14612m01394<ul> <li class="take-home-list">The majority of patients with major depressive disorder have reported some level of functional impairment such as difficulties in work and home life.</li> <li class="take-home-list">Patient self-rated scales, such as the Sheehan Disability Scale, can assess impairment in social life, family life, and work/school responsibilities related to depression.</li> <li class="take-home-list">Current evidence supports aripiprazole augmentation of antidepressant therapy to improve functioning in depression.</li> </ul>False
14611m01173<ul> <li class="take-home-list">There is a high prevalence of sleep disorders in patients with mental disorders.</li> <li class="take-home-list">Longer sleep latency and shorter sleep duration were the most common characteristics of low quality sleep in patients with mental disorders and were most notable in those with depression.</li> </ul> 
14612m01385<ul> <li class="take-home-list">Depression care managers in primary care settings can ensure that a treatment plan is being followed, monitor symptoms and medication side effects, educate patients about their disease, encourage self-management techniques, and provide time-limited psychotherapy.</li> <li class="take-home-list">Hispanics are more likely to receive mental health care in primary care settings than at specialized mental health facilities for a variety of reasons, from lack of access to mental health specialists and income and insurance issues to the stigma surrounding mental illness and the trust of the relationship with the family physician.</li> <li class="take-home-list">Non–English-speaking individuals are less likely to receive needed mental health treatment, and when they do, fewer than 20% receive care that meets minimally adequate standards. However, when treated in a collaborative care model adapted for Spanish-speaking populations, patients with limited English proficiency showed significant improvement in their mental health.</li> </ul> 
14611r01336<ul> <li class="take-home-list">Attention-deficit/hyperactivity disorder (ADHD) impacts multiple domains, beyond the characteristic symptoms of hyperactivity, impulsivity, and inattention.</li> <li class="take-home-list">A meaningful assessment of treatment effectiveness requires measures of functionality, quality of life, adaptive life skills, and executive function, as well as reductions of ADHD symptoms.</li> <li class="take-home-list">Validated rating instruments are available to assess the effects of treatment in all of these domains.</li> </ul> 
14612m01380<ul> <li class="take-home-list">Augmentation of antidepressant therapy with atypical antipsychotics is an effective strategy to alleviate depressive symptoms in patients who have failed antidepressant monotherapy.</li> <li class="take-home-list">There is no evidence that failure to respond to antidepressant monotherapy of different classes is necessary before augmentation with an atypical agent is tried.</li> </ul> 
14612m01407<ul> <li class="take-home-list">Long-acting injections of second-generation antipsychotics are a valuable option for patients with schizophrenia with poor adherence to treatment.</li> <li class="take-home-list">Gender may be a predictor of clinical response to antipsychotic treatment, but its influence is not the same for all antipsychotics.</li> <li class="take-home-list">Treatment with risperidone long-acting injections was associated with clinically significant improvement in both male and female patients with comparable severity of schizophrenia; there were no significant differences between men and women on most outcome measures.</li> </ul> 
14612m01410<ul> <li class="take-home-list">The presence of hot flashes during menopause is often concomitant with the presence of depression.</li> <li class="take-home-list">For women experiencing menopausal symptoms, depression is associated with worse quality of life and greater work productivity loss, health care resource use, and costs.</li> <li class="take-home-list">Clinicians’ proper assessment and management of depressive symptoms may have an important humanistic and economic benefit.</li> </ul> 
14612alz01491<ul> <li class="take-home-list">Delayed posthypoxic leukoencephalopathy is a rare complication resulting from any event that causes prolonged cerebral hypooxygenation.</li> <li class="take-home-list">On rare occasions, a full recovery from an initial comatose state can be followed days to weeks later by acute neuropsychiatric findings such as disorientation, amnesia, hyperreflexia, frontal release signs, parkinsonism, akinetic-mutism, or psychosis.</li> <li class="take-home-list"></li> </ul> 
14612br01401<ul> <li class="take-home-list">There is still no effective treatment of tardive dyskinesia (TD).</li> <li class="take-home-list">Fluvoxamine is a potent sigma-1 receptor agonist that is suggested to have various effects on neuropsychiatric disorders.</li> <li class="take-home-list">Fluvoxamine might be an effective treatment for TD with fewer side effects than tetrabenazine.</li> </ul> 
14512m01386<ul> <li class="take-home-list">There is still much to be learned about the mechanism(s) behind antipsychotic-induced weight gain.</li> <li class="take-home-list">One theory behind aripiprazole’s varying effects on weight gain is that, in the presence of high serotonergic activity, aripiprazole acts as an antagonist at the 5-HT2C receptor, thus increasing the potential for weight gain. Conversely, when in an environment of low serotonergic activity, aripiprazole acts as an agonist at the 5-HT2C receptor, thereby having less effect on weight.</li> <li class="take-home-list">Further research into the 5-HT2C receptor and other receptor subtypes and their relation to appetite and obesity is still needed.</li> </ul> 
14512m01344<ul> <li class="take-home-list">Many adults with attention-deficit/hyperactivity disorder (ADHD) exhibit evidence of a personality disorder (PD).</li> <li class="take-home-list">In this study, cluster C PDs were most common.</li> <li class="take-home-list">This study of methylphenidate transdermal system in adults showed that subjects having 2 or more PDs were less likely to respond to ADHD treatment than those with no or 1 PD.</li> </ul> 
14512m01364<ul> <li class="take-home-list">A naturalistic study of antidepressant monotherapy showed that 39% of patients improved substantially.</li> <li class="take-home-list">Greater initial depressive severity, comorbid substance abuse, and comorbid anxiety are associated with worse outcomes.</li> </ul> 
14512m01353<ul> <li class="take-home-list">Relationships between trauma in childhood and aggressive behavior in adulthood remain unclear.</li> <li class="take-home-list">In univariate analyses, all 5 forms of childhood trauma in this study (ie, witnessing violence, physical neglect, emotional abuse, physical abuse, sexual abuse) demonstrated statistically significant relationships with the number of different aggressive behaviors reported in adulthood.</li> <li class="take-home-list">In multivariate analyses, witnessing violence and emotional abuse remained statistically significant predictor variables.</li> </ul> 
14511m01309<ul> <li class="take-home-list">Depression is underdiagnosed in the adolescent population.</li> <li class="take-home-list">Hospitalizations and follow-up visits are important opportunities to evaluate young adults for depression.</li> <li class="take-home-list">A more proactive approach to depression screening is needed to identify members of this population who are at risk.</li> </ul> 
14512alz01463<ul> <li class="take-home-list">Frontotemporal dementia (FTD) frequently presents with severe personality changes, affective symptoms, psychosis, and/or anxiety and may mimic a psychiatric disorder.</li> <li class="take-home-list">On average, onset of FTD occurs approximately a decade earlier than Alzheimer’s disease, with some cases reported as early as 21 years of age and as late as 80 years of age.</li> <li class="take-home-list">There are currently no FDA-approved pharmacologic treatments for FTD. Treatment is symptomatic and should always include behavioral and environmental modifications as well as caregiver education and support.</li> </ul> 
14511016co2cc<ul> <li class="take-home-list">Patients with MS may present clinically with eye problems, mobility issues, bowel and bladder problems, cognitive deficits, muscle weakness, and fatigue.</li> <li class="take-home-list">The revised diagnostic criteria for MS require the presence of more than 2 silent lesions with dissemination in space and time.</li> <li class="take-home-list">In addition to using diagnostic criteria, clinicians must take a thorough patient history and complete a differential diagnosis.</li> <li class="take-home-list">A referral to a neurologist is necessary if the patient presents with new neurologic symptoms.</li> <li class="take-home-list">Medications are available to manage the symptoms of MS and to slow the disability and prevent exacerbations associated with the disease progression, but at this time there is no cure for MS.</li> </ul> 
14411m01142<ul> <li class="take-home-list">In these surveys, caregivers often reported a delay between observation of the first symptoms of Alzheimer’s disease and formal diagnosis and treatment of Alzheimer’s disease.</li> <li class="take-home-list">In general, caregivers wanted more information at the time of diagnosis as well as the chance to participate in therapeutic decisions.</li> <li class="take-home-list">The caregivers reported that transdermal patch therapy was advantageous and had a positive impact on daily life due to ease of application and avoiding conflict with the patient.</li> </ul> 
14412m01345<ul> <li class="take-home-list">Patients with shift work disorder exhibit impairments in functioning and quality of life.</li> <li class="take-home-list">Armodafinil is currently approved in the United States for the treatment of excessive sleepiness associated with shift work disorder.</li> <li class="take-home-list">The results of this study suggest that armodafinil improves patient functioning and quality of life in patients with shift work disorder.</li> </ul> 
14411m01312<ul> <li class="take-home-list">Limited experience with adult attention-deficit/hyperactivity disorder (ADHD) diagnosis and treatment is a barrier to adequate care in both primary care and psychiatry practice, and difficulty distinguishing ADHD from other disorders is a significant barrier to ADHD management.</li> <li class="take-home-list">All patients who present with significant mental health symptoms should be evaluated for ADHD because of the high prevalence rate in the general population and the high rate of comorbid psychiatric disorders (ie, depression, anxiety, and substance use disorders).</li> <li class="take-home-list">Although awareness of ADHD has grown, further education about adult ADHD will improve patient care by both primary care physicians and psychiatrists.</li> </ul> 
14411m01332<ul> <li class="take-home-list">The majority of US pediatricians do not treat children and adolescents with major depressive disorder (MDD) but refer them to psychiatrists.</li> <li class="take-home-list">Child and adolescent psychiatrists have the expertise to treat these patients; however, there is a serious shortage of these health care providers in the United States.</li> <li class="take-home-list">Pediatricians may be able to play a valuable role in the treatment of children and adolescents with MDD if their hesitation about treating this patient population is better understood and addressed.</li> </ul> 
14412m01343<ul> <li class="take-home-list">Clinicians should be aware of the severity associated with trichotillomania at all ages, regardless of age at onset.</li> <li class="take-home-list">Subjects with a later age at onset spent more time pulling each day and had a more clinically severe form of trichotillomania than the childhood-onset group.</li> <li class="take-home-list">Consistent with previous studies, neurocognitive testing revealed impaired stop-signal reaction times in the later-onset group versus healthy controls.</li> </ul> 
14411r01320<ul> <li class="take-home-list">Geriatric substance abuse is a common problem and includes both licit and illicit substances.</li> <li class="take-home-list">There are not yet reliable screening instruments or treatment methods for identification and treatment of illicit substance abuse in the elderly.</li> <li class="take-home-list">A high index of suspicion and consideration of illicit substance use as a real possibility are vital for early recognition and diagnosis of such abuse in the elderly.</li> </ul> 
14411m01296<ul> <li class="take-home-list">Eszopiclone 3 mg is an effective treatment for insomnia across 5 clinically diverse patient populations including those with primary insomnia, major depressive disorder, generalized anxiety disorder, perimenopause/ postmenopause, and rheumatoid arthritis.</li> <li class="take-home-list">For those with insomnia and major depressive disorder, eszopiclone was studied in conjunction with concomitant therapy with a selective serotonin reuptake inhibitor, which is how eszopiclone should be used in clinical practice in patients with these insomnia comorbidities.</li> </ul> 
14412alz01431<ul> <li class="take-home-list">Amyloid positron emission tomography (PET) imaging can be used in the workup of patients with mild cognitive impairment (MCI).</li> <li class="take-home-list">Negative results of amyloid PET imaging (showing little to no amyloid deposition) can help rule out an Alzheimer’s etiology of MCI.</li> <li class="take-home-list">A positive amyloid PET scan (showing moderate to frequent amyloid deposition) does not conclusively confirm an Alzheimer’s etiology of MCI.</li> </ul> 
14412f01371<ul> <li class="take-home-list">Drug testing has become widespread in clinical settings and elsewhere (eg, the workplace, the military, in professional sports, and in forensic settings).</li> <li class="take-home-list">Enzyme-mediated immunoassays (EIAs) use antibodies to specific opiates that bind to that opiate when present in a sample to produce a measurable reaction, while gas chromatography that separates different molecules in a sample is often followed by mass spectroscopy that compares spectrographic patterns to a standard to identify a separated molecule.</li> <li class="take-home-list">False-positive screens are the result of cross-reactivity to the antibody in EIA tests due to specific medications or direct binding to the antibody due to inadvertent ingestion of opiates (eg, poppy seeds) or use of medications (eg, quinolones, rifampin, verapamil, quetiapine, and diphenhydramine), as well as by interference caused by lactate dehydrogenase and lactate. </li> </ul> 
14311m01324<ul> <li class="take-home-list">Patients with schizophrenia frequently have non–mental health comorbidities that should also be managed.</li> <li class="take-home-list">Clinicians should monitor adherence to antipsychotic medications as well as medications for non–mental health conditions to improve health outcomes in patients with schizophrenia.</li> </ul> 
14311m01326<ul> <li class="take-home-list">Increasing numbers of deaths are due to opioid overdose among patients prescribed long-term opioid therapy to manage chronic pain.</li> <li class="take-home-list">Opioid therapy can adversely affect respiratory, gastrointestinal, musculoskeletal, cardiovascular, immune, endocrine, and central nervous systems.</li> <li class="take-home-list">The higher the daily dose of prescribed opioid, the higher the risk of overdose and other significant problems such as fractures, addiction, intestinal blockages, and sedation.</li> <li class="take-home-list">Physicians and patients are encouraged to weigh the full spectrum of medical risks against a realistic assessment of observed benefits for pain.</li> </ul> 
14311r01298<ul> <li class="take-home-list">Treatment effectiveness may be similar among all antipsychotics for various indications in youth and adults.</li> <li class="take-home-list">Youth appear to be especially sensitive to both metabolic and extrapyramidal side effects.</li> <li class="take-home-list">There may be a lower association of metabolic changes with certain antipsychotics, which should be carefully considered as the prevalence of obesity increases in the United States.</li> </ul> 
14311m01251<ul> <li class="take-home-list">The delayed onset of the therapeutic effect (~4–6 weeks) of antidepressant therapy (ADT) places patients at risk for continued morbidity (eg, suicide or other personal crises) even after the patient and clinician have decided to begin or adjust treatment.</li> <li class="take-home-list">The findings show that augmentation of ADT with aripiprazole results in an early (week 2) and more robust response to treatment than with continued antidepressant monotherapy.</li> <li class="take-home-list">This early response to adjunctive aripiprazole allows clinicians to reduce the morbidity risk and to make clinically meaningful decisions soon after treatment initiation.</li> </ul> 
14311m01293<ul> <li class="take-home-list">Hospitalization, a common complication of schizophrenia, is usually the result of treatment failure and accounts for about one-third of the cost of this illness.</li> <li class="take-home-list">The sulfotransferase 4A1 haplotype 1 (<i>SULT4A1-1</i>) genetic marker identifies a subset of patients that have lower risk of hospitalization when treated with olanzapine or quetiapine compared to risperidone, ziprasidone, or perphenazine.</li> <li class="take-home-list">Knowledge of a patient’s <i>SULT4A1-1</i> status may help to guide choice of antipsychotic treatment for patients with psychosis.</li> </ul> 
14311m01286&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;PC-MHI programs serve patients with less severe mental illness, such as nonmajor depressive disorders, without involving specialty mental health clinics.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;PC-MHI programs may be particularly useful for serving patients aged 65 years and older.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;PC-MHI programs should be prepared to effectively liaison with specialty mental health clinics for patients with severe mental illnesses.&lt;/li&gt; &lt;/ul&gt; 
14311m01256&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Depression is not limited to individuals. It is also contagious and may extend to people who are close to the patient.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Effective interventions for a patient’s depression may also reduce stress, depressiveness, and suicidality in the patient’s close interpersonal network.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;In addition to the individual patient, clinicians should take into account the patient’s interpersonal network when treating depression.&lt;/li&gt; &lt;/ul&gt; 
14311m01269&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Among diabetic patients, current depression may affect diabetes care, as these patients report poorer compliance, lower patient satisfaction, and poorer quality of life and show poor quality of care.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Depression is not well recognized, especially in mild cases, but is also sometimes overdiagnosed.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Physicians were more likely to recognize depression in their female patients, in those with moderate-severe depression (per PHQ-9 score), and among patients who reported a poorer quality of life.&lt;/li&gt; &lt;/ul&gt; 
14312alz01398&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Dementia with Lewy bodies (DLB) is a neurodegenerative disorder characterized by progressive cognitive decline plus at least 2 of the following symptoms: cognitive fluctuations, visual hallucinations (typically of mute animate objects appearing early in the course of the disease), or parkinsonism.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;There are currently no US Food and Drug Administration–approved treatments for DLB and no evidence base to direct treatment. Anecdotal evidence and limited studies indicate that cholinesterase inhibitors and memantine may be effective treatment options for individuals suffering from this disorder.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Nonpharmacologic approaches, including physical, occupational, and voice therapy, are also valuable options for comprehensive treatment of DLB.&lt;/li&gt; &lt;/ul&gt; 
14312f01341&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;The differential diagnosis of being found in feces is broad.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Those who let themselves be found in stool can be classified into 4 broad categories: those who are not aware that there is a problem, those who cannot move, those who will not move, and those who do not move.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;While the Mini-Mental State Examination can uncover moderate-to-severe impairments in cognitive function, it is insensitive to deficits in executive function; thus, more extensive mental status testing may be required during the assessment of neuropsychiatric dysfunction.&lt;/li&gt; &lt;/ul&gt; 
14211m01199&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Sexual dysfunction is very common in patients with schizophrenia who are receiving antipsychotics.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;The rate of sexual dysfunction varies with the assessment questionnaire that is used.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;There is a need to develop a valid and relevant instrument for assessing sexual dysfunction associated with use of psychotropics.&lt;/li&gt; &lt;/ul&gt; 
14211m01230&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Vitamin D deficiency has metabolic and mental health consequences beyond abnormalities in bone metabolism.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Current evidence suggests that vitamin D deficiency is prevalent among patients with psychiatric disorders.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Screening for vitamin D deficiency should be part of the health assessment of patients with major psychiatric illnesses.&lt;/li&gt; &lt;/ul&gt; 
14211r01179&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Clinical excellence comprises several domains, all of which are applicable and relevant to psychiatric patient care.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Mastery of these domains enables clinicians to provide the best possible care for all patients, including those with psychiatric illness.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Excellent patient care can be fostered in the academic medical setting by recognizing those clinicians who exemplify clinical excellence.&lt;/li&gt; &lt;/ul&gt;True
14211m01273&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Measures of processing speed in A Quick Test of Cognitive Speed may complement standard psychiatric intake procedures to differentiate adults with attention-deficit/hyperactivity disorder from referrals with mild psychiatric disorders.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Current evidence indicates a high degree of clinical utility (sensitivity 89%) when applying fail criteria for dual-dimension processing of color-form combinations and overhead, a measure of processing efficiency.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;A Quick Test of Cognitive Speed may provide objective, clinical baselines for evaluating the effects of treatment with pharmaceuticals.&lt;/li&gt; &lt;/ul&gt; 
14211r01222&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Posttraumatic stress disorder (PTSD) is a severe anxiety disorder that impacts a large percentage of the US population, in particular, veterans.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Current FDA-approved and unapproved treatments for PTSD are less than ideal due to their potential to produce insomnia.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Prazosin has been shown, in several published studies, to significantly reduce nightmares and improve sleep in patients suffering from PTSD.&lt;/li&gt; &lt;/ul&gt; 
14211m01220&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Patients with type 1 diabetes and depression have poorer adherence and worse clinical outcomes than patients without depression.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Cognitive-behavioral therapy (CBT) for adherence and depression has shown promise in improving depression and adherence in type 2 diabetes.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Integration of the treatment of depression with CBT-informed strategies to improve self-care and treatment adherence may improve health outcomes for adult patients with type 1 diabetes and depression.&lt;/li&gt; &lt;/ul&gt; 
14211m01162&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Guidelines addressing the treatment of veterans with posttraumatic stress disorder (PTSD) strongly recommend a therapeutic trial of selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;There may be obstacles in engaging Afghanistan and Iraq war veterans with PTSD, who also have a diagnosis of depression, to complete this recommended pharmacotherapy.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Clinicians should actively involve veterans in treatment planning. It would appear to be important to specifically inform veterans about the consequences of prematurely stopping SSRIs/SNRIs.&lt;/li&gt; &lt;/ul&gt; 
14211r01228&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Head injury and metallic plate implantation with subsequent severe depression is a challenging clinical problem, and a high suicide risk makes effective treatment imperative.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;A course of electroconvulsive therapy (ECT) in such patients and, if needed, maintenance ECT is a safe and effective option.&lt;/li&gt; &lt;/ul&gt; 
14212alz01370&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Careful review of medications taken by a patient with dementia should be performed to eliminate untoward side effects and improve quality of life.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Benzodiazepine use in patients with dementia could result in ataxia, falls, confusion, and sedation and should be limited if possible.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Tricyclic antidepressants have anticholinergic properties and could worsen confusion in patients with dementia as well as diminish the therapeutic effect of cholinesterase inhibitors that are used to treat Alzheimer’s disease.&lt;/li&gt; &lt;/ul&gt; 
14111m01233<ul> <li class="take-home-list">The <i>Perspectives</i> approach to the understanding and treatment of patients with psychiatric conditions offers an alternative to the <em>DSM</em>.</li> <li class="take-home-list">The <i>Perspectives</i> approach requires a systematic consideration of the patient’s psychiatric condition from 4 perspectives: disease, dimensional, behavior, and life story.</li> <li class="take-home-list">Although originating at Johns Hopkins University, the <i>Perspectives</i> approach has dispersed to other institutions and several countries.</li></ul>True
14111m01221&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Low vitamin D levels are reportedly associated with cardiometabolic risk factors such as obesity, hypertension, diabetes, and dyslipidemia, which are known to be common in psychiatric patients.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Nearly half of long-term hospitalized psychiatric patients had vitamin D levels &lt; 20 ng/mL, putting them at risk for poor bone health, indicating the need for vitamin D screening and supplementation in such populations.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Cardiometabolic risk factors were also common, but correlated poorly with vitamin D levels. Increasing vitamin D levels to ≥ 32 ng/mL did not improve BPRS score or any cardiometabolic risk factor, suggesting that intensification of therapeutic measures other than vitamin D supplementation is required.&lt;/li&gt; &lt;/ul&gt; 
14111m01191&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Symptom severity questionnaires such as the 9-item Patient Health Questionnaire (PHQ-9) can assist primary care clinicians in diagnosing and monitoring depression.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;This study showed that, when embedded into an electronic health record, the PHQ-9 is easy to use and leads to improvements in quality of care.&lt;/li&gt; &lt;/ul&gt; 
14111m01209&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;People at risk for somatoform/functional disorder are not more likely to be familiar with these diagnostic terms than others.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;The future diagnostic category of somatoform disorders should be conceptualized in a way that is more acceptable to patients and health professionals.&lt;/li&gt; &lt;/ul&gt; 
14111m01185&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;In a heterogeneous cohort of children and adolescents diagnosed with diabetes mellitus, the prevalence of depression (&lt; 10%) and psychosis (≤ 4%) and being prescribed antidepressant (20%) or antipsychotic medications (&lt; 1%) was low.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Use of antidepressants or antipsychotics alone, or the 2 in combination, was more likely to be associated with having diagnosed type 2 diabetes and its cardiometabolic comorbidities (obesity, hypertension, and dyslipidemia) by adolescence. However, the use of these psychotropic medications does not appear to contribute to the early onset of type 2 diabetes in this age group or to the initial, overlapping clinical picture between type 1 and type 2 diabetes mellitus in primary care settings.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Since these dysmetabolic conditions are highly associated with the onset and worsening of depressive or “sickness” symptoms over time and vice versa, the primary care physician must diligently and consistently monitor changes in all conditions (glucose control, weight, blood pressure, lipid levels, activity level, and mood symptoms) to effectively treat and manage the care of these individuals.&lt;/li&gt; &lt;/ul&gt; 
14111alz01337&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;People with dementia who live alone are at high risk for malnutrition, premature loss of instrumental activities of daily life function, misuse of medications, social isolation, and financial mismanagement.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;The Live Alone Assessment can be used to help identify whether it is safe for a patient with dementia to continue to live alone.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Moving cognitively impaired people who live alone in with family or into an institution can result in decreased psychosis, increased function, more activities, and better nutrition.&lt;/li&gt; &lt;/ul&gt; 
14111br01218&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Antidepressant therapy is often associated with a side effect of tinnitus.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Withdrawal from antidepressants should be tapered over a longer period (such as 6 to 24 months or more) when they have been taken for the longer term (a few years or more) in order to avoid withdrawal syndrome.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Rebound panic/anxiety occurring 2 or 3 months following antidepressant withdrawal might be effectively treated by returning to the same antidepressant at the same dose.&lt;/li&gt; &lt;/ul&gt; 
15112m01440<ul> <li class="take-home-list">Evaluation of sleep disturbance is important as sleep disorders are common in patients with psychiatric illness.</li> <li class="take-home-list">Encouraging patients to maintain good sleep hygiene and providing education about stimulus control may improve insomnia symptoms in patients with psychiatric illness.</li> <li class="take-home-list">Daily structure in life and sleep-wake schedules may have some beneficial effects on a patient’s sleep quality.</li> </ul> 
15112m01438<ul> <li class="take-home-list">Deep transcranial magnetic stimulation (dTMS) is a technique that is increasingly reported to benefit psychiatric conditions such as mood disorders and substance use disorders.</li> <li class="take-home-list">When patients with concurrent alcohol use disorder and dysthymic disorder respond poorly to otherwise appropriate treatment, add-on dTMS may prove successful.</li> <li class="take-home-list">If dTMS is made more available, this new, currently little-used technique may contribute to integrated treatment of an increasing number of patients with mood and substance use disorders.</li> </ul> 
15112m01435<ul> <li class="take-home-list">Many tools for evaluating memory and other cognitive functions are time-consuming, so brief instruments are welcomed by general practitioners and general neurologists.</li> <li class="take-home-list">The Memory Impairment Screen (MIS) is a brief instrument that can be easily administered, even to illiterate patients, as a first evaluation of recent memory in those with memory complaints who do not fulfill criteria for dementia.</li> <li class="take-home-list">A score of 0 or 1 on the MIS suggests eventual conversion to dementia of Alzheimer’s type. However, a normal score does not exclude such a conversion. Therefore, the MIS should be used in combination with other more sensitive tools.</li> </ul> 
15112m01382<ul> <li class="take-home-list">Patients with schizophrenia may suffer from a disturbance of the normal self-perception.</li> <li class="take-home-list">Due to puzzling experiences of self-disturbance, patients report incomprehensible experiences, leaving them misunderstood by others. </li> <li class="take-home-list">A phenomenological investigation may help to bridge the gap between the patient and clinician by giving insight into the experiential world of the patient and by connecting these experiences to the observed symptoms. </li> </ul> 
15112m01419<ul> <li class="take-home-list">The incidence of falling increases with age.</li> <li class="take-home-list">Older patients may experience a fall when taking psychoactive medications.</li> <li class="take-home-list">Patients may not spontaneously report falls; therefore, clinicians should ask their patients if they have fallen while taking antidepressants or other psychoactive medications.</li> </ul> 
15113alz01507<ul> <li class="take-home-list">Patients with Alzheimer’s dementia present with both cognitive and behavioral symptoms that can sometimes mimic other forms of dementia or affective disorders.</li> <li class="take-home-list">Nonpharmacologic interventions aimed at minimizing potential triggers for problem behaviors are key elements in the treatment of agitation and may lessen the need for increasingly aggressive pharmacotherapy. </li> </ul> 
15112f01471<ul> <li class="take-home-list">Atrial fibrillation is associated with increased rates of central nervous system complications including cognitive impairment and dementia.</li> <li class="take-home-list">The mechanism by which atrial fibrillation causes cognitive impairment is unclear; potential mechanisms include microemboli and transient cerebral hypoperfusion secondary to atrial beat-to-beat variability.</li> <li class="take-home-list">Future studies are needed to better determine whether treatment interventions for atrial fibrillation, including either rate or rhythm control, will lead to improvement in cognitive dysfunction.</li> </ul> 
15112br01466<ul> <li class="take-home-list">Treatment adherence to antidepressant pharmacotherapy can have a significant effect on health outcomes.</li> <li class="take-home-list">Use of selegiline transdermal system was associated with a greater probability of receipt compared to selective serotonin reuptake inhibitors or serotonin norepinephrine reuptake inhibitors at 120 days and 180 days.</li> <li class="take-home-list">Results suggest that after antidepressant treatment failure, earlier use of selegiline transdermal system may be warranted.</li> </ul> 
15212r01456<ul> <li class="take-home-list">Implantable cardioverter defibrillators, while potentially effective for the prevention of sudden death, may have serious psychological effects for patients and their families.</li> <li class="take-home-list">The frequency and intensity of shocks may promote anxiety and depression and may worsen depressive and anxiety disorders among those who already have them.</li> <li class="take-home-list">New strategies should be developed to improve quality of life and minimize psychiatric disorders that can be triggered with the implant of a cardioverter defibrillator or the first shock.</li> </ul> 
15212r01420<ul> <li class="take-home-list">Symptom presentation, level of severity, and response to antidepressants are equivalent between patients treated in primary care and specialty psychiatric clinics. </li> <li class="take-home-list">There should be some evidence of improvement of symptoms after 2 weeks; if not, then dose adjustment or other interventions should be considered to achieve virtual absence of all symptoms; evidence supporting add-on therapies is inconclusive, and they may increase side effects. </li> <li class="take-home-list">New research to find biomarkers of depression subtypes may help to select specific targets for new and existing antidepressants; the novel antidepressant vortioxetine may provide favorable outcomes as a monotherapy for a wider range of depressed patients. </li> </ul> 
15212r01468<ul> <li class="take-home-list">The mean life span in depressed patients is 25 to 30 years shorter than that in the general population, and the impact of depression on public health is on par with that of smoking and obesity.</li> <li class="take-home-list">Depression can be reliably diagnosed and treated in the primary care setting.</li> <li class="take-home-list">There are evidence-based, simple, and cost-effective screening tools to identify depression.</li> </ul> 
15212r01412<ul> <li class="take-home-list">Evidence for a role of butyrylcholinesterase (BuChE), including an effect of BuChE genotype, in the pathology of Alzheimer’s disease is increasing.</li> <li class="take-home-list">There are pharmacologic differences between the 3 main cholinesterase inhibitors approved for the symptomatic treatment of Alzheimer’s disease, which may affect the clinical response; rivastigmine inhibits both acetylcholinesterase (AChE) and BuChE, while donepezil and galantamine are AChE-selective.</li> <li class="take-home-list">An increased understanding of the relative importance of BuChE versus AChE over the disease course will help inform treatment decisions and optimize outcomes for each patient.</li> </ul> 
15213alz01518<ul> <li class="take-home-list">To improve the quality of life of those with dementia and of their caregivers, clinicians need to treat the symptoms that can be managed, as well as comorbid depression and agitation, and provide caregivers with management strategies.</li> <li class="take-home-list">Medication management of behavioral manifestations of dementia is often beneficial.</li> <li class="take-home-list">Caregiver counseling and support is a vital part of treating behavioral manifestations of dementia.</li> </ul> 
15212f01472<ul> <li class="take-home-list">Attention-deficit/hyperactivity disorder (ADHD) is a common disorder of children, adolescents, and adults; moreover, it coexists with a bevy of other psychiatric and medical disorders. Pharmacotherapy of ADHD with stimulants is a mainstay of evidence-based treatment for ADHD across the lifespan.</li> <li class="take-home-list">Stimulants have relatively few serious interactions with commonly prescribed medications.</li> <li class="take-home-list">Certain adverse effects of stimulants (eg, decreased appetite, insomnia) can be anticipated by virtue of their known pharmacologic properties, whereas others (eg, tics, mood changes, sudden death) are idiosyncratic.</li> </ul> 
15312m01494<ul> <li class="take-home-list">There is a significant and bidirectional association between obesity and depression, especially major depressive disorder (MDD), and clinical outcomes are worse when MDD is accompanied by the presence of obesity.</li> <li class="take-home-list">Combination therapy with naltrexone sustained-release and bupropion sustained-release has demonstrated substantial and sustained weight loss in overweight/obese nondepressed individuals; bupropion monotherapy is approved for the treatment of MDD.</li> <li class="take-home-list">The results of this open-label study suggest that combination therapy with naltrexone/bupropion, along with dietary and behavioral counseling, may be a potentially effective treatment for MDD complicated by concurrent overweight or obesity.</li> </ul> 
15312m01499<ul> <li class="take-home-list">Formal educational interventions to enhance knowledge of delirium among critical care providers are lacking at many institutions.</li> <li class="take-home-list">A psychiatric liaison rounding weekly with the medical intensive care unit team for 9 months was reported subjectively as being “very helpful” in terms of enhancing the overall care of patients and helped improve relations between medicine and psychiatry but appeared insufficient to meaningfully affect the attitudes and beliefs of frontline clinicians regarding delirium.</li> <li class="take-home-list">Successful delirium educational interventions for critical care providers will most likely involve a multimodal approach that combines didactic and clinical teaching on an ongoing basis, with opportunity for reflection and feedback.</li> </ul> 
15312m01469<ul> <li class="take-home-list">Depression is associated with cognitive impairments that may impact work productivity.</li> <li class="take-home-list">Current evidence supports increasing cognitive dysfunction with increasing severity of depressive symptoms.</li> </ul> 
15312m01484<ul> <li class="take-home-list">Patients in psychiatric day treatment programs may have a high prevalence of abnormal electrocardiograph (ECG) findings, especially conduction disorders (widened QRS complexes and prolonged QTc intervals).</li> <li class="take-home-list">Clinicians caring for patients taking medications that affect the cardiac conduction system or lipid profiles should consider monitoring their patients’ ECGs.</li> <li class="take-home-list">Although psychiatric medications may have relatively little cardiac toxicity in recommended doses, they may predispose to serious ECG findings if taken in high doses or as an overdose.</li> </ul> 
15312m01368<ul> <li class="take-home-list">Treatments for childhood- and adolescence-onset bipolar disorder include depot formulations of second-generation antipsychotics.</li> <li class="take-home-list">The best evidence currently available suggests that risperidone long-acting injection is efficient, well-tolerated, and safe in youths with bipolar disorder.</li> <li class="take-home-list">Clinicians can help bipolar patients who have relapsed due to medication nonadherence or failed to respond to standard therapies.</li> </ul> 
15313alz01532<ul> <li class="take-home-list">The work-up of a rapidly progressive dementia includes structural brain imaging, spinal fluid analysis, and electroencephalogram.</li> <li class="take-home-list">Clinical symptoms that indicate Creutzfeldt-Jakob disease include depression, apathy, anxiety, pain, and sometimes paresthesia; progression of the illness leads to motor dysfunction and finally to immobilization and muteness.</li> <li class="take-home-list">Provide counseling to family members of a patient diagnosed with Creutzfeldt-Jakob disease. </li> </ul> 
15413m01520<ul> <li class="take-home-list">In this real-world study, patients with depression taking l-methylfolate reported significant improvements in depressive symptoms and functioning, with 67.9% of patients responding and 45.7% achieving remission over 12 weeks.</li> <li class="take-home-list">The results of this study also showed patient medication satisfaction and compliance was very high, with over 90% of patients reporting taking every dose or nearly every dose of l-methylfolate. </li> </ul> 
15412r01474<ul> <li class="take-home-list">Practice guidelines contain numerous points of consensus, with most advocating a central role for the primary care physician in the detection, diagnosis, and treatment of Alzheimer’s disease.</li> <li class="take-home-list">A body of research suggests that implementation of team-based, collaborative care programs for Alzheimer’s disease can improve the quality of primary care for patients and their caregivers.</li> <li class="take-home-list">Incorporation of the cognitive assessment as part of the Medicare annual wellness visit will greatly assist primary care physicians in making the diagnosis of Alzheimer’s disease earlier and engaging patients and their families in treatment.</li> </ul> 
15413r01511<ul> <li class="take-home-list">Patients with congestive heart failure (CHF) have clinically significant depression at a rate 2- to 3-times higher than those of the general population, and depression creates barriers to successful CHF treatment (eg, more frequent adverse clinical events and hospitalizations, twice the risk of mortality).</li> <li class="take-home-list">Depression increases the risk of CHF, particularly in those with risk factors for CHF, such as systolic hypertension.</li> <li class="take-home-list">Depression is underrecognized and undertreated in patients with CHF, and clinicians can use screening tools to improve diagnosis and potentially improve morbidity and mortality in these patients.</li> </ul> 
15413m01504<ul> <li class="take-home-list">In patients with Williams syndrome, control of anxiety and sleep problems should be a priority and included as a preventative measure.</li> <li class="take-home-list">Low doses of low-potency antipsychotics are recommended to treat anxiety and insomnia, but mild depressive states might appear.</li> <li class="take-home-list">Treatment with a selective serotonin reuptake inhibitor is recommended to treat depressive states, but an increase in anxiety and a manic reaction might appear; low doses of antipsychotics are recommended to counteract these side effects.</li> </ul> 
15413m01506<ul> <li class="take-home-list">Childhood physical and sexual abuse has been related to pain intensity in adulthood; however, other forms of maltreatment (witnessing of violence, physical neglect, and emotional abuse) have been rarely examined, and relationships between childhood abuse and pain catastrophizing have not been explored.</li> <li class="take-home-list">In multivariate analyses, childhood emotional and sexual abuse demonstrated unique relationships with summed pain ratings in adulthood, and emotional abuse demonstrated a unique relationship with pain catastrophizing.</li> <li class="take-home-list">Emotional abuse stands out as a unique predictor of both pain as well as the catastrophizing of pain—a potential point of intervention in children and adolescents.</li> </ul> 
15412r01464<ul> <li class="take-home-list">Body dysmorphic disorder (BDD) has a high level of comorbidity with anxiety disorders, depression, and social phobia.</li> <li class="take-home-list">Patients with BDD have poor quality of life and high rates of psychiatric hospitalization and suicidal ideations and attempts.</li> <li class="take-home-list">Current evidence suggests that selective serotonin reuptake inhibitors and cognitive-behavioral therapy are often effective treatments for BDD.</li> <li class="take-home-list">Delayed diagnosis and lack of insight into the psychological nature of BDD symptoms are barriers to effective treatment intervention for BDD.</li> </ul> 
15412m01496<ul> <li class="take-home-list">Although total knee arthroplasty is a common procedure for painful osteoarthritis of the knee, approximately 1 in 8 patients continues to have pain without any complications from surgery.</li> <li class="take-home-list">The mechanisms of persistent pain (including relative contribution of nociceptive, neuropathic, and central components) after total knee arthroplasty are unknown.</li> <li class="take-home-list">The serotonin-norepinephrine reuptake inhibitor milnacipran may be an effective treatment for patients with persistent pain after total knee arthroplasty, as suggested by this small open-label pilot study.</li> </ul> 
15412m01495<ul> <li class="take-home-list">Inpatient treatment during acute relapses can result in better outcomes for patients with bipolar disorder and attention-deficit/hyperactivity disorder (ADHD).</li> <li class="take-home-list">Systematic ratings of the mood symptoms and functional impairment in patients with coexisting ADHD and bipolar disorder can help provide a better understanding of the long-term course of this comorbid condition.</li> </ul> 
15413alz01559<ul> <li class="take-home-list">Depression and insomnia must be recognized and promptly treated in patients with early-stage dementia. </li> <li class="take-home-list">Weight loss in patients with Alzheimer’s disease may be associated with medication side effects, depression, or other medical issues. </li> <li class="take-home-list">Driving and the ability to live independently should be closely monitored in patients with Alzheimer’s dementia. </li> </ul> 
15412f01490<ul> <li class="take-home-list">Understanding how structural and functional neuroimaging techniques work, and what their risks are, can help the clinician order these tests in a rational and cost-effective manner.</li> <li class="take-home-list">For patients presenting with cognitive, behavioral, or emotional symptoms, the use of neuroimaging can be of major relevance when certain conditions apply.</li> </ul> 
15513r01515<ul> <li class="take-home-list">Clinicians are advised to consider monoamine oxidase inhibitors (MAOIs) for patients who have had several unsuccessful trials of antidepressants or for patients with anxious or atypical symptoms.</li> <li class="take-home-list">Clinicians should provide education to their patients about MAOIs and their risks, monitor for adverse effects, and safeguard against hypertensive crisis and serotonin syndrome, which can occur with certain foods and when co-administered with adrenergic and serotonergic medications.</li> <li class="take-home-list">Guidelines generally reserve MAOIs as third- and fourth-line treatments due to concerns over safety and tolerability, but transdermal delivery may allay some of those concerns.</li> </ul> 
15513r01509<ul> <li class="take-home-list">After acute coronary syndrome, depression symptoms should be monitored. Transient mild or moderate depression does not affect prognosis, but persistence of depression is a high-risk marker for adverse coronary events.</li> <li class="take-home-list">The Coronary Psychosocial Evaluation Studies intervention, in which patients could choose between problem-solving therapy and/or antidepressants, improved coronary artery disease outcomes in patients with persistent depression after acute coronary syndrome.</li> <li class="take-home-list">Among patients with coronary artery disease, prescription of noradrenergic antidepressants should be done with caution in consultation with the patient’s internist or cardiologist.</li> </ul> 
15513m01530<ul> <li class="take-home-list">People with severe mental illness die, on average, 25 years earlier than the general public mostly from preventable diseases like cardiovascular disease.</li> <li class="take-home-list">Colocation of primary care services in the community mental health clinic is a newer form of integration and not well characterized.</li> <li class="take-home-list">Referral for colocated services appears to be based primarily on level of mental health rather than medical illness.</li> <li class="take-home-list">The most common medical illnesses in this colocated clinic were related to metabolic syndrome.</li> <li class="take-home-list">Further research is necessary to determine if reverse colocation is effective and, if so, for which group of patients does it best serve.</li> </ul> 
15513r01525<ul> <li class="take-home-list">Mirtazapine leads to rapid and sustained improvement in depressive symptoms and is effective in subgroups of depressed patients, particularly anxious patients and those with melancholic depression, treatment-resistant depression, geriatric depression, depression and anxiety associated with alcohol dependence, and agitated elderly patients.</li> <li class="take-home-list">Mirtazapine’s range of clinically useful applications includes improved sleep, antiemetic benefits, improved appetite, pain management, and weight gain.</li> <li class="take-home-list">There is no conclusive evidence to support the use of mirtazapine for treatment of depression associated with dementia, treatment of depression with cocaine dependence, or treatment of obstructive sleep apnea.</li> </ul> 
15513m01536<ul> <li class="take-home-list">Patients with borderline personality features report higher levels of pain as well as pain catastrophizing—characteristics that may need to be factored into the pain assessments for these individuals.</li> <li class="take-home-list">When present, borderline personality disorder is often associated with substance misuse as well as suicide attempts—factors that need to be considered in the pharmacologic management of such individuals who present with pain.</li> <li class="take-home-list">Overall, the presence of borderline personality disorder in a patient with pain indicates the need for closer clinical monitoring (eg, prescriptions, outside prescribers, suicide risk).</li> </ul> 
15512r01487<ul> <li class="take-home-list">For optimal results, antidepressant pharmacotherapy should start 3 months before initiating interferon therapy.</li> <li class="take-home-list">Most of the antidepressant drugs are effective in treating affective disorders; however, limited efficacy has been reported in the prevention of interferon-induced depression.</li> </ul> 
15513alz01595<ul> <li class="take-home-list">Despite the fact that hypersexuality affects up to 17% of all patients with dementia, there are currently no US Food and Drug Administration–approved treatments or official guidelines for treating sexually disinhibited behaviors in dementia.</li> <li class="take-home-list">Nonpharmacologic interventions should be attempted first and require a thorough assessment of problem behaviors, the context in which they occur, who is distressed by the behavior, frequency, contributing factors, and associated risks.</li> <li class="take-home-list">Since little is published on pharmacologic treatment of hypersexuality in dementia, data are insufficient to dictate best clinical practice. Results extrapolated from treatment studies of patients with paraphilias and of sexual offenders may be helpful in guiding pharmacologic treatment.</li> </ul> 
15613m01555&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Milnacipran was well tolerated and showed beneficial improvement in pain and mood and thus can be effective in treatment of patients with fibromyalgia with depression, but further studies are needed.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;This milnacipran study was the first to use standardized and systematic cognitive batteries to evaluate the effect on cognition in fibromyalgia.&lt;/li&gt; &lt;/ul&gt; <div></div>False
15610m01065<div>&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Motivational interview training of physicians in primary care accompanied by an Internet-based self-managed depression prevention/intervention demonstrates potential for significant public health impact.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Shifting the focus to the patient (motivational interview plus Internet-based program) and minimizing changes in practice work flow could address barriers to implementation of interventions for depressive disorders in primary care.&lt;/li&gt; &lt;/ul&gt;</div>False
15613m01541<div>&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Implementation of an essential tool of collaborative care, the depression screening instrument, can be used to enrich clinical encounters with patients and give physicians a reliable method for monitoring their patients by reframing depression as a set of symptoms in need of amelioration.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Depression care managers in a collaborative care model can monitor outcomes, discuss and support treatment recommendations, and provide brief counseling using evidence-based techniques.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;The development of collaborative care teams is a core tenet of health reform, which involves transdisciplinary collaboration that advances team work from an interdisciplinary approach to one in which team members from various disciplines develop a common language and loosen hierarchical structures, pool bodies of knowledge and theories, and jointly develop new methods and analytic techniques within a philosophy of whole person care.&lt;/li&gt; &lt;/ul&gt;</div>False
15613r01529<div>&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Postpartum depression is a heterogeneous entity.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Women should be evaluated to clarify the nature and severity of depression prior to antidepressant treatment.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;There is a paucity of randomized controlled data in the pharmacologic treatment of postpartum depression.&lt;/li&gt; &lt;/ul&gt;</div>False
15613m01558<div>&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Patients with psychiatric diagnoses are more likely to experience insomnia.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;In this inpatient psychiatric setting, trazodone was a more effective alternative to quetiapine for insomnia. However, patients receiving trazodone reported more gastrointestinal side effects than those receiving quetiapine.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Clinicians can help distinguish which sleep-inducing agent may work best for a patient on the basis of patient-specific criteria.&lt;/li&gt; &lt;/ul&gt;<br /></div>False
15612075co3c<div>&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Use guideline-concordant, measurement-based care with assessment tools for treating patients with MDD.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Encourage patients with depression to be active partners in their care.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Refocus patients to continue treatment if they have not regained full remission and functioning.&lt;/li&gt; &lt;/ul&gt;</div>False
15613f01538<div>&lt;ul&gt; &lt;li class=&quot;take-home-list&quot;&gt;Certain clinical situations (eg, patients and illnesses) can make a caregiver feel helpless.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;Clinicians can overcome their helplessness by dividing an overwhelming situation into its smaller and more manageable components and by understanding the situation with which they are faced.&lt;/li&gt; &lt;li class=&quot;take-home-list&quot;&gt;By analyzing and interpreting their own psychological reactions, clinicians can often gain valuable insights into their patients.&lt;/li&gt; &lt;/ul&gt;<br /></div>False
17315r01786 False