Cannabinoids for epilepsy: What do we know and where do we go?

Over the past decade there has been an increasing interest in using cannabinoids to treat a range of epilepsy syndromes following reports of some remarkable responses in individual patients. The situation is complicated by the fact that these agents do not appear to work via their attachment to endogenous cannabinoid receptors. Their pharmacokinetics are complex, and bioavailability is variable, resulting in difficulty in developing a suitable formulation for oral delivery. Drug interactions also represent another complication in their everyday use. Nevertheless, recent randomized, placebo‐controlled trials with cannabidiol support its efficacy in Dravet and Lennox‐Gastaut syndromes. Further placebo‐controlled studies are underway in adults with focal epilepsy using cannabidivarin. The many unanswered questions in the use of cannabinoids to treat epileptic seizures are briefly summarized in the conclusion.     

What do patients want and do we want to know? A review of patients' requests of psychiatric services

OBJECTIVE: A systematic review was conducted of the literature concerning patients' requests of psychiatric care in order to identify the types of requests patients make, psychiatrists' perceptions of their patients' requests, and the relationship between requests and the outcome of care. METHOD: A total of 28 published original articles which fulfilled specific inclusion criteria were reviewed. RESULTS: The studies showed that there are certain core requests that patients make irrespective of the type of service attended. Patients mainly request psychological approaches, and the most common requests are for 'clarification', 'psychological expertise' and 'psychodynamic insight'. There is evidence that patients normally feel inhibited about making requests, and that psychiatrists often fail to identify what their patients want. CONCLUSION: The majority of patients attending psychiatric services have requests which they will express when encouraged to do so, but little is known about the relationship between patients' requests and the outcome of care. Recommendations are made for future research.     

What do we know about the mechanism of action of the placebo?

The placebo is a substance or a procedure capable to induce a subjective or objective healing effect, but which efficacy or mechanism of action could not be demonstrated by the conventional scientific procedures. The main objective of this review is to synthesize the theories about the way the placebo acts. Conditioning, expectancy and desire theories, as well as the possible symbolic level in which placebo acts are reviewed. Some recent investigations showed that nerobiological responses elicited by placebo administration mimic those induced by it corresponding active drug. Finally, following evidences from development research, we suggest, that early expierences provide individuals with a "correction program of physiological functions" which could be eventually activated by contextual clues, as placebo.     

Factors influencing young adults’ attitudes and knowledge of late-life sexuality among older women

Objectives: Although sexuality is valued throughout the lifespan, older women's sexual expression can be influenced by physical, mental and social factors, including attitudes and stereotypes held by younger generations. By gaining an understanding of what influences negative attitudes toward sexuality and beliefs about sexual consent capacity, the stigma associated with sexuality in late life may be reduced.

Method: Using vignette methodology in an online survey, we examined older women's health and young adults’ (N = 606; mean age = 18.86, SD = 1.42, range 17–36) general knowledge and attitudes toward aging and sexuality, personal sexual behavior, religious beliefs and perceived closeness with an older adult on attitudes towards sexual behavior and perceptions of consent capacity among older women.

Results: The health status of older women proved important in determining young adults’ acceptance and perception of sexual consent capacity regarding late-life heterosexual/autoerotic and homosexual behaviors. Specifically, young adults expressed lower acceptance and more doubt regarding capacity to consent to sexual expression when the older woman was described as cognitively impaired. Additionally, young adults’ personal attitudes toward late-life sexuality, but not knowledge, predicted acceptance toward sexual expression and belief in sexual consent capacity.

Conclusion: Attention toward the influence of older women's cognitive health and young adults’ attitudes toward late-life sexuality may prove beneficial in designing interventions to decrease the stigma associated with sexual activity in later life.     

New-onset depression after hip fracture surgery among older patients: Effects on associated clinical outcomes and what can we do?

BACKGROUNDHip fracture in the elderly is a worldwide medical problem. New-onset depression after hip fracture has also received attention because of its increasing incidence and negative impact on recovery.AIMTo provide a synthesis of the literature addressing two very important questions arising from postoperative hip fracture depression (PHFD) research: the risk factors and associated clinical outcomes of PHFD, and the optimal options for intervention in PHFD.METHODSWe searched the PubMed, Web of Science, EMBASE, and PsycINFO databases for English papers published from 2000 to 2021.RESULTSOur results showed that PHFD may result in poor clinical outcomes, such as poor physical function and more medical support. In addition, the risk factors for PHFD were summarized, which made it possible to assess patients preoperatively. Moreover, our work preliminarily suggested that comprehensive care may be the optimal treatment option for PHFDs, while interdisciplinary intervention can also be clinically useful.CONCLUSIONWe suggest that clinicians should assess risk factors for PHFDs preoperatively, and future research should further validate current treatment methods in more countries and regions and explore more advanced solutions.     

Animal models of depression and anxiety: What do they tell us about human condition?

While modern neurobiology methods are necessary they are not sufficient to elucidate etiology and pathophysiology of affective disorders and develop new treatments. Achievement of these goals is contingent on applying cutting edge methods on appropriate disease models. In this review, the authors present four rodent models with good face-, construct-, and predictive-validity: the Flinders Sensitive rat line (FSL); the genetically “anxious” High Anxiety-like Behavior (HAB) line; the serotonin transporter knockout 5-HTT^−/− rat and mouse lines; and the post-traumatic stress disorder (PTSD) model induced by exposure to predator scent, that they have employed to investigate the nature of depression and anxiety.     

What do mental health professionals really think of family members of mental health patients?

Mental health professionals working at three rural public community mental health agencies were asked for their views on the families of mental health patients. Findings revealed themes that included families as supportive caregivers, as unsupportive agitators, as in pain, as uninformed, and as unequal partners. Implications for clinical intervention, education, and research are discussed.     

Racial/ethnic disparities in the treatment of epilepsy: what do we know? What do we need to know?

We examine current understanding of the minority disadvantage in the clinical management of epilepsy. We performed an online literature search using several keywords (race, ethnicity, epilepsy, treatment, and quality of life) and identified additional literature through cross-referencing/manual search. The search produced 58 items published between 1977 and 2005. Of 49 original research studies, 38 were quantitative, 7 were qualitative, and 4 used mixed methods. Three or more articles were published in Epilepsia, Epilepsy &Behavior, Epilepsy Research, Neurology, and Seizure. Research concerning racial/ethnic differences in epilepsy treatment is scarce and limited by methodology, but suggests underutilization of state-of-the-art therapies by minorities. Racial/ethnic minorities also appear to have limited knowledge about epilepsy and its treatment, experience barriers to care, lack social support, and seek alternative therapies for epilepsy. We propose a framework to identify the array of disparities, points of intervention, and interventions.     

What do we know about the role of IncRNAs in multiple sclerosis?

Multiple sclerosis is a chronic,inflammatory and degenerative disease of the central nervous system of unknown aetiology although well-defined evidence supports...     

Vagus nerve stimulation (VNS) for depression: What do we know now and what should be done next?

Vagus nerve stimulation (VNS) therapy is the first US Food and Drug Administration-approved somatic clinical intervention for treatment-resistant depression (TRD). Long-term open data suggest a sustainable antidepressant response over time. Here we review the clinical data that exist so far and their limitations. We also discuss guidelines that may inform the clinical utilization of this procedure. Further clinical studies, in addition to prospective cost utilization and health economic investigations, are needed to better understand VNS therapy and the impact it holds on TRD care.