The Journal of clinical psychiatry
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Review
Prophylactic antipsychotic use for postoperative delirium: a systematic review and meta-analysis.
Although antipsychotics have been used empirically to prevent the development of postoperative delirium, there has been no confirming evidence to support their use. Thus, we conducted a systematic review and a meta-analysis to elucidate their efficacy and tolerability in surgical patients. ⋯ Our results suggest that second-generation antipsychotics are more beneficial than placebo for preventing the incidence of delirium. Among patients who do develop delirium, the severity of delirium is not reduced in those who received prophylactic antipsychotics.
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Depressive and anxiety disorders may predict first incidence of alcohol abuse and alcohol dependence. This study aims to identify those persons who are at an increased risk of developing alcohols abuse or alcohol dependence by considering the heterogeneity of depressive and anxiety disorders and exploring the role of other risk factors. ⋯ Current depressive disorder, anxiety disorder, or both significantly predicted first incidence of alcohol dependence, which stresses the importance of addiction prevention strategies for depressed and anxious patients in mental health settings. Subthreshold alcohol problems and recent negative life events may help to identify persons at an increased risk for developing alcohol dependence.
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Chronic pain is the leading reason patients see their primary care physician, and the burden of pain and depression in those with medical illness is particularly severe. Improving depressive symptoms can decrease physical symptoms in many patients, but these patients may require a different treatment strategy than those with depression alone. This activity provides guidance on recognizing and accurately diagnosing pain and major depression, managing these conditions using assessment tools and measurement-based care, avoiding unwanted side effects and drug interactions, and properly matching patients to appropriate treatments.