Initial studies-such as the stepped collaborative care intervention, Texas Medication Algorithm Project (TMAP), and German Algorithm Project (GAP) phase 2-predominantly investigated whether following an expert opinion–based clinical algorithm (irrespective of the content of the algorithm) led to a better outcome than treatment as usual did
Anxiety disorders are the most prevalent psychiatric disorders in the United States. Although effective treatments are available, such as the SSRIs and cognitive-behavioral therapy (CBT), it is estimated that in about 40% of patients, anxiety disorders are partially or completely resistant to first-line treatment.
In 1931, Gananath Sen and Kartick Chandra Bose reported on the use of an alkaloid extract from the Rauwolfia serpentina plant in the treatment of hypertension and "insanity with violent maniacal symptoms." They noted that dosages "of 20 to 30 grains of the powder twice daily produce not only a hypnotic effect but also a reduction of blood pressure and violent symptoms
Hundreds of uniquely adapted venomous marine cone snail species inhabit the coral reefs of the Indian and Pacific oceans. Researchers posit that each may be a virtual neurologic pharmacopoeia with potential value for the treatment of everything from diabetic neuropathy to schizophrenia. The venoms, known as conotoxins, selectively inhibit a wide range of ion channels involved in neuromuscular signaling.
The editors of Pediatric Neuropsychiatry must have drawn on their experiences and the feedback they received on their first book, Textbook of Pediatric Neuropsychiatry (American Psychiatric Press, 1998), for this text.
Wayne S. Fenton, MD, died in Washington, DC, on September 3, 2006.
The need for better tools, as well as better use of existing tools, to measure treatment response in clinical trials was a principle focus of the 46th annual NIMH-sponsored NCDEU (New Clinical Drug Evaluation Unit) meeting, held June 12-15 in Boca Raton, Fla. Improved clinical research techniques are needed to better separate treatment effect from placebo response, to distinguish between active comparators, and to facilitate development of novel treatments, according to several presenters at the conference.
In its latest report on medication errors, a committee assembled by the Institute of Medicine (IOM) included some sidebars on psychiatric drugs. The report, issued in July, said that there is too little data on misadministration of psychiatric drugs and that clinical trials with psychiatric drugs have been small and incapable of providing pragmatic, comparative information.
A new edition of an established text is an opportunity for its authors and editors to review new information and prune what is no longer useful. The 4th edition of Principles and Practice of Psychopharmacotherapy is more successful at the former than it is at the latter.
Despite the progressive increase in the number of available antidepressants, many patients with depression continue to be symptomatic.
CBT is a comprehensive system of therapy that builds on core therapeutic values by using a wide range of reliable methods to produce cognitive and behavioral change.
Ampakines, agents that have been shown to enhance memory, appear to trigger endogenous brain-derived neurotrophic factor (BDNF), a natural mechanism in the brain that could restore neuronal viability and synaptic plasticity through increased trophic support.
Stress Neurobiology and Corticotropin-Releasing Factor
Interventions addressing symptom education, service continuity, and daily structure are the most effective in avoiding inpatient stays in patients with schizophrenia who have had multiple hospitalizations, a study in the June issue of The Journal of Nervous and Mental Disease reported.
The continuation of the epidemic of childhood obesity and overweight has major implications and consequences for future research in psychopathology.
Current treatments for autistic spectrum disorders (ASD) are useful in some cases, but have little enduring impact. This had lead to many parents seeking nonconventional treatments that often border on quackery.
New findings in epidemiology, developmental psychiatry, and neuroscience offer the opportunity for a new perspective on the problems of juvenile delinquency and bring to bear the insights of modern psychiatry in the treatment and successful rehabilitation of juvenile offenders.
The inclusion of parents in their children's treatment for eating disorder is not universally accepted. However, recent studies suggest that families should be included in treatment and that they are often a powerful resource for helping their children recover.
Friendship with patients, particularly those with serious mental illness, may seem anathema for a psychiatric ethicist, yet there is a long and rich history of physician-patient friendship in medical ethics.
DSM-IV-TR emphasizes that patients with borderline personality disorder (BPD) show a "instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts," and any five out of nine listed criteria must be present for the diagnosis to be made.
Because personality is shaped by experiences during childhood and adolescence, it is likely that mental disorders occurring during these years may have an influence on personality development.
While dementia is marked by such cognitive deficits as disorientation, memory loss and changes in intellectual functioning, these are not the symptoms that cause the most distress to caregivers.
College students are far less likely to kill themselves than are nonstudent peers, according to a 10-year research study examining suicide rates at 12 Midwestern campuses.
What does the term “polypharmacy” actually mean? Dr Pies likens polypharmacy to fire: just as the latter may either heat your house or burn it down, polypharmacy may either help or harm the patient.
Can sociodemographic and clinical variables predict outcome in cases of schizophrenia? Results from studies related to prognostic variables for schizophrenia have yielded interesting yet inconsistent results.
