The American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults

Association, American Psychiatric

doi:10.1176/appi.books.9780890426760

Cited by 56 publications

(28 citation statements)

References 205 publications

(267 reference statements)

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“…Delirious patients can be restless or agitated (American Psychiatric Association, 2013), which may have influenced the quality of EEG and fMRI measurements (Power et al, 2015; Ciric et al, 2017). Although in EEG analyses artifact-free epochs were used and usage of fMRI motion correction was part of our quality criteria, the results shown in this study may still have been (partly) effected by motion.…”

Section: Discussionmentioning

confidence: 99%

“…These impairments can even be a fingerprint of a specific disorder (Crossley et al, 2014) or a marker for vulnerability (Douw et al, 2010; van Diessen et al, 2013). Delirium is an acute neuropsychiatric syndrome characterized by an altered level of attention and awareness with other cognitive deficits, due to another medical condition (American Psychiatric Association, 2013). Delirium has several clinical manifestations: hypoactive, hyperactive and a mixed type.…”

Section: Introductionmentioning

confidence: 99%

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Brain network disintegration as a final common pathway for delirium: a systematic review and qualitative meta-analysis

Montfort

Dellen

Stam

et al. 2019

NeuroImage: Clinical

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Delirium is an acute neuropsychiatric syndrome characterized by altered levels of attention and awareness with cognitive deficits. It is most prevalent in elderly hospitalized patients and related to poor outcomes. Predisposing risk factors, such as older age, determine the baseline vulnerability for delirium, while precipitating factors, such as use of sedatives, trigger the syndrome. Risk factors are heterogeneous and the underlying biological mechanisms leading to vulnerability for delirium are poorly understood. We tested the hypothesis that delirium and its risk factors are associated with consistent brain network changes. We performed a systematic review and qualitative meta-analysis and included 126 brain network publications on delirium and its risk factors. Findings were evaluated after an assessment of methodological quality, providing N=99 studies of good or excellent quality on predisposing risk factors, N=10 on precipitation risk factors and N=7 on delirium. Delirium was consistently associated with functional network disruptions, including lower EEG connectivity strength and decreased fMRI network integration. Risk factors for delirium were associated with lower structural connectivity strength and less efficient structural network organization. Decreased connectivity strength and efficiency appear to characterize structural brain networks of patients at risk for delirium, possibly impairing the functional network, while functional network disintegration seems to be a final common pathway for the syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Brain network disintegration as a final common pathway for delirium: a systematic review and qualitative meta-analysis

Montfort

Dellen

Stam

et al. 2019

NeuroImage: Clinical

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“…Anorexia nervosa (AN) is a severe mental disorder characterized by an intense fear of weight gain and a distorted body image, and patients continue to engage in dietary restriction or other (compensatory) behaviours to avoid weight gain despite severe undernutrition 1,2 . Relapse rates in AN are high and long-term outcome studies generally show only low rates of full recovery 3 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of spontaneous regional brain activity in weight-recovered anorexia nervosa

et al. 2020

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Whereas research using structural magnetic resonance imaging (sMRI) reports sizable grey matter reductions in patients suffering from acute anorexia nervosa (AN) to be largely reversible already after short-term weight gain, many task-based and resting-state functional connectivity (RSFC) studies suggest persistent brain alterations even after long-term weight rehabilitation. First investigations into spontaneous regional brain activity using voxel-wise resting-state measures found widespread abnormalities in acute AN, but no studies have compared intrinsic brain activity properties in weight-recovered individuals with a history of AN (recAN) with healthy controls (HCs). SMRI and RSFC data were analysed from a sample of 130 female volunteers: 65 recAN and 65 pairwise age-matched HC. Cortical grey matter thickness was assessed using FreeSurfer software. Fractional amplitude of low-frequency fluctuations (fALFFs), mean-square successive difference (MSSD), regional homogeneity (ReHo), voxel-mirrored homotopic connectivity (VHMC), and degree centrality (DC) were calculated. SMRI and RSFC data were analysed from a sample of 130 female volunteers: 65 recAN and 65 pairwise age-matched HCs. Cortical grey matter thickness was assessed using FreeSurfer software. Fractional amplitude of low-frequency fluctuations (fALFF), mean-square successive difference (MSSD), regional homogeneity (ReHo), voxel-mirrored homotopic connectivity (VHMC), and degree centrality (DC) were calculated. Abnormal regional homogeneity found in acute AN seems to normalize in recAN, supporting assumptions of a state rather than a trait marker. Aberrant fALFF values in the cerebellum and the infertior temporal gyrus could possibly hint towards trait factors or a scar (the latter, e.g., from prolonged periods of undernutrition), warranting further longitudinal research.

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“…Persistent drug use despite negative consequences, and long-lasting relapse propensity are cardinal features of addiction in humans [78]. Though compulsive drug intake despite punishment is common in rodents following extended drug access [22, 23, 70], some rats seem to transition to compulsive use even after short access to cocaine.…”

Section: Discussionmentioning

confidence: 99%

Ventral Pallidum is Essential for Cocaine Reinstatement After Voluntary Abstinence

Castillo

et al. 2019

Preprint

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21Addiction is a chronic relapsing disorder, and during recovery many people experience several relapse events as 22 they attempt to voluntarily abstain from drug. New preclinical relapse models have emerged which capture this 23 common human experience of relapse after voluntary abstinence, and mounting evidence indicates that 24 reinstatement of drug seeking after voluntary abstinence recruits neural circuits distinct from reinstatement 25 following experimenter-imposed abstinence, or abstinence due to extinction training. Ventral pallidum (VP), a key 26 limbic node involved in drug seeking, has well-established roles in conventional reinstatement models tested 27 following extinction training, but it is unclear whether this region also participates in more translationally-relevant 28 models of relapse. Here we show that chemogenetic inhibition of VP neurons strongly attenuates cocaine-, 29 context-, and cue-induced reinstatement tested after voluntary, punishment-induced abstinence. This effect was 30 strongest in the most compulsive, punishment-resistant rats, and reinstatement was associated with neural 31 activity in anatomically-defined VP subregions. VP inhibition also attenuated the propensity of rats to display 32 'hesitations,' a risk assessment behavior seen during punished drug taking that is likely due to concurrent 33 approach and avoidance motivations. These results indicate that VP, unlike other connected limbic brain regions, 34 is essential for reinstatement of drug seeking after voluntary abstinence. Since VP inhibition effects were 35 strongest in the most compulsively cocaine-seeking individuals, this could indicate that VP plays a particularly 36 important role in the most pathological, addiction-like behavior, making it an attractive target for future 37 therapeutic interventions. 38 39 40 41 42

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The American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults

Abstract: the Work Group on Psychiatric Evaluation especially thank Laura J. Fochtmann, M.D., M.B.I, and Robert Kunkle, M.A., for their outstanding work and effort on developing these guidelines.The executive summary for this practice guideline was published by

Cited by 56 publications

References 205 publications

Brain network disintegration as a final common pathway for delirium: a systematic review and qualitative meta-analysis

Brain network disintegration as a final common pathway for delirium: a systematic review and qualitative meta-analysis

Evaluation of spontaneous regional brain activity in weight-recovered anorexia nervosa

Ventral Pallidum is Essential for Cocaine Reinstatement After Voluntary Abstinence

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