The Journal of clinical psychiatry
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Childhood maltreatment strongly predicts poor psychiatric and physical health outcomes in adulthood. This overview of the literature shows that individuals who suffer abuse, neglect, or serious family dysfunction as children are more likely to be depressed, to experience other types of psychiatric illness, to have more physical symptoms (both medically explained and unexplained), and to engage in more health-risk behaviors than their nonabused counterparts. ⋯ Individuals with a history of childhood abuse, particularly sexual abuse, are more likely than individuals with no history of abuse to become high utilizers of medical care and emergency services. Childhood maltreatment is highly prevalent among both men and women, especially in specialty settings such as emergency psychiatric care.
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Letter Case Reports
Use of propofol for alcohol withdrawal delirium: a case report.
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The evidence for a spectrum of bipolar disorders is mounting. Of particular interest and importance is the evolution and recurrence of bipolar disorder in the postpartum period and its relationship to postpartum psychosis. Understanding whether such a phenomenological link exists has diagnostic, prognostic, and treatment implications. ⋯ Understanding the relationship between postpartum psychosis and bipolar disorder has implications for perinatal and long-term treatment. Prophylactic treatment of women with bipolar disorder and/or a history of postpartum psychosis may be indicated. Epidemiological, genetic, and pharmacologic research must be completed to understand, prevent, and adequately treat postpartum psychosis.
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Clinical Trial
A prospective, open-label, flexible-dose study of quetiapine in the treatment of delirium.
Delirium is an organic psychiatric syndrome characterized by fluctuating consciousness and impaired cognitive functioning. High-potency typical neuroleptics have traditionally been used as first-line drugs in the treatment of delirium. However, these drugs are frequently associated with undesirable adverse events including extrapyramidal symptoms (EPS). The purpose of the present open-label, flexible-dose study was to provide preliminary data on the usefulness and safety of quetiapine for patients with delirium. ⋯ Quetiapine may be a useful alternative to conventional neuroleptics in the treatment of delirium due to its rapid onset and relative lack of adverse events. Further double-blind, placebo-controlled studies are warranted.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Efficacy of controlled-release paroxetine in the treatment of late-life depression.
Depression is the second most common neuropsychiatric disorder in older Americans, with significant clinical and public health costs. Despite advances in treatment, late-life depression remains a clinical challenge. Although the selective serotonin reuptake inhibitors (SSRIs) are the most common pharmacologic intervention for late-life depression, few placebo-controlled trials have assessed the efficacy of SSRIs for this condition. ⋯ Paroxetine CR and paroxetine IR are effective and well tolerated treatments for major depressive disorder in elderly patients, including those with chronic depression.