Journal of affective disorders
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Review Meta Analysis
Effectiveness and acceptability of deep brain stimulation (DBS) of the subgenual cingulate cortex for treatment-resistant depression: a systematic review and exploratory meta-analysis.
Deep brain stimulation (DBS) applied to the subgenual cingulate cortex (SCC) has been recently investigated as a potential treatment for severe and chronic treatment-resistant depression (TRD). Given its invasive and experimental nature, a comprehensive evaluation of its effectiveness and acceptability is of paramount importance. Therefore, we conducted the present systematic review and exploratory meta-analysis. ⋯ DBS applied to the SCC seems to be associated with relatively large response and remission rates in the short- and medium- to long-term in patients with severe TRD. Also, its maximal antidepressant effects are mostly observed within the first 6 months after device implantation. Nevertheless, these findings are clearly preliminary and future controlled trials should include larger and more representative samples, and focus on the identification of optimal neuroanatomical sites and stimulation parameters.
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DSM׳s replacement of 'mixed episodes' with 'mixed features' has ironically created a specifier, which potentially lacks specificity because it overlooks two key symptoms: psychomotor agitation and distractibility. Therefore, the present study examined the presence of psychomotor agitation and distractibility across the mood disorder spectrum. ⋯ The present findings suggest that distractibility and psychomotor agitation may represent the core of mixed states, as they are more common in patients with mixed depression and bipolar spectrum disorder than patients diagnosed with unipolar depression and bipolar I disorder. Future research and clinical implications are discussed.
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Randomized Controlled Trial
Improving the detection and prediction of suicidal behavior among military personnel by measuring suicidal beliefs: an evaluation of the Suicide Cognitions Scale.
Newer approaches for understanding suicidal behavior suggest the assessment of suicide-specific beliefs and cognitions may improve the detection and prediction of suicidal thoughts and behaviors. The Suicide Cognitions Scale (SCS) was developed to measure suicide-specific beliefs, but it has not been tested in a military setting. ⋯ The SCS is a reliable and valid measure that predicts suicidal ideation and suicide attempts among military personnel better than other well-established risk factors.
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Randomized Controlled Trial
Cost-effectiveness analysis of a collaborative care programme for depression in primary care.
Collaborative care programmes lead to better outcomes in the management of depression. A programme of this nature has demonstrated its effectiveness in primary care in Spain. Our objective was to evaluate the cost-effectiveness of this programme compared to usual care. ⋯ The intervention yields better outcomes than usual care with a modest increase in costs, resulting in favourable ICERs. This supports the recommendation for its implementation.
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Suicide attempts by self-poisoning utilizing prescription opioids account for more than half of prescription drug abuse and misuse emergency calls received by poison centers. Additionally seasonal suicidal behavior using other means is a commonly replicated finding. We hypothesized seasonal behavior would exist in individuals using opioid medication as a suicide means, and that this pattern would change at different latitudes in the United States. ⋯ Suicidal behavior with prescription opioids follows a seasonal pattern that changes with latitude within the United States. Further, increased accessibility may contribute to increased suicidal attempt rates utilizing prescription opioids.