Details of a Researcher - KISHIMOTO Taishiro

Papers - KISHIMOTO Taishiro

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Fecal Microbial and Metabolomic Change during treatment course for depression: An Observational Study

Kurokawa S., Tomizawa Y., Miyaho K., Ishii D., Takamiya A., Ishii C., Sanada K., Fukuda S., Mimura M., Kishimoto T.

Journal of Psychiatric Research (Journal of Psychiatric Research) 140 45 - 52 2021.08

ISSN 00223956

Background: There is growing evidence regarding the connection between alterations in gut microbiota and their metabolites in patients with depressive disorders, suggesting a potential role in pathophysiology. Our study aimed to investigate the relationship between microbial, metabolomic features and the course of treatment for depression in a real-world clinical setting. Methods: Patients diagnosed with depressive disorders were recruited, and their stool was collected at three time points during their depression treatments. Patients were divided into three groups: non-responders, responders, and stable remitters. Gut microbiomes were analyzed using 16S rRNA gene sequencing, and gut metabolomes were analyzed by a mass spectrometry approach. Microbiomes/metabolomes were compared between groups cross-sectionally and longitudinally. Results: A total of 33 patients were recruited and divided into non-responders (n = 16), responders (n = 11), and stable remitters (n = 6). Non-responders presented lower alpha diversity in the Phylogenic Diversity index compared to responders during the treatment course (p = 0.003). Non-responders presented increased estimated glutamate synthesis functions by the microbiota compared to responders and stable remitters (p = 0.035). There were no specific microbiota or metabolome that differentiated the three groups. Limitations: Small sample size with no healthy controls. Conclusions: Our results indicate that both cross-sectional microbial features and longitudinal microbial transitions are different depending on the treatment course of depression. Controlled studies, as well as animal studies, are needed in the future to elucidate the causal relationship between microbiota and depression.

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Long-acting injectable versus oral antipsychotics for schizophrenia reply

Kishimoto Taishiro, Hagi Katsuhiko, Kurokawa Shunya, Kane John M., Correll Christoph U.

LANCET PSYCHIATRY 8 ( 7 ) 567 - 567 2021.07

ISSN 2215-0374

Elevated body weight modulates subcortical volume change and associated clinical response following electroconvulsive therapy

Opel N., Narr K.L., Abbott C., Argyelan M., Espinoza R., Emsell L., Bouckaert F., Sienaert P., Vandenbulcke M., Nordanskog P., Repple J., Kavakbasi E., Jorgensen M.B., Paulson O.B., Hanson L.G., Dols A., Van Exel E., Oudega M.L., Takamiya A., Kishimoto T., Ousdal O.T., Haavik J., Hammar Å., Oedegaard K.J., Kessler U., Bartsch H., Dale A.M., Baune B.T., Dannlowski U., Oltedal L., Redlich R.

Journal of Psychiatry and Neuroscience (Journal of Psychiatry and Neuroscience) 46 ( 4 ) E418 - E426 2021.07

ISSN 11804882

Background: Obesity is a frequent somatic comorbidity of major depression, and it has been associated with worse clinical outcomes and brain structural abnormalities. Converging evidence suggests that electroconvulsive therapy (ECT) induces both clinical improvements and increased subcortical grey matter volume in patients with depression. However, it remains unknown whether increased body weight modulates the clinical response and structural neuroplasticity that occur with ECT. Methods: To address this question, we conducted a longitudinal investigation of structural MRI data from the Global ECT-MRI Research Collaboration (GEMRIC) in 223 patients who were experiencing a major depressive episode (10 scanning sites). Structural MRI data were acquired before and after ECT, and we assessed change in subcortical grey matter volume using FreeSurfer and Quarc. Results: Higher body mass index (BMI) was associated with a significantly lower increase in subcortical grey matter volume following ECT. We observed significant negative associations between BMI and change in subcortical grey matter volume, with pronounced effects in the thalamus and putamen, where obese participants showed increases in grey matter volume that were 43.3% and 49.6%, respectively, of the increases found in participants with normal weight. As well, BMI significantly moderated the association between subcortical grey matter volume change and clinical response to ECT. We observed no significant association between BMI and clinical response to ECT. Limitations: Because only baseline BMI values were available, we were unable to study BMI changes during ECT and their potential association with clinical and grey matter volume change. Conclusion: Future studies should take into account the relevance of body weight as a modulator of structural neuroplasticity during ECT treatment and aim to further explore the functional relevance of this novel finding.

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Associations Between Gut Microbiota and Treatment Response in Patients With Major Depressive Disorders Stratified by Dairy Intake: A Prospective Observational Study

Tachibana Tomoyuki, Sanada Kenji, Miyaho Katsuma, Kurokawa Shunya, Nakajima Shinichiro, Kishimoto Taishiro, Iwanami Akira

BIOLOGICAL PSYCHIATRY 89 ( 9 ) S228 - S229 2021.05

ISSN 0006-3223

The Potential Impact of Age on the Gut Microbiota in Patients With Major Depressive Disorders: A Prospective Observational Study

Miyaho Katsuma, Sanada Kenji, Kurokawa Shunya, Tanaka Arisa, Noda Yoshihiro, Nakajima Shinichiro, Kishimoto Taishiro, Iwanami Akira

BIOLOGICAL PSYCHIATRY 89 ( 9 ) S341 - S341 2021.05

ISSN 0006-3223

Long-acting injectable versus oral antipsychotics for the maintenance treatment of schizophrenia: a systematic review and comparative meta-analysis of randomised, cohort, and pre–post studies

Kishimoto T., Hagi K., Kurokawa S., Kane J.M., Correll C.U.

The Lancet Psychiatry (The Lancet Psychiatry) 8 ( 5 ) 387 - 404 2021.05

ISSN 22150366

Background: Evidence of comparative benefits of long-acting injectable antipsychotics (LAIs) versus oral antipsychotics for schizophrenia has been inconsistent across study designs. The aim of this study was to evaluate the comparative benefits of LAIs versus oral antipsychotics in three study designs to inform clinical decision making. Methods: We did a comprehensive systematic review and meta-analysis comparing LAIs versus oral antipsychotics for schizophrenia covering three study designs: randomised controlled trials (RCTs), cohort studies, and pre–post studies. Our literature search was without language restrictions, in MEDLINE and PubMed, the Cochrane Library, Scopus, and Embase, for studies published from database inception up to a last search on March 13, 2020. We also searched for unpublished studies and ClinicalTrials.gov. We included studies lasting at least 6 months that targeted adults with schizophrenia and related disorders (>80% of participants). Studies on penfluridol (neither an LAI or daily oral antipsychotic), case reports, and case series with fewer than 20 patients were excluded. Two investigators independently extracted study-level data and resolved disagreement by consensus, or via a third investigator. Study authors were contacted to obtain additional information as needed. For our primary outcome we meta-analysed the risk ratio (RR) for hospitalisation or relapse with LAIs versus oral antipsychotics by a random-effects model, with hospitalisation used preferentially over relapse. As secondary analyses, we reversed the preferential order to relapse over hospitalisation, and assessed hospitalisation risk and relapse risk individually. Other secondary outcomes included all meta-analysable data, classed by relevance to effectiveness, efficacy, safety, quality of life, cognitive function, and other outcomes, and analysed by study design. Dichotomous outcomes were expressed as pooled RR and continuous outcomes as standardised mean difference (SMD). The protocol is registered with PROSPERO (CRD42019142094). Findings: We identified 14 687 records, of which 137 studies (397 319 patients) met the inclusion criteria (32 RCTs [23·4%; 8577 patients], 65 cohort studies [47·4%; 377 447 patients], and 40 pre–post studies [29·2%; 11 295 patients]) and were analysed. The quality of studies in terms of risk of bias varied across study designs and within each study design from low to high. LAIs were associated with a lower risk of hospitalisation or relapse than oral antipsychotics in each of the three study designs (RCTs: 29 studies, 7833 patients, RR 0·88 [95% CI 0·79–0·99], p=0·033; cohort studies: 44 studies, 106 136 patients, RR 0·92 [0·88–0·98], p=0·0044; pre–post studies: 28 studies, 17 876 patients, RR 0·44 [0·39–0·51], p<0·0001). This association was maintained across the study designs when we reversed the preferential order to risk of relapse over hospitalisation, and in individual analysis of hospitalisation risk. The association was maintained only in pre–post studies for relapse risk alone. In all other outcomes related to effectiveness, efficacy, safety, quality of life, cognitive function, and other outcomes, LAIs were more beneficial than oral antipsychotics in 60 (18·3%) of 328 comparisons, not different in 252 (76·8%) comparisons, and less beneficial in 16 (4·9%) comparisons when analysed by study design. Significant heterogeneity was observed across all three study designs. Publication biases were apparent in cohort and pre-post studies, but effect sizes were similar after trim-and-fill analyses. Interpretation: Although study designs have strengths and weaknesses, including potential low quality of observational studies, we consistently identified significant benefit with LAIs versus oral antipsychotics in preventing hospitalisation or relapse, in settings ranging from restricted research (RCTs) to real-word application (cohort and pre–post studies). Our findings suggest that increased clinical use of LAIs could improve outcomes in schizophrenia. Funding: None. Translations: For the Chinese, French, German, Italian, Japanese, Portugese and Spanish translations of the abstract see Supplementary Materials section.

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Personalization of repetitive transcranial magnetic stimulation for the treatment of major depressive disorder according to the existing psychiatric comorbidity

Chou P.H., Lin Y.F., Lu M.K., Chang H.A., Chu C.S., Chang W.H., Kishimoto T., Sack A.T., Su K.P.

Clinical Psychopharmacology and Neuroscience (Clinical Psychopharmacology and Neuroscience) 19 ( 2 ) 190 - 205 2021.05

ISSN 17381088

Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) are evidenced-based treatments for patients with major depressive disorder (MDD) who fail to respond to standard first-line therapies. However, although various TMS protocols have been proven to be clinically effective, the response rate varies across clinical applications due to the heterogeneity of real-world psychiatric comorbidities, such as generalized anxiety disorder, posttraumatic stress disorder, panic disorder, or substance use disorder, which are often observed in patients with MDD. Therefore, individualized treatment approaches are important to increase treatment response by assigning a given patient to the most optimal TMS treatment protocol based on his or her individual profile. This literature review summarizes different rTMS or TBS protocols that have been applied in researches investigating MDD patients with certain psychiatric comorbidities and discusses biomarkers that may be used to predict rTMS treatment response. Furthermore, we highlight the need for the validation of neuroimaging and electrophysiological biomarkers associated with rTMS treatment responses. Finally, we discuss on which directions future efforts should focus for developing the personalization of the treatment of depression with rTMS or iTBS.

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Unobtrusive Sensing Technology for Quantifying Stress and Well-Being Using Pulse, Speech, Body Motion, and Electrodermal Data in a Workplace Setting: Study Concept and Design

Izumi K., Minato K., Shiga K., Sugio T., Hanashiro S., Cortright K., Kudo S., Fujita T., Sado M., Maeno T., Takebayashi T., Mimura M., Kishimoto T.

Frontiers in Psychiatry (Frontiers in Psychiatry) 12 611243 2021.04

ISSN 1664-0640

Introduction: Mental disorders are a leading cause of disability worldwide. Depression has a significant impact in the field of occupational health because it is particularly prevalent during working age. On the other hand, there are a growing number of studies on the relationship between “well-being” and employee productivity. To promote healthy and productive workplaces, this study aims to develop a technique to quantify stress and well-being in a way that does not disturb the workplace. Methods and analysis: This is a single-arm prospective observational study. The target population is adult (>20 years old) workers at companies that often engage in desk work; specifically, a person who sits in front of a computer for at least half their work hours. The following data will be collected: (a) participants' background characteristics; (b) participants' biological data during the 4-week observation period using sensing devices such as a camera built into the computer (pulse wave data extracted from the facial video images), a microphone built into their work computer (voice data), and a wristband-type wearable device (electrodermal activity data, body motion data, and body temperature); (c) stress, well-being, and depression rating scale assessment data. The analysis workflow is as follows: (1) primary analysis, comprised of using software to digitalize participants' vital information; (2) secondary analysis, comprised of examining the relationship between the quantified vital data from (1), stress, well-being, and depression; (3) tertiary analysis, comprised of generating machine learning algorithms to estimate stress, well-being, and degree of depression in relation to each set of vital data as well as multimodal vital data. Discussion: This study will evaluate digital phenotype regarding stress and well-being of white-collar workers over a 4-week period using persistently obtainable biomarkers such as heart rate, acoustic characteristics, body motion, and electrodermal activity. Eventually, this study will lead to the development of a machine learning algorithm to determine people's optimal levels of stress and well-being. Ethics and dissemination: Collected data and study results will be disseminated widely through conference presentations, journal publications, and/or mass media. The summarized results of our overall analysis will be supplied to participants. Registration: UMIN000036814

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Cognitive Intervention Through Photo-Integrated Conversation Moderated by Robots (PICMOR) Program: A Randomized Controlled Trial

Otake-Matsuura M., Tokunaga S., Watanabe K., Abe M.S., Sekiguchi T., Sugimoto H., Kishimoto T., Kudo T.

Frontiers in Robotics and AI (Frontiers in Robotics and AI) 8 633076 2021.04

ISSN 2296-9144

Social interaction might prevent or delay dementia, but little is known about the specific effects of various social activity interventions on cognition. This study conducted a single-site randomized controlled trial (RCT) of Photo-Integrated Conversation Moderated by Robots (PICMOR), a group conversation intervention program for resilience against cognitive decline and dementia. In the RCT, PICMOR was compared to an unstructured group conversation condition. Sixty-five community-living older adults participated in this study. The intervention was provided once a week for 12 weeks. Primary outcome measures were the cognitive functions; process outcome measures included the linguistic characteristics of speech to estimate interaction quality. Baseline and post-intervention data were collected. PICMOR contains two key features: 1) photos taken by the participants are displayed and discussed sequentially; and 2) a robotic moderator manages turn-taking to make sure that participants are allocated the same amount of time. Among the primary outcome measures, one of the subcategories of cognitive functions, verbal fluency significantly improved in the intervention group. Among the process outcome measures, a part of the subcategories of linguistic characteristics of speech, the amount of speech and richness of words, proportion of providing topics, questions, and answers in total utterances were larger for the intervention group. This study demonstrated for the first time the positive effects of a robotic social activity intervention on cognitive function in healthy older adults via RCT. The group conversation generated by PICMOR may improve participants’ verbal fluency since participants have more opportunity to provide their own topics, asking and answering questions which results in exploring larger vocabularies. PICMOR is available and accessible to community-living older adults. Clinical Trial Registration: UMIN Clinical Trials Registry, identifier UMIN000036667.

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Improvements in the degree of understanding the treatment guidelines for schizophrenia and major depressive disorder in a nationwide dissemination and implementation study

Numata S., Nakataki M., Hasegawa N., Takaesu Y., Takeshima M., Onitsuka T., Nakamura T., Edagawa R., Edo H., Miura K., Matsumoto J., Yasui-Furukori N., Kishimoto T., Hori H., Tsuboi T., Yasuda Y., Furihata R., Muraoka H., Ochi S., Nagasawa T., Kyou Y., Murata A., Katsumoto E., Ohi K., Hishimoto A., Inada K., Watanabe K., Hashimoto R.

Neuropsychopharmacology Reports (Neuropsychopharmacology Reports) 41 ( 2 ) 199 - 206 2021

© 2021 The Authors. Neuropsychopharmacology Reports published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Society of NeuropsychoPharmacology. Background: To implement clinical practice guidelines (CPGs), it is necessary for psychiatrists to deepen their understanding of the CPGs. The Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project is a nationwide dissemination and implementation study of two sets of CPGs for schizophrenia and major depressive disorder (MDD). Methods: A total of 413 psychiatrists (n = 212 in 2016; n = 201 in 2017) learned the two CPGs in the education program of the EGUIDE project, and clinical knowledge of these CPGs was evaluated at baseline and after the programs. To improve the correct answer rate for clinical knowledge after the programs, we revised the lecture materials associated with items that had a low correct answer rate in 2016 and used the revised lecture materials with the CPGs in 2017. The rates of correct answers after the programs between the 2016 and 2017 groups were compared. Results: The correct answer rate of one item on the schizophrenia CPG and one item on the MDD CPG tended to be improved (S-D5 and D-C6) and that of one on the MDD CPG was significantly improved (D-D3, P = 0.0008) in the 2017 group compared to those in the 2016 group. Conclusions: We reported improvements in clinical knowledge of CPGs after the EGUIDE program in the 2017 group following revision of the lecture materials based on results from the 2016 group. These attempts to improve the degree of understanding of CPGs may facilitate the successful dissemination and implementation of psychiatric guidelines in everyday practice.

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Using video conferencing technology to conduct neuropsychological evaluations of seniors: validity and points of note for utilization

Iiboshi Kiyoko, Yamaoka Yoshitaka, Eguchi Yoko, Koto Yuka, Narumoto Jin, Yoshida Kazunari, Kishimoto Taishiro, Mimura Masaru

Japanese Journal of Cognitive Neuroscience (Japanese Society of Cognitive Neuroscience) 22 ( 3 ) 158 - 167 2021

ISSN 1344-4298

<p>As the population of Japan continues to age, there is an increased need to conduct neuropsychological evaluations of seniors for conditions such as dementia.　Neuropsychological evaluations must be conducted by specialists who possess both strong technical abilities and a proficient understanding of higher brain functions, but as the number of patients requiring such evaluations continues to rise, there are not enough qualified specialists to meet the demand.　One way to correct this imbalance is to perform evaluations using telemedicine.　In parallel with this, the importance of using telemedicine has been further heightened by COVID-19 pandemic.　In this paper, we present:1） a review comparing the validity of in-person neuropsychological evaluations with that of evaluations conducted remotely using a video conferencing system （remote evaluations）;2） a review of patient satisfaction for in-person and remote evaluations;and 3） concrete processes that should be employed and important points to remember for remote evaluations, based on our team's experiences conducting them.　We found that studies reported a high reliability for remote evaluations even when performed on dementia patients.　Patient satisfaction with remote evaluations was generally favorable, but there were some complaints about difficulty hearing the reviewer via the remote system and the mental burden required to use the system/technology.　Regarding the processes required for remote evaluations, we recommend referring to the telepsychiatry manual created by the Telepsychiatry Guideline Manual Taskforce.　In the future, we hope that equitable access to guideline-adherent remote evaluations will become available across Japan. </p>

What Can We Tell About the Effect of Electroconvulsive Therapy on the Human Hippocampus?

Takamiya A., Kishimoto T., Mimura M.

Clinical EEG and Neuroscience (Clinical EEG and Neuroscience) 54 ( 6 ) 15500594211044066 - 593 2021

ISSN 15500594

Electroconvulsive therapy (ECT) is the most effective antidepressant treatment, although its mechanisms of action remain unclear. Since 2010, several structural magnetic resonance imaging studies based on a neuroplastic hypothesis have consistently reported increases in the hippocampal volume following ECT. Moreover, volume increases in the human dentate gyrus, where neurogenesis occurs, have also been reported. These results are in line with the preclinical findings of ECT-induced neuroplastic changes, including neurogenesis, gliogenesis, synaptogenesis, and angiogenesis, in rodents and nonhuman primates. Despite this robust evidence of an effect of ECT on hippocampal plasticity, the clinical relevance of these human hippocampal changes continues to be questioned. This narrative review summarizes recent findings regarding ECT-induced hippocampal volume changes. Furthermore, this review also discusses methodological considerations and future directions in this field.

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Speech Paralinguistic Approach for Detecting Dementia Using Gated Convolutional Neural Network

RODRIGUES MAKIUCHI Mariana, WARNITA Tifani, INOUE Nakamasa, SHINODA Koichi, YOSHIMURA Michitaka, KITAZAWA Momoko, FUNAKI Kei, EGUCHI Yoko, KISHIMOTO Taishiro

IEICE Transactions on Information and Systems (The Institute of Electronics, Information and Communication Engineers) 104 ( 11 ) 1930 - 1940 2021

ISSN 09168532

<p>We propose a non-invasive and cost-effective method to automatically detect dementia by utilizing solely speech audio data. We extract paralinguistic features for a short speech segment and use Gated Convolutional Neural Networks (GCNN) to classify it into dementia or healthy. We evaluate our method on the Pitt Corpus and on our own dataset, the PROMPT Database. Our method yields the accuracy of 73.1% on the Pitt Corpus using an average of 114 seconds of speech data. In the PROMPT Database, our method yields the accuracy of 74.7% using 4 seconds of speech data and it improves to 80.8% when we use all the patient's speech data. Furthermore, we evaluate our method on a three-class classification problem in which we included the Mild Cognitive Impairment (MCI) class and achieved the accuracy of 60.6% with 40 seconds of speech data.</p>

Quantum Kinetic Equilibrium

Chad T. Kishimoto, Heather Hodlin, Olexiy Dvornikov

2020.11

We solved the Quantum Kinetic Equations (QKEs) for an active-sterile neutrino
system in the early universe. While on the surface this may seem to be an
overly simplistic system, other linear two-state systems can be mapped onto the
active-sterile system. In the early universe, we find that solutions to the
QKEs are well described by an adiabatic approximation where the off-diagonal
terms of the density operator are constant on short (oscillation and/or
scattering) timescales, but may slowly evolve on long (expansion) timescales.
This "quantum kinetic equilibrium" attains as the quantum development of phase
balances with the kinetic destruction of phase. In this work, we introduce and
assess this equilibrium ansatz as the neutrino states evolve in the early
universe with a non-zero lepton number, engendering level crossings that result
in scattering-induced active-sterile neutrino transformation.

Safety/tolerability of antipsychotics in the treatment of adult patients with major depressive disorder: a systematic review and meta-analysis

Hagi K., Kishimoto T., Kurokawa S., Correll C. U.

EUROPEAN NEUROPSYCHOPHARMACOLOGY 40 S184 - S185 2020.11

ISSN 0924-977X

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Risk/benefit balance of antipsychotics in the treatment of adult patients with major depressive disorder: a systematic review and meta-analysis

Kishimoto T., Hagi K., Kurokawa S., Kane J. M., Correll C. U.

EUROPEAN NEUROPSYCHOPHARMACOLOGY 40 S185 - S185 2020.11

ISSN 0924-977X

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Long-acting injectable vs. oral antipsychotics for preventing rehospitalisation in schizophrenia: a meta-analysis of randomised, mirror-image, and cohort studies

Kishimoto T., Hagi K., Kane J. M., Correll C. U.

EUROPEAN NEUROPSYCHOPHARMACOLOGY 40 S315 - S316 2020.11

ISSN 0924-977X

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Dose-response relationships of antipsychotic drugs for major depressive disorder: a systematic review and meta-analysis

Kurokawa S., Kishimoto T., Hagi K., Kane J., Correll C.

EUROPEAN NEUROPSYCHOPHARMACOLOGY 40 S253 - S253 2020.11

ISSN 0924-977X

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Virtual reality exposure therapy for social anxiety disorder: A systematic review and meta-Analysis

Horigome T., Kurokawa S., Sawada K., Kudo S., Shiga K., Mimura M., Kishimoto T.

Psychological Medicine (Psychological Medicine) 50 ( 15 ) 2487 - 2497 2020.11

ISSN 00332917

Copyright © The Author(s) 2020. Published by Cambridge University Press. Background Virtual reality exposure therapy (VRET) is currently being used to treat social anxiety disorder (SAD); however, VRET's magnitude of efficacy, duration of efficacy, and impact on treatment discontinuation are still unclear. Methods We conducted a meta-Analysis of studies that investigated the efficacy of VRET for SAD. The search strategy and analysis method are registered at PROSPERO (#CRD42019121097). Inclusion criteria were: (1) studies that targeted patients with SAD or related phobias; (2) studies where VRET was conducted for at least three sessions; (3) studies that included at least 10 participants. The primary outcome was social anxiety evaluation score change. Hedges' g and its 95% confidence intervals were calculated using random-effect models. The secondary outcome was the risk ratio for treatment discontinuation. Results Twenty-Two studies (n = 703) met the inclusion criteria and were analyzed. The efficacy of VRET for SAD was significant and continued over a long-Term follow-up period: Hedges' g for effect size at post-intervention,-0.86 (-1.04 to-0.68); three months post-intervention,-1.03 (-1.35 to-0.72); 6 months post-intervention,-1.14 (-1.39 to-0.89); and 12 months post-intervention,-0.74 (-1.05 to-0.43). When compared to in vivo exposure, the efficacy of VRET was similar at post-intervention but became inferior at later follow-up points. Participant dropout rates showed no significant difference compared to in vivo exposure. Conclusion VRET is an acceptable treatment for SAD patients that has significant, long-lasting efficacy, although it is possible that during long-Term follow-up, VRET efficacy lessens as compared to in vivo exposure.

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Safety of Psychotropic Medications in People With COVID-19: Evidence Review and Practical Recommendations.

Ostuzzi G, Papola D, Gastaldon C, Schoretsanitis G, Bertolini F, Amaddeo F, Cuomo A, Emsley R, Fagiolini A, Imperadore G, Kishimoto T, Michencigh G, Nosé M, Purgato M, Serdar D, Stubbs B, Taylor D, Thornicroft G, Ward PB, Hiemke C, Correll CU, Barbui C

Focus (American Psychiatric Publishing) 18 ( 4 ) 466 - 481 2020.10

ISSN 1541-4094

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