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Please take a moment to answer 2 questions about schizophrenia.

1. You diagnose Mr Y, a 30-year-old single man, with schizophrenia. Before initiating treatment with an antipsychotic, you counsel Mr Y about the risks of weight gain. Which of the following best describes the baseline information you will gather concerning weight?

Body mass index (BMI) and fasting plasma glucose level

BMI and waist circumference

BMI, weight, and lipid profile

BMI, weight, waist circumference, lipid profile, and fasting plasma glucose level

2. Mr Y’s baseline BMI was 29.0. You are concerned about potential weight gain, so you select a weight-neutral antipsychotic. At 4 weeks, Mr Y has responded well to treatment, and his BMI did not change. What is your next step?

Continue current treatment and add pharmacotherapy for weight loss

Add behavioral weight loss strategies (eg, diet and exercise)

Switch to another antipsychotic to promote weight loss

Consider bariatric surgery

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A Roadmap to Key Pharmacologic Principles in Using Antipsychotics: Application in Clinical Practice Sheldon H. Preskorn, MD

Read this Academic Highlights to discover how the underlying properties of antipsychotics can improve outcomes.

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Treating Partial Responders to Antidepressant Treatment Madhukar H. Trivedi, MD

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Articles published electronically 6/30/09

Is DSM-IV Bereavement Exclusion for Major Depressive Episode Relevant to Severity and Pattern of Symptoms? A Case-Control, Cross-Sectional Study. Emmanuelle Corruble, MD, PhD; Virginie-Anne Chouinard, MD; Alexia Letierce, PhD; Philip A. P. M. Gorwood, MD, PhD; and Guy Chouinard, MD, MSc Pharmacol
[Abstract] [PDF] Posted 6/30/09

Double-Blind Crossover Study of the Cognitive Effects of Lorazepam in Healthy Apolipoprotein E (APOE)-ε4 Carriers. Cynthia M. Stonnington, MD; Peter J. Snyder, PhD; Joseph G. Hentz, MS; Eric M. Reiman, MD; and Richard J. Caselli, MD
[Abstract] [PDF] Posted 6/30/09

Double-Blind Study of Dextroamphetamine Versus Caffeine Augmentation for Treatment-Resistant Obsessive-Compulsive Disorder. Lorrin M. Koran, MD; Elias Aboujaoude, MD; and Nona N. Gamel, MSW
[Abstract] [PDF] Posted 6/30/09

Complex Trauma Among Psychiatrically Impaired Children: A Cross-Sectional, Chart-Review Study. Julian D. Ford, PhD; Daniel F. Connor, MD; and Josephine Hawke, PhD
[Abstract] [PDF] Posted 6/30/09

Association of Adverse Childhood Environment With Late-Life Depression. Karen Ritchie, PhD; Isabelle Jaussent, MSc; Robert Stewart, MD, PhD; Anne-Marie Dupuy, MD, PhD; Philippe Courtet, MD, PhD; Marie-Laure Ancelin, PhD; and Alain Malafosse, MD, PhD
[Abstract] [PDF] Posted 6/30/09

Is Psychopharmacologic Treatment Associated With Neuropsychological Deficits in Bipolar Youth? Aude Henin, PhD; Eric Mick, ScD; Joseph Biederman, MD; Ronna Fried, EdD; Dina R. Hirshfeld-Becker, PhD; Jamie A. Micco, PhD; Katherine G. Miller, BA; Caroline C. Rycyna, BA; and Janet Wozniak, MD
[Abstract] [PDF] Posted 6/30/09

Intervention in Individuals at Ultra High Risk for Psychosis: A Review and Future Directions. Patrick D. McGorry, PhD; Barnaby Nelson, PhD; G. Paul Amminger, MD; Andreas Bechdolf, MD; Shona M. Francey, PhD; Gregor Berger, MD; Anita Riecher-Rössler, MD; Joachim Klosterkötter, MD; Stephan Ruhrmann, MD; Frauke Schultze-Lutter, PhD; Merete Nordentoft, PhD; Ian Hickie, MD, FRANZCP; Philip McGuire, MD; Michael Berk, PhD; Eric Y. H. Chen, MD, MRCPscyh, FHKAM; Matcheri S. Keshavan, MD; and Alison R. Yung, MD
[Abstract] [PDF] Posted 6/30/09

Articles published electronically 6/16/09

A Cross-Sectional Study of Problem and Pathological Gambling in Patients With Schizophrenia/Schizoaffective Disorder. Rani A. Desai, PhD, MPH, and Marc N. Potenza, MD, PhD
[Abstract] [PDF] Posted 6/16/09

Three-Year Follow-Up of Syndromal Antisocial Behavior in Adults: Results From the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Risë B. Goldstein, PhD, MPH, and Bridget F. Grant, PhD, PhD
[Abstract] [PDF] Posted 6/16/09

Cutaneous Adverse Reactions to Psychotropic Drugs: Data From a Multicenter Surveillance Program. Christian Lange-Asschenfeldt, MD; Renate Grohmann, MD; Bernhard Lange-Asschenfeldt, MD; Rolf R. Engel, PhD; Eckart Rüther, MD; and Joachim Cordes, MD
[Abstract] [PDF] Posted 6/16/09

A 6-Month Follow-Up Study of Posttraumatic Stress and Anxiety/Depressive Symptoms in Korean Children After Direct or Indirect Exposure to a Single Incident of Trauma. Boong-Nyun Kim, MD, PhD; Jae-Won Kim, MD, PhD; Hyo-Won Kim, MD; Min-Sup Shin, PhD; Soo-Churl Cho, MD, PhD; Nam Hee Choi, PhD; Hyunnie Ahn, PhD; Seung-Yeon Lee, PhD; Jeong Ryu, MA; and Myoung-Joo Yun, MA
[Abstract] [PDF] Posted 6/16/09

Is Depersonalization Disorder Initiated by Illicit Drug Use Any Different? A Survey of 394 Adults. Daphne Simeon, MD; David S. Kozin, BA; Karina Segal, BSc; and Brenna Lerch, BA
[Abstract] [PDF] Posted 6/16/09

Serotonin Transporter Gene Promoter Polymorphism and Somatoform Symptoms. Anika Hennings; Peter Zill, Dr rer nat; and Winfried Rief, PhD
[Abstract] [PDF] Posted 6/16/09

Bipolar Disorder, Schizoaffective Disorder, and Schizophrenia Overlap: A New Comorbidity Index. Thomas Munk Laursen, PhD; Esben Agerbo, MSc; and Carsten Bøcker Pedersen, MSc
[Abstract] [PDF] Posted 6/16/09

Articles published electronically 6/2/09

Medication Nonadherence and Treatment Outcome in Patients With Schizophrenia or Schizoaffective Disorder With Suboptimal Prior Response. Jean-Pierre Lindenmayer, M.D.; Hong Liu-Seifert, Ph.D.; Pandurang M. Kulkarni, Ph.D.; Bruce J. Kinon, M.D.; Virginia Stauffer, Pharm.D.; Sara E. Edwards, Pharm.D.; Lei Chen, M.S.; David H. Adams, Ph.D.; Haya Ascher-Svanum, Ph.D.; Peter F. Buckley, M.D.; Leslie Citrome, M.D., M.P.H.; and Jan Volavka, M.D., Ph.D.
[Abstract] [PDF] Posted 6/2/09

Clinical Usefulness of the Diagnostic Manual-Intellectual Disability for Mental Disorders in Persons With Intellectual Disability: Results From a Brief Field Survey. Robert J. Fletcher, D.S.W., A.C.S.W.; Susan M. Havercamp, Ph.D.; Steven L. Ruedrich, M.D.; Betsey A. Benson, Ph.D.; L. Jarrett Barnhill, M.D.; Sally Ann Cooper, M.D.; and Chrissoula Stavrakaki, M.D., Ph.D.
[Abstract] [PDF] Posted 6/2/09

Inflammation and the Phenomenology, Pathophysiology, Comorbidity, and Treatment of Bipolar Disorder: A Systematic Review of the Literature. Benjamin I. Goldstein, M.D., Ph.D.; F.R.C.P.C., David E. Kemp, M.D.; Joanna K. Soczynska, H.B.Sc.; and Roger S. McIntyre, M.D., F.R.C.P.C.
[Abstract] [PDF] Posted 6/2/09

Quetiapine Augments the Effect of Citalopram in Non-Refractory Obsessive-Compulsive Disorder: A Randomized, Double-Blind, Placebo-Controlled Study of 76 Patients. Nienke C. C. Vulink, M.D.; Damiaan Denys, M.D., Ph.D.; Sjoerd B. A. H. A. Fluitman, M.D.; Jantien C. M. Meinardi, M.D.; and Herman G. M. Westenberg, Ph.D.
[Abstract] [PDF] Posted 6/2/09

Treatment Nonadherence and Neurocognitive Impairment in Bipolar Disorder. Anabel Martinez-Aran, Ph.D.; Jan Scott, Ph.D.; Francesc Colom, Ph.D.; Carla Torrent, Ph.D.; Rafael Tabares-Seisdedos, M.D., Ph.D.; Claire Daban, Ph.D.; Marion Leboyer, M.D.; Chantal Henry, M.D.; Guy M. Goodwin, F.Med.Sci., F.R.C.Psych.; Ana Gonzalez-Pinto, M.D., Ph.D.; Nuria Cruz, M.D.; Jose Sanchez-Moreno, Psy.D.; and Eduard Vieta, M.D., Ph.D.
[Abstract] [PDF] Posted 6/2/09

Articles published electronically 5/19/09

The Maudsley Staging Method for Treatment-Resistant Depression: Prediction of Longer-Term Outcome and Persistence of Symptoms. Abebaw Fekadu, M.D.; Sarah C. Wooderson, Ph.D.; Kalypso Markopoulou, M.D.; and Anthony J. Cleare, Ph.D.
[Abstract] [PDF] Posted 5/19/09

Articles published electronically 3/24/09

Varenicline Augmentation in Depressed Smokers: An 8-Week, Open-Label Study. Noah S. Philip, M.D.; Linda L. Carpenter, M.D.; Audrey R. Tyrka, M.D., Ph.D.; Laura B. Whiteley, M.D.; and Lawrence H. Price, M.D.
[Abstract] [PDF] Posted 3/24/09

Ahead of Print
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VOLUME 70   2009   NUMBER 6

Commentary

782 Defining and Managing Suicidal Risk in Patients Taking Psychotropic Medications. [CME] Jan A. Fawcett, Ross J. Baldessarini, William H. Coryell, Morton M. Silverman, and Dan J. Stein
[PDF]

Original Articles

790 The DEMO Trial: A Randomized, Parallel-Group, Observer-Blinded Clinical Trial of Strength Versus Aerobic Versus Relaxation Training for Patients With Mild to Moderate Depression. Jesper Krogh, Bengt Saltin, Christian Gluud, and Merete Nordentoft
[Abstract] [PDF]

801 Applicability of a Genetic Signature for Enhanced Iloperidone Efficacy in the Treatment of Schizophrenia. Simona Volpi, Steven G. Potkin, Anil K. Malhotra, Louis Licamele, and Christian Lavedan
[Abstract] [PDF]

810 Cataplexy in Anxious Patients: Is Subclinical Narcolepsy Underrecognized in Anxiety Disorders? Dawn L. Flosnik, Bernadette M. Cortese, and Thomas W. Uhde
[Abstract] [PDF]

817 Pegylated Interferon and Ribavirin–Induced Depression in Chronic Hepatitis C: Role of Personality. Pere Castellvi, Ricard Navinés, Fernando Gutierrez, Dolors Jiménez, Carme Márquez, Susana Subirà, Ricard Solà, and Rocío Martín-Santos
[Abstract] [PDF]

829 Lurasidone in the Treatment of Acute Schizophrenia: A Double-Blind, Placebo-Controlled Trial. Mitsutaka Nakamura, Masaaki Ogasa, John Guarino, Debra Phillips, Joseph Severs, Josephine Cucchiaro, and Antony Loebel
[Abstract] [PDF]

837 The Longitudinal Course of Posttraumatic Stress Disorder Symptom Clusters Among War Veterans. [CME] Zahava Solomon, Danny Horesh, and Tsachi Ein-Dor
[Abstract] [PDF]

844 Long-Term Safety and Efficacy of Ziprasidone in Subpopulations of Patients With Bipolar Mania. Paul E. Keck, Jr., Marcio Versiani, Lewis Warrington, Antony D. Loebel, and R. Lynn Horne
[Abstract] [PDF]

852 A Review of Fragile X Premutation Disorders: Expanding the Psychiatric Perspective. James A. Bourgeois, Sarah M. Coffey, Susan M. Rivera, David Hessl, Louise W. Gane, Flora Tassone, Claudia Greco, Brenda Finucane, Lawrence Nelson, Elizabeth Berry-Kravis, Jim Grigsby, Paul J. Hagerman, and Randi J. Hagerman
[Abstract] [PDF]

863 A Long-Term Trial of the Effectiveness and Safety of Atypical Antipsychotic Agents in Augmenting SSRI-Refractory Obsessive-Compulsive Disorder. Hisato Matsunaga, Toshihiko Nagata, Kazuhisa Hayashida, Kenzo Ohya, Nobuo Kiriike, and Dan J. Stein
[Abstract] [PDF]

869 Estimating the Risk for Suicide Following the Suicide Deaths of 3 Asian Entertainment Celebrities: A Meta-Analytic Approach. King-wa Fu and Paul S. F. Yip
[Abstract] [PDF]

879 A Novel Examination of Atypical Major Depressive Disorder Based on Attachment Theory. Robert D. Levitan, Leslie Atkinson, Rebecca Pedersen, Tom Buis, Sidney H. Kennedy, Kevin Chopra, Eman M. Leung, and Zindel V. Segal
[Abstract] [PDF]

888 Predictors of Longitudinal Changes in Schizophrenia: The Role of Processing Speed. Pedro Sánchez, Natalia Ojeda, Javier Peña, Edorta Elizagárate, Ana Blanca Yoller, Miguel Gutiérrez, and Jesús Ezcurra
[Abstract] [PDF]

897 The Safety, Acceptability, and Effectiveness of Acupuncture as an Adjunctive Treatment for Acute Symptoms in Bipolar Disorder. Ellen B. Dennehy, Rosa Schnyer, Ira H. Bernstein, Robert Gonzalez, Geetha Shivakumar, Dorothy I. Kelly, Diane E. Snow, Suresh Sureddi, and Trisha Suppes
[Abstract] [PDF]

906 Use of Antipsychotics in the Treatment of Major Depressive Disorder in the U.S. Department of Veterans Affairs. Somaia Mohamed, Douglas L. Leslie, and Robert A. Rosenheck
[Abstract] [PDF]

Focus on Alzheimer's Disease and Related Disorders

913 Introduction. Untangling the Roles of Antidepressants and Mood Stabilizers in the Treatment of Alzheimer's Disease. Eric M. Reiman
[PDF]

915 Effect of a Serotonin Reuptake Inhibitor on Irritability, Apathy, and Psychotic Symptoms in Patients With Alzheimer's Disease. Haroon Siddique, Linda S. Hynan, and Myron F. Weiner
[Abstract] [PDF]

919 Commentary. Can Lithium or Valproate Untie Tangles in Alzheimer's Disease? Pierre N. Tariot and Paul S. Aisen
[PDF]

922 Lithium Trial in Alzheimer's Disease: A Randomized, Single-Blind, Placebo-Controlled, Multicenter 10-Week Study. Harald Hampel, Michael Ewers, Katharina Bürger, Peter Annas, Anette Mörtberg, Anna Bogstedt, Lutz Frölich, Johannes Schröder, Peter Schönknecht, Matthias W. Riepe, Inga Kraft, Thomas Gasser, Thomas Leyhe, Hans-Jürgen Möller, Alexander Kurz, and Hans Basun
[Abstract] [PDF]

ASCP Corner      [PDF]

932 Adding Lithium or Anticonvulsants to Antipsychotics for the Treatment of Schizophrenia: Useful Strategy or Exercise in Futility? Leslie Citrome

Letters To the Editor 

934 Long-Term Effects of the Terrorist Attack in Beslan on Adolescent Survivors. Peter G. van der Velden and Joris C. Yzermans
[PDF]

  • Reply by Ughetta Moscardino, Sara Scrimin, Fabia Capello, and Gianmarco Altoè
    [PDF]

935 Self-Medication, Bipolar Disorders, and Stimulant Dependence. Edward J. Khantzian and Mark J. Albanese
[PDF]

  • Reply by Vicki A. Nejtek, Matthew Avila, and A. John Rush
    [PDF]

937 Switching Antipsychotic Medications: A 2-Year Chart-Review Study Exploring Patient Characteristics and Psychiatric Service Use of Schizophrenia Patients. Andrea L. Schneider, Karen E. Mosier, and Raymond P. Tempier
[PDF]

Book Reviews

940 Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 10th ed. Ethan Samuel Rofman
[PDF]

940 Mental Health and Violent Youth: A Developmental/Lifecourse Perspective. Michael C. Harlow
[PDF]

941 Clinical Handbook of Psychiatry and the Law, 4th ed. William Bernet
[PDF]

941 The Guidebook of Sexual Medicine. Robert Taylor Segraves
[PDF]

942 Antipsychotics and Mood Stabilizers: Stahl’s Essential Psychopharmacology, 3rd ed. Henry A. Nasrallah
[PDF]

Electronic CME Activities

Available through www.psychiatrist.com/toc

e16 Treating Depression and Pain. John F. Greden
[Abstract]

e17 Overview of Managing Medical Comorbidities in Patients With Severe Mental Illness. Roger S. McIntyre
[Abstract]

e18 Initial Treatment Approaches for Patients With Major Depressive Disorder. George I. Papakostas
[Abstract]

e19 The Implications of Pain and Physical Symptoms in Depression. Rakesh Jain
[Abstract]

e20 Augmentation and Combination Strategies in Resistant Depression. J. Craig Nelson
[Abstract]

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The Journal of Clinical Psychiatry is the official journal of the American Society for Clinical Psychopharmacology

 
 
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Early Career Psychiatrists

Marlene P. Freeman, MD (Editor)

Focus on Alzheimer's Disease and Related Disorders

Eric M. Reiman, MD (Editor)

Focus on Childhood and Adolescent Mental Health

Karen D. Wagner, MD, PhD (Editor)

Focus on Women's Mental Health

Marlene P. Freeman, MD (Editor)

ASCP Corner

J. Craig Nelson, MD (Editor)

Brainstorms

Stephen M. Stahl, MD, PhD (Editor)

Depression and Pain

John H. Greist, M.D. (Chair), et al.

Pain can be both a symptom and a predictor of depression. Read this Academic Highlights to learn about the common neuropathic pathways shared by pain and depression, understand how pain affects the diagnosis and course of illness in depression, and receive a road map for treating your patients with both of these conditions.

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Balancing the Equation: Managing Comorbidities in Patients With Severe Mental Illness

Roger S. McIntyre, MD, FRCPC (Chair), et al

How can you help your patients with schizophrenia or bipolar disorder lead healthier lives? Read this new Supplement and learn what you can do to implement treatment strategies that address modifiable health risk factors and provide a better quality of life for your patients.

>>See the entire supplement

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Insights Into Generalized Anxiety Disorder

Mark H. Pollack, MD (Chair), et al

In this Supplement, learn how to manage GAD in the presence of comorbidities and help your patients achieve and retain remission.

>>See the entire activity

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Pain and the Brain 2: The Recognition and Management of Chronic Pain in Primary Care

Rakesh Jain, MD, MPH (Moderator), et al

NEW! Chronic pain conditions can affect all ages, genders, and ethnicities. In this video, view 3 patient cases and receive expert diagnosis and treatment recommendations for your patients with chronic pain and comorbid conditions.

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International Consensus Group on the Evidence-Based Pharmacologic Treatment of Bipolar I and II Depression

Siegfried Kasper, MD (Chair), et al

Read this Academic Highlights to analyze the available evidence on the treatment of bipolar depression and evaluate how that evidence can be applied in your practice.

>>See the entire activity

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Learn. Practice. Treat.

Definition and Management of Suicidality in Psychiatric Patients

Jan A. Fawcett, MD (Chair), et al

In this activity, review the dangers and benefits of prescribing psychotropic medications and learn how to identify and manage suicidal risk during treatment.

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Our user-friendly electronic manuscript submission and peer review system allows you to submit your manuscript online securely, conveniently, and instantly. Authors can track the progress of their manuscripts from submission to publication. Assistance is available via e-mail if needed.

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Journal Statistics and Impact Information (updated October 2007)

Journal Statistics

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31%

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Mean=16, range=14–22

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51.6 days

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4 months

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Mean=5.2 months,
range=3–9 months

Impact Information

The Journal of Clinical Psychiatry continues to be ranked as the most-read and 6th most-cited psychiatric journal in the world (according to the Focus Readership Study, June 2007, and Citation Index, July 2007, respectively). The Journal mails to about 35,184 recipients,* and over 20,000 allied mental health professionals have requested daily receipt of informational e-mails about our journals and Web CME activities.

The JCP is also a member of BPA Worldwide and is the official journal of the American Society of Clinical Psychopharmacology, which consists of 800 members who are biopsychiatric researchers, academicians, and clinicians.

*Source: BPA Circulation Statement, June 2007

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James Dalen, M.D., M.P.H.

James H. Kocsis, M.D.

David C. Emelity, M.D.

Francisco A. Moreno, M.D.

Maurizio Fava, M.D.

Michael K. Popkin, M.D.

Marlene P. Freeman, M.D.

George M. Simpson, M.D.

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Michael E. Thase, M.D.

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