The Week in Review: November 13-17

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This week, Psychiatric Times® discussed a wide variety of psychiatric issues and industry updates, from sleep disturbances in ADHD to psychotherapy for treatment-resistant depression. Here are some highlights from the week.

Objectively Measured Sleep in ADHD

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Sleep disturbances are common in children with ADHD, with an estimated 25% to 50% prevalence. However, systematic reviews of subjective sleep complaints and objective data have yielded mixed results. The most commonly reported sleep problems in children with ADHD are increased sleep latency, bedtime resistance, nocturnal awakening, and daytime sleepiness.

By contrast, there is less evidence in objectively measured sleep continuity (eg, actigraphy and polysomnography), including sleep latency (SL), sleep efficiency (SE), total sleep time (TST), and time awake after sleep onset (WASO). Continue Reading

Psychotherapy for Treatment-Resistant Depression Is Overlooked, Underused

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When initial treatments for depression do not work, patients often feel responsible. They blame themselves, feel stigmatized, and think they are not trying hard enough. Family relationships and work suffer. Life becomes still more constricted and cold. Suicide risk is an ongoing concern. Thus, patients who suffer from treatment-resistant depression (TRD) need and deserve the full range of the best available treatments.

An oft-neglected treatment for TRD, both in research studies and in clinical practice, is evidence-based psychotherapy. Indeed, many definitions of TRD focus on medications and somatic treatments and do not even consider psychotherapies. Continue Reading

Lifting the “Brain Fog” of Long COVID With TMS

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Transcranial magnetic stimulation (TMS) for the treatment of neuropsychiatric symptoms in patients with post–COVID-19 condition, also called long COVID, appeared to improve their cognitive function and symptoms of depression but not their chronic fatigue, according to results of an open-label pilot study recently conducted in Japan.

The treated population with long COVID was a subset from a TMS consortium research project to elucidate treatment mechanisms and identify predictors of therapeutic response to TMS. The initial stage of the project is the development of a centralized registry database of TMS treatment in patients with refractory psychiatric disorders in Japan. Continue Reading

Changing the Way Climate Change Psychiatry Is Researched: A Medical Student Perspective

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In an ever-changing world, the effects of climate change lay far beyond volatile weather and melting ice caps. The intersection of medicine and environmental issues has never been more far-reaching, and its ubiquitous nature ensures that individuals of all tongues and cultures are within its reach.

Being a medical student through this global transition is frustrating. While we might learn the fundamental skills required to treat common psychiatric illnesses, there are no guidelines on how to help patients navigate the complexities of climate change. As we ourselves experience the exponential destruction of the climate crisis, a sense of foreboding and urgency to acquire these therapeutic tools grows stronger. Part of the onus certainly falls on the institutions that train future doctors. Continue Reading

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