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
Epidemiologic studies of adults show that DSM-IV intermittent explosive disorder (IED) is a highly prevalent and seriously impairing disorder. Although retrospective reports in these studies suggest that IED typically begins in childhood, no previous epidemiologic research has directly examined the prevalence or correlates of IED among youth.|To present epidemiologic data on the prevalence and correlates of IED among US adolescents in the National Comorbidity Survey Replication Adolescent Supplement.|United States survey of adolescent (age, 13-17 years) DSM-IV anxiety, mood, behavior, and substance disorders.|Dual-frame household-school samples.|A total of 6483 adolescents (interviews) and parents (questionnaires).|The DSM-IV disorders were assessed with the World Health Organization Composite International Diagnostic Interview (CIDI).|Nearly two-thirds of adolescents (63.3%) reported lifetime anger attacks that involved destroying property, threatening violence, or engaging in
Although childhood adversities (CAs) are known to be highly co-occurring, most research examines their associations with psychiatric disorders one at a time. However, recent evidence from adult studies suggests that the associations of multiple CAs with psychiatric disorders are nonadditive, arguing for the importance of multivariate analysis of multiple CAs. To our knowledge, no attempt has been made to perform a similar kind of analysis among children or adolescents.|To examine the multivariate associations of 12 CAs with first onset of psychiatric disorders in a national sample of US adolescents.|A US national survey of adolescents (age range, 13-17 years) assessing DSM-IV anxiety, mood, behavior, and substance use disorders and CAs. The CAs include parental loss (death, divorce, and other separations), maltreatment (neglect and physical, sexual, and emotional abuse), and parental maladjustment (violence, criminality, substance abuse, and psychopathology), as well as economic
For several decades, both in vitro and in vivo models of seizures and epilepsy have been employed to unravel the molecular and cellular mechanisms underlying the occurrence of spontaneous recurrent seizures (SRS)-the defining hallmark of the epileptic brain. However, despite great advances in our understanding of seizure genesis, investigators have yet to develop reliable biomarkers and surrogate markers of the epileptogenic process. Sadly, the pathogenic mechanisms that produce the epileptic condition, especially after precipitating events such as head trauma, inflammation, or prolonged febrile convulsions, are poorly understood. A major challenge has been the inherent complexity and heterogeneity of known epileptic syndromes and the differential genetic susceptibilities exhibited by patients at risk. Therefore, it is unlikely that there is only one fundamental pathophysiologic mechanism shared by all the epilepsies. Identification of antiepileptogenesis targets has been an
New theoretical models of mood and anxiety disorders have been proposed to better understand the relations and patterns leading to their high diagnostic comorbidities. These models have highlighted two new groupings of the disorders, focused on the prevalence of fear and distress symptoms. The present study investigated the fit of the symptoms of posttraumatic stress disorder (PTSD) in these new models. The relations between the two primary sets of symptom scales of PTSD and the diagnoses of other comorbid disorders were examined in a large multisite sample of veterans from primary care clinics. The results suggested that there was no reliable difference in the predictive power of any of the PTSD symptom scales across the two diagnostic groups. New transdiagnostic models, assessment practices, and treatment approaches may provide better understanding of symptom overlap and diagnostic comorbidity in PTSD and related disorders.