bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mood Disorders During Pregnancy and Lactation: Defining Issues of Exposure and Treatment
Authors: Stowe Zachary N. , Calhoun Kelley , Ramsey Clayton , Sadek Noha , Newport Jeffrey 
Published: August 2016

AbstractEpidemiologic studies have consistently demonstrated a greater incidence of depressive disorders and anxiety among women. Many women experience these conditions during the reproductive years. The dramatic expanse of literature focusing on the use of medications often has failed to pay homage to the potential impact of the disorders. When considering the extant human and laboratory data on mental illness and stress during pregnancy and the postpartum period, it is evident that some degree of exposure (be it treatment or illness) always occurs. The primary goal of the risk-benefit assessment for the treatment of mental illness during these periods is to assist patients and their families in choosing the path of potential exposure that possesses the least risk for them. Once this decision is made, the goal is to limit the number of exposures for the fetus/neonate.
Obesity, Diabetes, and the Metabolic Syndrome: New Challenges in Antipsychotic Drug Therapy
Authors: Caballero Enrique 
Published: August 2016

ABSTRACTObesity and diabetes continue to be national health epidemics. Greater than 50% of adults in the United States are overweight, and >17 million people have diabetes—one third of whom are not diagnosed. Diabetes ranks number 1 in direct health care costs of any disease category. Patients who suffer from schizophrenia may be at twice the risk of developing diabetes compared with the general population. Some new antipsychotic agents are among several types of medications that may potentially impair glucose metabolism. For example, studies have shown that people treated with clozapine and olanzapine have developed elevated fasting serum insulin levels, suggestive of insulin resistance. Insulin resistance may be a result of irregularities in the insulin action sequence and it may occur long before overt diabetes. The further study of the effects of medications on glucose metabolism and their mechanisms, therefore, is essential to developing better treatment regimens that minimize insulin resistance and avoid associated health risks such as obesity and diabetes.
Outcome Measures for Clinical Drug Trials in Autism
Authors: Aman Michael G. , Novotny Sherie , Samango-Sprouse Carole , Lecavalier Luc , Leonard Elizabeth , Gadow Kenneth D. , King Bryan H. , Pearson Deborah A. , Gernsbacher Morton Ann , Chez Michael 
Published: August 2016

ABSTRACTThis paper identifies instruments and measures that may be appropriate for randomized clinical trials in participants with autism spectrum disorders (ASDs). The Clinical Global Impressions scale was recommended for all randomized clinical trials. At this point, however, there is no “perfect” choice of outcome measure for core features of autism, although we will discuss five measures of potential utility. Several communication instruments are recommended, based in part on suitability across the age range. In trials where the intention is to alter core features of ASDs, adaptive behavior scales are also worthy of consideration. Several “behavior complexes” common to ASDs are identified, and instruments are recommended for assessment of these. Given the prevalence of cognitive impairment in ASDs, it is important to assess any cognitive effects, although cognitive data from ASD randomized clinical trials, thus far, are minimal. Guidance from trials in related pharmacologic areas and behavioral pharmacology may be helpful. We recommend routine elicitation of side effects, height and weight, vital signs, and (in the case of antipsychotics) extrapyramidal side-effects assessment. It is often appropriate to include laboratory tests and assessments for continence and sleep pattern.
Treatment-resistant Depression in Late Life
Authors: Flint Alastair J. 
Published: August 2016

ABSTRACTTreatment resistance is reported in up to 40% of older patients with major depression. Before labeling an episode of depression as treatment resistant, it is important to ensure that the diagnosis is correct and that the patient has received and adhered to an adequate dose of treatment for an appropriate length of time. It is also important to assess the patient for comorbid physical and psychiatric conditions that can contribute to treatment resistance. In patients who do not experience remission of symptoms with an adequate trial of medication, the following options can be considered: augmenting the antidepressant with a drug that is not primarily an antidepressant, adding a second antidepressant to the first, switching to a different antidepressant medication, or switching to electroconvulsive therapy. This paper reviews the concept of treatment-resistant depression and discusses its assessment and management in the elderly. The author concludes that when a systematic stepped-care approach to treatment is followed, most older patients with major depression will experience remission of symptoms.
Brain-Imaging Studies of Posttraumatic Stress Disorder
Authors: Liberzon Israel , Phan K. Luan 
Published: August 2016

ABSTRACTBrain-imaging studies of posttraumatic stress disorder (PTSD) have rapidly increased in recent years. Structural studies have identified potential smaller volumes of the hippocampus of traumatized and/or PTSD subjects. Functional activation studies have implicated hyperactive or altered functioning of brain regions, such as the amygdala and the insula, and a failure to engage emotional regulatory structures, such as the medial prefrontal and anterior cingulate cortex. Recent neurochemical investigations have suggested that neuromodulatory systems (eg, γ-aminobutyric acid, μ-opioid) may underlie these aberrant brain activation patterns. This article reviews the literature on structural, functional, and neurochemical brain-imaging studies of PTSD.
Social Cognition and Its Neural Correlates in Schizophrenia and Autism
Authors: Abdi Zeinab , Sharma Tonmoy 
Published: August 2016

AbstractThe study of social cognition in psychiatric disorders has become increasingly popular in recent years. This is due to the its proposed link to social functioning and the inability of general neurocognitive skills to explain the spectrum of impairments observed in patients. This article reviews research into two of the processes thought to underlie social cognition (emotion perception and theory of mind) in schizophrenia and autism. This is followed by a look at neuroimaging studies and their efforts to localize the neural correlates of emotion perception and theory of mind in the two disorders. We concluded that while a specific impairment in emotion perception and theory of mind skills cannot be generalized to all individuals with autism and schizophrenia, there are subpopulations that have lingering deficits of social cognition tasks. Neuroimaging work consistently points to the involvement of the fusiform gyrus and amygdala in emotion processing, while the medial prefrontal and frontal cortex are implicated in tasks invoking theory of mind. We propose that deficits of social cognition may benefit from cognitive remediation therapy and pharmacological cognitive enhancers.
Ziprasidone as an Augmenting Agent in the Treatment of Anxiety-Spectrum Disorders
Authors: Crane Daniel L. 
Published: August 2016

AbstractAnxiety disorders are currently one of the most common health concerns in the United States. Overall, they are the single largest cost to the healthcare system. They are also underdiagnosed and undertreated. Selective serotonin reuptake inhibitors and benzodiazepines appear to be the most common pharmacologic treatment approaches. Unfortunately, not all patients respond to these treatments. Many augmentation strategies have been tried in the past with varying levels of success or safety. This article describes a safe and highly effective augmentation technique in patients suffering from some of the most serious and debilitating forms of anxiety disorders, namely obsessive-compulsive disorder and panic disorder.
Hypercoagulable States and Stroke: A Selective Review
Authors: Levine Steven R. 
Published: August 2016

AbstractBlood disorders have been implicated in ~5% to 10% of ischemic stroke, with an increased frequency in younger patients. Most disorders are associated with an increased thrombotic tendency and, therefore, an increased risk of ischemic stroke. Less commonly, a bleeding diathesis may predispose a patient to intracranial hemorrhage. While many conditions predisposing to thrombosis have been associated with stroke, there are relatively few prospective, epidemiological studies addressing hypercoagulable states and arterial stroke compared with the number of studies on the genetic thrombophilias, which are predominantly associated with venous thrombosis. When ordering tests of coagulation in stroke patients, one should keep in mind whether the results will influence therapy and/or patient outcome. It is generally not advocated to screen all stroke patients for a “hypercoagulable workup”. Typically, patients to be screened for coagulation defects will have a prior history of one or more unexplained thromboembolic events. The yield for diagnosing a hypercoagulable state is typically greatest for young stroke patients or those with a family history of thrombosis and who have no other explanations for their stroke (cryptogenic stroke). The yield in typically low in unselected ischemic stroke patients and older patients. Treatment of a first stroke with a documented hypercoagulable state is typically long-term or indefinite duration warfarin, although there is a paucity of clinical trial data supporting this clinical approach.
A Neuropsychiatrist's Perspective on Selected Dermatoses
Authors: Chemali Zeina N. , Touma Dany J. 
Published: August 2016

AbstractMany neuropsychiatric diseases present with concomitant dermatologic manifestations. These manifestations may help the clinician formulate a correct diagnosis when it is otherwise unclear. In this article, we present six cases with clinical photographs of associated skin findings discussed from a neuropsychiatrist's perspective. Each case will be followed by a discussion and a brief review of the associated neuropsychiatric and dermatologic aspects of the disease.
Brain Stimulation Techniques in the Treatment of Obsessive-Compulsive Disorder: Current and Future Directions
Authors: Dell'Osso Bernardo , Altamura Alfredo Carlo , Allen Andrea , Hollander Eric 
Published: August 2016

AbstractRecent studies on the epidemiology of obsessive-compulsive disorder (OCD) estimate 50 million patients suffer from OCD worldwide, thus making it a global problem. The treatment of OCD has changed substantially over the last 2 decades following the introduction of selective serotonin reuptake inhibitors, which provide symptom improvement in ~60% of patients. However, some patients remain resistant to the standard pharmacologic and behavioral treatments. Although some treatment-resistant patients respond to pharmacologic augmentations, others do not, and there is evidence that some of the most severe cases benefit from treatment with neurosurgical interventions. Besides pharmacologic, behavioral, and neurosurgical approaches, different brain stimulation methods—transcranial magnetic stimulation, deep brain stimulation, and electroconvulsive therapy—have been investigated in treatment-resistant patients with OCD. However, available data about the use of these techniques in OCD treatment are quite limited in terms of sample size and study design, given the difficulty in conducting standard blinded trials for these procedures. In addition, none of the mentioned treatments have received Food and Drug Administration approval for the treatment of OCD. Nevertheless, promising findings regarding efficacy, tolerability, and non-invasiveness and/or reversibility of these techniques have increased interest in investigating their use in treatment-resistant OCD.
Imitators of Epilepsy
Authors: Fisher Robert S. 
Published: August 2016

AbstractEpilepsy is common, but conditions that imitate epilepsy are even more common. In order to make a correct diagnosis of epilepsy, the clinician must carefully elicit a detailed history of the seizure episode. Realizing the overlap that exists between seizures that define epilepsy and those of other psychiatric conditions can also help in differentiating between epilepsy and an imitator of epilepsy. Deciphering the features of a seizure episode is also key to correct diagnosis.In this article, the physiological and psychological imitators of epilepsy are described, as well as the features of a seizure episode that should be considered in making a diagnosis. Seizure presentations are also explained followed by a description of common diagnostic pitfalls to avoid.
Neuroimaging in Temporal Lobe Epilepsy
Authors: Muro Gerard J. , Karis John P. 
Published: August 2016

AbstractVarious neuroimaging modalities are available for evaluating patients with temporal lobe epilepsy (TLE). All patients considering surgery should undergo magnetic resonance imaging, which is valuable in the detection and characterization of lesions, particularly mesial temporal sclerosis, the most common abnormality in TLE. A localized seizure focus is predictive of successful surgical outcome. Complimentary neuroimaging studies include positron emission tomography, single-photon emission tomography, and proton magnetic resonance spectroscopy.
Augmentation of Antidepressant Pharmacotherapy: A Preclinical Approach Using the Mouse Forced Swimming Test
Authors: Redrobe John P. , Bourin Michel 
Published: August 2016

AbstractUntil recently, several weeks of treatment were required in order to obtain a clinically significant antidepressant response using pharmacotherapy. The present study, using the mouse forced swimming test, investigated possible antidepressant augmentation strategies, together with the probable mechanisms involved in such potentiations. It is clear from this and other similar studies that it is possible to enhance the activity of antidepressant drugs with the addition of other compounds (ie, clonidine, quinine, glyburide, pindolol, or buspirone). These data indicate that direct/indirect manipulation of serotonergic receptor systems potentiates the effect antidepressant drugs (ie, selective serotonergic reuptake inhibitors) in the mouse forced swimming test, and thus establish this model as a reliable preclinical tool for the investigation of possible antidepressant augmentation strategies. It also appears that this model can be used as a method for identifying the mechanisms involved in such treatment strategies.
Genetics of Bipolar Disorder
Authors: Pato Carlos N. , Kennedy James L. , Bauer Amy , Pato Michele T. 
Published: August 2016

ABSTRACTThe growing number of reports on candidate genes an genomic regions of interest in bipolar disorder reveals a tremendously active field of study. As with other complex psychiatric syndromes, these early findings will require a great deal of effort to replicate and clarify. This review serves both as an update and an introduction to some of the issues confronting investigators. Potential strategies in study design, population selection, and molecular methods are explored as well.
Psychoanalytic Treatment of a Woman With Anxiety Attacks and Conversion
Authors: Goldstein David 
Published: August 2016

AbstractThis case study describes the psychoanalytic treatment of a young woman presenting with symptoms of overwhelming anxiety, panic, and conversion. The emphasis is on technique with detailed reporting on the psychoanalytic process. Attention is paid to transference-countertransference paradigms at critical junctures in the treatment. The role of clinical supervision in the unfolding of the process is described also. This patient developed an identifiable transference neurosis during the course of the treatment, which became the focus of the analysis. Follow-up observations on this patient are also presented, as she returned for a brief course of treatment 4 years following initial termination.
Neurobiology of Social Phobia
Authors: Bebchuk Joseph M. , Tancer Manuel E. 
Published: August 2016

AbstractSocial phobia is an anxiety disorder that is characterized by excessive fear and/or avoidance of situations in which an individual believes that he or she may be the subject of evaluation or scrutiny while interacting with other people or performing a specific task. This article reviews the available literature on the neurobiology underlying social phobia, including autonomic nervous system effects, neuroimaging findings, pharmacologic challenge studies, and neuroendocrine responsivity and function. Overall, such studies have found few consistently demonstrable differences in neurobiology between patients with social phobia and healthy controls, but further investigations are needed.
Theory-Driven Interventions in Psychoneuroimmunology and HIV-1 Infection
Authors: Tyll Mary D. , Goodkin Karl , Blaney Nancy T. , Baldewicz Teri T. , Hunt Jodi Dee , Asthana Deshratn 
Published: August 2016

AbstractPsychoneuroimmunology (PNI) is a rapidly evolving multidisciplinary field founded on the premise that psychosocial factors, the central nervous system, and the immune system are intimately linked. Following publication of scientific evidence supporting this link, a number of animal and human studies have been published, both inside and outside the area of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome. These studies support the existence of bidirectional feedback mechanisms operating between the brain and the immune system. To date, however, there is no all-encompassing model that predicts individual differences in the relationship among psychosocial factors, immunologic measures, and clinical disease progression in HIV type 1 (HIV-1) infection. This variability in human response has been explained by a number of cofactors (host as well as environmental) that appear to accelerate the course of the disease.Since psychosocial factors are highly amenable to behavioral interventions, several models for intervention research have been proposed to evaluate whether such interventions can enhance immune functioning, thereby curtailing disease progression. Examination of these interventions in the context of PNI and HIV-1 infection, however, is rather limited. Therefore, researchers and clinicians must not only consider conceptualizations and paradigms in this area of research, but also focus on empirically testable, theory-driven models that allow for the unique characteristics of individual patients.
Mixed Amphetamine Salts Extended Release for the Treatment of ADHD in Adolescents: Current Evidence
Authors: Spencer Thomas J. 
Published: August 2016

Ongoing research on attention-deficit/hyperactivity disorder (ADHD) has yielded important new information that has impacted the clinical recognition and management of this disorder. ADHD has long been considered one of the most common psychiatric disorders initially diagnosed and treated in childhood. Contrary to the once widely held assumption that symptoms spontaneously resolved or abated, clinically significant symptoms for most patients persist into adolescence and adulthood. While hyperactivity appears to decrease with age, impaired attention and impulsivity persist into adolescence and are linked to clinically significant functional impairments in academic, social, and family settings.Like their younger counterparts, adolescents with ADHD exhibit higher rates of comorbid psychiatric illness and concomitant mental health service use. Among the most common comorbid psychiatric disorders seen in adolescents with ADHD are major depression, anxiety disorders, conduct disorder, and oppositional defiant disorder (ODD). In young adults, a direct correlation has been revealed between ongoing ADHD symptom severity and lower levels of academic achievement, greater risk of illicit drug use, and drug-related crime. These findings highlight the potential importance of adequate ADHD symptom management in adolescence in predicting long-term outcomes; as a result, a lifespan approach toward ADHD is beginning to be adopted by many clinicians, and anti-ADHD medication (including psychostimulants) is being recommended for the management of ADHD in all age groups. However, most clinical research involving psychostimulants has been conducted in school-age children <12 years of age, and knowledge concerning the use of medications in adolescents with ADHD is limited. Questions about dosing, safety, level of efficacy to be expected, and optimal duration of treatment in adolescents with ADHD must be addressed. Clinical choice of therapy is also complicated by the fact that the anti-ADHD armamentarium continues to evolve, and now includes long-acting formulations of methylphenidate, mixed amphetamine salts, and nonstimulants.
Pharmacokinetics of Mixed Amphetamine Salts Extended Release in Adolescents With ADHD
Authors: Kramer William G. , Read Stephanie C. , Tran Bao-Van , Zhang Yuxin , Tulloch Simon J. 
Published: August 2016

AbstractObjectiveA randomized, open-label, single-dose, three-treatment, three-period, crossover, phase I study was conducted to assess the pharmacokinetics of mixed amphetamine salts extended release (MAS XR) in adolescents with attention-deficit/hyperactivity disorder (ADHD).MethodsTwo cohorts of healthy adolescents 13–17 years of age with ADHD were enrolled in the study. Seventeen subjects, weighing ≤75 kg (≤ 65 lbs), were randomized to one of three dosing sequence groups (a single oral dose of MAS XR 10, 20, or 40 mg, follwed by crossover to the alternate treatments, with a 7-day washout between treatments). Six additional subjects, weighing >75 kg (>165 lbs), were randomized simihrly but received larger doses of MAS XR (20, 40, and 60 mg). Blood samples were collected before and at hours 1–12 after drug administration, as well as before and at hours 14, 24,48, and 60.FindingsLinear pharmacokinetics of dextroamphetamine (D-amphetamine) and loamphetamine (L-amphetamine) were observed with MAS XR in both cohorts. The pharmacokinetics of D-amphetamine and L-amphetamine did not differ between male and female adolescents. A significant decrease in maximum exposure (Cmax) and increase in half-life were seen for both isomers with increasing age, but overall exposure (AUC∞ was not affected. Cmax and AUC∞ for both isomers decreased as body weight increased.ConclusionExposure to MAS XR was linear and directly proportional to the dose administered in 13–17-year-old adolescents with ADHD. The time course of drug absorption and elimination did not appear to be affected by dose at 10–40 mg in subjects weighing ≤75 kg, and at 20–60 mg in subjects weighing >75 kg. Gender did not affect the pharmacokinetics of MAS XR; age and body weight influenced the profile of certain pharmacokinetic variables.