Although antidepressants are advised only as second-line treatment in patients with bipolar disorder, the matter is complicated by conflicting data surrounding antidepressant use during pregnancy. Read More
The diagnosis of bipolar disorder is typically associated with significant disability and impaired functioning. This article explores the pros and cons of functional and quality-of-life measures. Read More
Is combination therapy with lithium and valproate more effective in preventing relapses in patients with bipolar I disorder than montherapy with either drug alone?The authors of a study that recently appeared in The Lancet set out to address that important question. Dr. S. Nassir Ghaemi has chosen that study as his “Top Paper” of the year. Dr Ghaemi, who is professor of psychiatry at Tufts University School of Medicine and Director of the Mood Disorders Program at Tufts Medical Center, discusses highlights -- and the clinical implications.
To the Editor: Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimers disease. Patients with PD develop motor symptoms such as muscular rigidity, slowness of movement, and reduced gait speed, as well as non-motor deficits such as disorders of mood and distinctive alteration of speech and voice (hypokinetic dysarthria).1 The severity of PD can be
To the Editors: Miss H, a 17-year-old girl, did not have history of mooddisorders, conduct problems, substance misuse, or physical illness. She was diagnosed with schizophrenia at age 16, with initial presentations of persecutory delusion and formal thought disorder. She received comprehensive physical examinations, and organic etiology was excluded. Because of aggravated psychotic symptoms, she was admitted for 1 week. He
To the Editor: Vitamin-B12 deficiency (VB12D) has been associated with neuropsychiatric abnormalities like posterolateral myelopathy, peripheral neuropathy, autonomic neuropathy, optic atrophy, mooddisorders, psychosis, delirium, and dementia (especially in elderly persons).1 However, a strong causal relationship between VB12D and dementia has not been established.
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
To assess the progression of mental health research over four decades in the Arab world.|Publications on mental health in 21 Arab countries from 1966 to 2006 were screened using PubMed and Psychinfo. Data were collected and analyzed for Arab authors and affiliations, publication year, topic and type of journal.|In 40 years (1966-2005), the Arab world published 2,213 articles on a vast variety of topics, most common being mood, anxiety and substance use disorders, and mostly in international journals. By the last decade, the total yearly publications increased about eightfold since the first two decades, and nearly doubled from the third one. The disparity of output was high across countries. The highest yearly output was from Egypt, Saudi Arabia, Kuwait and Lebanon. Per million population, the top four producing countries were Kuwait, Bahrain, Lebanon and United Arab Emirates.|Over a decade, the Arab world produced approximately 17% of the global output of mental health
To examine major factors affecting readiness in the Army National Guard (ARNG), 265 soldiers of the Pennsylvania ARNG redeploying in 2010 from Iraq and Afghanistan were evaluated with validated questionnaires during their first unit formation. The questionnaires assessed demographic information, health habits, levels of perceived stress, mood, diet, sleep, and exercise habits, and included a screening question for depression. Our analysis revealed no negative effects of multiple deployments in this cohort of ARNG soldiers. There was no apparent impact on readiness attributable to soldiers' living locations; there did not appear to be an urban-rural divide. There were, however, numerous opportunities to improve health behaviors, including smoking (prevalence of 41%), poor dietary choices and sleep habits, as well as management of stress and mooddisorders. A striking prevalence of sleep apnea exists in these ARNG soldiers (40%), approximately double that previously measured in the
To investigate those ante- and perinatal circumstances preceding suicide attempts and suicides, which have so far not been studied intensively.|Examination of the Northern Finland Birth Cohort 1966 (n = 10,742), originally based on antenatal questionnaire data and now followed up from mid-pregnancy to age 39, to ascertain psychiatric disorders in the parents and offspring and suicides or attempted suicides in the offspring using nationwide registers.|A total of 121 suicide attempts (57 males) and 69 suicides (56 males) had occurred. Previously unstudied antenatal factors (maternal depressed mood and smoking, unwanted pregnancy) were not related to these after adjustment. Psychiatric disorders in the parents and offspring were the risk factors in both genders. When adjusted for these, the statistically significant risk factors among males were a single-parent family for suicide attempts (OR 3.71, 95% CI 1.62-8.50) and grand multiparity for suicides (OR 2.67, 95% CI 1.15-6.18). When a
To describe outcomes after unplanned hospital admission in older people and to determine whether disease trajectories in those admitted with ill-defined conditions (symptoms and signs) are distinct from other diagnostic groups and consistent with known disease trajectories.|Longitudinal follow-up after a retrospective cross-sectional study of emergency admissions to general internal and geriatric medicine units in one hospital.|Acute hospital in southern England.|All people aged 65 and older with unplanned admissions to general internal and geriatric medicine inpatient units during 2002 (N = 5,312).|Age, sex, comorbidity, presence of cognitive and mooddisorders, residence, and primary diagnostic group at discharge. Outcomes were death up to 36 months from admission, any readmission, and readmission for ill-defined conditions up to 36 months after discharge.|There were significant differences in death rates between the diagnostic groups, with mortality being highest in individuals
Recognizing suicidal communication from the distressful catharsis in a high-risk group with suicidal tendencies is essential for suicide prevention. This study analyzes whether suicidal communication can indicate the severity of suicidal intent. Various types of suicidal communication are defined, and their clinical significance is further explored.|A comprehensive analysis of the psychological autopsy data of 200 victims of completed suicide, including their general socio-demographic status, suicidal communication methods, previous suicide attempts, mental disorders, and psychosocial situation.|Our results showed that 39.5% of all the subjects were suicidal communicators, 23.0% had previously attempted suicide, and 14.0% left suicide notes; 32.4% of 142 subjects free of physical disease suffered from mental disorders. Suicidal communication included verbal communication, behavioral communication, and suicidal notes. Younger people with a higher level of education were more inclined