Diagnostic workup of early onset dementias often takes a circuitous route. Here, the authors demonstrate how clinically meaningful information can be gleaned from an inconclusive diagnostic workup using a longitudinal and multidisciplinary approach.
Care coordination across health systems is critical to optimize patient care for chronic medical and psychiatric conditions. Group concept mapping provides a strategic process to allow shared decision making among stakeholders.
Could family physicians embedded in mental health institutions reduce the need to transfer patients out of the hospital to receive care for nonpsychiatric conditions? Read this interesting study to find out.
Many adolescents with mental disorders do not receive specialist treatment, and those who do often wait several years before beginning treatment. Do parents, teachers, or the adolescents themselves have the biggest influence on if and when treatment is sought? Read this article to learn more.
Most integrated care programs do not include dental care services, presumably due to a variety of economic factors. Here, read the results of a survey on dental health to find out just how important this aspect of care is to your patients.
The use of multidisciplinary health care teams for patients with multiple complex needs may improve patient outcomes. In this Commentary, read about an often overlooked solution to care coordination and medication management problems—the utilization of appropriately trained pharmacists to support patient-focused care.
This article presents an alternative approach to the DSM for the understanding and treatment of patients with psychiatric conditions. This alternative approach, based on The Perspectives of Psychiatry, requires a systematic consideration of the patient's psychiatric condition from 4 perspectives: disease, dimensional, behavior, and life story.
Baclofen, a French Exception, Seriously Harms Alcohol Use Disorder Patients Without Benefit
To the Editor: Dr Andrade’s analysis of the Bacloville trial in a recent Clinical and Practical Psychopharmacology column, in which he concluded that “individualized treatment with high-dose baclofen (30-300 mg/d) may be a useful second-line approach in heavy drinkers” and that “baclofen may be particularly useful in patients with liver disease,” deserves comment.1
First, Andrade failed to recall that the first pivotal trial of baclofen, ALPADIR (NCT01738282; 320 patients, as with Bacloville), was negative (see Braillon et al2).
Second, Dr Andrade should have warned readers that Bacloville’s results are most questionable, lacking robustness. Although he cited us,3 he overlooked the evidence we provided indicating that the Bacloville article4 was published without acknowledging major changes to the initial protocol, affecting the primary outcome. Coincidentally (although as skeptics, we do not believe in coincidence), the initial statistical team was changed when data were sold to the French pharmaceutical company applying for the marketing authorization in France. As Ronald H. Coase warned, “If you torture the data long enough, it will confess.”