Pharmacological treatment of patients with depression may produce significant improvement in symptoms of depression in general, yet may not address insomnia. This article addresses this and other concerns.Read More
This article discusses clinical studies that demonstrate the antidepressant effect of ketamine and other glutamatergic drugs and highlights the many still unanswered questions regarding treatment.Read More
We've put many of the clinical scales online, hoping healthcare professionals—whether in specialty practices, primary-care settings, or emergency services—will find this format convenient. … Read More
While it is true that the intense grief of bereavement and major depressive disorder often share some features—for example, tearfulness, insomnia, low... More »
Young women who report having sleeping difficulties “often” in their early 20s have a 4- to 5-times increased risk of depression within 9 years,... More »
Discussing the Neuropsychiatric Outcomes After Heart Surgery study, testing the vascular hypothesis of post-coronary artery bypass graft depression. More »
An obese woman in her thirties with a history of fibromyalgia syndrome, depression, polycystic ovarian syndrome, and diabetes presents with midline... More »
Lamotrigine is an important option in bipolar disorders. However, many clinicians also use it in patients with a (unipolar) depressive disorder who... More »
Because the aftermath of sexual violence can result in suicidal feelings, depression, PTSD, and other mental disorders, clinicians play an important... More »
An obese woman in her thirties with a history of fibromyalgia syndrome, depression, polycystic ovarian syndrome, and diabetes mellitus presents to... More »
An obese woman in her thirties with a history of fibromyalgia syndrome, depression, polycystic ovarian syndrome, and diabetes mellitus presents to her... More »
The associations between depressive symptoms and hypersomnia are complex and often bidirectional. Of the many disorders associated with excessive sleepiness in the general population, the most frequent are mental health disorders, particularly depression. However, most mood disorder studies addressing hypersomnia have assessed daytime sleepiness using a single response, neglecting critical and clinically relevant information about symptom severity, duration and nighttime sleep quality. Only a few studies
AbstractObjective To evaluate the effectiveness of a behavioural-educational sleep intervention delivered in the early postpartum in improving maternal and infant sleep.Design Randomised controlled trial.Setting Postpartum units of two university affiliated hospitals.Participants 246 primiparous women and their infants randomised while in hospital with an internet based randomisation service to intervention (n=123) or usual care (n=123) groups.Interventions The behavioural-educational sleep intervention i
AbstractObjective To evaluate the effect of initial low energy permissive underfeeding (trophic feeding) versus full energy enteral feeding (full feeding) on physical function and secondary outcomes in patients with acute lung injury.Design Prospective longitudinal follow-up evaluation of the NHLBI ARDS Clinical Trials Networks EDEN trialSetting 41hospitals in the United States.Participants 525 patients with acute lung injury.Interventions Randomised assignment to trophic or full feeding fo
Prevalence and Characteristics of Smokers Interested in Internet-Based Smoking Cessation Interventions: Cross-sectional Findings From a National Household Survey|Background: An accurate and up-to-date estimate of the potential reach of Internet-based smoking cessation interventions (ISCIs) would improve calculations of impact while an understanding of the characteristics of potential users would facilitate the design of interventions. Objective: This study reports the prevalence and the sociodemographic, s
Little research has been done into the mental health of Iraqis. Only one national survey is availablethe Iraq Mental Health Survey (IMHS) of 2007, with 4332 respondentswhich showed that anxiety disorders were the most common group (138%) and major depressive disorder the most common disorder (72%). Child and adolescent mental health issues are particularly important: the IMHS reported substantially increasing lifetime prevalence of most disorders across generations, and individuals younger than
Mood and substance use disorders commonly co-occur, yet there is little evidence-based research to guide the pharmacologic management of these comorbid disorders. The authors review the existing empirical findings, some of which may call into question current clinical pharmacotherapy practices for treating co-occurring mood and substance use disorders. The authors also highlight knowledge gaps that can serve as a basis for future research. The specific mood disorders reviewed are bipolar and major depressivedisorders (either one co-occurring with a substance use disorder). Overall, findings from the relatively small amount of available data indicate that pharmacotherapy for managing mood symptoms can be effective in patients with substance dependence, although results have not been consistent across all studies. Also, in most studies, medications for managing mood symptoms did not appear to have an impact on the substance use disorder. In a recent trial for comorbid major depression
Besides its use in epilepsy, lamotrigine (LTG) is also effective as mood stabilizer. The pathophysiology of mood disorders may incorporate a dysfunction of neuronal plasticity and animal experiments suggest that mood stabilizers influence induction of long-term potentiation (LTP) and -depression (LTD), two major forms of synaptic plasticity. However, the exact modes of action of LTG and its impact on neuronal plasticity in humans remain unclear.|Here, we tested the effects of a single oral dose of LTG (300 mg) on motor cortical plasticity induced by paired associative stimulation (PAS(25)), a protocol that typically induces LTP-like plasticity, in 26 young healthy adults in a placebo-controlled, randomized, double-blind crossover design. We stratified analysis of the LTG effects according to the individual PAS(25) response in the placebo session (14 LTP-responders vs. 12 LTD-responders). Plasticity was indexed by motor evoked potential (MEP) amplitudes recorded before and for 60 min
Episodes of bipolar disorder are defined as depressive or manic, but depressive and manic symptoms can combine in the same episode. Coexistence or rapid alternation of depressive and manic symptoms in the same episode may indicate a more severe form of bipolar disorder and may pose diagnostic and treatment challenges. However, definitions of mixed states, especially those with prominent depression, are not well established.|The authors performed literature searches for bipolar disorder, multivariate analyses, and the appearance of the terms "mixed" in any field; references selected from the articles found after the search were combined after a series of conferences among the authors.|The authors reviewed the evolution of the concept of mixed states and examined the symptom structure of mixed states studied as predominantly manic, predominantly depressive, and across both manic and depressive episodes, showing essentially parallel structures of mixed states based on manic or depressive
Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specific epidemiology has been done since the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and 2010 with methods to enable meaningful comparisons over time.|We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYs were calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional and global estimates of disease burden for three points in time with strictly comparable definitions and methods. YLLs were calculated from age-sex-country-time-specific estimates of
Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs).|Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method,
Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.