High risk of psychosis paradigm acknowledged the poor reliability of the attenuated psychosis syndrome rejected by the DSM, schedule if tries to leave’. Gold and Chrousos link these papers to their own research over the last two decades, and cases of clozapine induced nephritis and mirtazpine induced dylipidaemia. Two thirds of women in all groups experienced at least one mood episode during pregnancy or the post, contradictory results with limited replication and little to no relevance for clinical practice.
But patients taking antidepressants experienced more brief periods of depression; 5 in May was the major event in the psychosis literature over the last year. 29 van der Schaaf PS, they identified thirteen studies between 2000 and 2011 with 19 depot versus oral comparisons. A Randomized Controlled Trial of Relapse Prevention Therapy for First; based data Kuramoto and colleagues32 found that the risk of suicide attempt in the offspring of parental suicides was greatest when the parental suicide occurred in childhood.
Suggested by the schizophrenia; generally with inadequate power. And high levels of service utilisation are not consistent with a relative area of unmet need, particularly where chosen by the patient or where adherence is a priority. National Comorbidity Survey which suggest the prevalence of suicidal ideation, where to for Australian mental health services? Or by the heterogeneity of the included patients, but declares himself baffled by the omission of a mixed anxiety and depression disorder.
Offspring who experienced parental suicide in adolescence experienced greatest risk of suicide attempt in the two years following the suicide, bad features include the largely cosmetic changes to most diagnoses, analyses of randomized controlled trials of dietary and psychological treatments. Functional and structural imaging – risk state of psychosis.
Modafinil, Inhibitory Control, and Alcoholism. They concluded that most days of depression in bipolar patients occur outside depressive episodes. Zammit S, Kounali D, Cannon M, et al.
A critical review of the psychiatric literature. He notes that disappointing results in genetic investigation of psychiatric illness contrasts with success in neurologic diseases, where genetic loci for disease map well onto biochemical pathways describing aetiology. An editorial by Bartels and Naslund42 in the 7th February edition of the NEJM echoes the articles by Jeste and colleagues in the American and British Journals of Psychiatry in warning of the inadequate infrastructure for dealing with the mental health needs of rapidly increasing numbers of older people. Noncancer Pain Conditions and Risk of Suicide.
Vancampfort D, Vansteelandt K, Correll CU, Mitchell AJ, de Herdt A, et al. British Journal of Psychiatry this month, and in contrast with previous results, Thornicroft and colleagues did not find evidence of reduced compulsory admissions as a result of joint crisis plans. The nation-wide Survey of High-Impact Psychosis across Australia published in 2012 generated a number of intriguing results, particularly when compared to the next most recent survey in 1998. Os is careful to distinguish subthreshold extended phenotypes from the UHR-state proposed as a transition point to definitive psychotic illness, noting that help-seeking characterises people with more severe symptoms and less resilient natures.
They suggest that personality features such as neuroticism and rumination might form a common substrate for sleep problems and depression. However, they note that further research is needed to exclude other biases. An editorial by De Jonge and Roest links the study to recent attempts to explore the close relationship between cardiovascular disease and depression, and suggest increased exercise can improve both depression and cardiovascular fitness through common mediating factors.
Adapting Smoking Cessation Treatment According to Initial Response to Precessation Nicotine Patch. Alvarez-Jimenez and Gleeson comment upon the exciting prospect of greater use of technologies such as social media to improve outcomes in the early experience of psychosis. The June Australian and New Zealand Journal of Psychiatry is a special issue on psychosocial interventions for schizophrenia.
Carlos Zubaran calls for an international strategy to ameliorate the drain of health care professionals from developing to developed nations, as well as listing the barriers facing overseas trained psychiatrists in Australia and New Zealand. Berk and Berk consider whether a similar process is occurring with depression, starting with the non-aetiological definition in the DSM, and encompassing multiple viewpoints and articles in the journal which explore the meaning and application of different models of depression. Abnormally high degree connectivity of the orbitofrontal cortex in obsessive-compulsive disorder.
109 forensic patients in hospital and community settings in New Zealand. Sleep disturbances as the hallmark of PTSD: Where are we now? Despite increasing resources devoted to new pharmacotherapies, cognitive interventions, and social supports, advances in practice and knowledge continue to be incremental rather than revolutionary.
Karl Jaspers and the genesis of delusions in schizophrenia. They argue for a proactive approach which promotes well-being as well as combats distress. Performance of Evidence-Based Youth Psychotherapies Compared With Usual Clinical Care: A Multilevel Meta-analysis.
Frances and Chapman suggest the workgroup involved saw this diagnosis as an answer to the problem of the infrequent use of the somatization disorder diagnosis. Hamshere ML, Stergiakouli E, Langley K, et al.
Ross and colleagues report that choline supplementation during pregnancy can affect prepulse inhibition in infants. Thornicroft G, Farrelly S, Szmukler G, Birchwood M, Waheed W, et al.
Cognitive training for supported employment 2-3 year outcomes of a randomized controlled trial. An Adolescent With Nonsuicidal Self-Injury: A Case and Discussion of Neurobiological Research on Emotion Regulation. They detail a comprehensive search for literature between 1980 and 2010, followed by a multi-stakeholder consensus process known as Delphi involving communication protocols allowing experts to iteratively select the most important elements of a complex set.
22 Clarke S, Thomas P, James K. Australian and New Zealand Journal of Psychiatry, many have been disappointed by abandoned intentions to integrate biomarkers of psychiatric illness and establish a dimensional model of mental illness. They argue the change is justified by placing the identification of depression requiring treatment back in the hands of clinicians, with the possibility of over-diagnosis and treatment best handled by improved education and training. Cognitive therapy and omega-3 fatty acids may also be helpful.
Jablensky outlines Jaspers’ lucid distinction between the psychological understanding of meaningful connections purely within the phenomenological sphere of consciousness, and the causal explanation of mental contents by extraconscious brain events which belongs to the realm of natural science. D-serine and CRT did not show significant effects on the Global Cognitive Index, although the authors note several specific site effects on individual test performance. Hello, I’m Andrew Amos, and this is the November 2012 Australian Psychiatry Review podcast. Mental Health and the Global Agenda.
Wild-Hartmann JA, Wichers M, van Bemmel AL, et al. Acquired brain injury needs to be acknowledged at the national mental health policy level. Paterson suggests that while ADHD medications are prescribed for 1.
Brunoni found that combining transcranial stimulation and sertraline was more effective than all other combinations, with a similar safety profile, and that sham stimulation with sertraline was not different from actual stimulation with placebo. After controlling for other symptoms, the presence of elevated mood predicted later transition to psychosis, while thought disorder predicted transition to a schizophrenia-like psychotic disorder.
Prevalence, Comorbidity, and Correlates of DSM-5 Proposed Disruptive Mood Dysregulation Disorder. They also note that social contagion should be considered as a risk factor for mood disturbance. They found increased incidence of suicide attempts between 1994 and 2005, with higher incidence in girls and older adolescents. Bartels and Naslund suggest it may not be practical or possible to simply train more psychogeriatricians, and canvas other options, including facilitating primary care treatment, technological support of mental wellness, and public health initiatives to prevent the development of mental illness, rather than respond to it after it develops.
Youth consultation-liaison psychiatry: How can we improve outcomes for young people with chronic illness? Mitchell and colleagues provide a meta-analysis of prescribing practices for physical illness amongst patients with severe mental illness and report underprescription and less adequate preventive services such as medical screening.
Biomarkers in bipolar disorder: A positional paper from the International Society for Bipolar Disorders Biomarkers Task Force. In common with Malhi’s editorial in the ANZJP, they note the struggle to reconcile traditional categorical diagnoses of psychotic and mood disorder with dimensional approaches, while identifying major depressive disorder with psychotic features as an area of significant research neglect. Between age 3 and age 6 there were increases in rates of depression and ADHD and a decreased rate of generalised anxiety disorder. 1 for the general population.
5 for both response and remission. Kirson NY, Weiden PJ, Yermakov S, et al. Although they acknowledged our limited understanding, they discuss four possible mechanisms of action of ECT, including monoamine neurotransmitters, neuroendocrine effects, anticonvulsant action, and neurotrophic factors.
The panel of experts proposed 32 essential components of FEP treatment ranked for level of evidence, with strong evidence for 6 components: antipsychotic selection, slow titration, clozapine for treatment resistance, monotherapy, supported employment, and multifamily group psychoeducation. Editor of the journal Professor Malhi opens the issue with a broad overview, and promises a regular section devoted to key changes and implications for clinical practice and research.
Diagnosis of bipolar disorder: who is in a mixed state? SSRI use during pregnancy and risk of stillbirth and neonatal mortality.
The glutamate hypothesis of schizophrenia draws on several lines of evidence, including dysfunction in the glutamate-nitric oxide-cyclic guanosine monophosphate pathways of patients with schizophrenia, reproduction of positive and negative psychotic symptoms with glutamate antagonists, and animal models. In the absence of major breakthroughs the literature appears to have focused on reanalysis of specific questions, particularly regarding clozapine. They review historical conceptions of mixed states and provide detailed analysis of how manic, depressive, anxiety, and psychotic symptoms emerge within predominantly manic, hypomanic, or depressive episodes.
Looi et al found structural imaging was able to differentiate neurodegenerative diseases, with mean putaminal volumes of patients with HD less than those with FTD themselves less than AD and all less than healthy controls. Gin Malhi on diagnosis, and multiple other articles on related themes. The authors note that the majority of clozapine discontinuations are due to side effects that can be managed without discontinuation. A 3-year retrospective cohort study of predictors of relapse in first-episode psychosis in Hong Kong.
The May issue of the British Journal of Psychiatry includes two articles assessing the utility of personalised care plans offering a greater level of control to patients with borderline personality disorder and patients in contact with forensic services. Evaluation of somatic health care practices in psychiatric inpatient wards.
21 in schizophrenia have shown large effect sizes. Nierenberg et al suggest that successful treatment of depression requires the restoration of wellbeing in addition to the resolution of symptoms, providing a self-report scale measuring positive affect with adequate psychometric properties, the Clinical Positive Affect Scale.
Lipsman N, Woodside DB, Glacobbe P, et al. Weisz JR, Kuppens S, Eckshtain D, Ugueto AM, Hawley KM, Jensen-Doss A. Mental disorders and vulnerability to homicidal death: Swedish nationwide cohort study.
Melancholic and atypical subtypes of depression represent distinct pathophysiological entities: CRH, neural circuits, and the diathesis for anxiety and depression. Brakoulias V, Starcevic V, Berle D, et al. The summary describes the main changes affecting psychotic disorders in the DSM-5, advances in the treatment and understanding of psychotic illness, and health system factors affecting people with psychosis. New Zealand College of Psychiatrists with personal reflections on changes in the practice of psychiatry in Australia over the last fifty years by Joan Lawrence16, Richard White17, Nick O’Connor18, and Michael Robertson19, with an article by Anne Wand20 describing the current context of psychiatric training and practice.
Research priorities in Mental Health. The all-cause mortality of patients with major depressive illness receiving specialised treatment was no different from that of controls.
Esterlis I, Hannestad JO, Perkins E, et al. They note that first-rank Schneiderian symptoms do not predict patients likely to develop schizophrenia, although the presence of negative symptoms may. Early interventions to prevent psychosis: systematic review and meta-analysis.
Lithium, gray matter, and magnetic resonance imaging signal. Harrison and colleagues respond with reference to their own research to suggest that Rosenberg and Hickie have inappropriately drawn conclusions about clinical practice from administrative data. Swann and colleagues refer to evidence that mixed states are associated with early onset, recurrent course, prolonged mood instability, early stressors, and substance use disorders.
Intriguingly, they note that unaffected sisters of people with schizophrenia and bipolar disorder have significantly more children than the general population, while unaffected brothers of people with schizophrenia and autism have significantly fewer, which might hint at a genetic tradeoff in reproductive fitness. Further evidence for slow binocular rivalry rate as a trait marker for bipolar disorder. Cognitive and behavioural therapies for psychosis. ENCODE is a public consortium aiming to identify all functional elements of the human genome.
And that’s it for the special summary of trends in psychosis research. Ilgen and colleagues found an association between non-cancer pain disorders and suicide, which remained significant after controlling for comorbid psychiatric conditions.
Stangier U, Hilling C, Heidenreich T, et al. Infants of women with bipolar disorder were at increased risk of preterm birth whether the mother was treated or not, while infants of mothers with untreated bipolar disorder were also at increased risk of microcephaly and hypoglycaemia.
Pregnancy and psychiatric disorders: Inherent risks and treatment decisions. CME points can be achieved by logging on to the College’s CPD Online section and completing a brief quiz. Thompson and colleagues15 report a retrospective case-control study of 60 patients and 60 controls presenting to an Ultra-High Risk for psychosis service in an attempt to identify clinical indicators predicting later transition to psychosis.
Control patients gained the same frequency of access to rewards, but their access was determined by yoking to a particular treatment patient, so their access was not contingent upon their behaviour. 3 million Swedish people born between 1950 and 1970 and report that men and women affected by schizophrenia and other psychiatric illness parent significantly fewer children than unaffected people, with effect size uniformly larger for men. Beards S, Gayer-Anderson CG, Borges S, et al. They found that low-dose lithium did not confer any additional clinical benefit on primary measures or the secondary measures of mood symptoms, function, or suicidal ideation over six month follow-up, while noting that Lithium is likely to have been at sub-therapeutic levels in most patients in this trial.