Psychotic disorders in Asian Americans and DSM-5.

The DSM-5 lists 13 psychotic disorders and introduces modest but significant changes in their diagnosis. Asian Americans bring unique issues to the assessment, diagnosis and treatment of these disorders. They may exhibit greater prevalence of culturally influenced psychosis-like experiences that may or may not constitute a pathological condition such as psychosis risk syndrome or attenuated psychosis.

Brain stimulation therapies for psychiatric disorders: The first decade of the new millennium--A review.

Three new brain stimulation therapies have emerged in the last decade for clinical use in psychiatric disorders. Combined with electroconvulsive therapy (ECT), these therapies offer much hope to patients with medication refractory depression, obsessive-compulsive disorder and auditory hallucinations of schizophrenia. In this article we briefly review the history, development and evidence for each of the four stimulation therapies and describe the current state-of-the-art.

MentalSquares: a generic bipolar Support Vector Machine for psychiatric disorder classification, diagnostic analysis and neurobiological data mining.

MentalSquares (MSQs)--an equilibrium-based dimensional approach is presented for the classification and diagnostic analysis of psychological conditions with Bipolar Disorders (BPDs) as an example. While a Support Vector Machine (SVM) is defined in Hilbert space. A MSQ can be considered as a generic SVM for improved classification.

Metabolic syndrome associated with schizophrenia and atypical antipsychotics.

Patients with schizophrenia are at increased risk for developing the metabolic syndrome or its individual components due to their lifestyle, suspected genetic predisposition, and exposure to antipsychotic medications that can cause weight gain and other metabolic side effects. Despite the availability of clinical guidelines, screening for and monitoring of metabolic problems in this patient population continue to be suboptimal. We provide an overview specifically addressing 1) why patients with schizophrenia are at increased risk for metabolic problems; 2) how commonly used antipsychotic medications vary in terms of their metabolic liability; 3) how to effectively screen for and monitor metabolic problems in patients receiving antipsychotic medications; 4) what interventions can prevent, limit, or reverse the metabolic side effects of antipsychotic drug treatment; and 5) what are the barriers to the care of these patients.

Report of the Indo-US health care summit 2009 - Mental health section.

The 2nd Indo-US Health Care Summit held in January 2009 was a forum to discuss collaboration between physicians in the US and India on medical education, health care services and research. Six specialties were represented including Mental Health (MH). Using Depression as the paradigmatic disorder, the following objectives were developed.

Indian - American contributions to psychiatric research.

The Indian Diaspora, especially in North America, is a visible force in the field of psychiatric medicine. An estimated 5000 persons of Indian origin practice psychiatry in the USA and Canada, and an estimated 10% of these are in academic psychiatry. Wide ranging contributions, from molecular biology of psychiatric disorders to community and cultural psychiatry, are being made by this vibrant group of researchers.

Proarrhythmic risk with antipsychotic and antidepressant drugs: implications in the elderly.

The quinidine-like effects of some antidepressant drugs (particularly tricyclic antidepressants) and many antipsychotic drugs (particularly the phenothiazines) confound treatment of psychosis and depression in patients with major mental illness. This is especially true among elderly patients with existing risk factors for corrected QT (QTc) interval prolongation. We used PubMed, previously reported review articles and the extensive personal files of the authors to identify cases of subjects aged>or=60 years who developed QTc interval prolongation, polymorphic ventricular tachycardia (PVT)/torsade de pointes (TdP) and/or sudden cardiac death while taking antipsychotic or antidepressant drugs or a combination of these medications.

Pharmacological management of psychosis in elderly patients with parkinsonism.

Parkinsonism is a characteristic feature of Parkinson's disease and dementia with Lewy bodies and is commonly seen in Alzheimer's disease. Psychosis commonly appears during the course of these illnesses. Treatment of parkinsonism with antiparkinsonian medications constitutes an additional risk factor for the appearance or worsening of psychosis.

Clinical monitoring and management of the metabolic syndrome in patients receiving atypical antipsychotic medications.

Individuals with major mental illness are a high-risk group for cardio-metabolic derangements due to genetic predisposition, developmental and environmental stressors, and lifestyle. This risk is compounded when they receive antipsychotic medications. Guidelines for screening, monitoring, and managing these patients for metabolic problems have been in place for several years.

Polypharmacy with second-generation antipsychotics: a review of evidence.

Objective: The objective of this study was to review the prevalence of polypharmacy with second-generation antipsychotics (SGAs) in clinical practice, pharmacological reasons for such practice, and the evidence for and against such polypharmacy.

Methods: Clinical trial reports, case reports, and reviews were identified by a PubMed literature search from 1966 through October 2006, with retrieved publications queried for additional references. We excluded reports on augmentation with non-antipsychotic medications and polypharmacy involving combinations of SGAs and first-generation (conventional) antipsychotics (FGAs) or combinations of two FGAs.

Psychotropic drug considerations in depressed patients with metabolic disturbances.

Depression, obesity, diabetes mellitus, and the metabolic syndrome are conditions commonly treated in primary care. The prevalence of each condition separately does not explain the frequency of their co-occurrence. Depression may lead to or exacerbate these endocrine and metabolic conditions.

The risk of overweight in children and adolescents with major mental illness.

Objectives: To survey the charts of youths with major mental illness who may constitute a high-risk group (HRG) for overweight.

Methods: We reviewed the charts of youths admitted to a public sector psychiatric hospital. For the 795 cases of patients 6 to 18 years old identified as the study cohort, we derived body mass index percentiles using the Centers for Disease Control Epi Info software.

Equilibrium-based bipolar neurological modeling.

This work introduces an equilibrium-based dynamic model for the characterization, classification, and diagnostic analysis of bipolar disorder, a psychiatric syndrome with manic and depressive phases. The new model extends the traditional spectrum model of mood states from a static and closed world to a dynamic open-world of equilibria with a bipolar universal modus ponens (BUMP). The utility of the new model is illustrated in diagnostic analysis of depression and clinical psychopharmacology of different phases of this disorder.

Yin Yang dynamic neurobiological modeling and diagnostic analysis of major depressive and bipolar disorders.

Since millions suffer from major depressive and bipolar disorders, the modeling, characterization, classification, and diagnostic analysis of such mental disorders bear great significance in medical and pharmaceutical research. YinYang bipolar sets are introduced for neurobiological modeling and diagnostic analysis of such disorders. It is shown that bipolar sets and a bipolar dynamic modus ponens (BDMP) build a technological bridge from a linear, static, and closed world to a nonlinear, dynamic, and open world of equilibria, quasi-equilibria, or nonequilibria and provide a novel model for bipolar neurobiological diagnostic analysis with added rigor to the current standard.

Correlation between high risk obesity groups and low socioeconomic status in school children.

Objective: Obesity is a major health problem among children and adolescents which is potentially affected by socioeconomic status (SES). The high risk group (HRG) comprises those youths with a body mass index (BMI) between the 85th and 95th percentile (at risk for overweight) and > or = 95th percentile (overweight). We sought a potential link between the HRG and SES.

Posttraumatic stress disorder in male military veterans with comorbid overweight and obesity: psychotropic, antihypertensive, and metabolic medications.

Unlabelled: Posttraumatic stress disorder (PTSD) is an important syndrome among military veterans. Little has been written about comorbid medical conditions of PTSD, particularly overweight and obesity. We focus on psychotropic and non-psychotropic drugs, their interactions, and metabolic issues most relevant to primary care physicians.

Treatment of depression in patients with coronary heart disease.

Depression and coronary heart disease are common conditions that often occur together. Evidence shows that the co-occurrence of these illnesses is not random but driven by depression as a risk factor for the occurrence and progression of coronary heart disease. This link is due, in part, to the impact that depression has on neuroendocrine pathways leading to increased platelet activation, cortisol and catecholamine excess, and altered autonomic nervous system function that influence the pathogenesis and progression of coronary atherosclerosis and subsequent heart disease.

Posttraumatic stress disorder: clinical features, pathophysiology, and treatment.

Posttraumatic stress disorder (PSTD), classified as an anxiety disorder, has become increasingly important because of wars overseas, natural disasters, and domestic violence. After trauma exposes the victim to actual or threatened death or serious injury, 3 dimensions of PTSD unfold: (1) reexperiencing the event with distressing recollections, dreams, flashbacks, and/or psychologic and physical distress; (2) persistent avoidance of stimuli that might invite memories or experiences of the trauma; and (3) increased arousal. Traumatic events sufficient to produce PTSD in susceptible subjects may reach a lifetime prevalence of 50% to 90%.

Posttraumatic stress disorder and body mass index in military veterans. Preliminary findings.

Introduction: Current management of posttraumatic stress disorder (PTSD) focuses on the psychiatric parameters of this condition. Little has been written about co-morbid overweight and obesity in PTSD.

Methods: We used the database of the recently constituted PTSD program at the Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Virginia to assess and better understand the prevalence and severity of overweight and obesity among military veterans with PTSD.

Body mass index relates to males with posttraumatic stress disorder.

Introduction: We looked at the relationships among posttraumatic stress disorder (PTSD), body mass index (BMI) and socioeconomic status (SES) in a newly formed PTSD program at the Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, VA.

Methods: We reviewed 265 records and then selected only black and white male veterans (n=252) for study. Variables were: 1) age, 2) decade of life, 3) height, 4) weight, 5) sex, 6) race, and 7) SES (estimated using priority group status).