Abstract: Objective: Primary care screening programs for mental health disorders are designed to detect patients who might benefit from treatment. As such, the utility of these programs is predicated on the actions that take place in response to a positive screen.
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Abstract: A 19-year-old woman with a medical history of depressive mood arrived and was treated with lamotrigine at 25 mg/day. On day 10, a high fever of 39.3°C and a diffuse, erythematous, pruritic full-body rash involving the palms of her hands and the soles of her feet developed, and she was diagnosed with Stevens-Johnson syndrome (SJS). On day 17, white blood cell count (WBC) result was 1,240/μl with 54.1% neutrophils (670/μl), and the WBC decreased to 840/μl with 60.7% neutrophils (510/μl) on day 18.
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Abstract: Objective: Previous epidemiologic studies have documented a link between anxiety disorders and ulcer among adults. Few studies have examined these associations over time and little is understood about the pathways underlying these relationships.Method: Data were drawn from n=2101 adult participants in the Midlife Development in the United States I and II. Data on ulcer diagnoses were collected through self-report: among participants in the current sample, 38 reported ulcer at Waves 1 and 2 (prevalent ulcer), and 18 reported ulcer at Wave 2 but not at Wave 1 (incident ulcer)
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Abstract: Background: The psychopathological and clinical characteristics of adult patients with epilepsy attending our neurology clinic was evaluated to determine prevalence of psychopathology and its associated factors towards improving services and initiating collaborative care which is currently non-existent.Methods: The study was a 2 stage procedure conducted over one year using the General Health Questionnaire (GHQ-12) in the first stage and Schedule for Clinical Assessment in Neuropsychiatry (SCAN) in the second stage. Diagnosis of psychiatric disorders was based on ICD-10 criteria.Results: Sixty-three patients were interviewed. Mean age was 34.43±13.7 years; more than half of the patients had less than one seizure episode per month
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Abstract: Objective: The present study aimed to extract discriminating indicators for diagnosis of autism spectrum disorder (ASD) from personal backgrounds and past history among depressed adult outpatients.Methods: Subjects were 430 depressed adults, consisting of patients with ASD (n=70) and those without ASD (n=360). Group comparison and discriminant analysis was conducted with regard to backgrounds (age, gender, education, marriage, living alone, physical diseases and family history of mood disorders) and past history (school non-attendance, bullied experience, psychotic-like experiences, conduct problems, suicide-related behaviors and interpersonal friction).Results: Six discriminating indicators (interpersonal friction, bullied experience, psychotic-like experiences, age under 32 years, school non-attendance and university educational level) were identified by stepwise discriminant analysis (P
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Abstract: Objective: To test the feasibility and efficacy of a psychosocial intervention to address high-risk substance use in patients scheduled for elective surgery.Method: A group-format intervention, based in motivational interviewing principles, was provided prior to elective surgery to 107 participants with at-risk substance use, identified using the AUDIT-C and self-report of illicit drug use. Patient satisfaction was assessed with an anonymous survey. Within-subject comparisons of substance use at baseline and at a postoperative follow-up evaluation were conducted
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Abstract: Objective: Cardiovascular side effects of lithium have been reported to occur mainly at higher-than-therapeutic serum levels. We aimed to investigate the impact of the long-term lithium use on electrocardiogram (ECG) parameters in association with the serum levels in patients with bipolar disorder (BD) and in healthy controls (HCs) serving as the reference group.Methods: The study sample consisted of 53 euthymic BD type I patients on lithium monotherapy at therapeutic serum levels (M=0.76, S.D.=0.14, range=0.41–1.09 mmol/l) for at least 12 months and 45 HCs.
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Abstract: Objective: To understand collaborative care psychiatric consultants’ views and practices on making the diagnosis of and recommending treatment for bipolar disorder in primary care using collaborative care.Method: We conducted a focus group at the University of Washington in December 2013 with nine psychiatric consultants working in primary care-based collaborative care in Washington State. A grounded theory approach with open coding and the constant comparative method revealed categories where emergent themes were saturated and validated through member checking, and a conceptual model was developed.Results: Three major themes emerged from the data including the importance of working as a collaborative care team, the strengths of collaborative care for treating bipolar disorder, and the need for psychiatric consultants to adapt specialty psychiatric clinical skills to the primary care setting. Other discussion topics included gathering clinical data from multiple sources over time, balancing risks and benefits of treating patients indirectly, tracking patient care outcomes with a registry, and effective care.Conclusion: Experienced psychiatric consultants working in collaborative care teams provided their perceptions regarding treating patients with bipolar illness including identifying ways to adapt specialty psychiatric skills, developing techniques for providing team-based care, and perceiving the care delivered through collaborative care as high quality.
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Ten to 15% of the population use benzodiazepines in any given year, and 2% use benzodiazepines chronically. However, benzodiazepine use disorder is more prevalent in individuals who abuse other substances .
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Abstract: Objective: The aims of this study were 1) to assess the long-term effects of a collaborative care intervention for patients with depression on process of care outcomes, and 2) to describe whether case management was continued after the end of the original one-year intervention.Methods: This 24-month follow-up of a randomized controlled trial took place 12months after the end of the 1-year intervention. Data collection occurred by means of self-rating questionnaires and from medical records.
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Abstract: Objective: Pain and depression are prevalent and treatable symptoms among patients with cancer yet they are often undetected and undertreated. The Indiana Cancer Pain and Depression (INCPAD) trial demonstrated that telecare management can improve pain and depression outcomes.
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Abstract: Objective: To estimate 1-year mortality risk associated with preoperative serious mental illness (SMI) as defined by the Veterans Health Administration (schizophrenia, bipolar disorder, posttraumatic stress disorder [PTSD], major depression) following nonambulatory cardiac or vascular surgical procedures compared to patients without SMI. Cardiac/vascular operations were selected because patients with SMI are known to be at elevated risk of cardiovascular disease.Method: Retrospective analysis of system-wide data from electronic medical records of patients undergoing nonambulatory surgery (inpatient or day-of-surgery admission) October 2005–September 2009 with 1-year follow-up (N=55,864; 99% male;
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A small number of older studies have demonstrated efficacy for a few antidepressants in cancer care – namely mianserin, fluoxetine and paroxetine – but we lack an evidence base for most of the currently used antidepressants. In their systematic review and meta-analysis in this issue of the role of antidepressants in the treatment of cancer-related depression, Riblet, Larson, Watts and Holtzheimer call for high quality randomized clinical trials that properly examine the efficacy, tolerability and safety of modern day antidepressants .
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Abstract: Objective: NICE recommends the use of structured tools to improve holistic care for patients with cancer. The Distress Thermometer and Problem Checklist (DT) is commonly used for screening in physical health settings. However, it has not been integrated into the clinical pathway within specialist psycho-oncology services
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Abstract: A series of case reports and neuroimaging research points to the underlying neuropathological substrate for obsessive–compulsive disorder (OCD) and the underlying associations between OCD and areas of the frontal lobe. We report a patient wherein the onset of OCD occurred after resection of meningioma of the right frontal lobe and who was treated successfully with paroxetine hydrochloride. We suggest that the onset of secondary (organic) OCD is associated with the frontal lobe, and we propose that the origin of obsessions is located in the right frontal lobe.
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Abstract: Objective: Eating disorder (ED) symptoms have gone mostly unexamined among veterans. The current study assessed rates of bulimia nervosa (BN) and binge eating disorder (BED) symptoms and diagnoses and their associations with common comorbidities among male and female veterans.Method: Participants were US military veterans who screened positive for trauma histories and/or a probable Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) posttraumatic stress disorder (PTSD) diagnosis (n=499). Symptoms of PTSD were assessed using the Clinician-Administered PTSD Scale, and symptoms of EDs, mood, and substance use disorders were assessed using the Structured Clinical Interview for the DSM-IV.Results: Lifetime rates of BN and BED diagnoses were comparable to civilian populations, and a considerable range of lifetime and current BN and BED symptoms were identified
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Abstract: Objective: Depression is one of the most common mental illnesses. The reliability and the validity of the Patient Health Questionnaire (PHQ)-9, a depression screening tool, have not been examined in the general population in China.
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Abstract: Objectives: To examine the epidemiology of and possible risk factors for skin diseases in patients with schizophrenia.Methods: All of 337 patients with schizophrenia were recruited from the therapeutic community of a psychiatric hospital and underwent a detailed skin examination. The National Health Insurance Research Database (NHIRD) was used to compare the prevalence of skin diseases between patients with schizophrenia and those without.Results: In the clinical survey, fungal infection (61.4%) and dermatitis (46.9%) were the most common skin diseases.
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Abstract: Objective: To report a case of cycloserine-induced acute psychosis in a young female while on second line antitubercular treatment (ATT) for tubercular meningitis.Method: Case report.Results: A 20-year-old female, known case of tubercular meningitis on ATT since 8 months, presented with a 10-days history of headache, vomiting, and photophobia. A provisional diagnosis of drug-resistant tuberculosis was made, and second-line ATT including cycloserine (750 mg/day) and levofloxacin (750 mg/day) was added.
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Abstract: Objective: The aim of this study was to quantify the effects of psychiatric disorders on major surgery outcomes and care resource use.Methods: This study adopted a retrospective cohort study design. The samples consisted of hospital stays.
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Abstract: Objective: Project TEACH provides training, consultation and referral support to build child and adolescent mental health (MH) expertise among primary care providers (PCPs) . This study describes how TEACH engages PCP, how program components lead to changes in practice, and how contextual factors influence sustainability.Method: 30 PCPs randomly selected from 139 trained PCPs and 10 PCPs from 143 registered with TEACH but not yet trained completed semi-structured interviews.
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Abstract: Objective: To determine the 12-month cost-effectiveness of a collaborative care (CC) program for treating depression following coronary artery bypass graft (CABG) surgery versus physicians’ usual care (UC).Methods: We obtained 12 continuous months of Medicare and private medical insurance claims data on 189 patients who screened positive for depression following CABG surgery, met criteria for depression when reassessed by telephone two-weeks following hospitalization (9-item Patient Health Questionnaire ≥10), and were randomized to either an 8-month centralized, nurse-provided, and telephone-delivered collaborative care (CC) intervention for depression or to their physicians’ usual care (UC).Results: At 12-months following randomization, CC patients had $2,068 lower but statistically similar estimated median costs compared to UC (P=0.30) and a variety of sensitivity analyses produced no significant changes. The incremental cost effectiveness ratio of CC was -$9,889 (-$11,940 to -$7,838) per additional quality-adjusted life-year (QALY), and there was 90% probability it would be cost-effective at the willingness to pay threshold of $20,000 per additional QALY.
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Abstract: Objective: Prior reviews evaluating the role of antidepressants in cancer-related depression have drawn conflicting conclusions. These reviews have also not explored differences in efficacy and tolerability between antidepressants. We conducted a meta-analysis to address these limitations.Method: We searched Medline (1948–2013), the Cochrane Library (1800–2013), CINAHL (1986–2013), ClinicalTrials.gov (2013) and meeting abstracts
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Abstract: Objective: Depression is a highly prevalent disorder that is associated with disability. The aim of this study was to determine the relationship between depression and hyperlipidemia, and whether the onset of depression is associated with administering statins to patients with hyperlipidemia.Material and Methods: The data analyzed in this study were retrieved from the National Health Insurance Research Database (NHIRD) in Taiwan.
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The menopausal transition is a period of profound bodily and psychological changes. Although precise epidemiological data are scarce, the prevalence of panic disorder in perimenopausal women is estimated at around 10% [1]. Estrogen replacement therapy may offer relief from the physical symptoms of menopause
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