• Patients who attempted suicide in the week before psychiatric admission had a 5-fold higher risk of inpatient suicide compared with patients who did not have a recent suicide attempt.
• Patients with the highest level of education had an increased risk of inpatient suicide compared with patients with a lower level of education.
• Fifty-eight percent of the completed inpatient suicides occurred outside the hospital among patients who either were taking an agreed-upon leave or had absconded from the hospital.

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• The high prevalence of specific phobia in adolescents coupled with high comorbidity and lack of treatment-seeking expressly for specific phobia suggests that many adolescents in psychiatric treatment may suffer from specific phobia even though the disorder is not the consultation motive or presenting complaint.
• Youth seeking psychiatric services should be evaluated for specific phobia given that the disorder is persistent and highly comorbid and that few seek treatment specifically for it despite the existence of effective treatments.

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• Levels of criminality in schizophrenic patients may be differentiated by a genetic method.
• Genetic examination in schizophrenic patients may lead to a better assessment and treatment for aggression followed by prevention of criminal behavior.
• Clinicians can refer potentially aggressive patients to therapists who are experts in aggression.

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• Potential predictors of clinical outcome of major depression in adults have been studied with inconclusive results. The observation of cohorts of patients in real-world conditions over a long period of time would offer new and relevant information about the prognosis of the illness.
• In this study, early (within 6 weeks) response and remission were strongly associated with a good outcome in the clinical course of major depression at 12-month follow-up; other factors associated with a good outcome were being employed and the absence of physical comorbidities.
• Furthermore, having early response and remission had a strong association with better social and occupational functionality and, in the case of early response, also with better quality of life.

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• For many individuals, attention-deficit/hyperactivity disorder (ADHD) spans from childhood through adult life, resulting in ongoing impairments and functional impact.
• Optimal management requires an understanding of the presentation of symptoms and impairments within developmental phases and changing environmental demands.
• The ADHD Life Transition Model is aimed at raising awareness of phase-specific presentations and providing a basis for developing rational, prospective approaches to the symptoms and impairments at each transition phase.

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• The deletion of 5 personality disorders, as recommended by the DSM-5 Personality and Personality Disorders Work Group, does not eliminate diagnostic comorbidity.
• The deletion of 5 personality disorders may result in increased rates of personality disorder not otherwise specified diagnoses, signaling a problem with the nosology that was not adequately solved by removing these disorders.
• Comorbidity rates may decline by virtue of classification of fewer disorders; however, without empirical evidence supporting such changes, the removal of disorders may lead to false-negative diagnoses.

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• Depressive episodes following bereavement are excluded from a DSM-IV diagnosis unless they are prolonged or complicated.
• In a population-based sample, individuals with bereavement-related depression had fewer external indicators of psychopathology than individuals with depression that was unrelated to bereavement.
• There was no evidence to support the diagnostic distinction between complicated bereavement and bereavement not identified as complicated.

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• Weight gain has been very commonly reported during olanzapine treatment.
• We observed no significant difference on the primary outcome measure for this study: difference in weight gain between olanzapine monotherapy and the pooled results for the 2 weight gain treatment algorithms.
• Participants who initiated on metformin (500–1,500 mg/d), progressing as needed to amantadine (200 mg/d) and then to zonisamide (100–400 mg/d), experienced significantly less weight gain than participants on olanzapine monotherapy.

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• Individuals with a major depressive episode (MDE) with atypical features can be distinguished from individuals without them based on the presence of 1 or both reversed vegetative symptoms (ie, hypersomnia or hyperphagia).
• An MDE with atypical features (ie, presence of reversed vegetative symptoms) is associated with greater rates of lifetime psychiatric comorbidity, number of episodes, individual episode severity, disability, and suicide attempts than an episode without those features.
• Individuals with an MDE with atypical features had significantly higher rates of bipolar I disorder than those without atypical features.

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• It is advisable to screen for personality disorder in a psychiatric outpatient population.
• The most cost-efficient and effective screening instruments are the self-report form of the Standardized Assessment of Personality-Abbreviated Scale (SAPAS-SR) and the Iowa Personality Disorder Screen (IPDS).
• These 2 screening instruments raise the a priori chance of detecting a personality disorder from 50% to between 80% and 84% for patients in a psychiatric outpatient population.

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• Exclusive reliance on diagnostic criteria has impoverished the clinical process and does not reflect the complex thinking that underlies decisions in psychiatric practice.
• The accuracy of clinical judgment can be greatly increased with specific strategies: global formulations, staging methods, and a better organization of clinical information (encompassing macroanalysis and microanalysis).
• The concept of disease is no longer adequate to guide psychiatric care; therefore, clinical decision making should be addressed to attainment of individual goals.

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• Sertraline as an adjunctive treatment to psychotherapy may confer no added advantage over brief dynamic psychotherapy alone in women suffering from mild-to-moderate postpartum depression.
• When treating women suffering from moderate postpartum depression, clinicians should consider an initial intervention with brief dynamic psychotherapy alone before initiating antidepressant treatment.
• If treatment with a selective serotonin reuptake inhibitor is initiated for postpartum depression, a relatively high dose may be warranted for clinical efficacy.

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• Accurate diagnosis of bipolar disorder in women prior to pregnancy is especially important for maximizing maternal and fetal well-being.
• Among young women previously diagnosed with bipolar disorder, a history of antidepressant-associated mania/hypomania provides particularly strong support for a diagnosis of bipolar disorder.
• Among young women previously diagnosed with bipolar disorder, early onset of the disorder and a history of substance use disorder complicate efforts to confirm the diagnosis.

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• Maternal depression or anxiety during pregnancy is associated with poorer compliance with prenatal vitamins and with increased fetal exposure to numerous substances, including tobacco, hypnotics, antiemetics, opioid analgesics, and benzodiazepines.
• The risk-benefit assessment for managing prenatal depression and anxiety must consider the risks of fetal exposure to these other substances.

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