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7. Comparing randomized controlled trials of outpatient family‐based or inpatient multimodal treatment followed by outpatient care in youth with anorexia nervosa: Differences in populations, metrics, and outcomes

Author

Haas, Verena, Nadler, Janine, Crosby, Ross D, Madden, Sloane, Kohn, Michael, Le Grange, Daniel, Gonçalves, Ana Sofia Oliveira, Hebebrand, Johannes, and Correll, Christoph U

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Pediatric, Nutrition, Comparative Effectiveness Research, Serious Mental Illness, Anorexia, Eating Disorders, Mental Health, Brain Disorders, Clinical Research, Clinical Trials and Supportive Activities, Adolescent, Ambulatory Care, Anorexia Nervosa, Combined Modality Therapy, Family Therapy, Humans, Inpatients, Outpatients, Randomized Controlled Trials as Topic, Treatment Outcome, adolescent, eating disorders, hospitalisation, review, setting, weight gain, Psychology, Clinical Psychology, Clinical sciences, Nutrition and dietetics, Clinical and health psychology
Abstract

ObjectiveVarious approaches exist to treat youth with anorexia nervosa (AN). Family-based treatment (FBT) has never been compared to long inpatient, multimodal treatment (IMT) in a randomized controlled trial (RCT). The aim of this study was to compare data on body weight trajectories, change in eating disorder psychopathology, hospital days and treatment costs in RCTs delivering FBT or IMT.MethodReview of RCTs published between 2010 and 2020 in youth with AN, delivering FBT or IMT.ResultsFour RCTs delivering FBT (United States, n = 2; Australia, n = 2), one RCT delivering Family Therapy for AN (United Kingdom) and two RCTs delivering IMT (France, n = 1; Germany, n = 1) were identified from previous meta-analyses. The comparison of studies was limited by (1) significant differences in patient baseline characteristics including pretreated versus non-pretreated patients, (2) use of different psychometric and weight measures and (3) different initial velocity of weight recovery. Minimal baseline and outcome reporting standards for body weight metrics and nature/dose of interventions allowing international comparison are needed and suggestions to developing these standards are presented.DiscussionAn RCT should investigate, whether FBT is a viable alternative to IMT, leading to comparable weight and psychopathology improvement with less inpatient time and costs.

Published
2022

8. The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management

Author

McIntyre, Roger S, Alda, Martin, Baldessarini, Ross J, Bauer, Michael, Berk, Michael, Correll, Christoph U, Fagiolini, Andrea, Fountoulakis, Kostas, Frye, Mark A, Grunze, Heinz, Kessing, Lars V, Miklowitz, David J, Parker, Gordon, Post, Robert M, Swann, Alan C, Suppes, Trisha, Vieta, Eduard, Young, Allan, and Maj, Mario

Subjects
Health Services and Systems, Health Sciences, Clinical Research, Serious Mental Illness, Patient Safety, Prevention, Behavioral and Social Science, Suicide, Mental Health, Brain Disorders, Management of diseases and conditions, 7.3 Management and decision making, 7.1 Individual care needs, Mental health, Good Health and Well Being, Bipolar disorder, clinical characterization, phenotyping, subtypes, mixed features, cognition, rapid cycling, trauma, comorbidity, social determinants, stigma, stressors, resilience, bipolar I disorder, bipolar II disorder, mania, depression, personalization, Clinical Sciences, Psychiatry, Clinical sciences, Health services and systems
Abstract

Bipolar disorder is heterogeneous in phenomenology, illness trajectory, and response to treatment. Despite evidence for the efficacy of multimodal-ity interventions, the majority of persons affected by this disorder do not achieve and sustain full syndromal recovery. It is eagerly anticipated that combining datasets across various information sources (e.g., hierarchical "multi-omic" measures, electronic health records), analyzed using advanced computational methods (e.g., machine learning), will inform future diagnosis and treatment selection. In the interim, identifying clinically meaningful subgroups of persons with the disorder having differential response to specific treatments at point-of-care is an empirical priority. This paper endeavours to synthesize salient domains in the clinical characterization of the adult patient with bipolar disorder, with the overarching aim to improve health outcomes by informing patient management and treatment considerations. Extant data indicate that characterizing select domains in bipolar disorder provides actionable information and guides shared decision making. For example, it is robustly established that the presence of mixed features - especially during depressive episodes - and of physical and psychiatric comorbidities informs illness trajectory, response to treatment, and suicide risk. In addition, early environmental exposures (e.g., sexual and physical abuse, emotional neglect) are highly associated with more complicated illness presentations, inviting the need for developmentally-oriented and integrated treatment approaches. There have been significant advances in validating subtypes of bipolar disorder (e.g., bipolar I vs. II disorder), particularly in regard to pharmacological interventions. As with other severe mental disorders, social functioning, interpersonal/family relationships and internalized stigma are domains highly relevant to relapse risk, health outcomes, and quality of life. The elevated standardized mortality ratio for completed suicide and suicidal behaviour in bipolar disorder invites the need for characterization of this domain in all patients. The framework of this paper is to describe all the above salient domains, providing a synthesis of extant literature and recommendations for decision support tools and clinical metrics that can be implemented at point-of-care.

Published
2022

9. Changes in telepsychiatry regulations during the COVID-19 pandemic: 17 countries and regions' approaches to an evolving healthcare landscape

Author

Kinoshita, Shotaro, Cortright, Kelley, Crawford, Allison, Mizuno, Yuya, Yoshida, Kazunari, Hilty, Donald, Guinart, Daniel, Torous, John, Correll, Christoph U, Castle, David J, Rocha, Deyvis, Yang, Yuan, Xiang, Yu-tao, Kølbæk, Pernille, Dines, David, ElShami, Mohammad, Jain, Prakhar, Kallivayalil, Roy, Solmi, Marco, Favaro, Angela, Veronese, Nicola, Seedat, Soraya, Shin, Sangho, de Pablo, Gonzalo Salazar, Chang, Chun-Hung, Su, Kuan-Pin, Karas, Hakan, Kane, John M, Yellowlees, Peter, and Kishimoto, Taishiro

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Health Services, Good Health and Well Being, Humans, COVID-19, Telemedicine, Pandemics, Psychiatry, Referral and Consultation, government regulation, health insurance reimbursement, telemedicine, telepsychiatry, Neurosciences, Public Health and Health Services, Psychology, Clinical sciences, Biological psychology, Clinical and health psychology
Abstract

BackgroundDuring the COVID-19 pandemic, the use of telemedicine as a way to reduce COVID-19 infections was noted and consequently deregulated. However, the degree of telemedicine regulation varies from country to country, which may alter the widespread use of telemedicine. This study aimed to clarify the telepsychiatry regulations for each collaborating country/region before and during the COVID-19 pandemic.MethodsWe used snowball sampling within a global network of international telepsychiatry experts. Thirty collaborators from 17 different countries/regions responded to a questionnaire on barriers to the use and implementation of telepsychiatric care, including policy factors such as regulations and reimbursement at the end of 2019 and as of May 2020.ResultsThirteen of 17 regions reported a relaxation of regulations due to the pandemic; consequently, all regions surveyed stated that telepsychiatry was now possible within their public healthcare systems. In some regions, restrictions on prescription medications allowed via telepsychiatry were eased, but in 11 of the 17 regions, there were still restrictions on prescribing medications via telepsychiatry. Lower insurance reimbursement amounts for telepsychiatry consultations v. in-person consultations were reevaluated in four regions, and consequently, in 15 regions telepsychiatry services were reimbursed at the same rate (or higher) than in-person consultations during the COVID-19 pandemic.ConclusionsOur results confirm that, due to COVID-19, the majority of countries surveyed are altering telemedicine regulations that had previously restricted the spread of telemedicine. These findings provide information that could guide future policy and regulatory decisions, which facilitate greater scale and spread of telepsychiatry globally.

Published
2022

10. Stepped, evidence-based and integrated care service model vs. usual care for mental disorders: A randomized controlled trial (RECOVER)

Author

Lambert, Martin, König, Hannah, Karow, Anne, König, Hans-Helmut, Rohenkohl, Anja, Luedecke, Daniel, Schröter, Romy, Finter, Constanze, Tlach, Lisa, Schindler, Andreas, Peter, Helmut, Scherer, Martin, Mews, Claudia, Härter, Martin, Bindt, Carola, Löwe, Bernd, Briken, Peer, Peper, Heike, Schweiger, Michael, Mösko, Mike, Bock, Thomas, Deister, Arno, Correll, Christoph U., Ozga, Ann-Kathrin, Pepić, Amra, Zapf, Antonia, Gallinat, Jürgen, Peth, Judith, Konnopka, Alexander, and Schulz, Holger

Published
2024
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11. Identifying differential predictors for treatment response to amisulpride and olanzapine combination treatment versus each monotherapy in acutely ill patients with schizophrenia: Results of the COMBINE-study

Author

Galuba, Viktoria, Cordes, Joachim, Feyerabend, Sandra, Riesbeck, Mathias, Meisenzahl-Lechner, Eva, Correll, Christoph U., Kluge, Michael, Neff, Andrea, Zink, Mathias, Langguth, Berthold, Reske, Dirk, Gründer, Gerhard, Hasan, Alkomiet, Brockhaus-Dumke, Anke, Jäger, Markus, Baumgärtner, Jessica, Leucht, Stefan, and Schmidt-Kraepelin, Christian

Published
2024
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16. An umbrella review of candidate predictors of response, remission, recovery, and relapse across mental disorders

Author

Solmi, Marco, Cortese, Samuele, Vita, Giovanni, De Prisco, Michele, Radua, Joaquim, Dragioti, Elena, Köhler-Forsberg, Ole, Madsen, Nanna M., Rohde, Christopher, Eudave, Luis, Aymerich, Claudia, Pedruzo, Borja, Rodriguez, Victoria, Rosson, Stella, Sabé, Michel, Hojlund, Mikkel, Catalan, Ana, de Luca, Beatrice, Fornaro, Michele, Ostuzzi, Giovanni, Barbui, Corrado, Salazar-de-Pablo, Gonzalo, Fusar-Poli, Paolo, and Correll, Christoph U.

Published
2023
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18. Towards a youth mental health paradigm: a perspective and roadmap

Author

Uhlhaas, Peter J., Davey, Christopher G., Mehta, Urvakhsh Meherwan, Shah, Jai, Torous, John, Allen, Nicholas B., Avenevoli, Shelli, Bella-Awusah, Tolulope, Chanen, Andrew, Chen, Eric Y. H., Correll, Christoph U., Do, Kim Q., Fisher, Helen L., Frangou, Sophia, Hickie, Ian B., Keshavan, Matcheri S., Konrad, Kerstin, Lee, Francis S., Liu, Cindy H., Luna, Beatriz, McGorry, Patrick D., Meyer-Lindenberg, Andreas, Nordentoft, Merete, Öngür, Dost, Patton, George C., Paus, Tomáš, Reininghaus, Ulrich, Sawa, Akira, Schoenbaum, Michael, Schumann, Gunter, Srihari, Vinod H., Susser, Ezra, Verma, Swapna K., Woo, T. Wilson, Yang, Lawrence H., Yung, Alison R., and Wood, Stephen J.

Published
2023
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23. Effects of antipsychotic treatment on cardio-cerebrovascular related mortality in schizophrenia: A subanalysis of a systematic review and meta-analysis with meta-regression of moderators

Author

Solmi, Marco, Croatto, Giovanni, Gupta, Arnav, Fabiano, Nicholas, Wong, Stanley, Fornaro, Michele, Schneider, Lynne Kolton, Rohani-Montez, S. Christy, Fairley, Leanne, Smith, Nathalie, Bitter, István, Gorwood, Philip, Taipale, Heidi, Tiihonen, Jari, Cortese, Samuele, Dragioti, Elena, Rietz, Ebba Du, Nielsen, Rene Ernst, Firth, Joseph, Fusar-Poli, Paolo, Hartman, Catharina, Holt, Richard I G, Høye, Anne, Koyanagi, Ai, Larsson, Henrik, Lehto, Kelli, Lindgren, Peter, Manchia, Mirko, Nordentoft, Merete, Skonieczna-Żydecka, Karolina, Stubbs, Brendon, Vancampfort, Davy, De Prisco, Michele, Boyer, Laurent, Vieta, Eduard, and Correll, Christoph U.

Published
2024
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25. Efficacy and tolerability of antipsychotic polypharmacy for schizophrenia spectrum disorders. A systematic review and meta-analysis of individual patient data

Author

Lochmann van Bennekom, Marc W.H., IntHout, Joanna, Gijsman, Harm J., Akdede, Berna B.K., Yağcıoğlu, A. Elif Anıl, Barnes, Thomas R.E., Galling, Britta, Gueorguieva, Ralitza, Kasper, Siegfried, Kreinin, Anatoly, Nielsen, Jimmi, Nielsen, René Ernst, Remington, Gary, Repo-Tiihonen, Eila, Schmidt-Kraepelin, Christian, Shafti, Saeed S., Xiao, Le, Correll, Christoph U., and Verkes, Robbert-Jan

Published
2024
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29. Exploring low clozapine C/D ratios, inverted clozapine-norclozapine ratios and undetectable concentrations as measures of non-adherence in clozapine patients: A literature review and a case series of 17 patients from 3 studies

Author

Ruan, Can-Jun, Olmos, Ismael, Ricciardi, Carina, Schoretsanitis, Georgios, Vincent, Philippe D., Anıl Yağcıoğlu, A. Elif, Eap, Chin B., Baptista, Trino, Clark, Scott R., Fernandez-Egea, Emilio, Kim, Se Hyun, Lane, Hsien-Yuan, Leung, Jonathan, Maroñas Amigo, Olalla, Motuca, Mariano, Every-Palmer, Susanna, Procyshyn, Ric M., Rohde, Christopher, Suhas, Satish, Schulte, Peter F.J., Spina, Edoardo, Takeuchi, Hiroyoshi, Verdoux, Hélène, Correll, Christoph U., Molden, Espen, De Las Cuevas, Carlos, and de Leon, Jose

Published
2024
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30. Clozapine ultrarapid metabolism during weak induction probably exists but requires careful diagnosis. A literature review, five new cases and a proposed definition

Author

Schoretsanitis, Georgios, Anıl Yağcıoğlu, A. Elif, Ruan, Can-Jun, Eap, Chin B., Molden, Espen, Baptista, Trino, Clark, Scott R., Fernandez-Egea, Emilio, Kim, Se Hyun, Lane, Hsien-Yuan, Leung, Jonathan, Maroñas Amigo, Olalla, Motuca, Mariano, Olmos, Ismael, Every-Palmer, Susanna, Procyshyn, Ric M., Rohde, Christopher, Satish, Suhas, Schulte, Peter F.J., Spina, Edoardo, Takeuchi, Hiroyoshi, Verdoux, Hélène, Correll, Christoph U., and de Leon, Jose

Published
2024
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42. The Impact of Inpatient Multimodal Treatment or Family-Based Treatment on Six-Month Weight Outcomes in Youth with Anorexia Nervosa: A Naturalistic, Cross-Continental Comparison.

Author

Nadler, Janine, Correll, Christoph U, Le Grange, Daniel, Accurso, Erin C, and Haas, Verena

Subjects
Humans, Weight Gain, Treatment Outcome, Combined Modality Therapy, Anorexia Nervosa, Family Therapy, Adolescent, Inpatients, adolescent medicine, eating disorders, international comparison, psychotherapeutic approaches, treatment setting, Brain Disorders, Clinical Research, Serious Mental Illness, Nutrition, Mental Health, Pediatric, Eating Disorders, Anorexia, Food Sciences, Nutrition and Dietetics
Abstract

In the USA, family-based treatment (FBT) with inpatient medical stabilization as needed is the leading evidence-based treatment for youth with anorexia nervosa (AN). In continental Europe, typically inpatient multimodal treatment targeting weight recovery followed by outpatient care (IMT) is standard care, if prior outpatient treatment was not sufficient. Our aim was to compare weekly weight gain and hospital days over six months for adolescents receiving FBT (USA) versus IMT (Germany) using naturalistic treatment data. To yield similar subgroups of youth aged 12−18 years, inclusion criteria were a percent median BMI (%mBMI) between 70−85 and the restrictive AN subtype. Weight gain and hospital days were compared, adjusted further in a multiple linear regression analysis (MLRA) for baseline group differences. Samples differed on baseline %mBMI (FBT [n = 71], 90.5 ± 12.8; IMT [n = 29], 78.3 ± 9.1, p < 0.05). In subgroups with comparable baseline %mBMI, the weekly weight gain over 6 months was similar (FBT [n = 21]: 0.35 ± 0.18 kg/week; IMT [n = 20]: 0.30 ± 0.18, p = 0.390, p = 0.166 after MLRA), but achieved fewer hospital days in FBT (FBT [n = 7]: 4 ± 6 days, IMT [n = 20]: 121 ± 42 days, p < 0.0001 before and after MLRA). FBT may be effective for a subgroup of adolescents with AN currently receiving IMT, but head-to-head studies in the same healthcare system are needed.

Published
2022

43. Outcomes of a Standardized, High-Caloric, Inpatient Re-Alimentation Treatment Protocol in 120 Severely Malnourished Adolescents with Anorexia Nervosa

Author

Dalenbrook, Sophia, Naab, Silke, Garber, Andrea K, Correll, Christoph U, Voderholzer, Ulrich, and Haas, Verena

Subjects
Paediatrics, Biomedical and Clinical Sciences, Clinical Research, Nutrition, Mental Health, Anorexia, Pediatric, Clinical Trials and Supportive Activities, Brain Disorders, Eating Disorders, Zero Hunger, energy intake, eating disorders, refeeding syndrome, nutrition, Clinical Sciences, Biomedical and clinical sciences
Abstract

Evidence accumulates that, with close medical monitoring and phosphate supplementation, higher-caloric re-alimentation protocols beginning at 2000 kcal/day (HCR) are not associated with an increased incidence of electrolyte abnormalities in patients with anorexia nervosa (AN) but rather result in faster weight gain. These studies are still scant and have largely been performed in adults or moderately malnourished adolescents. Methods: A retrospective chart review of patients with AN aged 12−20 years and with a body mass index (BMI) < 15 kg/m2 alimented according to a standardized treatment protocol in a German clinic specialized in AN was conducted. All patients received 2000 kcal/day from day one. The effect of HCR was examined with respect to laboratory changes and weight development over 4 weeks. Results: In 120 youth (119 (99.2%) females and 1 (0.8%) male, the mean BMI was 13.1 ± 1.1 (range = 10.2−15.0), %mBMI was 62.1 ± 6.0% and weight gain was 0.76 ± 0.22 kg per week, with the highest rate of weight gain during week 1 (1.25 ± 1.28 kg/week). Over 4 weeks, the total weight gain was 3.00 ± 1.92 kg. Nine patients (7.5%) developed mild hypophosphatemia, and none developed refeeding syndrome. Conclusions: Starting re-alimentation with 2000 kcal/d under close medical surveillance, severely malnourished youth with AN met the recommended weight gain targets between 0.5 and 1 kg/week according to current treatment guidelines, without anyone developing refeeding syndrome.

Published
2022

46. Regional differences in mortality risk and in attenuating or aggravating factors in schizophrenia: A systematic review and meta-analysis

Author

Solmi, Marco, Croatto, Giovanni, Fornaro, Michele, Schneider, Lynne Kolton, Rohani-Montez, S. Christy, Fairley, Leanne, Smith, Nathalie, Bitter, István, Gorwood, Philip, Taipale, Heidi, Tiihonen, Jari, Cortese, Samuele, Dragioti, Elena, Rietz, Ebba Du, Nielsen, Rene Ernst, Firth, Joseph, Fusar-Poli, Paolo, Hartman, Catharina, Holt, Richard I G, Høye, Anne, Koyanagi, Ai, Larsson, Henrik, Lehto, Kelli, Lindgren, Peter, Manchia, Mirko, Nordentoft, Merete, Skonieczna-Żydecka, Karolina, Stubbs, Brendon, Vancampfort, Davy, Boyer, Laurent, De Prisco, Michele, Vieta, Eduard, and Correll, Christoph U.

Published
2024
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47. Physical activity, suicidal ideation, suicide attempt and death among individuals with mental or other medical disorders: A systematic review of observational studies

Author

Fabiano, Nicholas, Gupta, Arnav, Wong, Stanley, Tran, Jason, Mohammad, Ibrahim YZ, Bal, Shan, Fiedorowicz, Jess G., Firth, Joseph, Stubbs, Brendon, Vancampfort, Davy, Schuch, Felipe B., Carr, Lucas J., Shorr, Risa, Cortese, Samuele, Manchia, Mirko, Hartman, Catharina A., Høye, Anne, Fusar-Poli, Paolo, Koyanagi, Ai, Vieta, Eduard, Nielsen, René Ernst, Holt, Richard IG, Correll, Christoph U., Du Rietz, Ebba, Taipale, Heidi, Lehto, Kelli, Larrson, Henrik, Nordentoft, Merete, Dragioti, Elena, Skonieczna-Żydecka, Karolina, and Solmi, Marco

Published
2024
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48. Psychopharmacology in children and adolescents: unmet needs and opportunities

Author

Cortese, Samuele, Purper-Ouakil, Diane, Apter, Alan, Arango, Celso, Baeza, Inmaculada, Banaschewski, Tobias, Buitelaar, Jan, Castro-Fornieles, Josefina, Coghill, David, Cohen, David, Correll, Christoph U, Grünblatt, Edna, Hoekstra, Pieter J, James, Anthony, Jeppesen, Pia, Nagy, Péter, Pagsberg, Anne Katrine, Parellada, Mara, Persico, Antonio M, Roessner, Veit, Santosh, Paramala, Simonoff, Emily, Stevanovic, Dejan, Stringaris, Argyris, Vitiello, Benedetto, Walitza, Susanne, Weizman, Abraham, Wong, Ian C K, Zalsman, Gil, Zuddas, Alessandro, Carucci, Sara, Butlen-Ducuing, Florence, Tome, Maria, Bea, Myriam, Getin, Christine, Hovén, Nina, Konradsson-Geuken, Asa, Lamirell, Daphne, Olisa, Nigel, Nafria Escalera, Begonya, and Moreno, Carmen

Published
2024
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