Canadian journal of psychiatry. Revue canadienne de psychiatrie
-
Depression is among the most disabling and costly illnesses in the world. Despite good short-term efficacy outcomes in the treatment of depression, long-term outcomes remain disappointing. Depression continues to be missed or underdiagnosed and undertreated, and comorbidities are frequently not identified. ⋯ Patients who fail to achieve a full remission have a more recurrent and chronic course, increased medical and psychiatric comorbidities, greater functional burden, and increased social and economic costs. Cost-effective treatment for depression includes antidepressant therapies with higher remission rates. Antidepressants with a dual mechanism of action and combination therapies are associated with higher remission rates, more depression-free days, reduced pain-symptom morbidity, reduced health service utilization, and improved productivity.
-
Delirium, an important event in hospital, is associated with significant mortality and morbidity. Most patients with delirium recover fully; however, when left untreated, delirium may progress to stupor, coma, or death. Delirium is less likely to resolve completely in elderly patients in whom persistent cognitive deficits commonly occur. The extent to which this information is available to family doctors after discharge was investigated. ⋯ Delirium episodes that occur during a period of hospitalization for treatment of any medical disorder are underreported, even when specifically diagnosed. Structured discharge summaries tend to increase the rate of reporting.
-
Letter Case Reports
Treatment noncompliance with orally disintegrating olanzapine tablets.
-
It is common for individuals with symptoms of posttraumatic stress disorder (PTSD) to present with co-occurring pain problems, and vice versa. However, the relation between these conditions often goes unrecognized in clinical settings. ⋯ We also present several possible explanations for the co-occurrence of these disorders, based primarily on the notions of shared vulnerability and mutual maintenance. The paper concludes with an overview of future research directions, as well as practical recommendations for assessing and treating patients who present with co-occurring PTSD or chronic pain symptoms.