Psychiatric Research and Clinical Practice

Clozapine remains universally underutilized as the gold‐standard therapy for treatment‐resistant schizophrenia spectrum disorders. Among a cohort of hospitalized adults with treatment‐resistant schizophrenia or schizoaffective disorder, only 12% of patients received clozapine. Black patients were twice as likely to be prescribed clozapine. Our findings add to a growing body of evidence of differential antipsychotic prescribing patterns among minority racial‐ethnic groups.

There is considerable variation in the frequency and use of evidence‐based screening and diagnostic tools among clinicians targeting adolescent substance use. This study determines the utility of the Global Appraisal of Individual Needs‐Quick Version 4 (GAIN‐Q4) at diagnosing substance use disorders (SUDs) and co‐occurring mental health disorders in adolescents.

20%–60% of all cases in psychiatry are labeled “treatment resistant.” Effective treatment options remain in 2/3 of these cases. No consensus exists on definition or criteria for “treatment resistance.” A broad range of individual causes leads to treatment failure. Labeling a case “treatment resistant” erodes quality of care and outcome.

Qualifying for Medicaid suspension was not associated with a significant decrease in opioid overdose mortality within one year of prison release. Drug overdose remained the leading cause of post‐release death for adults with an opioid use disorder diagnosis. The risk of opioid overdose mortality after prison release increased between 2015 and 2018, particularly from synthetic narcotics.

The relationship between suicide attempt (SA) and ideation recency and reattempt has not been examined among pediatric emergency department (ED) patients. Pediatric ED patients are at greater risk of reattempting suicide if they report a SA from the past 3 months, or suicidal ideation (SI) from the past 24 h. Pediatric patients with a past SA from over 1 year ago may be considered at lower risk of reattempt if they also deny recent SI.

Exposure to stress during the COVID‐19 pandemic is associated with worse mental disorder symptoms and higher problematic drinking. However, limited research has examined the potential role of suicidality history as a moderator of these associations.

Twenty‐three hospitals switched from using a “danger to self” (DTS) question among the adult general population to standardized suicide screening with the Columbia‐Suicide Severity Rating Scale (C‐SSRS).

Among low and middle‐income countries (LMICs), mental health challenges are compounded by poverty and limited access to mental health services, particularly among older adults (1, 2, 3). There is a need for effective and innovative interventions tailored to these populations. Mindfulness interventions can be applied trans‐diagnostically and have been shown as feasible and effective in LMICs (4). However, mindfulness can be challenging to engage with, especially at the start of the practice (5).

In adults with psychiatric disorders presenting for outpatient psychiatric evaluation and treatment patients, nearly 71% reported severe impairment in quality of life (QOL) and 60% reported severe impairment in functioning. Patients with mood disorders were disproportionately more likely to endorse severely impaired QOL and functioning, particularly those with major depressive disorder (MDD), recurrent, and Bipolar Disorder I, depression.

To the Editor: COVID‐19 infection leads to various symptoms such as fatigue, difficulty concentrating, memory loss, anxiety, and depressed mood (1). We report the first case to our knowledge of a patient with treatment‐resistant depression secondary to COVID‐19 infection who was treated with repetitive transcranial magnetic stimulation (rTMS) and present neuroinflammatory alterations revealed by positron emission tomography (PET).