Volume 73December 2012Number 12

Original Research

1503 Response to Past Depression Treatments Is Not Accurately Recalled: Comparison of Structured Recall and Patient Health Questionnaire Scores in Medical Records

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.

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1509 Effects of Co-Occurring Depression on Treatment for Anxiety Disorders: Analysis of Outcomes From a Large Primary Care Effectiveness Trial

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.

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1517 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 [free access]

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.

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1541 A 12-Week, Randomized, Double-Blind, Placebo-Controlled, Sequential Parallel Comparison Trial of Ziprasidone as Monotherapy for Major Depressive Disorder

Meta-Analysis

1533 Meta-Analyses of the Efficacy of Asenapine for Acute Schizophrenia: Comparisons With Placebo and Other Antipsychotics [free access]

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.

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1524 Pretest

CME Activity

1531 Posttest

 

1525 Clinician-Rated Versus Self-Rated Screening for Bipolar Disorder Among Inpatients With Mood Symptoms and Substance Misuse

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.

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Focus on Alzheimer’s Disease and Related Disorders

1548 Gender Differences in Clinical Manifestations and Outcomes Among Hospitalized Patients With Behavioral and Psychological Symptoms of Dementia

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.

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1555 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

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.

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ASCP Corner

1563 Cardiovascular Disease and Bipolar Disorder:Risk and Clinical Implications

Book Reviews

1566 Clinical Manual of Neuropsychiatry

1566 Depression and Cancer

Online Exclusives

Practical Psychopharmacology

e1475 Drug Interactions in the Treatment of Depression in Patients With Ischemic Heart Disease

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.

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Original Research

e1478 The Daytime Impact of DSM-5 Insomnia Disorder: Comparative Analysis of Insomnia Subtypes From the Great British Sleep Survey

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.

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e1485 Phenotypic Differences Between Pregnancy-Onset and Postpartum-Onset Major Depressive Disorder

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.

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Focus on Alzheimer’s Disease and Related Disorders

e1492 Long-Term Observation of a Multicomponent Cognitive Intervention in Mild Cognitive Impairment

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

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Free Online Activities

e31 An Update on MAOIs: Dietary Restrictions and Drug Interactions [CME]

e32 Accurately Diagnosing and Comprehensively Managing MS [CME]

Information for Authors

see www.psychiatrist.com/author.htm