Current opinion in psychiatry
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Curr Opin Psychiatry · Mar 2007
ReviewAre somatoform disorders 'mental disorders'? A contribution to the current debate.
During the last 2 years, a debate has started over whether the somatoform symptoms/medically unexplained symptoms are wrongly placed under the category of mental disorders (section F in International classification of diseases-10 and in Diagnostic and statistical manual for mental disorders-IV). ⋯ The classification of somatoform disorders as 'mental disorders' could be justified if empirically founded psychological and behavioural characteristics are included into the classification process. Attention focusing, symptom catastrophizing, and symptom expectation are outlined as possible examples of involved psychological processes.
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Curr Opin Psychiatry · Mar 2007
ReviewNeuroendocrine mechanisms of stress and social interaction: implications for mental disorders.
The purpose of the present review is to consider further evidence for the role of neuroendocrine mechanisms in mental disorders by focusing on recent trends and advances in the field of psychoneuroendocrinology. ⋯ Neuroendocrine systems relevant to behavior clearly demonstrate their impact for the field of psychiatry. Further neuroendocrine research provides insight into the origins of mental disorders both from an etiological perspective and an interventional perspective.
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In the absence of a specific treatment for dementia, the effective management of cognitive symptoms is a clinical priority. ⋯ Pharmacological treatment of cognitive disorder is beneficial but has only temporary benefit for a subgroup of patients. Pharmacogenetics may have an important future role to play in deciding which patients may best benefit from the treatment. Low side effect therapies such as cognitive therapy and acupuncture show some benefits but their utility in combination with pharmacotherapies remains to be demonstrated. Prevention of milder forms of cognitive disorder by controlling risk factors such as hypertension and diabetes may reduce rates of more severe cognitive degeneration. Persons with cognitive dysfunction are commonly excluded from making decisions about the implementation of cognition-enhancing treatments although they wish to do so.
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Curr Opin Psychiatry · Sep 2006
ReviewUpdate on treatment of epilepsy in people with intellectual disabilities.
On the basis of the relevance of adequate epilepsy treatment (antiepileptic drugs, surgery and vagus nerve stimulation) for people with intellectual disabilities, all articles, published from the beginning of 2005 to March 2006 and searched by MEDLINE, on this topic were reviewed. ⋯ A contradiction exists between the relevance of epilepsy treatment in people with intellectual disabilities and the small number of published studies on pharmacological treatment. Some of the reasons are addressed and some alternatives are proposed.
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This article reviews literature published over the period January 2004-May 2005 on suicidal behaviour and self-harm in personality disorders. ⋯ Although recent studies have contributed to the theoretical knowledge and clinical practice, there are unsettled questions that should be addressed in the future. More randomized, controlled trials evaluating the efficacy of interventions in suicidal individuals with personality disorders should be conducted. As the majority of studies conducted to date have concentrated on borderline personality disorder and antisocial personality disorder, the prevalence and risk factors for suicidal behaviours and self-mutilation in other personality disorders require further clarification. The introduction of unified nomenclature related to suicidal behaviours and self-mutilation would facilitate comparability of results across studies.