The Journal of clinical psychiatry
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Patients with anxiety, depression, and bipolar disorder are known to be impaired relative to healthy controls on neurocognitive tests, but the degree of impairment may be obscured if the data are analyzed in terms of group means. ⋯ Substantial numbers of patients with anxiety, depression, and bipolar disorder are cognitively impaired. A score that is 2 standard deviations below the mean is usually clinically important, and 2 domain scores in that range is cause for serious concern. The importance of this finding is discussed, with respect to clinical trials, in terms of establishing a homogeneous trial population and minimizing the placebo response rate.
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To retrospectively examine published cases of neuroleptic malignant syndrome (NMS) in patients aged 18 and below who had been treated with atypical antipsychotics (clozapine, risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole). ⋯ Young patients can develop NMS during treatment with atypical antipsychotics. Symptoms of this disorder are consistent with those described in adults. Although NMS is rare in this population, clinicians should maintain a high index of suspicion. Appropriate caution in treating children and adolescents with any antipsychotic is warranted.
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There are no previous studies describing the correlates of suicide attempts in individuals with major depressive disorder in a nationally representative sample. This study explores the sociodemographic variables, mental disorders, and specific depressive symptoms associated with suicide attempts in depression. ⋯ This study contributes to the existing literature on risk factors for suicide attempts in depressed individuals. Identifying specific depressive symptoms and comorbid mental illnesses may improve the clinical assessment of suicide risk in people with major depressive disorder.
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Although increasing numbers of war veterans are seeking treatment for posttraumatic stress disorder (PTSD) at the U.S. Department of Veterans Affairs (VA), information on the role of psychotropic pharmacotherapy in their treatment has not been available. ⋯ Diverse psychotropic medication classes are extensively used in the treatment of PTSD in the VA. While disease-specific use for both PTSD and comorbid disorders is common, substantial use seems to be unrelated to diagnosis and thus is likely to be targeted at specific symptoms (e.g., insomnia, anxiety, nightmares, and flashbacks) rather than diagnosed illnesses. A new type of efficacy research may be needed to determine symptom responses to psychotropic medications as well as disorder responses, perhaps across diagnoses.