Accelerated Aging after Traumatic Brain Injury: An ENIGMA Multi-Cohort Mega-Analysis.

Objective: The long-term consequences of traumatic brain injury (TBI) on brain structure remain uncertain. Given evidence that a single significant brain injury event increases the risk of dementia, brain-age estimation could provide a novel and efficient indexing of the long-term consequences of TBI. Brain-age procedures use predictive modeling to calculate brain-age scores for an individual using structural magnetic resonance imaging (MRI) data.

The environmental crisis and the film : Paths to paralysis and change.

The natural world has always been integral to our existence; currently, we are compelled to reckon with our assumptions about this connection with mounting urgency. Individual reactions to the environment are influenced not only by the sociocultural surround, but also by one's internal world, particularly whether one's internal objects are felt to have been irreparably damaged or are potentially salvageable. Excessive guilt about destructive impulses can limit one's ability to recognize individual responsibility for the current situation without catastrophizing the weight of one's ecological footprint.

Development and Evaluation of a Therapist Training Program for Psilocybin Therapy for Treatment-Resistant Depression in Clinical Research.

Psychological support throughout psilocybin therapy is mandated by regulators as an essential part of ensuring participants' physical and psychological safety. There is an increased need for specially trained therapists who can provide high-quality care to participants in clinical studies. This paper describes the development and practical implementation of a therapist training program of psychological support within a current phase IIb international, multicenter, randomized controlled study of psilocybin therapy for people experiencing treatment-resistant depression.

Toward a global and reproducible science for brain imaging in neurotrauma: the ENIGMA adult moderate/severe traumatic brain injury working group.

The global burden of mortality and morbidity caused by traumatic brain injury (TBI) is significant, and the heterogeneity of TBI patients and the relatively small sample sizes of most current neuroimaging studies is a major challenge for scientific advances and clinical translation. The ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Adult moderate/severe TBI (AMS-TBI) working group aims to be a driving force for new discoveries in AMS-TBI by providing researchers world-wide with an effective framework and platform for large-scale cross-border collaboration and data sharing. Based on the principles of transparency, rigor, reproducibility and collaboration, we will facilitate the development and dissemination of multiscale and big data analysis pipelines for harmonized analyses in AMS-TBI using structural and functional neuroimaging in combination with non-imaging biomarkers, genetics, as well as clinical and behavioral measures.

Update on the Neuropsychiatry of Substance Use Disorders.

This article reviews some of the recent discoveries about how neurobiological processes contribute to the understanding and treatment of substance use disorders. Particular focus is given to cannabis, opioids, and designer drugs. Important areas addressed include triggers and cravings, the central roles of dopamine and stress, and the endocannabinoid system.

Neuropsychiatry: Definitions, Concepts, and Patient Types.

Neuropsychiatry is an integrative discipline defined by its history, its preferred patients, and its theoretic framework. Dealing with human behavior needs to consider the brain, but such consideration should avoid oversimplification: neurologic understanding is not essential, necessary, or desirable in all conditions encountered in clinical psychiatry. Neuropsychiatric theory is founded on discoveries in the areas of synaptic plasticity and cortical/limbic anatomy (bottom-up), but also evolutionary biology and anthropology (top-down).

A Clinical Approach to Cognitive Impairment.

Cognitive impairment is ubiquitous in medicine and a common experience in everyday life. When severe, persistent, or progressive, it becomes a matter of clinical concern. Top causes of clinically significant cognitive impairment are neurodegenerative disease, stroke or atherosclerotic vascular disease of the brain, medication toxicity, and alcoholism.

Features associated with excessive exercise in women with eating disorders.

Objective: Excessive exercise and motor restlessness are observed in a substantial number of patients with eating disorders. This trait has been studied extensively among animal models of activity anorexia nervosa (AN) and may hold particular interest as an endophenotype for AN. We explored features associated with excessive exercise across subtypes of eating disorders.

Implications of aggressive children's positively biased relatedness views for future relationships.

The present study examined the tendency of aggressive children to generalize the positive bias in their perceptions of relatedness across different interpersonal relationships. Secondly, it examined the implications of distorted perceptions of relatedness for quality of aggressive children's future relationships. Subjects included 62 second and third grade children nominated and rated by teachers as aggressive.

Psychiatric inferences from data on psychologic/psychiatric symptoms in multiple chemical sensitivities syndrome.

When abnormal psychologic/psychiatric symptom data are obtained on personality tests or psychiatric interviews administered to patients who report symptoms of Multiple Chemical Sensitivities Syndrome, investigators typically attribute these to either psychiatric traits or to psychogenic origins of illness. The primary purpose of these studies was the evaluation of the plausibility of nonpsychiatric explanations of psychologic/psychiatric symptom data. In Study 1, patients with Multiple Chemical Sensitivities Syndrome used the Minnesota Multiphasic Personality Inventory 2 (MMPI-2) to describe which items had changed after they developed the condition.

Economics redefining the practice of psychiatry.

Major economic forces are dramatically affecting the practice of psychiatry. In the light of these changes, the author suggests how psychiatrists can have an expanded role in the emerging outcome-driven world of health care.

Reflections on multiple personality disorder as a developmentally complex adaptation.

Recent advances in the understanding of multiple personality disorder provide the groundwork for its creative reconciliation with psychoanalysis. This paper uses psychoanalytic, modern developmental, and psychological assessment perspectives to conceptualize multiple personality disorder as a developmentally protective response to chronic childhood trauma. Implications of this theory for clinical work with these patients are discussed.

Dramatic changes in care: the experience of one psychiatric hospital.

Recent and dramatic changes in this country's mental healthcare service are widely documented. To assess the extent and timing of those changes at one private psychiatric hospital, the authors examined length of stay, number of admissions, and patient age for general trends between 1980 and 1990 and more closely examined trends between July 1990 and December 1991. We related our findings to data for other private psychiatric hospitals and compared them with data from psychiatric units in general hospitals.

Psychiatric care and health insurance reform.

Concerns about cost, access, and quality of health care in the United States have led to a variety of legislative proposals that would reform our health care system and its financing. Health insurance benefits for mental illness, including substance abuse, are treated differently from medical/surgical benefits, with stricter limits on outpatient visits and hospital days. Medicare, Medicaid, and most private health insurance plans contain this historic disparity of coverage for mental illness compared to general medical illness.

Treatment choices: rehabilitation services used by patients with multiple personality disorder.

This article identifies mental health rehabilitation services for patients with multiple personality disorder. Through the use of a literature review and a retrospective examination of 20 patients' records, the frequency of discipline-specific services is noted in occupational therapy, art therapy, movement therapy, vocational counseling, and recreational therapy. Recommendations for practice and program development include ongoing education about multiple personality disorder and continual assessment of the patient's functional level to identify subsequent treatment needs and services.

Facility issues of the 1990s.

In the 1980s there was overbuilding of facilities of all kinds, including facilities with acute psychiatric beds. A subsequent decrease in patient days in most of these hospitals caused significant excess capacity. With all the problems now confronting mental healthcare facilities, it may be difficult to focus attention on hospital buildings; however, intelligent planning for the use of these large investments may be part of an overall solution.

Safety considerations in the psychiatric setting.

Safety in the psychiatric setting involves many aspects of facility design, renovation, operations, training, and administrative control. Through the application of a systematic hazard-control program, risks may be identified and action taken to reduce or eliminate the potential for accidental or self-inflicted injuries. This paper addresses specific aspects of the hazard-control process and its application at The Sheppard and Enoch Pratt Hospital, Baltimore, Maryland.