bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alzheimer's Disease Pathways to Practice: Assessing Diagnosis and Outcome Measures
Authors: Grossberg George T. 
Published: August 2016

Alzheimer's disease is the most common form of dementing illness, affecting nearly 4.5 million Americans according to current estimates. The disease exhibits a strong association with old age, and is not commonly observed in individuals <65 years of age. Among individuals >65 years of age, the prevalence of Alzheimer's disease is ∼10%, and nearly half of all persons >85 years of age are affected by this condition. Given the apparent link between Alzheimer's risk and increasing age, as well as expected changes in the demographic structure of the United States population, it has been projected that the number of Americans with Alzheimer's disease will reach unprecedented levels in the coming years. In fact, it has been predicted that, barring the development of novel preventive therapies, the number of US residents with Alzheimer's will increase to 11–16 million by the year 2050.The expected rise in the number of Alzheimer's disease cases represents a daunting challenge, due to the far-reaching negative impact of the disease. Alzheimer's disease is a condition that not only has profound effects on the affected patient but also takes a dramatic toll on the patient's primary caregiver, who is in many cases the spouse or an adult child of the patient. Patients with Alzheimer's experience cognitive and functional declines, often in association with behavioral disturbances, while caregivers frequently suffer reductions in quality of life attributable to the immense emotional, physical, and financial burdens associated with the task of providing care.
“Mirror, Mirror…” Whose Explanation is the Fairest? Evolving Notions of Somatization and Idiopathic Physical Symptoms
Authors: Engel Charles C. 
Published: August 2016

Somatization disorder, multiple chemical sensitivities, chronic fatigue syndrome, fibromyalgia, Gulf War syndrome, neurasthenia, irritable bowel syndrome, conversion disorder…idiopathies one and all. These syndromes and the many others like them have perhaps one overriding commonality: enormous unexplained heterogeneity. Patients and clinicians gaze into the suffering and impact of these symptoms and see as many potential causes as there are symptom combinations.Whose explanation is best? When I am speaking with psychiatrists, the notion of somatoform symptoms goes largely unchallenged. When I am with rheumatologists, however, fibromyalgia is anything but a psychiatric problem and certainly not a somatoform disorder. Among my toxicologist colleagues, it is readily accepted that low-tevel toxic exposures could account for many idiopathic “sensitivities.”But what of the high rate of depression and anxiety disorders we see in these patients?” I sometimes unwisely retort.“Well, it could be a co-factor or an interaction,” is a common response.Unshaken, I step further into the abyss: “How, then, do you explain the high rate of adverse childhood experiences among people with idiopathic symptom syndromes?”The response is swift. “You cannot rule out biased recall. We cannot expect people to remember these things accurately in such a negative state of mind.”And so it goes. After several of these kinds of conversations, I have finally concluded there is no point in arguing.The debate is largely irreconcilable, a debate that strikingly parallels the conflicts many primary care physicians experience with symptomatic patients. “How is your personal life?” the doctor may ask a symptomatic patient, suspecting a psychosocial explanation.
Application of The APA Practice Guidelines on Suicide to Clinical Practice
Authors: Jacobs Douglas G. , Brewer Margaret L. 
Published: August 2016

ABSTRACTThis article presents charts from The American Psychiatric Association Practice Guideline for the Assessment and Treatment of Patients with Suicidal Behaviors, part of the Practice Guidelines for the Treatment of Psychiatric Disorders Compendium, and a summary of the assessment information in a format that can be used in routine clinical practice. Four steps in the assessment process are presented: the use of a thorough psychiatric examination to obtain information about the patient's current presentation, history, diagnosis, and to recognize suicide risk factors therein; the necessity of asking very specific questions about suicidal ideation, intent, plans, and attempts; the process of making an estimation of the patient's level of suicide risk is explained; and the use of modifiable risk and protective factors as the basis for treatment planning is demonstrated. Case reports are used to clarify use of each step in this process.
Healthcare Resource Utilization in Bipolar Depression Compared with Unipolar Depression: Results of a United States Population-Based Study
Authors: Frye Mark A. , Calabrese Joseph R. , Reed Michael L. , Hirschfeld Robert M.A. 
Published: August 2016

ABSTRACTIntroduction:This study examined healthcare utilization in the past year by subjects who screened positive for bipolar versus unipolar depression.Method:A self-administered survey was completed in 2002 by a United States population-based sample. Respondents were categorized into one of three subgroups: bipolar depressed screen positive (BP DEP+, n=394); unipolar depressed screen positive (UP DEP+, n=794); and control subjects (n=1,612).Results:For depressive symptoms in the past year, BP DEP+ respondents were significantly more likely than UP DEP+ respondents to report a healthcare visit to a number of diverse care providers. In analyses controlled for demographics and depression severity, the differences in psychiatric hospitalization, psychologist/counselor outpatient visit, substance abuse/social services visit, and number of emergency room visits remained significant between BP DEP+ and UP DEP+ respondents.Conclusion:Subjects with self-reported bipolar depression sought care more often from a number of diverse healthcare resources than subjects with self-reported unipolar depression. These findings underscore the morbidity associated with bipolar depression.
Potential Markers for Problematic Internet Use: A Telephone Survey of 2,513 Adults
Authors: Aboujaoude Elias , Koran Lorrin M. , Gamel Nona , Large Michael D. , Serpe Richard T. 
Published: August 2016

ABSTRACTObjective:The Internet has positively altered many aspects of life. However, for a subset of users, the medium may have become a consuming problem that exhibits features of impulse control disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.Method:This is the first large-scale epidemiological study of problematic Internet use through a random-digit-dial telephone survey of 2,513 adults in the United States. Given the lack of validated criteria, survey questions were extrapolated from established diagnostic criteria for impulse control disorders, obsessivecompulsive disorder, and substance abuse. Four possible diagnostic criteria sets were generated.The least restrictive set required the respondent to report an unsuccessful effort to reduce Internet use or a history of remaining online longer than intended, Internet use interfering with relationships, and a preoccupation with Internet use when offline.Results:The response rate was 56.3%. Interviews averaged 11.3 minutes in duration. From 3.7% to 13% of respondents endorsed ≥1 markers consistent with problematic Internet use. The least restrictive proposed diagnostic criteria set yielded a prevalence of problematic Internet use of 0.7%.Conclusion:Potential markers of problematic Internet use seem present in a sizeable proportion of adults. Future studies should delineate whether problematic Internet use constitutes a pathological behavior that meets criteria for an independent disorder, or represents a symptom of other psychopathologies.
Impulsive-Compulsive Sexual Behavior
Authors: Mick Thomas M. , Hollander Eric 
Published: August 2016

ABSTRACTImpulsive-compulsive sexual behavior is a little studied clinical phenomenon which affects ~5% to 6% of the population. In theDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision, it is classified as an impulse control disorder not otherwise specified or a sexual disorder not otherwise specified. It may be placed in a possible new category in theDiagnostic and Statistical Manual of Mental Disorders, Fifth Editioncalled substance and behavioral addictions.This clinical entity is reviewed and the merit of classifying it as an addiction is assessed. Information is presented regarding its diagnostic criteria, epidemiology, types of behavior it can involve, relationship to hypersexuality, comorbidities, treatment, and etiology. The data regarding this disorder and its overlap with chemical addiction is limited. If the two disorders are to be grouped together, further data are needed.
Long-Term Treatment of Patients with Recurrent Unipolar Major Depression: Evidence to Clinical Practice
Authors: Keller Martin B. 
Published: August 2016

Major depressive disorder (MDD) is almost exclusively recurrent. The vast majority of patients who experience one episode of MDD will eventually experience at least one more episode during their lifetime. The recurrent nature of MDD increases the burden to both the individual and society. Hence, it is imperative that treatment strategies focus on achieving remission acutely, as well as maintaining of remission and preventing recurrence. The articles in this supplement are based on presentations and a dialogue among a group of experts who convened for a roundtable discussion on improving long-term outcomes with antidepressant therapy.Improving long-term treatment of MDD begins with understanding the clinical course of recurrent depression and the ability to recognize those patients who are at greatest risk for recurrence. James H. Kocsis, MD, reviews the course of recurrent depression, emphasizing the tendency for it to progressively worsen. He also discusses patient characteristics and other risk factors for recurrence as well as current recommendations for long-term management of recurrent depression.Although long-term antidepressant maintenance treatment studies are somewhat limited in number, they provide the evidence base that shapes existing guidelines for long-term management of recurrent depression. Michael E. Thase, MD, examines this evidence for the different classes of antidepressants. In addition, Thase reviews evidence for the efficacy of psychotherapy and discusses its potentially important role in long-term depression management.
Aripiprazole in Juvenile Bipolar Disorder Comorbid with Attention-Deficit/Hyperactivity Disorder:An Open Clinical Trial
Authors: Tramontina Silzá , Zeni Cristian Patrick , Pheula Gabriel Ferreira , de Souza Carla Ketzer , Rohde Luis Augusto 
Published: August 2016

ABSTRACTIntroductionJuvenile bipolar disorder (JBD) is a highly impairing chronic mental health condition that affects children and adolescents' overall functioning. Comorbidity with attention-deficit/hyperactivity disorder (ADHD) is extremely prevalent and may determine worse response to treatment. Few investigations have addressed the use of recent atypical antipsychotics in JBD, although several guidelines suggest their use.MethodsWe conducted a 6-week open trial with aripiprazole in 10 children and adolescents with JBD comorbid with ADHD to assess impact on mania and ADHD symptoms, respectively, by means of the Young Mania Rating Scale and the Swanson, Nolan and Pelham Scale, as well as on global functioning (Clinical Global Impressions–Severity), and adverse events.ResultsSignificant improvement in global functioning scores (F=3.17,P=.01, effect size=0.55), manic symptoms (F=5.63,P<.01; ES=0.93), and ADHD symptoms (t=3.42,P<.01; ES=1.05) were detected. Although an overall positive tolerability was reported, significant weight gain (F=3.07,P=.05) was observed.ConclusionAripiprazole was effective in improving mania and ADHD symptoms, but neither JBD nor ADHD symptom remission was observed in most of the cases. Randomized placebo-controlled trials for JBD and ADHD are needed.
Quetiapine for Mania Due to Traumatic Brain Injury
Authors: Oster Timothy J. , Anderson C. Alan , Filley Christopher M. , Wortzel Hal S. , Arciniegas David B. 
Published: August 2016

ABSTRACTSecondary mania develops in as many as 9% of persons with traumatic brain injuries.The treatment of posttraumatic mania is not well defined, and agents traditionally used for the treatment of idiopathic manic episodes may not be well suited for use among individuals with traumatic brain injuries. Atypical antipsychotics are indicated for the treatment of idiopathic bipolar disorder, and have been used for other purposes among individuals with posttraumatic neuropsychiatric disturbances. This article offers the first description of the treatment of posttraumatic mania using the atypical antipsychotic quetiapine. Beneficial effects of this agent on posttraumatic mania, cognitive impairments, and functional disability in the subacute post-injury period are described. Possible mechanisms of action are discussed and the need for additional investigation of quetiapine for posttraumatic mania is highlighted.
Social Anxiety Disorder: Psychobiological and Evolutionary Underpinnings
Authors: Stein Dan J. , Vythilingum Bavanisha 
Published: August 2016

ABSTRACTSocial anxiety disorder (SAD) also know as social phobia is increasingly recognized as a highly prevalent and disabling psychiatric disorder. SAD patients demonstrate cognitive-affective distortions in relation to social situations and abnormal activation patterns in limbic structures during functional imaging. Behavioral inhibition is an endophenotype that may be useful in understanding vulnerability to SAD, and that has specific imaging and genetic correlates. From an evolutionary perspective, it has been speculated that SAD represents a false appeasement alarm. It is notable that SAD responds to selective serotonin reuptake inhibitors and monoamine oxidase inhibitors, but not to most tricyclic antidepressants; this finding is consistent with the importance of serotonin and dopamine in mediating this disorder.
The Ventral Striatum as an Interface Between the Limbic and Motor Systems
Authors: Groenewegen Henk J. , Trimble Michael 
Published: August 2016

Over the next 2 years,CNS Spectrumswill be publishing a series of articles on neuroanatomy. The purpose of these articles is to broaden knowledge and interest in neuroanatomy, with a special reference to some key brain structures that are important for neuropsychiatry. Interest in nuclear structures and hodology, in connectivity and circuitry between brain regions, and in neurochemical associations has increased in the last 3 decades due to new neuroanatomical staining methods, brain imaging, and new treatments, such as deep brain stimulation.These columns will enliven an understanding of the clinical neuroscience interface but also provide a solid framework of contemporary neuroanatomy for psychiatrists and neurologists.The first in the series reviews the ventral striatum. Henk J. Groenewegen, MD, PhD, in a column dedicated to the late Lennart Heimer, MD, reveals the importance of this structure and its connectivity for a contemporary understanding of brain-behavior relationships. In earlier conceptions, the basal ganglia were solely related to motor function, uninvolved with emotion or cognition. This conception arose from a misunderstanding of basic neuroanatomy, which has been unravelled by careful neuroanatomical studies in the last 30 years with new tissue staining and tracing techniques.The basal ganglia are the main target structures of the limbic system, hence the motion in emotion.
An Open-Label Trial of Venlafaxine in Body Dysmorphic Disorder
Authors: Allen Andrea , Hadley Sallie Jo , Kaplan Alicia , Simeon Daphne , Friedberg Jennifer , Priday Lauren , Baker Bryann R. , Greenberg Jennifer L. , Hollander Eric 
Published: August 2016

ABSTRACTObjective:Body dysmorphic disorder (BDD), a preoccupation with imagined ugliness, is a disabling condition that seems to respond preferentially to selective serotonin reuptake inhibitors. This open-label trial examines venlafaxine's efficacy in BDD and is the first known study of this serotonin-norepinephrine reuptake inhibitor in BDD.Methods:A total of 17 BDD patients 16–65 years of age entered and 11 completed a 12–16 week open-label trial of venlafaxine. Participants were treated with venlafaxine until a therapeutic dose (minimum of 150 mg/day) was reached and then maintained at that dose for 8 weeks. Key outcome measures were the Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder and Clinical Global Impressions-Improvement scale.Results:Venlafaxine was found to be effective in lessening the specific symptoms and global severity of BDD. Paired t-tests were used to compare baseline and final ratings on the Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder total, obsessions, and compulsions scores; by this measure venlafaxine significantly reduced BDD symptoms overall (P=.012), as well as obsessions (P=.034) and compulsions specifically (P=.021). A single sample t-test, comparing final Clinical Global Impressions-Improvement scale ratings to “no change” (score: 4) found significant improvement following treatment.Conclusion:Venlafaxine may be an effective treatment for BDD, including both obsessive and compulsive symptoms. Controlled research on venlafaxine in BDD is recommended.
Aripiprazole as Augmentation Treatment of Refractory Generalized Anxiety Disorder and Panic Disorder
Authors: Hoge Elizabeth A. , Worthington John J. , Kaufman Rebecca E. , Delong Hannah R. , Pollack Mark H. , Simon Naomi M. 
Published: August 2016

ABSTRACTIntroduction:Individuals with anxiety disorders often remain symptomatic despite treatment with a first-line pharmacologic agent. More research examining pharmacotherapy augmentation strategies to improve outcomes is needed.Methods:In an 8-week, open-label, prospective augmentation study, we examined the efficacy and tolerability of the novel antipsychotic agent aripiprazole for adult outpatients with generalized anxiety disorder (n=13) or panic disorder (n=10) who remained symptomatic despite treatment for at least 8 weeks with an adequate (or maximally tolerated) dose of typical pharmacotherapy.Results:Aripiprazole augmentation was associated with a significant reduction in Clinical Global Impressions-Severity scores (paired t=4.41, df=22, P<.001) in the intent-to-treat sample of 23 individuals. Three subjects (13%) discontinued due to sedation, chest discomfort, and restlessness, respectively.Conclusion:These data provide preliminary evidence that aripiprazole may be a useful augmentation strategy for individuals with generalized anxiety disorder or panic disorder who show a limited response to initial pharmacotherapy.
The Role of the Glutamatergic System in Posttraumatic Stress Disorder
Authors: Nair Jyotsna , Ajit Sarbjot Singh 
Published: August 2016

ABSTRACTAntiglutamatergic agents, such as lamotrigine, have been used successfully for the treatment of posttraumatic stress disorder (PTSD). They could be potentially acting through the stabilization of the corticotropin-releasing factor (CRF) systems. Glutamate mediates CRF release in various brain regions involved in the pathophysiology of PTSD, antiglutamatergic agents could stabilize the CRF system and, thereby, improve the symptom complex of PTSD (reexperiencing, hyperarousal, and avoidance). The role of glutamate and CRF in PTSD and other anxiety disorders are still being elucidated. However, it is clear that the glutamatergic systems play a role in the pathophysiology of PTSD.
Long-Term Improvement in Efficacy and Safety After Switching to Ziprasidone in Stable Outpatients with Schizophrenia
Authors: Simpson George M. , O'Gorman Cedric J. , Loebel Antony , Yang Ruoyong 
Published: August 2016

ABSTRACTIntroduction:The long-term efficacy and tolerability of treatment with ziprasidone following a switch from prior antipsychotics was evaluated in outpatients with schizophrenia or schizoaffective disorder in three open-label, flexible-dose, 1-year extension studies.Methods:These studies enrolled completers of 6-week trials in which subjects were switched to ziprasidone from conventional antipsychotics, olanzapine, or risperidone. Identical study designs and the small number of patients entering the extensions supported pooling of the data.Results:Of 185 pooled subjects entering the extension studies, 72 completed 58 weeks of treatment. Median treatment duration was 34.6 weeks; median dose was 120 mg/day at endpoint. The intent-to-treat population showed significant improvement in Positive and Negative Syndrome Scale (PANSS) total scores (−4.3 [P≤.01]), PANSS negative scores (−2.4 [P≤.0001]), and Clinical Global Impression of severity score (−0.3 [P≤.001]). Completers showed significant improvement in mean PANSS total scores (−10.2 [P<.0001]), PANSS positive scores (−2.7 [P<.0001]), PANSS negative scores (−2.7 [P<.001]), and Clinical Global Impression of severity scores (−0.6 [P<.0001]).Conclusion:Ziprasidone was well tolerated, and patients demonstrated significant improvement in metabolic parameters and in all movement disorder assessments. Insomnia and somnolence were the only adverse events with an incidence >10% in pooled subjects. No subject had a corrected QT interval ≥500 msec.
Major Psychosis and Chromosome 22: Genetics Meets Epigenetics
Authors: Petronis Arturas , Popendikyte Violeta , Kan Peixiang , Sasaki Tsukasa 
Published: August 2016

ABSTRACTElucidation of genetic factors in schizophrenia and bipolar disorder remains a challenging task to psychiatric researchers. As a rule, data from genetic linkage and association studies are quite controversial. In this article, we further explore the possibility that in addition to DNA sequence variation, a putative epigenetic dysregulation of brain genes plays an important role in the etiopathogenesis of major psychosis. We provide an epigenetic interpretation of unclear genetic findings specifically pertaining to chromosome 22 in schizophrenia and bipolar disorder. It is suggested that epigenetic strategies, when applied in conjunction with traditional genetic ones, may significantly expedite the uncovering of the molecular causes of major psychosis.
Diffusion Tensor MRI Methods: Historical Perspective and New Directions
Authors: Davis Timothy L. , Tuch David S. 
Published: August 2016

ABSTRACTThis article will briefly review the history of diffusion physics and diffusion imaging beginning with Brown's initial observations of the diffusion phenomenon in the early part of the 19th century, through the development of diffusion-weighted imaging, and diffusion tensor imaging. The basic principles and limitations of diffusion tensor imaging are discussed. We conclude by reflecting on some of the open interpretative questions in diffusion imaging.