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Pharmacotherapy for personality disorder

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https://www.readbyqxmd.com/read/28314093/clinical-impact-of-pharmacogenetic-guided-treatment-for-patients-exhibiting-neuropsychiatric-disorders-a-randomized-controlled-trial
#1
RANDOMIZED CONTROLLED TRIAL
Marilyn C Olson, Alejandra Maciel, Jean Francois Gariepy, Ali Cullors, Juan-Sebastian Saldivar, David Taylor, Joel Centeno, Jorge A Garces, Sandeep Vaishnavi
Objective: Pharmacogenetic testing holds promise as a personalized medicine tool by permitting individualization of pharmacotherapy in accordance with genes influencing therapeutic response, side effects, and adverse events. The authors evaluated the effect on outcomes for patients diagnosed with neuropsychiatric disorders of pharmacogenetics (PGx)-guided treatment compared to usual standard of care. Methods: This was a prospective, randomized study of 237 patients at an outpatient community-based psychiatric practice conducted between April 2015 and October 2015...
March 16, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28291968/integrative-treatment-of-personality-disorder-part-i-psychotherapy
#2
Mirjana Divac Jovanovic, Dragan Svrakic
In this paper, we outline the concept of integrative therapy of borderline personality, also referred to as fragmented personality, which we consider to be the core psychopathology underlying all clinical subtypes of personality disorder. Hence, the terms borderline personality, borderline disorder, fragmented personality, and personality disorder are used interchangeably, as synonyms. Our integrative approach combines pharmacotherapy and psychotherapy, each specifically tailored to accomplish a positive feedback modulation of their respective effects...
March 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28231682/unmet-needs-of-the-patients-with-obsessive-compulsive-disorder
#3
Jan Prasko, Radovan Hruby, Marie Ociskova, Michaela Holubova, Klara Latalova, Marketa Marackova, Ales Grambal, Zuzana Sigmundova, Petra Kasalova, Jana Vyskocilová
BACKGROUND: Obsessive compulsive disorder (OCD) is a disabling mental disorder with the chronic and difficult course. The disorder is accompanied by numerous limitations in personal and interpersonal functioning. OCD decreases the quality of life and the chance to maintain relationships and professional status. The patients with OCD often experience a severe disabling course of the disorder. Even the individuals, who follow treatment advice, are often still highly symptomatic. In the last decade, the concept of the needs has been assessed as an extent of the traditional outcome evaluation in order to focus on the identification of the specific needs of the patients and their relatives, improve the patients´ overall mental condition and quality of life, and also to increase the treatment effectiveness of the mental disorders...
October 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28166473/a-retrospective-analysis-of-the-outcomes-of-smoking-cessation-pharmacotherapy-among-persons-with-mental-health-and-substance-use-disorders
#4
Chizimuzo T C Okoli, Vivek Anand, Milan Khara
OBJECTIVES: It is common practice to individualize smoking cessation pharmacotherapy based on clinical judgment and patient response. However, little has been documented about the use and outcomes of smoking cessation pharmacotherapy in real-world settings. This study examines factors associated with using smoking cessation pharmacotherapy and related outcomes among smokers with psychiatric and/or substance use disorders who completed an intensive tobacco treatment program within mental health and addiction services settings in Vancouver, Canada...
January 2017: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/28105501/-diagnostics-and-multimodal-treatment-of-depression-in-old-age-new-developments
#5
Gerhard W Eschweiler
Depressive disorders in elderly persons are frequent and can either first be manifested at a younger age and show a recurrent pattern during later life (ICD 10, F33.*) or have an onset beyond 60 years, which is termed late onset depression (LOD). This LOD has a higher tendency to chronification and implies an increased risk of progression, especially to vascular dementia. The multifactorial genesis of depression in old age includes psychosocial, vascular and metabolic factors and requires multimodal therapy modules at the biological and psychosocial level, which is now increasingly being empirically proven...
February 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28104065/borderline-personality-disorder-psychological-treatment-an-integrative-review
#6
Beverly Reeves-Dudley
Borderline personality disorder (BPD) is a complex and at times debilitating mental disorder, treatment of which has eluded effective pharmacotherapy (Gunderson, 2007). Although once considered untreatable, psychodynamic therapy and cognitive therapy (two types of psychological therapies) have provided hope for better lives for patients with this diagnosis (Gunderson). The author performed an integrative review of the literature pertaining to the present role of evidence-based practice (EBP) using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR) definition of BPD to identify symptoms of the disorder...
February 2017: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/28101793/substance-use-disorders-among-patients-with-type-2-diabetes-a-dangerous-but-understudied-combination
#7
REVIEW
Kimberly N Walter, Julie A Wagner, Eda Cengiz, William V Tamborlane, Nancy M Petry
PURPOSE OF REVIEW: This paper reviews research on substance use and disorders (SUDs) among adults with diabetes. It describes epidemiological data on SUDs in persons with type 2 diabetes, overviews effects of substance use on diabetes outcomes, and discusses treatments for SUDs in patients with diabetes. RECENT FINDINGS: Rates of current smoking range from 10 to 26% and alcohol use disorders are 0-5%. Rates of illicit SUDs are 3-4%, but there are no population-based studies using nationally representative samples...
January 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28061017/feasibility-and-safety-of-extended-release-naltrexone-treatment-of-opioid-and-alcohol-use-disorder-in-hiv-clinics-a-pilot-feasibility-randomized-trial
#8
Philip T Korthuis, Paula J Lum, Pamela Vergara-Rodriguez, Keith Ahamad, Evan Wood, Lynn E Kunkel, Neal L Oden, Robert Lindblad, James L Sorensen, Virgilio Arenas, Doan Ha, Raul N Mandler, Dennis McCarty
BACKGROUND AND AIMS: HIV-infected people with substance use disorders are least likely to benefit from advances in HIV treatment. Integration of extended-release naltrexone (XR-NTX) into HIV clinics may increase engagement in the HIV care continuum by decreasing substance use. We aimed to compare (1) XR-NTX treatment initiation, (2) retention and (3) safety of XR-NTX versus treatment as usual (TAU) for treating opioid use disorder (OUD) and/or alcohol use disorder (AUD) in HIV clinics...
January 6, 2017: Addiction
https://www.readbyqxmd.com/read/27960533/a-cross-validation-delphi-method-approach-to-the-diagnosis-and-treatment-of-personality-disorders-in-older-adults
#9
Erlene Rosowsky, Alexander S Young, Mary C Malloy, S P J van Alphen, James M Ellison
INTRODUCTION: The Delphi method is a consensus-building technique using expert opinion to formulate a shared framework for understanding a topic with limited empirical support. This cross-validation study replicates one completed in the Netherlands and Belgium, and explores US experts' views on the diagnosis and treatment of older adults with personality disorders (PD). METHODS: Twenty-one geriatric PD experts participated in a Delphi survey addressing diagnosis and treatment of older adults with PD...
December 14, 2016: Aging & Mental Health
https://www.readbyqxmd.com/read/27956009/maintenance-pharmacotherapy-normalizes-the-relapse-curve-in-recently-abstinent-tobacco-smokers-with-schizophrenia-and-bipolar-disorder
#10
A Eden Evins, Susanne S Hoeppner, David A Schoenfeld, Bettina B Hoeppner, Corinne Cather, Gladys N Pachas, Kristina M Cieslak, Melissa Culhane Maravic
OBJECTIVE: To compare the effect of maintenance pharmacotherapy on sustained abstinence rates between recently abstinent smokers with schizophrenia and bipolar disorder (SBD) and general population smokers without psychiatric illness. METHOD: We performed a person-level, pooled analysis of two randomized controlled trials of maintenance varenicline, conducted in adult smokers with SBD and general population smokers, controlling for severity of dependence. Smokers abstinent after 12-weeks of open varenicline treatment were randomly assigned to ≥12-weeks maintenance varenicline or identical placebo...
December 9, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27914248/the-difficult-lives-of-individuals-with-bipolar-disorder-a-review-of-functional-outcomes-and-their-implications-for-treatment
#11
REVIEW
Michael J Gitlin, David J Miklowitz
BACKGROUND: Most longitudinal or treatment studies in bipolar disorder have used symptomatic or syndromal status as the primary outcome variable. More recently, psychosocial functioning has been highlighted as a key domain of outcome. Patients with bipolar disorder appear to be impaired in all functional domains, although the factors that cause impairment have not been clearly specified. METHODS: This paper reviews cross-sectional and longitudinal studies on functional impairment and its relationship to symptomatic, neurocognitive, personality, and stress variables in bipolar disorder; and the implications of these relationships for defining treatment targets...
February 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/27907271/adult-attention-deficit-hyperactivity-disorder-diagnosis-management-and-treatment-in-the-dsm-5-era
#12
REVIEW
Joel L Young, David W Goodman
Objective: To increase awareness of adult attention-deficit/hyperactivity disorder (ADHD) in the primary care community and to provide guidance for the management of this condition. Despite its increasing prevalence, adult ADHD largely remains underdiagnosed and inappropriately treated in the United States. The publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has provided more clear diagnostic criteria for adult ADHD, but a solid framework supporting the transition of ADHD management from pediatric to adult primary care is lacking...
November 17, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27883293/psychological-mislabeling-of-chronic-pain-lessons-from-migraine-in-the-20th-century
#13
Howard B Pikoff
Starting with Freud, psychoanalytically oriented practitioners described a complex of unconscious conflicts, desires and personality traits they believed to be the primary cause of a wide range of medical disorders. This was the psychogenic model. With the advance of basic research and pharmacotherapy, the psychogenic model was gradually replaced by a biopsychobehavioral model. This model treats chronic pain as a biologically based disorder that can be influenced by psychological factors and lifestyle. The present paper argues that many patients with chronic pain may not be significantly impacted by psychological factors, and that for those who are, cognitive-behavioral therapy is the treatment of choice...
March 2017: Pain Management
https://www.readbyqxmd.com/read/27834145/pharmacogenetics-and-pharmacotherapy-of-military-personnel-suffering-from-posttraumatic-stress-disorder
#14
Janine Naß, Thomas Efferth
BACKGROUND: Posttraumatic stress disorder (PTSD) is a severe problem among soldiers with combat experience and still difficult to treat. The pathogenesis is still not fully understood at the psychological level. Therefore, genetic research became a focus of interest. The identification of single nucleotide polymorphisms (SNPs) may help to predict, which persons are at high risk to develop PTSD as a starting point to develop novel targeted drugs for treatment. METHODS: We conducted a systematic review on SNPs in genes related to PTSD pathology and development of targeted pharmacological treatment options based on PubMed database searches...
November 11, 2016: Current Neuropharmacology
https://www.readbyqxmd.com/read/27785031/personality-features-dissociation-self-stigma-hope-and-the-complex-treatment-of-depressive-disorder
#15
Jan Prasko, Marie Ociskova, Ales Grambal, Zuzana Sigmundova, Petra Kasalova, Marketa Marackova, Michaela Holubova, Kristyna Vrbova, Klara Latalova, Milos Slepecky
OBJECTIVE: Identifying the predictors of response to psychiatric and psychotherapeutic treatments may be useful for increasing treatment efficacy in pharmacoresistant depressive patients. The goal of this study was to examine the influence of dissociation, hope, personality trait, and selected demographic factors in treatment response of this group of patients. METHODS: Pharmacoresistant depressive inpatients were enrolled in the study. All patients completed Clinical Global Impression - both objective and subjective form (CGI), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) at baseline and after 6 weeks of combined pharmacotherapy and psychotherapy (group cognitive-behavioral or group psychodynamic) treatment as an outcome measures...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27742833/exposure-response-relationships-during-free-access-intravenous-alcohol-self-administration-in-non-dependent-drinkers-influence-of-alcohol-expectancies-and-impulsivity
#16
Bethany L Stangl, Vatsalya Vatsalya, Molly R Zametkin, Megan E Cooke, Martin H Plawecki, Sean O'Connor, Vijay A Ramchandani
BACKGROUND: Self-administration is a hallmark of all addictive drugs, including alcohol. Human laboratory models of alcohol self-administration have characterized alcohol-seeking behavior, and served as surrogate measures of the effectiveness of pharmacotherapies for alcohol use disorders. Intravenous alcohol self-administration (IV-ASA) is a novel method that assess alcohol exposure driven primarily by the pharmacological response to alcohol, and may have utility in characterizing unique behavioral and personality correlates of alcohol-seeking and consumption...
October 14, 2016: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27717262/abandoning-personalization-to-get-to-precision-in-the-pharmacotherapy-of-depression
#17
Roy H Perlis
Effectiveness studies and analyses of naturalistic cohorts demonstrate that many patients with major depressive disorder do not experience symptomatic remission with antidepressant treatments. In an effort to better match patients with effective treatments, numerous investigations of predictors or moderators of treatment response have been reported over the past five decades, including clinical features as well as biological measures. However, none of these have entered routine clinical practice; instead, clinicians typically personalize treatment on the basis of patient preferences as well as their own...
October 2016: World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
https://www.readbyqxmd.com/read/27692183/primary-care-providers-interest-in-using-a-genetic-test-to-guide-alcohol-use-disorder-treatment
#18
Emily C Williams, Jessica P Young, Carol E Achtmeyer, Christian S Hendershot
BACKGROUND: Efforts to identify genetic moderators of pharmacotherapy response have generated interest in clinical applications of pharmacogenetic tests in alcohol use disorder (AUD) treatment. To date, no research on providers' interest in using pharmacogenetic tests in the context of AUD treatment has been reported. We conducted qualitative interviews with primary care providers from 5 clinics in the Veterans Health Administration (VA) to assess their interest in using a hypothetical genetic test to inform treatment of AUD with pharmacotherapy...
November 2016: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/27669762/pharmacological-treatment-of-borderline-personality-disorder-a-retrospective-observational-study-at-inpatient-unit-in-italy
#19
Enrico Paolini, Francesca Alice Fiore Mezzetti, Francesca Pierri, Patrizia Moretti
OBJECTIVE: Borderline personality disorder (BPD) is a high prevalence personality disorder. Pharmacotherapy is commonly used, however, a minority of studies investigated patterns of prescription for BPD, particularly in inpatients unit. We aimed to describe the clinical features and the prescribing practice for BPD patients, and to investigate the possible advantages of a single class of medications or of combined drug treatments in terms of length of stay in hospital. METHODS: This is a retrospective observational study evaluating 109 BPD inpatients from June 2011 to June 2013...
March 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/27633982/multifaceted-academic-detailing-program-to-increase-pharmacotherapy-for-alcohol-use-disorder-interrupted-time-series-evaluation-of-effectiveness
#20
Alex H S Harris, Thomas Bowe, Hildi Hagedorn, Andrea Nevedal, Andrea K Finlay, Risha Gidwani, Craig Rosen, Chad Kay, Melissa Christopher
BACKGROUND: Active consideration of effective medications to treat alcohol use disorder (AUD) is a consensus standard of care, yet knowledge and use of these medications are very low across diverse settings. This study evaluated the overall effectiveness a multifaceted academic detailing program to address this persistent quality problem in the US Veterans Health Administration (VHA), as well as the context and process factors that explained variation in effectiveness across sites. METHODS: An interrupted time series design, analyzed with mixed-effects segmented logistic regression, was used to evaluate changes in level and rate of change in the monthly percent of patients with a clinically documented AUD who received naltrexone, acamprosate, disulfiram, or topiramate...
September 15, 2016: Addiction Science & Clinical Practice
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