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CNS Spectrums

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https://www.readbyqxmd.com/read/28077190/measures-of-the-dsm-5-mixed-features-specifier-of-major-depressive-disorder
#1
Mark Zimmerman
During the past two decades, a number of studies have found that depressed patients frequently have manic symptoms intermixed with depressive symptoms. While the frequency of mixed syndromes are more common in bipolar than in unipolar depressives, mixed states are also common in patients with major depressive disorder. The admixture of symptoms may be evident when depressed patients present for treatment, or they may emerge during ongoing treatment. In some patients, treatment with antidepressant medication might precipitate the emergence of mixed states...
January 12, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28065178/investigating-the-role-of-anticipatory-reward-and-habit-strength-in-obsessive-compulsive-disorder
#2
Gabriela M Ferreira, Murat Yücel, Andrew Dawson, Valentina Lorenzetti, Leonardo F Fontenelle
: Aims To determine the rates and associated illness characteristics of obsessive-compulsive disorder (OCD) patients who describe their symptoms as either rewarding or habitual. METHODS: Seventy-three treatment-seeking OCD patients had their dominant compulsive behavior assessed with a structured interview (the Temporal Impulsive-Compulsive Scale-Revised) to track the progression of rewarding (ie, gain in positive affect), aversive (ie, decrease in negative affect), and neutral (or non-affective) states and a self-report scale (the Self-Report Habit Index) to evaluate their habitual features...
January 9, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28059046/long-term-effects-of-aripiprazole-exposure-on-monoaminergic-and-glutamatergic-receptor-subtypes-comparison-with-cariprazine
#3
Yong Kee Choi, Nika Adham, Béla Kiss, István Gyertyán, Frank I Tarazi
OBJECTIVE: This study examined the chronic effects of aripiprazole and cariprazine on serotonin (5-HT1A and 5-HT2A) and glutamate (NMDA and AMPA) receptor subtypes. In addition, the effects of aripiprazole on D2 and D3 receptors were tested and compared with previously reported cariprazine data. METHODS: Rats received vehicle, aripiprazole (2, 5, or 15 mg/kg), or cariprazine (0.06, 0.2, or 0.6 mg/kg) for 28 days. Receptor levels were quantified using autoradiographic assays on brain sections from the medial prefrontal cortex (MPC), dorsolateral frontal cortex (DFC), nucleus accumbens (NAc), caudate-putamen medial (CPu-M), caudate-putamen lateral (CPu-L), hippocampal CA1 (HIPP-CA1) and CA3 (HIPP-CA3) regions, and the entorhinal cortex (EC)...
January 6, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28031070/mixed-features-in-bipolar-disorder
#4
Eva Solé, Marina Garriga, Marc Valentí, Eduard Vieta
Mixed affective states, defined as the coexistence of depressive and manic symptoms, are complex presentations of manic-depressive illness that represent a challenge for clinicians at the levels of diagnosis, classification, and pharmacological treatment. The evidence shows that patients with bipolar disorder who have manic/hypomanic or depressive episodes with mixed features tend to have a more severe form of bipolar disorder along with a worse course of illness and higher rates of comorbid conditions than those with non-mixed presentations...
December 29, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/28031054/decreased-lymphocyte-dopamine-transporter-in-romantic-lovers
#5
Donatella Marazziti, Stefano Baroni, Gino Giannaccini, Armando Piccinni, Federico Mucci, Mario Catena-Dell'Osso, Grazia Rutigliano, Gabriele Massimetti, Liliana Dell'Osso
OBJECTIVE: The role of dopamine (DA) in romantic love is suggested by different evidence and is supported by the findings of some brain imaging studies. The DA transporter (DAT) is a key structure in regulating the concentration of the neurotransmitter in the synaptic cleft. Given the presence of DAT in blood cells, the present study aimed to explore it in resting lymphocytes of 30 healthy subjects of both sexes in the early stage of romantic love (no longer than 6 months), as compared with 30 subjects involved in a long-lasting relationship...
December 29, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/28004626/treating-mixed-mania-hypomania-a-review-and-synthesis-of-the-evidence
#6
Minoru Takeshima
The DSM-5 incorporates a broad concept of mixed states and captured ≥3 nonoverlapping symptoms of the opposite polarity using a "with mixed features" specifier to be applied to manic/hypomanic and major depressive episodes. Pharmacotherapy of mixed states is challenging because of the necessity to treat both manic/hypomanic and depressive symptoms concurrently. High-potency antipsychotics used to treat manic symptoms and antidepressants can potentially deteriorate symptoms of the opposite polarity. This review aimed to provide a synthesis of the current evidence for pharmacotherapy of mixed states with an emphasis on mixed mania/hypomania...
December 22, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/28004621/augmentation-of-phenelzine-with-aripiprazole-and-quetiapine-in-a-treatment-resistant-patient-with-psychotic-unipolar-depression-case-report-and-literature-review
#7
Jonathan M Meyer, Michael A Cummings, George Proctor
Irreversible monoamine oxidase inhibitor (MAOI) antidepressants have significant efficacy in treatment-resistant unipolar depression, but in some instances patients may not achieve remission. Among the adjunctive and augmentation strategies, certain second-generation antipsychotics (SGAs) have approval for inadequate responders to antidepressant therapy, including aripiprazole, brexpiprazole, and quetiapine, with lurasidone and the olanzapine/fluoxetine combination indicated for bipolar depression. Clinicians may eschew SGA options in part due to the limited literature on SGA-MAOI combinations, with only one published case involving aripiprazole, and none for olanzapine, lurasidone, or brexpiprazole...
December 22, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27989265/posttraumatic-stress-disorder-symptom-severity-is-associated-with-left-hippocampal-volume-reduction-a-meta-analytic-study
#8
Michael D Nelson, Alecia M Tumpap
OBJECTIVE: Many studies have reported hippocampal volume reductions associated with posttraumatic stress disorder (PTSD), while others have not. Here we provide an updated meta-analysis of such reductions associated with PTSD and evaluate the association between symptom severity and hippocampal volume. METHODS: A total of 37 studies met the criteria for inclusion in the meta-analysis. Mean effect sizes (Hedges' g) and 95% confidence intervals (CI 95%) were computed for each study and then averaged to obtain an overall mean effect size across studies...
December 19, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27989258/musical-hallucinations-a-brief-review-of-functional-neuroimaging-findings
#9
Francesco Bernardini, Luigi Attademo, Karen Blackmon, Orrin Devinsky
Musical hallucinations are uncommon phenomena characterized by intrusive and frequently distressful auditory musical percepts without an external source, often associated with hypoacusis, psychiatric illness, focal brain lesion, epilepsy, and intoxication/pharmacology. Their physiological basis is thought to involve diverse mechanisms, including "release" from normal sensory or inhibitory inputs as well as stimulation during seizures, or they can be produced by functional or structural disorders in diverse cortical and subcortical areas...
December 19, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27899165/cognitive-dysfunction-in-body-dysmorphic-disorder-new-implications-for-nosological-systems-and-neurobiological-models
#10
Kiri Jefferies-Sewell, Samuel R Chamberlain, Naomi A Fineberg, Keith R Laws
: Introduction Body dysmorphic disorder (BDD) is a debilitating disorder, characterized by obsessions and compulsions relating specifically to perceived appearance, and which has been newly classified within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Obsessive-Compulsive and Related Disorders grouping. Until now, little research has been conducted into the cognitive profile of this disorder. METHODS: Participants with BDD (n=12) and participants without BDD (n=16) were tested using a computerized neurocognitive battery investigating attentional set-shifting (Intra/Extra Dimensional Set Shift Task), decision-making (Cambridge Gamble Task), motor response-inhibition (Stop-Signal Reaction Time Task), and affective processing (Affective Go-No Go Task)...
November 30, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27869049/exclusion-of-overlapping-symptoms-in-dsm-5-mixed-features-specifier-heuristic-diagnostic-and-treatment-implications
#11
Gin S Malhi, Yulisha Byrow, Tim Outhred, Kristina Fritz
This article focuses on the controversial decision to exclude the overlapping symptoms of distractibility, irritability, and psychomotor agitation (DIP) with the introduction of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) mixed features specifier. In order to understand the placement of mixed states within the current classification system, we first review the evolution of mixed states. Then, using Kraepelin's original classification of mixed states, we compare and contrast his conceptualization with modern day definitions...
November 21, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27869048/efficacy-safety-and-tolerability-of-vortioxetine-for-the-treatment-of-major-depressive-disorder-in-patients-aged-55-years-or-older
#12
George G Nomikos, Dapo Tomori, Wei Zhong, John Affinito, William Palo
OBJECTIVE: These post hoc analyses evaluate the efficacy, safety, and tolerability of vortioxetine versus placebo in patients aged ≥55 years with major depressive disorder (MDD). METHODS: Study-level efficacy data from 12 short-term, fixed-dose, randomized, placebo-controlled trials of vortioxetine 5-20 mg/day were assessed using a random-effects meta-analysis. Adverse events (AEs), vital signs, ECG values, liver enzymes, and body weight were pooled from the same studies...
November 21, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27866506/the-surprising-blindness-in-modern-psychiatry-do-guidelines-really-guide
#13
Pedro Antônio Schmidt do Prado-Lima
No abstract text is available yet for this article.
November 21, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27866502/dysphoric-mania-mixed-states-and-mania-with-mixed-features-specifier-are-we-mixing-things-up
#14
Susan L McElroy, Paul E Keck
Various terms have been used to describe mania when it is accompanied by depressive symptoms. In this article, we attempt to define and discuss 3 of these terms: dysphoric mania, mixed state, and mania with mixed features specifier. We conclude that whatever term is used, it is important to be aware that mania is more often unpleasant than pleasant, and that the unpleasantness is not limited to depression.
November 21, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27866497/neurodevelopmental-outcomes-in-infants-exposed-in-utero-to-antipsychotics-a-systematic-review-of-published-data
#15
Salvatore Gentile, Maria Luigia Fusco
The proportion of pregnancies exposed to either second-generation antipsychotics (SGAs) or first-generation antipsychotics (FGAs) varies between 0.3%-2% of all pregnancies, but, until now, little is known about the potential neurobehavioral teratogenicity of antipsychotics. Assessing this safety facet is the aim of this article. PubMed, Scopus, and Google Scholar were searched for eligible articles. PubMed (1954 to May 2016) was searched using several medical subject headings, variously combined. PubMed search results were also limited using the search filter for human studies published in English...
November 21, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27834163/is-not-just-right-experience-njre-in-obsessive-compulsive-disorder-part-of-an-autistic-phenotype
#16
Josselyn Hellriegel, Caroline Barber, Maheshi Wikramanayake, Naomi A Fineberg, William Mandy
OBJECTIVE: Harm avoidance (HA) and "not just right experience" (NJRE) have been proposed to be 2 core motivational processes underlying obsessive-compulsive disorder (OCD). The objective of this study was to explore whether NJRE demarcates a neurodevelopmental OCD subgroup distinct from HA related to autistic traits and/or to a broader phenotype of cognitive rigidity and sensory processing difficulties associated with an earlier age of OCD onset. METHODS: A correlational design investigated whether NJRE and HA are distinct entities in OCD and explored their relationship to autism spectrum disorder (ASD) traits measured by the Autism Quotient (AQ), sensory processing, set-shifting, and age of OCD onset in an OCD sample (N=25)...
November 11, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27831463/what-is-the-role-of-conventional-antidepressants-in-the-treatment-of-major-depressive-episodes-with-mixed-features-specifier
#17
Gianni L Faedda, Ciro Marangoni
The newly introduced Mixed Features Specifier of Major Depressive Episode and Disorder (MDE/MDD) is especially challenging in terms of pharmacological management. Prior to the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the symptoms of the mixed features specifier were intradepressive hypomanic symptoms, always and only associated with bipolar disorder (BD). Intradepressive hypomanic symptoms, mostly referred to as depressive mixed states (DMX), have been poorly characterized, and their treatment offers significant challenges...
November 10, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27821210/asenapine-for-the-treatment-of-adults-with-an-acute-exacerbation-of-schizophrenia-results-from-a-randomized-double-blind-fixed-dose-placebo-controlled-trial-with-olanzapine-as-an-active-control
#18
Ronald Landbloom, Mary Mackle, Xiao Wu, Linda Kelly, Linda Snow-Adami, Roger S McIntyre, Maju Mathews, Carla Hundt
OBJECTIVE: Evaluate the efficacy and safety of asenapine 2.5 mg twice daily (bid; n=97) or 5 mg bid (n=113) versus placebo (n=101) in adults with acute exacerbation of schizophrenia. METHODS: Adults with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) schizophrenia diagnosis were randomized to asenapine 2.5 mg bid, 5 mg bid, placebo, or olanzapine 15 mg once daily. The primary objective was to test superiority of asenapine versus placebo as measured by the change from baseline to day 42 in the Positive and Negative Syndrome Scale (PANSS) total score...
November 8, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/28044946/optimizing-outcomes-in-adhd-treatment-from-clinical-targets-to-novel-delivery-systems
#19
Gregory W Mattingly, Richard H Anderson
Our knowledge and understanding of the underlying neurobiology and symptomatic expression of ADHD has advanced dramatically over the past decade. Associated with these advances has been a similar explosion of new treatment options to individualize treatment for our patients. This article will: ∙ review strategies to measure ADHD symptoms and functional difficulties while seeking to achieve full symptomatic remission throughout the day ∙ summarize recent findings regarding the management and prioritization of ADHD and comorbid conditions and ∙ discuss the various pharmacologic treatment options with a focus on recently developed molecules and novel delivery systems...
December 2016: CNS Spectrums
https://www.readbyqxmd.com/read/28044945/recognizing-and-treating-pseudobulbar-affect
#20
William M Sauvé
Pseudobulbar affect, thought by many to be a relatively newly described condition, is in fact a very old one, described as early as the 19th century. It refers to those who experience inappropriate affect, disconnected from internal state, or mood, generally thought to be the result of an upper motor neuron injury or illness. One possible explanation for this condition's relative obscurity is the dearth of treatment options; clinical medicine is not typically in the habit of identifying conditions that cannot be modified...
December 2016: CNS Spectrums
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