Importance The structural abnormalities in the brain that accurately differentiate unipolar depression (UD) and bipolar depression (BD) remain unidentified. Objectives First, to investigate and compare morphometric changes in UD and BD, and to replicate the findings at 2 independent neuroimaging sites; second, to differentiate UD and BD using multivariate pattern classification techniques.
Neurobiological research in psychiatry has increasingly placed emphasis on understanding how neural systems go awry in psychiatric disorders. Toward this end, advanced imaging methods go beyond the study of isolated brain areas, probing the connections within neural networks. Diffusion imaging (DI) assesses white matter (WM) microstructure, informing us about the physical state of these connections (the wiring within a system)
For pediatricians and parents, one of the most important tools is decidedly low tech. The growth chart, a simple graph of the trajectory of the normal range of height, weight, and head circumference across age, is a vital tool for detecting problems in development. Even when a child is in the normal range, identifying a change from the 80 th percentile at age 6 to the 20 th percentile at age 8 can indicate a problem.
In this issue of JAMA Psychiatry , Gur et al evaluated differences in age-related neurocognitive test performance and psychosis symptoms in the context of a large population-based cohort. The rationale for this study grew out of observations that psychotic symptoms are relatively common in the general population and that individuals who have had a recent emergence of psychoticlike symptoms, but of subpsychotic intensity, are at increased risk for progressing to full psychosis within a few years of ascertainment. Given that such prodromal cases show neurocognitive deficits similar to those observed in first-episode schizophrenia, the Gur et al study sought to extend evidence of this link to participants with psychotic symptoms as ascertained through primary care, independently of seeking treatment for psychiatric indications.
In a recently published paper in General Hospital Psychiatry , we described the association between a diagnosis of a serious mental illness and a chronic pain condition. In a national sample of all patients who utilized services from the Veterans Health Administration within a given year, those individuals with schizophrenia and bipolar disorder were significantly more likely to have a chart diagnosis of chronic pain compared to those without these psychiatric diagnoses. We concluded that this line of research has important implications for understanding how chronic pain might impact mental health recovery.
The current issue of JAMA Psychiatry includes an important article on premature mortality among patients with traumatic brain injury (TBI) in Sweden between 1969 and 2009. According to the study by Fazel et al, among 218?300 patients with a TBI compared with age- and sex-matched controls without brain injury (10 to 1 match, n?=?2?163?190) and unaffected siblings of TBI patients (n?=?150?513), there was a 3-fold increased odds of all-cause mortality, adjusted for sociodemographic confounders (adjusted odds ratio [aOR],?3.2; 95% CI, 3.0-3.4), among patients who survived at least 6 months after TBI compared with general population controls or unaffected siblings (aOR, 2.6; 95% CI, 2.3-2.8).
In this issue of General Hospital Psychiatry, we continue with a new dimension that we have added to the journal ? point and counterpoint editorials on two topics: (1) prescription of marijuana for chronic benign pain, and (2) should a psychiatric consultation be required for all patients requesting physician assisted suicide? There are many controversial areas of clinical practice, and having experts with opposing views on the subject describe their perspectives in a scholarly way can enhance understanding of differing viewpoints.
Importance Alterations in glutamatergic neurotransmission have been postulated to be a key pathophysiologic mechanism in schizophrenia. Objective To evaluate hippocampal volumetric measures and neurometabolites in unmedicated patients with schizophrenia and the correlations between these markers.
A look at the safety, efficacy, and potential therapeutic role of the newly approved antidepressant levomilnacipran. Medscape Psychiatry
The FDA has approved a new SNRI for major depressive disorder in adults. FDA Approvals