Depression, Cognitive Functions, and Impaired Functioning in Middle-Aged Adults From the CONSTANCES Cohort.
CONCLUSIONS: In middle-aged adults from the general population, cognitive impairment is unlikely to substantially explain the association between depressive symptoms and later role limitations and social functioning. PMID: 30474938 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - November 28, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Physical Frailty Correlates With Behavioral and Psychological Symptoms of Dementia and Caregiver Burden in Alzheimer's Disease.
Authors: Sugimoto T, Ono R, Kimura A, Saji N, Niida S, Toba K, Sakurai T Abstract OBJECTIVE: The aim of this study was to clarify the association of physical frailty with behavioral and psychological symptoms of dementia (BPSD) and caregiver burden in patients with Alzheimer's disease (AD). METHODS: The subjects were 1,193 AD patients who presented to the Memory Clinic at the National Center for Geriatrics and Gerontology of Japan during the period from October 2010 to February 2015 (mean ± SD age = 78.8 ± 6.3 years; female, 68.6%). AD was diagnosed based on the criteria of the National Institute ...
Source: Journal of Clinical Psychiatry - November 28, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Care of Youth in Their First Emergency Presentation for Psychotic Disorder: A Population-Based Retrospective Cohort Study.
Authors: Kozloff N, Jacob B, Voineskos AN, Kurdyak P Abstract OBJECTIVE: Emergency departments (EDs) are often the first point of care for youth with psychotic disorders; however, the care and aftercare they receive have not been well described. The aim of this study was to examine care and aftercare following first ED visit for psychotic disorder among youth. METHODS: We conducted a population-based retrospective cohort study of first ED presentations for psychotic disorder among youth 16 to 24 years old (N = 2,875) in Ontario, Canada. The youth were diagnosed with a psychotic disorder according to ICD-10 codi...
Source: Journal of Clinical Psychiatry - November 13, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Access to Psychotropic Medication via Prescription Is Associated With Choice of Psychotropic Medication as Suicide Method: A Retrospective Study of 27,876 Suicide Attempts.
CONCLUSIONS: Individuals at high risk for suicide with prescribed access to any psychotropic medication should be targeted for means safety interventions. PMID: 30418710 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - November 13, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Traumatic Brain Injury in Early Childhood and Risk of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder: A Nationwide Longitudinal Study.
Authors: Chang HK, Hsu JW, Wu JC, Huang KL, Chang HC, Bai YM, Chen TJ, Chen MH Abstract OBJECTIVE: Early childhood ( 99% of the Taiwanese population, were analyzed. Children with TBI in their early childhood were enrolled from 1998-2008, and the incidence of subsequent ADHD, ASD, or DD (according to ICD-9 criteria) was assessed and compared with controls without TBI. Patients' age, number of TBI events, and TBI severity were investigated for the risk of ADHD, ASD, or DD. RESULTS: A total of 7,801 and 31,204 children were enrolled in the TBI and control cohorts, respectively. The TBI cohort exhibited a higher in...
Source: Journal of Clinical Psychiatry - November 9, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Prevalence and Correlates of Benzodiazepine Use, Misuse, and Use Disorders Among Adults in the United States.
CONCLUSIONS: While benzodiazepine use is highly prevalent among US adults, benzodiazepine use disorders are relatively rare among benzodiazepine users. Our results help characterize benzodiazepine users and identify adults at risk for misuse and use disorders. PMID: 30403446 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - November 9, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

One Month of Cannabis Abstinence in Adolescents and Young Adults Is Associated With Improved Memory.
CONCLUSIONS: This study suggests that cannabis abstinence is associated with improvements in verbal learning that appear to occur largely in the first week following last use. Future studies are needed to determine whether the improvement in cognition with abstinence is associated with improvement in academic and other functional outcomes. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03276221. PMID: 30408351 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - November 9, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

When Further Pharmacotherapy Seems Futile.
Authors: Goldberg JF PMID: 30408352 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - November 9, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Benzodiazepines, Health Care Utilization, and Suicidal Behavior in Veterans With Posttraumatic Stress Disorder.
CONCLUSIONS: Benzodiazepine users had higher rates of health care utilization and were more likely to attempt and complete suicide than patients without benzodiazepine exposure. This study strengthens the empirical evidence against the use of benzodiazepines in veterans with PTSD. Prescribers should weigh the benefits and risks-especially the almost 3-fold increase in suicide risk-when prescribing benzodiazepines in these patients. PMID: 30358240 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - October 26, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Circadian Pattern of Deaths Due to Suicide in Intoxicated Alcohol-Dependent Individuals.
We examined the hours of peak and nadir in completed suicides over a 24-hour period among intoxicated, alcohol-dependent individuals. We also evaluated suicide-related factors associated with intoxication at different times of the day. METHODS: We analyzed cross-sectional data from the 2003-2010 National Violent Death Reporting System provided by 16 US states. In the primary database, the deceased individuals' alcohol-dependent status was classified as "yes" or "no or unknown." We restricted the analysis to alcohol-dependent individuals with alcohol level data available (N = 3,661). The primary outc...
Source: Journal of Clinical Psychiatry - October 26, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Trajectories in Cerebral Blood Flow Following Antidepressant Treatment in Late-Life Depression: Support for the Vascular Depression Hypothesis.
In this study, we investigated the dynamic CBF changes over the course of antidepressant treatment and the association of these changes with depressive symptoms. METHODS: We used pseudocontinuous arterial spin labeling to investigate CBF changes in a sample of older patients (≥ 50 years of age; N = 46; 29 female) with a DSM-IV diagnosis of major depressive disorder. Participants had 5 magnetic resonance imaging scans (at baseline, the day after receiving a placebo, the day after receiving a first dose of venlafaxine, a week after starting venlafaxine treatment, and at the end of trial [12 weeks]). Montgomery-Asberg ...
Source: Journal of Clinical Psychiatry - October 26, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Relationship Between Neuroanatomical and Serotonergic Hypotheses of Obsessive-Compulsive Disorder: A Combined Functional Magnetic Resonance Imaging-Evoked Potential Study.
CONCLUSIONS: The 2 main pathophysiologic hypotheses of OCD seem to be related to each other as measured by LDAEP and fMRI OFC activity during the delay discounting task. This could be interpreted as a further hint that low serotonergic activity induces altered OFC responsivity, which has to be treated in each patient with OCD by a serotonin agonist. PMID: 30326190 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - October 17, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Effects of Psychiatric Disorders on Suicide Attempt: Similarities and Differences Between Older and Younger Adults in a National Cohort Study.
Authors: Pascal de Raykeer R, Hoertel N, Blanco C, Olfson M, Wall M, Seigneurie AS, Schuster JP, Lemogne C, von Gunten A, Limosin F Abstract OBJECTIVE: Several common psychiatric disorders are associated with increased risk of suicide attempts, and the strength of these associations may vary between younger and older adults, which may explain age differences in suicide risk. Because psychiatric disorders often co-occur, it remains unclear whether (1) the risk of suicide attempt in older and younger adults is due to specific psychiatric disorders or underlying psychopathology dimensions (ie, internalizing and extern...
Source: Journal of Clinical Psychiatry - October 17, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Suicide Methods and Specific Types of Accidental Death and Fatal Poisoning Among Discharged Psychiatric Patients: A National Cohort Study.
CONCLUSIONS: Closer liaison between inpatient services and community care, more effective early treatment for comorbid substance abuse, enhanced psychosocial assessment following self-harm, and tighter medication surveillance could decrease risk of unnatural death post-discharge. PMID: 30289629 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - October 6, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Tobacco Smoking and Psychotic-Like Experiences in a General Population Sample.
CONCLUSIONS: In a large population-based, nationally representative sample, smoking status was associated with various PLEs. This association was not explained only by other known risk factors of PLEs or schizophrenia. There is a need to identify the potential neurobiological mechanisms by which smoking and PLEs are associated, for patients and from a public health perspective. PMID: 30289630 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - October 6, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Safety of Pregabalin in Pregnancy.
Authors: Andrade C Abstract In different parts of the world, pregabalin is an approved treatment for neuropathic pain syndromes, fibromyalgia, partial-onset seizures, and generalized anxiety disorder. Few studies have examined the safety of pregabalin exposure during pregnancy. Among 4 studies identified through a PubMed search conducted in September 2018, one small study (exposed n = 30) recorded a major malformation rate of 3.3%, which was similar to that in unexposed controls. Another small study (exposed n = 30) recorded increased rates of spontaneous abortion (23.3%), preterm birth (25.0%), and major malformat...
Source: Journal of Clinical Psychiatry - October 6, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Psychiatric Disorders and Comorbid Cannabis Use: When Should We Be Concerned and What Can We Do About It?
Authors: Satre DD, Borsari B, Tompkins DA, Ramo D PMID: 30256546 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - September 27, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Insomnia and Impaired Quality of Life in the United States.
CONCLUSIONS: Insomnia is prevalent and associated with substantial population-level burden in self-assessed health. The co-occurrence of insomnia with common medical conditions is differentially related to pain and to a lesser extent to stressful life events and mental disorders. PMID: 30256547 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - September 27, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Twelve-Month Outcomes Following Successful Panic-Focused Psychodynamic Psychotherapy, Cognitive-Behavioral Therapy, or Applied Relaxation Training for Panic Disorder.
CONCLUSIONS: Improvement in any of the 3 treatments examined in this trial was largely maintained for a year following the end of therapy. Future treatment development could focus on factors to increase the level of response in the active phase of therapy. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00353470. PMID: 30256548 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - September 27, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Toward an Empirically Based Developmental Trauma Disorder Diagnosis for Children: Factor Structure, Item Characteristics, Reliability, and Validity of the Developmental Trauma Disorder Semi-Structured Interview.
CONCLUSIONS: The DTD-SI yielded reliable, structurally meaningful, and valid item- and criterion-level data for the proposed DTD syndrome. Further clinical and scientific investigation of the clinical utility of DTD as a childhood psychiatric syndrome and diagnosis is warranted. PMID: 30256549 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - September 27, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Association of Polypharmacy With Mild Cognitive Impairment and Cognitive Ability: A Nationwide Survey in Taiwan.
Authors: Cheng CM, Chang WH, Chiu YC, Sun Y, Lee HJ, Tang LY, Wang PN, Chiu MJ, Yang CH, Tsai SJ, Tsai CF Abstract BACKGROUND: Polypharmacy, defined as the concomitant use of 5 or more medications, has a documented negative association with cognitive impairment such as delirium and is associated, potentially, with a higher risk of dementia. However, whether polypharmacy contributes to increased risk of mild cognitive impairment (MCI) or decreased cognitive capacity requires further investigation. This nationwide population survey investigated the association among polypharmacy, MCI, and dementia. METHODS: Throu...
Source: Journal of Clinical Psychiatry - September 27, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

A 6-Month, Prospective, Randomized Controlled Trial of Customized Adherence Enhancement Versus Bipolar-Specific Educational Control in Poorly Adherent Individuals With Bipolar Disorder.
Authors: Sajatovic M, Tatsuoka C, Cassidy KA, Klein PJ, Fuentes-Casiano E, Cage J, Aebi ME, Ramirez LF, Blixen C, Perzynski AT, Bauer MS, Safren SA, Levin JB Abstract OBJECTIVE: Nonadherence in bipolar disorder (BD) ranges from 20% to 60%. Customized adherence enhancement (CAE) is a brief, BD-specific approach that targets individual adherence barriers. This prospective, 6-month, randomized controlled trial conducted from October 2012 to July 2017 compared CAE versus a rigorous BD-specific educational program (EDU) on adherence, symptoms, and functional outcomes in poorly adherent individuals. METHODS: One hund...
Source: Journal of Clinical Psychiatry - September 27, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Combining Postcards, Crisis Cards, and Telephone Contact Into a Decision-Making Algorithm to Reduce Suicide Reattempt: A Randomized Clinical Trial of a Personalized Brief Contact Intervention.
CONCLUSIONS: These results may help researchers better integrate BCIs into routine health care and provide new insights concerning personalized suicide prevention strategies. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01123174. PMID: 30256552 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - September 27, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

The Use of Statins for Antipsychotic Augmentation in Schizophrenia: Examination of Meta-Analyses With Flawed Methods and Conclusions.
Conclusions. J Clin Psychiatry. 2018 Sep 25;79(5): Authors: Andrade C Abstract A very large number of psychopharmacologic agents have been trialed as antipsychotic augmentation strategies for the improvement of positive, negative, mood, cognitive, and other symptoms of schizophrenia; statins are one among these. Two very recent meta-analyses examined data on statin augmentation from 5 to 6 randomized controlled trials (RCTs) in the field. One meta-analysis found that statins were superior to placebo for the improvement of total scale and general psychopathology subscale scores on the Positive and Negat...
Source: Journal of Clinical Psychiatry - September 27, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Metabolic Syndrome and Illness Severity Predict Relapse at 1-Year Follow-Up in Schizophrenia: The FACE-SZ Cohort.
CONCLUSIONS: Further studies should determine if reducing or preventing MetS could help to protect subjects with schizophrenia from relapse. PMID: 30257079 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - September 27, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Clozapine Monotherapy as a Treatment for Antipsychotic-Induced Tardive Dyskinesia: A Meta-Analysis.
Authors: Mentzel TQ, van der Snoek R, Lieverse R, Oorschot M, Viechtbauer W, Bloemen O, van Harten PN Abstract OBJECTIVE: Tardive dyskinesia (TD) is an antipsychotic-induced movement disorder that typically occurs after long-term exposure to antipsychotic drugs. There is evidence that switching to clozapine reduces TD. This meta-analysis reviews the effect of switching to clozapine on the severity of TD. DATA SOURCES: The PubMed, PsycINFO, and Embase databases were searched for clozapine, tardive dyskinesia, and related keywords. The search was restricted to articles written in English and Dutch, and it was las...
Source: Journal of Clinical Psychiatry - September 27, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

A Retrospective Comparative Effectiveness Study of Medications for Posttraumatic Stress Disorder in Routine Practice.
Authors: Shiner B, Westgate CL, Gui J, Maguen S, Young-Xu Y, Schnurr PP, Watts BV Abstract OBJECTIVE: Fluoxetine, paroxetine, sertraline, topiramate, and venlafaxine have consistently shown efficacy for posttraumatic stress disorder (PTSD) in meta-analyses of randomized controlled trials. However, no study has compared the effectiveness of these agents in routine clinical practice. We conducted a retrospective comparative effectiveness study of these 5 medications using electronic medical record data. METHODS: We identified 2,931 Department of Veterans Affairs outpatients initiating treatment for PTSD between f...
Source: Journal of Clinical Psychiatry - September 27, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Transdermal Nicotine for the Treatment of Mood and Cognitive Symptoms in Nonsmokers With Late-Life Depression.
This study examined whether transdermal nicotine benefits mood symptoms and cognitive performance in LLD. METHODS: In a 12-week open-label outpatient study conducted between November 2016 and August 2017, transdermal nicotine was given to 15 nonsmoking older adults (≥ 60 years of age). Eligible participants met DSM-IV-TR criteria for major depressive disorder with ≥ 15 on the Montgomery-Asberg Depression Rating scale (MADRS) and endorsed subjective cognitive impairment. Transdermal nicotine patches were applied daily and titrated in a rigid dose escalation strategy to a maximum dose of 21.0 mg/d, allowing dose re...
Source: Journal of Clinical Psychiatry - September 9, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Impact of Drug Adherence on Oppositional Defiant Disorder and Conduct Disorder Among Patients With Attention-Deficit/Hyperactivity Disorder.
This study aims to examine whether adherence to medication treatment is associated with developing ODD and CD among youths with ADHD. METHODS: A total of 33,835 youths (4 years ≤ age of diagnosis ≤ 18 years) with ADHD (ICD-9-CM code 314.X) undergoing medication treatment for at least 90 days were selected from Taiwan's National Health Insurance Research Database during the period of January 2000 through December 2009. Patients' medical records were monitored through December 31, 2011, or until they had a diagnosis of ODD or CD. We categorized participants as compliant or noncompliant on the basis of a medication ...
Source: Journal of Clinical Psychiatry - September 9, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Cost-Effectiveness of Behavioral Activation for Depression in Older Adult Veterans: In-Person Care Versus Telehealth.
CONCLUSIONS: Although the intervention costs for telehealth were higher relative to in-person care, veterans receiving behavioral activation via telehealth had lower health utilization costs 1 year after the intervention than those receiving care in person while QALYs were approximately the same. These results demonstrate the noninferiority of telehealth in treating depression in veterans with respect to QALYs and a large and significant cost benefit of using telehealth in terms of health services utilization post-intervention. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00324701. PMID: 30192446 [PubMed -...
Source: Journal of Clinical Psychiatry - September 9, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Suicidality 6 Years After Occupational Injury.
CONCLUSIONS: The suicidality rate increased at 6 years after occupational injury. The relevant factors for suicidal ideation were injury severity and work instability. Periodic monitoring of psychological and physical health and economic stability are warranted. PMID: 30192447 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - September 9, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Depression Plays a Moderating Role in the Cognitive Decline Associated With Changes of Brain White Matter Hyperintensities.
CONCLUSIONS: Depressive disorder and WMH are interactively associated with the poor performance of multiple cognitive functions. Depressive disorder may moderate the cognitive decline associated with the changes of brain WMH. PMID: 30192448 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - September 9, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Maternal Anxiety During Pregnancy and the Association With Adverse Perinatal Outcomes: Systematic Review and Meta-Analysis.
Authors: Grigoriadis S, Graves L, Peer M, Mamisashvili L, Tomlinson G, Vigod SN, Dennis CL, Steiner M, Brown C, Cheung A, Dawson H, Rector NA, Guenette M, Richter M Abstract OBJECTIVE: This systematic review and meta-analysis examined the association between maternal antenatal anxiety (AA) and a range of perinatal outcomes. DATA SOURCES: Ovid MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, PsycINFO, CINAHL, Embase, and the Cochrane Library were searched to May 31, 2016, using controlled vocabulary and keywords (eg, prenatal, anxiety, preterm). STUDY SELECTION: Perinatal outcomes of women with a...
Source: Journal of Clinical Psychiatry - September 9, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Differences in Duloxetine Dosing Strategies in Smoking and Nonsmoking Patients: Therapeutic Drug Monitoring Uncovers the Impact on Drug Metabolism.
Authors: Augustin M, Schoretsanitis G, Hiemke C, Gründer G, Haen E, Paulzen M Abstract BACKGROUND: For certain psychotropic drugs, such as clozapine or olanzapine, the influence of smoking on drug metabolism is well studied. Tobacco smoke increases the metabolism of drugs that are substrates for cytochrome P450 (CYP) 1A2 due to CYP induction. The antidepressant duloxetine, acting as a serotonin-norepinephrine reuptake inhibitor, is mainly metabolized via CYP1A2. To date, little is known about the influence of smoking on serum duloxetine concentrations. METHODS: A therapeutic drug monitoring database consis...
Source: Journal of Clinical Psychiatry - September 9, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Chronic Vagus Nerve Stimulation Significantly Improves Quality of Life in Treatment-Resistant Major Depression.
CONCLUSION: Compared to TAU, adjunctive VNS significantly improved QOL in TRD, and this QOL advantage was sustained. Further, TRD patients treated with VNS experienced clinically meaningful QOL improvements even with depression symptom reduction less than the conventional 50% reduction used to ascribe "response." PMID: 30152645 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - August 30, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

The Use of Technology in the Clinical Care of Depression: An Evidence Map.
CONCLUSIONS: This evidence map provides a broad overview of the existing research evaluating technology in depression care. Computer applications are still most common. Almost all applications yield symptom improvement. More information is needed to evaluate the role of technology in clinical care. PMID: 30152646 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - August 30, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Psychiatric Medications and Reproductive Safety: Scientific and Clinical Perspectives Pertaining to the US FDA Pregnancy and Lactation Labeling Rule.
Authors: Freeman MP, Farchione T, Yao L, Sahin L, Taylor L, Huybrechts KF, Nonacs R, Sosinsky AZ, Viguera AC, Cohen LS Abstract Pregnancy labeling of prescription medications in the US is in the midst of a major transformation. The FDA's previous system, which used letter ratings to convey drug safety, was simple but led to misunderstandings-both faulty assurances and undue concerns. The new system, established under the Pregnancy and Lactation Labeling Rule, aims for more descriptive and up-to-date explanations of risk as well as context needed for informed decision-making based on available data. In April 2017, a...
Source: Journal of Clinical Psychiatry - August 30, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Major Congenital Malformations Associated With Exposure to Antiepileptic Drugs During Pregnancy.
Authors: Andrade C Abstract Antiepileptic drugs (AEDs) are prescribed for approved and off-label indications that include epilepsy, bipolar disorder, and other neurologic and psychiatric disorders. The risk of major congenital malformations (MCMs) following gestational exposure to AEDs, particularly exposure at the time of conception and early trimester exposure, has been examined in many studies. This risk has been compared with the risk in unexposed general population controls as well as in untreated controls with the same treatment indication, and this risk has been compared pairwise among the AEDs. There is con...
Source: Journal of Clinical Psychiatry - August 30, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

An Examination of Screening Tools for Collaborative Care of Adolescent Depression.
Authors: Ginsburg AD, Stadem PS, Takala CR, Croarkin PE, Mattson AB, Billings ML, Brennan RM, Huxsahl JE Abstract OBJECTIVE: Collaborative care models for treatment of adolescent depression are rapidly evolving. However, a dearth of information exists regarding patient characteristics associated with positive outcomes. We explored the association between baseline scores on routine screening tools for substance abuse, mood disorders, and anxiety with depression remission and graduation from a collaborative care program in an outpatient pediatric practice. METHODS: Adolescents (aged 12-17 years) with Patient Heal...
Source: Journal of Clinical Psychiatry - August 30, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Nondaily Cigarette Smoking Is Increasing Among People With Common Mental Health and Substance Use Problems in the United States: Data From Representative Samples of US Adults, 2005-2014.
Authors: Weinberger AH, Streck JM, Pacek LR, Goodwin RD Abstract OBJECTIVE: The current study estimated trends in the prevalence of daily and nondaily cigarette smoking among United States adults with any common mental health or substance use problem (MHSUP), compared to US adults without MHSUP, from 2005 to 2014. METHODS: Data were drawn from the years 2005 to 2014 from the public use data files for the annually conducted National Survey on Drug Use and Health. Linear time trends of current, daily, and nondaily cigarette smoking among adults (age 18 years and older) with and without MHSUP were assessed using l...
Source: Journal of Clinical Psychiatry - August 30, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Correlates of Prescription Opioid Use, Misuse, Use Disorders, and Motivations for Misuse Among US Adults.
CONCLUSIONS: Our results suggest that clinicians should assess prescription opioid misuse and its motivations and screen for multiple co-occurring behavioral health conditions in patients who misuse prescription opioids. PMID: 30153405 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - August 30, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Meta-Analysis of the Prevalence of Major Depressive Disorder Among Older Adults With Dementia.
CONCLUSIONS: Depression is common among individuals with dementia, and the type of dementia and diagnostic criteria affect prevalence estimates of DpD. Further studies are required to understand factors that lead to the development of DpD and strategies to prevent and treat DpD. PMID: 30085437 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - August 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

A Comprehensive Model of Predictors of Suicide Attempt in Depressed Individuals and Effect of Treatment-Seeking Behavior: Results From a National 3-Year Prospective Study.
CONCLUSIONS: This model may help identify high-risk individuals with MDE and inform future research on risk of suicide. PMID: 30085438 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - August 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Adverse Pregnancy Outcomes Associated With Gestational Exposure to Antiepileptic Drugs.
This article critically examines the risk of fetal loss, intrauterine growth retardation (IUGR), and preterm birth following gestational exposure to 14 AEDs, based on information obtained from a recent network meta-analysis of mostly nonrandomized, observational studies. The AEDs studied were carbamazepine, clobazam, clonazepam, ethosuximide, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, phenobarbitone, phenytoin, primidone, topiramate, valproate, and vigabatrin. The results show that very few AEDs are significantly associated with each adverse outcome and that the implicated AEDs are different for different outco...
Source: Journal of Clinical Psychiatry - August 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Effect of Lurasidone on Sexual Function in Major Depressive Disorder Patients With Subthreshold Hypomanic Symptoms (Mixed Features): Results From a Placebo-Controlled Trial.
Authors: Clayton AH, Tsai J, Mao Y, Pikalov A, Loebel A Abstract OBJECTIVE: The aim of this secondary analysis was to evaluate whether treatment with lurasidone was associated with impairment in sexual functioning in major depressive disorder (MDD) patients with subthreshold hypomanic symptoms (mixed features). METHODS: Patients meeting DSM-IV-TR criteria for MDD, who presented with 2 or 3 protocol-specified manic symptoms, were randomized to 6 weeks of double-blind treatment with flexible doses of either lurasidone 20-60 mg/d (n = 109) or placebo (n = 100). The study was conducted between September 2011 and Oc...
Source: Journal of Clinical Psychiatry - August 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Further Evidence of Morbidity and Dysfunction Associated With Subsyndromal ADHD in Clinically Referred Children.
Authors: Biederman J, Fitzgerald M, Kirova AM, Woodworth KY, Biederman I, Faraone SV Abstract BACKGROUND: While the diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD) have evolved over the years, some children with impairing ADHD symptoms fail to meet the full diagnostic threshold for the disorder. The main aim of this study was to evaluate the morbidity and dysfunction of subsyndromal ADHD in the clinical setting. METHODS: Subthreshold and full ADHD subjects were derived from consecutive referrals (n = 2,947) to a pediatric psychopharmacology program at a major academic center. Subjects we...
Source: Journal of Clinical Psychiatry - August 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Prevalence and Clinical Correlates of and Cognitive Function at the Time of Suicide Attempts in First-Episode and Drug-Naive Patients With Schizophrenia.
CONCLUSIONS: FEDN patients with schizophrenia attempt suicide more often than the general population. The suicidal patients were more likely to smoke, had lower severity of negative symptoms, and showed better attention than nonsuicidal patients. PMID: 30063302 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - August 3, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Appetitive Symptoms Differentially Predict Treatment Response to Fluoxetine, Light, and Placebo in Nonseasonal Major Depression.
Authors: Levitan RD, Levitt AJ, Michalak EE, Morehouse R, Ramasubbu R, Yatham LN, Tam EM, Lam RW Abstract OBJECTIVE: We previously reported that morning bright light therapy is efficacious in adults with nonseasonal major depressive disorder (MDD), both on its own and in combination with fluoxetine. Given that appetitive symptoms predict response to bright light therapy in seasonal depression, we examined, in this secondary analysis, whether the same held true in these nonseasonal MDD patients. METHODS: Data were collected from October 7, 2009, to March 11, 2014. One hundred twenty-two patients who met DSM-IV-T...
Source: Journal of Clinical Psychiatry - August 3, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Acute and Longer-Term Outcomes Using Ketamine as a Clinical Treatment at the Yale Psychiatric Hospital.
CONCLUSIONS: In general, ketamine infusions were tolerated well. The response and remission rates in this clinical sample were lower than those observed in some research protocols. The small number of patients who were treated on a maintenance schedule limits the conclusions that can be drawn regarding the long-term safety of ketamine; however, no long-term adverse effects were observed in this sample. PMID: 30063304 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - August 3, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Parkinson Disease: Current and Emerging Treatment Strategies.
Authors: Ramirez-Zamora A Abstract Although levodopa is effective for treating Parkinson disease, physicians and patients face significant management challenges related to disease progression. Patients may develop fluctuations in motor symptoms and dyskinesias as well as nonmotor symptoms. Review this CME Brief Report activity to learn about new and emerging treatment options to manage patients' symptoms. PMID: 29999254 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - July 14, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research