In this CME journal article, the authors describe a case of new-onset psychosis in a middle-aged woman, review red-flags for a neurodegenerative diagnosis rather than a primary psychotic disorder, and examine the role of genetics.
Experiencing a first episode of schizophrenia during adolescence may influence response to cognitive training. This study compared response to cognitive training in patients with early-onset schizophrenia versus those with adult-onset schizophrenia.
How would you use a symptom-focused approach to provide a more nuanced method for the assessment, monitoring, and treatment of PTSD? Read on to answer this question and gain a better understanding of PTSD in veterans.
Computer-assisted cognitive-behavior therapy (CCBT) allows clinicians to deliver evidence-based care to more patients than would be possible with standard CBT. This meta-analysis sought to determine if additional clinician support can increase the efficacy of CCBT—read the report to learn what the authors found.
A new dementia screening tool—notably one that is intended to remain free and available to all clinicians—was developed by the memory disorders group at the University of Alabama at Birmingham. Read all about it here.
Individuals with depression can experience diminished levels of reward positivity (RewP), a neurophysiologic index of reward responsiveness. Can changing levels of RewP be used as an objective index of depressive symptom improvement? Read this article to learn more.
Cognitive therapists spend a great deal of time establishing a relationship with everyone they treat. Some patients just want a friend to meet with and talk to. And, for some, this relationship is vital to their well-being. In this Psychotherapy Casebook article, Dr Schuyler discusses the meaning of friendship and how relationships affect psychotherapeutic change.
Cognitive impairments due to electroconvulsive therapy, traumatic brain injury, and neurologic and psychiatric disorders are prevalent. Could the galantamine-memantine combination significantly improve socio-occupational functioning in these patients? Read this narrative review to find out more.
Can a computer program help primary care clinicians and their patients in treatment of depression? This systematic review of eight studies of computer-assisted cognitive-behavior therapy found that computerized delivery of treatment is effective as long as a clinician offers a modest amount of support to users of the computer program. Read on to find out more.
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.”