bluuebunny/crossref_metadata_2025_split huggingface dataset:
WCA Recommendations for the Long-Term Treatment of Posttraumatic Stress Disorder
Authors: Stein Dan J. , Bandelow Borwin , Hollander Eric , Nutt David J. , Okasha Ahmed , Pollack Mark H. , Swinson Richard P. , Zohar Joseph 
Published: August 2016

ABSTRACTPosttraumatic stress disorder (PTSD) is a common and disabling condition. In addition to combat-related PTSD, the disorder occurs in civilians exposed to severe traumatic events, with the community prevalence rate for the combined populations reaching as high as 12%. If left untreated, PTSD may continue for years after the stressor event, resulting in severe functional and emotional impairment and a dramatic reduction in quality of life, with negative economic consequences for both the sufferer and society as a whole. Although PTSD is often overlooked, diagnosis is relatively straight-forward once a triggering stressor event and the triad of persistent symptoms—reexperiencing the traumatic event, avoiding stimuli associated with the trauma, and hyperarousal—have been identified. However, comorbid conditions of anxiety and depression frequently hamper accurate diagnosis. Treatment for PTSD includes psychotherapy and pharmacotherapy. The latter includes selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and monoamine oxidase inhibitors. Only SSRls have been proven effective and safe in long-term randomized controlled trials. Current guidelines from the Expert Consensus Panel for PTSD recommend treatment of chronic PTSD for a minimum of 12–24 months.
Neurobiological Models of Attention-Deficit/Hyperactivity Disorder: A Brief Review of the Empirical Evidence
Authors: Schulz Kurt P. , Himelstein Jessica , Halperin Jeffrey M. , Newcorn Jeffrey H. 
Published: August 2016

AbstractAttention-deficit/hyperactivity disorder (ADHD) is a psychiatric disorder characterized by inattention, impulsivity, and overactivity that begins in childhood. While considerable research has focused on the neurobiological substrates of this disorder, the specific nature of the brain dysfunction in ADHD has remained elusive. However, early data from pharmacological treatment studies, as well as from basic research in animals and humans, initially led several investigators to develop neurobiological models of ADHD. These models of ADHD and more recent evidence from neuropsychological, neuroimaging, neurochemical, and genetic research are briefly reviewed. While not completely consistent, the empirical data suggest that dysfunction in prefrontal-striatal neural circuits, as well as in brain stem catecholamine systems that innervate these circuits, may underlie the executive function deficits in ADHD.
Recent Developments in the Neuroendocrinology of Posttraumatic Stress Disorder
Authors: Yehuda Rachel 
Published: August 2016

In 1980, the diagnosis of posttraumatic stress disorder (PTSD) was established to recognize that exposure to events such as rape, physical assault, torture, or combat can leave long-lasting psychological scars in persons who undergo these experiences. The intention of the diagnosis was to acknowledge that exposure to a traumatic event was a sufficient explanation for the occurrence of longterm psychological problems. Prior to this formulation, stressful events were thought to precipitate symptoms that would resolve over time. The symptoms manifested by persons following adverse events were characterized as transient adjustment reactions. Longerterm symptoms were considered to be a reflection of underlying neurosis, rather than stress exposure per se.The diagnosis of PTSD provided a paradigm for acknowledging that exposure to devastating trauma can produce symptoms that can be quite severe and chronic in nature. Although many of the symptoms of PTSD were similar to those that occur in other anxiety or mood disorders, the hallmark of PTSD appeared to be a preoccupation with the traumatic event and a resultant set of behavioral changes that occurred because of attempts to avoid reminders of the event.
The Obsessive Compulsive Spectrum: A Survey of 800 Practitioners
Authors: Hollander Eric , Twersky Rebecca , Bienstock Carol 
Published: August 2016

AbstractThe obsessive-compulsive (OC) spectrum is a group of related disorders that appear to share symptomatology, neurobiology, and treatment response with obsessive-compulsive disorder. To collect data on the appreciation of the OC spectrum concept among clinicians, 800 participants completed a questionnaire to help determine their understanding and appreciation of this concept, at a workshop on the OC spectrum.
Circadian Rhythm Sleep Disorders as a Possible Side Effect of Fluvoxamine
Authors: Hermesh Haggai , Lemberg Hadas , Abadi Judith , Dagan Yaron 
Published: August 2016

AbstractSleep problems, day somnolence, and fatigue as a result of psychotropic drugs are very common. Psychiatrists usually consider these effects a result of insomnia and treat them by prescribing sleeping pills or other benzodiazepine agents.We describe here 10 cases of circadian rhythm sleep disorders (CRSD)—and not merely insomnia—as a possible side effect of fluvoxamine (FVA). Two other serotonin reuptake inhibitors, fluoxetine and clomipramine, did not induce CRSD in any of these 10 patients. We speculate that FVA-induced CRSD is caused by the effect of FVA on serotonin and melatonin levels in the central nervous system.CRSD as a side effect of FVA can be treated by replacing the suspected FVA or adding melatonin to a beneficial FVA treatment. Thus, it is important to be aware of possible iatrogenic CRSD in order to treat appropriately. Prospective studies are needed to confirm our observation and to study the influence of other psychotropic drugs on sleep-wake schedule.
The Consequences of Uncontrolled Epilepsy
Authors: Sperling Michael R. 
Published: August 2016

AbstractThe consequences of epilepsy can be quite severe and include shortened lifespan, excessive bodily injury, neuropsychological and psychiatric impairment, and social disability. There is evidence that seizures cause brain injury, including neuronal death and physiological dysfunction. Mortality rates are 4—7 times higher in people with medically refractory seizures, and injury rates are substantial, ranging from one per 20 person-years to as much as one per 3 person-years. Quality of life is impaired in epilepsy, and relates to seizure control. Psychosocial disabilities, including lower social interaction with reduced marriage rates and reduced employment levels, are more common in people with refractory seizures. Complete seizure control is desirable, since seizures potentially constitute a serious threat to health and well-being. Therefore, satisfactory seizure control should be defined as having no seizures. Treatment should be directed to preventing seizures whenever possible and achieving control early in the course of illness. The risks of uncontrolled seizures outweigh the risks of aggressive medical or surgical therapy.
The “Prodromal” Patient: Both Symptomatic and At-Risk
Authors: Woods Scott W. , Miller Tandy J. , McGlashan Thomas H. 
Published: August 2016

AbstractThis article discusses conceptual issues relevant to the prospective diagnosis of the schizophrenic prodrome. Recent efforts to diagnose these patients with operational criteria based on current symptoms are reviewed. Symptomatic patients so identified appear to be treatment-seeking and to have mild cognitive impairments. In addition to being currently symptomatic, these patients are imminently at risk for progression of illness and development of schizophrenia. Data from three international centers suggest that this risk is approximately 40% over the next year of follow-up if untreated. The implications of the reviewed data for the appropriateness of the term “prodromal” and for treatment/prevention research for these patients are discussed.
Trichotillomania in a Schizophrenia Patient
Authors: Kähkönen Seppo 
Published: August 2016

ABSTRACTComorbidity of trichotillomania with different psychiatric disorders is common. However, until recently there have been no reports of trichotillomania in schizophrenia patients. In this article, the case of a female schizophrenia patient with trichotillomania is reported. Her schizophren was being treated with risperidone. Citalopram was later administered as an augmentation to risperidone. This combination therapy presented a partial response of trichotillo mania without exacerbating schizophrenia symptoms.
Presence of Irritability During Depressive Episodes in Bipolar Disorder
Authors: Deckersbach Thilo , Perlis Roy H. , Frankle W. Gordon , Gray Stephen M. , Grandin Louisa , Dougherty Darin D. , Nierenberg Andrew A. , Sachs Gary S. 
Published: August 2016

ABSTRACTBackground:This study examined the prevalence of irritability in patients with bipolar I disorder during an episode ofDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)major depression who do not meet criteria for a mixed episode.Method:A chart review of 111 patients with bipolar I disorder treated at the Massachusetts General Hospital Bipolar Clinic between 1998 and 2000 identified 34 patients who met criteria for aDSM-IVmajor depressive episode in the absence of (1) mood elevation and/or (2) irritability associated with any additional above thresholdDSM-IVsymptoms of mania. Data gathered from the charts utilized prospective ratings made routinely at each clinic visit using the Clinical Monitoring Form (CMF), a structured assessment instrument which includes modified versions of the mood modules of the Structured Clinical Interview forDSM-IV.Data from these 34 patients were reviewed to determine the presence of irritability.Results:The frequency of abnormal irritability in these 34 patients followed a bimodal distribution: 26% of the patients showed abnormal irritability ≥75% of the time, compared with 68% of the patients with abnormal irritabihty ≤30% of the time. Of the high-irritability patients, psychomotor agitation was rated as definitely present to a significant degree in 44%. Talkativeness and distractibility were rated present but subthreshold in one patient each. All other symptoms ofDSM-IVmania were absent.Conclusion:Approximately 25% of patients with bipolar I disorder who meet criteria for aDSM-IVmajor depressive episode also experienced substantial irritability in the absence of associated symptoms of mania. Our results suggest that abnormal irritability is not limited to mania or mixed states.
Trail Making and Olfaction in Schizophrenia: Implications for Processing Speed
Authors: Goudsmit Nora , Wolitzky Rachel , Seckinger Regine Anna , Corcoran Cheryl , Stanford Arielle , Rosenfield Paul , Goetz Ray , Malaspina Dolores 
Published: August 2016

AbstractBackground:Previous research has established a relationship between smell identification deficits (SID) and particular aspects of cognitive function among patients with schizophrenia.Objective:To expand the extant literature, we examined the relationship between SID and the Trail Making Test to determine if processing speed is related to SID.Methods:Our sample included 60 inpatients from the New York State Psychiatric Institute's Schizophrenia Research Unit. We considered age, deficit syndrome, verbai intelligence quotient, and education in our analyses due to their documented relationship to smell identification ability.Results:Trails A errors and Trails A seconds accounted for a significant amount of the variance in University of Pennsylvania Smell Identification Test scores in a regression analysis (R2=.10, P=.008 and R2=.05, P=.04).Conclusion:Linking neurocognition to smell identification deficits may prove to be an essential marker for schizophrenia research.
Family Psychoeducation as an Evidence-Based Practice
Authors: Murray-Swank Aaron B. , Dixon Lisa 
Published: August 2016

AbstractFamily psychoeducation programs have emerged as a strongly supported evidence-based practice in the treatment of schizophrenia and bipolar disorder. Over 30 randomized clinical trials demonstrated that psychoeducation programs reduce relapse, improve symptomatic recovery, and enhance psychosocial and family outcomes. Recent work supports family psychoeducation strategies for other disorders, including major depression, obsessive-compulsive disorder, and borderline personality disorder. This review summarizes the research evidence supporting prominent models of family psychoeducation. Professional and peer-led family education programs are also reviewed and differentiated from family psychoeducation. Directions for future research studies to enhance the evidence base and inform treatment recommendations are proposed. Finally, strategies for implementation of family psychoeducation in routine clinical practice are discussed.
Implementing Evidence-Based Psychosocial Practices: Lessons Learned from Statewide Implementation of Two Practices
Authors: Moser Lorna L. , DeLuca Natalie L. , Bond Gary R. , Rollins Angela L. 
Published: August 2016

AbstractObjective: As part of this national project, we examined barriers and strategies to implementation of two evidence-based practices (EBPs) in Indiana.Background: Despite many advances in the knowledge base regarding mental health treatment, the implementation of EBPs in real-world setting remains poorly understood. The National EBP Project is a multi-state study of factors influencing implementation of EBPs.Methods: Over a 15-month period we observed eight assertive community treatment (ACT) programs and six integrated dual disorders treatment (IDDT) programs and noted pertinent actions taken by the state mental health agency influencing implementation. We created a database containing summaries of monthly visits to each program and interviews with key leaders. Using this database and clinical impressions, we rated barriers and strategies at each site on seven factors: Attitudes, Mastery, Leadership, Staffing, Policies, Workflow, and Program Monitoring.Results: At the site level, the most frequently observed barriers were in the areas of leadership, staffing and policies for ACT, and mastery and leadership for IDDT. Overall, barriers were more evident for IDDT than for ACT. Strategies were less frequently noted but generally paralleled the areas noted for barriers. However, our central finding was that ACT was generally more successfully implemented than IDDT throughout the state, and that this difference could be traced in large part to state-level factors relating to historical preparation for the practice, establishment of standards, formation of a technical assistance center, and funding.Conclusion: In this case study, both state-level and site-specific factors influenced success of implementation of EBPs. To address these factors, the field needs systematic strategies to anticipate and overcome these barriers if full implementation is to be realized.
Lamotrigine in Psychiatry: Pharmacology and Therapeutics
Authors: Jefferson James W. 
Published: August 2016

AbstractFollowing the introduction of lamotrigine in 1994 as a treatment for epilepsy in the United States, the drug has seen progressively greater application in psychiatry, particularly as a treatment for bipolar disorder. This review critically evaluates the support for lamotrigine use across a broad range of psychiatric disorders as well as discuss its pharmacology, side-effect profile, and interactions with other medications.
Lamotrigine Augmentation Strategy for Patients with Treatment-Resistant Depression
Authors: Gutierrez Rosben L. , McKercher Ruth , Galea Jason , Jamison Katrina L. 
Published: August 2016

AbstractObjective:To investigate if lamotrigine added to an antidepressant regimen reduces the symptoms of major depression in treatment-resistant patients.Introduction:Charts were retrospectively reviewed for 34 patients (36–63 years of age) with major depressive disorder who received lamotrigine augmentation to the antidepressant regimen for treatment-resistant depression (TRD). Data collection occurred at baseline and at an average of 30 (Time 2), 78 (Time 3), 167 (Time 6), and 356 days (Time 12), thereafter, using a “Medication Visit by MD” scale for collection of target symptom data at each timepoint.Results:Following the addition of lamotrigine to the antidepressant regimen (mean dose of 43, 63, and 113 mg/day for Time 3, Time 6, and Time 12, respectively), a statistically significant reduction of scores was shown as early as Time 2 for target symptoms of depressed mood, loss of interest, anxiety, irritability, (low) energy, and cognitive impairment. The difference from baseline remained statistically significant at Time 3, Time 6, and Time 12 (with the exception of irritability, which was not statistically significant at Time 6). “Patient's response” also reflected statistically significant improvement at each time period compared with baseline. The most common side effect reported and reason for discontinuation was tiredness.Discussion:Because TRD is a clinical condition that can present with severe and disabling symptoms, many clinicians are faced with an urgent need to find relief for their patients. Trying to achieve symptom improvement in a timely manner during a medication change can be challenging and difficult. This can be managed by an augmentation strategy using a psychotropic add-on to an existing medication regimen. Our results show the benefits of lamotrigine augmentation to an antidepressant regimen. Prospective, controlled clinical trials with larger sample size are needed to confirm our results.Conclusion:In this retrospective chart review, augmentation with lamotrigine was a tolerable and efficacious strategy for treating patients with TRD.
Metabolic and Endocrine Disturbances in Psychiatric Disorders:A Multidisciplinary Approach to Appropriate Atypical Antipsychotic Utilization
Authors: Masand Prakash S. , Culpepper Larry , Henderson David , Lee Scott , Littrell Kimberly , Newcomer John W. , Rasgon Natalie 
Published: August 2016

AbstractPatients with psychiatric disorders have an increased rate of cardiovascular morbidity and mortality compared with the general population. Metabolic issues such as weight gain, dyslipidemia, diabetes mellitus, diabetic ketoacidosis, and pancreatitis have been reported with the use of antipsychotic agents. Although atypical antipsychotics have not been linked directly to the development of metabolic syndrome, these medications have been shown to increase risk factors that can lead to metabolic and endocrine disturbances. Therefore, clinicians should provide ongoing monitoring for patients who are being treated for psychiatric disorders with these agents. According to the 2004 Consensus Report on Antipsychotics, screening measures should include baseline and follow-up monitoring of personal/family histories, weight (body mass index), waist circumference, blood pressure, fasting plasma glucose, and fasting lipid profile.
The Role of Estrogen Therapy in Postpartum Psychiatric Disorders: An Update
Authors: Gentile Salvatore 
Published: August 2016

AbstractObjectives:The aim of this review is to assess and summarize the existing literature data about the efficacy of estrogen replacement therapy (ERT) in preventing and treating postpartum psychiatric disorders.Methods:An extensive and unrestrictive computerized search (from 1970 to June 2005) on MEDLINE/PubMed, TOXNET, EMBASE, and Cochrane Databases was conducted with the following search terms: estradiol, estrogen-treatment, hormonal treatment, therapy, postpartum depression, postnatal depression, puerperal depression, postpartum blues, postpartum psychosis, lactation, and breastfeeding.Results:In assessing available literature information about the role of ERT in preventing and treating puerperal psychiatric diseases, all reviewed studies were found to suffer from severe methodological limitations.Conclusion:Well-designed and strictly focused multicenter trials are warranted in order to firmly establish the effectiveness of ERT in puerperal psychiatric disorders.
Posttraumatic Stress Disorder in Medically Ill Patients: What is Known, What Needs to be Determined, and Why is it Important?
Authors: Shemesh Eyal , Stuber Margaret L. 
Published: August 2016

AbstractCan a medical illness or its treatment qualify as an emotionally traumatic event and can it cause posttraumatic stress disorder symptoms? If so, can the view of a medical illness as a traumatic experience enhance our ability to understand patients' adjustment to illness and their emotional reactions to it? Is it important to identify posttraumatic symptoms and try to address them in medically ill patients? These questions form the backbone for this review. Because many questions remain unanswered (or the answers are not definitive yet), we concisely summarize the issues and present our own view of the most pressing questions for further research.
The Medical Traumatic Stress Toolkit
Authors: Stuber Margaret L. , Schneider Stephanie , Kassam-Adams Nancy , Kazak Anne E. , Saxe Glenn 
Published: August 2016

AbstractChildren and their parents who are exposed to medical life-threat due to illness or injury are at risk for developing symptoms of posttraumatic stress. However, the prevention, detection, and treatment needed are often not available in the acute care settings of the hospital. The National Child Traumatic Stress Network and the Substance Abuse and Mental Health Services Administration have created a set of materials for use by hospital health providers and families that is available for download free from the National Child Traumatic Stress Network website, www.nctsn.org.
The Psychiatry of Tourette Syndrome
Authors: Walkup John T. 
Published: August 2016

AbstractTourette syndrome (TS) has been conceptualized as a psychological problem, a neurological problem, and more recently a neurobehavioral problem. Each conceptual model has had an impact on how persons with TS view themselves and how practitioners view individuals with TS, as well as an impact on what both clinicians and patients expect from diagnosis and treatment. This article reviews the common comorbid psychiatric disorders and their relationship to TS, and discusses how the evolving conceptions of TS have impacted psychologically on persons with tics and TS, as well as on the providers who treat them.
The Role of the Mental Health Professional in the Assessment and Management of Irritable Bowel Syndrome
Authors: Gaynes Bradley N. , Drossman Douglas A. 
Published: August 2016

AbstractIrritable bowel syndrome (IBS), a condition common in the health-care setting, can be especially challenging to manage for both the referring physician and the psychiatrist. Much of this difficulty arises from the understanding and treatment of the disorder from a disease-based biomedical approach rather than a biopsychosocial model. The latter model offers a more effective method to understand the development and clinical expression of IBS, and as a result, directly informs subsequent management. This article defines and describes the epidemiology of IBS, reviews its pathophysiology, identifies the role of psychosocial factors using a biopsychosocial model of IBS, and clarifies the role of the mental health professional in its management. IBS management involves identifying psychiatric comorbidities, assessing the patient's perspective of the role of psychosocial factors, offering psychotherapy directed toward adaptive coping mechanisms, providing psychotropic medication consultation, and engaging in ongoing collaboration with the referring physician.