Интересные новости для специалистов.

[Aminazinka]

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11 May 2006

Light therapy and fluoxetine appear to have comparable efficacy for the treatment of seasonal affective disorder, research shows.

The only significant differences were an earlier response onset and lower rate of some adverse events with light treatment than with fluoxetine.

"This study supports the effectiveness and tolerability of both treatments for seasonal affective disorders and suggests that other factors including patient preference, should guide selection of first-line treatment," say Raymond Lam (University of British Columbia, Vancouver, Canada) and colleagues.

The researchers compared the efficacy of light therapy and fluoxetine treatment in 96 patients who were randomly assigned to receive 10,000-lux light treatment and a placebo capsule or 100-lux light treatment (placebo) and 20 mg/day of fluoxetine for 8 weeks.

Light treatment was applied for 30 minutes every morning with a fluorescent white-light box, while placebo light boxes used neutral density filters.

Overall, there were no differences between the two treatment groups with regard to clinical response rates, defined as a 50% or greater reduction in Hamilton Depression Rating Scale scores, at 67% for each group.

There was also no significant difference in rates of remission, classified as a clinical response plus a Hamilton Depression Rating Scale score of 8 points or less, at 50% for patients receiving active light therapy and 54% for patients taking fluoxetine.

The investigators note in the American Journal of Psychiatry that patients treated with light therapy showed a greater improvement at 1 week than those taking fluoxetine, but not at other time points.

Both treatments were generally well tolerated, with no difference in the overall number of adverse events or in drop-out rates due to side effects. However, fluoxetine was associated with a greater frequency of some treatment-emergent effects, including agitation, sleep disturbance, and palpitations.

Concluding that fluoxetine and light therapy have comparable efficacy for seasonal affective disorder, Lam et al comment: "In the absence of clear superiority for either treatment, patient preference should be a major factor in treatment selection."

They add: "Predictive factors (symptoms, personality traits, circadian measures) of response to light or medication, and differences in quality of life and cost-benefit of treatment, also should be of interest."



Source: Am J Psychiatry 2006; 163: 805-812

[Aminazinka]

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17 May 2006

Body–oriented psychological therapy (BPT) may be effective for the treatment of persistent negative symptoms in patients with schizophrenia, exploratory trial data show.

"The approach of body-oriented interventions is based on phenomenological findings and the assumption that movement and emotional experiences are biologically and experientially associated," note Frank Röhricht (Newham Centre for Mental Health, London, UK) and Stefan Priebe (Barts and The London Queen Mary's School of Medicine and Dentistry, UK).

"This is supported by close anatomical and functional links between the limbic system, particularly the extended amygdala, and the basal ganglia."

The researchers investigated the potential for such therapy to reduce negative symptoms in 24 outpatients with schizophrenia. To control for the influence of non-specific attention and structured group activities, BPT was compared with supportive counseling, which was received by 21 schizophrenia patients.

The aims of BPT were to overcome communication barriers through non-verbal techniques; refocus cognitive and emotional awareness towards the body; stimulate activity and emotional responsiveness; promote exploration of self-potentials, focusing on body strength and capability; modify dysfunctional self-perception; and address common psychopathological features.

Each participant received 20 sessions of therapy in addition to treatment as usual.

Patients undergoing BPT attended more sessions than those assigned to supportive counseling, and had significantly lower negative symptoms scores on the Positive and Negative Symptom scale at the end of the trial.

Indeed, 50% of patients receiving BPT achieved a 20% or greater reduction in negative symptoms from baseline, compared with just 21% of those receiving supportive counseling.

"The findings did not suggest an influence of potentially confounding factors, ie, antipsychotic medication, extrapyramidal symptoms, improvement of positive symptoms, on the different treatment effect in the two groups," the investigators report in the journal Psychological Medicine.

Patients' assessment of treatment was broadly positive and their rating of the therapeutic relationship generally appreciative, with no significant differences between the two treatments.

"BPT was accepted by patients and associated with a favorable effect," Röhricht and co-workers comment. "The effect size was substantial and at least as high as those reported in the literature for antipsychotic medication and cognitive-behavioral therapy."

The team says further detailed studies to explore the therapeutic mechanisms involved in BPT are warranted.



Source: Psychol Med 2006; 36: 669–678

©2006 Current Medicine Group Ltd

[Aminazinka]

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19 May 2006

Obese women with binge-eating disorder (BED) are already at increased risk of suffering from comorbid psychopathology, including anxiety and depression, but smoking could increase this risk further, US investigators report.

"These patients may have a deficit in coping strategies, making them more prone to using substances and/or food to regulate emotion," Marney White and Carlos Grilo, from Yale University School of Medicine in New Haven, Connecticut, comment.

The researchers explored whether obese women with BED who had smoked at some point in their lifetime differed from their nonsmoking counterparts in lifetime rates of comorbid psychopathology.

A total of 103 obese treatment-seeking women with a current DSM-IV diagnosis of BED participated in the study and were asked to complete diagnostic interviews to assess all Axis I psychiatric disorders.

Fifty-two of the women had never smoked, 45 were former smokers, and six were current smokers.

For the group as a whole, 68.9% met the criteria for at least one additional lifetime psychiatric disorder, of which mood disorders (53.4%), anxiety disorders (36.9%), and substance use disorders (13.6%) were the most common.

Comparing daily smokers with never smokers, the researchers found that the presence of any Axis I psychiatric disorder was more common in daily smokers, at 81.4%, compared with 57.7% for non-smokers.

Specifically, smokers were significantly more likely than non-smokers to meet the criteria for co-occurring diagnoses of major depressive disorder (62.8% vs 40.4%), panic disorder (27.9% vs 7.7%), post-traumatic stress disorder (11.6% vs 1.9%), and substance abuse or dependence (16.3% vs 1.9%).

Recognizing that the presence of substance use dependence may have confounded the results, the team compared the groups after removing individuals with lifetime substance use dependence from the analysis.

"Although attenuated, the results showed a pattern of increased lifetime risk of anxiety disorders among lifetime smokers," White and Grilo report in the Journal of Clinical Psychiatry.

They conclude: "The results of this study indicate that women with BED and a history of smoking may be especially distressed, with higher rates of comorbid lifetime psychiatric diagnosis."

The researchers add: "There is a great need for treatments to address multiple impulse control behaviors as clinicians and patients struggle with important unanswered questions around treatment formulation and planning."



Source: J Clin Psychiatry 2006; 67: 594–599

©2006 Current Medicine Group Ltd

[Aminazinka]

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23 May 2006

Research presented at the 159th Annual Meeting of the American Psychiatric Association in Toronto, Canada, has revealed five predictors for bipolar disorder risk that could aid diagnosis of the condition.

The five factors were anxiety, feelings of people being unfriendly, family history of bipolar disorder, a recent diagnosis of depression, and legal problems.

In all, 43% of patients who reporting having any three of the risk factors also screened positive for bipolar disorder on the Mood disorder Questionnaire (MDQ).

"Bipolar disorder may be difficult for both patients and doctors to identify because the symptoms are often confused with major depression," said Joseph Calabrese, from Case Western Reserve University in Cleveland, Ohio, USA.

"Given the difficulty of diagnosing bipolar disorder, the five predictors identified in this study may help physicians better assess a patient's risk for bipolar disorder, which could lead to more effective treatment."

For the current study, the investigators selected patients attending community and private practice clinics who were unsuccessfully treated with antidepressants. Self-reported information was collected for the participants using the Epidemiologic Studies Depression (CES-D) scale and the patients were screened for bipolar disorder with the MDQ.

Among the 602 patients enrolled in the study, 18.6% screened positive for bipolar disorder on the MDQ. The researchers identified five key variables that they found were associated with bipolar risk: the CES-D item "people were unfriendly" (p<0.001), comorbid anxiety (p<0.002), depression diagnosis within 5 years (p<0.001), family history of bipolar disorder (p<0.010), and legal problems (p<0.026).

For the 41 patients with none of the five risk factors, 2.4% screened positive for bipolar disorder on the MDQ. Among the 103 patients reporting that "people were unfriendly," 31.1% screened positive for bipolar disorder.

The presence of this factor in addition to comorbid anxiety increased the rate of screening positive for bipolar disorder to 35.4%, with the addition of a recent diagnosis of depression onset increasing the likelihood of a positive screen for bipolar disorder to 41.2%. The combination of feeling people were unfriendly and a family history of bipolar disorder was associated with a 75% rate of screening positive for bipolar disorder on the MDQ.

All patients who reported the presence of all five factors screened positive for bipolar disorder on the MDQ, as did 43% of patients who had any three factors.

The researchers conclude that the five factors may prove useful indicators of bipolar disorder risk among patients with major depression from whom antidepressant treatment has failed.



Source: 159th Annual Meeting of the American Psychiatric Association; Toronto, Canada; 20–25 May 2006

[Aminazinka]

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30 May 2006

The children of parents with panic disorder are likely to go on to develop a variety of psychiatric problems, researchers have found.

Presenting the findings at the 159th Annual Meeting of the American Psychiatric Association in Toronto, Canada, Joseph Biederman, from Massachusetts General Hospital in Boston, USA, pointed out that the development of separation anxiety in such children is a good indicator of later mental health issues.

The results of his study imply that early recognition and treatment of this condition could prevent or mitigate the onset of later psychiatric disorders.

Biederman and colleagues carried out a longitudinal study in which 95 parents with panic disorder and their 186 children, who ranged in age from 4 to 31 years, were monitored over a 5-year period and assessed for both childhood anxiety and later psychiatric conditions.

Among the children, 74 had separation anxiety, 48 had agoraphobia, and 46 had generalized anxiety disorder.

Children who presented with separation anxiety had a significantly increased risk of later developing four other conditions.

Seventeen developed agoraphobia, with an odds ratio (OR) of 2.7, compared with children without separation anxiety. Nineteen developed generalized anxiety disorder, with an OR of 2.7, while 16 developed major depressive disorder and 11 developed panic disorder, with ORs of 2.8 and 4.8, respectively.

Among the 48 children with agoraphobia, eight went on to develop panic disorder (OR=5.9), while 10 of the 47 children with generalized anxiety disorder later developed social phobia (OR=2.4).

James Scully, medical director of the American Psychiatric Association, described Biederman's findings as "fascinating".

He said that the increased risk of psychiatric problems for children with separation anxiety is a "serious problem," noting that, generally speaking, child psychiatry has collapsed all the anxiety categories.

He recommended that clinicians take a close look at the children of their parents with panic disorder.



Source: 159th Annual Meeting of the American Psychiatric Association; Toronto, Canada; 20–25 May 2006

©2006 Current Medicine Group Ltd

[Aminazinka]

К проблеме депрессии. Для меня это только лищний повод продолжать говорить, что у детей и подростков депресия тоже бывает, и пренебрегать этим нельзя.
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31 May 2006

Boys who show depressive symptoms as children appear to be more likely than their non-depressed peers to be smokers at age 18 years, study findings show.

The findings show that evaluating childhood psychopathology can have predictive value for later problems, lead researcher Solja Niemelä, from Turku University in Finland, commented at the 159th Annual Meeting of the American Psychiatric Association in Toronto, Canada.

Niemelä and colleagues assessed for depression in 2946 boys aged 8 years in 1989. Information was gathered from parents, teachers, and the boys, using the 31-item Rutter's parent questionnaire, the 26-item teacher's version, and the Childhood Depression Inventory.

Ten years later, the smoking status of 2307 of the participants was determined. The boys were divided into groups according to whether they did not smoke, occasionally smoked, smoked fewer than 10 cigarettes a day, or more than 10 cigarettes a day.

More than 40% of boys remained non-smokers, but 517 reported occasional smoking, 460 reported smoking fewer than 10 cigarettes a day, and 370 reported smoking more than 10 cigarettes a day.

After taking into account family background variables and hyperactivity and conduct problems, the investigators found that eight-year-old children with depressive symptoms were 20% more likely to smoke at age 18 years than children without such symptoms.

Moreover, children with depression were significantly more likely than those without the condition to be heavy smokers, with an odds ratio of 1.4.

The clear take-home message is that children who are depressed are more vulnerable to later cigarette smoking, Niemelä noted.

While further research is needed to explore the mechanisms underlying the association, the findings suggest that depression may be a useful risk measurement to identify children who are at higher risk of smoking.



Source: 159th Annual Meeting of the American Psychiatric Association; Toronto, Canada; 20–25 May 2006

©2006 Current Medicine Group Ltd

[Aminazinka]

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31 May 2006

Comorbid migraine appears to be frequent in patients with bipolar disorder and associated with greater dysfunction and medical service use, particularly among men, investigators have found.

Roger McIntyre, from the University of Toronto in Ontario, Canada, and colleagues say the findings indicate a possible need for opportunistic screening for bipolar disorder and comorbid migraine.

The team explored the prevalence of comorbid migraine and its implications among 36,984 respondents of the Canadian Community Health Survey for Mental Health and Wellbeing.

Sociodemographic factors, course of illness, and medical service use were compared between individuals meeting the criteria for manic episode and with physician-diagnosed migraine with patients with manic episode but without migraines.

An estimated 2.4% of the participants met the criteria for bipolar disorder. Among these individuals, there was a 24.8% prevalence of migraine, which was significantly higher than the 10.3% for the general population.

The specific prevalence of migraine in men and women with bipolar disorder was 14.9% and 34.7%, respectively, compared with corresponding rates of 5.8% and 14.7% for the general population.

The association between migraine and bipolar disorder remained true even after taking into account age, gender, and other sociodemographic factors, chronic medical conditions, history of major depressive episode, and psychotropic drug use.

The researchers note in the journal Headache that migraine comorbidity appeared to have more serious implications for men with bipolar disorder than for women. Men with both bipolar disorder and migraines had a more severe illness course and more harmful dysfunction as demonstrated by earlier age of onset, more anxiety comorbidity, greater use of multiple medications, disability, and welfare payment than men with bipolar disorder alone.

Among women with bipolar disorder, there was no difference in these factors between those with and without migraines.

"Migraine is more prevalent among persons with bipolar disorder than in the general population," McIntyre and team write.

They suggest that the bipolar disorder and migraine phenotype may comprise a subphenotype of bipolar disorder.

"We feel that there is enough evidence to warrant opportunistic screening and surveillance for the co-occurrence of bipolar disorder and migraine," the researchers conclude.



Source: Headache 2006; 46: 973–982

©2006 Current Medicine Group Ltd

[Aminazinka]

Еще о коморбидности. Конечно, когда есть явные физические проблемы, психические традиционно отодвигаются на второй план. Однако хорошо ли это прогностически?
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2 June 2006

Medical comorbidities appear to be common among patients with bipolar I disorder, say researchers who note that this comorbidity can have a detrimental effect on the prognosis and outcome of the condition.

"Not only do preventing and treating medical comorbidities in bipolar patients decrease the morbidity and mortality related to physical illness, but they could also enhance psychological wellbeing and possibly improve the course of bipolar illness," report Wesley Thompson (University of Pittsburgh School of Medicine, Pennsylvania, USA) and colleagues.

The researchers studied the relationship between number of medical comorbidities in 174 patients with bipolar I disorder and their demographic and clinical characteristics.

The participants were all enrolled in the acute phase of the Pittsburgh Maintenance Therapies in Bipolar Disorder study, which compared Interpersonal and Social Rhythm Theory with an intensive clinical management approach.

A total of 160 (92%) of the patients reported some type of comorbid medical condition, such as asthma, diabetes, gastrointestinal, or thyroid dysfunction, at the start of the study. The average number of comorbidities reported was 4.2, with a maximum of 13.

Patients with a high number of medical comorbidities, at three or more, had a longer duration of both lifetime depression and lifetime inpatient depression treatment than patients with fewer to moderate medical comorbidities, at 34.2 versus 28.0 months and 1.5 versus 0.8 months, respectively. A high level of comorbidity was also associated with a higher baseline Hamilton Rating Scale for Depression (HAM-D) score than lower levels of comorbidity, at 23.2 versus 18.6 points.

Even after controlling for baseline severity of depression, medical comorbidities still predicted slower decreases in HAM-D score and mixed/cycling episodes.

"Medical illness could be influencing the outcome of bipolar disorder through several factors including its negative impact on quality of life, functioning, and psychological wellbeing," suggest Thompson et al in the Journal of Clinical Psychiatry.

"Medical comorbidities may also disrupt sleep and other circadian rhythms, thus causing or contributing to mood destabilization."

The researchers conclude: "We strongly support the development and testing of a model of care that includes interventions specifically designed for patients with bipolar disorder and that integrates medical treatment with psychiatric treatment of individuals suffering from bipolar I disorder."



Source: J Clin Psychiatry 2006; 67: 783–788

©2006 Current Medicine Group Ltd

[Aminazinka]

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5 June 2006

Asking parents to complete the Mood Disorder Questionnaire-Adolescent Version (MDQ-A) with regard to their adolescents' symptoms may be a useful instrument for screening for bipolar disorder, study findings suggest.

"The MDQ, a 13-item self-report scale, has been shown to be a valid instrument for the screening of bipolar disorders in adults across a wide array of settings, including psychiatric outpatient clinics, psychiatric inpatient units, the general population, and primary care practices," note Karen Dineen Wagner (University of Texas Medical Branch, Galveston, USA) and colleagues.

To determine the validity of the MDQ as a screening instrument for bipolar disorders in an adolescent outpatient psychiatric population, the team used three versions: self-report of symptoms by adolescent; attributional report based on how the adolescent believed teachers or friends would describe their symptoms; and parent report of adolescent's symptoms.

The three versions were administered to 104 adolescents and their parents. DSM-IV diagnoses were made based on the clinician-administered Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL).

According to this measure, 33 adolescents were diagnosed with bipolar I disorder, one with bipolar II disorder, six with bipolar disorder not otherwise specified, and one adolescent had cyclothymia.

The average number of positive items on the MDQ-A for the entire group were 6.0 for parent report, 6.3 for self-report, and 6.0 for attributional report.

Further analysis showed that, based on a cutoff of five items, parent report predicted bipolar disorder with a sensitivity of 72% and specificity of 81%. Self-report was associated with a sensitivity of 38% and a specificity of 73%, while the values for attributional report were 38% and 74%, respectively.

Statistically, parent report proved to be superior to either self-report or attributional report.

The researchers note in the Journal of Clinical Psychiatry that the sensitivity and specificity for parent report on the MDQ-A is similar to that for the MDQ when given to adults in a psychiatric outpatient clinic.

"The MDQ-A adds to the armentarium of screening instruments for bipolar disorder in youth," they say.

"Administration of the MDQ-A to the parents of adolescents in a psychiatric outpatient clinic may facilitate recognition of bipolar disorder in these youths."



Source: J Clin Psychiatry 2006; 67: 827–830

©2006 Current Medicine Group Ltd

[Aminazinka]

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5 June 2006

Researchers have found a significant relationship between anxiety disorders and illicit drug use that they say clinicians should be aware of.

Data from two independent community surveys conducted in the USA and Ontario showed that all anxiety disorders, except for social phobia with fears limited to speaking situations, were significantly associated with a lifetime use of cocaine, stimulants, hallucinogens, and heroin.

In all, 13,993 individuals were asked about lifetime anxiety disorder diagnoses, including social phobia, panic disorder, agoraphobia, specific phobia, and generalized anxiety disorder, along with lifetime use of amphetamines, hallucinogens, cocaine, and heroin.

Among individuals with lifetime use of stimulants, cocaine, or hallucinogens, approximately one third had at least one lifetime anxiety disorder.

After taking into account, age, gender, and education, each of the anxiety disorders was significantly associated with each of the drugs examined.

When social phobia was subdivided into social phobia-complex and social phobia-speaking, only social phobia-complex remained significantly associated with illicit drug use.

The investigators note in the journal Psychiatry Research that the association between anxiety disorder and heroin use was stronger, at an odds ratio (OR) of around 3.0, than the associations between anxiety disorder and stimulant, cocaine or hallucinogen use, at an odds ratio of around 2.0 in each case.

Social phobia and specific phobia both tended to occur at a younger age than drug use onset, although age of onset was less consistent for the remaining anxiety disorders. Generalized anxiety disorder was the only disorder that developed after the onset of stimulant and hallucinogen use.

Lead author Jitender Sareen (University of Manitoba, Winnipeg, Canada) and colleagues suggest that anxiety may increase the vulnerability for the use of substances. They speculate that individuals with social anxiety may use drugs to decrease their self-consciousness in social interactions.

Alternatively, an indirect causal relationship may exist whereby anxiety disorders increase the risk of illicit drug use through increasing the risk of major depression and alcohol use disorders.

Sareen and team conclude: "Clinicians and researchers need to be aware of this relationship between anxiety and substance use.

"Early intervention programs targeting adolescents with certain anxiety disorders may prevent the onset of illicit drug use, thereby leading to a reduction in the societal burden of mental illness."



Source: Psychiatry Res 2006; 14: 11–17

©2006 Current Medicine Group Ltd

Учитывая возраст первого употребления drugs в нашей стране, видимо надо громче кричать, что у детей тоже бывает депрессия и тревога...

[bill]

Новая парадигма в психиатрии
Ю. Савенко
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Заместительная терапия зависимости от опиоидов (обзор)
О. Айзберг
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Две модели специфического вмешательства
Д. Нардонэ, П. Вацлавик
Представлены две специфические модели вмешательства при фобических расстройствах, таких как приступы паники и агорафобия; и при обсессивных расcтройствах, таких как компульсивные ритуалы и обсессивные навязчивые идеи.

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Биологические основы синдрома психической зависимости при аддиктивных заболеваниях химической этиологии
А. Головко, Л. Леонтьева, С. Головко

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НЕЙРОХИМИЯ СИНДРОМА ПСИХИЧЕСКОЙ ЗАВИСИМОСТИ ПРИ АДДИКТИВНЫХ БОЛЕЗНЯХ ХИМИЧЕСКОЙ ЭТИОЛОГИИ
А.Головко, С.Головко, Л.Леонтьева


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[Aminazinka]

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9 June 2006

The European Medicines Agency has ruled that fluoxetine can be used in the treatment of children aged 8 years and older who suffer from moderate-to-severe depression.

The Agency has recommended that psychological therapy be used as a first treatment, with fluoxetine then considered for children who do not respond.

Fluoxetine is authorized in most European Member States for the treatment of major depressive episodes, obsessive–compulsive disorder, and bulimia nervosa in adults. But following a request, an application was submitted for the drug's indications to be extended to include the treatment of major depressive episodes in children and adolescents.

The Agency's Committee for Medicinal Products for Human Use concluded that the benefits of using fluoxetine in the treatment of children with moderate-to-severe depression outweighed the potential risks.

The group advises that prozac should only be used together with psychological therapy in children who have still not responded to such therapy alone after 4 to 6 sessions. The starting drug dose should be 10 mg/day, given as 2.5 ml of the oral solution, and can be increased to 20 mg/day after 1 to 2 weeks.

If after 9 weeks no clinical benefit is evident, it is advised that treatment be reconsidered.

Safety data regarding the use of the drug in children will continue to be collected and analyzed, particularly with regard to sexual development.

The ruling has been met with some concerns from mental health charities that the drug may be prescribed more than necessary because of long waiting lists for psychotherapy and other counseling services.

Nevertheless, Avis Johns, development director of the UK charity Young Minds, commented that while drug treatments such as fluoxetine should not be considered a first course of action, "the ability to combine a range of therapies with appropriate medication can provide significant benefits and should therefore be welcomed."



Source: European Medicines Agency

©2006 Current Medicine Group Ltd

[Aminazinka]

Одна из моих "любимых" тем - "нас пороли - мы людьми выросли".

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15 June 2006

Researchers reporting at a conference in Madrid have highlighted child abuse as a key risk factor in the development of schizophrenia.

They said that around two-thirds of people with schizophrenia have suffered physical abuse or sexual abuse, suggesting it makes a major contribution to the disorder, along with the proven connection between schizophrenia and post-traumatic stress disorder.

Paul Hammersley from the University of Manchester in the UK commented: "We are not returning to the 1960s and making the mistake of blaming families, but professionals have to realize that child abuse was a reality for a large number of adult sufferers of psychosis."

Hammersley and co-presenter John Read, from the University of Auckland in New Zealand, reviewed the findings of 40 studies that showed childhood or adulthood sexual or physical abuse was present in the history of psychiatric patients.

A second review of 13 studies of patients with schizophrenia found rates of abuse that ranged from 51% to 97%.

Abuse was associated with an increased likelihood of experiencing hallucinations or flashbacks, which are associated with the schizophrenic experience, as well as hearing voices that bully them just as their abuser did, leading to paranoia and mistrust of people.

The researchers noted that not all patients with schizophrenia have suffered trauma and not all people who have been victims of abuse go on to develop schizophrenia or psychosis. They stressed, however, that more studies in schizophrenia need to look at childhood abuse.

Indeed, in their review of 33,648 studies between 1961 and 2000, less than 1% examined the impact of parental care.

Hammersley and Read acknowledged that genes are still likely to play a role in the development of schizophrenia but they are not the only factor.

They said that the belief that schizophrenia is a genetic disorder could negatively impact on treatment and lead patients to think that they are less likely to recover.

The findings were presented at the 15th International Congress for the Psychotherapy of Schizophrenia and other Psychoses held in Madrid, Spain.



Source: [Ссылки доступны только зарегистрированным пользователям ]

©2006 Current Medicine Group Ltd

[Aminazinka]

Panic Disorder - Guideline Watch - 2006

Organisation
American Psychiatric Association

Website
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Journal reference:
American Psychiatric Association April 2006

Access:
Free access

Bipolar Disorder - Guideline Watch - 2005

Organisation
American Psychiatric Association

Website
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Journal reference:
American Psychiatric Association Nov 2005

Access:
Free access

Оба файла в формате пдф открываются после нажатия на ссылку.

[Aminazinka]

К сожалению, из-за возросшей занятости никак не хватает времени пополнять тему. Но мимо этой новости не смогла пройти равнодушно.
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21.06.06

Антидепрессанты не помогают больным anorexia nevrosa (AN) удерживать набранный вес и не снижают вероятность рецидива. К такому выводу пришла группа ученых из США и Канады, проведя рандомизированное двойное-слепое плацебо-контролируемое исследование с участием 93 пациентов, прошедших интенсивную стационарную или дневную программу терапии AN в Нью-Йоркском Институте Психиатрии и Генеральном Госпитале Торонто.
В исследование включались больные, набравшие вес до минимального индекса массы тела (ИМТ) 19,0. Они были рандомизированы на 1 год лечения либо флуоксетином (fluoxetine) в средней дозе 60 мг в день (n=49), либо плацебо (n=44). Все пациенты также получали индивидуальную когнитивно-поведенческую терапию. Больные завершали исследование досрочно в случаях снижения ИМТ до 16,5 и ниже, развития тяжелых осложнений или значительного ухудшения психического состояния. Исследователи не обнаружили значимых различий между группами ни в частоте рецидивов, ни в доле больных завершивших исследование досрочно. До 52 недели исследования дошли 45% больных из группы плацебо и 43% больных из группы флуоксетина.
Авторы исследования считают, что для поддержания терапевтического эффекта при лечении AN разумнее отдавать предпочтение психологическим и поведенческим вмешательствам. При этом изучение медикаментозных методов терапии должно продолжаться.

JAMA. 2006;295:2605-2612