bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nail-Biting Stuff? The Effect of N-acetyl Cysteine on Nail-Biting
Authors: Berk Michael , Jeavons Sue , Dean Olivia M. , Dodd Seetal , Moss Kirsteen , Gama Clarissa S. , Malhi Gin S. 
Published: August 2016

ABSTRACTN-acetyl cysteine (NAC) is a widely available nutraceutical with a variety of actions. As a precursor of cysteine and glutathione, it has antioxidant properties that may impact on mood and contribute to an effect on impulsivity and obsessive behaviour. Via its additional effect on glutamate via the cystine-glutamate exchange system, NAC has been shown to mediate impulsivity in preclinical models of addiction, reduce craving, and cue extinction. Further, by boosting glutathione, NAC acts as a potent antioxidant and has been shown in two positive, large-scale randomized placebo-controlled trials to affect negative symptoms in schizophrenia and depression in bipolar disorder. We describe three cases in which its actions specifically on nail-biting and associated anxiety may offer a potential treatment. The spontaneous findings are reported as part of an ongoing treatment trial examining the utility of NAC in bipolar disorder. Its actions, if robustly replicated, also point to potential treatment targets in glutathione or glutamate pathways in the brain.
Neuropsychopharmacologic Treatment of Depression and Other Neuropsychiatric Disorders in HIV-Infected Individuals
Authors: Repetto Martin J. , Evans Dwight L. , Cruess Dean G. , Gettes David R. , Douglas Steven D. , Petitto John M. 
Published: August 2016

AbstractHow can neuropsychiatric disorders and syndromes be underdiagnosed and inadequately treated in individuals infected with human immunodeficiency virus? Depression in particular is among the most prevalent diagnoses and there is a solid foundation of data from controlled clinical studies that has begun to examine the efficacy of various antidepressants in HIV-infected persons. This article summarizes essential findings pertaining to the use of psychotropic medications to treat depression and other neuropsychiatric disorders in the context of immunodeficiency. This includes discussion of clinically significant treatment considerations (eg, efficacy, side effects, drug-drug interactions) derived from the existing literature. Taken together, there is compelling evidence that psychopharmacologic intervention can improve the quality of life of mentally ill HIV-infected individuals.
Oxytocin and Vasopressin: Social Neuropeptides
Authors: Stein Dan J. 
Published: August 2016

ABSTRACTOxytocin and vasopressin are highly conserved neuropeptides that play a key role in social attachment and affiliation, including parental care and pair-bonding. Oxytocin attenuates neural responses to aversive pictures and has been associated with reduced coupling of amygdala to brainstem regions involved in the fear response. Differential activation of the amygdala has been found to be associated with different genetic variants of the vasopressin receptor. There is growing evidence that oxytocin and vasopressin receptor variants are associated with individual differences in prosocial behavior. It is humbling that differences in complex human behaviors may be partially explicable on the basis of relatively simple neuropeptide systems. Nevertheless, such findings potentially allow for targeted interventions for a range of psychiatric disorders in which such systems play a role.
Low-dose Transdermal Testosterone Augmentation Therapy Improves Depression Severity in Women
Authors: Miller Karen K. , Perlis Roy H. , Papakostas George I. , Mischoulon David , Iosifescu Dan V. , Brick Danielle J. , Fava Maurizio 
Published: August 2016

ABSTRACTBackground: Inadequate response to antidepressant monotherapy in women with major depressive disorder is common. Testosterone administration has been shown to be an effective augmentation therapy in depressed hypogonadal men with selective serotonin reuptake inhibitor-resistant depression. However, the effects of low-dose testosterone as augmentation therapy in women with treatment-resistant depression have not been studied.Methods: Low-dose transdermal testosterone (300 mcg/day, Intrinsa, Procter and Gamble Pharmaceuticals) was administered to nine women with treatment-resistant depression in an 8 week open-label pilot protocol.Results: There was a statistically significant improvement in mean Montgomery-Asberg Depression Rating Scale (MADRS) scores at 2 weeks, sustained through the 8 week period. Two-thirds of subjects achieved a response to the treatment (decrease in MADRS score of ≥50%) and 33% achieved remission (final MADRS score <10) after 8 weeks of therapy. Mean levels of fatigue, as measured by the MADRS lassitude item, significantly decreased at all time points with a mean 38% decrease from baseline to 8 weeks.Conclusion: These preliminary pilot data suggest that low-dose transdermal testosterone may be an effective augmentation therapy in women with treatment-resistant depression. Further studies are warranted.
Association of OCD with a History of Traumatic Events Among Patients in Methadone Maintenance Treatment
Authors: Peles Einat , Adelson Miriam , Schreiber Shaul 
Published: August 2016

ABSTRACTIntroduction: We studied the relationship between obsessive-compulsive disorder (OCD) and lifetime history of any traumatic events among methadone maintenance treatment (MMT) patients.Methods: In a cross-sectional sample of 167 patients, we clinically assessed for OCD using the Yale-Brown Obsessive Compulsive Scale and interviewed for their lifetime history of traumas.Results: OCD was defined among 40.1% patients. Sixteen percent of patients reported having been victims of sexual abuse or rape, 21.6% had self-inflicted physical injuries, 34.1% attempted suicide, 44.9% sustained other physical violence or abuse, 28.7% were involved in a car accident as drivers and 6% as passengers, and 16.8% had significant falls. Patients with OCD compared with patients without OCD included more rape victims (28.4% vs. 9%), had more self-inflicted physical injuries (31.3% vs. 15%), and had more suicide attempts (46.3% vs. 26%), with no differences in other traumatic events exposure. The OCD group was characterized as being female (OR=4.0 [95% CI 1.7-9.3]), having a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text-Revision Axis I psychiatric disorder (OR=2.6 [95% CI 1.2-5.5]), being Israeli born (OR=2.9 [95% CI 1.2-6.9]), abusing benzodiazepines (OR=2.2 [95% CI 1.02-4.6]), having attempted suicide (OR=2.5 [95% CI 1.1-5.4]), and having longer duration of opiate abuse before admission to MMT (OR=1.06 [95% CI 1.01-1.1]).
Prevalence of Irritable Bowel Syndrome in Obsessive–Compulsive Disorder
Authors: Masand Prakash S. , Keuthen Nancy J. , Gupta Sanjay , Virk Subhdeep , Yu-Siao Barbara , Kaplan David 
Published: August 2016

ABSTRACTIntroduction:Irritable bowel syndrome (IBS) occurs more frequently in psychiatric patients, especially those with anxiety and mood disorders.Methods:We sought to determine the prevalence and phenomenology of IBS in patients diagnosed with obsessive-compulsive disorder (OCD). A semi-structured diagnostic interview was administered to patients seeking treatment for OCD in outpatient settings. Structured questions regarding gastrointestinal functioning and IBS symptoms were administered. IBS was diagnosed by a gastroenterologist using Rome I criteria.Results:Thirty-seven patients (35.1%) with OCD met criteria for IBS. Of these, 53.8% had IBS with both diarrhea and constipation, 30.8% had diarrhea-predominant IBS, and 15.4% had constipation-predominant IBS.The prevalence rate of IBS in an age- and sex-matched control group (n=40) of medical patients in a family practice was 2.5%. IBS prevalence rates were significantly higher for OCD patients than control subjects (P=.0002).Conclusion:IBS and psychiatric illness have high rates of bi-directional comorbidity. This study shows that 35.1% of patients with OCD satisfied criteria for IBS in contrast to 2.5% of the controlled subjects. In most patients the IBS was characterized by both diarrhea and constipation. While taking the initial history clinicians should inquire about bowel symptoms in patients presenting with psychiatric illnesses, including OCD. SSRIs could potentially worsen such symptoms and lead to non-adherence.
Recognition and Treatment of Depression with or Without Comorbid Anxiety Disorders
Authors: Zimmerman Mark , Chelminski Iwona , Zisook Sidney , Ginsberg David L. 
Published: August 2016

ABSTRACTAnxiety disorders are common in depressed patients. Several studies of the full range of Diagnostic and Statistical Manual of Mental Disorders-defined anxiety disorders in depressed psychiatric outpatients each found that when diagnoses are based on semi-structured diagnostic interviews >40% of the patients had a comorbid anxiety disorder. The recognition of comorbidity is not simply of academic interest, but it has important clinical significance. Epidemiological studies, such as the National Comorbidity Study, have demonstrated that depressed individuals with a history of anxiety disorders are at increased risk for hospitalization, suicide attempt, and greater impairment from the depression. The co-occurrence of anxiety disorders in depressed patients has been associated with a more chronic course of depression in psychiatric patients, primary care patients, and epidemiological samples. Recent research has suggested that clinicians underrecognize anxiety disorder comorbidity in depressed patients. The clinical significance of this underrecognition is highlighted by the finding that patients often want treatment to address their anxiety disorder comorbidity. When anxiety disorders are detected they often influence clinicians' selection of antidepressant medication, though some of clinicians' prescribing biases are not supported by empirical data.In this monograph, Iwona Chelminski, PhD, reviews the significance of anxiety in patients with depression as well as diagnostic instruments for recognizing this comorbidity. Next, Mark Zimmerman, MD, addresses the factors that affect the clinician's choice of antidepressant, focusing on the influence of comorbid anxiety. Finally, Sidney Zisook, MD, discusses the differential efficacy of antidepressants as well as the role of psychotherapy in patients with comorbid anxiety and depression.
Reassessing Carbamazepine in Bipolar Disorders
Authors: Ketter Terence A. 
Published: August 2016

This discussion focuses on the historical trends of carbamazepine in the treatment of acute mania, acute bipolar depression, and as maintenance treatment for bipolar disorder. Clinical implications of efficacy, safety, tolerability, and drug interactions associated with carbamazepine are discussed as well.Important progress in bipolar disorders therapeutics began in the 1970s with lithium and the conventional antipsychotics, and continued in the 1980s with carbamazepine, in the 1990s with divalproex, and in the 2000s with lamotrigine and the introduction of the atypical antipsychotics. Electroconvulsive therapy (ECT) has been used throughout these periods and still has a place in bipolar disorder, especially for severe, treatment-resistant, and very acute cases.
Introduction: Assessing Current Practice in Alzheimer's Disease
Authors: Mintzer Jacobo E. 
Published: August 2016

Alzheimer's disease (AD) is a debilitating condition currently affecting 4.5 million elderly citizens in the United States alone. It is the most common form of dementia and is associated with significant disability. For many years the prognosis of the disease has remained largely unchanged. Those patients who develop AD face progressive cognitive and functional decline that ultimately shortens their life expectancy and destroys their quality of life. At the same time, the disease has a significant adverse impact on the lives of those family members who serve as caregivers. With the aging of the baby-boomer generation and the expected associated increase in the number of patients with AD, clinicians who treat the elderly will clearly be in need of some new answers. Recent advances in assessment, diagnosis, and treatment offer some hope for relief from this bleak prognosis.Advances in AD include the establishment of clear diagnostic criteria, the validation of disease-specific assessment instruments, and pharmacologic and behavioral therapies for management of symptoms. A handful of medications that enhance cognition have obtained the approval of the Food and Drug Administration, and more are currently in development. Trials of existing medications have demonstrated benefit in the management of the psychiatric symptoms (eg, psychosis and agitation) typically associated with the disease. But much still remains to be done.In the first article in this supplement, Michael A. Rogawski, MD, PhD, explains what is known about the pathogenesis and the behavioral and psychological symptoms of AD. He discusses the scientific basis for empirical therapies currently being used to relieve the symptoms of this disease, focusing on drug therapies approved by the FDA, including the newest AD medication to market memantine.
The Fourth IOCDC
Authors: Hollander Eric , Zohar Joseph , Marazziti Donatella 
Published: August 2016

The Fourth International Obsessive Compulsive Disorder Conference (IOCDC) was held February 10–12, 2000, on the beautiful island of St. Thomas. The IOCDC is an annual meeting which brings together the world's leading experts in obsessive-compulsive disorder (OCD) and related disorders in a small workshop setting to present recent research advances, discuss gaps in our current knowledge, and plan or international approaches that address these knowledge gaps. The IOCDC meetings have been held on islands on both sides of the Atlantic—Capri, Guadeloupe, Madeira, and now St. Thomas.The International Organizing Committee consists of Eric Hollander, MD (USA), Joseph Zohar, MD (Israel), and Donatella Marazziti, MD (Italy). The proceedings are generously supported by an unrestricted educational grant from Solvay Pharmaceuticals Inc. and Solvay Pharmaceuticals, and we would like to acknowledge the very important contributions of Chantal Vekens and Mary Blangiardo of Solvay. Also, an mportant part of the success of these meetings stems from the very active role of the chairpersons and cochairpersons of the workshops who lead the discussions, who synthesize the future directions and prepare the manuscripts that result from these discussions that appear in this academic supplement.The meeting led off with a state-of-the-art plenary address by Mark George, MD (USA), describing how new methods of brain stimulation are improving research and therapy in OCD and promise to revolutionize neuropsychiatric research and herapy over the next decade. He describes how transcranial magnetic stimulation (TMS) is used to test the circuits in OCD and test electrophysiologic evaluations of cortical inhibition n OCD. Newer techniques that are less invasive than ablative surgery and appear promising in OCD therapy include vagus nerve stimulation and deep brain stimulation.
Are All Atypical Antipsychotics Equal for the Treatment of Cognition and Affect in Schizophrenia?
Authors: Zohar Joseph 
Published: August 2016

One of the major developments in psychiatry in the last decade is the development and widespread use of the new antipsychotics. The field has moved from the typical dopamine D2-blocking neuroleptics into the new era of antipsychotics with the addition of the serotonin 5-HT2A properties to the classical D2 antagonism. These “atypical” antipsychotic drugs (APDs) provide us with new tools with which to treat our patients. However, do we really know how to make the most of these new medications? Are we equipped with the knowledge to do the best matching between the different APDs and the patients that we will see in an hour's time?One potential way to get the maximum therapeutic effect of a specific medication is to improve the matching between the compound and the patient that we are seeing, ie, to try and get the best medication for the patient. For example, the medication one would choose for a patient with cognitive decline and a tendency to be overweight, would likely be different from an antipsychotic one would select for a patient with the same diagnosis, but who is slim and has paranoid delusions. It is also intuitively clear to us that we should treat first-episode patients differently from those with a 20-year history of social decline. Similarly, a patient with pronounced affective component would receive a different treatment regimen from a patient who is affectively “flat.”Although we have been hearing and reading a lot about all the different APDs, it would be quite accurate to postulate that a concise updated summary of the different APDs, examining them around four different critical axes, might be welcomed by our readers.The topics covered in this supplement are: the differential receptor's profile of APDs and their clinical implications, the issue of cognitive impairment in schizophrenia and APDs, monitoring guidelines to assess metabolic abnormalities that may occur with APDs, and an update on treatment after first-episode psychosis.
Maximizing Function After First-Episode Psychosis
Authors: Kopala Lili C. 
Published: August 2016

AbstractInterest in early and preventive interventions in patients with psychotic disorders has increased over the past few years as a result of die intuitive appeal of such interventions. Results of studies point to an association between longer duration of untreated psychosis and poor outcome, atypical antipsychotic agents less likely to cause extrapyramidal side effects, and a shift from hospital to community-based care for many patients with severe mental illness. Treatment strategies specifically directed to firsUepisode psychosis may help to improve outcomes. Such strategies include the use of lower doses of antipsychotic medications, the predominant use of atypical antipsychotic agents, and the deployment of psychological interventions that address the unique needs of young, first-episode patients and their families.
Mechanisms of Action of Atypical Antipsychotics
Authors: Cañas Fernando 
Published: August 2016

AbstractAtypical antipsychotics—clozapine, risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole—differ from conventional antipsychotics primarily by virtue of their actions at multiple central receptor sites. Each agent has its own unique receptor profile. The discovery of dopaminergic receptor-blocking capabilities of conventionblockingal antipsychotic drugs led to the dopamine hypothesis of schizophrenia. More recently, the role of serotonergic and other receptors in the pathophysiology and symptomology of schizophrenia and schizoaffective disorder has been identified, and the receptor actions of atypical antipsychotics have been linked to both antipsychotic efficacy and the propensity for extrapyramidal symptoms and other adverse effects. Receptor occupancy is directly related to antipsychotic dose, and the nature of the relationship between clinical utility and receptor occupancy is beginning to emerge. As our understanding of this relationship becomes more clear, the mechanism underlying clinical distinctions between agents will be understood.
Non-Western Therapies for Affective Disorders: In Pursuit of Open-Minded Considerations of Concepts and Applications
Authors: Halbreich Uriel 
Published: August 2016

ABSTRACTIntroduction: Complementary and alternative medicine (CAM) modalities are gaining popularity among patients in Western countries. They are especially popular among patients seeking treatment for mental and mood symptoms. Some CAMs are according to current Western approaches but have not achieved approval by regulatory agencies. Some other modalities are acording to non-Western concepts of mental order and disorder. This installment of “The Well-Rounded Brain” will illuminate some non-Western concepts with an example of treatment modality for affective disorders, and compare them to conventional Western approach.Methods: Principles of the Chinese concept of affective disorders and acupuncture modalities for their treatments are briefly described from a culturally sensitive perspective.Results: Traditional Chinese medicine and current conventional Western medicine substantially differ in underlying concepts, development of treatment modalities, as well as their goals and implementation.Conclusion: Some non-Western concepts and treatment modalities have been meticulously and rigorously developed through trial and error, though the evidence for their efficacy and efficiency is not necessarily according to current Western standards. The consistent epidemiological demonstrations of the demand for CAM among patients suffering from mental disorders call for an open-minded, unbiased assessment of efficacy of non-Western treatment modalities for specific clusters of affective symptoms.
Lifetime Subthreshold Mania is Related to Suicidality in Posttraumatic Stress Disorder
Authors: Dell'Osso Liliana , Carmassi Claudia , Rucci Paola , Ciapparelli Antonio , Paggini Rosemma , Ramacciotti Carla Emilia , Conversano Ciro , Balestrieri Matteo , Marazziti Donatella 
Published: August 2016

ABSTRACTIntroduction: Although the association between mood disorders, and particularly bipolar disorders, comorbidity and suicidality in posttraumatic (PTSD) patients is well established, less information is available on the impact of subsyndromal mood symptoms. The aim of the present study was, thus, to explore the frequency and relationship between subthreshold mood symptoms, assessed by a specific and validated questionnaire, and suicidality in PTSD patients.Method: Sixty-five PTSD outpatients without bipolar disorders and 65 healthy control subjects were asked to complete the Mood Spectrum-SR-Lifetime Version (MOODS-SR), a questionnaire exploring the presence of subthreshold affective symptoms. Logistic regression models were used to analyze the relationships between suicidality, explored by six items of the MOODS-SR combined and dichotomized to denote the presence or absence of suicidal ideations/plans and/or attempts, and the number of manic/hypomanic or depressive symptoms.Results: Statistically significant and positive associations were found between the presence of manic/hypomanic and depressive symptoms and the likelihood of suicidal ideation or attempts.Conclusion: Besides depressive, even subthreshold manic/hypomanic features seem to be associated with higher suicidality in PTSD patients.