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Roger McIntyre

Lakshmi N Yatham, Sidney H Kennedy, Sagar V Parikh, Ayal Schaffer, David J Bond, Benicio N Frey, Verinder Sharma, Benjamin I Goldstein, Soham Rej, Serge Beaulieu, Martin Alda, Glenda MacQueen, Roumen V Milev, Arun Ravindran, Claire O'Donovan, Diane McIntosh, Raymond W Lam, Gustavo Vazquez, Flavio Kapczinski, Roger S McIntyre, Jan Kozicky, Shigenobu Kanba, Beny Lafer, Trisha Suppes, Joseph R Calabrese, Eduard Vieta, Gin Malhi, Robert M Post, Michael Berk
The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments...
March 14, 2018: Bipolar Disorders
Larry Culpepper, Raymond W Lam, Roger S McIntyre
How can you help your patients who are experiencing both depression and cognitive dysfunction? Tune in to this CME podcast to hear experts in psychiatry discuss 2 patient cases that illustrate the burden of cognitive impairment in major depressive disorder as well as effective assessment tools and management strategies.
January 2018: Journal of Clinical Psychiatry
Roger S McIntyre
How many of your patients achieve remission from depression with their first treatment? In this CME Health Spectrum activity, enter a virtual office to follow 2 patient cases about inadequate response to treatment. Learn as an expert describes strategies based on recent evidence-based guidelines.
January 2018: Journal of Clinical Psychiatry
Sung Keun Park, Ju Young Jung, Jae-Hong Ryoo, Chang-Mo Oh, Jae-Hon Lee, Zihang Pan, Rodrigo B Mansur, Margarita Shekotikhina, Roger S McIntyre, Joong-Myung Choi
There has been increasing evidence about psychosomatic relationship between mood disorder and blood pressure (BP). However, the degree to which BP categories are associated with depression has been less well described. Thus, this study was to investigate the association of depression with BP categories. A total of 90,643 men and 68,933 women were enrolled in this study. They were stratified into four groups (normal, prehypertension, newly diagnosed hypertension, and recognized hypertension) according to the BP levels and the history of hypertension...
February 16, 2018: Journal of the American Society of Hypertension: JASH
Rodrigo B Mansur, Yena Lee, Mehala Subramaniapillai, Elisa Brietzke, Roger S McIntyre
Major depressive disorder and bipolar disorder are highly prevalent and disabling conditions. Cognition is considered a core domain of their psychopathology and a principle mediator of psychosocial impairment, disproportionately accounting for overall illness-associated costs. There are few interventions with replicated evidence of efficacy in treating cognitive deficits in mood disorders. Evidence also indicates that cognitive deficits are associated with obesity and involve significant impairment across multiple domains...
February 23, 2018: Neuropharmacology
Mark S Wallace, James North, Eric J Grigsby, Leonardo Kapural, Mahendra R Sanapati, Stephen G Smith, Channing Willoughby, Patrick J McIntyre, Steven P Cohen, Richard M Rosenthal, Shaik Ahmed, Ricardo Vallejo, Farshad M Ahadian, Thomas L Yearwood, Allen W Burton, Edward J Frankoski, Jai Shetake, Sherry Lin, Brad Hershey, Benjamin Rogers, Nitzan Mekel-Bobrov
Objective: Despite the high prevalence of chronic multisite pain, there is little consensus on methods to characterize it. Commonly used assessments report only one dimension of pain, that is, intensity, thus ignoring the spatial aspect of pain. We developed a novel pain quantification index, the Integrated Pain Quantification Index (IPQI), on a scale of 0 to 1 that integrates multiple distinct pain measures into a single value, thus representing multidimensional pain information with a single value...
February 21, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Robert Queissner, René Pilz, Nina Dalkner, Armin Birner, Susanne A Bengesser, Martina Platzer, Frederike T Fellendorf, Nora Kainzbauer, Simone Herzog-Eberhard, Carlo Hamm, Bernd Reininghaus, Sieglinde Zelzer, Harald Mangge, Rodrigo B Mansur, Roger S McIntyre, Hans-Peter Kapfhammer, Eva Z Reininghaus
OBJECTIVES: Immunological/inflammatory processes have been proposed to play an important role in the pathophysiology of mood disorders, including bipolar disorder (BD). The present study aimed to examine the influence of immune activation, measured on the basis of inflammatory markers, on the course of illness, proxied by the number of affective episodes, in patients with BD. METHODS: We investigated the relationship between high-sensitive CRP (hsCRP) and Interleukin 6 (IL-6), two inflammatory markers and characteristics of course of illness (e...
February 3, 2018: Psychoneuroendocrinology
Traci Aladeen, Erica Westphal, Yena Lee, Carola Rong, Michelle Rainka, Horacio Capote, Roger S McIntyre
PURPOSE: We sought to characterize the clinical experience of outpatients treated with brexpiprazole after achieving suboptimal outcomes with aripiprazole or bupropion as determined by the treating psychiatric provider. DESIGN AND METHODS: Case series; inefficacy, intolerability, or other unsatisfactory outcome to previous trial with aripiprazole or bupropion. FINDINGS: The majority of individuals in our sample exhibited tolerability of brexpiprazole...
February 10, 2018: Perspectives in Psychiatric Care
Rodrigo B Mansur, Yena Lee, Aileen J Zhou, Nicole E Carmona, Danielle S Cha, Joshua D Rosenblat, Robert Bruins, Ron Kakar, Natalie L Rasgon, Julie A Lovshin, Tonita E Wroolie, Kang Sim, Elisa Brietzke, Hertzel C Gerstein, Carola Rong, Roger S McIntyre
BACKGROUND: Type 2 diabetes mellitus (T2DM) is associated with deficits across multiple cognitive domains; however, the determinants of cognitive impairment in T2DM are not well characterized. We aimed to evaluate body mass index (BMI), glycemic control, and T2DM duration as moderators of cognitive dysfunction in T2DM. METHODS: We conducted a meta-analytic review of the literature reporting data on BMI, hemoglobin A1c (HbA1c), T2DM duration, and validated measures of processing speed (ie, Digit Symbol Substitution Test, Trail Making Test [TMT]-A), verbal learning and memory (ie, Rey Auditory Verbal Learning Test), and working memory/executive function (ie, TMT-B) among individuals with vs without T2DM...
February 2018: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
Yena Lee, Nicole E Carmona, Margarita Shekotikhina, Mehala Subramaniapillai, Rodrigo B Mansur, Danielle S Cha, Jae-Hon Lee, JungGoo Lee, Aileen J Zhou, Roman M Dale, David J Muzina, Sidney H Kennedy, Roger S McIntyre
BACKGROUND: Individuals with binge eating disorder (BED) are differentially affected by attention-deficit/hyperactivity disorder (ADHD), obesity, and substance use disorder. We have investigated to what extent cognitive deficits are relevant to binge eating behavior (BEB). METHODS: Data from the International Mood Disorders Collaborative Project were retrospectively and cross-sectionally analyzed to compare individuals with and without BEB on measures of anhedonia and general cognitive functions (n = 566)...
February 2018: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
Mehala Subramaniapillai, Roger S McIntyre
Obesity is becoming an increasing problem worldwide. In addition to causing many physical health consequences, there is increasing evidence demonstrating that obesity is toxic to the brain and, as such, can be considered a disease of the central nervous system. Peripheral level regulators of appetite, such as leptin, insulin, ghrelin, and cholecystokinin, feed into the appetite center of the brain, which is controlled by the hypothalamus, to maintain homeostasis and energy balance. However, food consumption is not solely mediated by energy balance, but is also regulated by the mesolimbic reward system, where motivation, reward, and reinforcement factors influence obesity...
December 2017: CNS Spectrums
Roger S McIntyre
You know that measuring cognition in your patients with depression is important. But cognitive assessment instruments can be difficult to access, expensive, time consuming, and not available in an electronic format. Read this CME activity to learn about a new free tool.
November 2017: Journal of Clinical Psychiatry
Larry Culpepper, Raymond W Lam, Roger S McIntyre
​​ Cognitive impairment is a common, often persistent, symptom of major depressive disorder (MDD) that is disproportionately represented in patients who have not returned to full psychosocial functioning. The ultimate goal of treatment in depression is full functional recovery, and assessing patients for cognitive impairment and selecting treatments that address cognitive dysfunction should lead to improved functional outcomes. Unfortunately, many clinicians use screening and assessment tools that are not suited for measuring cognitive impairment in patients with depression...
November 2017: Journal of Clinical Psychiatry
Vincent Chin-Hung Chen, Yao-Hsu Yang, Ting-Yu Kuo, Kuo-You Huang, Yin-Cheng Huang, Yena Lee, Roger S McIntyre, Yu-Shu Huang, Chung-Yao Hsu
BACKGROUND: We report the first nationwide population-based cohort study using Taiwan's National Health Insurance Research Database on the association between enterovirus infection and the incidence of sleep disorders in a pediatric population. METHODS: Two matched groups of children under 18 years of age were included in the analyses for non-apneic sleep disorder and obstructive sleep apnea (OSA). Among them, 316 subjects were diagnosed with OSA during the surveillance period, including 182 in the EV infection group and 134 in the non-EV infection group...
January 8, 2018: Pediatric Infectious Disease Journal
Roger S McIntyre
Although many branded and generic antidepressants are approved for the treatment of major depressive disorder (MDD) in Canada, efficacy and tolerability differ among patients, and new treatment options are needed. Symptom types (eg, fatigue, energy/motivation, cognition, and functioning), medication type, treatment duration, and the need for maintenance therapy are factors that may influence treatment effectiveness. Three antidepressants, vortioxetine, levomilnacipran extended-release (ER), and vilazodone have recently become available in Canada...
2017: Neuropsychiatric Disease and Treatment
Renee-Marie Ragguett, Samantha J Yim, Peter T Ho, Roger S McIntyre
Major depressive disorder (MDD) is the leading cause of disability worldwide with a heterogeneous symptom profile. Levomilnacipran extended release (ER) (Fetzima), a SNRI, has been approved by the Food and Drug Administration for treatment of MDD. While categorized as a SNRI, in contradistinction to other approved SNRIs, levomilnacipran exhibits differential affinity for the norepinephrine reuptake transporter when compared to the serotonin reuptake transporter. Areas covered: Completed clinical trials which focused on levomilnacipran ER administered in those with MDD were included in this drug evaluation...
December 2017: Expert Opinion on Pharmacotherapy
Vincent Chin-Hung Chen, Chao-Yu Shen, Sophie Hsin-Yi Liang, Zhen-Hui Li, Ming-Hong Hsieh, Yeu-Sheng Tyan, Mong-Liang Lu, Yena Lee, Roger S McIntyre, Jun-Cheng Weng
Major depressive disorder (MDD) is highly prevalent, recurrent, and associated with functional impairment, morbidity, and mortality. Herein, we aimed to identify disruptions in functional connectomics among subjects with MDD by using resting-state functional magnetic resonance imaging (rs-fMRI). Sixteen subjects with MDD and thirty health controls completed resting-state fMRI scans and clinical assessments (e.g., Hamilton Depression Rating Scale (HAMD) and Hospital Anxiety and Depression Scale (HADS)). We found higher amplitude of low frequency fluctuations (ALFF) bilaterally in the hippocampus and amygdala among MDD subjects when compared to healthy controls...
2017: PeerJ
Yena Lee, Joshua D Rosenblat, JungGoo Lee, Nicole E Carmona, Mehala Subramaniapillai, Margarita Shekotikhina, Rodrigo B Mansur, Elisa Brietzke, Jae-Hon Lee, Roger C Ho, Samantha J Yim, Roger S McIntyre
INTRODUCTION: Work-related disability and productivity loss in Major Depressive Disorder (MDD) are critical determinants of patient quality of life and contribute significantly to the human and economic costs of MDD. Notwithstanding the return to work and pre-morbid levels of functioning as a critical therapeutic objective among individuals with MDD, it is unclear whether antidepressant treatment significantly and reliably improves measures of workplace functioning. Herein, we investigate to what extent antidepressant treatment improves workplace functioning among adults with MDD...
February 2018: Journal of Affective Disorders
Sophie Hsin-Yi Liang, Yao-Hsu Yang, Ting-Yu Kuo, Yin-To Liao, Tzu-Chin Lin, Yena Lee, Roger S McIntyre, Brent A Kelsen, Tsu-Nai Wang, Vincent Chin-Hung Chen
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) youths have increased suicide risk. Nevertheless, the beneficial effects of methylphenidate (MPH) on suicide attempt have received relatively little attention. AIMS: To investigate the MPH usage and the risk of suicide attempt among ADHD youths. METHODS: We identified 84,898 youths less than 18 years old with ADHD diagnosis between 1997 and 2013 from National Health Insurance, and examined whether MPH use affected suicide attempt risk using Cox proportional-hazards models...
November 6, 2017: Research in Developmental Disabilities
Trisha Suppes, Jonas Eberhard, Ole Lemming, Allan H Young, Roger S McIntyre
BACKGROUND: Symptoms of anxiety, irritability, and agitation (AIA) are prevalent among patients with bipolar I disorder (BD-I) mania with depressive symptoms, and could potentially be used to aid physicians in the identification of this more severe form of BD-I. Using data from two clinical trials, the aims of this post hoc analysis were to describe the phenomenology of bipolar mania in terms of AIA and depressive symptoms, and to evaluate the influence of these symptoms on the likelihood of remission during treatment...
November 6, 2017: International Journal of Bipolar Disorders
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