A Cannabinoid Hypothesis of Schizophrenia: Pathways to Psychosis.

Background: Observations regarding psychostimulant and psychedelic drug-induced psychotic states led to the dopamine, serotonin, and glutamate hypotheses of schizophrenia. Expanding knowledge about the endocannabinoid system and the impact of exogenous cannabinoids on the brain and behavior have elucidated several putative pathways to cannabis-induced psychosis.

Objective: The purpose of the present article was to describe these pathways and propose a cannabinoid hypothesis of schizophrenia.

A retrospective study of the role of long-acting injectable antipsychotics in preventing rehospitalization in early psychosis with cannabis use.

Background: Despite compelling evidence that cannabis use is associated with neurocognitive deficits, loss of cerebral gray matter, relapse and rehospitalization, a substantial number of individuals with early psychosis continue to use recreational or medicinal marijuana. One identified pathway to relapse is non-adherence. Recurrent relapses modify the trajectory of illness and culminate in long-term disability.

Efficacy of a brief mindfulness intervention upon anxiety in early psychosis patients.

Aim: To examine the efficacy of a brief mindfulness intervention in reducing anxiety in early psychosis patients, and to determine whether symptom burden mitigates therapeutic response.

Methods: Our study included patients who had experienced an initial episode of psychosis, with less than 30 months of antipsychotic exposure. First, the prescriber completed the COMPASS Clinician Rating Form (measuring symptom burden), and patients completed the POMS questionnaire (measuring anxiety).

Teaching residents mental health care.

Objective: We tested the hypothesis that trained medical faculty can train residents effectively in a mental health care model.

Methods: After the authors trained medical faculty intensively for 15 months in primary care mental health, the newly trained faculty taught medical residents intensively. Residents were evaluated pre- and post-residency and compared to non-equivalent control residents in another city.

Barriers to utilizing long-acting injectable antipsychotic medications.

Background: Long-acting injectable (LAI) antipsychotic medications are superior to their oral equivalents in reducing relapse, yet schizophrenia treatment guidelines favor oral formulations. A minority of eligible patients receive LAI preparations in the United States. The purpose of the present study is to examine barriers faced by psychiatrists in implementing the use of LAI antipsychotics.

Barriers to utilizing long-acting injectable antipsychotic medications.

Background: Long-acting injectable (LAI) antipsychotic medications are superior to their oral equivalents in reducing relapse, yet schizophrenia treatment guidelines favor oral formulations. A minority of eligible patients receive LAI preparations in the United States. The purpose of the present study is to examine barriers faced by psychiatrists in implementing the use of LAI antipsychotics.

Addressing mental health issues in primary care: an initial curriculum for medical residents.

Objective: Many express concern that modern medicine fails to provide adequate psychosocial and mental health care. Our educational system has not trained the primary care providers who care for most of these patients. Our objective here is to propose a quantum change: prepare residents and students during all years of training so that they are as effective in treating psychosocial and mental health issues as they are medical problems.

Are your patients depressed? Implications for dental practice.

Depressive disorders traditionally reside outside the realm of customary dental practice. Nonetheless, one in every five patients who visits a dentist experiences clinically significant symptoms of depression. The clinical implications of this are substantial.

Using nurse practitioners to implement an intervention in primary care for high-utilizing patients with medically unexplained symptoms.

Patients with medically unexplained symptoms (MUS) often are a source of frustration for clinicians, and despite high quality biomedical attention and frequent diagnostic tests, they have poor health outcomes. Following upon progress in depression treatment approaches, we developed a multidimensional treatment protocol for deployment by primary care personnel. This multi-faceted intervention for MUS patients emphasized cognitive-behavioral principles, the provider-patient relationship, pharmacological management, and treating comorbid medical diseases.