From the Pages of Psychiatric Times: June 2023

In the June issue of Psychiatric Times®, we worked with experts from multiple psychiatric areas to bring you thoughtful articles about a wide variety of psychiatric topics, from neuromodulation for eating disorders to ethically educating teens about mental health care in the age of social media. Here are some highlights from the issue.

Conversations With Artificial Intelligence: Mental Health vs Machine

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There is much talk about the role of artificial intelligence (AI) in everyday life as well as in medicine. This has experts wondering: Can machines possess genuine consciousness? Are they capable of original insight, creativity, and even emotion? Philosophers, scientists, and ethicists have been asking these questions for decades, but they have recently become more urgent and relevant.

AI has promise as a tool for clinical practice, specifically regarding clinical prediction and decision-making. However, there are risks and limitations. As one expert put it, “Early AI researchers hoped to build machines that emulated the human mind... Instead, we have learned to build machines that don’t really reason at all. They associate, and that is very different.”

Clinicians and Psychiatric Times® contributors have investigated AI, specifically as it pertains to psychiatry, and made several interesting—and some concerning—realizations. Through these conversations, we may better understand AI’s future role in addressing mental health. Continue Reading

Neuromodulation in Anorexia Nervosa and Bulimia

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The eating disorders anorexia nervosa (AN) and bulimia nervosa (BN) are serious medical illnesses. AN has one of the highest mortality rates of any psychiatric illness, and high rates of development of chronic, treatment-resistant illness. BN has a lower, but meaningful mortality rate and can also become chronic.

Although there are gold standard treatments for BN that produce remissions in approximately two-thirds of patients, many do not respond to these standard treatments. The situation for AN is much bleaker, with perhaps only 50% making an eventual recovery. There has been little progress in the development of new treatments in either condition for several decades.

Neuromodulation refers to treatments that attempt to directly affect brain circuitry function. Two such treatments are repetitive transcranial magnetic stimulation (rTMS) and deep brain stimulation (DBS). With rTMS, a magnetic field is applied from outside the skull to a target within the brain to either increase or decrease the activity of specific brain circuits. It has been used in the treatment of depression for several decades. Continue Reading

Clozapine-Induced Weight Gain: Is It Dependent on Dose?

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Clozapine is the gold-standard antipsychotic for treatment-resistant psychosis; however, it is associated with considerable risk of cardiometabolic adverse effects. It is unclear whether clozapine’s adverse effects are dose-dependent, and findings regarding its effects on weight, glucose, and lipids are mixed.

The Current Study

Piras and colleagues analyzed the effects of clozapine dose on weight, blood pressure, and metabolic parameters in a prospective cohort of psychiatric patients in Switzerland. Data were obtained from the PsyMetab and PsyClin cohorts, which included patients who had started clozapine between 2007 and 2020 and had at least 2 weight observations and 3 weeks of clinical follow-up. Continue Reading

Psychiatry on TikTok: Providing Education to Teens in an Ethical Manner

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“Have you considered rocket fuel? It is the perfect stimulant to replace Adderall!” Swipe. “PTSD? Try tap therapy! It is better than any drug on the market!” Swipe and groan. Anyone who spends time on social media has seen these ads. Influencers, vloggers, celebrities, and everyone in between are selling a new unproven treatment for a mental health disorder. What was once found only on television and in magazines now appears on our patients’ smartphones, particularly via social media applications like TikTok.

Mental Health Misinformation Origins

The origin of the adolescent mental health misinformation debacle plaguing social media platforms involved multiple factors striking simultaneously. Adolescents prize peer acceptance and identity formation, for which social interaction, group affiliation, and peer affirmation are necessary. However, the COVID-19 pandemic quarantine deprived youth of such experiences, replacing them with social isolation. Concurrently, youth mental health deteriorated. Continue Reading

See the full June issue of Psychiatric Times here. And be sure to stay up-to-date by subscribing to the Psychiatric Times E-newsletter.

Do you have a comment on any of these or other articles? Have a good idea for an article and want to write? Interested in sharing your perspectives? Write to us at PTeditor@mmhgroup.com.