Acta psychiatrica Scandinavica
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Recognizing and incorporating the patient's own perspective into treatment recommendations are essential to optimizing clozapine use. The study describes how the patient's perspective influences clinicians' decision strategies and affects their clozapine recommendations. ⋯ A clozapine optimization strategy requires skill in advanced decision making, and specifically in prioritizing the patient's perspective without diminishing the importance of clinical information. This skill can be developed through practice-based learning.
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Acta Psychiatr Scand · Mar 2012
Evidence that interactive effects of COMT and MTHFR moderate psychotic response to environmental stress.
A functional interaction between Catechol-O-Methyltransferase (COMT) Val158Met and methylenetetrahydrofolate reductase (MTHFR) C677T has been shown to differentially affect cognition in patients with schizophrenia and healthy controls; the effect of COMT Val158Met × MTHFR interaction on resilience to stress in patients and controls remains to be examined. ⋯ Stress reactivity associated with COMT Val158Met in patients with psychosis may crucially depend on MTHFR C677T genotype.
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Acta Psychiatr Scand · Feb 2012
ReviewA systematic review of the literature about competence and poor insight.
Formally, incompetence implies that a patient cannot meet the legal requirements for informed consent. Our aim was to review the scientific literature on the relationship between competence and insight in patients with psychiatric disorders, how competence and insight are connected in these patients and whether there are differences in competence and insight among patients with different disorders. ⋯ Most incompetent psychotic patients have poor insight, but non-psychotic patients with adequate insight were incompetent in a substantial number of cases. In sum: non-psychotic patients with adequate insight can be incompetent.
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Acta Psychiatr Scand · Dec 2011
Psychiatric diagnosis in late adolescence and long-term risk of suicide and suicide attempt.
To investigate the associations between psychiatric diagnosis in late adolescence in an unselected population and subsequent suicide attempt and suicide during 36-year follow-up. ⋯ Psychiatric diagnoses made in late adolescence predicted subsequent suicide and suicide attempt over a 36-year follow-up period. The increased relative risks were not limited to young adulthood but were also evident 18-36 years after conscription examination.
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Acta Psychiatr Scand · Dec 2011
Positive and negative life events and personality traits in predicting course of depression and anxiety.
To examine the prognostic value of personality dimensions and negative and positive life events for diagnostic and symptom course trajectories in depressive and anxiety disorder. ⋯ Negative life events have an independent effect on diagnostic and symptom course trajectories of depression and to a lesser extent anxiety unconfounded by sociodemographic, clinical, and personality characteristics.