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Psychotherapy is an important part of managing bipolar depression and its associated impairments. There is considerable evidence that psychotherapies are effective adjuncts to pharmacotherapy in delaying or preventing episodes of bipolar depression. Individuals with bipolar depression may be reticent to consider these treatments. This paper surveys the utility, evidence base, effective treatment components, and controversies surrounding adjunctive psychosocial interventions. [Psychiatr Ann. 2023;53(2):58–62.] [ABSTRACT FROM AUTHOR]

As psychedelic-assisted therapy research and clinical trials continue to grow, there is a positive outlook on the future, but also concerns about who will benefit. Most research shows that there is an obvious deficit of racial and ethnically minoritized populations, defined within the article, enrolling in studies. The objectives of this paper are (1) to provide a history of psychedelics and its resurgence over the last two decades; (2) to present an understanding of the racialization of psychedelics in the treatment of psychiatric disorders; (3) to showcase the current inequity of psychedelic medicine; and (4) to operationalize an antiracism framework for racial equity to decolonize psychedelic research, or remove the historically pervasive White power dynamic in hopes of shifting power back to the originating indigenous cultures. The psychedelic movement is in a rare place to optimize inclusion and this article aims to demonstrate how. [Psychiatr Ann. 2022;52(12):494–499.] [ABSTRACT FROM AUTHOR]

Extensive epidemiological data show an association between diet and mental health. Now, emerging data from intervention studies show dietary interventions can be effective in the treatment of a range of psychiatric disorders, particularly depression. This has led to guidelines for mood disorders now containing recommendations that lifestyle-based approaches, including dietary change, form "foundational" treatment. However, without direct access to a dietitian, there are challenges for mental health clinicians implementing these recommendations and consumers initiating and maintaining dietary improvements in the context of their mental disorder. Digital delivery of evidence-based dietary interventions may help overcome these challenges. This paper discusses practical learnings from our experiences piloting digital dietary interventions with participants experiencing depressive symptoms and the current evidence base to aid the translation of digital dietary programs in psychiatry and mental health settings. [Psychiatr Ann. 2022;52(2):62–66.] [ABSTRACT FROM AUTHOR]

Growing evidence from preclinical studies, epidemiology, and randomized controlled trials supports a causal role for diet quality in mental disorder risk, and clinical psychiatric guidelines now place diet, along with other lifestyle behaviors, as foundational treatment targets for mood disorders. Diet quality in the perinatal period is related to both mothers' mental health and children's emotional and neurodevelopment outcomes. The human gut microbiota composition is influenced by diet, and emerging evidence suggests that disturbances in gut microbiota, at least in part, mediate these relationships. Thus, optimizing maternal diet should be prioritized as part of a multidisciplinary approach for promoting physical and mental health in mothers and their off spring. This paper addresses the current evidence base and discusses its application in perinatal health care. [Psychiatr Ann. 2022;52(2):51–55.] [ABSTRACT FROM AUTHOR]

Childhood and adolescence are vulnerable periods for development of a depressive disorder, with potentially lifelong negative consequences. Research increasingly suggests that lifestyle practices, including diet, are an effective adjunct strategy for the management of poor mental health. Dietary improvements are now recommended as the first actionable step in the treatment of depression in adults. In young people, evidence is also suggestive of a link between diet and mental health. However, implementing dietary interventions in youth can be challenging owing to numerous barriers. This paper reviews the literature on the topic and proposes several strategies that could be used by mental health clinicians to address diet as part of their practice. [Psychiatr Ann. 2022;52(2):56–61.] [ABSTRACT FROM AUTHOR]

Despite the often-neglected association between mental health and oral health, their significant interaction highlights the necessity for integrated health care approaches, particularly for vulnerable populations, such as children with disabilities and patients with mental illness. This delineates the unique challenges faced by children with neurodevelopmental disorders and congenital syndromes, necessitating tailored interventions and heightened awareness among caregivers and health care providers. Further, maternal mental health has emerged as a pivotal determinant of oral health outcomes in children, underscoring the need for comprehensive support systems. Acknowledging and mitigating oral health implications within mental health frameworks is important to enhance the overall well-being and quality of life of individuals with mental health conditions. [Psychiatr Ann. 2024;54(8):e235–e239.] [ABSTRACT FROM AUTHOR]

Homelessness is one of the most significant humanitarian, policy, and public health issues in the United States. People experiencing homelessness are at a heightened risk of various health issues, including severe mental illness, and face a life expectancy up to 30 years shorter than those with stable housing. The US Department of Housing and Urban Development (HUD) defines homelessness as lack of a fixed, regular, and adequate nighttime residence and reports that there has been a steady rise in the number of individuals with mental illness lacking stable housing, far outpacing the capacity of available services. Despite the importance of housing for mental health, psychiatrists are often ill-equipped to intervene on this key social determinant of health. This article reviews underlying factors contributing to homelessness for individuals with mental illness, details clinical ramifications of homelessness, and outlines evidence-based interventions for supporting people experiencing homelessness and psychiatric illness. [Psychiatr Ann. 2024;54(7):e202–e208.] [ABSTRACT FROM AUTHOR]

Discusses the consideration of psychological evaluation in the ethics of genetic testing for breast cancer. Comparison of ethics with morality; Intention of genetic testing to identify whether the person tested carries a gene or genes thought to have a probability of resulting in some medical condition or disease; Issuance of a paper by the National Breast Cancer Coalition in the U.S. which appears to be based in descriptive ethics.

Precision psychiatry is becoming a realistic ambition for clinical practice. Modern data gathering and data analysis tools create great opportunities for prediction of outcomes, decreased trial and error in selecting treatments, and improved understanding of complex mechanisms leading to more effective treatments. Some current challenges to implementation of these approaches are highlighted in this article. These include the limitations related to characteristics of the statistical methods used for precision medicine, standardization and clinical implementation of the various behavioral research paradigms in use, and the process of defining new outcome measures. Some clinical experiences and possible ways forward are also discussed, including patient and clinician interest in objective measures to complement current clinical assessments, sensitivity to existing workflows, a focus on defining new clinical categories rather than attempting to predict DSM diagnosis, and the use of alternative measures as meaningful outcome measures themselves. [Psychiatr Ann. 2024;54(4):e108-e112.] [ABSTRACT FROM AUTHOR]

Major attention-deficit/hyperactivity disorder (ADHD) treatment advances have occurred in addressing functional impairments associated with the condition. Work to understand how the core symptoms of inattention and hyperactivity/impulsivity hinder family, school, and social functioning has been conducted. This work has created approaches with proven or promising efficacy in altering the life course of young persons afflicted with this chronic condition. This review describes well-established methods and newly emerging treatments for reducing the impact of ADHD on the home, school, social, and emotional lives of ADHD youth. [Psychiatr Ann. 2024;54(3):e88–e93.] [ABSTRACT FROM AUTHOR]

The article describes the case of a 31-year-old married, employed white woman who was diagnosed with obsessive-compulsive disorder during pregnancy. According to the patient, she opted to have herself checked because of her intense need to use white paper for writing assignments. She also experienced agitation and anxiety.

An editorial is presented which argues argued that our patients need to be active participants in their care.

This provocative and controversial article addresses efforts at prevention of lethal psychotic rampages by challenging the long-established medical concept that functional psychosis means a diagnosis of schizophrenia. Schizophrenia has been the diagnosis given to most psychotic mass murderers, but detailed media reports of the perpetrators' behaviors, when available, have suggested states of psychotic mania, defining a bipolar disorder, not schizophrenia. Psychotic killers murder more than 1,000 innocent victims, including children, each year, usually with firearms; however, efforts at prevention must go beyond gun control and include focus on the severely mentally ill. Psychiatry has an opportunity to more effectively intervene regarding diagnostics, treatment, and restraint in cases who come into contact with mental health facilities prior to their rampages. Bipolar disorder is a bona fide medical disease with strikingly specific diagnostic criteria that includes psychosis in half of severe cases, thus accounting for many cases diagnosed with schizophrenia. Seven typical cases have been detailed in this paper to support these opinions. All were diagnosed with schizophrenia despite reports of multiple symptoms suggesting psychotic mania. Manic patients misdiagnosed with schizophrenia do not receive standard-of-care treatment, resulting in suboptimal efforts at prevention and increasing the risk for medical malpractice liability. Litigation can change psychiatric diagnostic practices. [ABSTRACT FROM AUTHOR]

The article focuses on the rising popularity of the concept of eco-cemeteries in South Africa in 2011 as demonstrated by the launch of the country's first eco-friendly cemetery called Legacy Parks by chief executive officer Willie Fouché in August.

Sleep disturbances (eg, insomnia, hypersomnia, poor sleep quality) are a prominent feature of bipolar disorder (BD). Furthermore, sleep difficulties are present across all phases of BD, including euthymia, and these difficulties contribute to the risk and maintenance of depressive and (hypo)manic episodes. Although existing pharmacological and psychosocial treatments offer hope for ameliorating sleep difficulties in BD, conventional treatments are limited in their ability to accurately capture detailed sleep patterns, detect early onset of sleep difficulties, and deliver personalized interventions. Widely accessible contemporary digital technologies show promise for mitigating these limitations and advancing sleep treatment for individuals with BD. We summarize and synthesize research examining the use of three digital tools for sleep assessment and intervention in BD: smartphone applications, ecological momentary assessment, and actigraphy. We also discuss the benefits, risks, and limitations of these technologies. [Psychiatr Ann. 2023;53(11):496–501.] [ABSTRACT FROM AUTHOR]

The limited recognition and treatment of attention-deficit/hyperactivity disorder (ADHD) in adults has been studied in the research setting and addressed in the clinical education setting during recent years. Despite these efforts, health care professionals continue to struggle with the management of adult ADHD in everyday practice. To better evaluate and measure meaningful practice metrics, a set of 10 key quality measures (QMs) that can help improve health care outcomes in adult ADHD was identified using a combination of evidence-based literature reviews and expert consensus. Subsequently, these QMs were field-tested in a sample of 71,310 adult ADHD patients in the primary care setting and behavioral health clinics over the course of a decade to assess whether these measures were attained. The results allowed us to understand how the clinician approach to diagnosing and treating ADHD has evolved in the past few years and highlighted the ongoing challenges in practice variation by clinicians caring for patients with adult ADHD. In turn, this information also guides our understanding of the next steps needed to improve the quality of care provided to adults with ADHD in different care settings. Accordingly, the American Professional Society of ADHD and Related Disorders (APSARD) assembled a guidelines committee to create a set of clinical practice guidelines to provide practitioners with a standardized, evidence-based approach to diagnosing and treating ADHD in adults. [Psychiatr Ann. 2023;53(10):444–448.] [ABSTRACT FROM AUTHOR]

Experienced clinicians and academics from the International MAOI Expert Group comment on questions of interest concerning monoamine oxidase inhibitor (MAOI) pharmacotherapy for depression. These comments in this Part Two of the Expert Roundtable Discussion emphasize good pharmacological practice, starting with a low dose and progressing slowly and only changing one element at a time. Issues related to augmentation and drug combinations are also mentioned, including comments about the safety of ketamine. The special ability of MAOIs to improve dopamine function is highlighted, especially in relation to melancholic and psychotic depression. [Psychiatr Ann. 2023;53(8):364–369.] [ABSTRACT FROM AUTHOR]

Russia has nearly the highest incidence of suicide among children and teenagers in the world. We attempted to create one of the most comprehensive in-depth reviews on this important topic, which is highly relevant for accelerating progress in reducing the thousands of suicides of children and adolescents, most of which are the result of easily preventable or treatable conditions. We analyzed the published data (in both English and Russian) on the prevalence of suicide in minors, current trends related to the phenomenon, and its possible causes. This report shows that suicide is the leading cause of death in Russia for children and teenagers, with the rate among girls exceeding that of boys. The suicide rate in this age category has increased in the last decade and is still growing. We hope that this report will assist health care providers in identifying and managing Russian adolescents at risk for suicide. [Psychiatr Ann. 2023;53(7):314–324.] [ABSTRACT FROM AUTHOR]

Warrior psychotherapy (WP) is a therapeutic concept which can be used to restore and improve functioning in all people. The idea behind warrior psychotherapy is to utilize traditional core values from the United States Military Service Branches and translate these traits into useful clinical tools, promoting optimal performance, and improved resilience, along with overall wellness and mental health. [Psychiatr Ann. 2023;53(4):179–183.] [ABSTRACT FROM AUTHOR]

In the United States, 18.9% of the population identifies as Hispanic or Latin. The culture of these communities is as diverse, heterogenous, and rich as the history of this population. Culture shapes the perception of symptoms and psychiatric disorders. To provide culturally sensitive care, it is relevant to understand the history of these communities in the US, recognize cultural humility, and acknowledge aspects and values (eg, culturally bound syndromes, familism, paternalism, stigma of mental illness, machismo, immigration) inherent to the cultural experience and unique barriers to care. Incorporating these aspects into clinical practice is essential for positive outcomes. The purpose of this article is to give a brief historical context, encourage cultural humility, and describe cultural aspects that are essential when providing culturally sensitive care to the Hispanic and Latinx community in the US. [Psychiatr Ann. 2023;53(3):127–132.] [ABSTRACT FROM AUTHOR]

The article focuses on the issues that were raised in the analysis of longitudinal studies. This includes a discussion on the determination of sample size for clustered and longitudinal studies and the role of the principle called intent-to-treat to such studies. Advances in the analysis of longitudinal information and conceptual and experimental design issues related to missing information are presented as well.

The author reflects on developments relevant to the field of psychiatry. According to the author, this issue of the journal will feature several cases of attention-deficit/hyperactivity disorder in adults. He also express excitement over a plan to feature a series of papers on complementary and alternative medicine appraoches to post-traumatic stress disorder. He cites some expectations surrounding the fifth edition of the book "Diagnostic and Statistical Manual of Mental Disorders."

The article discusses the phenomena of weird coincidence and the reasons why they are to be studied by psychiatrists. A study of weird coincidences provide psychiatrists with a useful way of understanding the neurobiology of belief whose interpretation maybe useful in clinical practice. It refers to synchronicity as defined by C. G. Jung as meaningful coincidences that help a person's individuality. People who often notice and interpret coincidences are described as highly self-referential, highly intuitive with high religious commitment.

We describe a case of a 25-year-old Quiché (or K'iche') speaking G2P2022 (2 pregnancies, 2 term births, 2 live births) woman who was transferred from an outside hospital on postpartum day 3, to preserve mother-baby dyad while her infant required a higher level of care after suffering an apneic episode at 22 hours of life. Although the patient was a known Quiché speaker, lack of access to Quiché interpreters in the hospital led to the use of Spanish interpreters. Her treatment team subsequently described her affect as "flat" and reported "poor maternal care," leading to a report to the Administration for Children's Services. As we analyze this case, we use person-centered maternity care as a framework to discuss areas for improvement in providing care to peripartum individuals, as well as cultural safety and humility as solutions to cultural gaps between patients and providers. [Psychiatr Ann. 2022;52(12):500–503.] [ABSTRACT FROM AUTHOR]

The article discusses various papers published in this issue including one by Sophie C. Schneider and Eric A. Storch on the treatment of pediatric obsessive-compulsive disorder, one by Megan M. Kelly and Katharine A. Phillips on body dysmorphic disorder and one by Joseph F. McGuire and Nathaniel Girder on behavior therapy for tics and tic disorder.

The article presents a study which explores the working of the antidepressants, along with explores the implications of antidepressants for medical practice.

This article highlights the importance of attending to the relational aspects of psychopharmacological work with diverse youth and families. While technical and scientific knowledge remain the focus of medical education, the therapeutic skills known as "nonspecific" treatment factors or "common factors" can also be deconstructed, taught, and examined. [Psychiatr Ann. 2023;53(7):298–300.] [ABSTRACT FROM AUTHOR]

Hyperkinetic catatonia is a rare syndrome found in mood and psychotic disorders characterized by features such as purposeless motor hyperactivity, extreme agitation, and echophenomena. Although general catatonia is often treated with benzodiazepines and electroconvulsive therapy (ECT), there is no standardized treatment for hyperkinetic catatonia. The case presented here is that of a 44-year-old woman with a diagnosis of schizophrenia with hyperkinetic catatonia. Included is a review of the clinical evaluation and diagnostic impressions, as well as approaches to management and treatment. The patient underwent multiple sessions of ECT that yielded significant improvement in disorganized behavior and hyperactivity. This case demonstrates the diagnostic challenges in differentiating hyperkinetic catatonia from delirious mania and other mood disorders, and the effectiveness and safety of ECT in a patient with hyperkinetic catatonia. [Psychiatr Ann. 2022;52(9):389–392.] [ABSTRACT FROM AUTHOR]

Initial promise and dire need have inspired the multiple research programs of the second psychedelic renaissance. Serotonergic psychedelics (psilocybin, lysergic acid diethylamide, and ayahuasca) have decreased end-of-life anxiety in cancer patients, treatment-resistant depression, alcohol dependence, social anxiety in autistic adults, and nicotine dependence when applied with supportive therapies. Methylenedioxymethamphetamine (MDMA), as part of a multisession treatment, improves symptoms of post-traumatic stress disorder and its negative correlates. Meta-analyses reveal promising effect sizes. Nevertheless, concerns about brief follow-ups, small samples, and other methodological issues remain. Mechanisms underlying improvement appear poorly understood. Generalization to the public is premature. The clarion call for more research appears justified. A proliferation of specialized clinics might not. Continued, coordinated trials and judicious application should be the rule, not the exception. Reasonable expectations of prediction intervals rather than patterns of statistical significance will also help the field, as replications might not show effects as large as in initial trials. [Psychiatr Ann. 2022;52(9):354–358.] [ABSTRACT FROM AUTHOR]

To date, ketamine is the only prescribable psychedelic medicine in the United States. Ketamine is also one of the most promising drugs for the treatment of depression. In the current paradigm of care, most ketamine clinics in the United States treat patients with mood disorders with ketamine and its derivatives alone without psychotherapy. The purpose of this article is to review the most recent literature about ketamine and psychotherapy for the treatment of psychiatric disorders and reflect and open a discussion about the potential benefits of combined ketamine treatment with psychotherapy versus ketamine alone. [Psychiatr Ann. 2022;52(9):371–374.] [ABSTRACT FROM AUTHOR]

An editorial is presented which discusses the current state of cognitive-behavioral therapy (CBT), highlighting its efficacy and underutilization, especially in treating psychiatric conditions in children and adolescents. It provide updates on CBT science and practice, including treatments for PTSD, OCD, anxiety disorders, and ADHD, emphasizing the importance of incorporating these interventions into routine clinical practice to improve patient outcomes.

College students faced many challenges due to the coronavirus disease 2019 (COVID-19) pandemic that are unique to them (eg, sudden relocation, interruption in their education and transition to virtual learning, and having to find a mental health provider licensed in their home state when returning home for school closure) and adjunct to challenges faced by the general population (eg, economic strains, racial discrimination, health disparities, and sense of social isolation). Previous studies consistently reported increased stress, mood, and anxiety symptoms and even suicidal ideation among college students since the COVID-19 outbreak. Anecdotally, many students have also shared concerns and anxiety due to returning to normal college life. To better prepare for potential future disruptions and/or other similar challenges, schools need to consider proactive steps for supporting student mental health in their transition not only to virtual learning but also to having them back on campus. [Psychiatr Ann. 2022;52(8):323–327.] [ABSTRACT FROM AUTHOR]

A large fraction of patients with mental disorders obtain no relief from medications, psychotherapy, or noninvasive treatments. For these patients, deep brain stimulation (DBS) may be an option. DBS is a surgical therapy that places electrodes precisely into specific brain structures (targets). It has evidence for clinical efficacy from open-label studies in obsessive-compulsive disorder and major depressive disorder. In both disorders, more than 50% of otherwise refractory patients obtain meaningful benefit. At the same time, DBS has not yet passed a large, well-controlled, multisite trial. This is in part because the devices are complex to program, such that many patients do not receive an adequate "therapy" dose. New technologies may overcome that complexity, either through precision mapping of a patient's individual brain anatomy or by directly measuring the electrical activity of key brain structures and titrating DBS to change that activity. [Psychiatr Ann. 2022;52(7):283–287.] [ABSTRACT FROM AUTHOR]

Higher education has traditionally promoted increased opportunities for young people to gain technical and occupational skills for personal advancement. Matriculation to postsecondary education often coincides with a developmental period associated with increased rates of behavioral health conditions, including major mental illness and substance use disorders. Studies have shown that rates during the past decade of both mental illness and treatment use are increasing in this group. Ideally, colleges and universities need to address the unique mental health needs of this growing population using evidenced-based approaches. Various evidence-informed models and novel interventions exist to help both students and schools prepare to meet these growing needs. Continued engagement and outreach to transition-age youth who may struggle with academic persistence for a multitude of reasons will be important to maintain diversity and equity in institutions of higher learning. [Psychiatr Ann. 2022;52(6):232–237.] [ABSTRACT FROM AUTHOR]

Transitional-age youth with chronic medical illness are a particularly vulnerable population that are at higher risk of mental health issues and psychosocial stress. It is important that both medical and mental health issues be addressed in a developmentally and culturally informed manner, as they transition from the long-term relationships they have built in pediatric settings to adult health care providers. [Psychiatr Ann. 2022;52:227–231.] [ABSTRACT FROM AUTHOR]

The article discusses adverse early life experiences (AELEs) as a social determinant of mental health. It refers to negative social interactions experienced by infants, children and adolescents with individual and the social or physical environment that are broadly associated with unstable or unsafe out-of-home environments. It discusses the prevalence of AELEs in the U.S., examples of AELEs at the clinical level and the need for psychiatrists to be proactive in promoting protective factors.

Peripheral edema is characterized by interstitial fluid accumulation in the extravascular compartment. Use of psychotropic drugs can cause edema either directly or by causing systemic disease. We present a case of bilateral ankle edema reaching up to the middle of both legs in a 50-year-old female patient, which is considered to be a result of the use of mianserin 10 mg/day. Dramatic regression was observed in the patient's edema 15 days after the cessation of mianserin. This is the second case in the literature that demonstrated peripheral edema associated with mianserin. Clinicians need to know about the management of edema and edema associated with the use of antidepressants. [Psychiatr Ann. 2022;52(5):213–216.] [ABSTRACT FROM AUTHOR]

The goal of achieving a universally acceptable and empirically sound diagnostic manual in psychiatry remains an ongoing challenge. From the time of its production to the present day, DSM-5 has been criticized for its diagnostic criteria, timeline, scope, clinical and research utility, and scientific validity. The level of such criticism ranges from constructive and scholarly to destructive and impractical. Deluged by the vastness of such levels of criticism, it becomes difficult for both mental health professionals and consumers to sort the nature of such arguments. It is prudent that professionals should become educated about the historical perspectives and the scientific limitations that are barriers in the development of a consensual diagnostic manual without ignoring and while appreciating the practical and educational benefits of the imperfect DSM-5. This article serves this purpose by analyzing the major controversies surrounding DSM-5. [Psychiatr Ann. 2022;52(4):161–169.] [ABSTRACT FROM AUTHOR]

This article identifies the factors that minimize the development of post-traumatic stress disorder (PTSD) in deployed service members. It reviews the differences between Australian, U.S. and British service members' rates of PTSD and alcohol abuse. It also identifies the measures used to assess the health and well-being of the Australian Defence Force (ADF).

The article discusses bereavement-related depression issues faced by clinicians and whether, when and how to intervene. Identification and facilitating healthy, adaptive mourning, and recognizing and treating are mental health agenda for bereavement. It references a study bereavement studies and bereaved people requiring treatment. Understanding the symptoms and course of adaptive grief and the occurrence of significant complications of grief are considered important in clinical management of bereaved people.

The article presents a case study of a 13-year-old boy with medical history of attention-deficit/ hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and absence epilepsy. Topics include high risk of being harmed or unintentionally harming others due to emotional/ behavioral dysregulation and demonstrating an inability for understanding consequences of impulsive actions; and treatments targeting emotional regulation and behaviors leading to an overall better quality of life.

The article discusses papers in the current issue devoted to the diagnoses of psychotic mass killers that can aid in advancing efforts at prevention.

Human trafficking (HT) affects a large number of populations worldwide, including men, women, and children. The traffickers exploit the vulnerability of the victims, including their poor socioeconomic status, political instabilities in their countries, and existing mental illness. They use fraud and coercion to involve these victims in forced labor or commercial sex. The victims encounter significant physical, emotional, and sexual trauma resulting in posttraumatic stress disorder along with depression, anxiety, and substance use disorder. Standard treatment protocols to manage the victims of HT do not exist. Trauma-informed care is key, as it provides the victims a sense of empowerment and safety while preventing retraumatization and enhancing treatment adherence. Mental health clinicians can play a significant role in providing services to the victims of HT. They can take the lead role in the integrated care model, which collaborates services with other stakeholders. They can also help provide training to other health care providers in identifying the victim, providing trauma-centered care, and establishing continuity of services. [Psychiatr Ann. 2021;51(8):373–377.] [ABSTRACT FROM AUTHOR]

Human trafficking (HT) is a growing public and social health issue internationally. HT is a violation of human rights that needs to be fought vigorously by legal policy, law enforcement, and public health policy. People who are trafficked include men, women, and children of diverse cultural and socioeconomic backgrounds and nationalities. Victims of HT are subject to a high prevalence of violence and mental distress and suffer multiple short-and long-term adverse medical and psychological issues resulting from being held captive, working/living in poor conditions, and having limited/no access to health care. Risks for psychiatric disorders among victims of HT can arise from multiple factors: being isolated and cut off from the outside world, physical and mental abuse perpetrated by traffickers, increased likelihood of substance use and misuse, unsafe working conditions, and lack of social support. In this article, we present the basic epidemiology of HT and its mental and physical correlates and discuss directions for future investigations. [Psychiatr Ann. 2021;51(8):359–363.] [ABSTRACT FROM AUTHOR]

Public and community psychiatrists who care for patients with serious mental illnesses regularly face ethical challenges. This article summarizes key ethical considerations in the care of a population that can be difficult to engage and may reject treatment, sometimes necessitating coercive care. The digital revolution in medicine, with its promises and perils and accelerated by coronavirus disease 2019 (COVID-19), has added ethical complexity regarding privacy and access to care. Shared decision-making, a process to resolve ethical dilemmas, and commitments to professionalism and reflective practice are emphasized as three ways to practice ethically in public and community psychiatrists' daily work. Additionally, COVID-19 has highlighted that engagement in social justice is a critical element of ethical practice for physicians today. [Psychiatr Ann. 2021;51(6):272–277.] [ABSTRACT FROM AUTHOR]

A recent study published in Science by Jeff Lichtman and colleagues has reconstructed every cell and connection in a one square millimeter sample of cerebral cortex taken from a patient who had epilepsy surgery. The researchers used high throughput serial section electron microscopy and complex computations to create a three-dimensional map of the brain tissue. Surprisingly, they found that the ratio of glia to neurons was 2:1, the density of neurons was lower than previously thought, and they discovered various unique structures and connections within the brain. This study highlights the complexity of the brain and the need for further research to better understand its construction and function. [Extracted from the article]

Occupational therapy is an essential component of psychiatric treatment. The purpose of this naturalistic cohort study is to evaluate the impact of a structured occupational therapy program in an acute mental health setting (AMHS) on psychiatric inpatients' function and occupational performance. The participants (N = 397) attended the structured occupational therapy program during their hospitalization in an AMHS. Function and occupational performance were evaluated with the Occupational Abilities and Performance Scale. The results indicate a positive therapeutic role in the structured occupational therapy program. An interesting finding is related to the adequate duration of patient participation needed to improve their function and occupational performance. The inclusion of structured, purposeful, and comprehensive occupational therapy programs of adequate duration in the daily routine of an AMHS could be a valuable therapeutic component of the treatment armamentarium, as it may enhance patients' occupational performance, social functioning, and well-being. [Psychiatr Ann. 2021;51(3):131–139.] [ABSTRACT FROM AUTHOR]

Digital health technologies are advancing characterization of mental health and functioning using objective, sensitive, and scalable tools for measurement of disease. These efforts directly address well-documented issues with traditional clinical assessments of psychiatric functioning, which can be burdensome, subjective, and insensitive to change. In this article, we highlight novel approaches for digital phenotyping of mental health. Each approach is categorized by the way biomarker data are collected, focusing on passive monitoring, active assessment, individual self-report, and biological measurement. Common challenges faced by each of these approaches are discussed, including pathways to validation, regulatory approval, and integration into patient care and clinical research. Finally, we present our perspective on the promise of such technology, focusing on how integration of independent digital measurement tools into a common technological infrastructure would allow for highly accurate, multimodal machine learning models for unprecedented objective measurement of mental health. Digital health technologies are advancing characterization of mental health and functioning using objective, sensitive, and scalable tools for measurement of disease. These efforts directly address well-documented issues with traditional clinical assessments of psychiatric functioning, which can be burdensome, subjective, and insensitive to change. In this article, we highlight novel approaches for digital phenotyping of mental health. Each approach is categorized by the way biomarker data are collected, focusing on passive monitoring, active assessment, individual self-report, and biological measurement. Common challenges faced by each of these approaches are discussed, including pathways to validation, regulatory approval, and integration into patient care and clinical research. Finally, we present our perspective on the promise of such technology, focusing on how integration of independent digital measurement tools into a common technological infrastructure would allow for highly accurate, multimodal machine learning models for unprecedented objective measurement of mental health. [[Psychiatr Ann. 2021;51(1):14–20.] [ABSTRACT FROM AUTHOR]

The article discusses various papers published within the issue including "Brain-Body Interactions: The Physiological Impact of Mental Processes--The Neurobiology of Stress Responses," and "The Sickness Response: An Adaptive Brain-Body Reaction to Medical Illness."

The article discusses various reports published within the issue, including one by Helena Kraemer on the proper use of statistical methods to identify risk factors and the assessment of the properties of diagnostic and prognostic tests and another by Elizabeth Stuart on the analysis of observational or nonexperimental data.