Lunsford-Avery JR, Bidopia T, Jackson L
… +1 more, Sloan JS
Psychiatr Clin North Am
· 2024 Mar · PMID 38302200
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Insomnia and related sleep disturbances are prevalent among youth and are associated with adverse consequences, including poorer psychiatric functioning. Behavioral sleep interventions, ranging from brief educational int...Insomnia and related sleep disturbances are prevalent among youth and are associated with adverse consequences, including poorer psychiatric functioning. Behavioral sleep interventions, ranging from brief educational interventions to behavioral therapies (cognitive behavior therapy-insomnia), are associated with positive outcomes for pediatric sleep health. In addition, sleep interventions may improve psychiatric health for children and adolescents with neurodevelopmental and internalizing disorders. Additional research is necessary to clarify the efficacy of these interventions over the long-term and across demographic groups; however, evidence suggests incorporating behavioral sleep strategies may prove beneficial to pediatric patients with sleep disturbances and related psychiatric complaints.
Psychiatr Clin North Am
· 2024 Mar · PMID 38302199
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Adequate sleep is essential for healthy development in childhood and adolescence. Healthy sleep contributes to good physical health, immune function, mental health, and academic performance. The regulation and architectu...Adequate sleep is essential for healthy development in childhood and adolescence. Healthy sleep contributes to good physical health, immune function, mental health, and academic performance. The regulation and architecture of sleep change greatly across childhood and adolescence, and the ability to obtain sufficient sleep is impacted by a range of factors that change with maturation. This article describes normal sleep across childhood and adolescence and discusses some of the most common barriers to adequate sleep, including early school start times, technology use, and changes to circadian rhythms, and sleep homeostasis across puberty.
Subramaniam GA, Nolan L, Huntley K
… +5 more, Corbin M, Crenshaw K, Mandell T, Linton J, Blackeney Q
Psychiatr Clin North Am
· 2023 Dec · PMID 37879839
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The wide and effective dissemination of research findings is crucial to the mission of the National Institute on Drug Abuse (NIDA). This article describes NIDA dissemination efforts and resources that are available to in...The wide and effective dissemination of research findings is crucial to the mission of the National Institute on Drug Abuse (NIDA). This article describes NIDA dissemination efforts and resources that are available to inform clinicians, teens, families, and educators about youth and substance use. Resources that are available include content addressing facts about youth drug use, trends in use, and stigma, in addition to substance use disorder (SUD) prevention and treatment. Information is provided about resources such as infographics, research-based practice guides, training, educational events, and online videos. How input is solicited to inform dissemination efforts is described and future directions for NIDA's dissemination efforts are outlined.
Psychiatr Clin North Am
· 2023 Dec · PMID 37879838
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This review summarizes treatments for cannabis use disorder (CUD) in adolescents. The best supported CUD treatments are cognitive behavioral psychotherapies, including family-based models that facilitate environmental ch...This review summarizes treatments for cannabis use disorder (CUD) in adolescents. The best supported CUD treatments are cognitive behavioral psychotherapies, including family-based models that facilitate environmental changes and youth-focused models that incorporate skills training, motivational interviewing, and contingency management to promote reductions in cannabis use. Some medications show promise in reducing cannabis craving and withdrawal symptoms. Further research is needed on the efficacy and implementation of existing treatments given the changes in cannabis use trends over time and on emerging technologies that may expand access to evidence-based CUD treatments.
Winters KC, Waldron H, Hops H
… +2 more, Ozechowski T, Montano A
Psychiatr Clin North Am
· 2023 Dec · PMID 37879837
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This article discusses the application of brief interventions to address adolescents with a cannabis use problem. Topics include a general model of brief interventions, the outcome literature, existing brief intervention...This article discusses the application of brief interventions to address adolescents with a cannabis use problem. Topics include a general model of brief interventions, the outcome literature, existing brief interventions that focus on youth cannabis use, adjustments to a brief intervention when addressing cannabis, referral to treatment issues, personalizing a brief intervention, the need to address coexisting problems, and future directions.
Psychiatr Clin North Am
· 2023 Dec · PMID 37879836
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Adolescent cannabis use is a modifiable health behavior with potential adverse developmental, cognitive, psychological, and health effects. Over the last 2 decades, work to promote implementation of screening, brief inte...Adolescent cannabis use is a modifiable health behavior with potential adverse developmental, cognitive, psychological, and health effects. Over the last 2 decades, work to promote implementation of screening, brief intervention, and referral to treatment has improved screening, use of validated screening tools, and preventive messaging. Current intervention strategies for cannabis use are associated with modest, short-term effects, and referral to treatment is limited by availability of resources for adolescent substance use. This article provides an update on the evidence base for screening, brief intervention, referral to treatment, and the current state of implementation focused on management of cannabis use disorder.
Psychiatr Clin North Am
· 2023 Dec · PMID 37879835
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Research has led to the development of hundreds of evidence-based prevention interventions, most of which are school-based prevention programs. Most primary care clinicians and child/adolescent behavioral health clinicia...Research has led to the development of hundreds of evidence-based prevention interventions, most of which are school-based prevention programs. Most primary care clinicians and child/adolescent behavioral health clinicians are unfamiliar with and/or lack training in evidence-based prevention interventions. However, most clinicians in these settings routinely screen children for developmental delays and skills deficits that increase the risk of developing substance abuse and a broad range of mental health and behavior problems by adolescence. It is hoped that the broader use of these practical evidence-based prevention tools may expand the prevention workforce to address the current youth mental health crisis.
Psychiatr Clin North Am
· 2023 Dec · PMID 37879834
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The current review highlights the available research related to cannabis and indicators of physical health in a variety of domains. Various studies have found associations between cannabis use with pulmonary, cardiovascu...The current review highlights the available research related to cannabis and indicators of physical health in a variety of domains. Various studies have found associations between cannabis use with pulmonary, cardiovascular, gastrointestinal, and endocrine function as well as body mass index and sleep. At this time, more research is needed to understand the influence of cannabis use on physical health, particularly among adolescent samples.
Psychiatr Clin North Am
· 2023 Dec · PMID 37879833
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Psychosis and cannabis use may overlap in multiple ways in young people. Research suggests that cannabis use increases risk for having psychotic symptoms, both attenuated (subthreshold) and acute. Cannabis use may also e...Psychosis and cannabis use may overlap in multiple ways in young people. Research suggests that cannabis use increases risk for having psychotic symptoms, both attenuated (subthreshold) and acute. Cannabis use may also exacerbate psychosis symptoms among young people with underlying psychosis risk and psychotic disorders. Although there are suggestions for treating co-occurring psychosis and cannabis use in young people (e.g., incorporating cannabis use assessment and treatment strategies into specialized early psychosis care), there are many gaps in clinical trial research to support evidence-based treatment of these overlapping concerns.
Psychiatr Clin North Am
· 2023 Dec · PMID 37879832
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Cannabis use often co-occurs with attention-deficit/hyperactivity disorder and other internalizing and externalizing disorders. Treatment planning, including pharmacologic and psychosocial interventions, for these comorb...Cannabis use often co-occurs with attention-deficit/hyperactivity disorder and other internalizing and externalizing disorders. Treatment planning, including pharmacologic and psychosocial interventions, for these comorbid disorders require thorough diagnostic evaluation to determine the extent of social, emotional, and behavioral impairments, severity of substance use, and motivation for change. Improved understanding of these comorbid disorders will inform treatment planning that address current symptoms and behaviors and may also prevent the development of mental health and substance use disorders in early adulthood.
Psychiatr Clin North Am
· 2023 Dec · PMID 37879831
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Although observational studies have shown that adolescent cannabis use is associated with impairments in important psychosocial domains, including peer, romantic, and parent-child relationships, educational outcomes, adu...Although observational studies have shown that adolescent cannabis use is associated with impairments in important psychosocial domains, including peer, romantic, and parent-child relationships, educational outcomes, adult socioeconomic status, and legal consequences, mechanisms underlying these associations remain largely unclear. Cannabis use may have a deleterious causal effect on functioning, but it is also possible the association may be due to reverse causation or confounding by shared vulnerability factors that account for both cannabis use in adolescence and concurrent and subsequent psychosocial impairment. Causally informative studies that delineate these possibilities, including research using epidemiologic samples and quasi-experimental designs, are critical to move the field forward.
Psychiatr Clin North Am
· 2023 Dec · PMID 37879830
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Research examining associations between frequent cannabis use in adolescence and brain-behavior outcomes has increased substantially over the past 2 decades. This review attempts to synthesize the state of evidence in th...Research examining associations between frequent cannabis use in adolescence and brain-behavior outcomes has increased substantially over the past 2 decades. This review attempts to synthesize the state of evidence in this area of research while acknowledging challenges in interpretation. Although there is converging evidence that ongoing, frequent cannabis use in adolescence is associated with small reductions in cognitive functioning, there is still significant debate regarding the persistence of reductions after a period of abstinence. Similarly, there is controversy regarding the replicability of structural and functional neuroimaging findings related to frequent cannabis use in adolescence. Larger studies with informative designs are needed.
Psychiatr Clin North Am
· 2023 Dec · PMID 37879829
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With increasing cannabis potency, increasing variety of methods of cannabis use, and lower perceived risk of cannabis use, it is increasingly important clinicians who work with adolescents remain up-to-date on the latest...With increasing cannabis potency, increasing variety of methods of cannabis use, and lower perceived risk of cannabis use, it is increasingly important clinicians who work with adolescents remain up-to-date on the latest literature regarding cannabis use and its associated outcomes. Adolescent cannabis use is associated with chronic cognitive, psychosocial, psychiatric, and physical outcomes. Clinicians working in this field should be able to recognize cannabis use disorder, understand how adolescent cannabis use can impact the developing mind, and have informed discussions with patients and families regarding risks of use.
Psychiatr Clin North Am
· 2023 Dec · PMID 37879828
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Because of substantial limitations in available national data, such as inconsistencies among surveys and small sample sizes, the increased prevalence of cannabis use among adolescents since recreational legalization has...Because of substantial limitations in available national data, such as inconsistencies among surveys and small sample sizes, the increased prevalence of cannabis use among adolescents since recreational legalization has not been directly observed. Nevertheless, both usage frequency and product potency have significantly increased, alongside alternative routes of delivery to smoking, such as vaping cannabis. Moreover, certain populations may be especially vulnerable to the effects of legalization. Regardless of differing state-level cannabis legalization status, the adverse consequences of cannabis on youth have clear negative impacts on mental health, medical symptoms, educational outcomes, and increased risk of addiction to other substances.
Psychiatr Clin North Am
· 2023 Sep · PMID 37500255
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Women veterans have unique life experiences and mental health needs, perhaps in part related to their high rates of exposure to traumatic events including military sexual trauma, combat trauma, and intimate partner viole...Women veterans have unique life experiences and mental health needs, perhaps in part related to their high rates of exposure to traumatic events including military sexual trauma, combat trauma, and intimate partner violence. We review mental health difficulties among women veterans and describe related functional impairment. Evidence-based treatments are available, but barriers to care remain, including providers' lack of awareness of the unique needs of women veterans. Efforts are needed to increase access to evidence-based interventions, remove barriers to care, and improve provider competency working with this population to maximize clinical outcomes.
Psychiatr Clin North Am
· 2023 Sep · PMID 37500254
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Reproductive rights, including access to comprehensive reproductive health care, are essential to the well-being of women and society. The Dobbs decision of the US Supreme Court has greatly exacerbated the confusion, the...Reproductive rights, including access to comprehensive reproductive health care, are essential to the well-being of women and society. The Dobbs decision of the US Supreme Court has greatly exacerbated the confusion, the stress, and the loss of services. Psychiatrists need to know and communicate the strong scientific evidence of the advantages of sex education, contraception, abortion, and bodily autonomy and to help patients process their feelings and make informed decisions about their own care.
Psychiatr Clin North Am
· 2023 Sep · PMID 37500253
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Human trafficking is one of the largest criminal enterprises in the world, generating an estimated $150 billion in illegal profits annually. Sex trafficking is the most common form of human trafficking, and survivors exp...Human trafficking is one of the largest criminal enterprises in the world, generating an estimated $150 billion in illegal profits annually. Sex trafficking is the most common form of human trafficking, and survivors experience significant physical, emotional, and sexual trauma that places them at increased risk of poor health outcomes. As sex trafficking continues to disproportionately impact the physical and mental health of individuals belonging to marginalized groups, a multidisciplinary approach to combat trafficking will require collaboration between health services, law enforcement, and social services. Therefore, medical professionals should be familiar with screening protocols for trafficking and evidence based, trauma-informed mental health treatment interventions.