Stigma Toward Bipolar Disorder Among Psychiatry Residents: A Pilot Study Utilizing Narrative Medicine and a Video Vignette.

Objective: Stigma toward mental illness has been extensively described among health care professionals and has important implications with respect to quality of care. Narrative medicine has the potential to bring about positive impacts on the practitioner-patient relationship and on patient outcomes. The authors carried out a pilot study investigating the impact of narrative medicine on residents' stigma toward bipolar disorder.

Amphetamine Use in the Elderly: A Systematic Review of the Literature.

Objective: To systematically review the literature on the therapeutic use of amphetamine, lisdexamfetamine and methylphenidate in elderly population with and without dementia.

Methods: We conducted two researches on the PubMed, Scopus and Embase using the keywords ("elderly") AND ("amphetamine" OR "methylphenidate" OR "lisdexamfetamine") and then ("Alzheimer" OR "dementia") AND ("amphetamine" OR "methylphenidate" OR "lisdexamfetamine").

Results: Twenty-nine papers met all the eligibility criteria.

Moving pharmacoepigenetics tools for depression toward clinical use.

Background: Major depressive disorder (MDD) is a leading cause of disability worldwide, and over half of patients do not achieve symptom remission following an initial antidepressant course. Despite evidence implicating a strong genetic basis for the pathophysiology of MDD, there are no adequately validated biomarkers of treatment response routinely used in clinical practice. Pharmacoepigenetics is an emerging field that has the potential to combine both genetic and environmental information into treatment selection and further the goal of precision psychiatry.

Association of Selective Serotonin Reuptake Inhibitors and Bone Mineral Density in Elderly Women.

Depression and osteoporosis are 2 common comorbidities in geriatric patients. There are concerns about the deleterious effects of selective serotonin reuptake inhibitor (SSRI) antidepressant use on bone mineral density (BMD). We examined the association between SSRI use and BMD in elderly women (≥65 yr) referred to a geriatric osteoporosis clinic for bone health evaluation.

Role of Botulinum Toxin in Depression.

Objective: The goal of this review was to consolidate the evidence concerning the efficacy of botulinum toxin type A (onabotulinumtoxinA) in depression.

Methods: We searched MEDLINE, EMBASE, Cochrane, and Scopus through May 5, 2014, for studies evaluating the efficacy of botulinum toxin A in depression. Only randomized controlled trials were included in the meta-analysis.

Mortality associated with anxiolytic and hypnotic drugs-A systematic review and meta-analysis.

Background: Use of hypnotics or anxiolytic drugs is common and various studies have reported increased mortality with hypnotics or anxiolytic use.

Objective: To consolidate the evidence on mortality risk associated with hypnotics or anxiolytic use

Methods: Major databases were searched through April 2014 for studies reporting mortality risk associated with hypnotics or anxiolytics use. A pooled hazard ratio with 95% confidence interval was estimated using random-effects model.

Evaluating the effects of cognitive support on psychiatric clinical comprehension.

Objective: Clinicians' attention is a precious resource, which in the current healthcare practice is consumed by the cognitive demands arising from complex patient conditions, information overload, time pressure, and the need to aggregate and synthesize information from disparate sources. The ability to organize information in ways that facilitate the generation of effective diagnostic solutions is a distinguishing characteristic of expert physicians, suggesting that automated systems that organize clinical information in a similar manner may augment physicians' decision-making capabilities. In this paper, we describe the design and evaluation of a theoretically driven cognitive support system (CSS) that assists psychiatrists in their interpretation of clinical cases.

Effects of escitalopram on attentional bias to cocaine-related stimuli and inhibitory control in cocaine-dependent subjects.

Key characteristics of cocaine dependence include attentional bias to cocaine cues and impaired inhibitory control. Studies suggest that serotonin modulates both cocaine cue reactivity and inhibitory control. We investigated effects of the selective serotonin reuptake inhibitor escitalopram on cocaine cue reactivity and inhibitory processes in cocaine-dependent subjects.

Risperidone and lorazepam concomitant use in clonazepam refractory catatonia: a case report.

The DSM-IV recognizes catatonia as a subtype of schizophrenia characterized by at least two of the following: motor immobility, excessive motor activity not influenced by external stimuli, and peculiarities of voluntary movement. Catatonia may also occur secondary to mania, depression, or a general medical condition including encephalitis, focal neurological lesions, metabolic disturbances, and drug intoxications and withdrawals. Benzodiazepines remain the first line of treatment; up to 80% of patients respond promptly to Lorazepam challenge; failure to respond to lorazepam may be followed by electroconvulsive therapy.

A placebo-controlled, random-assignment, parallel-group pilot study of adjunctive topiramate for patients with schizoaffective disorder, bipolar type.

Objectives: This pilot study evaluated the efficacy and safety of adjunctive topiramate compared with placebo in the treatment of patients with a diagnosis of schizoaffective disorder, bipolar type (SAD-BT).

Methods: A sample of 48 adult patients with a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) diagnosis of SAD-BT (supported by the Structured Clinical Interview for DSM-IV Axis I Disorder, Patient Edition) were randomly assigned in a 2:1 ratio (favoring topiramate) to 8 weeks of double-blind treatment with topiramate (100-400 mg/day) or placebo. Patients who had achieved a > or =20% decrease from baseline in their Positive and Negative Syndrome Scale (PANSS) total scores were given the opportunity to continue for an additional 8 weeks of double-blind treatment.

Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis.

Context: A history of depression may increase risk for developing Alzheimer disease (AD) later in life. Clarifying this relation might improve understanding of risk factors for and disease mechanisms in AD.

Objective: To systematically review and complete a meta-analysis on the relation of depression and AD.

The prevalence of the metabolic syndrome in patients with schizoaffective disorder--bipolar subtype.

Objectives: To evaluate the point prevalence of the metabolic syndrome in patients with schizoaffective disorder--bipolar type.

Methods: Consenting patients who were participants in an ongoing clinical trial of adjunctive topiramate treatment for schizoaffective disorder, bipolar type were evaluated at baseline for the point prevalence of the metabolic syndrome. The criteria for the metabolic syndrome included: (a) waist circumference > 102 cm (40 inches) in males, or > 88 cm (35 inches) in females; (b) fasting serum triglyceride levels > or = 150 mg/dL; (c) fasting high density lipoproteins (HDL) cholesterol <40 mg/dL in men or <50 mg/dL in women; (d) blood pressure > or = 130/85 mmHg; and (e) fasting glucose > or = 110 mg/dL.

A post hoc analysis of the impact on hostility and agitation of quetiapine and haloperidol among patients with schizophrenia.

Background: Quetiapine, a drug with a broad pharmacologic profile (similar to that of clozapine), may show benefits for agitation in patients with psychoses. Also, quetiapine may be superior to placebo and either equal or superior to haloperidol in treating this symptom. Available data for other second-generation antipsychotic agents show that quetiapine may have better efficacy in improving agitation compared with haloperidol.