Arch Gen Psychiat
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Comparative Study
Anomalous prefrontal-subcortical activation in familial pediatric bipolar disorder: a functional magnetic resonance imaging investigation.
The neurobiological features of pediatric bipolar disorder (BD) are largely unknown. Children and adolescents with BD may be important to study with functional neuroimaging techniques because of their unique status of early-onset BD and high familial loading for the disorder. Neuroimaging studies of adults with BD have implicated the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) in the development of this disorder. ⋯ Children and adolescents with BD may have underlying abnormalities in the regulation of prefrontal-subcortical circuits. Further functional magnetic resonance imaging studies of attention and mood with greater sample sizes are needed.
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Comparative Study
Subtype-specific alterations of gamma-aminobutyric acid and glutamate in patients with major depression.
Measurement of cortical gamma-aminobutyric acid (GABA) and glutamate concentrations is possible using proton magnetic resonance spectroscopy. An initial report, using this technique, suggested that occipital cortex GABA concentrations are reduced in patients with major depressive disorder (MDD) relative to healthy comparison subjects. ⋯ The study replicates the findings of decreased GABA concentrations in the occipital cortex of subjects with MDD. It also demonstrates that there is a change in the ratio of excitatory-inhibitory neurotransmitter levels in the cortex of depressed subjects that may be related to altered brain function. Last, the combined data set suggests that magnetic resonance spectroscopy GABA measures may serve as a biological marker for a subtype of MDD.
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Review Meta Analysis Comparative Study
Combined pharmacotherapy and psychological treatment for depression: a systematic review.
Adherence to antidepressant medication use is a problem in clinical practice. Some authors have posited that combined psychological treatment facilitates adherence to pharmacotherapy. ⋯ Psychological treatment combined with antidepressant therapy is associated with a higher improvement rate than drug treatment alone. In longer therapies, the addition of psychotherapy helps to keep patients in treatment. Further studies are needed to investigate whether the improvement in response attributable to the combination of drug treatment and psychotherapy can be achieved by a combination of pharmacotherapy and a compliance-enhancing intervention.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized effectiveness trial of interpersonal psychotherapy for depressed adolescents.
Adolescent depression is highly prevalent and has substantial morbidity, including suicide attempts, school dropout, and substance abuse, but many depressed adolescents are untreated. The school-based health clinic offers the potential for accessible and efficient treatment, although it is unknown whether school-based clinicians can be trained to implement evidence-based psychotherapies for depression in routine care. ⋯ Interpersonal psychotherapy delivered in school-based health clinics is an effective therapy for adolescent depression. This effort is a significant step toward closing the gap between treatment conducted in the laboratory and community clinic.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized effectiveness trial of stepped collaborative care for acutely injured trauma survivors.
Although posttraumatic stress disorder (PTSD) and alcohol abuse frequently occur among acutely injured trauma survivors, few real-world interventions have targeted these disorders. ⋯ Early mental health care interventions can be feasibly and effectively delivered from trauma centers. Future investigations that refine routine acute care treatment procedures may improve the quality of mental health care for Americans injured in the wake of individual and mass trauma.