Sertraline for anxiety in adults with a diagnosis of autism (STRATA): study protocol for a pragmatic, multicentre, double-blind, placebo-controlled randomised controlled trial.

Background: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to manage anxiety in adults with an autism diagnosis. However, their effectiveness and adverse effect profile in the autistic population are not well known. This trial aims to determine the effectiveness and cost-effectiveness of the SSRI sertraline in reducing symptoms of anxiety and improving quality of life in adults with a diagnosis of autism compared with placebo and to quantify any adverse effects.

The Clinical Relevance of Diabetes Distress versus Major Depression in Type 2 Diabetes: A Latent Class Analysis from the Fremantle Diabetes Study Phase II.

Background: The nosological position and clinical relevance of the concept of diabetes distress (DD) are uncertain. The aim of this study was to use latent class analysis (LCA) to categorise classes of people with type 2 diabetes and to compare their characteristics.

Methods: Data from 662 participants in the longitudinal observational Fremantle Diabetes Study Phase II were analysed.

Poststroke Depression: An Update.

The presence of neuropsychiatric disorders after stroke has been recognized for more than 100 years, but controlled systematic studies did not begin until the 1970s. The most clinically important advances, however, have been in the treatment and prevention of poststroke depression (PSD). Recent meta-analyses of randomized controlled trials (RCTs) for the treatment of PSD have demonstrated the efficacy of antidepressants.

Donepezil alone and combined with intensive language-action therapy on depression and apathy in chronic post-stroke aphasia: A feasibility study.

This study explored the feasibility and effectiveness of a short-term (10-week) intervention trial using Donepezil administered alone and combined with intensive language action therapy (ILAT) for the treatment of apathy and depression in ten people with chronic post-stroke aphasia. Outcome measures were the Western Aphasia Battery and the Stroke Aphasia Depression Questionnaire-21. Structural magnetic resonance imaging and fluorodeoxyglucose positron emission tomography were acquired at baseline and after two endpoints (Donepezil alone and Donepezil-ILAT).

Spectrum of neuropsychiatric symptoms in chronic post-stroke aphasia.

Background: Neuropsychiatric symptoms (NPS) have been insufficiently examined in persons with aphasia (PWA) because most previous studies exclude participants with language and communication disorders.

Aim: To report a two-part study consisting of a literature review and an observational study on NPS in post-stroke aphasia.

Methods: Study 1 reviewed articles obtained from PubMed, PsycINFO, Google Scholar and Cochrane databases after cross-referencing key words of post-stroke aphasia to NPS and disorders.

Measuring General Expectations of Advanced Stage Treatment Outcomes in Parkinson's Disease.

Background: Recent research suggests that a significant number of those who receive advanced treatments for Parkinson's disease (PD) do not report improvements for some symptoms, which may relate to their pre-treatment expectations. It is important that expectations of treatment are measured and discussed prior to advanced treatment.

Objective: The primary aim of this study was to develop a measure of treatment expectations of two advanced-stage treatments in PD, deep brain stimulation (DBS), and Levodopa/Carbidopa Intestinal Gel (LCIG).

Intensive aphasia therapy improves low mood in fluent post-stroke aphasia: Evidence from a case-controlled study.

Depressive symptoms are a major drawback of aphasia, negatively impacting on functional outcomes. In a previous study, Intensive Language-Action Therapy (ILAT) was effective in improving depression and low mood in persons with chronic non-fluent aphasia. We present a proof-of-concept case-control study that evaluates language and mood outcomes amongst persons with fluent post-stroke aphasia.

Risk factors and outcomes of anxiety symptom trajectories in type 2 diabetes: the Fremantle Diabetes Study Phase II.

Aim: To identify determinants and outcomes of 4-year trajectories of anxiety symptoms in a community-based cohort with type 2 diabetes.

Methods: Some 1091 participants in the Fremantle Diabetes Study-Phase II with type 2 diabetes completed the Generalized Anxiety Disorder Scale at baseline and biennially for 4 years, in addition to psychological, biomedical and self-management measures. Latent growth mixture modelling identified trajectories of anxiety symptom severity, and regression models determined predictors of trajectory membership and associated outcomes.

Nosology and Phenomenology of Psychosis in Movement Disorders.

Background: Psychotic symptoms, such as delusions and hallucinations, are part of the clinical picture of several conditions presenting movement disorders. Phenomenology and epidemiology of psychosis in Parkinson's disease have received wide attention; however, the presence of psychosis in other movement disorders is, comparatively, less well known.

Objectives: To review psychotic symptoms present in different movement disorders.

Design and validation of a new instrument to assess fear of falling in Parkinson's disease.

Background: Fear of falling may be significantly associated with falls in Parkinson's disease (PD) and may have a negative impact on quality of life. Nevertheless, there are no valid and reliable tools to examine this condition in PD. The objective of this study was to design and determine the psychometric attributes of an instrument to assess fear of falling in PD.

Treatment of Post-Stroke Depression.

Purpose Of Review: This review presents a critical appraisal of current therapeutic strategies for patients with post-stroke depression (PSD). We present the reader with the most recent evidence to support pharmacological, psychosocial, and neuromodulation interventions in PSD. We also discuss the relevance of using antidepressants and psychotherapy to prevent PSD and discuss evidence that antidepressant treatment may reduce mortality after stroke.

Anosognosia Is Associated With Greater Caregiver Burden and Poorer Executive Function in Huntington Disease.

Background: Anosognosia, or unawareness of one's deficits, is estimated to occur in 25% to 50% of Huntington disease (HD). The relationship between anosognosia and increased caregiver burden found in other dementias has not been determined in HD.

Methods: Patient-caregiver dyads presenting to a statewide HD clinic were assessed using the Anosognosia Scale and grouped into "anosognosia" and "no anosognosia.

Modified Mindfulness-Based Cognitive Therapy for Depressive Symptoms in Parkinson's Disease: a Pilot Trial.

Background: Mindfulness-based cognitive therapy (MBCT) has evidence of efficacy in a range of populations, but few studies to date have reported on MBCT for treatment of anxious and depressive symptoms in Parkinson's disease (PD).

Aims: The aim of this study was to examine the efficacy of modified MBCT in reducing symptoms of anxiety and depression and improving quality of life in PD.

Method: Thirty-six individuals with PD were randomly assigned to either modified MBCT or a waitlist control.

Discerning depressive symptoms in patients with obstructive sleep apnea: the effect of continuous positive airway pressure therapy on Hamilton Depression Rating Scale symptoms.

The assessment of depression in obstructive sleep apnea (OSA) is confounded by the overlap in symptoms between the disorders. However, previous analysis by our group has suggested that while some depressive symptoms tend to overlap with OSA (such as insomnia, lethargy, impaired concentration, psychomotor retardation) other, nonoverlapping symptoms appear more specific to depression (such as negative affect, anhedonia, and depressive cognitions). We sought to determine the value of such categorization of depressive symptoms in identifying clinical depression within OSA patient populations by examining the response of these two categories of depression symptoms to treatment of OSA by continuous positive airway pressure (CPAP).

Clinical risk factors for depressive syndrome in Type 2 diabetes: the Fremantle Diabetes Study.

Aims: To identify early clinical predictors of depressive syndrome in people with Type 2 diabetes.

Methods: Depressive syndrome was assessed in 325 individuals with Type 2 diabetes 15 years after a baseline assessment, which included information on antidepressant use and depressive symptoms obtained using a quality-of-life scale. Follow-up current and lifetime depressive syndrome were assessed using the nine-item Patient Health Questionnaire and the Brief Lifetime Depression Scale and taking account of antidepressant use.

Hippocampal atrophy, asymmetry, and cognition in type 2 diabetes mellitus.

Introduction: Type 2 diabetes mellitus is associated with global and hippocampal atrophy and cognitive deficits, and some studies suggest that the right hippocampus may display greater vulnerability than the left.

Methods: Hippocampal volumes, the hippocampal asymmetry index, and cognitive functioning were assessed in 120 nondemented adults with long duration type 2 diabetes.

Results: The majority of the sample displayed left greater than right hippocampal asymmetry (which is the reverse of the expected direction seen with normal aging).

The utility of the Diabetes Anxiety Depression Scale in Type 2 diabetes mellitus: The Fremantle Diabetes Study Phase II.

Background: Previous research using latent class analysis (LCA) identified classes of people with type 2 diabetes and specific profiles of depression and anxiety. Since LCA-derived anxious depression strongly predicts cardiovascular outcomes and mortality but cannot be applied to individuals, we developed a validated combined depression-anxiety metric, the Diabetes Anxiety Depression Scale (DADS), for potential clinical application in people with type 2 diabetes.

Methods: 1,337 participants with type 2 diabetes from the observational community-based Fremantle Diabetes Study Phase II completed the Patient Health Questionnaire 9-item version (PHQ-9) to assess symptoms of depression, and the Generalised Anxiety Disorder Scale (GADS) to assess symptoms of anxiety.

The neuroimaging basis of apathy: Empirical findings and conceptual challenges.

Apathy, usually defined as loss of motivation, is common in both neurodegenerative conditions such as Alzheimer's disease, and acute neurological disorders such as stroke. Neuroradiological studies on the imaging correlates of apathy have used a variety of methods such as structural and functional magnetic resonance imaging, diffusion tensor imaging, and single photon and positron emission tomography to assess brain metabolic activity and specific synaptic receptors. Dysfunction of the anterior cingulate cortex (ACC) is the strongest anatomical correlate of apathy in Alzheimer's disease, whereas lesions of the basal ganglia are the most common correlates of apathy in cerebrovascular disorders.

Management of Depression in Parkinson's Disease: A Systematic Review.

Background: Depression is a frequent psychiatric condition in Parkinson's disease (PD). The treatment of depression has been examined in several randomized controlled trials and meta-analyses, but no clear guidelines are available.

Methods: We carried out a systematic review of pharmacological and non-pharmacological treatments for depression in patients with PD using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Neuroimaging and its Relevance to Understanding Pathways Linking Diabetes and Cognitive Dysfunction.

Diabetes mellitus is associated with an elevated risk of cognitive impairment and dementia. Cerebrovascular disease and neurodegeneration are two major pathways that may explain the effect of diabetes on the brain and therefore deserve investigation. Neuroimaging provides an effective way to investigate the contribution of these pathways in vivo, guiding further mechanistic research and providing biomarkers for clinical correlation or interventional studies.

Depression symptoms are persistent in Type 2 diabetes: risk factors and outcomes of 5-year depression trajectories using latent class growth analysis.

Aims: To describe the long-term trajectories of depression symptom severity in people with Type 2 diabetes, and to identify predictors and associates of these trajectories.

Methods: A community-dwelling cohort of 1201 individuals with Type 2 diabetes from the Fremantle Diabetes Study Phase II was followed for 5 years. The nine-item version of the Patient Health Questionnaire was administered annually to assess depression symptoms, and biomedical and psychosocial measures were assessed at baseline and biennially.

The Structured Interview for Insight and Judgment in Dementia: Development and validation of a new instrument to assess awareness in patients with dementia.

Introduction: Poor insight about their cognitive and functional deficits is highly prevalent in patients with Alzheimer's disease (AD); however, there is a lack of reliable, valid instrumentation to measure this construct. The aim of this study was to develop and validate a semistructured interview to assess insight and judgment in patients with AD and to provide information regarding the assessment of competency and risk in this population.

Methods: We validated the Structured Clinical Interview for Insight and Judgment in Dementia (SIJID) in a consecutive series of 124 patients with probable AD.