The Journal of clinical psychiatry
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Randomized Controlled Trial
Efficacy and safety of levomilnacipran sustained release 40 mg, 80 mg, or 120 mg in major depressive disorder: a phase 3, randomized, double-blind, placebo-controlled study.
This phase 3, randomized, double-blind, placebo-controlled study evaluated the efficacy and tolerability of fixed-dose levomilnacipran sustained release (SR) compared with placebo in patients with major depressive disorder (MDD); the study was conducted from September 2009-May 2011. ⋯ Levomilnacipran SR demonstrated significant improvement in depressive symptoms and functioning relative to placebo. In this study, levomilnacipran SR was generally well tolerated.
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Major depressive episode (MDE) and posttraumatic stress disorder (PTSD) have been shown to be the most common mental disorders following traumatic war experiences and have been found to frequently co-occur. This study, designed as a randomized cross-sectional interview survey, aimed to identify whether the co-occurence of MDE and PTSD following exposure to war-related experiences is associated with different demographics, exposure to previous traumatic events, and clinical characteristics than either condition alone. ⋯ Concomitant MDE and PTSD are associated with the experience of different traumatic events and are characterized by more general psychological distress than either condition alone. The assessment of concomitant MDE and PTSD can facilitate better identification of individuals with severe psychopathology and poor quality of life. People with co-occurrence of MDE and PTSD may require specific health care programs following war.
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Comparative Study
Posttraumatic stress disorder in adult attention-deficit/hyperactivity disorder: clinical features and familial transmission.
Attention-deficit/hyperactivity disorder (ADHD) is characterized by clinically significant functional impairment due to symptoms of inattention and/or hyperactivity and impulsivity. Previous research suggests a link, in child samples, between ADHD and posttraumatic stress disorder (PTSD), which is characterized by (1) chronically reexperiencing a traumatic event, (2) hyperarousal, and (3) avoiding stimuli associated with the trauma while exhibiting numbed responsiveness. This study sought to address the link between ADHD and PTSD in adults by providing a comprehensive comparison of ADHD patients with and without PTSD across multiple variables including demographics, patterns of psychiatric comorbidities, functional impairments, quality of life, social adjustment, and familial transmission. ⋯ The comorbidity of PTSD and ADHD in adults leads to greater clinical severity in terms of psychiatric comorbidity and psychosocial functioning. The familial coaggregation of the 2 disorders suggests that these disorders share familial risk factors and that their co-occurrence is not due to diagnostic errors.
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To examine the quality of suicide risk assessment provided to veterans with a history of depression who died by suicide between 1999 and 2004. ⋯ Most VHA patients with a history of depression received some suicide risk assessment within the past year, but suicide risk assessments were infrequently administered at the final visit of patients who eventually died by suicide. Among patients who had assessments, denial of suicidal ideation appeared to be of limited value. Practice changes are needed to improve suicide risk assessment among patients with histories of depression, including the development of assessment and prevention strategies that are less dependent on the presence or disclosure of suicidal ideation at scheduled medical visits.