The Journal of clinical psychiatry
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Randomized Controlled Trial Multicenter Study Comparative Study
Children of currently depressed mothers: a STAR*D ancillary study.
To assess the current and lifetime prevalence of psychiatric disorders among children of currently depressed mothers and to assess the association of clinical features of maternal depression (i.e., severity, chronicity, and clinical features) with child psychopathology. Mothers were participants in the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) multisite trial, designed to compare effectiveness and acceptability of different treatment options for outpatients with non-psychotic major depressive disorder (MDD). ⋯ Children of mothers in the midst of a current MDE are at high risk for disruptive behavior and anxiety disorders. The elevated risk of psychopathology among children of depressed mothers may recommend assessment of these children when clinically suggested. Children of depressed mothers with comorbid panic disorder with agoraphobia are at high risk for depressive and anxiety disorders and deserve special attention from clinicians.
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Randomized Controlled Trial Multicenter Study Comparative Study
The selective GABA reuptake inhibitor tiagabine for the treatment of generalized anxiety disorder: results of a placebo-controlled study.
To evaluate the efficacy and tolerability of tiagabine, a selective gamma-aminobutyric acid (GABA) reuptake inhibitor, in adults with generalized anxiety disorder (GAD). ⋯ The primary LOCF analysis was negative; however, results from the observed case and MMRM analyses suggest that tiagabine may be a useful treatment option for adult patients diagnosed with GAD. These findings warrant further evaluation in randomized clinical studies.
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Multicenter Study Comparative Study Clinical Trial
Symptom clusters as predictors of late response to antidepressant treatment.
While there is some indication from studies in the acute phase of antidepressant treatment that there are differences in the timing of improvement in symptoms, relatively little work has explored the patterns of change for specific symptom clusters and the predictability of these changes to signal eventual response during the acute phase of treatment. This article investigates the use of clusters of symptoms on the 17-item Hamilton Rating Scale for Depression (HAM-D-17) to define the pattern of late response versus nonresponse to antidepressant medication. ⋯ Monitoring changes in symptom clusters from the HAM-D-17 during this crucial early stage (first 4 weeks) can be used to distinguish late responders (after week 4) from nonresponders. Successful identification of nonresponders based on symptom cluster change in the first 4 weeks would facilitate a shortening of an ineffective treatment trial and allow for necessary changes in treatment strategy, helping physicians more closely follow treatment guidelines.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
The efficacy and safety of the melatonin agonist beta-methyl-6-chloromelatonin in primary insomnia: a randomized, placebo-controlled, crossover clinical trial.
While melatonin agonists are known to regulate circadian sleep rhythms, it is not clear whether melatonin agonists have a direct soporific effect. It has been suggested that melatonin's soporific effect is secondary to its ability to induce hypothermia. beta-Methyl-6-chloromelatonin is a high-affinity melatonin receptor agonist that is not associated with hypothermia. The purpose of the present study was to determine if the melatonin agonist beta-methyl-6-chloromelatonin has a direct soporific effect in subjects with primary insomnia. ⋯ beta-Methyl-6-chloromelatonin significantly decreases both objective and subjective measures of sleep latency in subjects with primary insomnia. Thus, these data suggest that mel-atonin agonists may exert a direct soporific effect, as previous research indicates that beta-methyl-6-chloromelatonin is not associated with changes in body temperature, heart rate, or blood pressure.
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Multicenter Study Comparative Study Clinical Trial
Reducing violence risk in persons with schizophrenia: olanzapine versus risperidone.
This study prospectively examined the effectiveness of treatment with olanzapine versus risperidone in reducing violent behavior among patients with schizophrenia under "usual care" conditions in the community. ⋯ This study found that, in the complex "real world" settings where persons with schizophrenia reside, long-term treatment with olanzapine confers some advantage over risperidone in reducing violence risk. This advantage appears to be at least in part an indirect effect, via improvement in adherence with treatment. Specifically, adherence with prescribed medication was found to mediate the association between olanzapine treatment and reduced violent behavior.