The Journal of clinical psychiatry
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Randomized Controlled Trial Multicenter Study
Cost-efficacy of individual and combined treatments for panic disorder.
The objective of this study was to examine the relative cost-efficacy of empirically supported treatments for panic disorder. As psychosocial, pharmacologic, and combined treatments have all demonstrated efficacy in the treatment of panic disorder, cost-efficacy analysis provides an additional source of information to guide clinical decision making. ⋯ In the context of similar efficacy for combined treatments, but poorer cost-efficacy, current monotherapies should be considered the first-line treatment of choice for panic disorder. Additionally, CBT emerged as the most durable and cost-effective monotherapy and, hence, should be considered as a particularly valuable treatment from the perspective of cost accountability.
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Randomized Controlled Trial
Shared decision making and long-term outcome in schizophrenia treatment.
Compliance with antipsychotic medication is a major issue in schizophrenia treatment, and noncompliance with antipsychotic treatment is closely related to relapse and rehospitalization. An enhanced involvement of patients with schizophrenia in treatment decisions ("shared decision making") is expected to improve long-term compliance and reduce rehospitalizations. The aim of the present analysis was to study whether shared decision making (SDM) in antipsychotic drug choice would influence long-term outcome. ⋯ The intervention studied showed a positive trend but no clear beneficial effect on long-term outcomes. A more thorough implementation of SDM (e.g., iterative administration of decision aid) might yield larger effects. Those patients with higher participation preferences are at higher risk for poor treatment outcomes and therefore require special attention. Strategies to match these patients' needs might improve compliance and long-term outcomes.
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Randomized Controlled Trial Multicenter Study
The efficacy and safety of aripiprazole as adjunctive therapy in major depressive disorder: a multicenter, randomized, double-blind, placebo-controlled study.
To assess the efficacy and safety of aripiprazole versus placebo as adjunctive treatment to standard antidepressant therapy (ADT) in patients with major depressive disorder (MDD) who showed an incomplete response to 1 prospective and 1 to 3 historical courses of ADT within the current episode. ⋯ ClinicalTrials.gov identifier NCT00095823.
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Randomized Controlled Trial Multicenter Study
A double-blind, placebo-controlled study of the efficacy and safety of desvenlafaxine succinate in the treatment of major depressive disorder.
This study evaluated the efficacy and safety of desvenlafaxine succinate extended-release in major depressive disorder (MDD). ⋯ Desvenlafaxine is effective and well tolerated in the short-term treatment of MDD.
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Comparative Study
Decisional capacity to consent to research among patients with bipolar disorder: comparison with schizophrenia patients and healthy subjects.
Although clinical trials are needed to advance treatments for bipolar disorder, there has been little empirical research on the capacity of bipolar patients to consent to research. The aim of the present study was to evaluate levels of decisional capacity of bipolar patients compared with those of schizophrenia patients and healthy comparison subjects, as well as to examine whether symptom and neurocognitive deficits correlate with patients' decisional abilities. ⋯ The presence of bipolar disorder appears to be a risk factor for impaired understanding of information disclosed under standard consent procedures but should not be equated with a lack of competence to consent. The observed improvement in understanding with redisclosure of information suggests that enhanced consent procedures may be useful during enrollment of bipolar patients in research.