Archives of general psychiatry
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Arch. Gen. Psychiatry · Apr 2012
Psychiatric disorders with postpartum onset: possible early manifestations of bipolar affective disorders.
Childbirth has an important influence on the onset and course of bipolar affective disorder, and it is well established that there may be a delay of many years before receiving a diagnosis of bipolar disorder following an initial episode of psychiatric illness. ⋯ A psychiatric episode in the immediate postpartum period significantly predicted conversion to bipolar affective disorder during the follow-up period. Results indicate that the presentation of mental illness in the early postpartum period is a marker of possible underlying bipolarity.
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Arch. Gen. Psychiatry · Mar 2012
A dynamic view of depressive symptoms and neurocognitive change among patients with coronary artery disease.
Older patients with coronary artery disease often experience depressive symptoms and are vulnerable to developing cognitive impairment. Whether depressive symptoms increase their risk of cognitive decline is unknown. ⋯ Depressive symptoms persist in some patients with coronary artery disease, placing them at a greater risk for cognitive decline. Whether this decline is additionally modified by the presence of APOE ε4 requires further investigation.
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Arch. Gen. Psychiatry · Feb 2012
Randomized Controlled TrialPrevention of posttraumatic stress disorder by early treatment: results from the Jerusalem Trauma Outreach And Prevention study.
Preventing posttraumatic stress disorder (PTSD) is a pressing public health need. ⋯ Prolonged exposure, CT, and delayed PE effectively prevent chronic PTSD in recent survivors. The lack of improvement from treatment with escitalopram requires further evaluation. Trauma-focused clinical interventions have no added benefit to survivors with subthreshold PTSD symptoms. Trial Registration clinicaltrials.gov Identifier: NCT00146900.
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Arch. Gen. Psychiatry · Feb 2012
Clinical TrialSubcallosal cingulate deep brain stimulation for treatment-resistant unipolar and bipolar depression.
Deep brain stimulation (DBS) may be an effective intervention for treatment-resistant depression (TRD), but available data are limited. ⋯ The findings of this study support the long-term safety and antidepressant efficacy of subcallosal cingulate DBS for TRD and suggest equivalent safety and efficacy for TRD in patients with BP. Trial Registration clinicaltrials.gov Identifier: NCT00367003.
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Although concern exists over the quality of emergency mental health services, little is known about the mental health care of adults who are admitted to emergency departments for deliberately harming themselves and then discharged to the community. ⋯ Most adult Medicaid beneficiaries who present for emergency care for deliberate self-harm are discharged to the community, and many do not receive emergency mental health assessments or follow-up outpatient mental health care.