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Evidence-based Psychiatry

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https://www.readbyqxmd.com/read/27913990/sirukumab-a-potential-treatment-for-mood-disorders
#1
REVIEW
Aileen J Zhou, Yena Lee, Giacomo Salvadore, Benjamin Hsu, Trehani M Fonseka, Sidney H Kennedy, Roger S McIntyre
Convergent evidence indicates that abnormalities in the innate immune system may be pertinent to the pathogenesis, phenomenology, and possible treatment of several mental disorders. In keeping with this view, the targeting of interleukin-6 with the human monoclonal antibody sirukumab may represent a possible treatment and disease modification approach, for adults with brain-based disorders (e.g., major depressive disorder). A PubMed/Medline database search was performed using the following search terms: sirukumab; anti-IL-6; IL-6; major depressive disorder; inflammation...
December 2, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27886637/handling-clinical-comorbidity-in-randomized-clinical-trials-in-psychiatry
#2
Ruth O'Hara, Sherry A Beaudreau, Christine E Gould, Wendy Froehlich, Helena C Kraemer
The purpose of this paper is to a) outline the importance of including patients with clinical comorbidities in Randomized Clinical Trials (RCTs) of psychiatric treatments; and b) to propose a specific approach for best handling, analyzing and interpreting the data on clinical comorbidities in terms of their impact on treatment outcomes. To do this we first define and describe clinical comorbidity and differentiate it from other forms of comorbidity. We then describe the methodological and analytical problems associated with excluding patients with clinically comorbid conditions from RCTs, including the impact on the outcomes of RCTs in psychiatry and the impact on evidence-based clinical decision-making...
November 16, 2016: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/27872486/alpha-2-macroglobulin-in-alzheimer-s-disease-a-marker-of-neuronal-injury-through-the-rcan1-pathway
#3
V R Varma, S Varma, Y An, T J Hohman, S Seddighi, R Casanova, A Beri, E B Dammer, N T Seyfried, O Pletnikova, A Moghekar, M R Wilson, J J Lah, R J O'Brien, A I Levey, J C Troncoso, M S Albert, M Thambisetty
Preclinical changes that precede the onset of symptoms and eventual diagnosis of Alzheimer's disease (AD) are a target for potential preventive interventions. A large body of evidence suggests that inflammation is closely associated with AD pathogenesis and may be a promising target pathway for such interventions. However, little is known about the association between systemic inflammation and preclinical AD pathophysiology. We first examined whether the acute-phase protein, alpha-2 macroglobulin (A2M), a major component of the innate immune system, was associated with cerebrospinal fluid (CSF) markers of neuronal injury in preclinical AD and risk of incident AD in the predictors of cognitive decline among normal individuals (BIOCARD) cohort...
November 22, 2016: Molecular Psychiatry
https://www.readbyqxmd.com/read/27865900/detection-of-potentially-unnecessary-and-wasteful-clinical-trial-research-cumulative-meta-epidemiological-and-trial-sequential-analysis
#4
Philipp Storz-Pfennig
OBJECTIVE: The objective was to estimate the presence and extent to which potentially unnecessary and therefore maybe wasteful clinical trials regarding relevant interventions and outcomes in major clinical areas had been conducted. STUDY DESIGN AND METHODS: From current Cochrane collaboration systematic reviews in major medical fields (e.g. CVD, cancer, psychiatry) 13 different comparisons were sampled. A cumulative meta-analysis was conducted for each and trial sequential analysis applied to determine when in the course of evidence accrual evidence was found sufficient to reach a reliable conclusion...
November 16, 2016: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/27842737/-think-practice-and-write-the-revista-colombiana-de-psiquiatr%C3%A3-a-and-the-history-of-colombian-psychiatry-in-the-second-half-of-the-twentieth-century
#5
Olga Marcela Cruz Montalvo
This article analyses the part played by Revista Colombiana de Psiquiatría in the development of psychiatry as a medical speciality in Colombia. Moreover, it discusses its role in helping to consolidate the biomedical perspective and evidence-based medicine in Colombian psychiatry.
October 2016: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/27822275/the-effect-of-clinical-exposure-to-patients-on-medical-students-attitude-towards-mental-illness
#6
Homayoun Amini, Saeed Shoar, Maryam Tabatabaee, Somaye Arabzadeh
BACKGROUND: Stigma of mental disorders causes a reduction in seeking help from the health care professionals and is evident across the world. OBJECTIVES: The current study aimed to compare medical students' attitude towards mental illness after two different psychiatry clerkships in terms of the level of clinical exposure to patients with mental illness. PATIENTS AND METHODS: Through a quasi-experimental study, all of the 4(th)-year medical students were invited to enroll this study conducted in Tehran University of Medical Sciences (TUMS)...
September 2016: Iranian Journal of Psychiatry and Behavioral Sciences
https://www.readbyqxmd.com/read/27793702/clinical-and-biological-predictors-of-response-to-electroconvulsive-therapy-ect-a-review
#7
REVIEW
Martina Pinna, Mirko Manchia, Rossana Oppo, Filomena Scano, Gianluca Pillai, Anna Paola Loche, Piergiorgio Salis, Gian Paolo Minnai
Electroconvulsive therapy (ECT), developed in the 30's by Bini and Cerletti, remains a key element of the therapeutic armamentarium in psychiatry, particularly for severe and life-threatening psychiatric symptoms. However, despite its well-established clinical efficacy, the prescription of ECT has declined constantly over the years due to concerns over its safety (cognitive side effects) and an increasingly negative public perception. As for other treatments in the field of psychiatry, ECT is well suited to a personalized approach that would increment its efficacy, as well as reducing the impact of side effects...
October 25, 2016: Neuroscience Letters
https://www.readbyqxmd.com/read/27788697/innovation-and-pragmatism-required-to-reduce-seclusion-practices
#8
John Tully, Leo McSweeney, Katie-Lynn Harfield, Cindie Castle, Mrigendra Das
Seclusion may be harmful and traumatic to patients, detrimental to therapeutic relationships, and can result in physical injury to staff. Further, strategies to reduce seclusion have been identified as a potential method of improving cost-effectiveness of psychiatric services. However, developing alternative strategies to seclusion can be difficult. Interventions to reduce seclusion do not lend themselves to evaluation using randomized controlled trials (RCTs), though comprehensive literature reviews have demonstrated considerable non-RCT evidence for interventions to reduce seclusion in psychiatric facilities...
October 28, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27785752/training-psychiatry-residents-in-psychotherapy-the-role-of-manualized-treatments
#9
REVIEW
Joshua Pagano, Brandon N Kyle, Toni L Johnson, Sy Atezaz Saeed
Evidence-based treatment and manualized psychotherapy have a recent but rich history. As interest and research have progressed, defining the role of treatment manuals in resident training and clinical practice has become more important. Although there is not a universal definition of treatment manual, most clinicians and researchers agree that treatment manuals are an essential piece of evidence-based therapy, and that despite several limitations, they offer advantages in training residents in psychotherapy...
October 27, 2016: Psychiatric Quarterly
https://www.readbyqxmd.com/read/27784534/toward-understanding-thalamocortical-dysfunction-in-schizophrenia-through-computational-models-of-neural-circuit-dynamics
#10
REVIEW
John D Murray, Alan Anticevic
The thalamus is implicated in the neuropathology of schizophrenia, and multiple modalities of noninvasive neuroimaging provide converging evidence for altered thalamocortical dynamics in the disorder, such as functional connectivity and oscillatory power. However, it remains a challenge to link these neuroimaging biomarkers to underlying neural circuit mechanisms. One potential path forward is a "Computational Psychiatry" approach that leverages computational models of neural circuits to make predictions for the dynamical impact dynamical impact on specific thalamic disruptions hypothesized to occur in the pathophysiology of schizophrenia...
October 23, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27777415/brain-structure-in-pediatric-tourette-syndrome
#11
D J Greene, A C Williams Iii, J M Koller, B L Schlaggar, K J Black
Previous studies of brain structure in Tourette syndrome (TS) have produced mixed results, and most had modest sample sizes. In the present multicenter study, we used structural magnetic resonance imaging (MRI) to compare 103 children and adolescents with TS to a well-matched group of 103 children without tics. We applied voxel-based morphometry methods to test gray matter (GM) and white matter (WM) volume differences between diagnostic groups, accounting for MRI scanner and sequence, age, sex and total GM+WM volume...
October 25, 2016: Molecular Psychiatry
https://www.readbyqxmd.com/read/27766533/integrated-behavioral-health-in-pediatric-primary-care
#12
Wanjiku F M Njoroge, Cody A Hostutler, Billie S Schwartz, Jennifer A Mautone
There are multiple barriers to accessing high quality, evidence-based behavioral health care for children and adolescents, including stigma, family beliefs, and the significant paucity of child and adolescent psychiatrists. Although equal access continues to be an unmet need in the USA, there is growing recognition that integrated behavioral health services in pediatric primary care have the potential to reduce health disparities and improve service utilization. In a joint position paper, the American Academy of Pediatrics (AAP) and the American Academy of Child and Adolescent Psychiatry (AACAP) highlighted the multiple benefits of children receiving initial behavioral health screening, assessment, and evidence-based behavioral health treatments in the medical home...
December 2016: Current Psychiatry Reports
https://www.readbyqxmd.com/read/27752082/inhibition-of-step61-ameliorates-deficits-in-mouse-and-hipsc-based-schizophrenia-models
#13
J Xu, B J Hartley, P Kurup, A Phillips, A Topol, M Xu, C Ononenyi, E Foscue, S-M Ho, T D Baguley, N Carty, C S Barros, U Müller, S Gupta, P Gochman, J Rapoport, J A Ellman, C Pittenger, B Aronow, A C Nairn, M W Nestor, P J Lombroso, K J Brennand
The brain-specific tyrosine phosphatase, STEP (STriatal-Enriched protein tyrosine Phosphatase) is an important regulator of synaptic function. STEP normally opposes synaptic strengthening by increasing N-methyl D-aspartate glutamate receptor (NMDAR) internalization through dephosphorylation of GluN2B and inactivation of the kinases extracellular signal-regulated kinase 1/2 and Fyn. Here we show that STEP61 is elevated in the cortex in the Nrg1(+/-) knockout mouse model of schizophrenia (SZ). Genetic reduction or pharmacological inhibition of STEP prevents the loss of NMDARs from synaptic membranes and reverses behavioral deficits in Nrg1(+/-) mice...
October 18, 2016: Molecular Psychiatry
https://www.readbyqxmd.com/read/27739182/cost-effectiveness-of-donepezil-and-memantine-in-moderate-to-severe-alzheimer-s-disease-the-domino-ad-trial
#14
Martin Knapp, Derek King, Renée Romeo, Jessica Adams, Ashley Baldwin, Clive Ballard, Sube Banerjee, Robert Barber, Peter Bentham, Richard G Brown, Alistair Burns, Tom Dening, David Findlay, Clive Holmes, Tony Johnson, Robert Jones, Cornelius Katona, James Lindesay, Ajay Macharouthu, Ian McKeith, Rupert McShane, John T O'Brien, Patrick P J Phillips, Bart Sheehan, Robert Howard
OBJECTIVE: Most investigations of pharmacotherapy for treating Alzheimer's disease focus on patients with mild-to-moderate symptoms, with little evidence to guide clinical decisions when symptoms become severe. We examined whether continuing donepezil, or commencing memantine, is cost-effective for community-dwelling, moderate-to-severe Alzheimer's disease patients. METHODS: Cost-effectiveness analysis was based on a 52-week, multicentre, double-blind, placebo-controlled, factorial clinical trial...
October 13, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27670973/a-fuller-picture-evaluating-an-art-therapy-programme-in-a-multidisciplinary-mental-health-service
#15
Catherina Brady, Hilary Moss, Brendan D Kelly
Art therapy has a long history in mental healthcare, but requires an enhanced evidence base in order to better identify its precise role in contemporary services. This paper describes an evaluation of an art therapy programme in an acute adult psychiatry admission unit in Ireland. A mixed method research design was used. Quantitative data were collected through a survey of 35 staff members and 11 service users. Qualitative data included free text comments collected in the survey and individual feedback from service users...
September 26, 2016: Medical Humanities
https://www.readbyqxmd.com/read/27663821/liaison-psychiatry-and-bariatric-surgery-double-standards-what-are-the-possibilities-for-the-systematization-of-the-pre-operative-psychiatric-assessment-in-belgium
#16
Denis Jacques, Christine Reynaert, Nicolas Zdanowicz
BACKGROUND: In the context of health care in Belgium, the psychological or psychiatric opinion of a multidisciplinary team is required in the assessment of bariatric surgery candidates. In clinical practice, a wide variety of liaison psychiatry assessment methods exist. SUBJECTS AND METHODS: On the basis of a post-operative psychiatric comorbidity case report and a literature review on "liaison psychiatry and bariatric surgery" we aim to identify opportunities for the systematization of bariatric pre-surgery psychiatric evaluation...
September 2016: Psychiatria Danubina
https://www.readbyqxmd.com/read/27662279/study-329-continuation-phase-safety-and-efficacy-of-paroxetine-and-imipramine-in-extended-treatment-of-adolescent-major-depression
#17
Joanna Le Noury, John M Nardo, David Healy, Jon Jureidini, Melissa Raven, Catalin Tufanaru, Elia Abi-Jaoude
OBJECTIVE: This is an analysis of the unpublished continuation phase of Study 329, the primary objective of which was to compare the efficacy and safety of paroxetine and imipramine with placebo in the treatment of adolescents with unipolar major depression. The objectives of the continuation phase were to assess safety and relapse rates in the longer term. The objective of this publication, under the Restoring Invisible and Abandoned Trials (RIAT) initiative, was to see whether access to and analysis of the previously unpublished dataset from the continuation phase of this randomized controlled trial would have clinically relevant implications for evidence-based medicine...
September 17, 2016: International Journal of Risk & Safety in Medicine
https://www.readbyqxmd.com/read/27650639/how-voting-and-consensus-created-the-diagnostic-and-statistical-manual-of-mental-disorders-dsm-iii
#18
James Davies
This paper examines how Task Force votes were central to the development of Diagnostic and Statistical Manual of Mental Disorders (DSM-III and DSM-III-R). Data were obtained through a literature review, investigation of DSM archival material housed at the American Psychiatric Association (APA), and interviews with key Task Force members of DSM-III and DSM-III-R. Such data indicate that Task Force votes played a central role in the making of DSM-III, from establishing diagnostic criteria and diagnostic definitions to settling questions about the inclusion or removal of diagnostic categories...
September 21, 2016: Anthropology & Medicine
https://www.readbyqxmd.com/read/27644916/-iron-deficiency-a-diagnostic-and-therapeutic-perspective-in-psychiatry
#19
A Kassir
BACKGROUND: Iron plays an essential role in balancing the various metabolism in the body. It is also involved in the synthesis of several neurotransmitters. Nutritional iron deficiency is one of the most widespread worldwide; it poses a great health challenge due to the consequences it entails. OBJECTIVES: The aim of this research study is to explore the percentage of psychiatric patients who have a deficiency in iron. In addition, the study investigates the efficacy of iron administered by oral treatment on psychiatric symptomatology among iron deficient patients...
September 16, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27644429/teaching-medical-ethics-in-graduate-and-undergraduate-medical-education-a-systematic-review-of-effectiveness
#20
Santiago de la Garza, Vania Phuoc, Steven Throneberry, Jennifer Blumenthal-Barby, Laurence McCullough, John Coverdale
OBJECTIVE: One objective was to identify and review studies on teaching medical ethics to psychiatry residents. In order to gain insights from other disciplines that have published research in this area, a second objective was to identify and review studies on teaching medical ethics to residents across all other specialties of training and on teaching medical students. METHODS: PubMed, EMBASE, and PsycINFO were searched for controlled trials on teaching medical ethics with quantitative outcomes...
September 19, 2016: Academic Psychiatry
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