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Journal of Clinical Psychiatry

Joseph Biederman, Maura Fitzgerald, Anna-Mariya Kirova, K Yvonne Woodworth, Itai Biederman, Stephen V Faraone
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...
August 7, 2018: Journal of Clinical Psychiatry
Anita H Clayton, Joyce Tsai, Yongcai Mao, Andrei Pikalov, Antony Loebel
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)...
August 7, 2018: Journal of Clinical Psychiatry
Chittaranjan Andrade
Major congenital malformation risks in association with gestational exposure to antiepileptic drugs (AEDs) have been extensively studied. Less information is available on other adverse outcomes associated with the use of these drugs during pregnancy. 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...
July 31, 2018: Journal of Clinical Psychiatry
Nicolas Hoertel, Carlos Blanco, Mark Olfson, Maria A Oquendo, Melanie M Wall, Silvia Franco, Henri Leleu, Cédric Lemogne, Bruno Falissard, Frédéric Limosin
OBJECTIVE: Multiple factors have an impact on the risk of attempting suicide in depressed individuals. The elevated number of contributing factors and their frequent co-occurrence suggest the need to combine them in integrative models to develop more effective suicide prevention strategies. This report presents a comprehensive model of the 3-year risk of suicide attempt in individuals with major depressive episode (MDE) using a longitudinal nationally representative study, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; Wave 1, 2001-2002; Wave 2, 2004-2005)...
July 31, 2018: Journal of Clinical Psychiatry
M Selim Asmer, Julia Kirkham, Hailey Newton, Zahinoor Ismail, Heba Elbayoumi, Roxanne H Leung, Dallas P Seitz
OBJECTIVE: Little is known about the overall prevalence of major depressive disorder (MDD) in persons with dementia (ie, "depression in dementia": DpD). The aim of this systematic review and meta-analysis was to determine the prevalence and factors associated with DpD among older adults (age range 58.7-87.8 years). The protocol was registered in the PROSPERO registry (2015:CRD42015020681). DATA SOURCES: We searched the following electronic databases: MEDLINE (1946-February 2017), Embase (1980-2017 week 5), and PsycINFO (1967-February 2017) using medical subject headings and free-text search terms for studies in the English language...
July 31, 2018: Journal of Clinical Psychiatry
Samuel T Wilkinson, Rachel B Katz, Mesut Toprak, Ryan Webler, Robert B Ostroff, Gerard Sanacora
OBJECTIVE: Ketamine has emerged as a rapid-acting antidepressant, though controversy remains whether sufficient data exist to justify its use outside of research protocols. In October 2014, the authors' institution began providing ketamine as an off-label therapy on a case-by-case basis for patients unable to participate in research protocols. Here, the participant experience during 29 months of providing ketamine as a clinical treatment for severe and treatment-resistant mood disorders through February 2017 is described...
July 24, 2018: Journal of Clinical Psychiatry
Robert D Levitan, Anthony J Levitt, Erin E Michalak, Rachel Morehouse, Rajamannar Ramasubbu, Lakshmi N Yatham, Edwin M Tam, Raymond W Lam
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-TR criteria for MDD without a seasonal pattern were randomly assigned to light monotherapy, fluoxetine, combination light and fluoxetine, or double-placebo (inactivated negative ion generator plus placebo pill)...
July 24, 2018: Journal of Clinical Psychiatry
Xiang Yang Zhang, Xiangdong Du, Guangzhong Yin, Yingyang Zhang, Dachun Chen, Meihong Xiu, Changhong Wang, Ruilong Zhang, Ryan M Cassidy, Yuping Ning, Xingbing Huang, Jair C Soares
BACKGROUND: It is well established that patients with chronic schizophrenia have a substantially higher rate of attempted and completed suicide than the general population. However, the actual prevalence of suicide attempts at first-episode psychosis is relatively unknown. Previous studies showed that suicidal schizophrenia patients demonstrate higher cognitive function than nonsuicidal patients, though with inconsistent results. The aims of the study were to examine the prevalence of suicide attempts and the association of this prevalence with demographic and clinical variables and cognitive function in Chinese first-episode, drug-naive (FEDN) schizophrenia patients using a cross-sectional and case-control design...
July 24, 2018: Journal of Clinical Psychiatry
Ricardo Cáceda, Keith Bush, G Andrew James, Zachary N Stowe, Clint D Kilts
OBJECTIVE: A major target in suicide prevention is interrupting the progression from suicidal thoughts to action. Use of complex algorithms in large samples has identified individuals at very high risk for suicide. We tested the ability of data-driven pattern classification analysis of brain functional connectivity to differentiate recent suicide attempters from patients with suicidal ideation. METHODS: We performed a cross-sectional study using resting-state functional magnetic resonance imaging in depressed inpatients and outpatients of both sexes recruited from a university hospital between March 2014 and June 2016: recent suicide Attempters within 3 days of an attempt (n = 10), Suicidal Ideators (n = 9), Depressed Non-Suicidal Controls (n = 17), and Healthy Controls (n = 18)...
July 10, 2018: Journal of Clinical Psychiatry
K N Roy Chengappa, Jaspreet S Brar, Jessica M Gannon, Patricia J Schlicht
OBJECTIVE: To determine if adjunctive treatment with a standardized extract of Withania somnifera (WSE), with known anti-inflammatory and immunomodulating properties, improves psychopathology and stress in patients with schizophrenia or schizoaffective disorder (DSM-IV-TR). METHODS: Patients experiencing an exacerbation of symptoms were assigned to WSE (1,000 mg/d) or placebo for 12 weeks, added to their antipsychotic medication, in a random-assignment, double-blind, placebo-controlled study conducted from April 2013 to July 2016...
July 10, 2018: Journal of Clinical Psychiatry
Dennis Raven, Frederike Jörg, Ellen Visser, Robert A Schoevers, Albertine J Oldehinkel
OBJECTIVE: The aim of this study was to determine the relative importance of self-, parent-, and teacher-reported problem behavior for initial specialist mental health care use in adolescence and the extent to which the relative importance of each informant changes over time. METHODS: Data from the Dutch community-based cohort study TRacking Adolescents' Individual Lives Survey (TRAILS) were linked to administrative records of specialist mental health care organizations...
July 10, 2018: Journal of Clinical Psychiatry
Robin Emsley, Antti Ahokas, Aldo Suarez, Dragos Marinescu, Ivan Dóci, Andres Lehtmets, Vihra Milanova, Min Soo Lee, Roy Didi, Aleksander Araszkiewicz, Ahmad Hatim Sulaiman, Françoise Picarel Blanchot, Véronique Strijckmans Crutel, Catherine Antoine, Pierre-François Penelaud
OBJECTIVE: The present placebo-controlled study evaluated the efficacy and safety of 8 weeks of treatment with tianeptine 25-50 mg/d in elderly patients suffering from major depressive disorder (MDD) according to DSM-IV-TR. Escitalopram 5-10 mg/d was used as an active comparator. METHODS: Elderly outpatients aged at least 65 years with a primary diagnosis of moderate to severe episode of recurrent MDD were recruited by psychiatrists in 44 clinical centers in 10 countries from October 2013 to January 2016...
July 3, 2018: Journal of Clinical Psychiatry
Osamu Itani, Yoshitaka Kaneita, Kazuto Doi, Mikiko Tokiya, Maki Jike, Sachi Nakagome, Yuichiro Otsuka, Takashi Ohida
OBJECTIVE: To clarify the incidence of predictive risk factors for poor mental health status in Japanese adolescents. METHODS: In 2010, baseline surveys of first-year junior and senior high school students were conducted at 10 randomly selected junior high schools and 14 senior high schools in Japan. After 2 years, follow-up surveys were conducted on the same students. For both surveys, a self-administered questionnaire about mental health status and lifestyle, General Health Questionnaire-12 (GHQ-12), was provided to the students...
July 3, 2018: Journal of Clinical Psychiatry
Vilma Gabbay, Rachel D Freed, Carmen M Alonso, Stefanie Senger, Jill Stadterman, Beth A Davison, Rachel G Klein
OBJECTIVE: Reports are mixed on the efficacy of omega-3 fatty acids (O3FA) for the treatment of major depressive disorder (MDD), with only limited data in adolescents. The present trial aimed to investigate systematically the efficacy of O3FA as a monotherapy, compared to a placebo, in adolescents with MDD. Secondarily, we explored O3FA effects on anhedonia, irritability, and suicidality-all key features of adolescent MDD. METHODS: Fifty-one psychotropic medication-free adolescents with DSM-IV-TR diagnoses of MDD (aged 12-19 years; 57% female) were randomized to receive O3FA or a placebo for 10 weeks...
June 26, 2018: Journal of Clinical Psychiatry
George Loeffler, Rachael Coller, LaRee Tracy, Berg Roy Derderian
OBJECTIVE: The US Veterans Affairs (VA)/Department of Defense (DoD) Posttraumatic Stress Disorder (PTSD) Clinical Practice Guidelines provide evidence-based pharmacologic treatment recommendations. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are considered first-line medications. Benzodiazepines are relatively contraindicated with a warning that they may cause harm. This population-based study is the first to describe prescribing patterns for active duty service members (ADSMs) diagnosed with PTSD...
June 26, 2018: Journal of Clinical Psychiatry
Derek D Satre, Amber Bahorik, Tauheed Zaman, Danielle Ramo
No abstract text is available yet for this article.
June 26, 2018: Journal of Clinical Psychiatry
Robin Emsley, Isaac Nuamah, Srihari Gopal, David Hough, W Wolfgang Fleischhacker
BACKGROUND: It has been proposed that relapse rates after antipsychotic discontinuation may be artificially inflated and that some of these symptom recurrences may be due to rebound or withdrawal phenomena rather than due to illness recurrence. METHODS: Post hoc analysis of data from a relapse-prevention study (conducted from March 2005 to February 2007) of paliperidone palmitate once-monthly (PP1M) versus placebo was conducted to compare the nature of operationally defined relapse events in schizophrenia patients (diagnosed by DSM-IV criteria) experiencing relapses after randomization to placebo (n = 97) with those in patients receiving maintenance PP1M treatment (n = 36)...
June 19, 2018: Journal of Clinical Psychiatry
Jonathan H Hsu, Benoit H Mulsant, Eric J Lenze, Marcos Sanches, Jordan F Karp, Charles F Reynolds, Daniel M Blumberger
OBJECTIVE: Augmentation with aripiprazole is an effective pharmacotherapy for treatment-resistant late-life depression (LLD). However, aripiprazole can cause extrapyramidal symptoms (EPS) such as akathisia and parkinsonism; these symptoms are distressing and can contribute to treatment discontinuation. We investigated the clinical trajectories and predictors of akathisia and parkinsonism in older patients receiving aripiprazole augmentation for treatment-resistant LLD. METHODS: Between 2009 and 2013, depressed older adults who did not remit with venlafaxine were randomized to aripiprazole or placebo in a 12-week trial...
June 19, 2018: Journal of Clinical Psychiatry
Katie L Burkhouse, Stephanie M Gorka, Heide Klumpp, Amy E Kennedy, Shannon Karich, Jennifer Francis, Olusola Ajilore, Michelle G Craske, Scott A Langenecker, Stewart A Shankman, Greg Hajcak, K Luan Phan
OBJECTIVE: Reward positivity (RewP), a neurophysiologic index of reward responsivity, is consistently reduced in participants with depression and, to a lesser extent, anxiety. It remains unknown, however, whether RewP can be altered as psychiatric symptoms change with treatment. The current study addressed this question by examining differences in RewP within patients before and after 12 weeks of treatment with a selective serotonin reuptake inhibitor (SSRI) or cognitive-behavioral therapy (CBT)...
June 12, 2018: Journal of Clinical Psychiatry
George Mammen, Sergio Rueda, Michael Roerecke, Sarah Bonato, Shaul Lev-Ran, Jürgen Rehm
OBJECTIVE: To systematically review studies examining the longitudinal associations between cannabis use and symptomatic outcomes among individuals with an anxiety or mood disorder at baseline. DATA SOURCES: A search of the literature up to May 2017 was conducted using several databases. Search terms related to the exposure (ie, cannabis) and outcome (ie, symptoms) variables of interest. There were no search restrictions. STUDY SELECTION: In total, 10,191 citations were screened...
June 5, 2018: Journal of Clinical Psychiatry
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