The Journal of clinical psychiatry
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Chronic widespread pain is associated with several medical and psychiatric disorders including, but not limited to, chronic fatigue syndrome, fibromyalgia, mood disorders, hepatitis, endocrine disorders such as hypothyroidism, and rheumatologic disorders such as rheumatoid arthritis. Careful and comprehensive differential diagnosis must be performed to ensure a correct diagnosis before an appropriate treatment can be selected. Fibromyalgia, in particular, is challenging to diagnose and treat because it shares many characteristics with other disorders and is commonly concurrent with major mood disorders. A comprehensive disease management strategy including patient education, pharmacotherapy, cognitive-behavioral therapy, and aerobic and other forms of exercise can be beneficial for many patients with fibromyalgia.
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Randomized Controlled Trial Multicenter Study
Extended-release quetiapine as adjunct to an antidepressant in patients with major depressive disorder: results of a randomized, placebo-controlled, double-blind study.
This 6-week, randomized, double-blind study evaluated efficacy and safety of adjunctive extended-release (XR) quetiapine in patients with major depressive disorder (MDD) and an inadequate response to >or= 1 antidepressant. ⋯ Adjunctive quetiapine XR (150 mg/day and 300 mg/day) was effective in patients with MDD who had shown an inadequate response to antidepressant treatment. Significant reduction of depressive symptoms occurred as early as week 1. Findings were consistent with the known safety and tolerability profile of quetiapine.
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Randomized Controlled Trial
McLean-Harvard International First-Episode Project: two-year stability of DSM-IV diagnoses in 500 first-episode psychotic disorder patients.
Since stability of DSM-IV diagnoses of disorders with psychotic features requires validation, we evaluated psychotic patients followed systematically in the McLean-Harvard International First Episode Project. ⋯ Bipolar I disorder and schizophrenia were more stable diagnoses than delusional disorder or MDD, severe, with psychotic features, and much more than brief psychotic disorder, psychotic disorder NOS, or schizophreniform disorder. Diagnostic changes mainly involved emergence of affective symptoms and were predicted by several premorbid factors. The findings have implications for revisions of DSM and ICD.