Volume 72
July 2011
Number 7

CME Pretest | CME Posttest

Academic Highlights

1008 Optimizing Clinical Outcomes Across Domains of Life in Adolescents and Adults With ADHD

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Original Articles

885 Serum Lipoproteins Improve After Successful Pharmacologic Antidepressant Treatment: A Randomized Open-Label Prospective Trial

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892 Eszopiclone for the Treatment of Posttraumatic Stress Disorder and Associated Insomnia: A Randomized, Double-Blind, Placebo-Controlled Trial

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898 Is DSM-IV Bereavement Exclusion for Major Depression Relevant to Treatment Response? A Case-Control, Prospective Study

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903 Impact of Stimulant Pharmacotherapy on Sleep Quality: Post Hoc Analyses of 2 Large, Double-Blind, Randomized, Placebo-Controlled Trials

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Clinical Points

  • Attention-deficit/hyperactivity disorder (ADHD) is often associated with sleep disruption.
  • Stimulant therapy may not impair sleep quality in adults with ADHD significantly more often than placebo.
  • Comprehensive treatment of ADHD includes evaluation for and therapeutic targeting of sleep disruption.

909 Qualitative Methods in Early-Phase Drug Trials: Broadening the Scope of Data and Methods From an RCT of N-Acetylcysteine in Schizophrenia

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914 Improved Insomnia Symptoms and Sleep-Related Next-Day Functioning in Patients With Comorbid Major Depressive Disorder and Insomnia Following Concomitant Zolpidem Extended-Release 12.5 mg and Escitalopram Treatment: A Randomized Controlled Trial

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929 Late-Life Health Consequences of Exposure to Trauma in a General Elderly Population: The Mediating Role of Reexperiencing Posttraumatic Symptoms [CME]

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For Clinical Use

  • Elderly persons with a history of exposure to traumatic events should be carefully monitored for vascular pathology, irrespective of reexperiencing symptoms.
  • Elderly persons with a history of exposure to traumatic events that has led to reexperiencing symptoms should be carefully monitored for metabolic risk factors, hypertension, and thyroid dysfunction as well as psychiatric disorders.

936 Sudden Deaths in Psychiatric Patients

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942 Becoming the Center of Attention in Social Anxiety Disorder: Startle Reactivity to a Virtual Audience During Speech Anticipation

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949 Response Rates to Fluoxetine in Subjects Who Initially Show No Improvement

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Clinical Points

  • A significant minority of depressed patients respond to continued treatment with fluoxetine even when no improvement has yet been observed after 4, 6, or 8 weeks of treatment.
  • The optimal trial duration for antidepressant therapy remains largely unknown, though clinicians can offer prognostic guidelines for converting to a positive response with continued antidepressant therapy.

955 Efficacy of Antipsychotic Drugs Against Hostility in the European First-Episode Schizophrenia Trial (EUFEST) [CME]

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For Clinical Use

  • Olanzapine appears to be a superior treatment for hostility and aggression in first-episode schizophrenia spectrum disorders.
  • The superiority of olanzapine is expressed mostly in the first 3 months of treatment.
  • The efficacy advantage of olanzapine must be weighed against its propensity to cause adverse metabolic effects and weight gain.

962 Can We Really Accelerate and Enhance the Selective Serotonin Reuptake Inhibitor Antidepressant Effect? A Randomized Clinical Trial and a Meta-Analysis of Pindolol in Nonresistant Depression

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970 Quality of and Patient Satisfaction With Primary Health Care for Anxiety Disorders

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Focus on Women’s Mental Health

977 Antidepressant Medication Treatment During Pregnancy: Prevalence of Use, Clinical Implications, and Alternatives

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979 Pregnancy as a Major Determinant for Discontinuation of Antidepressants: An Analysis of Data From The Health Improvement Network

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986 A Randomized, Double-Blind, Placebo-Controlled Study of Light Therapy for Antepartum Depression

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994 Mother-Infant Antidepressant Concentrations, Maternal Depression, and Perinatal Events

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Clinical Points

  • Antidepressant-exposed newborns may experience transient perinatal events.
  • After birth, newborns of mothers who needed an extended duration of SRI therapy during pregnancy or newborns with exposure to shorter half-life drugs (eg, paroxetine or venlafaxine) require careful clinical monitoring for perinatal events.
  • Since unremitting depression can result in increased risk for perinatal events or preterm birth, clinicians are advised to screen for maternal depression symptoms, treatment adherence, and proper dosing to ensure a lasting antidepressant response.

1002 A Prospective, Naturalistic, Blinded Study of Early Neurobehavioral Outcomes for Infants Following Prenatal Antidepressant Exposure

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Clinical Points

  • Women are vulnerable to experiencing depression during the childbearing years.
  • Prenatal antidepressant use does not appear to have major adverse effects on early infant neurobehavioral development.
  • Clinicians can help guide patients in making pharmacologic treatment decisions for the treatment of depression during pregnancy, carefully weighing the risks and benefits to both the mother and the developing infant.

Letters To the Editor

1015 Keeping ’Em Honest: The Current Crisis of Confidence in Antidepressants

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• Reply by Andrew A. Nierenberg

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1016 The Emerging Role of Atypical Antipsychotics in the Treatment of Tardive Dyskinesia Induced by Other Atypical Antipsychotics

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• Reply by Hung-Yu Chan, Susan S.-F. Gau, and Ching-Jui Chang

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1017 Correction

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Book Reviews

1018 Primary Care Mental Health

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1018 Psychodynamic Therapy: A Guide to Evidence-Based Practice

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1019 Massachusetts General Hospital Handbook of General Hospital Psychiatry, 6th ed

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1019 The Psychiatrist as Expert Witness, 2nd ed.

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1020 The Madness Within Us: Schizophrenia as a Neuronal Process

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online CME Activities

e22 Strategies for the Early Recognition of Bipolar Disorder

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e23 Performance Improvement CME: Schizoaffective Disorder

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e24 Using Moderator-Based Algorithms and Electronic Medical Records to Achieve Optimal Outcomes in Depression

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information for authors

see www.psychiatrist.com/author.htm