Showing papers in "The Canadian Journal of Psychiatry in 2010"
TL;DR: Bullying and peer victimization constitute more than correlates of suicidality, and future research with long-term follow-up should continue to identify specific causal paths between bullying and suicide.
Abstract: Objective:To review the research addressing the association of suicide and bullying, from childhood to young adulthood, including cross-sectional and longitudinal research findings.Method:Relevant publications were identified via electronic searches of PsycNet and MEDLINE without date specification, in addition to perusing the reference lists of relevant articles.Results:Cross-sectional findings indicate that there is an increased risk of suicidal ideation and (or) suicide attempts associated with bullying behaviour and cyberbullying. The few longitudinal findings available indicate that bullying and peer victimization lead tosuicidality but that this association varies by sex. Discrepancies between the studies available may be due to differences in the studies' participants and methods.Conclusions:Bullying and peer victimization constitute more than correlates of suicidality. Future research with long-term follow-up should continue to identify specific causal paths between bullying and suicide.
426 citations
TL;DR: Risk factors that predict Conduct disorder and delinquency include impulsiveness, low IQ and low school achievement, poor parental supervision, punitive or erratic parental discipline, cold parental attitude, child physical abuse, parental conflict, disrupted families, antisocial parents, large family size, low family income, antissocial peers, high delinquency rate schools, and high crime neighbourhoods.
Abstract: Conduct disorder (CD) and delinquency are behavioural problems involving violation of major rules, societal norms, and laws. The prevalence of CD and delinquency peaks in mid-to-late adolescence. Both show considerable continuity over time. The most important studies of CD and delinquency have prospective longitudinal designs, large community samples, repeated personal interviews, measures of many possible risk factors, and both self-reports and official measures of antisocial behaviour. The most important risk factors that predict CD and delinquency include impulsiveness, low IQ and low school achievement, poor parental supervision, punitive or erratic parental discipline, cold parental attitude, child physical abuse, parental conflict, disrupted families, antisocial parents, large family size, low family income, antisocial peers, high delinquency rate schools, and high crime neighbourhoods. However, for many risk factors, it is not known whether they have causal effects. Future research should examine changes in risk factors and changes in CD and delinquency to identify the risk factors that are causes and those that are merely markers of other risk mechanisms.
419 citations
TL;DR: Results of the STAR*D trial have shed important light on the effectiveness of current treatment strategies for patients with depression.
Abstract: Objective:The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial is the largest open-label, pragmatic trial that has been undertaken to examine the treatment of major depressive ...
306 citations
TL;DR: During the past 20 years, significant progress has been made in the identification and treatment of depression following stroke, and antidepressant treatment will likely play an increasing role in the management of patients with acute stroke.
Abstract: Objective
To review the world’s (English-language) publications related to depression following stroke.
283 citations
TL;DR: The MAKS was found to be a brief and feasible instrument for assessing and tracking stigma-related mental health knowledge and should be used in conjunction with other attitude- and behaviour-related measures.
Abstract: Objective:Stigma has been conceptualized as comprised of 3 constructs: knowledge (ignorance), attitudes (prejudice), and behaviour (discrimination). We are not aware of a psychometrically tested in...
256 citations
TL;DR: There is substantial excess mortality in people with mental illness for almost all psychiatric disorders and all main causes of death in developed countries, and whether it has changed over time is investigated.
Abstract: Objective: To investigate the burden of excess mortality among people with mental illness in developed countries, how it is distributed, and whether it has changed over time. Method: We conducted a systematic search of MEDLINE, restricting our attention to peer-reviewed studies and reviews published in English relating to mortality and mental illness. Because of the large number of studies that have been undertaken during the last 30 years, we have selected a representative cross-section of studies for inclusion in our review. Results: There is substantial excess mortality in people with mental illness for almost all psychiatric disorders and all main causes of death. Consistently elevated rates have been observed across settings and over time. The highest numbers of excess deaths are due to cardiovascular and respiratory diseases. With life expectancy increasing in the general population, the disparity in mortality outcomes for people with mental illness is increasing. Conclusions: Without the development of alternative approaches to promoting and treating the physical health of people with mental illness, it is possible that the disparity in mortality outcomes will persist.
239 citations
TL;DR: The clinical staging model, which defines not only the extent of progression of a disorder at a particular point in time but also where a person lies currently along the continuum of the course of an illness, is particularly useful as it differentiates early, milder clinical phenomena from those that accompany illness progression and chronicity.
Abstract: Most mental illnesses emerge during adolescence and early adulthood, with considerable associated distress and functional decline appearing during this critical developmental phase. Our current diagnostic system lacks therapeutic validity, particularly for the early stages of mental disorders when symptoms are still emerging and intensifying and have not yet stabilized sufficiently to fit the existing syndromal criteria. While this is, in part, due to the difficulty of distinguishing transient developmental or normative changes from the early symptoms of persistent and disabling mental illness, these factors have contributed to a growing movement for the reform of our current diagnostic system to more adequately inform the choice of therapeutic strategy, particularly in the early stages of a mental illness. The clinical staging model, which defines not only the extent of progression of a disorder at a particular point in time but also where a person lies currently along the continuum of the course of an illness, is particularly useful as it differentiates early, milder clinical phenomena from those that accompany illness progression and chronicity. This will not only enable clinicians to select treatments relevant to earlier stages of an illness, where such interventions are likely to be more effective and less harmful than treatments delivered later in the course of illness, but also allow a more efficient integration of our rapidly expanding knowledge of the biological, social, and psychological vulnerability factors involved in the development of mental illness into a useful diagnostic framework.
229 citations
TL;DR: In this paper, the authors provided a best estimate of the prevalence of psychiatric disorders among detained male adolescents, with particular emphasis on impairment, multi-informant assessment, and race or ethnicity.
Abstract: Objective: To provide a best estimate of the prevalence of psychiatric disorders among detained male adolescents, with particular emphasis on impairment, multi-informant assessment, and race or ethnicity. Method: Computer-assisted searches were executed to identify relevant studies. Results: Fifteen studies using adolescents as informants met inclusion criteria (n = 3401), of which only 2 reported within a subsample on parent-derived diagnoses. The mean prevalence of any disorder was 69.9% (95% CI 69.5% to 70.3%); with conduct disorder occurring most frequently (46.4%, 95% CI 45.6% to 47.3%), followed by substance use disorder (45.1%, 95% CI 44.6% to 45.5%), oppositional defiant disorder (19.8%, 95% CI 19.2% to 20.3%), and attention-deficit hyperactivity disorder (13.5%, 95% CI 13.2% to 13.9%). Although lower, rates for internalizing disorders were still substantial, with any anxiety disorder found in 15.9% (95% CI 15.6% to 16.1%), major depression in 12.0% (95% CI 11.7% to 12.2%), and posttraumatic stress disorder in 9.6% (95% CI 9.2% to 10.0%). Three studies reported on psychotic disorders, finding low rates (1.35%, 95% CI 1.32% to 1.39%). Estimates of prevalence were only marginally different when impairment was not required, while consistency between adolescents and parents was poor. Findings on the relations between race or ethnicity were too scarce and inconsistent to interpret. Conclusion: Detained male adolescents bear substantial mental health needs, emphasizing the need to organize effective mental health services for this troubled group. However, our knowledge on mental disorders in detained youth should be enhanced, in particular regarding the reliability of adolescents, compared with parent report, and whether clinically relevant differences exist by race or ethnicity.
201 citations
TL;DR: PID is aimed at appraising overall health through pluralistic descriptions and evaluative partnerships, and leading through a research program to more effective, integrative, and person-centred health care.
Abstract: Objectives:To review the conceptual bases of Person-centred Integrative Diagnosis (PID) as a component and contributor to person-centred psychiatry and medicine and to outline its design and development.Method:An analysis was conducted of the historical roots of person-centred psychiatry and medicine, tracing them back to ancient Eastern and Western civilizations, to the vicissitudes of modern medicine, to recent clinical and conceptual developments, and to emerging efforts to reprioritize medicine from disease to patient to person in collaboration with the World Medical Association, the World Health Organization, the World Organization of Family Doctors, the World Federation for Mental Health, and numerous other global health entities, and with the coordinating support of the International Network for Person-centered Medicine.Results:One of the prominent endeavours within the broad paradigmatic health development outlined above is the design of PID. This diagnostic model articulates science and humanism ...
145 citations
TL;DR: The BBGS features psychometric advantages for health care providers that should encourage clinicians and epidemiologists to consider current PG along with other problems and is practical for clinical application because it uses only 3 items and is easy to ask, answer, and include in all modes of interviewing, including self-administered surveys.
Abstract: Objective:To develop a pathological gambling (PG) screen for efficient application to the household population and for clinicians to use with treatment seekers.Method:We applied a series of multivariate discriminant functions to past-12-month Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)-based, gambling-related problems; the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) measured and collected this data. The NESARC conducted computer-assisted personal interviews with 43 093 households and identified the largest sample of pathological gamblers drawn from the general household population.Results:We created a 3-item, brief biosocial gambling screen (BBGS) with high sensitivity (Sensitivity = 0.96; 76 of 79 pathological gamblers correctly identified) and high specificiy (Specificity = 0.99; 10 892 of 11 027 nonpathological gamblers correctly identified).Conclusions:Major US studies reveal extensive comorbidity of PG with other mental...
128 citations
TL;DR: Time-sensitive modelling techniques that are able to incorporate multiple interacting factors across long periods of time, such as structural equation models, will be critical in understanding the complexity of causal and influencing factors from early development to the end stages of life.
Abstract: Life course epidemiology seeks to understand how determinants of health and disease interact across the span of a human life, and has made significant contributions to understanding etiological mechanisms in many chronic diseases, including schizophrenia. The life course approach is ideal for understanding depression: causation in depression appears to be multifactorial, including interactions between genes and stressful events, or between early life trauma and later stress in life; timing of onset and remission of depression varies widely, indicating differing trajectories of symptoms over long periods of time, with possible differing causes and differing outcomes; and early life events and development appear to be important risk factors for depression, including exposure to acute and chronic stress in the first years of life. To better understand etiology and outcome of depression, future research must move beyond basic epidemiologic techniques that link specific exposures to specific outcomes and embrace life course principles and methods. Time-sensitive modelling techniques that are able to incorporate multiple interacting factors across long periods of time, such as structural equation models, will be critical in understanding the complexity of causal and influencing factors from early development to the end stages of life. Using these models to identify key pathways that influence trajectories of depression across the life course will help guide prevention and intervention.
TL;DR: The barriers to mental health quality measurement are delineated, and strategies to enhance the development and use of quality measures by mental health providers, programs, payers, and other stakeholders are identified in the service of improving outcomes for people with mental health and substance use disorders.
Abstract: The purpose of this paper is to delineate the barriers to mental health quality measurement, and identify strategies to enhance the development and use of quality measures by mental health providers, programs, payers, and other stakeholders in the service of improving outcomes for individuals with mental health and substance use disorders. Key reasons for the lag in mental health performance measurement include lack of sufficient evidence regarding appropriate mental health care, poorly defined quality measures, limited descriptions of mental health services from existing clinical data, and lack of linked electronic health information. We discuss strategies for overcoming these barriers that are being implemented in several countries, including the need to have quality improvement as part of standard clinical training curricula, refinement of technologies to promote adequate data capture of mental health services, use of incentives to promote provider accountability for improving care, and the need for mental health researchers to improve the evidence base for mental health treatment.
TL;DR: Apathy is a frequent neuropsychiatric complication of stroke that, although often associated with depression and cognitive impairment, may occur independently of both and its presence has been consistently associated with greater functional decline.
Abstract: Objective:We will review the available evidence on the frequency, clinical correlates, mechanism, and treatment of apathy following strokeMethods:We have explored relevant databases (that is, PubM
TL;DR: It is found that antenatal depression and anxiety directly impact postpartum parenting stress, regardless of antenatal AD treatment, and Ongoing maternal mental illness in pregnancy is an important predictor of postpartums parenting stress.
Abstract: Objective:Postpartum depression has been associated with parenting stress, impacting attachment and child development. However, the relation between antenatal depression or anxiety and postpartum parenting stress has not been investigated. We studied the effect of antenatal depression and anxiety and treatment with selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors (antidepressants [ADs]) on postpartum parenting stress.Method:Ninety-four pregnant women (part of a larger study examining prenatal AD exposure on infants) were prospectively monitored for depression and anxiety during the third trimester and 3- and 6-months postpartum using the Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale. Parenting stress was assessed using the Parenting Stress Index—Short Form at 3- and 6-months postpartum.Results:Both antenatal third trimester depression and anxiety were significant predictors of 3- and 6-month postpartum parenting stress, after controlling ...
TL;DR: Sedative drug use is associated with a small but significant increase in mortality risk, and physicians should systematically consider possibilities for nonpharmacological treatment of sleep disturbances and anxiety.
Abstract: Objective: Although widely used in the general population, sleeping pills and minor tranquilizers, also known as antianxiety agents, have been associated with undesirable outcomes. Reports about the association of these drugs with an elevated mortality rate are inconsistent and controversial. This study was designed to assess the mortality hazard associated with anxiolytic and hypnotic drug use in the National Population Health Survey in Canada. It was hypothesized that anxiolytic and hypnotic drug use would be associated with an elevated mortality hazard. Method: A population-based sample of 14 117 people aged 18 to 102 years participated in a longitudinal panel survey, with data collected every second year from 1994 to 2007. The primary outcome measures reported in this study are self-report use of anxiolytic and hypnotic drugs, and death. Results: For respondents who reported anxiolytic or hypnotic drug use in the past month the odds of mortality were 3.22 times more (95% CI 2.70 to 3.84) than for those who did not use anxiolytic or hypnotic drugs in the past month. After controlling for confounding sociodemographic, lifestyle, and health factors (including depression), the odds ratio was reduced to 1.36 (95% CI 1.09 to 1.70) but remained significant. Conclusion: Sedative drug use is associated with a small but significant increase in mortality risk. Further research is required to confirm the mechanisms by which sedative drug use increases mortality risk. Where possible, physicians should systematically consider possibilities for nonpharmacological treatment of sleep disturbances and anxiety. Can J Psychiatry. 2010;55(9):558–567.
TL;DR: The ongoing global economic crisis may have contributed to the increased prevalence of major depressive disorder and no changes in the 12-month prevalence of social phobia, panic disorder, and generalized anxiety disorder were found.
Abstract: Objectives:The ongoing global economic crisis may have affected people's mental health. This study aimed to, among a sample of the working population, estimate and compare the prevalence of depress...
TL;DR: The development of specialty psychiatric programs aiming to identify youth in the early stages of evolving psychosis are substantially ahead of services for youth with major mood disorders, as well as for the optimal organization of clinical services for high-risk youth.
Abstract: Longitudinal high-risk research has provided convergent evidence that major mood and psychotic disorders often develop from nonspecific antecedents in predisposed people over time and development. For example, bipolar disorder (BD) appears to evolve from nonspecific childhood antecedents, including anxiety and sleep problems, followed by adjustment and minor mood disturbances through early adolescence, culminating in major mood episodes in later adolescence and early adulthood. Therefore, the current cross-sectional symptom-based diagnostic approach requires rethinking: it considers neither the familial risk nor the longitudinal clinical course, with the consequence that the early stages of illness are not recognized as belonging to the end-stage disorder. Emerging evidence of identifiable clinical stages in the development of BD has tremendous potential for early identification, development of stage-specific treatments, and advancing our understanding of the pathophysiology associated with illness onset and progression. The clinical staging model also has direct implications for the optimal organization of clinical services for high-risk youth. Specifically, specialty psychiatric programs are needed that break down traditional institutional barriers to provide surveillance and timely comprehensive psychiatric assessment during the entire risk period, from childhood through to early adulthood. In this regard, the development of specialty psychiatric programs aiming to identify youth in the early stages of evolving psychosis are substantially ahead of services for youth in the early stages of evolving major mood disorders.
TL;DR: This study provides additional evidence that the PDD rate is close to 1%.
Abstract: Objectives:The prevalence of pervasive developmental disorders (PDDs) has increased. There has been speculation regarding a role of thimerosal-containing vaccines (TCVs) in this trend. Our objectiv...
TL;DR: An integrated mobile crisis team formed in partnership between mental health services, municipal police, and emergency health services resulted in increased use by people in crisis, families, and service partners and reduced time spent on-scene and call-to-door time.
Abstract: Objectives:Police are often the front-line response to people experiencing mental health crises. This study examined the impact of an integrated mobile crisis team formed in partnership between men...
TL;DR: In this paper, the authors classified pathological gambling patients according to personality variables and described the subgroups at a clinical level using the Eysenck's Impulsivity Scales.
Abstract: Objective: To classify into subgroups a sample of pathological gambling (PG) patients according to personality variables and to describe the subgroups at a clinical level Method: PG patients (n = 1171) were assessed with the South Oaks Gambling Screen; the Temperament and Character Inventory-Revised; the Symptom Checklist-90-Revised; Eysenck's Impulsivity Scales, a diagnostic questionnaire for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) PG criteria; and the Structured Clinical Interview for the DSM-IV, Axis I disorders, substance use module Clinical measures were collected through a semi-structured interview We performed a 2-step cluster analysis based on the above-mentioned personality variables Clinical data were compared across clusters Results: Four clusters were generated Type I (disorganized and emotionally unstable) showed schizotypic traits, high impulsiveness, substance and alcohol abuse, and early age of onset, as well as psychopathological disturbances Type II (schizoid) showed high harm avoidance, social aloofness, and alcohol abuse Type III (reward sensitive) showed high sensation seeking and impulsiveness but no psychopathological impairments Type IV (high-functioning) showed a globally adaptive personality profile, low level of substance and alcohol abuse or smoking, and no psychopathological disturbances Conclusions: At least 4 types of PG patients may be identified Two types showed a response modulation deficit, but only one of them had severe psychopathological disturbances Two other types showed no impulsiveness or sensation seeking and one of them even exhibited good general functioning The different personality and clinical configuration of these clusters might be linked to different therapeutic approaches Can J Psychiatry 2010;55(8):498-506 Clinical Implications * At least 4 subtypes of pathological gamblers, with differing severity level, comorbidity, and personality profiles, may be distinguished * Only some groups show high impulsiveness and (or) high sensation seeking * PG is a highly heterogeneous disorder that may require different therapeutic approaches according to its specific characteristics Limitations * Our sample consisted of treatment-seeking PG patients, which may affect generalizability of findings * Most patients were mainly slot machine pathological gamblers * Comorbidity with Axis I disorders other than substance use disorders was not directly assessed Key Words: pathological gambling, subtypes, personality, impulsiveness, sensation seeking, harm avoidance, substance abuse, alcohol abuse Abbreviations used in this article DSM Diagnostic and Statistical Manual of Mental Disorders GSI Global Severity Index PG pathological gambling SCID Structured Clinical Interview for DSM-IV SCL-90-R Symptom Checklist-90 Items-Revised SOGS South Oaks Gambling Screen SUD substance use disorder TCI-R Temperament and Character Inventory-Revised The DSM-III1 included PG for the first time as an impulse control disorder SUDs are the most frequent comorbid features of PG, ranging from 30% to 70%2'3 Increasing evidence points to PG and other disorders of impulse control (for example, bulimia nervosa or sexual addictions) as part of an addictive spectrum sharing the same underlying biopsychosocial process, together with other types of addictions4 In this regard, PG has been considered as an addictive disorder4 or behavioural addiction5 In studies of alcohol- or cocaine-dependent patients, the presence of comorbidity with other SUDs frequently characterizes specific subgroups,6 and drug of choice is frequently associated with specific personality profiles7 Concerning personality, impulsiveness and sensation seeking have received much attention and, together with low reward-dependence (sociability and emotional dependence), cooperativeness and self-directedness (goal-directed behaviour) have been identified as risk factors for the development of PG and the modulation of gambling behaviour …
TL;DR: Cannabis use or a cannabis use disorder at a younger age in a group with an UHR for transition to psychosis is related to onset of high-risk symptoms for psychosis at a Younger age.
Abstract: Objective:Increasing interest in the prodromal stage of schizophrenia over the past decade led us to perform our study to monitor people at high risk for developing a psychosis. We hypothesized tha...
TL;DR: This study confirms a strong association between abortion and mental disorders and possible mechanisms of this relation are discussed.
Abstract: Objective: Most previous studies that have investigated the relation between abortion and mental illness have presented mixed findings. We examined the relation between abortion, mental disorders, and suicidality using a US nationally representative sample. Methods: Data came from the National Comorbidity Survey Replication (n = 3310 women, aged 18 years and older). The World Health Organization–Composite International Diagnostic Interview was used to assess mental disorders based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria and lifetime abortion in women. Multiple logistic regression analyses were employed to examine associations between abortion and lifetime mood, anxiety, substance use, eating, and disruptive behaviour disorders, as well as suicidal ideation and suicide attempts. We calculated the percentage of respondents whose mental disorder came after the first abortion. The role of violence was also explored. Population attributable fractions were calculated for significant associations between abortion and mental disorders. Results: After adjusting for sociodemographics, abortion was associated with an increased likelihood of several mental disorders—mood disorders (adjusted odds ratio [AOR] ranging from 1.75 to 1.91), anxiety disorders (AOR ranging from 1.87 to 1.91), substance use disorders (AOR ranging from 3.14 to 4.99), as well as suicidal ideation and suicide attempts (AOR ranging from 1.97 to 2.18). Adjusting for violence weakened some of these associations. For all disorders examined, less than one-half of women reported that their mental disorder had begun after the first abortion. Population attributable fractions ranged from 5.8% (suicidal ideation) to 24.7% (drug abuse). Conclusions: Our study confirms a strong association between abortion and mental disorders. Possible mechanisms of this relation are discussed.
TL;DR: Pilot data show the CPS is a valid screening measure of cognitive performance among adult psychiatric inpatients and higher scores on the CPS were associated with greater functional impairment, older age, and a greater prevalence of dementia diagnoses than lower CPS scores.
Abstract: Objective:The validity of the Cognitive Performance Scale (CPS) embedded in the Resident Assessment Instrument—Mental Health (RAI-MH) was evaluated among adult psychiatric inpatients.Methods:The CPS is a brief measure of cognitive performance, with scores ranging from 0 (intact) to 6 (very severe impairment). The CPS scores were compared with the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) scores for 215 adult psychiatric inpatients.Results:The CPS scores were significantly correlated with MMSE scores (r = −0.69, P < 0.001) and MoCA scores (r = −0.69, P < 0.001). Higher scores on the CPS were associated with greater functional impairment, older age, and a greater prevalence of dementia diagnoses than lower CPS scores.Conclusions:Pilot data show the CPS is a valid screening measure of cognitive performance among adult psychiatric inpatients. Additional research is needed to replicate our study using a larger sample with more diverse mental health conditions.
TL;DR: Normal sleep architecture is summarized, sleep abnormalities and comorbid sleep disorders seen in schizophrenia, as well as anxiety, cognitive, and substance abuse disorders are examined.
Abstract: Although the precise function of sleep is unknown, decades of research strongly implicate that sleep has a vital role in central nervous system (CNS) restoration, memory consolidation, and affect regulation. Slow-wave sleep (SWS) and rapid eye movement (REM) sleep have been of significant interest to psychiatrists; SWS because of its putative role in CNS energy recuperation and cognitive function, and REM sleep because of its suggested involvement in memory, mood regulation, and possible emotional adaptation. With the advent of the polysomnogram, researchers are now beginning to understand some of the consequences of disrupted sleep and sleep deprivation in psychiatric disorders. The same neurochemistry that controls the sleep-wake cycle has also been implicated in the pathophysiology of numerous psychiatric disorders. Thus it is no surprise that several psychiatric disorders have prominent sleep symptoms. This review will summarize normal sleep architecture, and then examine sleep abnormalities and comorbid sleep disorders seen in schizophrenia, as well as anxiety, cognitive, and substance abuse disorders.
TL;DR: Better social support is associated with significantly greater gain following cognitive restructuring and (or) exposure therapy for PTSD, and future interventions should consider augmenting social support as an adjunct to treatment.
Abstract: Objective:To understand what predicts good outcome in psychiatric treatments, thus creating a pathway to improving efficacy.Method:Our study investigated relations between predictor variables and o...
TL;DR: Past efficacy trials have strongly supported the position that SGAs are superior to FGAs in the treatment of schizophrenia and in side effect profile, and two large independent effectiveness trials have offered a strong challenge to these claims.
Abstract: Objective:To comprehensively review the 2 recent and large antipsychotic effectiveness trials for treatment of schizophrenia: the United Kingdom's Cost Utility of the Latest Antipsychotic Drugs in ...
TL;DR: Treatment with ADs for depression in CAD results in significant therapeutic effects without substantially increased rates of discontinuation.
Abstract: Objective:Depression occurs in 18% to 45% of patients with coronary artery disease (CAD) where it is associated with an increased risk of acute coronary events and mortality. Our objective was to q...
TL;DR: Schizophrenia continues to represent a treatment challenge, with many people demonstrating suboptimal response and poor functional outcome, but in light of existing evidence this warrants re-examination of clozapine.
Abstract: Objective:To review clozapine's position in treatment algorithms for schizophrenia.Method:Clozapine's status is reviewed in the context of its initial discovery and unique clinical and (or) pharmac...
TL;DR: Anosognosia is a relatively frequent complication of acute stroke and may become an excellent model to understand the mechanism of human awareness and the different strategies used to diagnose this phenomenon.
Abstract: Objective:To review the frequency, clinical correlates, and mechanism of anosognosia after stroke.Methods:We searched the most recent relevant literature on anosognosia after stroke and carried out...
TL;DR: People with developmental disability display unique hospitalization patterns, compared with the general population, and were more likely to have 2 or more hospitalizations during the year when comparing the study groups.
Abstract: Objective:To report national demographics and diagnostic profiles of people with developmental disability hospitalized for psychiatric reasons, and to contrast results to psychiatric hospitalizatio...