Volume 72 • December 2011 • Number 12
Commentary
1574 The Impact of Omega-3 Fatty Acids on Depressive Disorders and Suicidality: Can We Reconcile 2 Studies With Seemingly Contradictory Results?
David Mischoulon
[Abstract] [Full Text]
Original Research
1577 Meta-Analysis of the Effects of Eicosapentaenoic Acid (EPA) in Clinical Trials in Depression
M. Elizabeth Sublette, Steven P. Ellis, Amy L. Geant, and J. John Mann
[Abstract] [Full Text] [Clinical Points] [Related Blog Post FREE to registered users]
- Meta-analysis of clinical trials of fish oil for depression indicates that the ratio of the constituent omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) may determine the effectiveness of the supplements.
- Significant improvement in depression scores was seen in the group of studies using supplements in which EPA was at least 60% of the combined fatty acids: EPA/(EPA + DHA).
- Effective doses of EPA in excess of DHA, calculated as EPA − DHA, were in the approximate range of 200–2,000 mg/d.
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1585 Suicide Deaths of Active-Duty US Military and Omega-3 Fatty-Acid Status: A Case-Control Comparison
Michael D. Lewis, Joseph R. Hibbeln, Jeremiah E. Johnson, Yu Hong Lin, Duk Y. Hyun, and James D. Loewke
[Abstract] [Full Text] [Clinical Points]
- The status of omega-3 fatty acids is extremely low among US military personnel.
- Low status of docosahexaenoic acid (DHA), an omega-3 fatty acid obtained from seafood and concentrated in the brain, is associated with increased risk for suicide death.
- Ensuring adequate omega-3 nutritional status is likely to benefit, and unlikely to harm, people at risk for suicide.
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1602 A 12-Month Randomized, Open-Label Study of the Metabolic Effects of Olanzapine and Risperidone in Psychotic Patients: Influence of Valproic Acid Augmentation
Herbert Y. Meltzer, Stefania Bonaccorso, William V. Bobo, Yuejin Chen, and Karuna Jayathilake
[Abstract] [Full Text] [eAppendix]
1611 Problematic Video Game Use Scale: Initial Psychometric Properties With Psychiatrically Hospitalized Adolescents
David R. Topor, Lance P. Swenson, Gina M. Liguori, Anthony Spirito, Elizabeth A. Lowenhaupt, and Jeffrey I. Hunt
[Abstract] [Full Text] [eAppendix] [Clinical Points]
- Two underlying factors emerged to account for problem video game playing: impairment in functioning factor and reinforcing effects factor.
- These findings highlight the importance of assessing video game use among an adolescent population, the factors associated with video game use, and the relation of video game use to symptoms of psychopathology.
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1616 Mid-Term and Long-Term Efficacy and Effectiveness of Antipsychotic Medications for Schizophrenia: A Data-Driven, Personalized Clinical Approach
Ira D. Glick, Christoph U. Correll, A. Carlo Altamura, Stephen R. Marder, John G. Csernansky, Peter J. Weiden, Stefan Leucht, and John M. Davis
[Abstract] [Full Text] [Clinical Points]
- Mid-term and long-term data suggest that some antipsychotics are more effective than others when treating schizophrenia over the long run. They include clozapine, olanzapine, and risperidone.
- Each antipsychotic has a unique side effect profile, with greater or less propensity for weight gain, but in general second-generation antipsychotics have fewer extrapyramidal symptoms and less tardive dyskinesia than first-generation antipsychotics over the long run.
- As much as possible, individualize medication, psychotherapy, and rehabilitation treatment choices, ie, share the decision-making with each “patient–significant other unit.” For many chronic patients over time, efficacy and improved function are more important than possible future side effects.
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1628 Panic as an Independent Risk Factor for Suicide Attempt in Depressive Illness: Findings From the National Epidemiological Survey on Alcohol and Related Conditions (NESARC)
Curren Katz, Zimri S. Yaseen, Ramin Mojtabai, Lisa J. Cohen, and Igor I. Galynker
[Abstract] [Full Text]
1636 Why Do Some Patients With Schizophrenia Want to Be Engaged in Medical Decision Making and Others Do Not?
Johannes Hamann, Rosmarie Mendel, Sarah Reiter, Rudolf Cohen, Markus Bühner, Matthias Schebitz, Stefan Diplich, Werner Kissling, and Achim Berthele
[Abstract] [Full Text]
1644 Effects of Acute Hydrocortisone Administration on Declarative Memory in Patients With Major Depressive Disorder: A Placebo-Controlled, Double-Blind Crossover Study
Kirsten Terfehr, Oliver Tobias Wolf, Nicole Schlosser, Silvia Carvalho Fernando, Christian Otte, Christoph Muhtz,Thomas Beblo, Martin Driessen, Carsten Spitzer, Bernd Löwe, and Katja Wingenfeld
[Abstract] [Full Text] [Clinical Points]
- A significant percentage of patients with MDD show hypothalamic-pituitary-adrenal axis (HPA) dysregulations, for example, hypercortisolism or reduced glucocorticoid receptor function.
- The results of our study further strengthened the hypothesis of reduced central glucocorticoid receptor functioning in MDD.
- The corticosteroid receptor hypothesis of depression has stimulated pharmacologic research to strive for new antidepressant agents that act directly on different sites within the HPA axis.
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1651 Brief Behavioral Therapy for Refractory Insomnia in Residual Depression: An Assessor-Blind, Randomized Controlled Trial
Norio Watanabe, Toshi A. Furukawa, Shinji Shimodera, Ippei Morokuma, Fujika Katsuki, Hirokazu Fujita, Megumi Sasaki, Chihiro Kawamura, and Michael L. Perlis
[Abstract] [Full Text]
Case Report
1659 A Case of Agranulocytosis Secondary to Rechallenge With Clozapine Following Severe Neutropenia During Previous Therapy
Unax Lertxundi, Pedro Sanchez, Rafael Hernandez, and Edorta Elizagarate
[Abstract] [Full Text]
1592 Increased Risk of Diabetes Mellitus Among Persons With Psychotic Symptoms: Results From the WHO World Health Survey
Roberto Nuevo, Somnath Chatterji, David Fraguas, Emese Verdes, Nirmala Naidoo, Celso Arango, and José Luis Ayuso-Mateos
[Abstract] [Full Text] [CME Activity] [Clinical Points]
- Psychotic symptoms are related to the presence of diabetes mellitus in the general population, independent of other factors.
- Clinicians should examine the lifestyles of patients with psychotic symptoms in order to reduce the risk of diabetes mellitus.
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Early Career Psychiatrists
1660 Efficacy of Antidepressants for Late-Life Depression: A Meta-Analysis and Meta-Regression of Placebo-Controlled Randomized Trials
Enrico Tedeschini, Yeciel Levkovitz, Nadia Iovieno, Victoria E. Ameral, J. Craig Nelson, and George I. Papakostas
[Abstract] [Full Text] [Clinical Points]
- Late-life major depressive disorder (MDD) is often underrecognized and undertreated even though it is the most prevalent psychiatric disorder, estimated to be present in 9%–18% of the population over 55 years of age.
- Antidepressants are efficacious in the treatment of late-life MDD, but antidepressant response rates are lower than in adult MDD (< 65 years).
- Executive dysfunction, comorbid Axis III conditions, greater chronicity of depressive episode, and undertreatment might influence antidepressant response specifically in patients older than 65 years.
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1669 Association Between Patient Beliefs Regarding Assigned Treatment and Clinical Response: Reanalysis of Data From the Hypericum Depression Trial Study Group
Justin A. Chen, George I. Papakostas, Soo Jeong Youn, Lee Baer, Alisabet J. Clain, Maurizio Fava, and David Mischoulon
[Abstract] [Full Text] [Clinical Points]
- In this reanalysis, patient beliefs regarding treatment were more strongly associated with clinical outcome than the actual medication received.
- The degree of influence of patient beliefs on clinical outcome may depend upon the particular combination of treatment guessed and treatment received.
- Results of this and future studies may have implications for how clinicians utilize the potentially therapeutic effects of patient beliefs in clinical practice.
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1677 Stress and Inflammation Reduce Brain-Derived Neurotrophic Factor Expression in First-Episode Psychosis: A Pathway to Smaller Hippocampal Volume
Valeria Mondelli, Annamaria Cattaneo, Martino Belvederi Murri, Marta Di Forti, Rowena Handley, Nilay Hepgul, Ana Miorelli, Serena Navari, Andrew S. Papadopoulos, Katherine J. Aitchison, Craig Morgan, Robin M. Murray, Paola Dazzan, and Carmine M. Pariante
[Abstract] [Full Text] [Supplementary Material] [Clinical Points]
- Biological abnormalities triggered by stress contribute to brain structure abnormalities at the onset of psychosis.
- Targeting biological pathways involved in the stress response might help to prevent development of psychosis and improve clinical outcome of patients with psychosis.
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1685 Variants of the Serotonin Transporter Gene, Selective Serotonin Reuptake Inhibitors, and Bone Mineral Density in Risperidone-Treated Boys: A Reanalysis of Data From a Cross-Sectional Study With Emphasis on Pharmacogenetics
Chadi A. Calarge, Vicki L. Ellingrod, Bridget Zimmerman, Michael M. Bliziotes, and Janet A. Schlechte
[Abstract] [Full Text] [Clinical Points]
- Selective serotonin reuptake inhibitors (SSRIs) are widely used in children and adults, with emerging evidence linking them to impaired skeletal metabolism.
- The use of SSRIs in children and adolescents is associated with lower trabecular bone mineral density.
- Preliminary evidence indicates that carriers of the ls genotype of the 5-HTTLPR variants are at an increased risk for reduced bone mineral density compared to those with the ll or ss genotypes.
- If replicated, these findings suggest that genotyping the 5-HTTLPR variants might help estimate the risk for SSRI-related skeletal effects. This would help optimize the long-term safety of SSRIs.
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1691 Time to Treatment Response in First-Episode Schizophrenia: Should Acute Treatment Trials Last Several Months?
Juan A. Gallego, Delbert G. Robinson, Serge M. Sevy, Barbara Napolitano, Joanne McCormack, Martin L. Lesser, and John M. Kane
[Abstract] [Full Text] [Clinical Points] [Related Blog Post FREE to registered users]
- Choosing the optimal duration for an antipsychotic treatment trial is an important clinical decision. Treatment trials for patients with a first episode of schizophrenia should be longer than treatment trials for multiepisode patients. Some first-episode patients may need up to 16 weeks of antipsychotic treatment to achieve response.
- The use of early lack of improvement as a predictor of subsequent nonresponse to treatment has limited value with patients with first-episode schizophrenia.
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Letters to the Editor
1697 Antidepressant Use and Risk for Suicide Attempts in Bipolar Disorder
Joseph F. Goldberg
[Purchase] [Full Text]
• Reply by Andrew C. Leon, David A. Solomon, Chunshan Li, Jess G. Fiedorowicz, William Coryell, and Jean Endicott
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1698 Predicting Suicide Attempt Risk: Logistic Regression Requires Large Sample Sizes
Steven C. Bagley
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• Reply by Alison M. Gilbert, Raphael J. Braga, and Katherine E. Burdick
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1698 Correction
Gilbert AM, Garno JL, Braga RJ, Shaya Y, Goldberg TE, Malhotra AK, Burdick KE. Clinical and cognitive correlates of suicide attempts in bipolar disorder: is suicide predictable? (J Clin Psychiatry 2011;72[8]:1027–1033)
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Book Reviews
1699 Genes, Memes, Culture, and Mental Illness: Toward an Integrative Model
Seeth Vivek
[Purchase] [Full Text]
1699 Religious and Spiritual Issues in Psychiatric Diagnosis: A Research Agenda for DSM-V
Susan J. Stagno
[Purchase] [Full Text]
1700 The American Psychiatric Publishing Textbook of Forensic Psychiatry, 2nd ed
Barry Morenz
[Purchase] [Full Text]
1700 Clinical Manual of Adolescent Substance Abuse Treatment
Pieter Joost van Wattum
[Purchase] [Full Text]
Author Index
1702 Author Index to Volume 72: January 2011 Through December 2011
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Psychiatrist.com Exclusives
CME Activities
e36 Using Algorithms and Computerized Decision Support Systems to Treat Major Depression
Richard C. Shelton and Madhukar H. Trivedi
[Abstract]
e37 Clinical Impact of Updated Diagnostic and Research Criteria for Alzheimer’s Disease
Eric M. Reiman, Guy M. McKhann, Marilyn S. Albert, Reisa A. Sperling, Ronald C. Petersen, and Deborah Blacker
[Abstract]
e38 Presentation and Diagnosis of Fibromyalgia
Larry Culpepper
[Abstract]
Information for Authors
see www.psychiatrist.com/author.htm
