An Orientation to Aviation Psychiatry: With 30 Case Examples and a 10-Year Follow-up.

This report orients general psychiatrists to assessment and care for "safety sensitive" aviation workers. Our case study of 30 sequential aviation patients consists of demographic, clinical, and aviation characteristics plus a 10-year follow-up. Relatively few pilots and other aviation workers self-identified their psychiatric condition.

Identifying, Assessing, and Treating Korsakoff Syndrome Patients: Updated Perspectives.

Objectives consist of updating published reports on the recognition, assessment, and care of patients with Wernicke-Korsakoff syndrome (WKS). Methods included defining relevant terms, describing core clinical phenomena, conducting meaningful reviews for latter-day WKS publications, and selecting instructive case examples. Findings covered epidemiology, precipitants, neuroimaging studies, alternate learning strategies in WKS, adjunctive treatments, and promising research.

Alcohol Craving and Psychiatric Disorders Among Current Drinkers.

Background And Objectives: Previous research has shown that alcohol craving is associated with psychiatric comorbidities. However, no population studies have examined the odds of psychiatric disorders in cravers and noncravers. The purpose of this study was to investigate current prevalence rates and odds ratios of psychiatric disorders among alcohol drinkers with and without alcohol craving in a population-based sample.

Zolpidem-Associated Consequences: An Updated Literature Review With Case Reports.

A post-2000 literature search reviewed prevalence of health consequences associated with zolpidem, plus two salient case reports. Common zolpidem-related harms encompassed accidents, falls, overdoses, delirium, and infections. Risks to others included assaults, vehicular accidents, various crimes, and civil actions that occurred during zolpidem-induced delirium, withdrawal, and other impediments.

Methadone-Related Delirium: Prevalence, Causes, and Outcomes.

Goals consist of determining 5-year prevalence and recurrence of methadone-related delirium (MRD), along with causes, treatments, and outcomes. Sample comprised 81 patients in methadone maintenance treatment. Criteria for MRD encompassed delirium with high methadone serum levels plus alleviation of delirium upon lowering methadone serum levels.

Call for "High-Dose" Olanzapine Research in Treatment-Resistant Psychosis.

Psychiatric care has entered a new era in which care for treatment-resistant psychiatric disorder has attained priority status. Addressing treatment resistance involves 1) alleviating symptoms and signs of the diagnostic condition, 2) returning the patient to functional capacity, and 3) preventing subsequent recurrence. This approach has achieved considerable momentum in regard to major depressive disorder, as evidenced by early recognition and timely treatment, medication augmentation strategies, mind-body training for the populace at large, effective and efficient psychotherapies, and new biomedical interventions.

Mental Health Effects of Stress over the Life Span of Refugees.

Information about the relative impact of stressful events across the lifespan on the mental health of refugees is needed. Cross-sectional data from a community sample of 135 Kurdish and 117 Vietnamese refugees were fit to a path model about the effects of non-war stress, war-related stress, and post-migration stress on mental health. Kurdish and Vietnamese data were generally consistent with the model.

Long QTc During Methadone Maintenance: Contributors and Interventions Over 4 Years.

Our goal consisted of describing the 4-year prevalence, contributors, and interventions for long QTc's in methadone maintenance treatment. Cardiologists' diagnosis of long QTc defined case-ness in 62 patients. Long QTc categories, drawn from epidemiological reports, encompassed 440 to 469 (borderline), 470 to 499 (moderate), and 500+ milliseconds (severe).

Effect of Antidepressant Switching vs Augmentation on Remission Among Patients With Major Depressive Disorder Unresponsive to Antidepressant Treatment: The VAST-D Randomized Clinical Trial.

Importance: Less than one-third of patients with major depressive disorder (MDD) achieve remission with their first antidepressant.

Objective: To determine the relative effectiveness and safety of 3 common alternate treatments for MDD.

Design, Setting, And Participants: From December 2012 to May 2015, 1522 patients at 35 US Veterans Health Administration medical centers who were diagnosed with nonpsychotic MDD, unresponsive to at least 1 antidepressant course meeting minimal standards for treatment dose and duration, participated in the study.

The 10-Item Substance Use Disorder Outcome Scale: Psychometric evaluation.

The current study describes the psychometric properties of a scale (entitled "Substance Use Disorder Outcome Scale-10 items" or 10-Item Substance Use Disorder Outcome Scale) designed for longitudinal studies. Sixteen male veterans attending a substance use disorder recovery clinic were studied over a 2-year period. The attending nurse and physician conducted four, 10-Item Substance Use Disorder Outcome Scale scale ratings, each encompassing a 6-month period, for each participant.

Feasibility, acceptability and clinical utility of the Cultural Formulation Interview: mixed-methods results from the DSM-5 international field trial.

There is a need for clinical tools to identify cultural issues in diagnostic assessment.To assess the feasibility, acceptability and clinical utility of the DSM-5 Cultural Formulation Interview (CFI) in routine clinical practice.Mixed-methods evaluation of field trial data from six countries.

Methadone maintenance dose/weight ratio, long QTc, and EKG screening.

Background And Objectives: Electrocardiogram (EKG) monitoring during methadone maintenance treatment (MMT) has been recommended to prevent potentially fatal prolonged computed QT intervals (QTc). However, risk indicators for obtaining EKGs do not exist. This study assessed 23 variables that might help identify prolonged QTc during MMT.

High-Dose Naltrexone Treatment and Gender in Alcohol Dependence.

Objectives: Little is known about whether safety and effectiveness of high-dose naltrexone (150 mg/d) are different in alcohol-dependent women and men. This study investigated sex differences in safety and treatment outcomes in alcohol-dependent women and men on high-dose naltrexone (150 mg/d).

Methods: In this exploratory study, safety and effectiveness of high-dose naltrexone (150 mg/d) were examined in men and women with alcohol dependence (n = 24; 11 men and 13 women) treated in an 8-week outpatient setting.

How Do Clinicians Prefer Cultural Competence Training? Findings from the DSM-5 Cultural Formulation Interview Field Trial.

Objective: This study's objective is to analyze training methods clinicians reported as most and least helpful during the DSM-5 Cultural Formulation Interview field trial, reasons why, and associations between demographic characteristics and method preferences.

Method: The authors used mixed methods to analyze interviews from 75 clinicians in five continents on their training preferences after a standardized training session and clinicians' first administration of the Cultural Formulation Interview. Content analysis identified most and least helpful educational methods by reason.

Housing First/HUD-VASH: Importance, Flaws, and Potential for Transformation: Response to Commentary.

This paper consists of responses to issues raised in the accompanying Commentary. Our response is organized under three topics: (1) reasons regarding the importance of issues, (2) the need for a comprehensive framework in housing placement, and (3) conceptualization and scientific design (with details on contemporary methods for investigating unanticipated consequences when randomization is no longer feasible). Recurrences to substance use disorder in the American Society of Addiction Medicine (ASAM) housing placement condition are noted within hours or days, with rapid implementation of planned contingencies, and avoidance of enabling.

Daily versus monthly reporting of post-traumatic symptoms: A study of reliability across time and instruments.

This study compared daily-versus-monthly self-ratings of post-traumatic symptoms using two similar but not wholly identical measures. The rationale was to determine whether (1) posttraumatic dissociation and/or minimization or (2) certain biases (more recent symptoms, more severe symptoms, practice effect, Hawthorne effect) might undermine symptom recall. Seventeen voluntary participants provided daily self-ratings for an average of 11.

Personality disorders in adopted versus non-adopted adults.

The goal of this epidemiological study was to investigate lifetime history and odds ratios of personality disorders in adopted and non-adopted adults using a nationally representative sample. Data, drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), were compared in adopted (n=378) versus non-adopted (n=42,503) adults to estimate the odds of seven personality disorders using logistic regression analyses. The seven personality disorders were histrionic, antisocial, avoidant, paranoid, schizoid, obsessive-compulsive, and dependent personality disorder.

Are there racial/ethnic disparities in VA PTSD treatment retention?

Background: Chronic posttraumatic stress disorder (PTSD) can result in significant social and physical impairments. Despite the Department of Veterans Affairs' (VA) expansion of mental health services into primary care clinics to reach larger numbers of Veterans with PTSD, many do not receive sufficient treatment to clinically benefit. This study explored whether the odds of premature mental health treatment termination varies by patient race/ethnicity and, if so, whether such variation is associated with differential access to services or beliefs about mental health treatments.

Nicotine dependence and psychiatric and substance use disorder comorbidities among American Indians/Alaska Natives: findings from the National Epidemiologic Survey on Alcohol and Related Conditions.

Background: American Indians and Alaska Natives (AI/ANs) have high rates of tobacco use compared to the general population. AI/ANs also have elevated rates of psychiatric and substance use disorders associated with nicotine dependence. However, very few studies have examined the comorbidity between nicotine dependence and psychiatric and substance use disorders within this population.

Internalizing disorder in adopted versus non-adopted adults: a NESARC based study.

The objective of the study consisted of comparing lifetime prevalence rates and odds ratios of anxiety, mood, and psychotic disorders in adopted-versus-non-adopted people in a nationally representative sample. The data were drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). The main outcome measure was the prevalence of lifetime internalizing psychiatric disorders in adopted (n=378) versus non-adopted (n=42,503) individuals.

Actigraphy in post traumatic stress disorder.

Unlabelled: Patients with posttraumatic stress disorder (PTSD) frequently complain of sleep disturbances such as insomnia and nightmares. Evaluation of sleep disturbances is often difficult due to the subjective nature of the complaints. Polysomnography (PSG) and other sleep studies are generally not indicated in the evaluation of insomnia or nightmares associated with PTSD.

Impact of treatment beliefs and social network encouragement on initiation of care by VA service users with PTSD.

Objectives: Despite the U.S. Department of Veterans Affairs' (VA) expansion of mental health services to treat VA service users with posttraumatic stress disorder (PTSD), many with PTSD do not engage in treatment.

Nocturnal Awakening & Sleep Duration in Veterans with PTSD: An Actigraphic Study.

Objective: To assess whether awakenings from sleep and sleep duration in Post Traumatic Stress Disorder (PTSD) were related to demography, posttraumatic or depressive symptoms, subjective sleep quality, and daytime sleepiness.

Methods: Sample consisted of 23 veterans with lifetime PTSD and current sleep disturbance not due to apnea or other diagnosable conditions. Data collection included demography, two weeks of actigraphy, Beck Depression Inventory, Posttraumatic Checklist, Clinical Assessment of Posttraumatic Symptoms, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale.