bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypothalamic-Pituitary-Adrenal Axis Function and the Metabolic Syndrome X of Obesity
Authors: Gohil Baiju C. , Rosenblum Leonard A. , Coplan Jeremy D. , Kral John G. 
Published: August 2016

AbstractObesity has negative health consequences related to fat distribution, particularly the central or visceral accumulation of fat. The major complications associated with visceral obesity, termed the “Metabolic Syndrome of Obesity,” or “Syndrome X,” are type II diabetes, hypertension, and dyslipidemia. As with certain mood disorders, the syndrome may be a consequence of neuroendocrine perturbations typically associated with chronic stress. Our work with bonnet macaque monkeys provides an animal model for the relationship between early stress, behavioral and hypothalamic-pituitary-adrenal (HPA) axis dysregulation, and Syndrome X. During their infant's first half-year, mothers face a variable foraging demand (VFD), in which ample food varies unpredictably in the difficulty of its acquisition, and the offspring show persistent abnormalities in systems known to modulate stress and affective regulation. Early work on the bonnet macaque noted the emergence of a sample of spontaneously obese subjects as they matured. Using the VFD model, the current study showed that there was a clear relationship between early cerebrospinal fluid corticotropin-releasing factor levels and subsequently measured body mass index, supporting the hypotheses regarding the interactive roles of early experience and HPA axis dysregulation in the ontogeny of both metabolic and mood disorders.
A Review of the Treatment for Refractory Obsessive-Compulsive Disorder: From Medicine to Deep Brain Stimulation
Authors: Husted David S. , Shapira Nathan A. 
Published: August 2016

ABSTRACTThis article provides an overview of the etiology, epidemiology, and first-line treatment options for obsessive-compulsive disorder (OCD). The subject of treatment-resistant and treatment-refractory OCD is the discussed, including a definition of these often-debated terms, and the latest treatment options delineated. This includes a review of the latest research concerning the pharmacological agents that have been studied as monotherapy or augmenting agents for the treatment of OCD, the use of experimental medications and procedures, treatment with reversible, minimally invasive procedure, such as vagal nerve stimulation and transcranial magnetic stimulation, invasive but the potentially reversible deep brain stimulation, and irreversible lesioning with ablative psychosurgery. A discussion of the role of psychotherapy in the treatment of OCD is also included.
Bipolar Disorders: Special Diagnostic and Treatment Considerations in Women
Authors: McElroy Susan L. 
Published: August 2016

AbstractBipolar disorder in women presents special diagnostic and treatment challenges to the clinician. The presentation of female bipolar may resemble depressive disorders, comorbid Axis I disorders, Axis II personality disorders, behavioral dysregulation, or general medical disorders; thus, it is critically important for clinicians to assess for a history of hypomania or mania when determining diagnosis in any woman presenting with psychological symptoms. Several gender differences may exist in the epidemiology and symptomatology of bipolar disorder, and each must be kept in mind during assessment. Rapid cycling and mixed states have been associated with female gender and may present diagnostic challenges as each often presents as major depression. Symptoms of postpartum psychosis tend to differ from the symptoms typically seen in bipolar mania; therefore, if postpartum psychosis is actually a manifestation of bipolar disorder, accurate diagnosis depends upon a knowledge of these differences. Special treatment considerations for bipolar disorder in women involve interactions between the illness and the female reproductive cycle. A risk of fetal malformation exists when some mood-stabilizing agents are used during conception and/or during the first trimester of pregnancy. Neurobehavioral teratogenicity and neonatal toxicity is also possible. Careful treatment management is necessary to reduce the risks to the fetus/infant and to effectively manage bipolar disorder in the mother. In treating women with bipolar disorder, clinicians should discuss the issue of pregnancy and associated risks of treatment versus no treatment with every patient of reproductive age. Further studies are needed on gestational timing and exposure to mood-stabilizing agents, especially newer agents recently approved or currently being considered for the treatment of bipolar disorder.
From Obsessive-Compulsive Spectrum to Obsessive-Compulsive Disorders: The Cape Town Consensus Statement
Authors: Zohar Joseph 
Published: August 2016

In awareness of recent developments and upcoming future changes in the conceptualization of obsessive-compulsive disorders (OCDs), a group of 14 experts with specific experience in this area decided that a consensus statement on the present and future of OCD is timely. The group, with their long-term interest and productivity in the area of OCD, met with the specific aim of providing a global perspective. Ten countries from four continents were represented in this 2-day consensus meeting.The meeting took place in Cape Town on February 27–28, 2006. The participants were asked to prepare and submit a relevant presentation before the meeting in order to enrich the discussion. Six presentations reviewed the following aspects of OCD: diagnosis, epidemiology, neurobiology, treatment, special populations, and pediatric OCD. A draft consensus was prepared, based on the presentations, recent consensus statements, evidence-based guidelines, and the ensuing discussions.
New Dimensions in the OCD Spectrum: Autism, Pathologic Gambling, and Compulsive Buying
Authors: Wong Cheryl M. , Hollander Eric 
Published: August 2016

AbstractThe obsessive-compulsive spectrum can be divided into two subclusters: disorders of impulsivity and neurologic disorders (Figure 1). This article examines autism (from the neurologic cluster) and pathologic gambling and compulsive shopping (from the impulse side of the spectrum). These three disorders are major mental health problems, impacting on society, the affected individuals, and their families. In addition, these three disorders are underrecognized and underdiagnosed. In this article, we outline and review the phenomenology, psychopathology, and treatment options of these three disorders.
Gender, Age, and the Risk of Insomnia
Authors: Zee Phyllis 
Published: August 2016

While insomnia is common among men and women and across all age groups, older adults and women experience markedly increased risk for this disorder. Insomnia complaints in adults ≥65 years of age are very common. Foley and colleagues demonstrated in a study of 9,282 older adults (mean age of 74) an insomnia prevalence rate of ∼60%.Approximately 57% of older adults have sleep complaints (Slide 1). Most of these are associated with comorbid conditions including depressed mood, respiratory problems, or poor physical health. The healthiest members of this population have far fewer sleep complaints.
Dosage and Administration Issues of Antipsychotic Agents (and Adjunctive Medicines) in the Acute Stabilization of Psychoses
Authors: Chengappa K. N. Roy 
Published: August 2016

ABSTRACTThere are several options and approaches available to practicing psychiatrists for the pharmacologic management of acute psychotic episodes that present in emergency room settings. This article focuses on the first hours and days of such episodes, the goals of treatment, and comparison of the “old favorites,” such as combination haloperidol and lorazepam (in liquid, tablet or injectable formulations), with the newer second-generation antipsychotic agents, such as olanzapine, ziprasidone, risperidone, quetiapine, or aripiprazole, which are available in different formulations. The speed of titration to an effective target dose for these newer agents are addressed as well.
Rethinking the Treatment Paradigm for Bipolar Depression: The Importance of Long-Term Management
Authors: Baldassano Claudia F. , Ballas Christos A. , O'Reardon John P. 
Published: August 2016

ABSTRACT:The need for long-term management of bipolar disorder is evident. Bipolar patients spend more time depressed than manic; however, few agents used for maintenance therapy of bipolar disorder have demonstrated good efficacy in delaying relapse into depression. This article provides a comprehensive review of open-label and randomized, controlled studies examining prophylactic efficacy in bipolar disorder, especially bipolar depression. Lithium, considered the gold standard for bipolar disorder maintenance therapy may be more effective in delaying manic relapse than in delaying depressive relapse. Evidence for the efficacy of divalproex and carbamazepine in delaying depressive relapse is yet to be fully elucidated. Lamotrigine has demonstrated efficacy in delaying time to depressive relapse. Unpublished studies show ohnzapine's efficacy in preventing manic recurrence, while its efficacy in preventing depressive recunence is yet to be proven. As patients with bipohr disorder are prone to experiencing depressive episodes, more attention needs to be focused on preventing depressive relapse. To date, three agents—lithium, lamotrigine, and olanzapine—have been shown to have prophylactic benefits in treating this highly recunent disorder.
Effective Dosing and Dose Equivalency of Second-Generation Antipsychotic Medications
Authors: Buckley Peter F. 
Published: August 2016

ABSTRACTDosing patterns with second-generation antipsychotic medications (SGAs) are dynamic, with some SGAs surpassing current recommendations while others are declining in dose since their initial regulatory guidelines. Pertinent recent studies and available pharmacoepidemiologic reports, information, and expert consenses are reviewed herein to illuminate current thinking on the topic of dosing with SGAs. There is a need for fixed-dose studies of each SGA. Additionally, dosing should be a primary consideration when designing and subsequently interpreting comparative studies between SGAs.
The Future of Biological Psychiatry
Authors: Van Praag H. M. 
Published: August 2016

AbstractProgress in biological psychiatry is contingent upon progress in neurobiology and progress in research of proper characterization and assessment of abnormal behavior. Advances in neurobiology are rapid and steady; however, advances are few and far between in psychopathology. In many ways, developments over the past two decades run counter to what I believe to be diagnostic pre-requisites for fruitful biological research in psychiatry. I presume this to be a major reason why thus far biology has made no significant contributions to the diagnoses of mental disorders.For progress to occur in biological psychiatry, the traditional diagnostic philosophies and attitudes must be reevaluated and alternative diagnostic approaches put into practice. This and the diagnostic method of functional psychopathology are reviewed in this article, with a focus on how the functional psychopathological approach could contribute to the advancement of the diagnostic process in psychiatry, and the opportunities it provides for biological psychiatric research.
Recognizing and Treating Nonmotor Disorders Associated with Parkinson's Disease
Authors: Stacy Mark 
Published: August 2016

AbstractRecognizing the nonmotor symptoms associated with Parkinson's disease (PD) is necessary to determine effective treatment regimens and achieve patients' maximum mobility, as well as enhance their quality of life. The Unified Parkinson's Disease Rating Scale (UPDRS) is a useful tool for the clinician in evaluating the entire patient. In this article, the nonmotor disorders related to PD are reviewed, with specific attention to the first and last sections of the UPDRS, which cover mentation and complications of therapy, respectively. Various treatment regimens for these nonmotor symptoms are presented. Other autonomic nervous system symptoms associated with PD, which are not assessed in the UPDRS, are also discussed.
Serotonergic and Noradrenergic Function in Pathological Gambling
Authors: DeCaria Concetta M. , Begaz Tomer , Hollander Eric 
Published: August 2016

AbstractResearch on pathological gambling has begun to demonstrate the significant pathophysiologic role of several neurotransmitter systems in this disorder. Challenge studies with various pharmacologic agents have suggested the importance of potential dysregulation of the serotonergic system in pathological gambling, as this system is linked to dysfunction in behavioral initiation and inhibition. In addition, the noradrenergic system has been associated with mediation of arousal, increases of which are manifested by pathological gamblers. The interactions between these and other neurotransmitter systems, as well as the similarities between pathological gambling and other behavioral disorders, may provide important clues for pharmacologic intervention.
Reconceptualization of Behavior Therapy for Obsessive-Compulsive Disorder from a Learning and Neurochemical Perspective
Authors: Neziroglu Fugen , Hsia Curtis 
Published: August 2016

AbstractThe etiology and treatment of obsessive-compulsive disorder has been explained from a social learning and neurobiological model. In this article a third model is proposed: the biobehavioral model, which encompasses a learning and neurochemical viewpoint. The authors suggest that behavior therapy and medications may operate in the same manner and that behavior therapy may need to be reconceptualized. Animal and human research supporting the interaction of behavioral change and neurochemical processes is presented. The authors also posit that urges precede anxiety and that compulsions are performed in response to the anxiety. Also, obsessions are viewed as secondary to compulsions. The mechanism of how behavior and cognitive-behavioral therapy may produce neurochemical changes is discussed.
Adenylyl Cyclase Activity and Mood Disorders: Preliminary Data in Human Brain Postmortem
Authors: Palego Lionella , Giromella Annalisa , Mazzoni Maria Rosa , Naccarato Antonio Giuseppe , Marazziti Donatella 
Published: August 2016

AbstractDuring the past decade, an increasing interest has been shifted from the study of neuroreceptors to their links with second-messenger pathways. In the present article, we shall briefly review the methodological tools for evaluating adenylyl cyclase activity in several human brain and peripheral models, as well as the studies suggesting its involvement in the pathophysiology of mood disorders. We shall present also some preliminary data obtained in our laboratory providing evidence for the measurement of serotonin-sensitive adenylyl cyclase activity in human brain postmortem.
Cross-National Epidemiology of Obsessive-Compulsive Disorder
Authors: Weissman Myrna M. 
Published: August 2016

Our knowledge of the prevalence and demographic and clinical characteristics of obsessive-compulsive disorder (OCD) has, until recently, been based almost exclusively on patient samples. The epidemiology of OCD was first described in a large United States household sample from the Epidemiologic Catchment Area (ECA) study. Since these original observations, the rates of OCD in household populations determined from diagnostic procedures similar to those used in the United States have been published from different parts of the world. Detailed comparisons of rates, sex ratios, age at onset, and demographic and clinical characteristics of OCD in these samples are now available.This article reports on the cross-national epidemiology of OCD from seven international epidemiologic surveys, including the United States ECA study. Each survey used the Diagnostic Interview Schedule (DIS), a highly structured interview, developed for use in epidemiologic surveys, that yields Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) psychiatric diagnoses. All investigators provided the data from their study to be pooled at Columbia University, and the prevalence rates were standardized to the age and sex distribution of the five-site ECA household population so that more precise estimates and comparisons could be made.
Comorbidity of Posttraumatic Stress Disorder and Depression in Israeli Veterans
Authors: Solomon Zahava , Bleich Avi 
Published: August 2016

AbstractThis article reviews a series of studies conducted on Israeli war veterans that assessed the interrelationship of posttraumatic stress disorder (PTSD) and comorbid disorder, focusing on five issues in particular: (1) the frequency of comorbidity among veterans diagnosed with PTSD; (2) how this comorbidity can be accounted for; (3) whether PTSDs with and without comorbidity are different; (4) the validity of PTSD as a distinct diagnosis; and (5) the clinical implications of comorbidity of PTSD.
Summary of the Genetics of Obsessive-Compulsive Disorder Proceedings of the Third IOCDC
Authors: Pato Michele T. , Pato Carlos N. , Kennedy James L. , Pauls David L. 
Published: August 2016

AbstractThe “Genetics of Obsessive-Compulsive Disorder” session at the Third International Obsessive-Compulsive Disorder Conference focused on the strong evidence of familial transmission of obsessive-compulsive disorder (OCD) and the new strategies available for molecular genetic research in this area. The opportunity to create a truly collaborative approach to the genetic study of OCD with standard methodology and large-scale cooperation among groups was emphasized. The importance of phenotype definition, including systematic subtyping, was discussed in the context of reducing heterogeneity and false-positive results.
Psychobiology of Boredom
Authors: Maggini Carlo 
Published: August 2016

AbstractThe study of the psychobiological bases of boredom has been limited by the vagueness of its clinical constructs and the difficulties in applying adequate experimental models. The theoretical background of previous research mainly has been based upon cognitive and behavioral psychology by using neuropsychological constructs, such as arousal, attention, motivation, sensation-seeking, and the reward system. Recently acquired data depict a complex and fragmentary picture. In this article, the author presents a review of the literature as well as some personal considerations on this intriguing topic.
Factors in Antipsychotic Drug Selection: Tolerability Considerations
Authors: Nasrallah Henry A. 
Published: August 2016

ABSTRACTWith the widespread use of atypical antipsychotics over the past several years, adverse metabolic effects have emerged as the most serious medical consequences of pharmacotherapy with some of these agents. Initially, weight gain and obesity were observed (especially with clozapine and olanzapine), but subsequently, type 2 diabetes and dyslipidemia became apparent as well. Further, many reports suggest that sudden and severe (occasionally fatal) diabetes ketoacidosis (DKA) can emerge during treatment with some atypical antipsychotics, even in the absence of adiposity. A marked increase of serum lipids (especially triglycerides) has also been reported, to varying degrees, with different atypicals. This article reviews the data regarding metabolic dysfunction in patients with psychosis (schizophrenia and bipolar disorder). Populations with psychosis have a 2–3-fold higher prevalence of diabetes even before treatment with any antipsychotics, suggesting a possible genetic linkage or comorbidity; this was confirmed with glucose regulation studies in schizophrenia and mania. The induction of type 2 diabetes with atypicals has further increased the prevalence of noninsulin-dependent diabetes from about 6%–8% to 11%–15% according to recent studies, and even higher rates of subclinical hyperglycemia. Serious weight gain (eg, 26–29 lbs after 1 year of clozapine or olanzapine treatment) is an important risk factor, but sudden DKA has now been reported in patients with minimal weight gain, suggesting alternative mechanisms, such as insulin resistance, as a direct effect of some atypicals. Psychiatrists can reduce the risk of metabolic disorders in schizophrenia and bipolar disorder by avoiding the use of certain atypicals as first-line treatment in patients with a personal or family history of diabetes, obesity, and hyperlipidemias. Regulatory agencies in some countries have already taken action in this regard.
Quality of Life in Geriatric Patients with Mood and Anxiety Disorders
Authors: Maddux Rachel E. , Delrahim Katia K. , Rapaport Mark H. 
Published: August 2016

AbstractThis article reviews the impact of depressive and anxiety disorders on quality of life (QOL), disability, and economic burden in the lives of older individuals. Distinctions between the terms QOL, disability, and burden are important in understanding the extent of improvement needed in treatment for elderly patients with depression or anxiety. Treatment efforts should be extended to remediate not only signs and symptoms of psychiatric syndromes but QOL and disability as well; increased understanding toward this end is evolving, yet it is clear that these issues need to be the focus of more investigation.
Impact of Recent Findings on Study Design of Future Autism Clinical Trials
Authors: Hollander Eric , Phillips Ann , King Bryan H. , Guthrie Donald , Aman Michael G. , Law Paul , Owley Thomas , Robinson Ricki 
Published: August 2016

ABSTRACTThere are specific challenges to studying the design of pharmacologic trials in child/adolescent and adult autism, such as subject stratification and parallel versus crossover designs. This article describes how optimal study design is influenced by subject selection and outcome measures chosen. Lessons learned in study design from the Research Units on Pediatric Psychopharmacology Autism Network trial with risperidone, Seaver Center trials with fluoxetine and valproate, Dartmouth trials with amantadine, and National Institutes of Health secretin trials are highlighted. The Internet System for Assessing Autistic Children system for managing multicenter clinical trials in autism and statistical issues in autism research are also described.
Autism Clinical Trials: Biological and Medical Issues in Patient Selection and Treatment Response
Authors: Anderson George M. , Zimmerman Andrew W. , Akshoomoff Natacha , Chugani Diane C. 
Published: August 2016

ABSTRACTBiomedical measures are critical in the initial patient-screening and -selection phases of a clinical trial in autism and related disorders. These measures can also play an important role in the assessment and characterization of response and can provide an opportunity to study underlying etiologic and pathophysiologic processes. Thus, biomedical measures, including clinical laboratory analyses, metabolic screening, and chromosomal analysis, are used to screen for potential safety-related problems, to decrease biological and genetic heterogeneity, and to define subgroups. Neurobiological measures can be examined as possible predictors, modifiers or surrogates of therapeutic response, and adverse effects. Neurobiological research measures can also be used to study mechanisms and extent of drug action and to perform baseline and longitudinal investigations of possible pathophysiologic alterations. The potential utility and desirability of specific measures are considered and the general approach to choosing measures for incorporation is discussed.