A potential link between switching to aripiprazole and worsening of psychosis was first reported in the early 2000s. There have since been numerous published case reports describing this phenomenon, but only recently has the concept of a theoretical aripiprazole-induced dopamine supersensitivity psychosis (DSP) caused by D2 receptor activation in patients undergoing a switch to aripiprazole appeared in the literature. There is less awareness in clinical practice of the possibility of inducing DSP with aripiprazole, which may be particularly severe in some patients. The objective of this article is to present four cases demonstrating rapid and dramatic onset of DSP during switching to aripiprazole. In each case, a patient with a Diagnostic and statistical manual of mental disorders (5th ed.) diagnosis of schizophrenia experienced severe worsening of psychosis within 4–5 days of abrupt switching to aripiprazole from a full D2 antagonist. To our knowledge, this is the first case series characterizing the previously well-documented worsening of psychosis during switching to aripiprazole specifically as aripiprazole-induced DSP. We discuss clinical relevance, prevention and future directions. Careful cross-titration per clinical practice guidelines may reduce occurrence of DSP during aripiprazole switching or augmentation treatment.
The objective of this review is to shed light on the literature regarding the psychological impact of invasive cosmetic surgery and to discuss future implications for research and clinical practice. Articles published through October 2021 were reviewed to answer the question, "Does cosmetic surgery improve a patient's overall psychological health?" Psychological well-being was examined through the lens of body image, self-esteem, anxiety, and depression scores. The studies revealed that although cosmetic surgery seems to boost patients' body image, other crucial aspects of psychological well-being may or may not similarly benefit. Notably, factors such as a patient's preoperative mental status, level of education, type of cosmetic procedure, postoperative healing time, sex, and age play a role in determining the direction and magnitude of psychological change after surgery. Limitations include the lack of diversity in study populations and the potential role of body dysmorphic disorder. Overall, researchers have concluded that cosmetic surgery improves body image but remain in disagreement on its effects on self-esteem, anxiety, and depression.
Background Frontal fibrosing alopecia (FFA) is a cicatricial alopecia affecting the frontotemporal hairline. This scarring, immune-mediated follicular destruction most commonly affects postmenopausal Caucasian women, however the exact etiology of FFA is still unknown. Recent literature has reported cases of FFA as being potentially caused by personal care product. Therefore, this systematic review and meta-analysis intends to be the first to analyze the relationship between FFA and cosmetic/personal care products and treatments, including sunscreen, moisturizer, foundation, shampoo, conditioner, hair mousse, hair gel, hair dye, hair straightening/rebonding, chemical/laser facial resurfacing, aftershave, and facial cleanser. Methods The Cochrane, PubMed, EMBASE, and Medline (Ovid) databases were searched for the relevant studies from the date of inception to August 2022. Case-control, cross-sectional, and cohort studies examining the effects of cosmetic/personal care product use on FFA, available in English full-text, were included. Analyses were performed using Review Manager, version 5.4. Results Nine studies were included in our quantitative analyses, totaling 1,248 FFA patients and 1,459 controls. There were significant positive associations found for FFA and sunscreen (OR 3.02, 95% CI 1.67–5.47; p < 0.05) and facial moisturizer (OR 2.20, 95% CI 1.51–3.20; p < 0.05) use. Gender sub-analyses demonstrated a positive association for FFA and facial moisturizer in men (OR 5.07, 95% CI 1.40-18.32; p < 0.05), but not women (OR 1.58, 95% CI 0.83–2.98; p < 0.05). There was no association found for facial cleanser (OR 1.14, 95% CI 0.33–1.52; p < 0.05), foundation (OR 1.13, 95% CI 0.83–1.55; p < 0.05), shampoo (OR 0.49, 95% CI 0.22–1.10; p < 0.05), hair conditioner (OR 0.81, 95% CI 0.52–1.26; p < 0.05), hair mousse (OR 1.37, 95% CI 0.75–2.51; p < 0.05), and hair gel (OR 0.90, 95% CI 0.48–1.69; p < 0.05), hair dye (OR 1.07, 95% CI 0.69–1.64; p < 0.05), hair straightening/rebonding (OR 0.53, 95% CI 0.01–32.76; p < 0.05), hair perming (OR 1.41, 95% CI 0.89–2.23; p < 0.05), facial toner (OR 0.51, 95% CI 0.12–2.21), or aftershave (OR 1.64, 95% CI 0.28–9.49; p < 0.05). Conclusions This meta-analysis strongly suggests that the leave-on facial products, facial sunscreen and moisturizer, are associated with FFA. There was no significant relationship found with hair products or treatments. These findings suggest a potential environmental etiology in the development of FFA, particularly UV-protecting chemicals.
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