Reevaluating Sensitivity of Self-Reported Suicidal Ideation.
Authors: Ludman EJ, Simon GE, Whiteside U, Richards JE, Pabiniak C PMID: 29873950 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - June 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Sedative Hypnotics and the Risk of Falls and Fractures in the Elderly.
Authors: Andrade C Abstract Older age, poor sleep, and the use of the "Z" sedative hypnotic drugs (zopiclone, eszopiclone, zolpidem, and zaleplon) commonly go together. Each of these can increase the risk of falls and fractures through mechanisms related to cognitive and psychomotor impairment. A recent systematic review and meta-analysis examined the risk of falls and fractures associated with the use of the Z-drugs. The authors of that meta-analysis identified 14 relevant cohort and case-control studies. They found that Z-drugs increased the risk of falls in 2 out of 3 studies that provided information ...
Source: Journal of Clinical Psychiatry - June 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Working With Decisionally Capable Patients Who Are Determined to End Their Own Lives.
Authors: Yager J, Ganzini L, Nguyen DH, Rapp EK Abstract Psychiatrists face complex, vexing, and often conflicting issues in assessing and managing patients with advanced medical illnesses who are determined to end their own lives. Substantial differences of opinion exist among psychiatrists regarding the roles they might take with such patients when the patients are decisionally capable and do not have clear-cut psychiatric disorders. Even those with psychiatric diagnoses often possess rational deliberative abilities and may make decisions to hasten death that are not impacted by their psychiatric disorder. How ps...
Source: Journal of Clinical Psychiatry - June 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

A Randomized, Placebo-Controlled Study of the Efficacy and Safety of Fixed-Dose Brexpiprazole 2 mg/d as Adjunctive Treatment of Adults With Major Depressive Disorder.
CONCLUSIONS: This study adds to the substantial body of evidence for the efficacy and tolerability of brexpiprazole as adjunctive treatment in patients with MDD and inadequate response to ADTs. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02196506; EudraCT number: 2014-000062-22​​​. PMID: 29873953 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - June 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Dose Increase Versus Unchanged Continuation of Antidepressants After Initial Antidepressant Treatment Failure in Patients With Major Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized, Double-Blind Trials.
CONCLUSIONS: With clinically and statistically nonsignificant effect estimates, there is evidence from RCTs against increasing the dose of SSRIs (with the possible exception of citalopram) in adult patients with major depression and ATF. Dose increase with other antidepressants (eg, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, monoamine oxidase inhibitors) and in other patient groups (minor depression, children and adolescents) or after long periods of first-line antidepressant therapy (ie, 8 weeks) have not been or not been sufficiently studied and, at this time, cannot be recommended in clinic...
Source: Journal of Clinical Psychiatry - June 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Risk Factors Associated With Antidepressant Exposure and History of Antidepressant-Induced Mania in Bipolar Disorder.
CONCLUSIONS: These data suggest that there are certain identifiable factors associated with antidepressant exposure in bipolar disorder patients, and some of these, specifically female sex, are also associated with a history of AIM. These data may be useful in designing prospective trials to identify interventions that can reduce the risk of this adverse outcome. PMID: 29873955 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - June 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Cognitive Effects of MIN-101 in Patients With Schizophrenia and Negative Symptoms: Results From a Randomized Controlled Trial.
CONCLUSIONS: Results suggest a possible benefit of MIN-101 on cognitive performance in individuals with schizophrenia with stable positive symptoms and concurrent clinically significant negative symptoms. TRIAL REGISTRATION: EU Clinical Trials Register identifier: 2014-004878-42​. PMID: 29873956 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - June 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Incidence of, Risk Factors for, and Changes Over Time in Treatment-Resistant Depression in Denmark: A Register-Based Cohort Study.
CONCLUSIONS: About 14% of patients with depression developed TRD during the first year after first hospital contact. The incidence was highest in patients with severe depression and was relatively stable over time. Various definitions of TRD provided different estimates of the frequency of TRD but were all associated with disease severity. PMID: 29873959 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - June 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

US Food and Drug Administration's Approval of Aripiprazole Tablets With Sensor: Our Perspective.
Authors: Lee DJ, Farchione TR, Mathis MV, Muniz J, Muoio BM PMID: 29873960 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - June 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Valproate in Pregnancy: Recent Research and Regulatory Responses.
Authors: Andrade C Abstract Valproate and formulations thereof are approved for the management of seizure disorders, bipolar disorder, and migraine. Valproate is also used for many off-label indications. Unfortunately, data from observational studies indicate that valproate is perhaps the most teratogenic drug in the neuropsychiatric pharmacopeia. It is significantly more teratogenic than many other antiepileptic drugs (AEDs). In observational studies, gestational exposure to valproate is also associated with higher risks of cognitive, language, and psychomotor delay during early childhood and possibly with an incr...
Source: Journal of Clinical Psychiatry - June 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Internet Addiction and Its Relationship With Suicidal Behaviors: A Meta-Analysis of Multinational Observational Studies.
CONCLUSIONS: This meta-analysis provides evidence that internet addiction is associated with increased suicidality even after adjusting for potential confounding variables including depression. However, the evidence was derived mostly from cross-sectional studies. Future prospective studies are necessary to confirm these findings. PMID: 29877640 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - June 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Association of Cannabis With Long-Term Clinical Symptoms in Anxiety and Mood Disorders: A Systematic Review of Prospective Studies.
CONCLUSIONS: Recent cannabis use was associated with negative long-term symptomatic and treatment outcomes across AMD. The findings should be interpreted with caution, considering the observational designs across studies and the biases associated with the samples (eg, inpatients) and sources of cannabis consumed (ie, unregulated sources). Nonetheless, clinicians can use the insight gained to inform their own and their patients' knowledge concerning potential risks of cannabis with regard to symptoms of AMD. PMID: 29877641 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - June 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Revisiting the Abnormal Involuntary Movement Scale: Proceedings From the Tardive Dyskinesia Assessment Workshop.
CONCLUSIONS: For both research and clinical practice, the AIMS is a valid measure for assessing TD and the effects of treatment, but alternative analyses of AIMS data (eg, effect size, minimal clinically important difference, response analyses, category shifts) may provide broader evidence of clinical effectiveness. No single analysis of AIMS data can be considered the standard of clinical efficacy; multiple analytic approaches are recommended. PMID: 29742330 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - May 11, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Youth With Autism Spectrum Disorder in the Emergency Department.
CONCLUSIONS: This review found significant gaps in the literature related to ED service use by youth with ASD. More research is needed to avoid unnecessary ED utilization and hospitalization, reduce medical costs, and improve outcome for youth with ASD. PMID: 29742331 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - May 11, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Clinical Features of Auditory Hallucinations in Patients With Dementia With Lewy Bodies: A Soundtrack of Visual Hallucinations.
Authors: Tsunoda N, Hashimoto M, Ishikawa T, Fukuhara R, Yuki S, Tanaka H, Hatada Y, Miyagawa Y, Ikeda M Abstract OBJECTIVE: Auditory hallucinations are an important symptom for diagnosing dementia with Lewy bodies (DLB), yet they have received less attention than visual hallucinations. We investigated the clinical features of auditory hallucinations and the possible mechanisms by which they arise in patients with DLB. METHODS: We recruited 124 consecutive patients with probable DLB (diagnosis based on the DLB International Workshop 2005 criteria; study period: June 2007-January 2015) from the dementia referral...
Source: Journal of Clinical Psychiatry - May 11, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Risk of Type 2 Diabetes in Adolescents and Young Adults With Attention-Deficit/Hyperactivity Disorder: A Nationwide Longitudinal Study.
DISCUSSION: Adolescents and young adults with ADHD were more likely than non-ADHD controls to develop type 2 DM in later life. In addition, those with ADHD taking atypical antipsychotics exhibited a higher risk. Although correlation does not equal causation, our findings merit further study about the relationship between ADHD and type 2 DM. PMID: 29727071 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - May 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Randomized Controlled Trials of Psychoeducation Modalities in the Management of Bipolar Disorder: A Systematic Review.
CONCLUSIONS: Future studies may include direct comparisons of different psychoeducation modalities to elucidate specific benefits of unique psychoeducation interventions at different phases of bipolar disorder. PMID: 29727072 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - May 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Efficacy, Safety, and Durability of Repeated Ketamine Infusions for Comorbid Posttraumatic Stress Disorder and Treatment-Resistant Depression.
Authors: Albott CS, Lim KO, Forbes MK, Erbes C, Tye SJ, Grabowski JG, Thuras P, Batres-Y-Carr TM, Wels J, Shiroma PR Abstract OBJECTIVE: The present study examined the efficacy, safety, and durability of repeated ketamine infusions for the treatment of comorbid posttraumatic stress disorder (PTSD) and treatment-resistant depression (TRD) in a sample of veterans. METHODS: Individuals with comorbid DSM-5-defined PTSD and DSM-IV-defined major depressive disorder (N = 15) received 6 intravenous ketamine infusions (0.5 mg/kg) on a Monday-Wednesday-Friday schedule over a 12-day period from May 2015 to June 2016. Data...
Source: Journal of Clinical Psychiatry - May 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Distinguishing Between Borderline Personality Disorder and Bipolar Disorder.
Authors: di Giacomo E, Colmegna F, Aspesi F, Dakanalis A, Clerici M PMID: 29718595 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - May 4, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Dr Gonzalez-Pinto and Colleagues Reply.
Authors: Gonzalez-Pinto A, Oquendo MA, Stanley B, de la Rosa I, Garcia G, Liu SM, Blanco C PMID: 29718596 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - May 4, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

No Changes in Gray Matter Density or Cortical Thickness in Late-Life Minor Depression.
Authors: Polyakova M, Mueller K, Sander C, Beyer F, Witte V, Lampe L, Then F, Riedel-Heller S, Hoffmann KT, Villringer A, Schroeter ML, Schoenknecht P PMID: 29718597 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - May 4, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Does a Meta-Analysis of Sleep Deprivation Studies Demonstrate Efficacy?
Authors: Stewart JW PMID: 29718598 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - May 4, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Drs Boland and Gehrman Reply.
Authors: Boland EM, Gehrman PR PMID: 29718599 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - May 4, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Relative Efficacy and Acceptability of Antidepressant Drugs in Adults With Major Depressive Disorder: Commentary on a Network Meta-Analysis.
Authors: Andrade C Abstract A large number of antidepressant drugs are available across the world. All have been compared against placebo, and many have been compared with some but not all other antidepressants. There is therefore little information about a hierarchy of the efficacy and acceptability of these drugs. About 9 years ago, a network meta-analysis attempted to rank the efficacy and acceptability of 12 newer antidepressant drugs in adults with major depressive disorder. Very recently, this network meta-analysis was updated to include 21 antidepressant drugs, most of which were introduced during the 1980s ...
Source: Journal of Clinical Psychiatry - May 4, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Diagnosing Bipolar Disorder in Pediatric Patients.
Authors: Chang KD Abstract As many as 2 million youths in the US alone could have bipolar disorder. In this CME brief report, get up-to-date on common presentations of pediatric bipolar disorder, DSM-5 diagnostic criteria, and structured interviews and screening tools that can help you detect manic symptomatology. PMID: 29718601 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - May 4, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Treating Bipolar Disorder in Adolescents.
Authors: Findling RL Abstract How do you select among treatments for bipolar disorder in adolescents? Check out this brief report activity to explore the efficacy and safety of lithium, anticonvulsants, and atypical antipsychotics in the treatment of adolescent bipolar disorder. Plus, receive guidance for monitoring for common adverse effects, such as weight gain and fatigue. PMID: 29718602 [PubMed - in process] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - May 4, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

A Commentary on Existential Psychopharmacologic Clinical Practice: Advocating a Humanistic Approach to the "Med Check".
A Commentary on Existential Psychopharmacologic Clinical Practice: Advocating a Humanistic Approach to the "Med Check". J Clin Psychiatry. 2018 Apr 24;79(4): Authors: Ghaemi SN, Glick ID, Ellison JM PMID: 29701934 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - April 29, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Risk Factors for Overdose in Treatment-Seeking Youth With Substance Use Disorders.
We examined the medical records of 200 patients (157 males and 43 females) with a mean ± SD age of 20.2 ± 2.8 years. At intake, 58 patients (29%) had a history of OD, and 62% of those patients had a history of unintentional OD only (n = 36). Youth with ≥ 2 SUDs were 3 times more likely to have a history of OD compared to youth with 1 SUD (all P
Source: Journal of Clinical Psychiatry - April 29, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

The Impact of Captivity and Posttraumatic Stress Disorder on Cognitive Performance Among Former Prisoners of War: A Longitudinal Study.
This study assesses the effect of captivity, PTSD trajectories, and the accumulating differential effect in the prediction of cognitive performance. METHODS: This longitudinal research includes 4 assessments (1991 [T1], 2003 [T2], 2008 [T3], 2015 [T4]) of Israeli ex-POWs and comparable combatants from the 1973 Yom Kippur War. Accordingly, 95 ex-POWs and 26 comparable combatants were included in this study. PTSD was assessed according to the DSM-IV, and cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). RESULTS: Ex-POWs reported higher levels of PTSD symptoms compared to controls (P =...
Source: Journal of Clinical Psychiatry - April 29, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Mediation Analyses of Insight, Quality of Life, Depression, and Suicidality: Results From the FACE-SZ Cohort.
CONCLUSIONS: Insight appears to be an indirect risk factor for suicide in patients with schizophrenia, with the link being mediated by poorer QoL and worse underlying depression, mainly by a sequential pathway but also by a less important parallel pathway. PMID: 29701937 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - April 29, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Childhood Adversity and Schizophrenia: The Protective Role of Resilience in Mental and Physical Health and Metabolic Markers.
CONCLUSIONS: To our knowledge, this is the first study to quantitatively assess effects of both childhood trauma and resilience in schizophrenia on health, notably metabolic function. Interventions to bolster resilience in the general population and in people with schizophrenia may improve outcomes for those with a history of childhood adversity. PMID: 29701938 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - April 29, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Bilateral Repetitive Transcranial Magnetic Stimulation Decreases Suicidal Ideation in Depression.
Authors: Weissman CR, Blumberger DM, Brown PE, Isserles M, Rajji TK, Downar J, Mulsant BH, Fitzgerald PB, Daskalakis ZJ Abstract OBJECTIVE: The purpose of this study was to evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on suicidal ideation in patients with treatment-resistant major depression (TRD) (patients who failed to clinically respond to at least 2 medication trials). METHODS: We pooled data from 2 published prospective randomized controlled trials of rTMS applied to the dorsolateral prefrontal cortex in patients with TRD. We compared the effect of bilateral, left unilateral,...
Source: Journal of Clinical Psychiatry - April 29, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Prevalence of Impulsive-Compulsive Symptoms in Elderly Parkinson's Disease Patients: A Case-Control Study.
CONCLUSIONS: Our data confirm a high prevalence of ICD symptoms in elderly PD patients, approximately twice that seen in the general population. PMID: 29702754 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - April 29, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Association of Up-Regulated Plasma Adiponectin With Risk of Incident Depression in a Community-Dwelling Elderly Population.
CONCLUSIONS: Up-regulation of plasma adiponectin may precede the onset of clinically significant depression in the elderly, and thus plasma adiponectin level is a potential candidate marker for the risk of depression. PMID: 29702755 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - April 29, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Antipsychotic-Free Status in Community-Dwelling Patients With Schizophrenia in China: Comparisons Within and Between Rural and Urban Areas.
This study examined the rural-urban differences among antipsychotic-free community-dwelling individuals with schizophrenia in China. METHODS: Data on 1,365 community-dwelling patients with schizophrenia (n = 742 in a rural area and n = 623 in an urban area) with diagnoses according to DSM-IV or ICD-10 were collected by interviews during 2013-2014 and 2015-2016. Data on patients' sociodemographic and clinical characteristics, prescriptions of psychotropic drugs, and antipsychotic treatment status were recorded using a standardized protocol and data collection procedure. RESULTS: The prevalence of antipsychotic-free ...
Source: Journal of Clinical Psychiatry - April 29, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Demographic, Economic, and Clinical Correlates of Depression Treatment Response in an Underserved Primary Care Population
Authors: Mittal D, Chekuri L, Lu L, Fortney JC Abstract Objective: To examine demographic, economic, and clinical correlates of depression treatment outcomes in a rural low-income population served by federally qualified health centers (FQHCs). Method: The current study utilized data collected during a pragmatic comparative effectiveness trial (N = 364) that was conducted at 9 FQHC clinics between November 2007 and June 2009. Participants were randomly assigned to either telemedicine-based collaborative care or practice-based collaborative care. Depression severity was measured at baseline and at 12-month follo...
Source: Journal of Clinical Psychiatry - April 22, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Executive Function Predicts Antidepressant Treatment Noncompletion in Late-Life Depression.
Authors: Cristancho P, Lenze EJ, Dixon D, Miller JP, Mulsant BH, Reynolds CF, Butters MA Abstract OBJECTIVE: To examine whether executive function (EF) is associated with nonremission and noncompletion of antidepressant pharmacotherapy in older adults with depression. DESIGN: In this prospective study (July 2009 to May 2014), older adults (aged ≥ 60 years; n = 468) with a DSM-IV-defined major depressive episode diagnosed via structured interview received 12 weeks of venlafaxine extended release with the goal of achieving remission. A hypothesis was made that worse baseline EF would predict both nonremission ...
Source: Journal of Clinical Psychiatry - April 18, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Effects of Antipsychotics on Secular Mortality Trends in Patients With Alzheimer's Disease.
Authors: Nielsen RE, Valentin JB, Lolk A, Andersen K Abstract OBJECTIVE: To investigate secular changes in mortality rates between patients with Alzheimer's disease (AD) and the general population as well as changes in antipsychotic drug treatment and the association between drug treatment and mortality in patients with AD in Denmark during a 12-year study period. METHODS: This nationwide, retrospective cohort study identified all-cause mortality in all Danish patients with incident ICD-10-defined AD from 2000 through 2011. The cumulative antipsychotic dosages from dementia diagnosis until end of study for each...
Source: Journal of Clinical Psychiatry - April 18, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Trajectories of Acute Antidepressant Efficacy: How Long to Wait for Response? A Systematic Review and Meta-Analysis of Long-Term, Placebo-Controlled Acute Treatment Trials.
CONCLUSIONS: In patients unresponsive to antidepressant pharmacotherapy, improvements in psychopathology can be expected with ongoing antidepressant treatment for up to 3 months. After 8 weeks of treatment, improvement with ongoing monotherapy is relatively small. PMID: 29659207 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - April 18, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Posttraumatic Stress Disorder as a Significant Correlate of Voluntary Antiretroviral Treatment Interruption in Adult HIV-Infected Patients Followed up in French Hospitals: Data From the ANRS-VESPA2 National Survey.
CONCLUSIONS: PTSD is highly prevalent in HIV-infected patients followed up in French hospitals and is a significant predictor of VTI. PTSD is a psychiatric disorder that is still underdiagnosed and undertreated in many countries despite its negative consequences on health behaviors. As there is evidence of effective treatment for PTSD, HIV care providers need to be trained in screening for this disorder. PMID: 29659208 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - April 18, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Improving the Diagnosis and Treatment of Pediatric Bipolar Disorder.
Authors: Findling RL, Chang KD Abstract ​​Reconsidering Insomnia as a Disorder Rather Than Just a Symptom in Psychiatric Practice Click to enlarge page Awareness of the prevalence and impact of bipolar disorder in pediatric patients has grown in recent years. Youths with this disorder are at risk for poor long-term outcomes, but with careful screening, clinicians may be able to detect early signs or subthreshold symptoms and provide a timely diagnosis and effective treatment. Although several pharmacologic options are available for patients aged 10 years and up, they differ in their safety and tolerability prof...
Source: Journal of Clinical Psychiatry - April 18, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Toward Understanding Sex Differences in the Prevalence of Posttraumatic Stress Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions.
Authors: Blanco C, Hoertel N, Wall MM, Franco S, Peyre H, Neria Y, Helpman L, Limosin F Abstract BACKGROUND: It is unclear whether the higher prevalence of posttraumatic stress disorder (PTSD) in women than in men is due to sex differences in the prevalence of the exposure to traumatic events or to differences in vulnerability to traumatic events among those exposed to them. METHODS: We applied mediation and moderated mediation models to a large nationally representative sample of US adults (N = 34,653) drawn from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. RES...
Source: Journal of Clinical Psychiatry - April 18, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Ketamine for Depression, 6: Effects on Suicidal Ideation and Possible Use as Crisis Intervention in Patients at Suicide Risk.
This article examines the benefits of ketamine in patients with suicidal ideation with particular focus on the findings of recent RCTs and meta-analyses. Important findings are that a single dose of ketamine is associated with antisuicidal benefits that emerge within an hour of administration and persist for up to a week. The benefits are seen in patients with mild as well as clinically significant suicidal ideation. The benefits are observed in midazolam- as well as saline-controlled trials. Effect sizes are medium to large. The improvement in suicidal ideation is only partly explained by improvement in depression severit...
Source: Journal of Clinical Psychiatry - April 18, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Treatment of Complicated Grief in Survivors of Suicide Loss: A HEAL Report.
This report provides data on the acceptability and effectiveness of antidepressant medication and complicated grief therapy (CGT), a CG-targeted psychotherapy, for suicide loss survivors with CG identified by an Inventory of Complicated Grief score ≥ 30. METHODS: This is a secondary analysis of data collected from March 2010 to September 2014 for a 4-site, double-blind, placebo-controlled randomized trial comparing the effectiveness of antidepressant medication alone or in combination with CGT for participants with CG (score ≥ 30 on the Inventory of Complicated Grief) who were bereaved by suicide (SB; n = 58), ac...
Source: Journal of Clinical Psychiatry - April 5, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Relationships Between Self-Injurious Behaviors, Pain Reactivity, and β-Endorphin in Children and Adolescents With Autism.
The objective of this study was to examine the relationships between SIB, pain reactivity, and β-endorphin levels in autism. METHODS: Study participants were recruited between 2007 and 2012 from day care centers and included 74 children and adolescents diagnosed with autism (according to DSM-IV-TR, ICD-10, and CFTMEA) and intellectual disability. Behavioral pain reactivity and SIB were assessed in 3 observational situations (parents at home, 2 caregivers at day care center, a nurse and child psychiatrist during blood drawing) using validated quantitative and qualitative scales. Plasma β-endorphin concentratio...
Source: Journal of Clinical Psychiatry - April 5, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

The Mixed Opioid Receptor Antagonist Naltrexone Mitigates Stimulant-Induced Euphoria: A Double-Blind, Placebo-Controlled Trial of Naltrexone.
CONCLUSIONS: Preclinical findings are extended to humans showing that naltrexone may mitigate stimulant-associated euphoria. Our findings provide support for further studies combining opioid receptor antagonists with stimulants to reduce abuse potential. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01673594. PMID: 29617066 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - April 5, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Motivational Interviewing: Overcoming Disparities in Pharmacotherapy Engagement.
Authors: Lewis-Fernández R, Coombs AA, Balán IC, Interian A PMID: 29570964 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - March 25, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Can Aripiprazole Worsen Psychosis in Schizophrenia? A Meta-Analysis of Double-Blind, Randomized, Controlled Trials.
CONCLUSIONS: Findings suggest that there is no direct evidence that a switch to aripiprazole is related to risk of psychotic worsening in participants in clinical trials, although a switch to aripiprazole may be associated with a higher risk of study discontinuation due to lack of efficacy. PMID: 29570965 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - March 25, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Is Cannabis Use Associated With Increased Risk of Cigarette Smoking Initiation, Persistence, and Relapse? Longitudinal Data From a Representative Sample of US Adults.
CONCLUSIONS: Cannabis use was associated with increased initiation of, persistence of, and relapse to cigarette smoking. Additional attention to cannabis use in tobacco control efforts and in clinical settings aimed at reducing cigarette smoking and smoking-related negative consequences may be warranted. PMID: 29570966 [PubMed - as supplied by publisher] (Source: Journal of Clinical Psychiatry)
Source: Journal of Clinical Psychiatry - March 25, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research

Tardive Dyskinesia: Recognition, Patient Assessment, and Differential Diagnosis.
Authors: Jain R, Correll CU Abstract Tardive dyskinesia (TD) is an involuntary movement disorder associated with antipsychotic treatment. Because of the serious and potentially irreversible nature of TD, accurate diagnosis is crucial. However, diagnosing TD can be challenging, since the subtle and often fluctuating symptoms can be easily mistaken for symptoms of mental illness or other side effects. Although the risk of developing TD in relation to treatment with second-generation antipsychotics is lower than that associated with first-generation antipsychotics, the risk still exists and may be greater than once be...
Source: Journal of Clinical Psychiatry - March 25, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research