scholarly journals Yoga for psychiatric disorders: from fad to evidence-based intervention?

2019 ◽  
Vol 216 (6) ◽  
pp. 291-293 ◽  
Author(s):  
Shivarama Varambally ◽  
Sanju George ◽  
Bangalore Nanjundaiah Gangadhar
Keyword(s):  
Clinical Practice ◽  
Psychiatric Disorders ◽  
Hpa Axis ◽  
Therapeutic Intervention ◽  
Mechanisms Of Action ◽  
Evidence Based ◽  
Autonomic Modulation ◽  
Gabaergic Neurotransmission ◽  
Hypothalamic Pituitary Adrenal

SummaryThere is growing evidence for yoga's neurobiological effects in people with psychiatric disorders. Postulated mechanisms of action include: (a) modulation of the hypothalamic–pituitary–adrenal (HPA) axis; (b) enhancement of GABAergic neurotransmission; (c) autonomic modulation; and (d) neuroendocrinological effects. Yoga as a therapeutic intervention in psychiatric disorders appears promising and merits further attention in clinical practice and research.

Pharmacogenomics and Precision Psychiatry

2018 ◽  
pp. 96-102
Author(s):  
Julia C. Stingl ◽  
Gonzalo Laje
Keyword(s):  
Genetic Variation ◽  
Clinical Practice ◽  
Drug Therapy ◽  
Mechanisms Of Action ◽  
Molecular Medicine ◽  
Evidence Based ◽  
Broad Definition ◽  
Clinical Syndromes ◽  
Definition Of ◽  
Future Work

Molecular medicine has opened new possibilities of personalized approaches in drug therapy. The development of evidence-based pharmacogenetic guidelines to steer therapy has slowly entered the field of psychiatric therapeutics. Some of the reasons behind the limited progress in psychiatric pharmacogenomics include the broad definition of clinical syndromes, limited knowledge of psychiatric pathophysiology, and limited understanding of psychotropics’ mechanisms of action. Pharmacogenomic markers have been reported for both pharmacodynamic and pharmacokinetic genes. However, only genetic variation in pharmacokinetic genes has shown to be helpful in clinical practice. There is little consensus as to when and if pharmacogenetic tests should be used in psychiatry. There are limited evidence-based dosing guidelines available for actionable gene–drug pairs. Future work in psychiatry may deepen our understanding of the biological underpinnings of psychiatric syndromes and provide the potential for individual tailored therapies.

Regulation of the Hypothalamic-Pituitary-Adrenal Axis by Cytokines: Actions and Mechanisms of Action

1999 ◽  
Vol 79 (1) ◽  
pp. 1-71 ◽  
Author(s):  
ANDREW V. TURNBULL ◽  
CATHERINE L. RIVIER
Keyword(s):  
Hpa Axis ◽  
Interleukin 1 ◽  
Hormone Secretion ◽  
Secretory Activity ◽  
Mechanisms Of Action ◽  
Hypothalamic Pituitary Adrenal Axis ◽  
Hypothalamic Pituitary Adrenal ◽  
Adrenal Axis ◽  
Pituitary Adrenal Axis ◽  
Neuroendocrine Systems

Turnbull, Andrew V., and Catherine L. Rivier. Regulation of the Hypothalamic-Pituitary-Adrenal Axis by Cytokines: Actions and Mechanisms of Action. Physiol. Rev. 79: 1–71, 1999. — Glucocorticoids are hormone products of the adrenal gland, which have long been recognized to have a profound impact on immunologic processes. The communication between immune and neuroendocrine systems is, however, bidirectional. The endocrine and immune systems share a common “chemical language,” with both systems possessing ligands and receptors of “classical” hormones and immunoregulatory mediators. Studies in the early to mid 1980s demonstrated that monocyte-derived or recombinant interleukin-1 (IL-1) causes secretion of hormones of the hypothalamic-pituitary-adrenal (HPA) axis, establishing that immunoregulators, known as cytokines, play a pivotal role in this bidirectional communication between the immune and neuroendocrine systems. The subsequent 10–15 years have witnessed demonstrations that numerous members of several cytokine families increase the secretory activity of the HPA axis. Because this neuroendocrine action of cytokines is mediated primarily at the level of the central nervous system, studies investigating the mechanisms of HPA activation produced by cytokines take on a more broad significance, with findings relevant to the more fundamental question of how cytokines signal the brain. This article reviews published findings that have documented which cytokines have been shown to influence hormone secretion from the HPA axis, determined under what physiological/pathophysiological circumstances endogenous cytokines regulate HPA axis activity, established the possible sites of cytokine action on HPA axis hormone secretion, and identified the potential neuroanatomic and pharmacological mechanisms by which cytokines signal the neuroendocrine hypothalamus.

scholarly journals Antiglucocorticoids in psychiatry

2009 ◽  
Vol 15 (4) ◽  
pp. 242-249 ◽  
Author(s):  
Sean A. McIsaac ◽  
Åsa Westrin ◽  
Allan H. Young
Keyword(s):  
Psychiatric Disorders ◽  
Hpa Axis ◽  
Pharmacological Treatment ◽  
Treatment Resistance ◽  
Therapeutic Strategies ◽  
Significant Evidence ◽  
Hypothalamic Pituitary Adrenal ◽  
Psychiatric Illnesses

SummarySignificant evidence has accrued suggesting that the hypothalamic–pituitary–adrenal (HPA) axis plays a role in some psychiatric disorders. This article reviews the physiology of the HPA axis, evidence of dysfunction in this axis in psychiatric illnesses and the role that this dysfunction might play in pharmacological treatment resistance. Future therapeutic strategies that may potentially arise from these researches are briefly outlined.

Psychiatric disorders in refugees and immigrants

2021 ◽  
pp. 475-482
Author(s):  
J. David Kinzie
Keyword(s):  
Clinical Practice ◽  
Psychiatric Disorders ◽  
Cultural Values ◽  
Treatment Guidelines ◽  
Good Clinical Practice ◽  
Evidence Based ◽  
Treatment Goals ◽  
Dsm 5 ◽  
Evidence Based Treatments ◽  
Cultural Formulation Interview

In setting treatment goals, the patient’s cultural values and goals, as well as diagnosis, need to be considered by the clinician. Psychiatrists are urged to use the Cultural Formulation Interview of the DSM-5 to aide in assessing patients. With the impacts of globalization and ubiquitous television viewing influencing the culture of the refugees and immigrants, clearly their cultures are in flux and not static, after they arrive in the new country. Doctors and medical approaches are well known to refugees and immigrants. However, they may experience resistance and fear on referral to psychiatrists for reasons of stigma. A sensitive medical approach can help reduce the resistance and fear on the part of the refugee. When a relationship forms, psychosocial issues can be addressed. Treatment guidelines for evidence-based treatments for Western patients exist, but these should be individualized for refugees with individual goals. Good clinical practice and cultural understanding must meet the patient’s personal goals.

scholarly journals RasGRF1 regulates the hypothalamic–pituitary–adrenal axis specifically in early-adolescent female mice

2015 ◽  
Vol 227 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Belkis Gizem Uzturk ◽  
Shan-xue Jin ◽  
Beverly Rubin ◽  
Christopher Bartolome ◽  
Larry A Feig
Keyword(s):  
Psychiatric Disorders ◽  
Hpa Axis ◽  
Knockout Mice ◽  
Restraint Stress ◽  
Molecular Mechanisms ◽  
Early Adolescent ◽  
Adolescent Male ◽  
Adolescent Female ◽  
Nucleotide Exchange ◽  
Hypothalamic Pituitary Adrenal

Dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis has been implicated in the induction and prolongation of a variety of psychiatric disorders. As such, much effort has been made to understand the molecular mechanisms involved in its control. However, the vast majority of the studies on the HPA axis have used adult animals, and among these the majority has used males. Here we show that in knockout mice lacking the guanine nucleotide exchange factor, RasGRF1, habituation to 30 min/day of restraint stress is markedly accelerated, such that these mice do not display elevated corticosterone levels or enhanced locomotion after 7 days of stress exposure, like WT mice do. Strikingly, this phenotype is present in early-adolescent female RasGRF1 knockout mice, but not in their early-adolescent male, mid-adolescent female, adult female or adult male counterparts. Moreover, not only is there a clear response to restraint stress in early-adolescent female RasGRF1 knockout mice, their response after one, three and five exposures is magnified approximately threefold compared to WT mice. These findings imply that distinct mechanisms exist to regulate the HPA axis in early-adolescent females that involves RasGRF1. A full understanding of how RasGRF1 controls the HPA axis response to stress may be required to design effective strategies to combat stress-associated psychiatric disorders initiated in young females.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Clinical Practice ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Speech Language Pathologists ◽  
School Based ◽  
Research Findings ◽  
Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

Effects of alprazolam on cholecystokinin-tetrapeptide (CCK-4) induced panic and hypothalamic-pituitary-adrenal (HPA) axis activity

2004 ◽  
Vol 36 (05) ◽  
Author(s):  
D Eser ◽  
P Zwanzger ◽  
S Aicher ◽  
C Schüle ◽  
TC Baghai ◽  
...  
Keyword(s):  
Hpa Axis ◽  
Hypothalamic Pituitary Adrenal ◽  
Hpa Axis Activity
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