The Journal of clinical psychiatry
-
Comparative Study
Mental illness and psychotropic drug use among prescription drug overdose deaths: a medical examiner chart review.
Between 1999 and 2006, there was a 120% increase in the rate of unintentional drug overdose deaths in the United States. This study identifies the prevalence of mental illness, a risk factor for substance abuse, and chronic pain among prescription drug overdose deaths in West Virginia and ascertains whether psychotropic drugs contributing to the deaths were used to treat mental illness or for nonmedical purposes. ⋯ Mental illness may have contributed to substance abuse associated with deaths. Clinicians should screen for mental illness when prescribing opioids and recommend psychotherapy as an adjunct or an alternate to pharmacotherapy. Benzodiazepines may have been used nonmedically rather than as a psychotropic drug, reflecting drug diversion. Restricting benzodiazepine prescriptions to a 30-day supply with no refills might be considered.
-
To examine the relationship between the personal beliefs that patients with auditory hallucinations have concerning their voices and the incidence of aggression toward self, others, and objects on the inpatient ward. ⋯ Individuals who believe their hallucinated voices to be all-powerful, malevolent, and irresistible are significantly more likely to engage in aggressive acts on the inpatient service. Examining the beliefs that an individual has about his/her voices may be a useful addition to current aggression risk batteries utilized on acute psychiatric inpatients.
-
Comparative Study
Insomnia and sleep duration in a large cohort of patients with major depressive disorder and anxiety disorders.
Disturbed sleep has a high impact on daily functioning and has been correlated with psychopathology. We investigated the extent to which insomnia and sleep duration were associated with both current and remitted depressive and anxiety disorders in a large-scale epidemiologic study, taking sociodemographics, health factors, and medication use into account. ⋯ Depressive disorder-but also anxiety disorder-is strongly associated with sleep disturbances. Insomnia and short sleep duration persist after remittance of these disorders, suggesting that these are residual symptoms or possibly trait markers. Also, long sleep duration is associated with current depressive or anxiety disorders.
-
Metabolic syndrome (MetS) is an important side effect of second-generation antipsychotics (SGAs). However, many SGA-treated patients with MetS remain undetected. In this study, we trained and validated artificial neural network (ANN) and multiple logistic regression models without biochemical parameters to rapidly identify MetS in patients with SGA treatment. ⋯ Our study developed accurate ANN and logistic regression models to detect MetS in patients with SGA treatment. The models are likely to provide a noninvasive tool for large-scale screening of MetS in this group of patients.
-
Comment Letter Case Reports
Antidepressants in bipolar disorder: caveats in interpreting and applying the findings of Altshuler et al.