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Psychiatric medication

Arjun Sethi, Valerie Voon, Hugo D Critchley, Mara Cercignani, Neil A Harrison
Computational models of reinforcement learning have helped dissect discrete components of reward-related function and characterize neurocognitive deficits in psychiatric illnesses. Stimulus novelty biases decision-making, even when unrelated to choice outcome, acting as if possessing intrinsic reward value to guide decisions toward uncertain options. Heightened novelty seeking is characteristic of attention deficit hyperactivity disorder, yet how this influences reward-related decision-making is computationally encoded, or is altered by stimulant medication, is currently uncertain...
March 13, 2018: Brain: a Journal of Neurology
Paula A Aduen, Michael J Kofler, Dustin E Sarver, Erica L Wells, Elia F Soto, Daniel J Cox
ADHD is associated with automobile crashes, traffic fatalities, and serious road trauma, but it is unclear whether this risk is (a) driven by ADHD symptoms specifically, and (b) unique to ADHD or transdiagnostic across psychiatric disabilities, such as depression, that also have concentration problems as core symptoms. The current study provides the first prospective, continuously-monitored evaluation of crash risk related to ADHD symptoms, including the first on-road comparison of ADHD with another high-prevalence psychiatric disability (depression)...
March 6, 2018: Journal of Psychiatric Research
Kouta Suzuki, Hidehito Niimura, Ryoko Yamazawa, Takahiro Nemoto, Masaaki Murakami, Masaru Mimura, Masafumi Mizuno
INTRODUCTION: In recent years, the early detection and treatment of the first episode of schizophrenia (FES) has attracted worldwide attention. In Japan, psychiatric care has changed to an open and accessible framework over the past decade. Therefore, the duration of untreated psychosis (DUP) is thought to have been shortened. The purposes of this study were to investigate whether recent DUP periods are shorter than they were 10 years ago and whether the DUP at present differs among psychiatric facilities...
March 7, 2018: Asian Journal of Psychiatry
John Gunderson, Sara Masland, Lois Choi-Kain
Borderline personality disorder (BPD) has moved from being an untreatable disorder to a disorder with multiple evidence-based psychotherapies. When a second generation of research showed that less intensive, easier-to-learn therapies could be nearly as effective, they offered an approach that would be responsive to the persisting unmet needs of these patients. This paper describes good psychiatric management (GPM), a once-weekly, generalist model that medicalizes the disorder, emphasizes psychoeducation, and focuses on social adaptation...
January 5, 2018: Current Opinion in Psychology
Emanuele F Osimo, Rudolf N Cardinal, Peter B Jones, Golam M Khandaker
Low-grade inflammation is a risk factor for depression, psychosis and other major psychiatric disorders. It is associated with poor response to antidepressant and antipsychotics, and could potentially be a treatment target. However, there is limited data on the prevalence of low-grade inflammation in major psychiatric disorders, and on the characteristics of patients who show evidence of inflammation. We examined the prevalence of low-grade inflammation and associated socio-demographic and clinical factors in acute psychiatric inpatients...
March 1, 2018: Psychoneuroendocrinology
Debasish Basu, Aniruddha Basu, Abhishek Ghosh
A large proportion of patients with substance use disorders have clinical comorbidities, either medical or psychiatric. An initial assessment is necessary initially for prompt identification and management of any psychiatric or medical emergency, and thereafter a more detailed assessment for the comprehensive understanding of the individual. This should be done keeping in mind the goals of both immediate and long term assessment so that a comprehensive but individualized, context and culture sensitive, reality based, recovery-oriented management plan can be formulated...
February 2018: Indian Journal of Psychiatry
Michael Matthew McClay, Stephen S O'Connor, Brittany Nicole Groh, Marissa Baudino, Lisa Venanzi, Angela Shields, Jo Ellen Wilson, John Bone, Stephen Nicolson
OBJECTIVE: Evidence suggests that suicide attempts by self-inflicted gunshot wound (GSW) are underreported and may in turn affect disposition following hospitalization. This study aimed to evaluate the clinical characteristics and use of services among individuals who do not disclose suicidal intent following a self-inflicted GSW. METHODS: Electronic medical record data from 128 survivors of self-inflicted GSWs at a level 1 trauma center were analyzed to identify factors associated with nondisclosure of a suicide attempt to medical staff...
March 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Babatunde Aremu, Pamela D Hill, Joanne M McNeal, Mary A Petersen, Debbie Swanberg, Kathleen R Delaney
Addressing tense and escalating situations with noncoercive measures is an important element of inpatient psychiatric treatment. Although restraint rates are frequently monitored, the use of pro re nata (PRN) intramuscular (IM) injections to address agitation is also an important indicator. In 2015, at the current study site, a significant increase was noted in PRN IM medication use despite unit leadership's efforts to build a culture of trauma-informed care (TIC). The purpose of the current quality improvement project was to educate staff on methods to incorporate TIC into daily practice and the use of brief solution-focused therapy techniques in escalating situations...
March 14, 2018: Journal of Psychosocial Nursing and Mental Health Services
Julia F Litzky, Maya A Deyssenroth, Todd M Everson, Barry M Lester, Luca Lambertini, Jia Chen, Carmen J Marsit
BACKGROUND: Depression and/or anxiety during pregnancy have been associated with impaired fetal growth and neurodevelopmental. Because placental imprinted genes play a central role in fetal development and respond to environmental stressors, we hypothesized that imprinted gene expression would be affected by prenatal depression and anxiety. METHODS: Placental gene expression was compared between mothers with prenatal depression and/or anxiety/obsessive compulsive disorder/panic and control mothers without psychiatric history (n=458) in the Rhode Island Child Health Study...
March 14, 2018: Pediatric Research
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
Nancy Byatt, Lucille Cox, Tiffany A Moore Simas, Nisha Kini, Kathleen Biebel, Padma Sankaran, Holly A Swartz, Linda Weinreb
To elucidate (1) the challenges associated with under-recognition of bipolar disorder in obstetric settings, (2) barriers pregnant and postpartum women with bipolar disorder face when trying to access psychiatric care, and (3) how obstetric settings can identify such women and connect them with mental health services. Structured, in-depth interviews were conducted with 25 pregnant and postpartum women recruited from obstetric practices who scored ≥ 10 on the Edinburgh Postnatal Depression Scale and met DSM-IV criteria for bipolar disorder I, II, or not otherwise specified using the Mini International Neuropsychiatric Interview...
March 13, 2018: Archives of Women's Mental Health
Sharon Ashong, Irene A Kretchy, Barima Afrane, Ama de-Graft Aikins
Background: Patients with schizophrenia are managed with antipsychotics and other psychotropic medications. Objectives: This study aimed to assess the commonly prescribed psychotropic medications for patients with schizophrenia, explore the types of therapeutic monitoring that were performed, and find out whether the side effects experienced by the patients played any role in their adherence behaviour. Methods: This hospital-based cross-sectional study enrolled 259 patients with schizophrenia from Accra Psychiatric Hospital and Pantang Psychiatric Hospital...
2018: Psychiatry Journal
Mohammed Basith, Andrew Francis, Alfredo Bellon
Gabapentin has become increasingly used in psychiatric practice specifically for anxiety disorders. Even though gabapentin is not approved by the US Food and Drug Administration to treat anxiety, physicians sometimes use it as an alternative to benzodiazepines in patients with a history of substance abuse. Gabapentin is also prescribed when individuals are at risk of thrombocytopenia which is not considered a side effect. Among patients at risk of thrombocytopenia are those positive for human immunodeficiency virus (HIV)...
2018: Case Reports in Psychiatry
Lisa Hochstrasser, Alexander Voulgaris, Julian Möller, Tatjana Zimmermann, Regine Steinauer, Stefan Borgwardt, Undine E Lang, Christian G Huber
Background: Implementing an open door policy is a complex intervention comprising changes in therapeutic stance, team processes, and a change from locked to open doors. Recent studies show that it can lead to a reduction of seclusion and forced medication, but the role of the physical change of door status is still unclear. Aims: The aims of this study is to examine the transition from closed to predominantly open doors on a psychiatric intensive care unit (PICU) and its associations with the frequency of seclusion and forced medication...
2018: Frontiers in Psychiatry
Luc Jansen, Maarten van Schijndel, Jeroen van Waarde, Jan van Busschbach
BACKGROUND: Hospital inpatients often experience medical and psychiatric problems simultaneously. Although this implies a certain relationship between healthcare utilization and costs, this relationship has never been systematically reviewed. OBJECTIVE: The objective is to examine the extent to which medical-psychiatric comorbidities relate to health-economic outcomes in general and in different subgroups. If the relationship is significant, this would give additional reasons to facilitate the search for targeted and effective treatments for this complex population...
2018: PloS One
Juliann M Mellin, Sankaraleengam Alagapan, Caroline Lustenberger, Courtney E Lugo, Morgan L Alexander, John H Gilmore, L Fredrik Jarskog, Flavio Fröhlich
BACKGROUND: Approximately 30% of patients with schizophrenia experience auditory hallucinations that are refractory to antipsychotic medications. Here, we evaluated the feasibility and efficacy of transcranial alternating current stimulation (tACS) that we hypothesized would improve auditory hallucination symptoms by enhancing synchronization between the frontal and temporo-parietal areas of the left hemisphere. METHOD: 22 participants were randomized to one of three arms and received twice daily, 20 min sessions of sham, 10 Hz 2 mA peak-to-peak tACS, or 2 mA tDCS over the course of 5 consecutive days...
March 10, 2018: European Psychiatry: the Journal of the Association of European Psychiatrists
Yen-Feng Lee
OBJECTIVES: Pisa syndrome is characterized by lateral trunk flexion. It is an uncommon adverse drug reaction in patients on antipsychotic medication. Although Pisa syndrome has been reported in patients on antipsychotic treatment, previous studies have not discussed the prognosis of patients with Pisa syndrome. We studied psychiatric patients with Pisa syndrome following antipsychotic treatment for a 2-year period. METHODS: From January 2012 to December 2014, 13 inpatients with Pisa syndrome following antipsychotic treatment were identified at our institution, from a prospectively collected database...
March 2018: Clinical Neuropharmacology
Sevdalina Kandilarova, Drozdstoy Stoyanov, Ivo D Popivanov, Stefan Kostianev
RATIONALE, AIMS, AND OBJECTIVES: In this study, we have attempted to replicate the findings of altered emotional processing in depressed patients compared with healthy controls by means of functional magnetic resonance imaging during passive viewing of positive, negative, and neutral pictures from the International Affective Pictures System. METHODS: Nineteen medicated depressed patients and 19 sex and age-matched healthy controls underwent functional magnetic resonance imaging during presentation of affective pictures in a block design...
March 13, 2018: Journal of Evaluation in Clinical Practice
John W Wax, Amy W An, Nicole Kosier, Timothy E Quill
Voluntary stopping of eating and drinking (VSED) is a deliberate, self-initiated attempt to hasten death in the setting of suffering refractory to optimal palliative interventions or prolonged dying that a person finds intolerable. Individuals who consider VSED tend to be older, have a serious but not always imminently terminal illness, place a high value on independence, and have significant illness burden. VSED can theoretically be performed independent of clinician assistance and therefore avoids many of the ethical and legal concerns associated with physician-assisted dying or other palliative measures of last resort, However, VSED is an intense process fraught with new sources of somatic and emotional suffering for individuals and their caregivers, so VSED is best supervised by an experienced, well-informed clinician who can provide appropriate pre-intervention assessment, anticipatory guidance, medical treatment of symptoms, and emotional support...
March 2018: Journal of the American Geriatrics Society
Cynthia Cheng, Fatima Mithoowani, Thomas Ungar, Monica Lee
Background: Interaction between alcohol and certain medications can lead to adverse consequences. Individuals with mental health disorders are particularly vulnerable because of their psychotropic medications, which are typically taken over extended periods and which are known to have pharmacokinetic and pharmacodynamic interactions with alcohol. It is unknown what education these patients receive from their health care providers and how such interactions are managed. Objectives: To determine whether individuals with mental health disorders are aware of alcohol-drug interactions and if so, how they use such information...
January 2018: Canadian Journal of Hospital Pharmacy
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