Changing response rates in clinical trials of depression: how did the introduction of DSM-III and DSM-III-R influence the outcome?
It has been argued recently that the drug-placebo difference is diminishing in clinical trials of depression. Recently a paper suggested that the placebo response in trials of antidepressant agents increased abruptly after 1991 and remained stable afterwards at the level of 35–40%.1 A possible explanation for this change could be the introduction of Diagnostic and Statistical Manual Third Edition (DSM)-III and DSM-III-Revised (R) and the change in paradigm concerning depression, which came with them since the early 1980s.2 3 With the introduction of operationalised diagnostic criteria, the concept of depression both ...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Fountoulakis, K. N. Tags: Letter Source Type: research

Simpler therapy may successfully treat adolescents with anorexia nervosa
ABSTRACT FROM: Le Grange D, Hughes EK, Court A, et al. Randomized clinical trial of parent-focused treatment and family-based treatment for adolescent anorexia nervosa. J Am Acad Child Adolesc Psychiatry 2016;55:683–92. What is already known on this topic Family-based treatment (FBT) is an effective evidence-based therapy for adolescent anorexia nervosa (AN) and is the recommended approach to treatment at the present time.1 The effectiveness of other treatments such as individual psychotherapy (ego-oriented therapy) and generic family therapy (systemic family therapy) is based on less evidence and such treatments are...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Agras, S. Tags: Psychological interventions Source Type: research

Targeted psychological interventions may prevent depression in children and adolescents
ABSTRACT FROM: Hetrick SE, Cox GR, Witt KG, et al. Cognitive–behavioural therapy (CBT), third-wave CBT and interpersonal therapy (IPT) based interventions for preventing depression in children and adolescents. Cochrane Database Syst Rev 2016;(8):CD003380. What is already known on this topic Major depressive disorder is a leading global cause of lifelong disability, with the greatest increase in incidence occurring in mid-to-late adolescence into young adulthood. Onset in childhood predicts poor long-term educational, social and health outcomes. Therefore, interventions to prevent depression in children and adolescent...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Watkins, E. Tags: Psychological interventions Source Type: research

Short-term adjunct of topiramate to antipsychotics in schizophrenia improves the psychopathology and has weight maintenance
This study included RCTs of antipsychotic cotreatment with topiramate in patients with schizophrenia-spectrum disorders (schizophrenia, schizophreniform disorder, schizoaffective disorder). PubMed, PsycINFO, Embase, Cochrane Library databases, the Cochrane Controlled Trials Register and... (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Kishi, T. Tags: Pharmacological interventions Source Type: research

Relative to SSRI users, SSRI-statin users have fewer psychiatric hospital contacts and no increase in suicidal behaviour or all-cause mortality
ABSTRACT FROM: Kohler O, Gasse C, Petersen L, et al. The effect of concomitant treatment with SSRIs and statins: a population-based study. Am J Psychiatry 2016;173:807–15. What is already known on this topic Observational studies have identified inflammatory changes in depression,1 2 and randomised controlled trials (RCTs) suggest that depression may respond better when anti-inflammatory drugs are used to augment antidepressant drugs.3 Statins have anti-inflammatory properties. The present study is the first population-level investigation of the benefits and risks of a selective serotonin reuptake inhibitor (SSRI)&nd...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Andrade, C. Tags: Outcomes Source Type: research

Hypersomnia: an overlooked, but not overestimated, sleep disturbance in bipolar disorder
ABSTRACT FROM: Steinan MK, Scott J, Lagerberg TV, et al. Sleep problems in bipolar disorders: more than just insomnia. Acta Psychiatr Scand 2016;133:368–77. What is already known on this topic Sleep disturbances are common across bipolar spectrum disorders. Reduced need for sleep, insomnia and hypersomnia (excessive sleep or sleepiness) are diagnostic features of illness episodes; these sleep disturbances persist into the interepisode period and are associated with functional impairment and risk for relapse.1 Few studies have investigated subtypes of sleep disturbances within bipolar spectrum disorders, and these hav...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Kaplan, K. A., Williams, R. Tags: Outcomes Source Type: research

Daily use of high-potency cannabis is associated with an increased risk of admission and more intervention after first-episode psychosis
ABSTRACT FROM: Schoeler T, Petros N, Di Forti M, et al. Effects of continuation, frequency, and type of cannabis use on relapse in the first 2 years after onset of psychosis: an observational study. Lancet Psychiatry 2016;3:947–53. What is already known about this topic Cannabis is a well-established environmental risk factor for psychosis.1 More frequent users and those who start at a younger age are at greater risk2 and the mean age of onset of psychosis among cannabis users is about 3 years younger than among non-users.3 In Europe and North America, about a third of patients with first-episode psychosis ...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Large, M., Nielssen, O. Tags: Causes and risk factors Source Type: research

Immigrant women and women with learning disabilities have complex mental health needs and service use in the perinatal period
Setting the scene Perinatal mental disorders are important contributors to maternal morbidity and mortality globally,1–3 and are associated with adverse infant and child outcomes.4 There is clear evidence-based guidance on the detection and treatment of perinatal mental disorders in the general population,5 6 but little evidence on vulnerable subgroups who may have distinct clinical presentation and/or service needs. In the two selected studies, population-based regional Canadian data are used to investigate perinatal mental health among migrant women (focusing on their postnatal use of mental health services compare...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Ayre, K., Khalifeh, H. Tags: Expert commentary Source Type: research

Correction
Rubio JM, Correll CU. Reduced all-cause mortality with antipsychotics and antidepressants compared to increased all-cause mortality with benzodiazepines in patients with schizophrenia observed in naturalistic treatment settings. Evidence Based Mental Health 2017;20:e6. The last name of the second author was misspelt. The correct spelling is Correll. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Tags: Correction Source Type: research

Prognosis of delirium
Clinical casePatient: a woman aged 77 yearsPresent illness The patient had type II diabetes since her 50s which had been fairly well controlled and also suffered from an old myocardial infarction, but had been able to live alone in her apartment, managing the household on her own. She caught a common cold several days ago, which worsened the next few days, and the patient was febrile, unable to eat or drink. The daughter living in the neighbourhood took her to the hospital, where she was diagnosed with severe pneumonia and dehydration and was hospitalised. In the general medicine ward, however, she developed delirium the n...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Furukawa, T. A. Tags: EBMH Evidence-Based Case Conference Source Type: research

Reporting guidance considerations from a statistical perspective: overview of tools to enhance the rigour of reporting of randomised trials and systematic reviews
Conclusions Reporting guidelines provide researchers with minimum criteria for reporting. If followed, they can enhance research transparency and contribute improve quality of biomedical publications. Authors should employ these tools for planning and reporting of their research. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Hutton, B., Wolfe, D., Moher, D., Shamseer, L. Tags: Editor's choice, EBMH Statistics in Practice Source Type: research

Implementing tools to support evidence-based practice: a survey and brief intervention study of the National Elf Service across Oxford Health NHS Foundation Trust
Conclusions Mental health professionals are engaged with EBM and those that used the National Elf Service felt it did, or could have the potential to impact on their clinical practice. Clinical implications Barriers and challenges to implement EBM more widely suggest targeted efforts should be made to embed evidence-based practice into the working culture. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Atkinson, L. Z., Forrest, A., Marriner, L., Geddes, J., Cipriani, A. Tags: Editor's choice Original article Source Type: research

Psychosocial interventions for self-harm, suicidal ideation and suicide attempt in children and young people: What? How? Who? and Where?
We reviewed the evidence for the effectiveness of indicated individual psychosocial interventions for the treatment of self-harm, suicidal ideation and suicide attempts in children and young people, with a particular emphasis on the emerging use of electronic methods to deliver psychological interventions. In total, 16 randomised controlled trials (RCTs) were identified, none of which included children under the age of 12 years. Cognitive–behavioural therapy is the most commonly implemented approach in RCTs until now, although problem-solving therapy, interpersonal psychotherapy, social support and distal suppor...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Cox, G., Hetrick, S. Tags: Editor's choice Clinical review Source Type: research

What is the impact of a research publication?
An increasing number of metrics are used to measure the impact of research papers. Despite being the most commonly used, the 2-year impact factor is limited by a lack of generalisability and comparability, in part due to substantial variation within and between fields. Similar limitations apply to metrics such as citations per paper. New approaches compare a paper's citation count to others in the research area, while others measure social and traditional media impact. However, none of these measures take into account an individual author's contribution to the paper or the number of authors, which we argue are key limitati...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Fazel, S., Wolf, A. Tags: Open access Perspective Source Type: research

Cognitive-behavioural therapy can prevent transition to psychosis in ultra-high-risk participants in the long term
ABSTRACT FROM: Ising HK, Kraan TC, Rietdijk J, et al. Four-year follow-up of cognitive behavioral therapy in persons at ultra-high risk for developing psychosis: the Dutch Early Detection and Intervention Evaluation (EDIE-NL) trial. Schizophr Bull 2016;42:1243–52. What is already known on this topic? Major efforts have been made to prevent ultra-high-risk (UHR) participants from transitioning to psychosis. Previous studies have examined the efficacy of -3 fatty acid, antipsychotic medication and cognitive–behavioural therapy (CBT) as preventive interventions, without conclusive results.1 Methods of the study In...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Miron, J.-P., Abdel-Baki, A. Tags: Psychological interventions Source Type: research

Mood Zoom could be a promising tool for daily mood variability monitoring, potentially differentiating bipolar from borderline patients
ABSTRACT FROM: Tsanas A, Saunders KE, Bilderbeck AC, et al. Daily longitudinal self-monitoring of mood variability in bipolar disorder and borderline personality disorder. J Affect Disord 2016;205:225–233. What is already known on this topic Psychiatric evaluations of patients' diagnoses and symptoms largely rely on their autobiographical memory, ability to reflect and verbalise their inner experience and behaviour, and the interviewers' ability to conceptualise these communications. Reliable biomarkers for purposes of diagnosis and follow-up of illness course and treatment effectiveness are constantly sought. Both c...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Isometsä, E. Tags: Outcomes Source Type: research

Uncertain association between depression and stroke risk in a Chinese mega-study
ABSTRACT FROM: Sun J, Ma H, Yu C, et al. Association of major depressive episodes with stroke risk in a prospective study of 0.5 million Chinese adults. Stroke 2016;47:2203–8. What is already known on this topic Depression may be a direct cause of stroke.1 Alternatively, an observed association between depression and stroke may be generated by indirect processes when depression is not the immediate cause.1 Thus, depression, particularly if chronic or recurrent, could act as an upstream influence leading to increased stroke risk via intervening behaviours linked with low motivation such as smoking and lack of exercise...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Brunner, E. J., Weinreb, I. R. Tags: Causes and risk factors Source Type: research

Largest study to date shows overall use of antipsychotics in pregnancy does not appear to significantly increase the risk of congenital malformations
ABSTRACT FROM: Huybrechts KF, Hernández-Díaz S, Patorno E, et al. Antipsychotic use in pregnancy and the risk for congenital malformations. JAMA Psychiatry 2016;73:938–46. What is already known on this topic Atypical and typical antipsychotics (APs) are used to treat bipolar and psychotic disorders, and atypicals are increasingly used off-label to treat other disorders.1 With the rise of their use during pregnancy, we are increasingly in need of high-quality data to rely on for treatment recommendations as data from randomised controlled trials (RCT) are not available. Previous research on whether APs a...
Source: Evidence-Based Mental Health - April 24, 2017 Category: Psychiatry & Psychology Authors: Grigoriadis, S., Peer, M. Tags: Causes and risk factors Source Type: research

Randomised or not?
Dear editor We read with interest the two perspective articles about methylphenidate (MPH) in children with attention deficit hyperactivity disorder (ADHD) published in the previous issue of Evidence-Based Mental Health.1 2 Both papers quote a study we published in 19973 and note that there is an issue about whether it was randomised or not. Our paper was published in 1997, and at that time the requirement for randomisation was different than now. The original research design makes it hard for us to decide whether the study should be classified as randomised or not, so we describe here the procedure for assigning participa...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Lufi, D., Parish-Plass, J. Tags: Letter Source Type: research

Letter in response to Drs Lee and Hoge's commentary
Dear editor, We are pleased to respond to Drs Lee and Hoge's1 commentary on our randomised controlled trial (RCT) published in JAMA (a summary of the original article can be found at https://www.ncbi.nlm.nih.gov/pubmed/26241597).2 While we readily acknowledge several limitations to the study, Drs Lee and Hoge have failed to consider or acknowledge several aspects of the study and its results. The main concern with Lee and Hoge's critique is its focus on a single time-point of data that seems to invite readers to ignore all other data. Lee and Hoge argue that the lack of a statistically significant difference between groups...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Erbes, C. R., Thuras, P., Lim, K. O., Polusny, M. A. Tags: Letter Source Type: research

Significant methodological flaws limit conclusions drawn by authors of a recent PTSD mindfulness study
ABSTRACT FROM: Polusny MA. Mindfulness-based stress reduction for posttraumatic stress disorder among veterans: a randomized clinical trial. JAMA 2015;314:456–65. What is already known on this topic Of six major international post-traumatic stress disorder (PTSD) treatment guidelines, only two mention mindfulness-based treatments, and none recommend their routine use.1 2 Few mindfulness-based intervention studies exist for PTSD, and all have significant limitations in design, outcome measures and/or data handling.1 However, these interventions remain widely used. A core-component of PTSD treatment addresses autonomic...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Lee, D. J., Hoge, C. W. Tags: Psychological interventions Source Type: research

Cognitive-behavioural group therapy for youth with high-functioning autism spectrum disorders demonstrates modest effects on social responsiveness
ABSTRACT FROM: Freitag CM, Jensen K, Elsuni L, et al.. Group-based cognitive–behavioural psychotherapy for children and adolescents with ASD: the randomised, multicentre, controlled SOSTA—net trial. J Child Psychol Psychiatry 2016;57:596–605. What is already known about this topic? Autism spectrum disorders (ASD) occur in ~1 in 63 children/adolescents1 and are characterised by impairments in cognition, communication and/or social responsiveness and interaction. A number of interventions have been developed and studied to target the social skills of children and adolescents with ASD.2 One particularly prom...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Storch, E. A. Tags: Psychological interventions Source Type: research

Antipsychotic adjunctive therapy to mood stabiliser should be continued for 6 months after remission of a manic episode
ABSTRACT FROM: Yatham LN, Beaulieu S, Schaffer A, et al.. Optimal duration of risperidone or olanzapine adjunctive therapy to mood stabilizer following remission of a manic episode: a CANMAT randomized double-blind trial. Mol Psychiatry 2016;21:1050–6. What is already known on this topic Recently, clinical guidelines about treatment of mania have been published by important scientific societies.1 Atypical antipsychotic adjunctive therapy to lithium or valproate is effective in treating acute mania; however, antipsychotics should not be continued unless the benefits of reducing relapse outweigh the risks such as weigh...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Hatta, K. Tags: Pharmacological interventions Source Type: research

Evidence of ocular side effects of SSRIs and new warnings
ABSTRACT FROM: Chen H, Lin C, Lai S, et al.. Association of selective serotonin reuptake inhibitor use and acute angle-closure glaucoma. J Clin Psychiatry 2016;77:e692–6. What is already known on this topic Acute angle-closure glaucoma (AACG) may cause symptoms including eye pain, changes in vision, or swelling and redness and can rapidly lead to permanent blindness if not treated.1 Medications can precipitate AACG through adrenergic or anticholinergic-mediated pupillary dilation that results in the physical obstruction of the outflow of intraocular fluid in susceptible individuals. Case reports and a previous large ...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Kirkham, J., Seitz, D. Tags: Outcomes Source Type: research

Involvement of patients in planning their future treatment may reduce compulsory admissions to hospital
ABSTRACT FROM: de Jong MH, Kamperman AM, Oorschot M, et al.. Interventions to reduce compulsory psychiatric admissions: a systematic review and meta-analysis. JAMA Psychiatry 2016;73:657–64. What is already known on this topic? The use of coercion in the treatment of psychiatric patients is of growing concern, particularly in the context of United Nations Convention on the Rights of Persons with Disabilities (http://www.un.org/disabilities/convention/conventionfull.shtml). Increasing rates of compulsory admission are one example. It is therefore important to find interventions that can prevent compulsory admission to...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Kisely, S. Tags: Outcomes Source Type: research

Impact of gun law reforms on rates of homicide, suicide and mass shootings in Australia
ABSTRACT FROM: Chapman S, Alpers P, Jones M. Association between gun law reforms and intentional firearm deaths in Australia, 1979–2013. JAMA 2016;316:291–299. What is already known on this topic Gun control is a highly topical yet polarising political issue.1 To date, there is limited evidence on the impact of gun law reforms on firearm-related violence and suicide.2 In Australia, substantial changes in gun laws that significantly restrict the use and ownership of weapons were introduced in 1996 following the Port Arthur massacre in Tasmania. In 2006, Chapman et al analysed the 10-year impact of this reform on...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Brown, P. Tags: EBMH Forensic Psychiatry Source Type: research

Exploratory trials in mental health: anything to learn from other disciplines?
Conclusions Although often not directly applicable, borrowing (study) design ideas from other medical disciplines has the potential to improve exploratory trials in the mental health field. At the same time, more explicit use of study designs specifically designed for exploratory trials will help to improve the transparency of such trials. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Trelle, S. Tags: Editor's choice, EBMH Statistics in Practice Source Type: research

Cognitive-behavioural therapy for non-motor symptoms of Parkinson's disease: a clinical review
Neuropsychiatric symptoms are common in Parkinson's disease (PD) and have a disproportionate impact on quality of life and carer burden. Pharmacological treatment is the main approach in dealing with these symptoms, but it is limited by variable efficacy and risk of drug interactions. Non-pharmacological approaches using the cognitive–behavioural therapy (CBT) model are viable alternatives and in this review paper we summarise the evidence of CBT for three of the most common psychiatric manifestations of PD: depression and anxiety, impulse-control disorders and insomnia. Most studies modified the usual CBT format to ...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Koychev, I., Okai, D. Tags: Editor's choice Old age psychiatry Source Type: research

Current status of electroconvulsive therapy for mood disorders: a clinical review
Electroconvulsive therapy (ECT) is an effective treatment for mood disorders and a viable treatment option especially when urgency of clinical situation requires a prompt treatment response. After acute series of ECT, the ECT long-term treatment may be considered, although this practice may vary significantly between countries or even within the same country, because there is no universal consensus about its indications, duration and frequency of administration. Continuation or maintenance ECT is common in routine clinical practice and clinicians should be aware of the risks of using ECT long term. Neuropsychological asses...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Kolar, D. Tags: Clinical review Source Type: research

Reduced all-cause mortality with antipsychotics and antidepressants compared to increased all-cause mortality with benzodiazepines in patients with schizophrenia observed in naturalistic treatment settings
ABSTRACT FROM: Tiihonen J, Mittendorfer-Rutz E, Torniainen M, et al.. Mortality and cumulative exposure to antipsychotics, antidepressants, and benzodiazepines in patients with schizophrenia: an observational follow-up study. Am J Psychiatry 2016;173:600–6. What is already known on this topic Individuals with schizophrenia die ~15–20 years prematurely compared to the general population, mostly due to cardiovascular disease, obesity-related cancer, diabetes and chronic obstructive pulmonary disease.1 Owing to the known metabolic effects of antipsychotics,2 clarifying their role in increased mortality is imp...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Rubio, J. M., Corell, C. U. Tags: Electronic pages Source Type: research

Mindfulness-based cognitive therapy delays depressive relapse across demographic subgroups
ABSTRACT FROM: Kuyken W, Warren FC, Taylor RS, et al.. Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse: an individual patient data meta-analysis from randomized trials. JAMA Psychiatry 2016;73:565–74. What is already known on this topic Several meta-analyses of about 20 year’s work on randomised controlled trials (RCTs) with mindfulness-based cognitive therapy for depression (MBCT)1 have concluded that MBCT is efficacious in reducing relapse/recurrence where people have had at least three major depressive episodes (MDEs). Methods of the study In an update to a previous m...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Meadows, G., Shawyer, F. Tags: Electronic pages Source Type: research

Short web-based guided self-help intervention prevents the onset of a major depressive disorder in adults with subthreshold depression
ABSTRACT FROM: Buntrock C, Ebert DD, Lehr D, et al.. Effect of a web-based guided self-help intervention for prevention of major depression in adults with subthreshold depression: a randomized clinical trial. JAMA 2016;315:1854–63. What is already known on this topic The available treatments can only moderately reduce the enormous burden of disease associated with depression.1 Prevention of the transition from subthreshold depression to a full-blown disorder is therefore highly needed. Offering accessible and affordable preventive interventions at a large scale, such as web-based interventions, could be an indispensa...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Bolier, L., Boon, B. Tags: Electronic pages Source Type: research

Pharmacological and non-pharmacological treatment of adults with ADHD: a meta-review
In conclusion, while available evidence addressed mainly the efficacy and tolerability of psychostimulants and non-psychostimulants for ADHD core symptoms in the short term, we still need further empirical support for the non-pharmacological and multimodal treatments. A comprehensive evidence-informed hierarchy of ADHD drugs based on their efficacy and tolerability is not yet available but it should be the next research priority in the field. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: De Crescenzo, F., Cortese, S., Adamo, N., Janiri, L. Tags: Editor's choice Clinical reviews Source Type: research

More ACTIONS needed to reach a consensus on adjunctive antidepressant therapy for negative symptoms of schizophrenia
ABSTRACT FROM: Barnes TR, Leeson VC, Paton C, et al.. Antidepressant Controlled Trial For Negative Symptoms In Schizophrenia (ACTIONS): a double-blind, placebo-controlled, randomised clinical trial. Health Technol Assess 2016;20:1–46. What is already known on this topic? Persistent negative symptoms which do not respond to antipsychotic regimens are experienced by 15–20% of patients with schizophrenia.1 Antidepressants have been the most studied augmentation strategy in these patients;2 however, previous findings are inconsistent in terms of their potential benefits. Methods of the study In this double-blind, p...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Akhondzadeh, S., Moazen-Zadeh, E. Tags: Electronic pages Source Type: research

Disruptive behaviour may hinder the acquisition of daily living skills for youth with autism spectrum disorder
ABSTRACT FROM: Scahill L, Bearss K, Lecavalier L, et al.. Effect of parent training on adaptive behavior in children with autism spectrum disorder and disruptive behavior: results of a randomized trial. J Am Acad Child Adolesc Psychiatry 2016;55:602–9. What is already known on this topic Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterised by impaired social communication and restricted/repetitive behaviours.1 Although arguably less cited, delayed adaptive functioning and disruptive behaviours are also considered hallmark features of this disorder. Parent training (PT) is a common treatment f...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Laugeson, E. A. Tags: Electronic pages Source Type: research

Prevention of depression and anxiety: is the whole better than the sum of the parts?
ABSTRACT FROM: Stockings EA, Degenhardt L, Dobbins L, et al.. Preventing depression and anxiety in young people: a review of the joint efficacy of universal, selective and indicated prevention. Psychological Medicine 2016;46:11–26. What is already known on this topic Depression and anxiety in young people are major causes of disability. There is potential for prevention by using effective treatment strategies for the disorders, but previously effects for depression and anxiety have not been aggregated. In this paper, the combined effects of prevention programmes on depression and anxiety are examined. Methods of the ...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Merry, S., Hetrick, S. Tags: Electronic pages Source Type: research

Twittering on about mental health: is it worth the effort?
The medical community disseminates information increasingly using social media. Randomised controlled trials are being conducted in this area to evaluate effectiveness of social media with mixed results so far, but more trials are likely to be published in the coming years. One recent twitter randomised control trial using Cochrane Schizophrenia Group reviews suggests that tweets increase the hits to the target web page by about threefold and time spent on the web page is also increased threefold when referrals come in via twitter. These are early findings and need further replication. Twitter appeals to professionals, ent...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Jayaram, M., Moran, L., Adams, C. Tags: Perspective Source Type: research

Are molecular scanners going to make double-blind placebo-controlled trials impossible?
Dear Editor, It almost looks like science fiction, but recently a molecular scanner (called SCiOS), which costs less than US$150, has hit the market (http://www.consumerphysics.com/myscio/scio/). It is advertised as being able to provide information on materials, including the composition and calories of food, quality of fruits and even details concerning the manufacture of perfumes. Future uses will probably include the development of a type of medical sensor to analyse biological material. It is reported to work by using near-infrared spectroscopy. There is one aspect of this new technology and the resulting gadget which...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Fountoulakis, K. N. Tags: Letter Source Type: research

Second-generation antidepressants and cognitive-behavioural therapy are both viable choices for initial treatment of major depression
ABSTRACT FROM: Amick HR, Gartlehner G, Gaynes BN, et al. Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis. BMJ 2015;351:h6019. What is already known on this topic There is a pressing need to generate clear hierarchies of the benefits and harms of available treatments to implement optimal clinical practice. Second-generation antidepressants (SGAs) and cognitive–behavioural therapy (CBT) have proven efficacy in the treatment of major depression.1 However, comparative benefits and ...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Nakagawa, A. Tags: Miscellaneous Source Type: research

Does community-based suicide prevention decrease suicide attempts? Strategies for reaching zero suicide
This study advances work on suicide prevention and intervention implementation/dissemination research. Rigorous suicide prevention research is critically needed, as suicide is the second leading cause of death among adolescents and young adults in the USA.1 The Garrett Lee Smith (GLS) Memorial Youth Suicide Prevention Programme is a US federal initiative that by June 2014 funded multiple community-based suicide prevention programmes across the USA (49 states, 48 tribes).2 This study examines the impact of the GLS programme on non-fatal suicide attempts (SAs), by comparing SA rates over time in counties that implemented GLS...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Asarnow, J. R., Wang, P. Tags: Miscellaneous Source Type: research

No evidence that CBT is less effective than antidepressants in moderate to severe depression
ABSTRACT FROM: Weitz ES, Hollon SD, Twisk J, et al. Baseline depression severity as moderator of depression outcomes between cognitive behavioral therapy vs pharmacotherapy: an individual patient data meta-analysis. JAMA Psychiatry 2015;72:1102–9. What is already known on this topic Some guidelines for the treatment of severe depression recommend that antidepressant medication be used instead of cognitive–behavioural therapy (CBT). This is inconsistent with evidence collating individual patient data (IPD) from multiple randomised controlled trials (RCTs).1 IPD meta analyses are one way of increasing statistical...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Lewis, G., Lewis, G. Tags: Clinical trials (epidemiology), Depressive disorder, Epidemiology Psychological interventions Source Type: research

Metoclopramide may be effective for clozapine-induced hypersalivation
ABSTRACT FROM: Kreinin A, Miodownik C, Mirkin V, et al. Double-blind randomized, placebo-controlled trial of metoclopramide for hypersalivation associated with clozapine. J Clin Psychopharmacol 2016;36:200–5. What is already known on this topic Clozapine-induced hypersalivation is the most prevalent adverse effect experienced by patients treated with clozapine and negatively impacts on quality of life,1 with symptoms particularly prevalent at night-time. Pharmacotherapeutic strategies employed to date, based on multiple mechanisms including antimuscarinic agents and α-2 agonists have largely been associated wit...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Hallahan, B. Tags: Clinical trials (epidemiology), Neurology, Schizophrenia spectrum, Epidemiology Pharmacological interventions Source Type: research

Routine use of antipsychotics to prevent or treat delirium is not recommended
ABSTRACT FROM: Neufeld KJ, Yue J, Robinson TN, et al. Antipsychotic medication for prevention and treatment of delirium in hospitalized adults: a systematic review and meta-analysis. J Am Geriatr Soc 2016;64:705–14. What is already known on this topic The American Geriatrics Society has developed guidelines to respond to the question of whether the use of antipsychotic medications in the perioperative period to prevent or treat delirium in older adults is supported by scientific evidence.1 2 Although the focus was on older adults after surgery, the panel raised concerns that the existing literature was too limited. T...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Kishi, T. Tags: Clinical trials (epidemiology), Epidemiologic studies, Neurology, Delirium, Drugs: psychiatry, Epidemiology Pharmacological interventions Source Type: research

Perinatal suicide associated with depression diagnosis and absence of active treatment in 15-year UK national inquiry
ABSTRACT FROM: Khalifeh H, Hunt IM, Appleby L, et al. Suicide in perinatal and non-perinatal women in contact with psychiatric services: 15 year findings from a UK national inquiry. Lancet Psychiatry 2016;3(3):233–42. What is already known on this topic Perinatal suicide is a rare but tragic complication of pregnancy and childbirth with significant public health implications.1 Among women with psychiatric illness, prior research suggests that suicide risk may be increased as much as 70-fold if compared with the general population.2 Beyond this, little is known about risk factors for completed suicide among perinatal ...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Kim, J. J., Silver, R. K. Tags: Epidemiologic studies, General practice / family medicine, Suicide (psychiatry), Epidemiology Outcomes Source Type: research

Prevention and treatment of mental health crises: examining the gaps in the evidence base
ABSTRACT FROM: Paton F, Wright K, Ayre N, et al. Improving outcomes for people in mental health crisis: a rapid synthesis of the evidence for available models of care. Health Technol Assess 2016;20:1–162. What is already known on this topic From a services’ perspective, a mental health crisis is a behavioural change that brings the service user to the attention of crisis services, for example, through relapse of a mental health condition.1 Preventing and supporting mental health crises is a priority in many jurisdictions plagued by fragmentation of health, community and social services, inequities in access and...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Stergiopoulos, V. Tags: Emergency medicine, Bipolar disorder Outcomes Source Type: research

PTSD is associated with elevated inflammation: any impact on clinical practice?
ABSTRACT FROM: Passos IC, Vasconcelos-Moreno MP, Costa LG, et al. Inflammatory markers in post-traumatic stress disorder: a systematic review, meta-analysis, and meta-regression. Lancet Psychiatry 2015;2:1002–12. What is already known on this topic Accumulating evidence indicates that elevated inflammation may play a causal role in the development of post-traumatic stress disorder (PTSD) symptoms, and in PTSD-related increased risk for cardiovascular, autoimmune and neurodegenerative diseases.1 2 At the same time, studies examining levels of inflammatory markers in individuals with PTSD have had mixed results, with m...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: O'Donovan, A. Tags: Epidemiologic studies, Neurology, Post-traumatic stress disorder, Depressive disorder, Epidemiology Causes and risk factors Source Type: research

Which psychotherapy for PTSD?
Clinical casePatient: 21-year-old man Present illness: The patient was 8 years old, when the Great Hanshin Earthquake hit the city of Kobe, Japan and killed some 6500 persons and injured 44 000 persons (https://en.wikipedia.org/wiki/Great_Hanshin_earthquake). Although the patient's house was shattered, all his family was safe and alive. However, he had many friends at school and some relatives who were killed. In particular, one of his best friends was lost. He recalls that he was despondent for a few years but gradually started living a normal life for a young boy. He graduated from primary school, junior high s...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Furukawa, T. A. Tags: Emergency medicine, General practice / family medicine, EBMH Evidence-Based Case Conference, Nursing, Post-traumatic stress disorder Source Type: research

Designing and analysing clinical trials in mental health: an evidence synthesis approach
Conclusions In the presence of reliable and relevant evidence, the design offers a way to conduct a smaller study without compromising power. It therefore fills a gap between the assessment of evidence and its actual use in the design and analysis of studies. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Wandel, S., Roychoudhury, S. Tags: Editor's choice, EBMH Statistics in Practice, Schizophrenia spectrum Source Type: research

Driving and dementia: a clinical update for mental health professionals
Most people with mild dementia can continue to drive, but dementia is progressive and many patients and clinicians will be faced with questions about driving safety in the course of their illness. Determining when this happens is a complex decision, with risks of personal and public safety needing to be weighed against individual patient benefits of driving in terms of autonomy, independence and well-being. Decisions need to make reference to cognitive abilities, as well as other factors including physical comorbidity, vision, mobility, insight and history of driving errors and accidents. Deciding to stop driving, or being...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Allan, C. L., Behrman, S., Baruch, N., Ebmeier, K. P. Tags: Editor's choice, Neurology Clinical review Source Type: research

Assessing and measuring cognitive function in major depressive disorder
Cognitive dysfunction is a major component of major depressive disorder (MDD). No ‘gold-standard’ tool exists for the assessment of cognitive dysfunction for adults with MDD. The use of measurement-based care to improve treatment outcomes invites the need for a systematic screening, evaluation and measurement tool. The aim herein was to provide a succinct summary of literature documenting clinical implication of cognitive dysfunction in MDD, and a review of available screening, diagnostic and measurement tools for cognitive dysfunction in MDD is provided. We also take the opportunity to introduce a screening to...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Ragguett, R.-M., Cha, D. S., Kakar, R., Rosenblat, J. D., Lee, Y., McIntyre, R. S. Tags: Neurology, Depressive disorder, Epidemiology, Screening (epidemiology) Clinical review Source Type: research