The American journal of psychiatry
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Review Comparative Study
Somatoform disorders: time for a new approach in DSM-V.
DSM-III introduced somatoform disorders as a speculative diagnostic category for somatic symptoms "not explained by a general medical condition." Although retained and enlarged in DSM-IV, somatoform disorders have been the subject of continuing criticism by both professionals and patients. The extended period of preparation for DSM-V offers an important opportunity to reconsider the category of somatoform disorders. ⋯ The authors promote a classification of somatic symptoms in DSM-V that is compatible with that used in general medicine and offers new opportunities both for research into the etiology and treatment of symptoms and for the greater integration of psychiatry into general medical practice.
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Comparative Study
Does memory of a traumatic event increase the risk for posttraumatic stress disorder in patients with traumatic brain injury? A prospective study.
The present study examined prospectively the relationship between memory of the traumatic event and subsequent development of posttraumatic stress disorder (PTSD). More specifically, the aims of this study were to 1) investigate the possibility that lack of memory of the traumatic event might be a protective factor; 2) assess whether memory of the traumatic event equally affects the three symptom clusters of PTSD: reexperiencing, avoidance, and hyperarousal; and 3) explore the predictive value of memory of the traumatic event for the development of subsequent PTSD in the immediate aftermath of the event. ⋯ Our study indicated that memory of a traumatic event is a strong predictor and a potential risk factor for subsequent development of PTSD. Future studies are needed to show whether these findings can be generalized to other traumatic conditions.
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Randomized Controlled Trial Comparative Study Clinical Trial
Remission in depressed geriatric primary care patients: a report from the PROSPECT study.
This study compared time to first remission for elderly depressed patients in primary care for practices that implemented a care management model versus those providing usual care. In addition, it sought to identify risk factors for nonremission that could guide treatment planning and referral to care managers or specialists. ⋯ Longitudinal assessment of depression, hopelessness, anxiety, and physical and emotional functional limitations in depressed older primary care patients is critical. Patients with prominent symptoms or impairment in these areas may be candidates for care management or mental health care, since they are at risk for remaining depressed and disabled.