A Pilot Study of Citalopram Treatment in Preventing Relapse of Depressive Episode after Acute Treatment.

Purpose: To examine the benefit of continuation treatment with citalopram in adolescents 13 to 18 years of age with major depression using a multi-site randomized placebo controlled discontinuation design.

Methods: Subjects with depression who responded to open label treatment with citalopram in 12-week acute phase were randomized to continued treatment with citalopram or placebo for 24 weeks.

Results: Twenty five subjects were randomized to either continued treatment with citalopram (n = 12) versus placebo (n = 13).

The enablers and barriers to the use of direct observation of trainee clinical skills by supervising faculty in a psychiatry residency program.

Objective: Studies have reported that medical trainees do not get sufficient direct observation. Our study aimed to determine the frequency of direct observation and the enablers and barriers to direct observation in the department of psychiatry at a large Canadian university.

Method: Focus groups and interviews explored the role and use of direct observation, followed by a survey both of faculty and of residents.

Maintenance study for adolescent depression.

Objective: Although recent studies and meta-analyses confirm the efficacy of antidepressants in the acute phase of treatment for adolescent depression, there are few data available to allow assessment of the value of continued use of antidepressants in depressed adolescents after acute response. This study examines the benefit of maintenance treatment with sertraline in adolescents aged 13-19 years with major depression using a multi-site randomized placebo controlled discontinuation design.

Methods: Subjects with a diagnosis of depression who responded to open-label treatment with sertraline in a 12-week acute phase and did not relapse with open-label continuation treatment for 24 weeks were randomized to placebo or continued treatment with sertraline for 52 weeks.

Axis I comorbidity of borderline personality disorder.

Objective: The purpose of this study was to assess the lifetime rates of occurrence of a full range of DSM-III-R axis I disorders in a group of patients with criteria-defined borderline personality disorder and comparison subjects with other personality disorders.

Method: The axis I comorbidity of 504 inpatients with personality disorders was assessed by interviewers who were blind to clinical diagnosis and who used a semistructured research interview of demonstrated reliability.

Results: Four new findings emerged from this study.

Axis II comorbidity of borderline personality disorder.

The purpose of this study was to assess the prevalence of a full range of DSM-III-R axis II disorders in a sample of criteria-defined borderline patients and axis II controls. The axis II comorbidity of 504 personality-disordered inpatients was assessed blind to clinical diagnosis using a semistructured research interview. Odd, anxious, and dramatic cluster disorders were each common among borderline patients.