Long-Term Treatment of Bipolar Disorder with Valproate: Updated Systematic Review and Meta-analyses
Learning objective
After participating in this activity, learners should be better able to:
• Evaluate the evidence regarding the effectiveness of long-term treatment of bipolar disorder with valproate
Background
Prophylactic treatment is critical for bipolar disorder (BD) patients. Valproate is commonly used for this purpose but lacks regulatory approval and carries appreciable risks.
Methods
Systematic literature searching through June 2020 sought prospective trials lasting ≥12 months with adults diagnosed with BD to support comparisons of risk of new illness episodes with valproate versus placeb...
Source: Harvard Review of Psychiatry - May 1, 2021 Category: Psychiatry Tags: Reviews Source Type: research
Bridging the Gap: Strategies to Make Psychiatric Neuroimaging Clinically Relevant
No abstract available (Source: Harvard Review of Psychiatry)
Source: Harvard Review of Psychiatry - May 1, 2021 Category: Psychiatry Tags: Disruptive Innovation Source Type: research
Psychiatric Advance Directives: No Longer a Fool’s Errand
No abstract available (Source: Harvard Review of Psychiatry)
Source: Harvard Review of Psychiatry - March 1, 2021 Category: Psychiatry Tags: Ethics Source Type: research
Treatment and Discharge Planning for a Suicidal Adolescent with Complex Psychosocial and Family Stressors
No abstract available (Source: Harvard Review of Psychiatry)
Source: Harvard Review of Psychiatry - March 1, 2021 Category: Psychiatry Tags: Clinical Challenge Source Type: research
A Clinician’s Guide to Polycultural Psychiatry
Patients and families each present unique microcultures, mixing and blending numerous broadly conceptualized cultural identity groups. Within individuals and families, cultural identities are experienced and enacted as complex matrices of intersecting identities that, to varying degrees, complement, assimilate, accommodate, or clash. In these patterns, individuals’ relationships to cultures are not necessarily categorically distinct (“multicultural”). Instead, they are often “polycultural,” defined as partial and plural; rather than interpreting different cultural traditions as separate and independent, they are,...
Source: Harvard Review of Psychiatry - March 1, 2021 Category: Psychiatry Tags: Perspectives Source Type: research
Is Attention-Deficit/Hyperactivity Disorder a Risk Syndrome for Parkinson’s Disease?
Recent epidemiological evidence indicates that diagnosis of attention-deficit/hyperactivity disorder (ADHD) is associated with increased risk for diseases of the basal ganglia and cerebellum, including Parkinson’s disease (PD). The evidence reviewed here indicates that deficits in striatal dopamine are a shared component of the causal chains that produce these disorders. Neuropsychological studies of adult ADHD, prodromal PD, and early-stage PD reveal similar deficits in executive functions, memory, attention, and inhibition that are mediated by similar neural substrates. These and other findings are consistent with the ...
Source: Harvard Review of Psychiatry - March 1, 2021 Category: Psychiatry Tags: Perspectives Source Type: research
Stigma of Treatment Stages for First-Episode Psychosis: A Conceptual Framework for Early Intervention Services
Early intervention services (EIS; in the United States, Coordinated Specialty Care) can lead to substantial improvements in psychiatric symptoms and social functioning for individuals with first-episode psychosis who engage in treatment. Nevertheless, stigma associated with early intervention services can limit their full potential benefits by preventing or reducing participation. Drawing from Corrigan’s “why try” model positing relationships between public and self-stigma, engagement in treatment services, and the EIS treatment model, this article proposes a framework that delineates how distinct forms of stigma are...
Source: Harvard Review of Psychiatry - March 1, 2021 Category: Psychiatry Tags: Perspectives Source Type: research
An Evaluation of Opioid Use in Black Communities: A Rapid Review of the Literature
Conclusions
Through this rapid review we suggest three main areas of focus: (1) including culturally informed collection methods in epidemiologic surveys to accurately reflect prevalences, (2) funding research that specifically addresses the importance of culture in accessing treatment, and (3) directly studying how social determinants can improve or exacerbate health outcomes. Focusing on the unique needs of Black people who use opioids is warranted to increase treatment initiation and adherence among a population less likely to engage with the traditional health care system. (Source: Harvard Review of Psychiatry)
Source: Harvard Review of Psychiatry - March 1, 2021 Category: Psychiatry Tags: Reviews Source Type: research
Obsessive-Compulsive Personality Disorder Co-occurring in Individuals with Obsessive-Compulsive Disorder: A Systematic Review and Meta-analysis
Learning objectives
After participating in this activity, learners should be better able to:
• Assess the rates of co-occurring obsessive-compulsive personality disorder (OCPD) in patients with obsessive-compulsive disorder (OCD)
• Identify characteristics related to OCD with co-occurring OCPD
The current literature discloses discrepant findings regarding the rates of co-occurring obsessive-compulsive personality disorder (OCPD) in patients with obsessive-compulsive disorder (OCD). In addition, it is not clear which characteristics are related specifically to OCD with co-occurring OCPD. We conducted the fi...
Source: Harvard Review of Psychiatry - March 1, 2021 Category: Psychiatry Tags: Reviews Source Type: research
Acknowledgments
No abstract available (Source: Harvard Review of Psychiatry)
Source: Harvard Review of Psychiatry - January 1, 2021 Category: Psychiatry Tags: Acknowledgments Source Type: research
Violence Risk Assessment in Clinical Settings: Enduring Challenges and Evolving Lessons
No abstract available (Source: Harvard Review of Psychiatry)
Source: Harvard Review of Psychiatry - January 1, 2021 Category: Psychiatry Tags: Forensics Source Type: research
Mental Illness, Mass Shootings, and the Future of Psychiatric Research into American Gun Violence
This article outlines a four-part strategy for future research in mental health and complementary disciplines that will broaden understanding of mass shootings and multi-victim gun homicides. First, researchers must abandon the starting assumption that acts of mass violence are driven primarily by diagnosable psychopathology in isolated “lone wolf” individuals. The destructive motivations must be situated, instead, within larger social structures and cultural scripts. Second, mental health professionals and scholars must carefully scrutinize any apparent correlation of violence with mental illness for evidence of racia...
Source: Harvard Review of Psychiatry - January 1, 2021 Category: Psychiatry Tags: Perspectives Source Type: research
Treatment of Aggression in Adults with Autism Spectrum Disorder: A Review
Conclusions
Additional randomized, controlled trials using consistent methodology that adequately addresses sources of bias are needed to determine which treatments are reliably effective in addressing aggression in adults with ASD. In the meantime, considering efficacy and adverse effect/long-term risk profiles, a practical approach could start with functional assessment–informed behavioral interventions along with encouragement of regular, vigorous aerobic exercise to target aggression in adults with ASD, with pharmacotherapy employed if these interventions are unavailable or inadequate based on symptom acuity. (So...
Source: Harvard Review of Psychiatry - January 1, 2021 Category: Psychiatry Tags: Reviews Source Type: research
Specific Anti-hostility Effects of Atypical Antipsychotics in Persons with Schizophrenia: From Clozapine to Cariprazine
Learning objective
After participating in this activity, learners should be better able to:
• Evaluate the anti-hostility effects of available atypical antipsychotic agents
In addition to hallucinations and delusions, persons with schizophrenia may exhibit hostility. In clinical trials of antipsychotics, hostility is routinely measured as part of rating scales such as the Brief Psychiatric Rating Scale or Positive and Negative Syndrome Scale. The availability of the atypical antipsychotic clozapine in 1989 led to the observation that it is possible to have a treatment effect on hostility that is independent of ...
Source: Harvard Review of Psychiatry - January 1, 2021 Category: Psychiatry Tags: Reviews Source Type: research
Violence by Persons with Serious Mental Illness Toward Family Caregivers and Other Relatives: A Review
Persons living with serious mental illness (SMI) are at a modestly increased risk of committing violence and are disproportionately likely to target family members when they do commit violence. In this article, we review available evidence regarding violence by persons with SMI toward family members, many of whom are caregivers. Evidence suggests that a sizable minority of family members with high levels of contact with persons with SMI have experienced violence, with most studies finding rates of past year victimization to be 20% or higher. Notable risk factors for family violence pertaining specifically to persons with S...
Source: Harvard Review of Psychiatry - January 1, 2021 Category: Psychiatry Tags: Reviews Source Type: research
