Explore the vast range of titles available.

Background Preliminary evidence suggests intravenous ketamine has rapid effects on suicidal cognition, making it an attractive candidate for depressed patients at imminent risk of suicide. In the first randomized controlled trial of ketamine using an anesthetic control condition, we tested ketamine's acute effects on explicit suicidal cognition and a performance‐based index of implicit suicidal cognition (Implicit Association Test; IAT) previously linked to suicidal behavior. Method Symptomatic patients with treatment‐resistant unipolar major depression (inadequate response to ≥3 antidepressants) were assessed using a composite index of explicit suicidal ideation (Beck Scale for Suicidal Ideation, Montgomery‐Asberg Rating Scale suicide item, Quick Inventory of Depressive Symptoms suicide item) and the IAT to assess suicidality implicitly. Measures were taken at baseline and 24 hr following a single subanesthetic dose of ketamine (n = 36) or midazolam (n = 21), a psychoactive placebo agent selected for its similar, rapid anesthetic effects. Twenty four hours postinfusion, explicit suicidal cognition was significantly reduced in the ketamine but not the midazolam group. Results Fifty three percent of ketamine‐treated patients scored zero on all three explicit suicide measures at 24 hr, compared with 24% of the midazolam group (χ2 = 4.6; P = .03). Implicit associations between self‐ and escape‐related words were reduced following ketamine (P = .01; d = .58) but not midazolam (P = .68; d = .09). Ketamine‐specific decreases in explicit suicidal cognition were largest in patients with elevated suicidal cognition at baseline, and were mediated by decreases in nonsuicide‐related depressive symptoms. Conclusions Intravenous ketamine produces rapid reductions in suicidal cognition over and above active placebo. Further study is warranted to test ketamine's antisuicidal effects in higher‐risk samples.

The management of treatment-resistant depression (TRD) is challenging. Researchers have identified novel targets, especially the glutamatergic system, in the pathogenesis of depressive disorder. N-methyl-D-aspartate (NMDA) receptor antagonists, like ketamine, have revolutionized the treatment of TRD due to their rapid antidepressant and antisuicidal effect. Various other receptor systems, including GABAergic, opioid receptors, the endogenous cannabinoid system, and cholinergic receptors, are novel targets to produce an antidepressant response. The US Food and Drug Administration (FDA) has approved intra-nasal ketamine as an add-on therapy to conventional antidepressants for TRD. Other compounds are in various stages of development. Identification and development of novel compounds by future research can help in overcoming the challenges of treating TRD. [Psychiatr Ann. 2024;54(6):e177–e181.]

The novel coronavirus 2019 (COVID-19) has affected the mental health of health care professionals and the general population. Most of the research has focused on the immediate and short-term implications of the COVID-19 pandemic, with a paucity of research available exploring the long-term mental health effects. Experience with previous disasters has shown that survivors suffer from various mental health problems including posttraumatic stress disorder, major depressive disorder, anxiety disorders, phobias, fears with avoidant behaviors, and various neuropsychiatric disorders. There has been an increased incidence of substance use and internet addiction along with increased rates of domestic violence and child abuse. Social distancing is helpful in limiting the spread of the disease, but the impact of social distancing and quarantine has resulted in increased anxiety among the general population. The long-term mental health effects are anticipated to be intensified due to the pandemic affecting people worldwide. Mitigation strategies need to be implemented as there will be no vaccine available to limit the long-term mental health effects of this pandemic. [ Psychiatr Ann . 2020;50(12):522–525.]

Research in the field of psychopharmacology is ongoing to develop novel compounds which can revolutionize the treatment of psychiatric disorders. The concept of bench-to-bedside is a tedious process, transforming the initial research performed in the laboratories into novel treatment options. Schizophrenia (SCZ) is a chronic psychiatric illness with significant morbidity and mortality. SCZ not only presents with psychotic symptoms including hallucinations and delusions but also with negative and cognitive symptoms. The negative symptoms include the diminished ability to express emotions, loss of pleasure, and motivation with minimal social interactions. Conventional antipsychotics primarily target positive symptoms with minimal therapeutic benefits for negative and cognitive symptoms along with metabolic side effects. Researchers have explored novel targets to develop new compounds to overcome the above limitations. The glutamatergic system has provided new hope in treating schizophrenia by targeting negative and cognitive symptoms. Other receptor modulators, including serotonergic, phosphodiesterase, trans-amine-associated receptors, etc., are novel targets for developing new compounds. Future research is required in this field to explore novel compounds and establish their efficacy and safety for the treatment of schizophrenia. Last but not least, pharmacogenomics has effectively utilized genetic information to develop novel compounds by minimizing the risk of failure of the clinical trials and enhancing efficacy and safety.

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.]

The coronavirus 2019 pandemic has affected people worldwide. The social determinants of health can disproportionately affect the outcomes of vulnerable populations, which include the elderly, racial or ethnic minorities, children and adolescents, as well as those with comorbid medical conditions. These populations may require additional resources and consideration in treatment of their mental health given the struggles they may face secondary to decreased resources, health care access, increased mortality and morbidity, lifestyle disturbances at crucial developmental times, and a host of other factors contributing to an increased vulnerability to the effects of the virus. This article provides background on those factors and reviews interventions to consider for treating these populations. [ Psychiatr Ann . 2020;50(12):531–535.]

Borderline personality disorder (BPD) is associated with functional impairment, characterized by marked impulsivity, instability of mood, interpersonal relationship problems, and suicidal behaviors with high suicide rates. It affects interpersonal relationships in all domains including child rearing, which can be a challenge for parents with BPD. BPD may also lead to poor socioeconomic outcomes due to frequent job losses and lack of productivity; criminal behavior from impulsivity; and increased resource use, resulting in high health care treatment costs. BPD is comorbid with other mental health disorders; therefore, its identification and treatment are paramount for management. The clinical challenge centers on managing chronic suicidality. Treatment consists of various modalities, including psychotherapy and psychopharmacology. [ Psychiatr Ann . 2020;50(1):14–18.]

A strict and adherence treatment is required by the patient with diabetes mellitus and it demands a proper self-medication by the patient. Pharmacists are involved in providing self-management support to the patients. This review evaluates the interventions of pharmacist for patients to improve self-management with diabetes mellitus and also to improve the clinical outcomes of diabetes mellitus. A comprehensive literature search was performed by using different keywords \"pharmacist-led intervention,\" \"diabetes,\" \"effect of pharmacist on outcome of diabetes,\" and \"self-management of diabetes\" with the help of various electronic databases such as PubMed, Science Direct, Embase, Web of Science, and the Cochrane Library from the beginning of the database through September 2018. The primary outcome was glycated hemoglobin (HbA1c), whereas the secondary outcomes were blood glucose level, blood pressure (BP) measure, body mass index, lipids, adherence to medication, and quality of life. Twenty-five studies comprising 2997 diabetic patients were included in the analysis. Pharmacist-led intervention was involved in all included studies in the form of education on diabetes and its complications, medication adherence, lifestyle, and education about self-management skills. Pharmacist-led interventions are able to reduce HbA1c levels with a mean of 0.75%. Most studies do not expose the material and methods used in pharmacist-led intervention. The variation in the reduction of HbA1c, fasting blood sugar, BP, and lipid profile was due to the lack of this standardization. The included studies indicated that pharmacist-led interventions in diabetes mellitus can significantly improve the outcomes of diabetes mellitus and its complication later on. Hence, these long-term improvements in outcomes added more value of pharmacists in health-care system of the world.

ABSTRACT Objective: Diabetes mellitus (DM) is a chronic metabolic disorder that can initiate organ damage inside the body if not treated appropriately. Apart from tight glycemic control, a suitable educational intervention is also needed from health-care providers to stop or decrease the progression of organ damage in diabetic patients. This study intended to measure the impact of pharmacist-led educational intervention on improvement in predictors of diabetic foot in two different hospitals in Malaysia. Materials and Methods: In two tertiary care selected hospitals, the included diabetic patients were randomly divided into two study arms. In the control group, 200 patients who were receiving usual treatment from hospitals were included. However, in the intervention group, those 200 patients who were receiving usual treatment along with counseling sessions from pharmacists under the Diabetes Medication Therapy Adherence Clinic (DMTAC) program were included. The study continued for 1 year, and there were four follow-up visits for both study arms. A prevalidated data collection form was used to measure the improvement in predictors of diabetic foot in included patients. Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) software program, version 24.0. Results: With the average decrease of 1.97% of HbA1c values in the control group and 3.43% in the intervention group, the univariate and multivariate analysis showed a statistically significant difference between both of the study arms in the improvement of predictors belonging to the diabetic foot (P < 0.05). The proportion of patients without any signs and symptoms of the diabetic foot in the intervention group was 91.7%, which increased from 42.3% at baseline (P < 0.05). However, this proportion in the control group was 76.9% at the fourth follow-up, from 48.3% at baseline (P < 0.05). Conclusion: A statistically significant reduction in the signs and symptoms of diabetic foot was observed in the intervention group at the end of 1 year. The progression of diabetic foot was significantly decreased in the pharmacist intervention group.