Why in the age of MRIs is a brain tumor mistaken for a psychiatric illness? Here, read about a patient whose first-ever brain scan revealed a meningioma after many years of various psychotic disorder diagnoses.
A 69-year-old woman with a history of depression presents with recent onset of cognitive symptoms and impairment in daily activities coupled with persistent atypical psychiatric symptoms and a poor response to treatment. Could she have a brain tumor?
The "C" word is frightening to patients with serious mental illness as much as to anyone, but whether these patients' survival is equal to those without an SMI is questioned. To evaluate potential disparities, the authors looked at patients with schizophrenia, a prototypical SMI, who were diagnosed with lung cancer, a common malignancy. Their results may not surprise you, but an unexpected finding should provide a glimmer of hope.
What would you do if you were diagnosed with cancer? Would you fight and attack it like an enemy? Or would you treat it as a part of yourself that needs to heal? Here, Dr Scott recommends the latter. She explains why waging war against cancer is like fighting a losing battle and, instead, suggests acceptance and starting the journey to return your body to a precancerous state.
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.”