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Journal of Clinical Psychiatry

Sudie E Back, Jenna L McCauley, Kristina J Korte, Daniel F Gros, Virginia Leavitt, Kevin M Gray, Mark B Hamner, Stacia M DeSantis, Robert Malcolm, Kathleen T Brady, Peter W Kalivas
OBJECTIVE: The antioxidant N-acetylcysteine is being increasingly investigated as a therapeutic agent in the treatment of substance use disorders (SUDs). This study explored the efficacy of N-acetylcysteine in the treatment of posttraumatic stress disorder (PTSD), which frequently co-occurs with SUD and shares impaired prefrontal cortex regulation of basal ganglia circuitry, in particular at glutamate synapses in the nucleus accumbens. METHODS: Veterans with PTSD and SUD per DSM-IV criteria (N = 35) were randomly assigned to receive a double-blind, 8-week course of N-acetylcysteine (2,400 mg/d) or placebo plus cognitive-behavioral therapy for SUD (between March 2013 and April 2014)...
October 11, 2016: Journal of Clinical Psychiatry
Guoyuan Sui, Bochen Pan, Guangcong Liu, Guangying Liu, Lie Wang
OBJECTIVE: Epidemiologists have explored the relationship between maternal postnatal depression (PND) and the intelligence quotient (IQ) of the resulting offspring, but the results remain inconclusive. This study aims to analyze the literature regarding the association between maternal PND and a child's IQ. DATA SOURCES: A search of articles in PubMed, Web of Science, and MEDLINE databases from inception to September 2015 was conducted and supplemented by a manual search of relevant reference lists...
October 11, 2016: Journal of Clinical Psychiatry
Wayne A Ray, Cecilia P Chung, Katherine T Murray, Kathi Hall, C Michael Stein
OBJECTIVE: Studies demonstrating that higher doses of citalopram (> 40 mg) and escitalopram (> 20 mg) prolong the corrected QT interval prompted regulatory agency warnings, which are controversial, given the absence of confirmatory clinical outcome studies. We compared the risk of potential arrhythmia-related deaths for high doses of these selective serotonin reuptake inhibitors (SSRIs) to that for equivalent doses of fluoxetine, paroxetine, and sertraline. METHODS: The Tennessee Medicaid retrospective cohort study included 54,220 persons 30-74 years of age without cancer or other life-threatening illness who were prescribed high-dose SSRIs from 1998 through 2011...
October 11, 2016: Journal of Clinical Psychiatry
Charmaine Tang, Mythily Subramaniam, Boon Tat Ng, Edimansyah Abdin, Lye Yin Poon, Swapna K Verma
OBJECTIVE: Early symptomatic response is pertinent in improving outcomes in first-episode psychosis. One of the ways in which this may be achieved is by reducing inappropriate delays in clozapine initiation. This study aimed to examine clozapine prescribing practices among clinicians by establishing the prevalence of clozapine use, identifying baseline clinical and demographic factors that were associated with clozapine use, examining outcomes in clozapine users versus nonusers, and identifying inappropriate antipsychotic prescription patterns prior to clozapine initiation...
October 11, 2016: Journal of Clinical Psychiatry
Charles M Richardson, Erica A Davis, Gopal R Vyas, Bethany A DiPaula, Robert P McMahon, Deanna L Kelly
OBJECTIVE: To determine if clozapine can be safely utilized in psychiatric patients with benign neutropenia. METHODS: A single-center, retrospective chart review study of records from 2001 to 2014 was conducted in an inpatient psychiatric hospital. Patients included had benign neutropenia prior to receiving clozapine and received clozapine using modified monitoring guidelines. All available laboratory values for absolute neutrophil count (ANC) before initiation and during treatment were evaluated...
October 11, 2016: Journal of Clinical Psychiatry
Virginia L Stauffer, Peng Liu, Celine Goldberger, Lauren B Marangell, Craig Nelson, Philip Gorwood, Maurizio Fava
OBJECTIVE: To identify symptoms potentially representative of a noradrenergic symptom cluster as possible predictors of response to the selective norepinephrine reuptake inhibitor (NRI) edivoxetine when used as monotherapy or adjunctive treatment in patients with DSM-IV-TR major depressive disorder (MDD). METHODS: Pooled data from 4 adjunctive treatment trials (selective serotonin reuptake inhibitor [SSRI] + edivoxetine 6-18 mg/d vs SSRI + placebo; N = 2,066) and data from 1 monotherapy trial (edivoxetine 6-18 mg/d versus placebo; N = 495) were used to identify predictors of response related to noradrenergic symptoms using a resampling-based ensemble tree method...
September 27, 2016: Journal of Clinical Psychiatry
Yuchen Li, Yajing Meng, Minlan Yuan, Ye Zhang, Zhengjia Ren, Yan Zhang, Hongru Zhu, Changjian Qiu, Wei Zhang
OBJECTIVE: We conducted a meta-analysis of the literature reporting neuroimaging in patients undergoing psychotherapy and pharmacotherapy for social anxiety disorder (SAD). DATA SOURCES: Using PubMed, MEDLINE, and Embase, we searched for English-language studies published between January 2000 and February 2015 with terms related to SAD, therapy, and neuroimaging. DATA SOURCES: Twelve studies were included with a total of 295 subjects with SAD before and after therapy from January 2000 to February 2015...
September 27, 2016: Journal of Clinical Psychiatry
Sara J Becker, Miriam M Midoun
OBJECTIVE: To systematically analyze the effects of direct-to-consumer advertising (DTCA) on patient requests for medication and physician prescribing across psychiatry-relevant studies. DATA SOURCES: MEDLINE, PsycINFO, Thomson Reuters' ISI Web of Knowledge, and Google Scholar were searched (1999-2014) using variations of the terms direct-to-consumer advertising and psychiatric. Reference lists and an online repository of DTCA manuscripts were also scrutinized. STUDY SELECTION: English-language studies collecting data at the point of service, focusing on or including psychiatric medication, and assessing the effects of DTCA on patient and/or physician behavior were included...
September 13, 2016: Journal of Clinical Psychiatry
Blair E Wisco, Brian P Marx, Mark W Miller, Erika J Wolf, Natalie P Mota, John H Krystal, Steven M Southwick, Robert H Pietrzak
OBJECTIVE: With the publication of DSM-5, important changes were made to the diagnostic criteria for posttraumatic stress disorder (PTSD), including the addition of 3 new symptoms. Some have argued that these changes will further increase the already high rates of comorbidity between PTSD and other psychiatric disorders. This study examined the prevalence of DSM-5 PTSD, conditional probability of PTSD given certain trauma exposures, endorsement of specific PTSD symptoms, and psychiatric comorbidities in the US veteran population...
September 13, 2016: Journal of Clinical Psychiatry
Kevin D Shield, Paul Kurdyak, Paul A Shuper, Jürgen Rehm
OBJECTIVE: First, to compare the level of disability and functioning of patients who access psychiatric emergency services by diagnosis and service use frequency. Second, to compare patients who access psychiatric emergency services to the general population in terms of demographics and the level of disability and functioning. METHODS: Data from 420 patients were obtained by time-based sampling from August 2011 to February 2012 in the emergency department of a psychiatric hospital that provides services to adolescents and adults...
September 13, 2016: Journal of Clinical Psychiatry
Froukje E de Vries, Danielle C Cath, Adriaan W Hoogendoorn, Patricia van Oppen, Gerrit Glas, Dick J Veltman, Odile A van den Heuvel, Anton J L M van Balkom
OBJECTIVE: The tic-related subtype of obsessive-compulsive disorder (OCD) has a distinct clinical profile. The course of tic-related OCD has previously been investigated in treatment studies, with inconclusive results. This study aimed to compare clinical profiles between tic-related and tic-free OCD patients and to establish the influence of tics on the 2-year natural course in adult OCD patients. METHODS: Within the Netherlands OCD Association cohort, 377 patients with a current DSM-IV diagnosis of OCD were divided into a tic-related group (28%) and a tic-free group and compared on clinical variables with t tests or χ² tests...
September 13, 2016: Journal of Clinical Psychiatry
Justin A Chen, Benjamin G Shapero, Nhi-Ha T Trinh, Trina E Chang, Susannah Parkin, Jonathan E Alpert, Maurizio Fava, Albert S Yeung
OBJECTIVE: Stigma has been proposed to be a major underlying factor contributing to lower rates of mental health service utilization among racial/ethnic minorities in the United States. Yet, surprisingly little research has specifically explored associations between stigma, race/ethnicity, and psychiatric morbidity. This study aims to assess the impact of stigmatizing attitudes on depression outcomes among a psychiatrically underserved, immigrant Chinese population. METHODS: Between 2009 and 2012, 190 Chinese immigrants with major depressive disorder as diagnosed by the Mini International Neuropsychiatric Interview were enrolled in a trial of culturally sensitive collaborative care for depression...
September 13, 2016: Journal of Clinical Psychiatry
Karin M Burgerhout, Astrid M Kamperman, Sabine J Roza, Mijke P Lambregtse-Van den Berg, Kathelijne M Koorengevel, Witte J G Hoogendijk, Steven A Kushner, Veerle Bergink
OBJECTIVE: Postpartum psychosis is an acute and severe mood disorder. Although the prognosis is generally good, postpartum psychosis is a highly stressful life-event presumed to have a major impact on functioning and well-being beyond the acute stage of the illness. We studied functional recovery, including psychosocial functioning and the presence of psychological distress, in patients with a recent diagnosis of postpartum psychosis. METHODS: Seventy-eight patients with postpartum psychosis consecutively admitted for inpatient hospitalization between 2005 and 2011 were assessed 9 months postpartum...
September 13, 2016: Journal of Clinical Psychiatry
Katleen Geladé, Tieme W P Janssen, Marleen Bink, Rosa van Mourik, Athanasios Maras, Jaap Oosterlaan
OBJECTIVE: The efficacy of neurofeedback as a treatment for attention-deficit/hyperactivity disorder (ADHD), and whether neurofeedback is a viable alternative for stimulant medication, is still an intensely debated subject. The current randomized controlled trial compared neurofeedback to (1) optimally titrated methylphenidate and (2) a semi-active control intervention, physical activity, to account for nonspecific effects. METHODS: A multicenter 3-way parallel-group study with balanced randomization was conducted...
September 13, 2016: Journal of Clinical Psychiatry
Catherine G Coughlin, Ewgeni Jakubovski, Michael H Bloch
OBJECTIVE: Selective serotonin reuptake inhibitors are first-line treatment for major depressive disorder (MDD), but their impact on suicidal ideation is equivocal. Our goal is to examine the time course and clinical predictors of citalopram-induced suicidal ideation during phase 1 of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. METHODS: Of the 4,041 subjects with DSM-IV nonpsychotic MDD in the STAR*D trial phase 1 (2001-2006), we included in our analysis 3,577 subjects who reported side-effect data and had received citalopram (20-60 mg/d) for 8-14 weeks...
September 13, 2016: Journal of Clinical Psychiatry
Robert M Post, Lori L Altshuler, Ralph Kupka, Susan L McElroy, Mark A Frye, Michael Rowe, Heinz Grunze, Trisha Suppes, Paul E Keck, Gabriele S Leverich, Willem A Nolen
OBJECTIVE: The age at onset of bipolar disorder varies greatly in different countries and continents. The association between load of family history of psychiatric illness and age at onset has not been adequately explored. METHODS: 979 outpatients with bipolar disorder (from 4 sites in the United States and 3 in the Netherlands and Germany) gave informed consent and completed a questionnaire about their demographics, age at onset of illness, and family history of unipolar and bipolar disorder, alcohol and substance abuse comorbidity, suicide attempts, and "other" illnesses in their parents, 4 grandparents, and any offspring...
September 13, 2016: Journal of Clinical Psychiatry
Erika F H Saunders, Christopher E Ramsden, Mostafa S Sherazy, Alan J Gelenberg, John M Davis, Stanley I Rapoport
OBJECTIVE: There is growing evidence that inflammation is an important mediator of pathophysiology in bipolar disorder. The omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acid (PUFA) metabolic pathways participate in several inflammatory processes and have been linked through epidemiologic and clinical studies to bipolar disorder and its response to treatment. We review the data on PUFAs as biomarkers in bipolar disorder and n-3 PUFA used as treatment for bipolar disorder. DATA SOURCES: PubMed and CINAHL were searched for articles on PUFA and bipolar disorder published in the English language through November 6, 2013, with an updated search conducted on August 20, 2015...
September 13, 2016: Journal of Clinical Psychiatry
Timothy E Wilens, Joseph Biederman, MaryKate Martelon, Courtney Zulauf, Jesse P Anderson, Nicholas W Carrellas, Amy Yule, Janet Wozniak, Ronna Fried, Stephen V Faraone
OBJECTIVE: Bipolar disorder (BPD) is a highly morbid disorder increasingly recognized in adolescents. The aim of this study was to examine the relative risk for substance use disorders (SUDs; alcohol or drug abuse or dependence) and cigarette smoking in adolescents with BPD. METHODS: We evaluated the relative risk for SUDs and cigarette smoking in a case-controlled, 5-year prospective follow-up of adolescents with (n = 105, mean ± SD baseline age = 13.6 ± 2.5 years) and without ("controls"; n = 98, baseline age = 13...
August 30, 2016: Journal of Clinical Psychiatry
Qiang Li, Zhe Li, Wei Li, Yi Zhang, Yarong Wang, Jia Zhu, Jiajie Chen, Yongbin Li, Xuejiao Yan, Jianjun Ye, Linbin Li, Wei Wang, Yijun Liu
BACKGROUND: Craving is associated with a high probability of relapse. However, the relationship between functional connectivity in the default mode network (DMN) during resting state and basal craving of heroin-dependent individuals remains unknown. METHODS: Data used in the present study were collected between August 10, 2009, and June 28, 2011. Twenty-four male heroin-dependent individuals based on DSM-IV criteria and 20 male healthy control subjects participated in a study of resting-state functional magnetic resonance imaging...
August 30, 2016: Journal of Clinical Psychiatry
Thiago G Pianca, Luis Augusto Rohde, Ronaldo L Rosa, Ana Paula A Begnis, Pedro B Ferronatto, Mariana C Jensen, Flavio Pechansky, Keila Maria Mendes Ceresér, Victoria P Fairchild, Claudia M Szobot
OBJECTIVE: To describe the clinical characteristics of adolescents with crack cocaine dependence and possible predictors of transition from drug experimentation to crack cocaine dependence. METHODS: This cross-sectional study enrolled a consecutive sample of 90 adolescents admitted to a psychiatric inpatient unit in the city of Porto Alegre in southern Brazil for crack cocaine detoxification between May 2011 and November 2012. Comorbid psychological conditions were assessed using the Kiddie-SADS-Present and Lifetime Version, and severity of drug use was assessed using the Teen Addiction Severity Index (T-ASI)...
August 30, 2016: Journal of Clinical Psychiatry
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