.

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Article Synopsis
  • - There is increasing global concern over problematic internet usage (PUI) and its effects on public health, which has intensified due to the COVID-19 pandemic, leading to a review by experts in the field.
  • - Key advancements include a consensus on clinical definitions of various types of PUI, resulting in new diagnoses in the ICD-11 by the World Health Organization, which helps standardize research on these issues.
  • - Despite progress in understanding PUI, significant knowledge gaps remain, such as the need for early identification methods, effective prevention strategies, and therapeutic interventions for different demographics at risk.
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Background: Classification of hypochondriasis as an obsessive-compulsive and related disorder in the International Classification of Diseases 11th Revision (ICD-11) has generated new heuristics for treatment of this common, chronic and disabling disorder. Standard treatment involves cognitive behaviour therapy (CBT) or selective serotonin reuptake inhibitors (SSRIs), but no meta-analysis has so far considered hypochondriasis as a structured diagnosis or assessed the role of medication. A clearer understanding of the relative effectiveness of these interventions and identification of clinically relevant factors moderating the treatment response is needed for clinical guideline development.

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Introduction: Our exploratory study aimed to determine whether obstructive sleep apnoea (OSA) could affect cognitive functioning in males with coronary artery disease (CAD), and whether such impact could be associated with changes in thyroid hormones and inflammatory marker regulation on cognitive functioning.

Method: We evaluated different endocrine and inflammatory biomarkers, including free triiodothyronine [fT3], free tetraiodothyronine [fT4], N-terminal pro-B-type natriuretic peptide [NT-pro-BNP], and high-sensitivity C-reactive protein [hs-CRP] serum levels in 328 males ( = 57 ± 10 years), undergoing cardiac rehabilitation after an acute coronary event. Participants underwent full-night polysomnography and were classified in mild/non-OSA ( = 253) and OSA ( = 75) according to an apnoea-hypopnoea index ≥ 15 event/h.

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Introduction: Despite promising results from several randomized controlled trials (RCTs) and meta-analyses, the efficacy of r-TMS as a treatment for OCD remains controversial, at least in part owing to inconsistency in the trial methodologies and heterogeneity in the trial outcomes. This meta-analysis attempts to explain some of this heterogeneity by comparing the efficacy of r-TMS in patients with or without resistance to treatment with selective serotonin reuptake inhibitors (SSRI), defined using standardized criteria.

Methods: We conducted a pre-registered (PROSPERO ID: 241381) systematic review and meta-analysis.

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Aim: This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders which was published in 2002 and revised in 2008.

Method: A consensus panel of 34 international experts representing 22 countries developed recommendations based on efficacy and acceptability of the treatments. In this version, not only medications but also psychotherapies and other non-pharmacological interventions were evaluated, applying the same rigorous methods that are standard for the assessment of medication treatments.

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Article Synopsis
  • The guideline by the World Federation of Societies of Biological Psychiatry offers updated recommendations for treating anxiety, OCD, and PTSD, aiming to enhance global treatment standards.
  • A panel of 33 experts from 22 countries evaluated over 1,000 clinical trials to ensure effective and acceptable treatment options.
  • The document emphasizes SSRIs and SNRIs as first-line medications and CBT as the main psychotherapy, while also addressing cases where standard treatments may not be adequate.
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This cross-sectional study aimed to explore specific online behaviours and their association with a range of underlying psychological and other behavioural factors during the COVID-19 pandemic. Eight countries (Italy, Spain, the United Kingdom, Lithuania, Portugal, Japan, Hungary, and Brazil) participated in an international investigation involving 2223 participants ( = 33 years old; = 11), 70% of whom were females. Participants were surveyed for specific type of Internet use severity, appearance anxiety, self-compassion, and image and use of performance-enhancing drugs (IPEDs).

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