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Treatment Resistant Anxiety Disorders

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https://www.readbyqxmd.com/read/29105627/macrophage-related-cytokine-expressions-in-depression-mouse-model-induced-by-chronic-unpredictable-mild-stress
#1
Shoulian Zhu, Lejing Li, Ying Li, Wenyuan Cao
Depression is characterized by mental retardation, interest blank, hypoactivity, anxiety, appetite loss, sexual dysfunction, sleep disorders and other symptoms. The incidence of depressed patients has demonstrated an upward trend in recent years. Antidepressant drugs are commonly used in modern medicine, but they have the side effect of drug resistance. This study aims to explore the effect of acupuncture stimulation on expressions of macrophage-related cytokines in mice with depression induced by chronic unpredictable mild stress (CUMS), and to explore the underlying immunological mechanism...
September 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29089909/effects-of-anterior-capsulotomy-on-decision-making-in-patients-with-refractory-obsessive-compulsive-disorder
#2
Chencheng Zhang, Yilin Chen, Shuaiwei Tian, Tao Wang, Yile Xie, Haiyan Jin, Guozhen Lin, Hengfen Gong, Kristina Zeljic, Bomin Sun, Tianming Yang, Shikun Zhan
Despite various lines of evidence implicating impaired decision-making ability in individuals with obsessive-compulsive disorder (OCD), neuropsychological investigation has generated inconsistent findings. Although the cortico-striato-thalamo-cortical (CSTC) circuitry has been suggested, the involvement of the cortex has not yet been fully demonstrated. Moreover, it is unknown whether surgical intervention on the CSTC circuitry results in a predicted improvement of decision-making ability of OCD. Here we present a study of decision making based on the Iowa Gambling Task (IGT) to investigate decision making in a large sample of individuals with treatment-resistant OCD with and without anterior capsulotomy (AC)...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/29069109/clinical-repetitive-transcranial-magnetic-stimulation-for-veterans-with-major-depressive-disorder
#3
F Andrew Kozel, Michael Hernandez, Kimberly Van Trees, Sean Phillips, Jaffrey Hashimie, Mark Weisman, Demian Obregon, Deborah L Sanchez, Glenn Catalano, Susan K Schultz
BACKGROUND: Repetitive transcranial magnetic stimulation (TMS) is a relatively new treatment modality for patients with major depressive disorder (MDD). Numerous studies have demonstrated the efficacy of TMS for MDD in the general population. However, there is limited information regarding clinical outcomes among veterans receiving TMS for MDD. METHODS: The clinical outcome and characteristics of all veterans with MDD who were treated with TMS as outpatients at the James A...
November 2017: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/29049935/intranasal-oxytocin-in-the-treatment-of-anorexia-nervosa-randomized-controlled-trial-during-re-feeding
#4
Janice Russell, Sarah Maguire, Glenn E Hunt, Alice Kesby, Anastasia Suraev, Jordyn Stuart, Jessica Booth, Iain S McGregor
BACKGROUND: Nutritional rehabilitation in anorexia nervosa (AN) is impeded by fear of food, eating and change leading to treatment resistance. Oxytocin (OT) exerts prosocial effects and modulates trust, fear, anxiety and neuroplasticity. The current placebo-controlled RCT examined the effects of intranasal oxytocin (IN-OT) in AN. The aim was to ascertain whether repeated doses of IN-OT enhance treatment outcomes in AN. METHODS: AN patients self-administered 36 IU IN-OT or placebo daily for 4-6 weeks during hospital treatment...
October 14, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/29046989/epilepsy-and-psychiatric-comorbidities-drug-selection
#5
REVIEW
Marco Mula
Purpose of review The pharmacological treatment of patients with epilepsy and psychiatric comorbidities may sometimes represent a therapeutic challenge. This review is focused on the pharmacological management of patients with epilepsy and psychiatric problems in terms of rationalization of the antiepileptic drug (AED) treatment and the pharmacological management of the most clinically relevant psychiatric comorbidities, namely mood and anxiety disorders, psychoses, and attention deficit hyperactivity disorder (ADHD)...
October 19, 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28965430/deep-brain-stimulation-for-severe-treatment-resistant-obsessive-compulsive-disorder-an-open-label-case-series
#6
Sarah Farrand, Andrew H Evans, Simone Mangelsdorf, Samantha M Loi, Ramon Mocellin, Adam Borham, JoAnne Bevilacqua, Scott Blair-West, Mark A Walterfang, Richard G Bittar, Dennis Velakoulis
OBJECTIVE: Deep brain stimulation can be of benefit in carefully selected patients with severe intractable obsessive-compulsive disorder. The aim of this paper is to describe the outcomes of the first seven deep brain stimulation procedures for obsessive-compulsive disorder undertaken at the Neuropsychiatry Unit, Royal Melbourne Hospital. The primary objective was to assess the response to deep brain stimulation treatment utilising the Yale-Brown Obsessive Compulsive Scale as a measure of symptom severity...
September 1, 2017: Australian and New Zealand Journal of Psychiatry
https://www.readbyqxmd.com/read/28932388/appeal-to-fear-in-health-care-appropriate-or-inappropriate
#7
J Keith Simpson
AIM: This paper examines appeal to fear in general: its perceived positive aspects, its negative characteristics, its appropriate as well as its fallacious use. BACKGROUND: Appeal to fear is a commonly used marketing method that attempts to change behaviour by creating anxiety in those receiving a fearful message. It is regularly used in public health initiatives such as anti-smoking, anti-drunk driving campaigns as well as in hypertension awareness campaigns. Some chiropractors appear to use appeal to fear to promote subluxation awareness and thereby encourage the use of chiropractic treatment...
2017: Chiropractic & Manual Therapies
https://www.readbyqxmd.com/read/28929349/depression-and-anxiety-in-polycystic-ovary-syndrome-etiology-and-treatment
#8
REVIEW
Laura G Cooney, Anuja Dokras
PURPOSE OF REVIEW: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women and is associated with an increased prevalence of depression and anxiety symptoms. This review presents potential mechanisms for this increased risk and outlines treatment options. RECENT FINDINGS: Women with PCOS have increased odds of depressive symptoms (OR 3.78; 95% CI 3.03-4.72) and anxiety symptoms (OR 5.62; 95% CI 3.22-9.80). Obesity, insulin resistance, and elevated androgens may partly contribute to this association...
September 20, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28922961/effect-of-ketamine-dose-on-self-rated-dissociation-in-patients-with-treatment-refractory-anxiety-disorders
#9
Cameron Castle, Andrew Gray, Shona Neehoff, Paul Glue
Patients receiving ketamine for refractory depression and anxiety report dissociative symptoms in the first 60 min post-dose. The most commonly used instrument to assess this is the Clinician-Administered Dissociative States Scale (CADSS), developed based on the assessment of patients with dissociative symptoms. Its psychometric properties for ketamine-induced dissociation have not been reported. We evaluated these from a study using 0.25-1 mg/kg ketamine and midazolam (as an active control) in 18 patients with treatment-resistant anxiety...
October 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28910493/using-interpersonal-process-recall-to-compare-patients-accounts-of-resistance-in-two-psychotherapies-for-generalized-anxiety-disorder
#10
Nicholas R Morrison, Michael J Constantino, Henny A Westra, Angela Kertes, Brien J Goodwin, Martin M Antony
In a trial examining whether cognitive-behavioral therapy (CBT) could be improved by integrating motivational interviewing (MI) to target resistance, MI-CBT outperformed CBT over 12-month follow-up (Westra, Constantino, & Antony, 2016). Given that effectively addressing resistance is both a theoretically and an empirically supported mechanism of MI's additive effect, we explored qualitatively patients' experience of resistance, possibly as a function of treatment. For 5 patients from each treatment who exhibited early in-session change ambivalence, and thus were at risk for later resistance, we conducted interpersonal process recall interviews after a session...
September 14, 2017: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/28871216/motivational-interviewing-as-an-adjunct-to-cognitive-behavior-therapy-for-anxiety-disorders-a-critical-review-of-the-literature
#11
Cameron L Randall, Daniel W McNeil
Cognitive behavior therapy (CBT) is efficaciously and effectively used in the treatment of anxiety disorders; however, as CBT for anxiety routinely utilizes exposure components, clients often experience ambivalence about treatment and their clinicians often must deal with resistance. Motivational Interviewing (MI) is a therapeutic strategy that addresses ambivalence about change in clinical interventions. MI has been applied as an adjunct for treatments such as CBT in order to increase motivation for and commitment to the intervention, especially when components of the treatment may be challenging (e...
August 2017: Cognitive and Behavioral Practice
https://www.readbyqxmd.com/read/28866299/clinical-experience-using-intranasal-ketamine-in-the-longitudinal-treatment-of-juvenile-bipolar-disorder-with-fear-of-harm-phenotype
#12
Demitri Papolos, Mark Frei, Daniel Rossignol, Steven Mattis, Laura C Hernandez-Garcia, Martin H Teicher
OBJECTIVES: Fear of Harm (FOH) is a pediatric onset phenotype of bipolar disorder (BD) characterized by BD plus treatment resistance, separation anxiety, aggressive obsessions, parasomnias, and thermal dysregulation. Intranasal ketamine (InK) in 12 youths with BD-FOH produced marked improvement during a two-week trial. Here we report on the open effectiveness and safety of InK in maintenance treatment of BD-FOH from the private practice of one author. METHODS: As part of a chart review, patients 18 years or older and parents of younger children responded to a clinical effectiveness and safety survey...
January 1, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28857658/minocycline-as-an-adjunct-for-treatment-resistant-depressive-symptoms-a-pilot-randomised-placebo-controlled-trial
#13
Muhammad I Husain, Imran B Chaudhry, Nusrat Husain, Ameer B Khoso, Raza R Rahman, Munir M Hamirani, John Hodsoll, Inti Qurashi, John Fw Deakin, Allan H Young
BACKGROUND: Evidence suggests that anti-inflammatory medication may be effective in the treatment of depressive symptoms. In this study, we aimed to investigate whether minocycline added to treatment as usual (TAU) for 3 months in patients with treatment-resistant depression will lead to an improvement in depressive symptoms. METHODS: Multi-site, 12-week, double-blind, placebo-controlled, pilot trial of minocycline added to TAU for patients suffering from DSM-5 major depressive disorder, whose current episode has failed to respond to at least two antidepressants...
September 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28816544/animal-inflammation-based-models-of-depression-and-their-application-to-drug-discovery
#14
REVIEW
Li Ma, Konstantin A Demin, Tatyana O Kolesnikova, Sergey L Kharsko, Xiaokang Zhu, Xiaodong Yuan, Cai Song, Darya A Meshalkina, Brian E Leonard, Li Tian, Allan V Kalueff
Depression, anxiety and other affective disorders are globally widespread and severely debilitating human brain diseases. Despite their high prevalence and mental health impact, affective pathogenesis is poorly understood, and often remains recurrent and resistant to treatment. The lack of efficient antidepressants and presently limited conceptual innovation necessitate novel approaches and new drug targets in the field of antidepressant therapy. Areas covered: Herein, the authors discuss the emerging role of neuro-immune interactions in affective pathogenesis, which can become useful targets for CNS drug discovery, including modulating neuroinflammatory pathways to alleviate affective pathogenesis...
October 2017: Expert Opinion on Drug Discovery
https://www.readbyqxmd.com/read/28814473/breaking-boundaries-optimizing-reconsolidation-based-interventions-for-strong-and-old-memories
#15
James W B Elsey, Merel Kindt
Recent research has demonstrated that consolidated memories can enter a temporary labile state after reactivation, requiring restabilization in order to persist. This process, known as reconsolidation, potentially allows for the modification and disruption of memory. Much interest in reconsolidation stems from the possibility that maladaptive memory traces-a core feature of several psychiatric conditions-could be tackled by disrupting their reconsolidation. However, research has indicated a range of supposed boundary conditions on the induction of reconsolidation...
September 2017: Learning & Memory
https://www.readbyqxmd.com/read/28804985/a-randomised-controlled-comparison-of-second-level-treatment-approaches-for-treatment-resistant-adults-with-bulimia-nervosa-and-binge-eating-disorder-assessing-the-benefits-of-virtual-reality-cue-exposure-therapy
#16
Marta Ferrer-García, José Gutiérrez-Maldonado, Joana Pla-Sanjuanelo, Ferran Vilalta-Abella, Giuseppe Riva, Massimo Clerici, Joan Ribas-Sabaté, Alexis Andreu-Gracia, Fernando Fernandez-Aranda, Laura Forcano, Nadine Riesco, Isabel Sánchez, Neli Escandón-Nagel, Osane Gomez-Tricio, Virginia Tena, Antonios Dakanalis
A question that arises from the literature on therapy is whether second-level treatment is effective for patients with recurrent binge eating who fail first-level treatment. It has been shown that subjects who do not stop binge eating after an initial structured cognitive-behavioural treatment (CBT) programme benefit from additional CBT (A-CBT) sessions; however, it has been suggested that these resistant patients would benefit even more from cue exposure therapy (CET) targeting features associated with poor response (e...
November 2017: European Eating Disorders Review: the Journal of the Eating Disorders Association
https://www.readbyqxmd.com/read/28768346/-psychotherapy-with-adjuvant-use-of-serotonergic-psychoactive-substances-possibilities-and-challenges
#17
Tomislav Majić, Henrik Jungaberle, Timo T Schmidt, Andrea Zeuch, Leo Hermle, Jürgen Gallinat
Background Recently, scientific interest in the therapeutic potential of serotonergic and psilocybin hallucinogens (psychedelics) such as lysergic acid diethylamide (LSD) and entactogens like 3,4-methylendioxymethamphetamine (MDMA) within the framework of psychotherapy has resumed. The present article provides an overview on the current evidence on substance-assisted psychotherapy with these substances. Method A selective search was carried out in the PubMed and Cochrane Library including studies investigating the clinical use of serotonergic psychoactive substances since 2000...
July 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28734239/stigma-resistance-and-its-association-with-internalised-stigma-and-psychosocial-outcomes-among-psychiatric-outpatients
#18
Ying Wen Lau, Louisa Picco, Shirlene Pang, Anitha Jeyagurunathan, Pratika Satghare, Siow Ann Chong, Mythily Subramaniam
Studies have suggested that stigma resistance plays an important role in the recovery from mental illness. However, there has been limited research in Asian countries that has examined the benefits of stigma resistance among the mentally ill in Asian populations. Hence, this study aimed to assess the prevalence of stigma resistance and establish the socio-demographic correlates of stigma resistance, as well as its association with internalised stigma and psychosocial outcomes among a multi-ethnic population of 280 outpatients with obsessive compulsive disorder (OCD), schizophrenia, depressive disorders and anxiety disorders in Singapore...
July 14, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28686560/-hoarding-disorder-in-dsm-5-clinical-description-and-cognitive-approach
#19
L Kalogeraki, I Michopoulos
Hoarding disorder is characterized by difficulty discarding or parting with possessions regardless their actual value as well as, in most cases, persistent acquisition of objects. Possessions are accumulated in large numbers that fill up and clutter active living space to the extent that its intended use is no longer possible resulting to significant functional impairment and/or distress. Saving and difficulty discarding appear to be associated to subjective beliefs about the instrumental, sentimental or intrinsic value of objects...
April 2017: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/28666206/low-dose-ketamine-for-treatment-resistant-depression-in-an-academic-clinical-practice-setting
#20
David Feifel, Benjamin Malcolm, Danielle Boggie, Kelly Lee
BACKGROUND: Recent studies demonstrating a rapid, robust improvement in treatment resistant depression (TRD) following a single sub-anesthetic infusion of ketamine have generated much excitement. However, these studies are limited in their generalizability to the broader TRD population due to their subject exclusion criteria which typically limit psychiatric comorbidity, concurrent medication, and level of suicide risk. This paper describes the safety and efficacy of sub-anesthetic ketamine infusions in a naturalistic TRD patient sample participating in a real-world TRD treatment program within a major university health system...
October 15, 2017: Journal of Affective Disorders
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