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Sleep-related eating disorder (SRED) is a non-REM parasomnia with potentially significant negative effects on general health (dangerous activities during night eating episodes, obesity, or metabolic syndrome, for example). Although the history of SRED encompasses more than six decades, public awareness and even the awareness of the mental health specialists of this disorder is very limited, a phenomenon that hinders the development of research in this field. Therefore, a systematic review based on PRISMA 2020 guidelines explored the available evidence for SRED found in four electronic databases (PubMed, Cochrane Collaboration, Google Scholar, and Clarivate/Web of Science). A number of 94 primary and secondary reports were retrieved, investigating aspects regarding the risk factors, epidemiology, clinical data and differential diagnosis, epidemiology, structured evaluation, and treatment of SRED. Based on the results of these reports, Z-drugs, but also certain benzodiazepines, antidepressants, antipsychotics, and psychostimulants may trigger the onset of SRED. Psychiatric and neurologic disorders have also been associated with SRED, either as risk factors or comorbid conditions. Cerebral glucose metabolism dysfunctions, neurotransmitter dysfunctions, and genetic factors have been invoked as pathogenetic contributors. Structured assessment of SRED is possible, but there is a dearth of instruments dedicated to this purpose. Data on the prevalence and treatment of SRED exist, but good-quality epidemiological studies and clinical trials are still missing. In conclusion, future research is expected to address the shortcomings of SRED exploration by creating the conditions for better quality and larger group clinical research. The need for such investigation is granted by the importance of this pathology and its negative functional consequences. [ABSTRACT FROM AUTHOR]

Patients with oncological diseases are very vulnerable to the action of psychological, physical and toxic stressors, requiring active monitoring by a multidisciplinary team. Quality of life and general well-being depend largely on early detection and the integration into case management of all aspects that influence the physical and mental health of these patients. In the context of the development of liaison psychiatry and psycho-oncology, this literature review emphasizes the importance of introducing psychotropic medication as soon as possible in combination with palliative medication to increase the quality of life of the terminally ill cancer patient. Based on the existing data in the literature, the main symptoms that require attention from the mental health specialists integrated into the team that ensures the case management of the oncological patient are pain, sleep disorders, lack of appetite, asthenia, anxiety, and depression. The initiation of psychotropic treatment in patients with oncological conditions must be early and must take into account all the somatic, psychological, social and pharmacological dimensions. In conclusion, the psychiatrist, as part of the multidisciplinary team that provides medical assistance to the oncological patient, is responsible for the early detection of psychiatric symptoms associated with the oncological condition, but also for initiating psychotropic medication as quickly as possible, along with monitoring its effectiveness and tolerability throughout the treatment. [ABSTRACT FROM AUTHOR]

Copyright of Psihiatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psihiatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psihiatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psihiatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Clozapine-resistant or ultra-resistant schizophrenia represents a challenge for clinicians, given the lack of recommendations in all the major treatment guidelines regarding the next steps once clozapine has failed or cannot be tolerated. The first part of this narrative review investigated the pharmacological arsenal available to the clinician to deal with cases of clozapine-resistant schizophrenia. In the present section of the analysis, the results of research that explored the efficacy and tolerability of nonpharmacological methods for this type of schizophrenia will be presented. Ongoing or upcoming clinical trials in patients with ultra-resistant schizophrenia will also be reviewed. Searching electronic databases and clinical trial archives identified seven reports on the effects of psychotherapy and 15 reports on neuromodulation techniques that aimed at ameliorating psychotic symptoms and functionality in clozapine-resistant schizophrenia. A number of six ongoing clinical trials targeting this type of schizophrenia are also presented. In conclusion, based on the data analyzed, cognitive-behavioral therapy for psychosis, cognitive-behavioral therapy, and occupational therapy benefit from moderate-quality data to support their efficacy as add-ons to clozapine in these patients. Except for electroconvulsive therapy, the evidence for other neuromodulation techniques is, at least for now, insufficient to recommend them in ultra-resistant cases. It is necessary to carry out good quality and long-term clinical studies in order to confirm the usefulness of these adjuvant treatments. [ABSTRACT FROM AUTHOR]

Epilepsy is a common condition worldwide, with approximately 50 million people suffering from it. A single seizure does not mean epilepsy; almost 10% of the population can have a seizure during their lifetime. In particular, there are many other central nervous system disorders other than epilepsy in which seizures occur, either transiently or as a comorbid condition. The impact of seizures and epilepsy is, therefore, widespread and easily underestimated. It is estimated that about 70% of patients with epilepsy could be seizure-free if correctly diagnosed and treated. However, for patients with epilepsy, quality of life is influenced not only by seizure control but also by antiepileptic drug-adverse reactions, access to education, mood, employment, and transportation. [ABSTRACT FROM AUTHOR]

Clozapine-resistant forms of schizophrenia are not exceptionally met in clinical practice, and epidemiological studies confirm this observation. Between one-third and two-thirds of patients undergoing treatment with clozapine present the so-called “ultra-resistant” form of schizophrenia – i.e., the persistence of significant psychotic symptoms even though the previously mentioned antipsychotic was administered for a sufficient duration, in adequate doses, and with good therapeutic adherence. This explains why it is necessary to identify therapeutic strategies for these patients, especially if the significant negative functional impairment of clozapine-resistant schizophrenia is taken into account. For this purpose, a narrative analysis of the literature was carried out, dedicated to the evaluation of pharmacological, psychotherapeutic and neuromodulatory methods that can be recommended in these patients as clozapine augmentation strategies. Alternatives to clozapine for clozapine-resistant patients or cases of individuals who cannot tolerate this antipsychotic are also explored in the current review. First- and second-generation antipsychotics added to clozapine, switching from clozapine to another antipsychotic or combination of antipsychotics, using high doses of antipsychotics in resistant cases, combining clozapine with mood stabilizers, antidepressants, anxiolytics or other pharmacological agents are analyzed from their efficacy and tolerability properties. Based on the analyzed reports, adding atypical antipsychotics with a complementary pharmacodynamic profile to clozapine for positive symptoms, or mood stabilizers or antidepressants for affective or negative symptoms in patients with ultra-resistant schizophrenia could be useful, for short durations and under adequate monitoring. [ABSTRACT FROM AUTHOR]

The therapeutic management of psychiatric disorders is currently confronted with a critical need to find new therapeutic interventions due to the high rates of non-responsivity or low responsivity in the key pathologies, e.g. schizophrenia spectrum disorders, alcohol use disorders, or major depressive disorder. The modulation of intestinal microbiota has been explored in various organic and psychiatric dysfunctions, with different degrees of success. However, this type of intervention may represent a helpful add-on at a conceptual level since it does not associate negative pharmacokinetics interactions, significant adverse events, or risk for non-adherence in the long term. Oral administration of pre-, pro-, or synbiotics, and especially the treatment with fecal microbiota transplantation (FMT), are methods still in their early research phase for patients with psychiatric disorders, therefore an exploration of data regarding the potential benefits and adverse events of FMT was considered necessary. In order to accomplish this purpose, the available results of research dedicated to each category of psychiatric disorders, starting with depressive and anxiety disorders, continuing with schizophrenia, substance use disorders, and finishing with disorders diagnosed during childhood, were presented in this paper. Seven clinical trials, 16 preclinical studies, three meta-analyses/systematic reviews, and six case reports, all of these representing ten distinct categories of psychiatric disorders or manifestations, have been reviewed. Mood disorders, anxiety disorders, and alcohol dependence have been the most extensively investigated clinical entities from the FMT efficacy and tolerability perspective, and reviewed data are generally promising. Based on the current status of research, FMT may be considered a helpful intervention in specific psychiatric pathologies. Still, this review showed that most of the information is derived from entirely preclinical studies. Therefore, clinical trials with sound methodology and more participants are needed to clarify FMT's benefits and risks in psychiatric disorders. [ABSTRACT FROM AUTHOR]

Healthcare professionals are confronted with multiple stressors in their daily practice and data from the literature support a higher incidence of stress-related disorders, as well as isolated symptoms of such disorders in physicians and auxiliary personnel than in the general population. The current pandemic increases not only the workload for these professionals, but also their risk to suffer from other possible stressors (e.g., worries about loss of personal health or fear to contaminate family members, facing misconceptions in the general population about the pandemic that may translate in a suspicious or even aggressive attitude toward physicians, periods of isolation secondary to work-related tasks, worries about their own lack of professional efficiency due to exhaustion, changes in personal lifestyle and daily routines, insufficient information about the new type of coronavirus, worries about the quality of the protective equipment etc.). All of these factors may lead to a higher rate of professional stress-related disorders in time of pandemic than during common working periods. Burnout syndrome, adjustment disorders, major depression, posttraumatic stress disorder, acute stress reaction and substance use disorders are expected to be reported more frequently in healthcare professionals, based on the analysis of data collected during previous epidemiological crises worldwide. Therefore, programs for prevention, early detection, and treatment that target healthcare professionals are recommended, and education about mental health should be actively promoted in this population. [ABSTRACT FROM AUTHOR]