The Journal of Clinical Psychiatry最新文献

{"title":"The Relationship Between Major Depressive Disorder and Multiple Medical Conditions: A Call to Improve Integrated Care Services.","authors":"Rachel A Weir, Mark Hyman Rapaport","doi":"10.4088/JCP.22com14600","DOIUrl":"https://doi.org/10.4088/JCP.22com14600","url":null,"abstract":"","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40574838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability of Second-Line Antidepressant Medications Using Filled Prescription Sequences in a Nationwide Cohort Study.","authors":"Charles Ouazana-Vedrines,&nbsp;Thomas Lesuffleur,&nbsp;Pierre Denis,&nbsp;Nicolas Hoertel,&nbsp;Romain Olekhnovitch,&nbsp;Mark Olfson,&nbsp;Carlos Blanco,&nbsp;Frédéric Limosin,&nbsp;Antoine Rachas,&nbsp;Philippe Tuppin,&nbsp;Cédric Lemogne","doi":"10.4088/JCP.21m14248","DOIUrl":"https://doi.org/10.4088/JCP.21m14248","url":null,"abstract":"<p><p><b><i>Background:</i></b> Although about half of patients do not respond to a first-line antidepressant medication, there is no consensus on the best second-line option. The aim of this nationwide population-based study was to rank antidepressants according to their relative acceptability (ie, efficacy and tolerability) using filled prescription sequences after failure of first treatment.</p><p><p><b><i>Methods:</i></b> About 1.2 million people were identified as new antidepressant users in the French national health data system in 2011. The inclusion criterion was having at least 2 filled prescriptions of a second-line treatment after a filled prescription of a first-line treatment, resulting in 63,726 participants. The outcome was clinical acceptability as measured by the continuation/change ratio for second-line treatment. Continuation sequence was defined as at least 2 refills of the same treatment. Change sequence was defined as at least 1 filled prescription of another antidepressant. Adjusted odds ratios (aORs) were computed through multivariable binary logistic regressions.</p><p><p><b><i>Results:</i></b> Intraclass switch had a better acceptability than interclass switch (aOR [95% CI]: 1.23 [1.20-1.28]). According to the first-line treatment, intraclass switch remained more acceptable for selective serotonin reuptake inhibitors only (1.37 [1.31-1.42]). For α₂ blockers and tricyclic agents, combination antidepressant therapy was the most acceptable second-line option (1.59 [1.27-2.01] and 2.53 [1.53-4.04], respectively), whereas for serotonin-norepinephrine reuptake inhibitors there was no significant difference between the strategies. For other antidepressants, intraclass switch had lower acceptability than interclass switch (0.70 [0.51-0.95]).</p><p><p><b><i>Conclusions:</i></b> Administrative claim databases may help with ranking acceptability of second-line treatments in real world settings and complement randomized controlled trials in informing clinicians about the most acceptable second-line options according to the first-line treatment.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40574841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lost in Translation: The Value of Psychiatric Clinical Trials.","authors":"John C Markowitz,&nbsp;Barbara L Milrod","doi":"10.4088/JCP.22com14647","DOIUrl":"https://doi.org/10.4088/JCP.22com14647","url":null,"abstract":"","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40574842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living in a Pharmacologically Imperfect World.","authors":"Joseph F Goldberg","doi":"10.4088/JCP.22ed14665","DOIUrl":"https://doi.org/10.4088/JCP.22ed14665","url":null,"abstract":"","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33540933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the Problem of Prescription of Valproate to Women of Childbearing Age: Reply to Tastenhoye et al.","authors":"Chittaranjan Andrade","doi":"10.4088/JCP.22lr14566a","DOIUrl":"https://doi.org/10.4088/JCP.22lr14566a","url":null,"abstract":"","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33540935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing Guideline for Valproic Acid and Women of Reproductive Potential: Forget It Exists.","authors":"Marlene P Freeman","doi":"10.4088/JCP.22ed14609","DOIUrl":"https://doi.org/10.4088/JCP.22ed14609","url":null,"abstract":"","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33540936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Economic Burden of Schizophrenia in the United States.","authors":"Aditi Kadakia,&nbsp;Maryaline Catillon,&nbsp;Qi Fan,&nbsp;G Rhys Williams,&nbsp;Jessica R Marden,&nbsp;Annika Anderson,&nbsp;Noam Kirson,&nbsp;Carole Dembek","doi":"10.4088/JCP.22m14458","DOIUrl":"https://doi.org/10.4088/JCP.22m14458","url":null,"abstract":"<p><p><b><i>Aim:</i></b> The economic burden of schizophrenia in the United States (US) was estimated at $155.7 billion in 2013. Since 2013, the US experienced significant health care reforms and treatment advances. This study analyzed recent data and literature to update the US economic burden estimate for schizophrenia.</p><p><p><b><i>Methods:</i></b> Direct and indirect costs associated with schizophrenia were estimated using a prevalence-based approach. Direct health care costs were assessed retrospectively using an exact matched cohort design in the IBM Watson Health MarketScan databases from October 1, 2015, through December 31, 2019. Patients with schizophrenia (identified using <i>ICD-10-CM</i> codes F20 and F25) were exactly matched to controls on demographics, insurance type, and index year. Direct non-health care costs were estimated using published literature and government data. Indirect costs were estimated using a human capital approach and the value of quality-adjusted life-years lost. Cost offsets were estimated to account for basic living costs avoided. Excess costs, comparing costs for individuals with and without schizophrenia, were reported in 2019 USD.</p><p><p><b><i>Results:</i></b> The estimated excess economic burden of schizophrenia in the US in 2019 was $343.2 billion, including $251.9 billion in indirect costs (73.4%), $62.3 billion in direct health care costs (18.2%), and $35.0 billion in direct non-health care costs (10.2%). The largest drivers of indirect costs were caregiving ($112.3 billion), premature mortality ($77.9 billion), and unemployment ($54.2 billion). Cost offsets, representing $6.0 billion (1.7%), were subtracted from direct non-health care costs.</p><p><p><b><i>Conclusions:</i></b> The estimated burden of schizophrenia in the US doubled between 2013 and 2019 and was $343.2 billion in 2019, highlighting the importance of effective strategies and treatment options to improve the management of this difficult-to-treat patient population.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33512500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antidepressant Discontinuation Syndrome Resulting in a Suicide Attempt: A Case Report.","authors":"Nicholas Waldvogel,&nbsp;Alan Akira","doi":"10.4088/JCP.22cr14562","DOIUrl":"https://doi.org/10.4088/JCP.22cr14562","url":null,"abstract":"","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33512499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frontothalamic Circuit Abnormalities in Patients With Bipolar Depression and Suicide Attempts.","authors":"Li Zhang,&nbsp;Zhiyong Li,&nbsp;Yu Wu,&nbsp;Yue Yu,&nbsp;Gong-Jun Ji,&nbsp;Yanghua Tian,&nbsp;Kai Wang","doi":"10.4088/JCP.21m14185","DOIUrl":"https://doi.org/10.4088/JCP.21m14185","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Suicide is the leading cause of premature death among patients with bipolar disorder (BD), so it is imperative to identify biological or psychometric markers for suicide risk. Previous functional neuroimaging studies of the general BD population have focused on abnormalities within cortical-subcortical circuits. The aim of the current study was to examine potential cortico-subcortical circuit abnormalities predictive of suicide attempt in patients with BD.</p><p><p><b><i>Methods:</i></b> We examined functional connectivity (FC) based on 5 regions of interest: bilateral anterior cingulate cortex (ACC), medial frontal cortex, inferior frontal cortex, amygdala, and thalamus, by resting-state functional magnetic resonance imaging (rs-fMRI) in 65 participants, including patients with BD and suicide attempts (SA group; n = 24), patients with BD and no suicide attempts (NSA group; n = 15), and healthy control subjects (HC group; n = 26). Patients met <i>DSM-5</i> criteria for bipolar I disorder with current major depressive episode.</p><p><p><b><i>Results:</i></b> The total patient group (SA+NSA) exhibited significantly lower FC between bilateral thalamus and frontal cortex (<i>F</i> = 35.11, <i>P</i> < .01), and this deficit was most severe in the SA group. In addition, patients demonstrated significantly reduced FC values between bilateral inferior frontal gyrus and both inferior temporal gyrus (<i>F</i> = 20.68, <i>P</i> < .01) and fusiform gyrus (<i>F</i> = 20.98, <i>P</i> < .01), but FC was stronger in the SA group than the NSA group. Both patient groups also exhibited reduced FC based on these seeds including bilateral amygdala, medial frontal cortex, and ACC, but without significant differences between the SA and NSA groups.</p><p><p><b><i>Conclusions:</i></b> The results suggest that reduced FC within specific frontothalamic circuits may increase the vulnerability for suicidal behavior in patients with BD. These FC abnormalities might provide potential predictors of suicide attempt in BD.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33505550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Fear Learning, Extinction Learning, and Reversal Learning in Obsessive-Compulsive Disorder: Implications for Treatment.","authors":"Elizabeth R Steuber,&nbsp;Joseph F McGuire","doi":"10.4088/JCP.21r14432","DOIUrl":"https://doi.org/10.4088/JCP.21r14432","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Given the implications in the etiology and treatment of obsessive-compulsive disorder (OCD), this systematic review examined fear acquisition, extinction learning, and reversal learning processes in individuals with OCD.</p><p><p><b><i>Data Sources:</i></b> In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed (1946-October 26, 2021), PsycInfo, and Embase were searched for empirical studies utilizing classical or reversal learning paradigms to compare learning and extinction processes in individuals with and without OCD.</p><p><p><b><i>Study Selection:</i></b> A total of 15,603 articles (7,761 from PubMed, 1,128 from PsycInfo, 6,711 from Embase, 3 from citation review) were identified. Articles were screened for duplicates and inclusion/exclusion criteria. Eleven studies met all inclusion/exclusion criteria.</p><p><p><b><i>Results:</i></b> Across studies, minimal evidence of abnormal fear learning was found. However, developmental differences emerged for extinction learning. Youth with OCD displayed impaired extinction learning and safety signal discrimination. Meanwhile, adults largely showed deficits in extinction recall. Conflicting findings emerged regarding impairments in reversal learning. Across learning processes, neuroimaging data implicated the importance of the ventromedial prefrontal cortex (vmPFC).</p><p><p><b><i>Conclusions:</i></b> The physiological and neuroimaging data suggest that extinction learning impairment varies across development. Notably, key associative learning processes remain largely unexamined. Findings underlying abnormalities in extinction learning suggest the potential of novel therapeutic approaches, such as neuromodulation and psychotherapy augmentation strategies (ie, attention bias modification training), to precisely target and resolve identified deficits.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33505551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}