JCP December Table of Contents E-Lert


The Journal of Clinical Psychiatry

Volume 73 • Number 12 • December 2012

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Original Research
Response to Past Depression Treatments Is Not Accurately Recalled: Comparison of Structured Recall and Patient Health Questionnaire Scores in Medical Records
Gregory E. Simon, Carolyn M. Rutter, Christine Stewart, Chester Pabiniak, and Linda Wehnes
[Abstract] [Full Text] [Audio Summary]
Clinical Points
  • Patients’ recall of response to past depression treatments agrees poorly with standardized outcome questionnaires they completed at the time of treatment.
  • Recall of treatment response is fair for the preceding 6 months and poor for treatments earlier than the last 6 months.
  • Accurate assessment of past treatment response will probably require review of medical records.


Effects of Co-Occurring Depression on Treatment for Anxiety Disorders: Analysis of Outcomes From a Large Primary Care Effectiveness Trial
Laura Campbell-Sills, Cathy D. Sherbourne, Peter Roy-Byrne, Michelle G. Craske, Greer Sullivan, Alexander Bystritsky, Ariel J. Lang, Denise A. Chavira, Raphael D. Rose, Stacy Shaw Welch, and Murray B. Stein
[Abstract] [Full Text] [Supplementary Material] [Audio Summary]
Clinical Points
  • Depression is common in patients seeking treatment for anxiety disorders, and depressed patients often present with more severe anxiety symptoms and other clinical complexities.
  • Depression does not, however, compromise the effectiveness of standard treatments for anxiety disorders; on the contrary, substantial reductions in anxiety symptoms and disability were observed in depressed patients receiving treatment for anxiety disorders.
  • Empirically supported treatments for anxiety (cognitive-behavioral therapy, medication management, or their combination) should typically be offered to patients with co-occurring depression.


A Randomized, Double-Blind, Placebo-Controlled, Multicenter Study Evaluating the Efficacy, Safety, and Tolerability of Extended-Release Metadoxine in Adults With Attention-Deficit/Hyperactivity Disorder
Iris Manor, Rachel Ben-Hayun, Judith Aharon-Peretz, Dana Salomy, Abraham Weizman, Yaron Daniely, Dalia Megiddo, Jeffrey H. Newcorn, Joseph Biederman, and Lenard A. Adler
[Abstract] [Full Text] [Audio Summary]
Clinical Points
  • Adult attention-deficit/hyperactivity disorder (ADHD) is a common and highly impairing condition.
  • A novel nonstimulant medication would be helpful in the treatment of adults with ADHD.
  • The findings of this trial indicate that metadoxine ER is a well-tolerated and effective treatment for adults with ADHD.


A 12-Week, Randomized, Double-Blind, Placebo-Controlled, Sequential Parallel Comparison Trial of Ziprasidone as Monotherapy for Major Depressive Disorder
George I. Papakostas, Ottavio V. Vitolo, Waguih W. IsHak, Mark H. Rapaport, John M. Zajecka, Gustavo Kinrys, David Mischoulon, Samuel H. Lipkin, Katherine A. Hails, Jonah Abrams, Sean G. Ward, Allison Meisner, David A. Schoenfeld, Richard C. Shelton, Andrew Winokur, Mahmoud S. Okasha, Mohammed A. Bari, and Maurizio Fava
[Abstract] [Full Text]
Meta-Analyses of the Efficacy of Asenapine for Acute Schizophrenia: Comparisons With Placebo and Other Antipsychotics [FREE ACCESS]
Armin Szegedi, Pierre Verweij, Wilbert van Duijnhoven, Mary Mackle, Pilar Cazorla, and Hein Fennema
[Full Text] [Supplementary Material]
Clinical Points
  • Asenapine is an approved treatment for schizophrenia in the United States.
  • The reported meta-analyses indicate that the efficacy of asenapine for acute schizophrenia is superior to placebo and comparable to several other second-generation antipsychotics.
CME Article
See the complete CME Activity.
Clinician-Rated Versus Self-Rated Screening for Bipolar Disorder Among Inpatients With Mood Symptoms and Substance Misuse
Joseph F. Goldberg, Amir Garakani, and Sigurd H. Ackerman
[Abstract] [Full Text] [Audio Summary]
For Clinical Use
  • Self-reported screening for bipolar disorder using the Mood Disorder Questionnaire (MDQ) may often yield false-positive results in patients with mood symptoms and substance misuse—particularly those with lifetime misuse of multiple substances.
  • Adapting the MDQ to an interview format enables clinicians to probe and clarify patients’ affirmative item endorsements, in turn substantially increasing the likelihood for identifying true cases of bipolar disorder.
  • In mood-disordered patients with substance misuse, negative self-report MDQ screens suggest the absence of bipolar disorder with relatively high confidence.
Focus on Alzheimer’s Disease and Related Disorders
Gender Differences in Clinical Manifestations and Outcomes Among Hospitalized Patients With Behavioral and Psychological Symptoms of Dementia
Tatsuru Kitamura, Maki Kitamura, Shoryoku Hino, Nana Tanaka, and Koichi Kurata
[Abstract] [Full Text] [Audio Summary]
Clinical Points
  • Men hospitalized for treatment of BPSD were more likely than women to present with aggressiveness and less likely to present with paranoid, delusional ideation; hallucination; affective disturbances; and anxieties and phobias.
  • Men with BPSD were less likely than women to be discharged into their communities.
  • More effective treatment options for aggressiveness and enhanced care strategies may be required for men.


Association Between White Matter Hyperintensity Severity and Cognitive Impairment According to the Presence of the Apolipoprotein E (APOE) ε4 Allele in the Elderly: Retrospective Analysis of Data From the CREDOS Study
Sang Joon Son, Kang Soo Lee, Yunhwan Lee, Jong Hwan Baek, Seong Hye Choi, Duk L. Na, Sang Won Seo, Byoung Hoon Oh, and Chang Hyung Hong
[Abstract] [Full Text] [Supplementary Material] [Audio Summary]
Clinical Points
  • Clinicians should consider the volume of white matter hyperintensities (WMHs), which seem to be predominantly associated with frontal/executive dysfunction irrespective of the presence of the apolipoprotein E (APOE) ε4 allele, in the elderly.
  • On the other hand, APOE ε4 carriers perform worse on memory tests, and it is only APOE ε4 noncarriers that show some relationship between WMH severity and memory performance among the elderly.
  • Current evidence supports the disassociation of APOE and WMHs relative to cognitive performance, a finding that may be helpful for clinicians in predicting the characteristics of cognitive impairment as affected by the APOE ε4 allele or WMHs.
ASCP Corner
Cardiovascular Disease and Bipolar Disorder: Risk and Clinical Implications
Holly A. Swartz and Andrea Fagiolini
[Purchase] [Full Text] [Audio Summary]
Book Reviews
Clinical Manual of Neuropsychiatry
Nicholas Kontos
[Purchase] [Full Text]


Depression and Cancer
Melinda Randall
[Purchase] [Full Text] Exclusives

Practical Psychopharmacology
Drug Interactions in the Treatment of Depression in Patients With Ischemic Heart Disease
Chittaranjan Andrade
[Purchase] [Full Text] [Audio Summary]
Clinical Points
  • Depression and ischemic heart disease commonly coexist, and each can worsen the course of the other.
  • SSRIs (commonly used for depression) can increase the risk of bleeding events with antiplatelet therapy (commonly used for ischemic heart disease); this risk may be diminished by use of a proton pump inhibitor.
  • Fluoxetine and fluvoxamine may inhibit the metabolic activation of clopidogrel and thus potentially diminish its efficacy.
Original Research
The Daytime Impact of DSM-5 Insomnia Disorder: Comparative Analysis of Insomnia Subtypes From the Great British Sleep Survey
Colin A. Espie, Simon D. Kyle, Peter Hames, Eva Cyhlarova, and Michaela Benzeval
[Abstract] [Full Text] [Audio Summary]
Clinical Points
  • DSM-5 proposes to move away from “primary” and “secondary” insomnia, recognizing that causality is often hard to determine, that sleep and comorbid conditions interact in a bidirectional manner, and that sleep disturbance is associated with illness vulnerability.
  • The new diagnostic entity of insomnia disorder highlights that significant sleep disturbance merits independent clinical attention, regardless of additional comorbidities.
  • The daytime consequences of insomnia disorder are most pronounced for those with a mixed subtype (problems with both initiating and maintaining sleep), those with poor mental health, and those with insomnia of childhood onset.


Phenotypic Differences Between Pregnancy-Onset and Postpartum-Onset Major Depressive Disorder
Margaret Altemus, Christine C. Neeb, Alida Davis, Mallay Occhiogrosso, Theresa Nguyen, and Kathryn L. Bleiberg
[Abstract] [Full Text] [Audio Summary]
Clinical Points
  • Risk of relapse of major depression may be higher during pregnancy than postpartum for women with a history of major depression, even if the prior major depression occurred postpartum.
  • Among women seeking care at a psychiatric clinic, 94% of cases of major depression that had an onset during the postpartum period began within the first 4 months postpartum.
Focus on Alzheimer’s Disease and Related Disorders
Long-Term Observation of a Multicomponent Cognitive Intervention in Mild Cognitive Impairment
Verena C. Buschert, Ina Giegling, Stefan J. Teipel, Sabrina Jolk, Harald Hampel, Dan Rujescu, and Katharina Buerger
[Abstract] [Full Text] [Audio Summary]
Clinical Points
  • A 6-month multicomponent cognitive intervention in individuals with amnestic mild cognitive impairment:
  • Appears to preserve immediate improvements in global cognitive status over an extended follow-up period for more than 2 years
  • Seems to be more effective in those receiving it earlier compared to those receiving it after an 8-month time lag
  • May delay conversion to Alzheimer’s disease for more than 2 years in those who receive it early
Free Online Activities
An Update on MAOIs: Dietary Restrictions and Drug Interactions [CME]
David A. Flockhart


Accurately Diagnosing and Comprehensively Managing MS [CME]
Emmanuelle Waubant


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