The Journal of clinical psychiatry
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Diagnosis of bipolar disorder in children and adolescents is increasing, and the early-onset form of bipolar disorder usually carries more morbidity than later-onset forms. Patient education and psychotherapeutic and psychosocial interventions should be used in conjunction with carefully planned medication regimens. Recent data support the use of atypical antipsychotics for manic or mixed states in children and adolescents. However, more information is needed about long-term treatment of mania, treatment of bipolar depression, and treatment of comorbid psychiatric conditions.
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Family and partner psychopathology characterizes 2 different types of potential risk factors for mental disorders linked to both biological and psychosocial processes, and no studies have included both variables in a study of risk of postpartum mental disorders (PPMD). The aim was to assess how a history of mental disorders in either a first-degree family member or partner affects the risk of admission or outpatient contact with PPMD. ⋯ Results indicated that family psychopathology represents a particular risk in the immediate postpartum period, especially if a family member suffers from bipolar affective disorder compared to other diagnostic groups. However, additional studies are needed to establish if partner psychopathology is a risk factor for PPMD specifically or has a more general influence on risk of mental disorders throughout pregnancy and postpartum.
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Randomized Controlled Trial
Efficacy and safety of duloxetine 60 mg once daily in the treatment of pain in patients with major depressive disorder and at least moderate pain of unknown etiology: a randomized controlled trial.
Experience of pain in major depressive disorder (MDD) can complicate diagnosis and impair treatment outcomes. This study evaluated the efficacy and safety of duloxetine in the treatment of patients with moderate pain associated with depression. ⋯ These results support duloxetine's efficacy and tolerability in the treatment of pain and depression in patients with at least moderate pain associated with depression.
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There are limited data on suicidal behavior in obsessive-compulsive disorder (OCD). This study examines suicidal behavior and its clinical correlates in OCD subjects. ⋯ OCD is associated with a high risk for suicidal behavior. Depression and hopelessness are the major correlates of suicidal behavior. It is vital that patients with OCD undergo detailed assessment for suicide risk and associated depression. Aggressive treatment of depression may be warranted to modify the risk for suicide. Future studies should examine suicidal behavior in a prospective design in larger samples to examine if severity of OCD and treatment nonresponse contribute to suicide risk.
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Randomized Controlled Trial Multicenter Study
Maintenance treatment with risperidone or low-dose haloperidol in first-episode schizophrenia: 1-year results of a randomized controlled trial within the German Research Network on Schizophrenia.
Second-generation antipsychotics (SGAs) have proven superior to first-generation antipsychotics regarding relapse prevention, mainly in multiple-episode patients. Practice guidelines recommend SGAs as first-line treatment particularly in first-episode patients, although evidence for this group is still limited. Accordingly, the hypothesis of whether 1-year relapse rate in first-episode schizophrenia under maintenance treatment with risperidone is lower compared to haloperidol in low dose was tested. ⋯ ClinicalTrials.gov identifier: NCT00159081.