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.
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.
Importance A proportion of patients experience long-lasting symptoms following mild traumatic brain injury (MTBI). The postconcussion syndrome (PCS), included in the DSM-IV , has been proposed to describe this condition. Because these symptoms are subjective and common to other conditions, there is controversy whether PCS deserves to be identified as a diagnostic syndrome
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.
Abstract: Objective: Bodily distress syndrome (BDS) was recently introduced as an empirically based, unifying diagnosis for so-called medically unexplained symptoms and syndromes. BDS relies on a specific symptom pattern rather than on a lack of objective findings, which may increase the risk of overlooking physical disease. We investigated whether physical disease was missed in the first patients diagnosed with BDS.Method: The study was a register-based follow-up study of 120 patients diagnosed with BDS at a University Clinic from 2005 to 2007.
Importance No medication has been established as an efficacious treatment for cocaine dependence. We hypothesized that dual modulation of the mesocorticolimbic dopamine system by topiramate—a glutamate receptor antagonist and ?-aminobutyric acid receptor agonist—would result in efficacious treatment for cocaine dependence compared with placebo. Objective To determine the efficacy of topiramate vs placebo as a treatment for cocaine dependence.
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.
Neuroscientist Robert Ferrante stands accused of poisoning his neurologist wife, Autumn Klein, both from the University of Pittsburgh. Medscape Medical News
Director’s Blog In a visit to a mental asylum in 1912 you would have seen many patients with “general paresis.” The word “paresis” is Latin for weakness. General paresis was a form of psychosis with delusions, hallucinations, and memory problems often of rapid onset and thought to be due to a general constitutional weakness. At least that was the explanation until 1913, when general paresis was shown to be caused by syphilitic infection of the brain
Director’s Blog In recent months, there has been a growing global interest in brain science. The President called attention to the effort to map the human brain in his State of the Union address, the European Union recently announced its largest scientific award (1 billion euros) for the Human Brain Project , and private foundations such as the Allen Brain Institute and the Kavli Foundation have announced new bold efforts to map the brain. 1 At the same time, there has been an unprecedented national conversation about what role mental illness plays in gun violence